A REVIEW OF CHEST-RADIOGRAPHY : Report 2 : Anterio-posterior Chest X-ray

Abstract Setting Mandatory initial screening of asylum seekers for tuberculosis (TB) in Switzerland, 2004-2005 and 2007-2008. Objective To compare the yield of screening by chest radiography with an individual assessment based on geographic origin, personal history and symptoms. Design Cross-sectional retrospective comparison of two 2-year periods. Results The prevalence of detected TB cases was defined as the proportion of screenees starting antit tuberculosis treatment for culture-confi rmed pulmonary TB within 90 days. TB prevalence was 14.3 per 10 000 asylum seekers screened (31/21 727) using chest radiography and 12.4 (29/23 402) using individual assessment. The sensitivity of radiography was 100% vs. 55% for individual assessment, but its specifi city was lower (89.9% vs. 96.0%, respectively). The higher sensitivity of radiography meant shorter delays between screening and start of treatment (median 6 vs. 25 days). Its lower specifi city led to a larger proportion of screenees needing further investigations for suspicion of TB (12% vs. 4%). Conclusions The interview-based system initially missed more cases, but the ultimate 90-day yield was comparable for the two periods. The main difference is the delay until start of treatment, which potentially increases transmission and secondary cases. The radiograph system was more burdensome to both the health care system and the screenees, as more suspects required further investigations.

Download Full-text

Diagnostic Value of Spiral CT Chest Enhanced Scan in Adult with Active Pulmonary Tuberculosis

Journal of Clinical and Nursing Research ◽

10.26689/jcnr.v4i3.1203 ◽

2020 ◽

Vol 4 (3) ◽

Author(s):

Ruishu Wang

Keyword(s):

Pulmonary Tuberculosis ◽

Chest Radiography ◽

Detection Rate ◽

Spiral Ct ◽

Diagnostic Value ◽

X Ray ◽

Active Pulmonary Tuberculosis ◽

Chest X Ray ◽

Tuberculosis Diagnosis ◽

The Difference

Aim: To explore the diagnostic value of spiral CT chest enhanced scan for adults with active pulmonary tuberculosis. Methods: The clinical data of 60 adult patients with active pulmonary tuberculosis who were treated in our hospital from January 2018 to November 2019 were retrospectively analyzed. All patients underwent conventional chest radiography and spiral CT chest enhanced scan. The number of tuberculosis diagnosis, the detection rate of special site lesions, and the detection rate of active pulmonary tuberculosis signs by the two methods were compared. Results: In 60 patients, the pathological results confirmed the existence of 75 tuberculosis lesions. The detection rate of spiral CT was 98.67%, which was not statistically significant compared with the detection rate of 92.00% (P>0.05) in the conventional chest X-ray. The detection rate of spiral CT enhanced scans for tuberculosis lesions in special sites was 100.00%, which was significantly higher than that of conventional chest X-ray of 7.69%, and the accuracy rate of active pulmonary tuberculosis signs was 98.85% higher than that of conventional chest X-ray of 79.31%. P<0.05). The difference was statistically significant (P<0.05). Conclusion: Spiral CT chest enhanced scan can not only find special tuberculosis lesions that cannot be detected by conventional chest radiography, but also accurately determine active pulmonary tuberculosis in adults, which is of high diagnostic value.

Download Full-text

Elevated Hemidiaphragm and Shortness of Breath: Challenges in Clinicoradiologic Integration

Integrative Medicine International ◽

10.1159/000494618 ◽

2018 ◽

Vol 4 (3-4) ◽

pp. 223-229

Author(s):

Vivek Podder ◽

Rakesh Biswas ◽

Nidhi Sehgal

Keyword(s):

Chest Radiography ◽

Systolic Function ◽

High Sensitivity ◽

Diaphragmatic Paralysis ◽

Peak Exercise ◽

X Ray ◽

St Segment ◽

History Of ◽

Chest X Ray ◽

Rule Out

Unilateral diaphragmatic paralysis is often suspected when a hemidiaphragm is found abnormally elevated on chest radiography. Chest radiography has a high sensitivity for diaphragmatic palsy. A 67-year-old male presented to the hospital with a history of 4 months of exertional breathlessness that improved after taking a rest. The patient had normal cardiac and respiratory physical function. He also had a normal electrocardiogram and good systolic function on echocardiography. A treadmill test revealed ST-segment changes during peak exercise and recovery phases. On chest X-ray, his right hemidiaphragm was shown to be significantly elevated. Further investigation was conducted to rule out diaphragmatic paralysis, and the findings took a surprising turn to an entirely different diagnosis.

Download Full-text

Dual-Ray Net: Automatic Diagnosis of Thoracic Diseases Using Frontal and Lateral Chest X-rays

Journal of Medical Imaging and Health Informatics ◽

10.1166/jmihi.2020.2901 ◽

2020 ◽

Vol 10 (2) ◽

pp. 348-355

Author(s):

Xin Huang ◽

Yu Fang ◽

Mingming Lu ◽

Fengqi Yan ◽

Jun Yang ◽

...

Keyword(s):

Chest Radiography ◽

Feature Fusion ◽

Small Data ◽

Data Sets ◽

X Rays ◽

X Ray ◽

Comparison Results ◽

Chest Disease ◽

Chest X Ray ◽

Lateral Chest

Computer-aided diagnosis (CAD) is an important work which can improve the working efficiency of physicians. With the availability of large-scale data sets, several methods have been proposed to classify pathology on chest X-ray images. However, most methods report performance based on a frontal chest radiograph, ignoring the effect of the lateral chest radiography on the diagnosis. This paper puts forward a kind of model, Dual-Ray Net, of a deep convolutional neural network which can deal with the front and lateral chest radiography at the same time by referring the method of using lateral chest radiography to assist diagnose during the diagnosis used by radiologists. Firstly, we evaluated the performance of parameter migration to small data after pre-training for large datasets. The data sets for pre-training are chest X-ray 14 and ImageNet respectively. The results showed that pre-training with chest X-ray 14 performed better than with the generic dataset ImageNet. Secondly, We evaluated the performance of the Frontal and lateral chest radiographs in different modes of input model for the diagnosis of assisted chest disease. Finally, by comparing different feature fusion methods of addition and concatenation, we found that the fusion effect of concatenation is better, which average AUC reached 0.778. The comparison results show that whether it is a public or a non-public dataset, our Dual-Ray Net (concatenation) architecture shows improved performance in recognizing findings in CXR images when compared to applying separate baseline frontal and lateral classes.

Download Full-text

Performance of Radiologists in the Evaluation of the Chest Radiography with the Use of a “new software score” in Coronavirus Disease 2019 Pneumonia Suspected Patients

Journal of Clinical Imaging Science ◽

10.25259/jcis_76_2020 ◽

2020 ◽

Vol 10 ◽

pp. 40

Author(s):

Silvia Bagnera ◽

Francesca Bisanti ◽

Claudia Tibaldi ◽

Massimo Pasquino ◽

Giulia Berrino ◽

...

Keyword(s):

Chest Radiography ◽

Work Experience ◽

Imaging Analysis ◽

Rater Agreement ◽

X Ray ◽

Cumulative Score ◽

Kappa Value ◽

Automatic Software ◽

Chest X Ray ◽

Group Agreement

Objectives: The purpose of this study is to assess the performance of radiologists using a new software called “COVID-19 score” when performing chest radiography on patients potentially infected by coronavirus disease 2019 (COVID-19) pneumonia. Chest radiography (or chest X-ray, CXR) and CT are important for the imaging diagnosis of the coronavirus pneumonia (COVID-19). CXR mobile devices are efficient during epidemies, because allow to reduce the risk of contagion and are easy to sanitize. Material and Methods: From February–April 2020, 14 radiologists retrospectively evaluated a pool of 312 chest X-ray exams to test a new software function for lung imaging analysis based on radiological features and graded on a three-point scale. This tool automatically generates a cumulative score (0–18). The intra- rater agreement (evaluated with Fleiss’s method) and the average time for the compilation of the banner were calculated. Results: Fourteen radiologists evaluated 312 chest radiographs of COVID-19 pneumonia suspected patients (80 males and 38 females) with an average age of 64, 47 years. The inter-rater agreement showed a Fleiss’ kappa value of 0.53 and the intra-group agreement varied from Fleiss’ Kappa value between 0.49 and 0.59, indicating a moderate agreement (considering as “moderate” ranges 0.4–0.6). The years of work experience were irrelevant. The average time for obtaining the result with the automatic software was between 7 s (e.g., zero COVID-19 score) and 21 s (e.g., with COVID-19 score from 6 to 12). Conclusion: The use of automatic software for the generation of a CXR “COVID-19 score” has proven to be simple, fast, and replicable. Implementing this tool with scores weighed on the number of lung pathological areas, a useful parameter for clinical monitoring could be available.

Download Full-text

Kerosene Oil Pneumonitis

Asian Journal of Medical Sciences ◽

10.3126/ajms.v12i6.36847 ◽

2021 ◽

Vol 12 (6) ◽

pp. 116-117

Author(s):

Ranjan Kumar Singh

Keyword(s):

Human Immunodeficiency Virus ◽

Negative Pressure ◽

Chest Radiography ◽

Clinical History ◽

X Ray ◽

Negative Pressure Pulmonary Oedema ◽

Immunodeficiency Virus ◽

Hiv Antibodies ◽

History Of ◽

Chest X Ray

Radiographic abnormalities in the lungs are very common in an individual positive for HIV antibodies. Majority of lesions are of infective or neoplastic in origin. We present a case of chemical pneumonitis following regurgitation of kerosene oil in a patient positive for human immunodeficiency virus (HIV) antibodies. Chemical pneumonitis is diagnosed with a characteristic clinical history of regurgitation of fluid and gravity-dependent infiltration in the lung on chest x-ray. Another condition arising from the aspiration of the fluid/chemical is negative-pressure pulmonary oedema which results from laryngeal spasm following regurgitation of fluid. Chest radiography, however, distinguishes it from chemical pneumonitis. Bilateral infiltration is seen in the former, while lesion at dependent portion of right lung is seen in the latter condition.

Download Full-text

Novel Multi-Modal Throat Inflammation and Chest Radiography based Early-Diagnosis and Mass-Screening of COVID-19

The Open Biomedical Engineering Journal ◽

10.2174/1874120702115010226 ◽

2021 ◽

Vol 15 (1) ◽

pp. 226-235

Author(s):

Ojas A. Ramwala ◽

Poojan Dalal ◽

Parima Parikh ◽

Upena Dalal ◽

Mita C. Paunwala ◽

...

Keyword(s):

Mass Screening ◽

Chest Radiography ◽

Fine Tuning ◽

Rt Pcr ◽

Close Collaboration ◽

X Ray ◽

Non Invasive ◽

Life Threatening ◽

Chest X Ray ◽

Future Direction

Background: The upsurge of COVID-19 has received significant international contemplation considering its life-threatening ramifications. To ensure that the susceptible patients can be quarantined to control the spread of the disease during the incubation period of the coronavirus, it becomes imperative to automatically and non-invasively mass screen patients. The diagnosis using RT-PCR is arduous and time-consuming. Currently, the non-invasive mass screening of susceptible cases is being performed by utilizing the thermal screening technique. However, with the consumption of paracetamol, the symptoms of fever can be suppressed. Methods: A novel multi-modal approach has been proposed. Throat inflammation-based mass screening and early prediction followed by Chest X-Ray based diagnosis have been proposed. Depth-wise separable convolutions have been utilized by fine-tuning Xception Net and Mobile Net architectures. NADAM optimizer has been leveraged to promote faster convergence. Results: The proposed method achieved 91% accuracy on the throat inflammation identification task and 96% accuracy on chest radiography conducted on the dataset. Conclusion: Evaluation of the proposed method indicates promising results and henceforth validates its clinical reliability. The future direction could be working on a larger dataset in close collaboration with the medical fraternity.

Download Full-text

Clinicoradiological Correlation of Covid19 Patients in Western Uttar Pradesh, India: A Descriptive Study

International Journal for Research in Applied Science and Engineering Technology ◽

10.22214/ijraset.2021.39411 ◽

2021 ◽

Vol 9 (12) ◽

pp. 1134-1148

Author(s):

Dr. Yasmeen Usmani

Keyword(s):

Chest Radiography ◽

Significant Proportion ◽

Lower Lobe ◽

Uttar Pradesh ◽

Medical Institute ◽

Shortness Of Breath ◽

X Ray ◽

Pictorial Review ◽

Air Space ◽

Chest X Ray

Abstract: A pilot study of 150 patients at premier medical institute of western Uttar Pradesh, INDIA. The purpose of this pictorial review article is to describe the most common manifestations and patterns of lung abnormality on CXR in COVID-19 in order to equip the medical community in its efforts to combat this pandemic. The varied spectra of COVID-19 presentation included fever, cough, shortness of breath, sore throat etc. Diabetes mellitus, hypertension, COPD/K-Chest and CAD were found as major comorbid conditions. Symptomatic presentation of COVID-19 was observed to be higher in patients with co morbid disease, especially if multiple. HRCT chest in COVID-19 patients had a major diagnostic and prognostic importance as positive CT findings were more prominent in symptomatic patients and co-morbid patients. Clinical symptoms of patients directly correlated with CT severity index. CT imaging was found to be useful in predicting clinical recovery of patients or progression of disease. Introduction: COVID-19 (coronavirus disease 2019) is a highly infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), declared as a pandemic on 11th March 2020. The chest imaging findings are nonspecific and most commonly show atypical or organizing pneumonia, often with a bilateral, peripheral and bi-basal predominant distribution. Our study is concerned with the data of COVID positive patients admitted in the institute for the period of March 16- May 17, 2020. Aims and Objectives 1) To correlate clinical and radiological spectra of covid positive patients and their final outcome. 2) To describe the spectrum of lung parenchyma changes in the symptomatic as well as asymptomatic in COVID- 19 patients. Review of literature: This case report series presents a summary of key findings frequently associated with COVID-19, which will assist radiologists and clinicians in preliminary clinical evaluation (PCE). Materials and Methods: The data for the study is sourced from clinically suspected patients from the Covid Ward, LLRM Medical College, Meerut,(U.P.),INDIA which were subjected to chest radiography on 60mAh portable X-Ray machine. The patients are followed up to correlate the findings with clinical outcome. The study has been conducted on a minimum of 150 patients with portable Chest X-Ray machine. Observations & Discussion: The most frequent findings encountered are airspace opacities are viz- Hazy pulmonary opacities, Bilateral lower lobe consolidations, Peripheral air space opacities, Uncommon CXR findings, Diffuse air space disease. Conclusion: Based on our study, few inferences have been deduced; A significant proportion of the clinically symptomatic cases shows characteristic radiological changes on chest X-ray and also how chest radiography can be used as a tool not to substitute but supplement RTPCR in evaluation of COVID positive cases. Keywords: Patchy areas of consolidation, shortness of breath, high resolution CT Scan, RTPCR.

Download Full-text

Lung Ultrasonography and Chest Radiography in Suspected Cases of Pneumonia in Critically Ill Patients- A Comparative Study

Asian Journal of Medical Radiological Research ◽

10.47009/ajmrr.2020.8.2.14 ◽

2020 ◽

Vol 8 (2) ◽

pp. 88-90

Author(s):

Bharat M.P ◽

Deepak K.S

Keyword(s):

Critically Ill ◽

Critically Ill Patients ◽

Chest Radiography ◽

Lung Ultrasound ◽

Age Group ◽

Lung Ultrasonography ◽

Predictive Values ◽

X Ray ◽

Chest X Ray ◽

The Difference

Background: The present study compared lung ultrasound (USG) and chest radiography in suspected cases of pneumonia in critically ill patients. Subjects & Methods: 56 patients age above 20 years of age of both genders diagnosed with pneumonia were included. Patients were subjected to chest USG and X ray. Positive predictive values for both lung ultrasound and chest X-ray were calculated. Results: Age group 20-30 years had 4 patients, 30-40 years had 6, 40-50years had 10, 50-60 years had 16 and >60 years had 20 patients. The difference was significant (P< 0.05). Chest x ray reveled 40 out of 56 cases positive and 16 negative and USH showed 52 positive and 4 negative. Positive predictive value (PPV) of chest x- ray was 71.4% and USG was 92.8%. The difference was significant (P< 0.05). Conclusion: Lung ultrasound is an effective radiological tool for the assessment of suspected cases of pneumonia as compared to chest x ray.

Download Full-text

Challenges of Irradiation on Extrathoracic and Non-Thoracic Organs in Portable Neonatal Chest Radiography: Do We Need Mandatory Protective Rules?

Iranian Journal of Pediatrics ◽

10.5812/ijp.107258 ◽

2021 ◽

Vol In Press (In Press) ◽

Author(s):

Alireza Mahmoudabadi ◽

Mohammad Keshtkar ◽

Majid Sadeghi Moghadam

Keyword(s):

Retrospective Study ◽

Chest Radiography ◽

Pediatric Patients ◽

Chest Radiographs ◽

Costal Margin ◽

X Ray ◽

Reduce Radiation Exposure ◽

Chest X Ray ◽

The Given ◽

The Ideal

Background: A chest X-ray (CXR) is known as the most common radiography used for adult and pediatric patients worldwide. Improper X-ray field collimation can result in excessive radiation dose on non-thoracic organs in chest radiographs. Objectives: This study was to investigate X-ray field collimation quality in neonatal chest radiography. Methods: A total of 213 chest radiographs of neonates from three hospitals were analyzed for collimation quality assessment in a retrospective study. Accordingly, ideal imaging field (IIF) and current imaging field (CIF) were initially defined. The margins of the IIF included acromioclavicular (AC) level to lower costal margin (i.e. top to bottom) and one centimeter beyond the broadest area of the chest on each side (that is, right to left). The CIF size was also defined as the square borders of collimators. Results: The findings revealed that the area of the CIF was 1.65 ± 0.39 times to the ideal imaging firlddd (IIF) for three hospitals, suggesting that collimation quality in neonatal chest radiographs was not accurate and it had defects. According to the results, acceptable collimation percentage (36.6%) in Hospital A was more than that in two other centers, and the given center also provided the lowest radiation due to the exposure of non-thoracic structures to primary beams. Conclusions: It was concluded that training radiographers and using patient immobilization devices and stabilizers were of important points that could reduce radiation exposure to non-thoracic organs in pediatric CXR.

Download Full-text