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E F Patz

Publications and source records attributed to E F Patz.

87 records · Page 5Linked to original sources
PubMedDate not supplied

Prospective comparison of helical CT and MR imaging in clinically suspected acute pulmonary embolism.

The purpose of this study is to compare sensitivity and specificity of helical CT and MR imaging for detecting acute pulmonary embolism(PE). Patients who were suspected clinically of having PE were randomly assigned to undergo either helical contrast-enhanced CT or gradient-echo MR (if one modality was contraindicated, the patient was assigned to the other.) Patients were considered to have PE if they had: 1) high-probability V-Q scan and low clinical probability of PE; 2) pulmonary angiogram positive for PE. Patients were considered not to have PE if they had either:1)normal V-Q scan; 2) low probability V-Q scan and low clinical probability of PE; or 3) pulmonary angiogram negative for PE. The CT and MR images were read randomly and independently by five radiologists with varying levels of CT and MR experience. Twenty eight patients underwent CT and 25 MR. A total of 21 patients underwent pulmonary angiography (6 had PE, 15 did not have PE). Of the other 32 patients, 15 had high probability scan/high clinical probability and 17 had low probability scan/low clinical probability. For the five observers, the average sensitivity of CT was 75% and of MR 46%; the average specificity of CT was 89% and of MR 90%. Experience with vascular MR and enhanced CT influenced diagnostic accuracy. For the two vascular MR experts, average sensitivity and specificity of MR were 71% and 97%, and of CT 73% and 97%. In this pilot study, when CT and MR were interpreted with comparable expertise, they had similar accuracy for detecting pulmonary embolism.

Adult↗
PubMedDate not supplied

Correlation of FDG-PET imaging with Glut-1 and Glut-3 expression in early-stage non-small cell lung cancer.

PURPOSE: To correlate FDG activity on PET with the expression of glucose transporter proteins Glut-1 and Glut-3 in patients with early stage non-small cell lung cancer (NSCLC). METHODS: Over a 5 year period, all patients with a PET scan and clinical stage I NSCLC underwent an immunohistochemical analysis of their tumor for Glut-1 and Glut-3 expression. The amount of FDG uptake in the primary lesion was measured by a standardized uptake ratio (SUR) and correlated with immunohistochemical results. RESULTS: Seventy-three patients with a mean age of 66 years had clinical stage I disease. The final pathologic stage showed 64 patients with stage IA/B disease, eight with stage IIA disease, and one patient with pathologic stage IIIA (T1N2) disease. Glut-1 transporter expression was significantly higher than Glut-3 (P<0.0001), and although there was some association between the SUR and Glut-1 (P=0.085) and SUR and Glut-3 (P=0.074) expression, this did not reach statistical significance. CONCLUSIONS: Glut-1 and Glut-3 transporter expression did not demonstrate a statistically significant correlation with FDG uptake in potentially resectable lung cancer. It appears that these transporters alone do not affect the variation in FDG activity in early stage NSCLC.

Aged↗
PubMedDate not supplied

Imaging features of nonmyxomatous primary neoplasms of the heart and pericardium.

We present the imaging findings in 13 patients with nonmyxomatous primary neoplasms of the heart and pericardium. Ten patients had abnormal chest films. While echocardiography was useful for determining origin of the tumor, CT (computed tomography) and MRI (magnetic resonance imaging) were better at delineating extent of disease. The radiographic appearance of these rare neoplasms of the heart and pericardium is varied. Cross-sectional imaging plays a crucial role in the surgical planning and management of these patients.

Adult↗
PubMedDate not supplied

Pseudoaneurysms at aortic cannulation site after coronary artery bypass graft: MR findings.

Pseudoaneurysm at the aortic cannulation site is a rare but potentially fatal complication of coronary artery bypass surgery. We present two cases in which MRI provided significant information regarding the anatomy and extent of a pseudoaneurysm. In one case both spin-echo imaging and cine MRI with and without gradient moment nulling (flow compensation) were used. The absence of gradient moment nulling in cine MRI provides additional contrast between flowing and static blood. This contrast may complement conventional cine images with gradient moment nulling, providing further information.

Aged↗
PubMedDate not supplied

Congenital cystic adenomatoid malformation in adults: CT findings.

OBJECTIVE: Congenital cystic adenomatoid malformation (CAM) of the lung usually presents in children, although it has rarely been described in adults. The aim of this study was to review the clinical history and the CT findings in adults with pathologically proven CAM. MATERIALS AND METHODS: Seven patients between 21 and 61 years of age with pathologically proved CAM were retrospectively identified at three institutions. Thoracic CT was reviewed in all cases. RESULTS: Six patients presented with recurrent pneumonia and one patient had recurrent pneumothoraces. Five cases were classified as a Type I CAM, and two were classified as Type II CAM. The CAMs were located exclusively in the lower lobes and exerted a mass effect on adjacent lung. They appeared as multiple thin-walled complex cystic masses ranging from 4 to 12 cm in diameter. No other congenital abnormality was identified in any patient. CONCLUSION: Cystic adenomatoid malformation in adults is rare. Patients usually present with recurrent pneumonia and a thin-walled lower lobe complex cystic mass. The diagnosis should be suggested on the basis of the clinical and CT findings.

Adult↗
PubMedDate not supplied

Cytomegalovirus pneumonia in transplant patients: CT findings.

OBJECTIVE: Our goal was to assess the CT findings of cytomegalovirus (CMV) pneumonia in transplant patients. MATERIALS AND METHODS: The study included 10 transplant patients who had chest CT scan and pathologically proven isolated pulmonary CMV infection. Five patients had bone marrow transplant and five had solid organ transplant. The CT scans were retrospectively reviewed for pattern and distribution of disease and the CT findings compared with the findings on open lung biopsy (n = 9) and autopsy (n = 1). RESULTS: Nine of 10 patients had parenchymal abnormalities apparent at CT and 1 had normal CT scans. The findings in the nine patients included small nodules (n = 6), consolidation (n = 4), ground-glass attenuation (n = 4), and irregular lines (n = 1). The nodules had a bilateral and symmetric distribution and involved all lung zones. The consolidation was most marked in the lower lung zones. CONCLUSION: The CT findings of CMV pneumonia in transplant patients are heterogeneous. The most common patterns include small nodules and areas of consolidation.

Adolescent↗
PubMedDate not supplied

Calcifying fibrous pseudotumor of pleura: radiologic features in three cases.

PURPOSE: Our goal was to describe the radiologic features of calcifying fibrous pseudotumor (CEPT) of pleura. METHOD: Chest radiographs and CT images of three patients, aged 23-34 years, with pathologically proven CFPT of pleura were reviewed with regard to lesion size, location, and appearance. RESULTS: Chest radiographs showed well marginated, noncalcified pleural masses in all cases. Two patients had solitary masses and one had multifocal ipsilateral masses. All masses were located in the inferior aspect of the chest and measured 3-12 cm. All masses were calcified on CT. The calcifications were thick and band-like in two cases and punctate in one. There was no chest wall invasion, pleural effusion, or parenchymal disease. CONCLUSION: CFPTs of pleura are rare lesions that manifest as calcified pleural masses in young adults.

Adult↗
PubMedDate not supplied

Thoracic imaging features of patients with antiphospholipid antibodies.

PURPOSE: Our aim was to determine the thoracic manifestations of patients with antiphospholipid antibodies (APAs). METHOD: We performed a retrospective review of the clinical records and thoracic imaging studies of 88 patients (63 women, 25 men; mean age 47 years) with APAs to determine the spectrum of thoracic disease. RESULTS: Nine patients (10%) had thoracic abnormalities, including eight with pulmonary embolism (PE) and one with aortic thrombus. One patient with PE had subclavian vein thrombosis. Coexistent thromboses included deep venous thrombosis of the leg in six patients. CONCLUSION: PE was the most common thoracic abnormality in our patients. The presence of these antibodies should be suspected in patients with PE of otherwise unexplained etiology.

Adult↗
PubMedDate not supplied

Evaluation of patients with round atelectasis using 2-[18F]-fluoro-2-deoxy-D-glucose PET.

PURPOSE: Our goal was to determine the spectrum of 2-[18F]fluoro-2-deoxy-D-glucose (FDG) PET findings in patients with round atelectasis (RA). METHOD: All patients from 1992 to 1997 with radiologic features of RA and FDG-PET scans were evaluated. There were nine men ranging in age from 52 to 75 years (mean 65 years). All had chest radiographs and CT scans that were correlated with FDG-PET. FDG-PET was considered positive if lesion activity was greater than mediastinal activity and negative if lesion activity was the same as or less than mediastinal activity. RESULTS: Nine patients had 10 lesions, ranging in size from 1.2 to 5.0 cm (mean 3.1 cm). Lesion locations were right lower lobe (n = 5), left lower lobe (n = 4), and lingula (n = 1). All lesions were homogeneous and of soft tissue attenuation on CT. None contained air bronchograms or calcification. All had in-curving vessels and bronchi (comet tail sign), adjacent pleural thickening, and volume loss on CT. All lesions were negative on FDG-PET. Four lesions were percutaneously biopsied and showed chronic inflammation consistent with RA. Two lesions were unchanged on 2 and 3 year follow-up CT and were presumed to be RA as were four other lesions with characteristic CT features and negative FDG-PET. CONCLUSION: Our experience suggest that RA in not metabolically active on FDG-PET imaging. Thus, FDG-PET scans can play a role in differentiating RA from malignancy when there are few or atypical features of RA on chest radiographs and CT.

Aged↗
PubMedDate not supplied

Thoracic FDG PET: state of the art.

The D-glucose analogue 2-(fluorine-18) fluoro-2-deoxy-D-glucose (FDG) is the most commonly used radionuclide in positron emission tomography (PET) of the thorax. Increased glucose metabolism by malignant cells allows physiologic differentiation between benign and malignant abnormalities. FDG PET is consequently useful in characterizing indeterminate pulmonary nodules and in staging and assessing the response to treatment of lung cancer. FDG PET is accurate in classification of indeterminate pulmonary nodules as benign. Nodules with low FDG uptake are followed up radiographically; nodules with increased FDG uptake should be evaluated with biopsy or resected. In the staging of lung cancer, FDG PET is useful in evaluating local disease and pleural and chest wall involvement. The accuracy of FDG PET in demonstrating intrathoracic metastatic nodal disease is greater than that of computed tomography or magnetic resonance imaging. Whole-body PET is useful in detection of extrathoracic metastases. Conventional imaging often does not allow differentiation of tumor from posttreatment scarring. Increased FDG uptake at the sites of residual radiographic abnormalities is indicative of persistent or recurrent tumor.

Adult↗
PubMedDate not supplied

Imaging of mediastinal lymph nodes: CT, MR, and FDG PET.

The evaluation of mediastinal lymph nodes is an important aspect of staging in patients with non-small cell lung cancer. Anatomic imaging of lymph nodes with computed tomography (CT) and magnetic resonance (MR) imaging has been limited by the relatively low sensitivity and specificity of these techniques. Advances in physiologic imaging of mediastinal lymph nodes with 2-[fluorine-18] fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) have resulted in improved diagnostic accuracy in the determination of nodal status. Despite the limitations of CT, this technique still plays an important role by aiding in the selection of the most appropriate procedure for staging, by guiding biopsy, and by providing anatomic information for visual correlation with FDG PET images. At present, anatomic MR imaging of lymph nodes is primarily a problem-solving tool for cases with inconclusive CT results. Physiologic MR imaging with iron oxide is an exciting area of investigation, and the accuracy of this technique is being assessed in clinical trials. Anatomic and physiologic imaging techniques should be considered complementary rather than competitive imaging strategies.

Carcinoma, Non-Small-Cell Lung↗
PubMedDate not supplied

Pulmonary nontuberculous mycobacterial infection: radiologic manifestations.

The nontuberculous mycobacteria (NTMB) are a group of bacteria that can infect the cervical lymph nodes, skin, soft tissues, and lung. Pulmonary NTMB disease is increasing in prevalence and is most commonly caused by Mycobacterium avium-intracellulare or M kansasii. Occasionally, M xenopi, M fortuitum, or M chelonae also causes pulmonary disease. Diagnosis of pulmonary NTMB infection is often difficult because isolation of the organism from sputum or bronchoalveolar lavage fluid can represent airway colonization. The radiologic manifestations of pulmonary NTMB infection are protean and include consolidation, cavitation, fibrosis, nodules, bronchiectasis, and adenopathy. Pulmonary NTMB infection has five distinct clinicoradiologic manifestations: (a) classic infection, (b) nonclassic infection, (c) nodules in asymptomatic patients, (d) infection in patients with achalasia, and (e) infection in immunocompromised patients. Although classic NTMB infection may be indistinguishable from active tuberculosis, it is usually more indolent. The radiologic features of nonclassic NTMB infection are characteristic: bronchiectasis and centrilobular nodules isolated to or most severe in the lingula and middle lobe. In patients with acquired immunodeficiency syndrome, mediastinal or hilar adenopathy is the most common radiographic finding. Knowledge of the full spectrum of clinical and radiologic features of pulmonary NTMB infection is important to facilitate diagnosis and treatment.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Transthoracic fine needle aspiration biopsy. Sensitivity in relation to guidance technique and lesion size and location.

OBJECTIVE: To obtain site- and size-specific data on transthoracic fine needle aspiration (TFNA) and determine the sensitivity in relation to guidance technique and lesion size and location. STUDY DESIGN: Data on 112 patients undergoing TFNA between 1992 and 1993 were analyzed for accuracy rates, stratified according to lesion size and location within the lung. The series included 13 benign lesions, 53 metastatic neoplasms and 46 primary carcinomas. RESULTS: Overall sensitivity was 90%, with 92% specificity. There was a clear relationship between nodule size and sensitivity of TFNA, with a sensitivity of 60% for lesions < 1 cm but 93% sensitivity for nodules > or = 2 cm in diameter. Similarly, lesion location affected sensitivity. Sensitivity was 100% for peripherally located nodules but was as low as 82% for nodules in the centrobasal portion of the lung. Sensitivity was higher for fluoroscopy (97%) than computed tomography (80%). CONCLUSION: The guidance technique as well as lesion location and size affect diagnostic accuracy.

Biopsy, Needle↗
PubMedDate not supplied

Molecular characterization of the human delta opioid receptor in lung cancer.

A variety of neuropeptide receptors have been detected in human lung cancer. They are thought to play a role in autocrine/paracrine regulation of cell growth, and may be clinically useful as diagnostic, prognostic or therapeutic targets. The current study characterizes the molecular structure of the delta opioid receptor and its gene expression level in lung cancer cell lines relative to normal human lung using a sensitive RT-PCR approach. The goals of this investigation were a) to define the correlation between receptor binding and gene expression in lung cancer cell lines, and b) to determine the cDNA sequence integrity of this receptor in comparison to the receptor recently found in human brain. Five small cell lung cancer (SCLC) cell lines revealed size-matched RT-PCR products which strongly hybridized to the human brain delta opioid receptor probe. One of three non-small cell lung cancer (NSCLC) cell lines (NCI-H23), known to be negative by binding analysis, demonstrated low level expression. No gene expression was found in normal human lung. RT-PCR products from two SCLC cell lines (SCLC-22H and 16HC) as well as the low level expressing NSCLC cell line (NCI-23) were subjected to bidirectional DNA sequence analysis and the receptor ends were resolved using a 3'-end RACE and 5'-end gene-specific approach. The isolated cDNA sequences proved to be identical to the published human brain delta opioid receptor sequence. These data show that lung cancers with neuroendocrine features express human brain delta opioid receptors in contrast to normal lung, and that the delta opioid receptor mRNA in lung cancer is not mutated. This unique feature of lung cancer may be exploitable for diagnostic, prognostic, and therapeutic strategies.

Benzamides↗