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Biomedical subjects

F P Stitik

Publications and source records attributed to F P Stitik.

At least 19 recordsLinked to original sources
PubMed1994

The new staging of lung cancer.

Lung cancer is the most common fatal malignancy in men and women worldwide. The radiologist is a key member of a team of physicians dedicated to diagnosing and staging this important disease. Staging is a quantitative assessment of malignant disease that allows a logical grouping of patients with similar extent of disease for prognostic, therapeutic, and analytic purposes. Recent changes in surgical and radiation oncologic management of lung cancer have necessitated a revamping of the American Joint Committee on Cancer system. This system accurately reflects survival expectations with current treatment options and has been validated worldwide.

Carcinoma, Small Cell↗
PubMed1990

Lung cancer staging.

Lung cancer remains a significant cause of death worldwide. A simple, accurate staging system is necessary to plan treatment regimens and to assess their effect on survival rates. In addition, the staging system provides a basis for planning research on newer adjuvant therapies for lung cancer. It should be applicable internationally, facilitating a global effort toward improved survival. The new AJCC staging system was designed to meet these needs, with initial international reports confirming its utility. Since diagnostic radiologists often are instrumental in pretreatment evaluation of these patients, familiarity with this new system is a must.

Humans↗
PubMed1990

Clinical staging of patients with non-small cell lung cancer.

This article is the first in a planned series from the Section on Lung Cancer of the ACCP addressing the important and clinically relevant aspects of what is now the most common malignancy in the world, lung cancer. This initial report addresses the problem of staging of lung cancer. Staging, or identifying the anatomic extent of disease according to the AJCC TNM classification scheme, is the first clinical activity in caring for a patient with known or presumed lung cancer because the results determine appropriate types of therapy. This is, therefore, a critically important aspect of the patient's care which forms the foundation for subsequent treatment. In addition, consistent use of this system, based on appropriate clinical and pathologic staging, in stratifying patients in clinical reports is mandatory; otherwise, meaningful comparisons and conclusions are impossible.

Biopsy↗
PubMed1990

Staging of lung cancer.

Lung cancer is in epidemic proportions throughout the world. It is imperative that a simple, accurate staging system be used to direct treatment and evaluate its effects on long-term survival. The staging system must be the basis for current and future research on the newer adjuvant treatments for lung cancer. It should be internationally accepted, enabling a worldwide effort to improve survival. The new AJCC staging system meets these requirements, with early international reports confirming its usefulness and validity. The diagnostic radiologist, often directs the pretreatment workup of these patients and should be familiar with this new system.

Humans↗
PubMed1988

Induction of thoracic malignancy in inorganic dust pneumoconiosis.

Pulmonary carcinoma is now the leading cause of death due to cancer in men and women. Aside from cigarette smoking, occupational exposure to carcinogens is the most important cause of lung cancer, accounting for up to one third of all cases. The following article is a review of occupationally induced thoracic neoplasms with an emphasis on those related to the inhalation of inorganic dust. After introducing some basic terms, describing the research methods, and reviewing the process of carcinogenesis, current information on the relationship between exposure to asbestos, synthetic mineral fibers, silica, and other nonfibrous mineral dusts and the development of lung cancer and malignant mesothelioma of the pleura will be presented. The goal of this article is to provide the practicing radiologist with knowledge and insight into this difficult area.

Asbestos↗
PubMed1986

CT of the pulmonary nodule: a cooperative study.

To evaluate the role of computed tomography (CT) in the investigation of pulmonary nodules, a special reference phantom that enabled CT densitometric measurements independent of variations between scanners and patients was used in ten institutions. A total of 384 nodules not considered calcified by conventional methods were examined; 118 (31%) proved to be benign, and in 65 of these (55%), unsuspected calcification was demonstrated. In 28 of the 65, definite calcification could be identified on thin-section CT scans by simple inspection of the scans at narrow windows. In the remaining 37, presence of calcification could not be clearly established without comparison with the reference CT number from the calibration phantom. CT was most effective in establishing the benignancy of nodules 3 cm or less in diameter and those with discrete or smooth margins. CT rarely yields a confident diagnosis of benign disease in larger nodules and in those with irregular or spiculated borders. After review of prior spot radiographs, low kilovolt peak spot radiographs, and conventional tomograms, the authors conclude that thin-section CT aided by a reference phantom in equivocal cases should be an integral part of the diagnostic approach to the pulmonary nodule.

Adult↗
PubMed1985

Computed tomography of the pulmonary parenchyma. Part 2: Interstitial disease.

A series of patients with documented predominantly interstitial pulmonary disease was examined by routine and high-resolution computed tomography (CT) and compared to a series of twenty-one normals. Inspiratory-expiratory lung density measurements were also obtained at predetermined levels. Several basic CT signs of interstitial disease were identified: finely irregular and thickened pleural surfaces; irregular vascular shadows; thickened and irregular bronchial walls making bronchi visible over a longer portion of their course in the lungs; reticular network of lines with three patterns easily distinguishable by the size of their reticular element; hazy patches of increased density of various sizes distinguishable from alveolar filling processes by the fact that vessels can still be visualized through them; and nodules of various sizes. Micronodules are often associated with a small or medium-size reticular network and in most cases seem to represent points of confluence rather than isolated nodules. The hematogenous origin of some nodules can be specifically suggested when feeding vessels are demonstrated on thin-section scans. Nodules associated with a large network of thickened septa are suggestive of lymphangitic carcinomatosis. Inspiratory-expiratory density gradients can be more useful in confirming the diagnosis of interstitial disease than absolute measurements.

Absorptiometry, Photon↗
PubMed1985

Pulmonary hamartoma: diagnosis by transthoracic needle-aspiration biopsy.

Hamartomas of the lung often present as asymptomatic, noncharacteristic masses that can seldom be differentiated from other lung masses such as primary cancer or metastases by conventional radiography. Transthoracic needle-aspiration biopsy (TNAB) has become a popular and reliable method for the diagnosis of a lung lesion, and it offers a valuable alternative to diagnostic thoracotomy. In our study, TNAB established the diagnosis of pulmonary hamartoma in 12 of 14 (86%) patients. In eight patients, one procedure (using one to three punctures) was sufficient to establish the diagnosis, and, in four patients, two procedures (using one to two punctures) were necessary. In two patients, the lesion was missed on second and/or third biopsy procedures, and the correct diagnosis was obtained at surgery. Cytologic examination of the material was diagnostic in five of the 14 patients. Tissue specimens were sent in 13/14 patients, and findings of histologic examination established the correct diagnosis in 11 of these patients. One of the 12 patients in whom hamartoma was correctly diagnosed by TNAB underwent resection of his lesion, and histologic examination confirmed the diagnosis. In the remaining 11 patients, the lesions have been stable on follow-up chest examinations.

Adult↗
PubMed1985

Transthoracic needle aspiration biopsy of benign and malignant lung lesions.

Transthoracic needle aspiration biopsy (TNAB) of lung lesions is a well established procedure for diagnosing lung lesions. The emphasis in the literature has been on diagnosing malignant lesions with an accuracy rate greater than 90% frequently reported. Experience with 650 patients showed that TNAB can diagnose malignant lesions in 95% of patients with cancer, and more importantly that TNAB can identify benign lesions in 88% of patients with such lesions. In this patient population, 22% of undiagnosed, noncalcified lung lesions were benign. Therefore, TNAB of lung lesions has a potential of limiting diagnostic thoracotomies to fewer than 8% of patients with lung lesions, significantly reducing the number of unnecessary thoracotomies for benign disease. The success of TNAB is affected by equipment, technique, skill, and experience and is enhanced by close cooperation among the various physicians involved.

Aged↗
PubMed1983

A standard phantom for quantitative CT analysis of pulmonary nodules.

The CT density of the same pulmonary nodule can vary significantly between scanners or with the same scanner because several independent factors besides partial volume averaging can affect its determination. Hence a single CT number cannot be used to distinguish calcified from noncalcified nodules, ruling out direct extrapolation of quantitative data between scanners. The authors designed a phantom that simulates CT measurements in patients and permits comparison of CT density of each nodule with a physical standard derived from clinical experience. Tests on 35 patients using a GE 8800 showed that no malignant nodules and 65% of benign lesions were more dense than the phantom nodule. This method is independent of inter- and intra-scanner variation and facilitates standardized quantitative analysis of pulmonary nodules with current scanners.

Adult↗
PubMed1982

Computed tomography of bronchiectasis.

Computed tomography (CT) was performed on six patients with bronchiectasis. In two cases of advanced cystic bronchiectasis, the diagnosis was apparent on plain chest roentgenograms. In four cases, bronciectasis was initially diagnosed by CT and later confirmed by bronchography. The CT signs of bronchiectasis include air--fluid levels in distended bronchi, a linear array or cluster of cysts, dilated bronchi in the periphery of the lung, and bronchial wall thickening due to peribronchial fibrosis. Distended bronchi must be distinguished from emphysematous blebs, which generally have no definable wall thickness and no accompanying vessels. It is concluded that CT should have a role in establishing the presence and anatomic extent of bronchiectasis.

Bronchiectasis↗
PubMed1982

Factors influencing quantitative CT measurements of solitary pulmonary nodules.

Quantitative computed tomographic (CT) measurement of pulmonary nodules has not been widely applied despite favorable reports. Its usefulness has been questioned by some investigators. A series of experiments on six different scanners was undertaken to study the factors that affect the applicability of this technique. The type of reconstruction algorithm, the design of the CT system, the true slice thickness, and the beam kilovoltage were the most important factors identified. These factors can produce large variations in the CT numbers of pulmonary nodules, preventing direct comparison of results from scanner to scanner. Before undertaking studies of pulmonary nodules, the effect of these variables in each individual scanner should be evaluated. Despite the current lack of standardization, reliable CT number measurements using a specific kilovoltage and slice thickness should be possible on every modern scanner provided it is positionally uniform and gives a linear response to varying densities. We propose that the CT number above which a pulmonary nodule can be considered benign should be the representative CT number of a 1 cm diameter syringe filled with a hydrous calcium chloride solution of 40 mg/ml of water and scanned in air. A better understanding of the physics of lung nodule densitometry is necessary for the proper application of this technique in the management of patients with solitary pulmonary nodules.

Evaluation Studies as Topic↗
PubMed1981

Diagnosis of lipoid pneumonia by computed tomography.

Computed tomography (CT) can establish the diagnosis of lipoid pneumonia in lung masses by detecting fat. In this case report, the diagnosis of lipoid pneumonia was first suggested by CT, supported by a long history of mineral oil ingestion, and confirmed by needle aspiration biopsy of the larger of two lung lesions and specific stains. In the future, the detection of fat in lung masses by CT will warrant intermittent follow-up by routine chest x-ray films. Needle aspiration biopsy or surgery would be needed only if a mass showed signs of growth.

Aged↗
PubMed1981

Ventilation-perfusion lung scanning in patients detected by a screening program for early lung carcinoma.

Ventilation-perfusion (V-P) lung scans obtained in 114 patients in screening program for the early detection of lung cancer were reviewed, and abnormalities were correlated with radiographic and surgical findings. Eighty-seven patients eventually had a tissue diagnosis of carcinoma; 65 (75%) had a perfusion defect and 56 (67%) had a ventilation abnormality at the tumor site. Lobar or segmental perfusion abnormalities were present at the tumor site in two of 13 patients whose lung cancer could not be localized by chest radiographs. However, 12 of these 13 patients and 54% of those with radiographically visible lesions had perfusion abnormalities in other lung regions. Twenty-seven patients with suspected carcinoma who were subsequently proved to have benign lesions had V-P abnormalities similar to those in patients with lung cancer. Thus, no pattern of V-P abnormalities similar to those in patients with lung cancer. Thus, no pattern of V-P abnormalities allowed lung cancer in this screened population to be reliably distinguished from coexisting airway disease or non-malignant pulmonary masses. V-P lung studies have a limited role in the early detection of lung cancer.

Aged↗