• Title/Summary/Keyword: Pulmonary nodule

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Incidental detection of myocardial ischemia during F-18 FDG CoDe PET for the evaluation of a solitary pulmonary nodule

  • Park, Chan-H.;Park, Kwang-J.;Lee, Myoung-Hoon
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.6
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    • pp.398-400
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    • 2001
  • The authors report a case of unsuspected myocardial ischemia detected during CoDe FDG PET (coincidence detection fluorodeoxyglucose positron emission tomogram) which was performed for the evaluation of a solitary pulmonary nodule. Camera-based FDG PET without attenuation correction often reveals false defect in the inferior wall of the left ventricle in normals due to excessive attenuation. However, this asymptomatic patient had increased uptake in the inferior wall suggesting ischemic myocardium. The scan finding was confirmed by Tl-201 myocardial SPECT and coronary angiogram. The patient then underwent successful PTCA of mild RCA and right ventricular branch followed by right upper lobectomy for small cell lung cancer.

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Pulmonary Cryptococcosis That Mimicked Rheumatoid Nodule in Rheumatoid Arthritis Lesion

  • Jang, Dong Won;Jeong, Ina;Kim, Seon Jae;Kim, Seok Won;Park, Soo Yeon;Kwon, Yong Hwan;Jeong, Yeon Oh;Lee, Ji Yeon;Kim, Bo Sung;Kim, Woo-Shik;Joh, Joon-Sung
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.6
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    • pp.266-270
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    • 2014
  • Recently, the incidence of pulmonary cryptococcosis is gradually increasing in rheumatoid arthritis (RA) patients. Pulmonary rheumatoid nodules (PRN) are rare manifestations of RA. Eighteen months ago, a 65-year old woman was admitted to hospital due to multiple nodules ( $2.5{\times}2.1{\times}2cm$) with cavitations in the right lower lobe. She was diagnosed with RA three year ago. She had been taking methotrexate, leflunomide, and triamcinolone. A video-assisted thoracoscopic surgery biopsy was performed and PRN was diagnosed. However, a newly growing huge opacity with cavitation was detected in the same site. Pulmonary cryptococcal infection was diagnosed through a transthoracic computed tomograpy guided needle biopsy. Cryptococcus antigen was detected in serum but not in cerebrospinal fluid. The patient was treated with oral fluconazole which resulted clinical improvement and regression of the nodule on a series of radiography. Herein, we report the case of pulmonary cryptococcosis occurring in the same location as that of the PRN.

Pulmonary Nodule Registration using Template Matching in Serial CT Scans (연속 CT 영상에서 템플릿 매칭을 이용한 폐결절 정합)

  • Jo, Hyun-Hee;Hong, He-Len
    • Journal of KIISE:Software and Applications
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    • v.36 no.8
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    • pp.623-632
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    • 2009
  • In this paper, we propose a pulmonary nodule registration for the tracking of lung nodules in sequential CT scans. Our method consists of following five steps. First, a translational mismatch is corrected by aligning the center of optimal bounding volumes including each segmented lung. Second, coronal maximum intensity projection(MIP) images including a rib structure which has the highest intensity region in baseline and follow-up CT series are generated. Third, rigid transformations are optimized by normalized average density differences between coronal MIP images. Forth, corresponding nodule candidates are defined by Euclidean distance measure after rigid registration. Finally, template matching is performed between the nodule template in baseline CT image and the search volume in follow-up CT image for the nodule matching. To evaluate the result of our method, we performed the visual inspection, accuracy and processing time. The experimental results show that nodules in serial CT scans can be rapidly and correctly registered by coronal MIP-based rigid registration and local template matching.

Performance Improvement of Convolutional Neural Network for Pulmonary Nodule Detection (폐 결절 검출을 위한 합성곱 신경망의 성능 개선)

  • Kim, HanWoong;Kim, Byeongnam;Lee, JeeEun;Jang, Won Seuk;Yoo, Sun K.
    • Journal of Biomedical Engineering Research
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    • v.38 no.5
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    • pp.237-241
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    • 2017
  • Early detection of the pulmonary nodule is important for diagnosis and treatment of lung cancer. Recently, CT has been used as a screening tool for lung nodule detection. And, it has been reported that computer aided detection(CAD) systems can improve the accuracy of the radiologist in detection nodules on CT scan. The previous study has been proposed a method using Convolutional Neural Network(CNN) in Lung CAD system. But the proposed model has a limitation in accuracy due to its sparse layer structure. Therefore, we propose a Deep Convolutional Neural Network to overcome this limitation. The model proposed in this work is consist of 14 layers including 8 convolutional layers and 4 fully connected layers. The CNN model is trained and tested with 61,404 regions-of-interest (ROIs) patches of lung image including 39,760 nodules and 21,644 non-nodules extracted from the Lung Image Database Consortium(LIDC) dataset. We could obtain the classification accuracy of 91.79% with the CNN model presented in this work. To prevent overfitting, we trained the model with Augmented Dataset and regularization term in the cost function. With L1, L2 regularization at Training process, we obtained 92.39%, 92.52% of accuracy respectively. And we obtained 93.52% with data augmentation. In conclusion, we could obtain the accuracy of 93.75% with L2 Regularization and Data Augmentation.

Diagnostic Efficacy of FDG-PET Imaging in Solitary Pulmonary Nodule (고립성폐결절의 진단시 FDG-PET의 임상적 유용성에 관한 연구)

  • Cheon, Eun Mee;Kim, Byung-Tae;Kwon, O. Jung;Kim, Hojoong;Chung, Man Pyo;Rhee, Chong H.;Han, Yong Chol;Lee, Kyung Soo;Shim, Young Mog;Kim, Jhingook;Han, Jungho
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.882-893
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    • 1996
  • Background : Over one-third of solitary pulmonary nodules are malignant, but most malignant SPNs are in the early stages at diagnosis and can be cured by surgical removal. Therefore, early diagnosis of malignant SPN is essential for the lifesaving of the patient. The incidence of pulmonary tuberculosis in Korea is somewhat higher than those of other countries and a large number of SPNs are found to be tuberculoma. Most primary physicians tend to regard newly detected solitary pulmonary nodule as tuberculoma with only noninvasive imaging such as CT and they prefer clinical observation if the findings suggest benignancy without further invasive procedures. Many kinds of noninvasive procedures for confirmatory diagnosis have been introduced to differentiate malignant SPNs from benign ones, but none of them has been satisfactory. FOG-PET is a unique tool for imaging and quantifying the status of glucose metabolism. On the basis that glucose metabolism is increased in the malignant transfomled cells compared with normal cells, FDG-PET is considered to be the satisfactory noninvasive procedure which can differentiate malignant SPNs from benign SPNs. So we performed FOG-PET in patients with solitary pulmonary nodule and evaluated the diagnostic accuracy in the diagnosis of malignant SPNs. Method : 34 patients with a solitary pulmonary nodule less than 6 cm of irs diameter who visited Samsung Medical Center from Semptember, 1994 to Semptember, 1995 were evaluated prospectively. Simple chest roentgenography, chest computer tomography, FOG-PET scan were performed for all patients. The results of FOG-PET were evaluated comparing with the results of final diagnosis confirmed by sputum study, PCNA, fiberoptic bronchoscopy, or thoracotomy. Results : (I) There was no significant difference in nodule size between malignant (3.1 1.5cm) and benign nodule(2.81.0cm)(p>0.05). (2) Peal SUV(standardized uptake value) of malignant nodules (6.93.7) was significantly higher than peak SUV of benign nodules(2.71.7) and time-activity curves showed continuous increase in malignant nodules. (3) Three false negative cases were found among eighteen malignant nodule by the FDG-PET imaging study and all three cases were nonmucinous bronchioloalveolar carcinoma less than 2 em diameter. (4) FOG-PET imaging resulted in 83% sensitivity, 100% specificity, 100% positive predictive value and 84% negative predictive value. Conclusion: FOG-PET imaging is a new noninvasive diagnostic method of solitary pulmonary nodule thai has a high accuracy of differential diagnosis between malignant and benign nodule. FDG-PET imaging could be used for the differential diagnosis of SPN which is not properly diagnosed with conventional methods before thoracotomy. Considering the high accuracy of FDG-PET imaging, this procedure may play an important role in making the dicision to perform thoracotomy in diffcult cases.

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Primary Pulmonary Amyloidosis with Mediastinal Lymphadenopathy

  • Kim, Dohun;Lee, Yong-Moon;Kim, Si-Wook;Kim, Jong-Won;Hong, Jong-Myeon
    • Journal of Chest Surgery
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    • v.49 no.3
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    • pp.218-220
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    • 2016
  • We report a case of inadvertent hoarseness after surgery for primary pulmonary amyloidosis. A 55-year-old male was transferred to our facility due to a lung mass. Chest computed tomography revealed a solitary pulmonary nodule. Positron emission tomography-computed tomography showed fluorodeoxyglucose uptake in the main mass and in the mediastinal lymph nodes. To confirm the pathology of the mass, wedge resection and thorough lymph node dissection were performed via video-assisted thoracic surgery (VATS). No complications except for hoarseness were observed; hoarseness developed soon after surgery and lasted for 3 months. The main mass was diagnosed as amyloidosis, but this was not found in the lymph nodes. In conclusion, VATS wedge resection for peripheral amyloidosis is a feasible and safe procedure. However, mediastinal lymph node dissection is not recommended unless there is evidence of a clear benefit.

A Lung Granuloma Case Possibly Associated with a Working Environment: A Case Report

  • Seehapanya, Sankom;Chaiear, Naesinee;Ratanawatkul, Pailin;Samerpitak, Kittipan;Intarawichian, Piyapharom;Wonglakorn, Lumyai
    • Safety and Health at Work
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    • v.12 no.2
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    • pp.268-271
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    • 2021
  • Lung granulomas are uncommon in Thailand. The disease typically develops from an occupational environment and is mostly caused by infection. Herein is a case report of a female patient, aged 48, working as a nurse in an Accident and Emergency Department at a hospital. Eighteen years prior to admission the patient was diagnosed with myasthenia gravis and pulmonary tuberculosis. The chest X-ray and CT scans showed a solitary pulmonary nodule in the lower left lung. The patient received an open thoracotomy with a left lobectomy. Granulomatous and nonseptate hyphae were found in the pathology diagnosis. The patient was thus diagnosed as having a lung granuloma. The galactomannan antigen test was positive. The solitary pulmonary nodule-found from the use of a Polymerase Chain Reaction (PCR) test-was an Aspergillus spp. The fungus culture was collected from air samples. The air samples were collected by the impaction technique using a microbial air sampler. Three types of Aspergillus spp. were found as well as Penicillium spp. and Monilia sitophila. The Aspergillus spp. was a match for the patient's disease. The patient was diagnosed as having a lung granuloma possibly Aspergillus nodule which was caused by airborne Aspergillus spp. from the occupational environment.

A Case of Coccidioidomycosis Manifested as Solitary Pulmonary Nodule (고립성 폐결절상을 보인 콕시디오이데스진균증 1예)

  • Yang, Hyun-Suk;Lee, Jae-Chun;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Son, Kwang-Hyun;Shim, Tae-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.2
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    • pp.266-272
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    • 1999
  • Coccidioidomycosis is a fungal infection acquired by inhalation of the arthrospore of Coccidioides immitis, and endemic disease in specific geographic areas, such as south central California, south Arizona. Nevada, and New Mexico. Approximately 60 percent of infected people is asymptomatic and the remainders mostly exhibit respiratory complaints, from flu-like coughing to overt pneumonia. Usually the infection due to Coccidioides immitis is self-limited. Symptoms resolve within several weeks but radiographic abnormalities could be resolved more slowly. If the radiographic abnormalities persist more than 8 weeks, the term' chronic pulmonary coccidioidomycosis' is designated. They take forms of nodules, cavities or progressive pneumonia. When manifested as nodule(s), lung malignancy is suspected as a possible diagnosis and histologic confirmation is needed. Here, we report a case of chronic pulmonary coccidioidomycosis manifested as solitary pulmonary nodule in a Korean woman who has traveled in Arizona, which is diagnosed finally by lobectomy and histologic examination.

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Log-polar Sampling based Voxel Classification for Pulmonary Nodule Detection in Lung CT scans (흉부 CT 영상에서 폐 결절 검출을 위한 Log-polar Sampling기반 Voxel Classification 방법)

  • Choi, Wook-Jin;Choi, Tae-Sun
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.6 no.1
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    • pp.37-44
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    • 2013
  • In this paper, we propose the pulmonary nodule detection system based on voxel classification. The proposed system consists of three main steps. In the first step, we segment lung volume. In the second step, the lung structures are initially segmented. In the last step, we classify the nodules using voxel classification. To describe characteristics of each voxel, we extract the log-polar sampling based features. Support Vector Machine is applied to the extracted features to classify into nodules and non-nodules.