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  • Journal Highlights

    March 01, 2014

    The following are highlights from the current issues of RSNA’s two peer-reviewed journals.

    Radiology
    State of the Art: Imaging of Occupational Lung Disease

    Thin-section CT image at the level of the right middle lobar bronchus
    (Click to enlarge) Thin-section CT image at the level of the right middle lobar bronchus in a patient with concentrated concrete dust exposure resulting in acute silicosis that manifested as posterior predominant patchy consolidation. Note some areas of ground-glass opacity and septal thickening consistent with a crazy-paving pattern (between arrows).
    (Radiology 2014;270;3:681–696) ©RSNA, 2014. All rights reserved. Printed with permission.  

    Imaging of occupational lung disease, often perceived as a static discipline, continues to evolve with changes in industry and imaging technology. The challenge of accurately identifying an occupational exposure as the cause of lung disease demands a team approach, requiring integration of imaging features with exposure type, time course and severity.

    In a State-of-the-Art article in the March issue of Radiology (RSNA.org/Radiology), Christian W. Cox, M.D., of National Jewish Health in Denver, and colleagues demonstrate the importance of a multidisciplinary approach to diagnosing occupational lung disease, with particular emphasis on a radiologic pattern-based approach. In addition, the authors illustrate the spectrum of lung injury related to occupational exposures and discuss the imaging features of several newly described occupational diseases.

    Increasing use of CT has demonstrated that specific occupational exposures can result in a variety of patterns of lung injury. The radiologist is often ideally placed to recognize potential occupational lung disease and question the clinician about possible exposures that, if causally relevant, may lead to more targeted medical management and prevention, according to the authors.

    “The radiologist must understand the spectrum of expected imaging patterns related to known occupational exposures and must also recognize newly described occupational exposure risks, often related to recent changes in industrial practices,” the authors write.

    This article meets the criteria for AMA PRA Category 1 Credit™. SA-CME is available online only. 

    Radiographics
    The Thyroid: Review of Imaging Features and Biopsy Techniques with Radiologic-Pathologic Correlation

    Metastatic lung carcinoma in a 63-year-old man with known lung carcinoma
    (Click to enlarge) Metastatic lung carcinoma in a 63-year-old man with known lung carcinoma in whom a new thyroid nodule was discovered at staging CT. Longitudinal duplex ultrasound image shows a mildly heterogeneous, hypoechoic 3-cm solid nodule with increased peripheral and central vascularity. Increased central vascularity is a suspicious ultrasound feature.
    (RadioGraphics 2014;34;276-293) ©RSNA, 2014. All rights reserved. Printed with permission. 

    Imaging has long been established as an essential element in the workup of clinically suspected lesions of the thyroid gland. While thyroid nodules are often detected incidentally at CT, MR imaging and PET, ultrasonography is the most commonly used imaging modality for characterizing the nodules.

    Knowledge of the normal and abnormal imaging appearances of the thyroid gland is essential for appropriate identification and diagnosis of thyroid lesions, according to Arun C. Nachiappan, M.D., of Baylor College of Medicine, Houston, and colleagues, authors of an article in the March-April issue of RadioGraphics (RSNA.org/RadioGraphics). The authors discuss: imaging appearance of thyroid lesions with special emphasis on clinical background and radiologic-pathologic correlation; current indications for thyroid fine-needle aspiration biopsy (FNAB); proper ultrasound-guided FNAB technique; and cytologic analysis of the acquired specimen.

    The critical roles of the radiologist in the management of thyroid disease are to decide whether to biopsy a nodule on the basis of ultrasound criteria and to use proper FNAB technique for thyroid biopsy, according to the authors.

    “It is also important for the radiologist to have a basic knowledge of thyroid disease, be familiar with specimen processing, and recognize the cytologic appearances of thyroid lesions, all of which will facilitate a multifaceted understanding of the management of thyroid nodules,” the authors write.

    This article meets the criteria for AMA PRA Category 1 Credit™. SA-CME is available in print. 
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