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Radiology-based diagnosis of fungal pulmonary infections in high-risk hematology patients: are we making progress?

In patients with hematological malignancies, high-resolution computed tomography (CT) is the recommended imaging approach for diagnosis, staging and monitoring of invasive fungal disease (IFD) but lacks specificity. We examined the status of current imaging modalities for IFD and possibilities for m...

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Autores principales: Lewis, Russell E, Stanzani, Marta, Morana, Giovanni, Sassi, Claudia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10351900/
https://www.ncbi.nlm.nih.gov/pubmed/37431554
http://dx.doi.org/10.1097/QCO.0000000000000937
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author Lewis, Russell E
Stanzani, Marta
Morana, Giovanni
Sassi, Claudia
author_facet Lewis, Russell E
Stanzani, Marta
Morana, Giovanni
Sassi, Claudia
author_sort Lewis, Russell E
collection PubMed
description In patients with hematological malignancies, high-resolution computed tomography (CT) is the recommended imaging approach for diagnosis, staging and monitoring of invasive fungal disease (IFD) but lacks specificity. We examined the status of current imaging modalities for IFD and possibilities for more effective applications of current technology for improving the specificity of IFD diagnosis. RECENT FINDINGS: Although CT imaging recommendations for IFD are largely unchanged in the last 20 years, improvements in CT scanner technology and image processing algorithms now allow for technically adequate examinations at much lower radiation doses. CT pulmonary angiography can improve both the sensitivity and specificity of CT imaging for angioinvasive molds in both neutropenic and nonneutropenic patients, through detection of the vessel occlusion sign (VOS). MRI-based approaches also show promise not only for early detection of small nodules and alveolar hemorrhage but can also be used to detect pulmonary vascular occlusion without radiation and iodinated contrast media. 18F-fluorodeoxyglucose (FDG) PET/computed tomography (FDG-PET/CT) is increasingly used to monitor long-term treatment response for IFD, but could become a more powerful diagnostic tool with the development of fungal-specific antibody imaging tracers. SUMMARY: High-risk hematology patients have a considerable medical need for more sensitive and specific imaging approaches for IFD. This need may be addressable, in part, by better exploiting recent progress in CT/MRI imaging technology and algorithms to improve the specificity of radiological diagnosis for IFD.
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spelling pubmed-103519002023-07-18 Radiology-based diagnosis of fungal pulmonary infections in high-risk hematology patients: are we making progress? Lewis, Russell E Stanzani, Marta Morana, Giovanni Sassi, Claudia Curr Opin Infect Dis INFECTIONS OF THE IMMUNOCOMPROMISED HOST: Edited by Genovefa Papanicolaou and Dionysios Neofytos In patients with hematological malignancies, high-resolution computed tomography (CT) is the recommended imaging approach for diagnosis, staging and monitoring of invasive fungal disease (IFD) but lacks specificity. We examined the status of current imaging modalities for IFD and possibilities for more effective applications of current technology for improving the specificity of IFD diagnosis. RECENT FINDINGS: Although CT imaging recommendations for IFD are largely unchanged in the last 20 years, improvements in CT scanner technology and image processing algorithms now allow for technically adequate examinations at much lower radiation doses. CT pulmonary angiography can improve both the sensitivity and specificity of CT imaging for angioinvasive molds in both neutropenic and nonneutropenic patients, through detection of the vessel occlusion sign (VOS). MRI-based approaches also show promise not only for early detection of small nodules and alveolar hemorrhage but can also be used to detect pulmonary vascular occlusion without radiation and iodinated contrast media. 18F-fluorodeoxyglucose (FDG) PET/computed tomography (FDG-PET/CT) is increasingly used to monitor long-term treatment response for IFD, but could become a more powerful diagnostic tool with the development of fungal-specific antibody imaging tracers. SUMMARY: High-risk hematology patients have a considerable medical need for more sensitive and specific imaging approaches for IFD. This need may be addressable, in part, by better exploiting recent progress in CT/MRI imaging technology and algorithms to improve the specificity of radiological diagnosis for IFD. Lippincott Williams & Wilkins 2023-08 2023-06-09 /pmc/articles/PMC10351900/ /pubmed/37431554 http://dx.doi.org/10.1097/QCO.0000000000000937 Text en Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/)
spellingShingle INFECTIONS OF THE IMMUNOCOMPROMISED HOST: Edited by Genovefa Papanicolaou and Dionysios Neofytos
Lewis, Russell E
Stanzani, Marta
Morana, Giovanni
Sassi, Claudia
Radiology-based diagnosis of fungal pulmonary infections in high-risk hematology patients: are we making progress?
title Radiology-based diagnosis of fungal pulmonary infections in high-risk hematology patients: are we making progress?
title_full Radiology-based diagnosis of fungal pulmonary infections in high-risk hematology patients: are we making progress?
title_fullStr Radiology-based diagnosis of fungal pulmonary infections in high-risk hematology patients: are we making progress?
title_full_unstemmed Radiology-based diagnosis of fungal pulmonary infections in high-risk hematology patients: are we making progress?
title_short Radiology-based diagnosis of fungal pulmonary infections in high-risk hematology patients: are we making progress?
title_sort radiology-based diagnosis of fungal pulmonary infections in high-risk hematology patients: are we making progress?
topic INFECTIONS OF THE IMMUNOCOMPROMISED HOST: Edited by Genovefa Papanicolaou and Dionysios Neofytos
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10351900/
https://www.ncbi.nlm.nih.gov/pubmed/37431554
http://dx.doi.org/10.1097/QCO.0000000000000937
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