1.Spectrum of Pulmonary Fibrosis from Interstitial Lung Abnormality to Usual Interstitial Pneumonia:Importance of Identification and Quantification of Traction Bronchiectasis in Patient Management
Takuya HINO ; Kyung Soo LEE ; Joungho HAN ; Akinori HATA ; Kousei ISHIGAMI ; Hiroto HATABU
Korean Journal of Radiology 2021;22(5):811-828
Following the introduction of a novel pathological concept of usual interstitial pneumonia (UIP) by Liebow and Carrington in 1969, diffuse interstitial pneumonia has evolved into UIP, nonspecific interstitial pneumonia (NSIP), and interstitial lung abnormality (ILA); the histopathological and CT findings of these conditions reflect the required multidisciplinary team approach, involving pulmonologists, radiologists, and pathologists, for their diagnosis and management. Concomitantly, traction bronchiectasis and bronchiolectasis have been recognized as the most persistent and important indices of the severity and prognosis of fibrotic lung diseases. The traction bronchiectasis index (TBI) can stratify the prognoses of patients with ILAs. In this review, the evolutionary concepts of UIP, NSIP, and ILAs are summarized in tables and figures, with a demonstration of the correlation between CT findings and pathologic evaluation. The CT-based UIP score is being proposed to facilitate a better understanding of the spectrum of pulmonary fibrosis, from ILAs to UIP, with emphasis on traction bronchiectasis/bronchiolectasis.
2.Spectrum of Pulmonary Fibrosis from Interstitial Lung Abnormality to Usual Interstitial Pneumonia:Importance of Identification and Quantification of Traction Bronchiectasis in Patient Management
Takuya HINO ; Kyung Soo LEE ; Joungho HAN ; Akinori HATA ; Kousei ISHIGAMI ; Hiroto HATABU
Korean Journal of Radiology 2021;22(5):811-828
Following the introduction of a novel pathological concept of usual interstitial pneumonia (UIP) by Liebow and Carrington in 1969, diffuse interstitial pneumonia has evolved into UIP, nonspecific interstitial pneumonia (NSIP), and interstitial lung abnormality (ILA); the histopathological and CT findings of these conditions reflect the required multidisciplinary team approach, involving pulmonologists, radiologists, and pathologists, for their diagnosis and management. Concomitantly, traction bronchiectasis and bronchiolectasis have been recognized as the most persistent and important indices of the severity and prognosis of fibrotic lung diseases. The traction bronchiectasis index (TBI) can stratify the prognoses of patients with ILAs. In this review, the evolutionary concepts of UIP, NSIP, and ILAs are summarized in tables and figures, with a demonstration of the correlation between CT findings and pathologic evaluation. The CT-based UIP score is being proposed to facilitate a better understanding of the spectrum of pulmonary fibrosis, from ILAs to UIP, with emphasis on traction bronchiectasis/bronchiolectasis.
3.Dynamic Chest X-Ray Using a Flat-Panel Detector System: Technique and Applications
Akinori HATA ; Yoshitake YAMADA ; Rie TANAKA ; Mizuki NISHINO ; Tomoyuki HIDA ; Takuya HINO ; Masako UEYAMA ; Masahiro YANAGAWA ; Takeshi KAMITANI ; Atsuko KUROSAKI ; Shigeru SANADA ; Masahiro JINZAKI ; Kousei ISHIGAMI ; Noriyuki TOMIYAMA ; Hiroshi HONDA ; Shoji KUDOH ; Hiroto HATABU
Korean Journal of Radiology 2021;22(4):634-651
Dynamic X-ray (DXR) is a functional imaging technique that uses sequential images obtained by a flat-panel detector (FPD).This article aims to describe the mechanism of DXR and the analysis methods used as well as review the clinical evidence for its use. DXR analyzes dynamic changes on the basis of X-ray translucency and can be used for analysis of diaphragmatic kinetics, ventilation, and lung perfusion. It offers many advantages such as a high temporal resolution and flexibility in body positioning. Many clinical studies have reported the feasibility of DXR and its characteristic findings in pulmonary diseases. DXR may serve as an alternative to pulmonary function tests in patients requiring contact inhibition, including patients with suspected or confirmed coronavirus disease 2019 or other infectious diseases. Thus, DXR has a great potential to play an important role in the clinical setting. Further investigations are needed to utilize DXR more effectively and to establish it as a valuable diagnostic tool.
4.Dynamic Chest X-Ray Using a Flat-Panel Detector System: Technique and Applications
Akinori HATA ; Yoshitake YAMADA ; Rie TANAKA ; Mizuki NISHINO ; Tomoyuki HIDA ; Takuya HINO ; Masako UEYAMA ; Masahiro YANAGAWA ; Takeshi KAMITANI ; Atsuko KUROSAKI ; Shigeru SANADA ; Masahiro JINZAKI ; Kousei ISHIGAMI ; Noriyuki TOMIYAMA ; Hiroshi HONDA ; Shoji KUDOH ; Hiroto HATABU
Korean Journal of Radiology 2021;22(4):634-651
Dynamic X-ray (DXR) is a functional imaging technique that uses sequential images obtained by a flat-panel detector (FPD).This article aims to describe the mechanism of DXR and the analysis methods used as well as review the clinical evidence for its use. DXR analyzes dynamic changes on the basis of X-ray translucency and can be used for analysis of diaphragmatic kinetics, ventilation, and lung perfusion. It offers many advantages such as a high temporal resolution and flexibility in body positioning. Many clinical studies have reported the feasibility of DXR and its characteristic findings in pulmonary diseases. DXR may serve as an alternative to pulmonary function tests in patients requiring contact inhibition, including patients with suspected or confirmed coronavirus disease 2019 or other infectious diseases. Thus, DXR has a great potential to play an important role in the clinical setting. Further investigations are needed to utilize DXR more effectively and to establish it as a valuable diagnostic tool.