2 articles
According to specialized literature, X-rays are also used in the diagnosis and suspicion of chronic broncho-pulmonary disease (bronchopulmonary dysplasia (BPD)), in premature children.
The study included 105 premature babies who were divided into the study group – premature babies with bronchopulmonary dysplasia (BPD) and the control group – premature babies without BPD. Data were statistically analyzed using Microsoft Excel, MedCalc, SPSS and Contingency Table Analysis as a method of evaluating the performance of a diagnostic test.
Radiological changes of discoidal atelectasis type in subjects with BPD were detected in 49.1% in the basic group versus 13.5% in the control group (χ2 = 15.431; p < 0.0001), subsegmental ones 47.2% vs 25.0% (χ2 = 5.586; p = 0.018); pulmonary emphysema areas 62.3% vs 5.8% (χ2 = 37.182; p < 0.0001), opaque fibrosis sectors 50.9% vs 11.5% (χ2 = 18.911; p < 0.0001); signs of pulmonary hypertransparency 47.2% vs 1.9% (χ2 = 28.843; p < 0.0001); microcystic formations 41.5% vs 5.8% (χ2 = 18.482; p < 0.0001). Depending on the severity degrees of BPD, changes such as discoidal atelectasis were noted, in those with mild grade – 50% medium grade – 38.5%, severe grade – 56.3% (χ2 = 16.502; p < 0.001), subsegmental atelectasis 41.7%, vs 38.5% (χ2 = 7.956; p = 0.047), pulmonary emphysema areas 58.3%, vs 38.5%, vs 87.5% (χ2 = 45.138; p < 0.0001); microcystic formations, 33.3%, vs 53.8%, vs 43.8% (χ2 = 20.502; p < 0.0001).
The changes recorded on radiological examination in mild, moderate, and severe cases of BPD in premature babies are of the type discoidal atelectasis, areas of emphysema, opaque sectors of fibrosis, pulmonary hypertransparency, microcystic formations.
Digital tomosynthesis is a relatively new imaging modality that is already used in the diagnosis of breast cancer and has shown promising results in evaluating patients with pulmonary, osteoarticular, and other pathologies. However, up to date, there are no published studies related to the usefulness of digital tomosynthesis in the evaluation of patients with laryngeal cancer. The purpose of this study was to evaluate the clinical role of digital tomosynthesis in the diagnosis of laryngeal cancer and compare the imaging results with those obtained by digital radiography and computed tomography.
The study was carried out between 2015 and 2019 at the Institute of Oncology in the Republic of Moldova and included 253 consecutive patients with laryngeal cancer referred to the Institute of Oncology during this period. All patients underwent digital radiography and digital tomosynthesis investigations. In 41 patients who provided written informed consent, computed tomography was performed. The results of all imaging investigations were compared.
The statistical analysis revealed a high degree of agreement and a strong linear correlation between the data obtained with digital tomosynthesis and computed tomography, as well as concordance correlation coefficients for different parameters between 0.63 and 1.0 (mean value = 0.82±0.11). For comparison, the concordance correlation coefficients for the same parameters obtained for digital radiography versus computed tomography ranged between 0.08 and 0.93 (mean value = 0.43±0.25). An updated imaging algorithm that includes digital tomosynthesis has also been proposed for investigating patients with suspected laryngeal cancer.
The study demonstrated the usefulness of digital tomosynthesis for the evaluation of patients with laryngeal cancer. When compared to computed tomography, which is considered the gold standard, digital tomosynthesis revealed a much higher performance compared to digital radiography. Considering the availability of low-dose protocols for digital tomosynthesis, the modality might also be helpful for laryngeal cancer screening in a high-risk population. However, new studies are also required to confirm our findings and define the place of digital tomosynthesis in the imaging algorithm for patients with laryngeal cancer.