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Appropriateness Criteria

Reference Study Type Patients/Events Study Objective(Purpose of Study) Study Results Study Quality
1. Dunlap DG, Ravenel J, Sechrist J, Semaan R. Interventional Therapies for Central Airways. [Review]. J Thorac Imaging. 34(4):W49-W59, 2019 Jul. Review/Other-Dx N/A To discuss the interventional Therapies for Central Airways. No results state din the abstract. 4
2. Little BP, Duong PT. Imaging of Diseases of the Large Airways. [Review]. Radiol Clin North Am. 54(6):1183-1203, 2016 Nov. Review/Other-Dx N/A To discuss the imaging of diseases of the large airways. No results stated in the abstract. 4
3. McInnis MC, Weisbrod G, Schmidt H. Advanced Technologies for Imaging and Visualization of the Tracheobronchial Tree: From Computed Tomography and MRI to Virtual Endoscopy. [Review]. Thorac Surg Clin. 28(2):127-137, 2018 May. Review/Other-Dx N/A To discuss The use of computed tomography (CT) has evolved to include multi-planar reconstructions and 3-dimensional reconstructions for the evaluation of benign and malignant disease of the trachea. No results stated in the abstract 4
4. Aslam A, De Luis Cardenas J, Morrison RJ, et al. Tracheobronchomalacia and Excessive Dynamic Airway Collapse: Current Concepts and Future Directions. Radiographics. 42(4):1012-1027, 2022 Jul-Aug. Review/Other-Dx N/A To discuss the Tracheobronchomalacia and Excessive Dynamic Airway Collapse, Current Concepts and Future Directions. No results stated in the abstract. 4
5. Mitropoulos A, Song WJ, Almaghlouth F, Kemp S, Polkey M, Hull JH. Detection and diagnosis of large airway collapse: a systematic review. [Review]. ERJ open res.. 7(3), 2021 Jul. Review/Other-Dx 10 071 patients (41 studies) To systematically review studies reporting a diagnostic approach to LAC in healthy adults and patients, to compare diagnostic modalities and criteria used. Studies that reported a diagnostic approach using computed tomography (CT), magnetic resonance imaging or flexible fibreoptic bronchoscopy were included. Random effects meta-analyses were performed to estimate the prevalence of LAC in healthy subjects and in patients with chronic obstructive airway diseases. We included 41 studies, describing 10 071 subjects (47% female) with a mean±sd age of 59±9 years. Most studies (n=35) reported CT findings, and only three studies reported bronchoscopic findings. The most reported diagnostic criterion was a =50% reduction in tracheal or main bronchi calibre at end-expiration on dynamic expiratory CT. Meta-analyses of relevant studies found that 17% (95% CI: 0-61%) of healthy subjects and 27% (95% CI: 11-46%) of patients with chronic airways disease were classified as having LAC, using this threshold. The most reported approach to diagnose LAC utilises CT diagnostics, and at a threshold used by most clinicians (i.e., =50%) may classify a considerable proportion of healthy individuals as being abnormal and having LAC in a quarter of patients with chronic airways disease. Future work should focus on establishing more precise diagnostic criteria for LAC, relating this to relevant physiological and disease sequelae. 4
6. Bhatt SP, Terry NL, Nath H, et al. Association Between Expiratory Central Airway Collapse and Respiratory Outcomes Among Smokers. JAMA. 315(5):498-505, 2016 Feb 02. Observational-Dx 8820 patients To determine whether ECAC is associated with respiratory morbidity in smokers independent of underlying lung disease The study included 8820 participants with and without COPD (mean age, 59.7 [SD, 6.9] years; 4667 [56.7%] men; 4559 [51.7%] active smokers). The prevalence of ECAC was 5% (443 cases). Patients with ECAC compared with those without ECAC had worse SGRQ scores (30.9 vs 26.5 units; P < .001; absolute difference, 4.4 [95% CI, 2.2-6.6]) and mMRC scale scores (median, 2 [interquartile range [IQR], 0-3]) vs 1 [IQR, 0-3]; P < .001]), but no significant difference in 6-minute walk distance (399 vs 417 m; absolute difference, 18 m [95% CI, 6-30]; P = .30), after adjustment for age, sex, race, body mass index, forced expiratory volume in the first second, pack-years of smoking, and emphysema. On follow-up (median, 4.3 [IQR, 3.2-4.9] years), participants with ECAC had increased frequency of total exacerbations (58 vs 35 events per 100 person-years; incidence rate ratio [IRR], 1.49 [95% CI, 1.29-1.72]; P < .001) and severe exacerbations requiring hospitalization (17 vs 10 events per 100 person-years; IRR, 1.83 [95% CI, 1.51-2.21]; P < .001). 2
7. Tanabe N, Terada K, Shima H, et al. Expiratory central airway collapse and symptoms in smokers. Respir Investig. 59(4):522-529, 2021 Jul. Observational-Dx 241 patients To test whether ECAC of the trachea and main bronchi could occur exclusively in smokers with lower E/I-LV and affect their symptoms independent of emphysema and intrapulmonary airway disease. Out of 241 smokers with and without COPD (n = 189 and 52, respectively), ECAC was found in 21 (9%) smokers. No ECAC was found in smokers with E/I-LV =0.75. CAT and mMRC in smokers with ECAC were higher than in non-ECAC smokers with E/I-LV <0.75, but comparable to those in non-ECAC smokers with E/I-LV =0.75. In the multivariable analysis of smokers with E/I-LV <0.75, ECAC was associated with increased mMRC and CAT independent of CT-emphysema severity, wall area percent of segmental airways, and forced expiratory volume in 1 s 2
8. Bezuidenhout AF, Boiselle PM, Heidinger BH, et al. Longitudinal Follow-up of Patients With Tracheobronchomalacia After Undergoing Tracheobronchoplasty: Computed Tomography Findings and Clinical Correlation. J Thorac Imaging. 34(4):278-283, 2019 Jul. Observational-Dx 18 patients To evaluate intermediate and long-term changes in expiratory tracheal collapsibility by computed tomography (CT) in patients with tracheobronchomalacia following surgical treatment with tracheobronchoplasty and to correlate CT findings with clinical Before surgery, expiratory collapsibility of the upper trachea was 72%±25% (mean±SD) and that of the lower trachea was 68%±22%. On intermediate follow-up (mean, 1.5 y), collapsibility significantly decreased to 37%±21% at the upper trachea and 35%±19% at the lower trachea (P<0.001). On long-term follow-up (mean, 6 y), collapsibility increased to 51%±20% at the upper trachea and 47%±17% at the lower trachea and was significantly worse than on intermediate follow-up (P=0.002). However, collapsibility on long-term follow-up remained significantly lower than preoperative collapsibility (P=0.015). Clinical findings showed a similar trend as quantitative CT measurements. 2
9. Chalmers JD, Chang AB, Chotirmall SH, Dhar R, McShane PJ. Bronchiectasis. [Review]. Nat Rev Dis Prim. 4(1):45, 2018 11 15. Review/Other-Dx N/A To discuss the review of Bronchiectasis. No results stated in the abstract 4
10. Milliron B, Henry TS, Veeraraghavan S, Little BP. Bronchiectasis: Mechanisms and Imaging Clues of Associated Common and Uncommon Diseases. Radiographics 2015;35:1011-30. Review/Other-Dx N/A To review various causes of bronchiectasis, including common causes, such as recurrent infection or aspiration, and uncommon causes, such as congenital immunodeficiencies and disorders of cartilage development. No results stated in the abstract. 4
11. LoCicero J 3rd, Costello P, Campos CT, et al. Spiral CT with multiplanar and three-dimensional reconstructions accurately predicts tracheobronchial pathology. Ann Thorac Surg. 62(3):811-7, 1996 Sep. Review/Other-Dx N/A To evaluate the clinical accuracy of multiplanar reconstructions and three-dimensional shaded surface displays compared with conventional transaxial computed tomography, bronchoscopy, and surgical pathologic findings. Compared with conventional transaxial computed tomographic images, multiplanar reconstructions and three-dimensional shaded surface displays provided a correlative map of bronchoscopic and surgical anatomy in patients with benign and malignant tracheobronchial pathology. The longitudinal extent of abnormalities are better demonstrated on the multiplanar reconstruction and three-dimensional images, whereas the transverse extent of disease and relationships to adjacent structures were better shown on axial computed tomographic sections. 4
12. Luo M, Duan C, Qiu J, Li W, Zhu D, Cai W. Diagnostic Value of Multidetector CT and Its Multiplanar Reformation, Volume Rendering and Virtual Bronchoscopy Postprocessing Techniques for Primary Trachea and Main Bronchus Tumors. PLoS ONE. 10(9):e0137329, 2015. Observational-Dx N/A To evaluate the diagnostic value of multidetector CT (MDCT) and its multiplanar reformation (MPR), volume rendering (VR) and virtual bronchoscopy (VB) postprocessing techniques for primary trachea and main bronchus tumors. Detection results with MDCT and its MPR, VR and VB were consistent with that of surgery and pathology, included tumor locations (tracheae, n = 19; right main bronchi, n = 6; left main bronchi, n = 6), tumor morphologies (endoluminal nodes with narrow bases, n = 2; endoluminal nodes with wide bases, n = 13; both intraluminal and extraluminal masses, n = 16), extramural invasions of tumors (brokethrough only serous membrane, n = 1; 4.0 mm-56.0 mm, n = 14; no clear border with right atelectasis, n = 1), longitudinal involvements of tumors (3.0 mm, n = 1; 5.0 mm-68.0 mm, n = 29; whole right main bronchus wall and trachea carina, n = 1), morphologies of luminal stenoses (irregular, n = 26; circular, n = 3; eccentric, n = 1; conical, n = 1) and extents (mild, n = 5; moderate, n = 7; severe, n = 19), distances between main bronchus tumors and trachea carinae (16.0 mm, n = 1; invaded trachea carina, n = 1; >20.0 mm, n = 10), and internal features of tumors (fairly homogeneous densities with rather obvious enhancements, n = 26; homogeneous density with obvious enhancement, n = 1; homogeneous density without obvious enhancement, n = 1; not enough homogeneous density with obvious enhancement, n = 1; punctate calcification with obvious enhancement, n = 1; low density without obvious enhancement, n = 1). 4
13. Taha MS, Mostafa BE, Fahmy M, Ghaffar MK, Ghany EA. Spiral CT virtual bronchoscopy with multiplanar reformatting in the evaluation of post-intubation tracheal stenosis: comparison between endoscopic, radiological and surgical findings. Eur Arch Otorhinolaryngol. 266(6):863-6, 2009 Jun. Observational-Dx 14 patients To evaluate the usefulness and accuracy of spiral CT in detection and assessment of post-intubation tracheal stenosis. Fourteen patients with post intubation stenosis underwent evaluation of their airway by spiral CT scan with multiplanar reformatting (MPR) and virtual endoscopy (VE) and conventional rigid bronchoscopy, and telescopy (RB). The following parameters were assessed: involvement of the subglottic larynx, site, number, and degree of the stenosis. The results were compared with the intra-operative findings. The detection rate for tracheal stenotic lesions was 94% by CT and 88% by rigid bronchoscopy. The sensitivity and specificity of both CT scan and bronchoscopy in the detection of subglottic stenosis was 100%. The preoperative assessment of the length of stenosis was accurate in 14 (87%) of the 16 stenotic segments detected by CT and in 11 (73%) of the 15 segments detected by bronchoscopy. The length of stenosis as assessed intra-operatively significantly correlated with the data obtained with CT scan (r = 0.98, p < 0.001) and RB (r = 0.94, p < 0.001). The grade of stenosis was correctly assessed by bronchoscopy in 13/15 lesions (86%). CT measurements correctly estimated 15/16 (93.75%) lesions and allowed accurate measurements of the stenotic segment as well as the proximal and distal airway segments. Spiral CT scan with MPR and VE may be considered as a substitute to direct endoscopic examination and the additional information on laryngeal function can be easily obtained during flexible nasolaryngoscopic examination of the awake patient. This policy can minimize patient morbidity and spare them an extra anaesthetic for evaluation. 2
14. Hernandez-Rojas D, Abia-Trujillo D, Rojas C, et al. Cinematic CT as a valuable protocol for severe ECAC. Respirol. case rep.. 10(1):e0884, 2022 Jan. Review/Other-Dx 1 patient To present a case of a 77-year-old man with suspected ECAC who underwent evaluation with two different expiratory CT protocols. No results stated in the abstract 4
15. Wagnetz U, Roberts HC, Chung T, Patsios D, Chapman KR, Paul NS. Dynamic airway evaluation with volume CT: initial experience. Can Assoc Radiol J. 61(2):90-7, 2010 Apr. Observational-Dx 6 patients To prospectively establish the use of a novel multidetector computed tomography unit (MDCT) with 320 x 0.5 detector rows for the evaluation of tracheomalacia by using a dynamic expiratory low-dose technique. All 6 patients had evidence of tracheomalacia, the proximal trachea collapsed at a later phase of expiration (3-4 seconds) than the distal trachea (2-3 seconds). The most common region of airway collapse occurred at the level of the aortic arch (5/6 [83%]), Three patients (50%) had diffuse segmental luminal narrowing that involved the tracheobronchial tree. The radiation dose (estimated dose length product, computed tomography console) measured 293.9 mGy in 1 subject and 483.5 mGy in 5 patients. 4
16. Zhang J, Hasegawa I, Feller-Kopman D, Boiselle PM. 2003 AUR Memorial Award. Dynamic expiratory volumetric CT imaging of the central airways: comparison of standard-dose and low-dose techniques. Acad Radiol. 10(7):719-24, 2003 Jul. Review/Other-Dx 20 patients To compare standard-dose and low-dose inspiratory and expiratory computed tomographic (CT) images with regard to their usefulness for measuring the tracheal lumen in patients with or without tracheobronchomalacia (TBM). The level of confidence in tracheal lumen measurement was high, regardless of respiratory phase and dose (inspiratory mean, 2.9; median, 3; range, 2-3; expiratory low-dose mean, 2.6; median, 3; range, 2-3; expiratory standard-dose mean, 2.8; median, 3; range, 2-3). There was no significant difference in confidence level between standard- and low-dose techniques (P = .53). Excessive central airway collapse (expiratory reduction in cross-sectional diameter, > 50%) was seen in all 10 patients with TBM and in none of the control subjects. 4
17. Boiselle PM, O'Donnell CR, Bankier AA, et al. Tracheal collapsibility in healthy volunteers during forced expiration: assessment with multidetector CT. Radiology. 252(1):255-62, 2009 Jul. Observational-Dx 15 patients To assess forced expiratory tracheal collapsibility in healthy volunteers by using multidetector computed tomography and to compare the results with the current diagnostic criterion for tracheomalacia. The final study population included 25 men and 26 women (mean age, 50 years). The mean percentage of expiratory reduction in tracheal lumen cross-sectional area was 54.34% +/- 18.6 (standard deviation) in the upper trachea and 56.14% +/- 19.3 in the lower trachea. Forty (78%) participants exceeded the current diagnostic criterion for tracheomalacia in the upper and/or lower trachea. Decreases in cross-sectional area of the upper and lower trachea correlated well with decreases in sagittal (r = 0.807 and 0.688, respectively) and coronal (r = 0.779 and 0.751, respectively) diameters (P < .001 for each correlation). 2
18. Cohen SL, Ben-Levi E, Karp JB, et al. Ultralow Dose Dynamic Expiratory Computed Tomography for Evaluation of Tracheomalacia. J Comput Assist Tomogr. 43(2):307-311, 2019 Mar/Apr. Observational-Dx 64 patients To determine the average effective radiation dose and feasibility of ultralow dose dynamic expiratory computed tomography (CT) for evaluation of tracheomalacia (ULD) and to evaluate factors that impact image quality. The ULD had a mean effective radiation dose of 0.08 mSv, with all studies of diagnostic image quality. The ULD showed 95% reduction in effective radiation dose (P < 0.001), 14% significant reduction in scan length (P = 0.029), and qualitatively decreased image quality compared w2 ith TD (P < 0.001). The ULD at 100 kVp had significantly better image quality compared with ULD at 80 kVp (P = 0.041) with higher effective radiation dose (0.09 vs 0.05 mSv) (P < 0.001). Body mass index significantly impacted image quality for all ULD studies but not for ULD at 80 or 100 kVp. 2
19. Wang SC, Yin LK, Zhang Y, et al. CT diagnosis and prognosis prediction of tracheal adenoid cystic carcinoma. Eur J Radiol. 140:109746, 2021 Jul. Observational-Dx 46 patients To evaluate computed tomography (CT) features and establish a predictive model for the clinical diagnosis and prognosis of tracheal adenoid cystic carcinoma (ACC). Compared with tracheal non-ACC patients, univariate analysis showed that ACC patients were more likely to have extensive longitudinal length (p < 0.001) and to appear as annular wall thickening (p = 0.001), transmural growth (p = 0.036), poorly defined border (p = 0.003) and mild enhancement (p = 0.001). Multivariate logistic analysis showed that longitudinal length and enhancement degree were independent predictors of tracheal ACC. The 3-year and 5-year disease-free survival (DFS) were 75.7 % and 64.5 %, respectively. Longitudinal length (= 34 mm), transverse length (= 20 mm) and transmural growth were associated with poor DFS in univariate analysis. After multivariate adjustment, only transverse length (= 20 mm) was an adverse prognostic factor for DFS (hazard ratio = 4.594, 95 % confidence interval = 1.240-17.017; p = 0.022). 2
20. Finkelstein SE, Schrump DS, Nguyen DM, Hewitt SM, Kunst TF, Summers RM. Comparative evaluation of super high-resolution CT scan and virtual bronchoscopy for the detection of tracheobronchial malignancies. Chest. 124(5):1834-40, 2003 Nov. Observational-Dx 44 patients to compare the diagnostic potentials of conventional CT scanning, super high-resolution CT (SHR-CT) scanning, and virtual bronchoscopy (VB) directly with fiberoptic bronchoscopy (FB) for the detection of tracheobronchial neoplasms. Image acquisition and simulation of the tracheobronchial anatomy were created successfully in all patients. Thirty-two patients who underwent both SHR-CT scanning and VB had correlative FBs within 1 month. In all nine patients who had a normal anatomy, SHR-CT scanning and VB accurately correlated with the FB findings. However, CT scanning demonstrated two false-positive obstructive lesions in one patient. Twenty-three patients had a total of 35 abnormal FB findings. The sensitivities of SHR-CT scanning and VB for the detection of endoluminal, obstructive, and mucosal lesions were 90%, 100%, and 16%, respectively. The overall sensitivities and specificities of SHR-CT scanning and VB were 83% and 100%, respectively. In contrast, CT scanning had sensitivities of 50%, 72%, and 0% for the detection of endoluminal, obstructive, and mucosal lesions with an overall sensitivity and specificity of 59%, and 85%, respectively. There was no case in which conventional CT scanning was better at detecting lesions than either SHR-CT scanning or VB. 2
21. Koletsis EN, Kalogeropoulou C, Prodromaki E, et al. Tumoral and non-tumoral trachea stenoses: evaluation with three-dimensional CT and virtual bronchoscopy. J Cardiothorac Surg. 2:18, 2007 Apr 12. Observational-Dx 16 patients To evaluate the ability of 3D-CT and virtual bronchoscopy to estimate trachea stenosis in comparison to conventional axial CT and fiberoptic bronchoscopy, with a view to assist thoracic surgeons in depicting the anatomical characteristics of tracheal strictures. The imaging modalities tested showed the same stenoses as the ones detected by flexible bronchoscopy and achieved accurate and non-invasive morphological characterization of the strictures, as well as additional information about the extraluminal extent of the disease. No statistically significant difference was observed between the bronchoscopic findings and the results of axial CT estimations (P = 1.0). No statistically significant differences were observed between bronchoscopic findings and the MPR, VRT and VE image evaluations (P = 0.705, 0.414 and 0.414 respectively). 2
22. Chen Q, Goo JM, Seo JB, Chung MJ, Lee YJ, Im JG. Evaluation of tracheobronchial diseases: comparison of different imaging techniques. Korean J Radiol. 1(3):135-41, 2000 Jul-Sep. Observational-Dx 41 patients To compare the clinical utility of the different imaging techniques used for the evaluation of tracheobronchial diseases. SSD images were the most informative with regard to the detection (3.95+/-0.31), localization (3.95+/-0.22) and extent of a lesion (3.85+/-0.42), and overall information (3.83+/-0.44), while thin-section spiral CT scans provided most information regarding its relationship with adjacent structures (3.56+/-0.50) and characterization of the lesion (3.51+/-0.61). 2
23. Sundarakumar DK, Bhalla AS, Sharma R, Hari S, Guleria R, Khilnani GC. Multidetector CT evaluation of central airways stenoses: Comparison of virtual bronchoscopy, minimal-intensity projection, and multiplanar reformatted images. Indian J Radiol Imaging. 21(3):191-4, 2011 Jul. Observational-Dx 150 patients To evaluate the diagnostic utility of virtual bronchoscopy, multiplanar reformatted images, and minimal-intensity projection in assessing airway stenoses. MPR images had the highest degree of agreement with FB (? = 0.76) in the depiction of degree of narrowing. minIP had the least degree of agreement with FB (? = 0.51) in this regard. The distal visualization was best on MPR images (84.2%), followed by axial images (80.7%), whereas FB could visualize the lesions only in 45.4% of the cases. VB had the best agreement with FB in assessing the segment length (? = 0.62). Overall there were no statistically significant differences in the measurement of the distance from the carina in the axial, minIP, and MPR images. MPR images had the highest overall degree of confidence, namely, 70.17% (n = 40). 4
24. Godoy MC, Saldana DA, Rao PP, et al. Multidetector CT evaluation of airway stents: what the radiologist should know. [Review]. Radiographics. 34(7):1793-806, 2014 Nov-Dec. Review/Other-Dx N/A To discuss Multidetector CT evaluation of airway stents No results stated in the abstract 4
25. Righini C, Aniwidyaningsih W, Ferretti G, et al. Computed tomography measurements for airway stent insertion in malignant airway obstruction. J Bronchology Interv Pulmonol. 17(1):22-8, 2010 Jan. Observational-Dx 69 patients To review the role of computed tomography (CT) airway measurements for planning stent placement in malignant airway obstruction before the actual therapeutic procedure to avoid invasive diagnostic evaluation before the stent placement and to reduce complications. Patient population consisted of 69 patients, 61.7±14.0 years old, 40 males, in whom 92 stents were inserted. The most frequent cause of airway obstructions was tracheobronchial cancer (32). All patients had nitinol stent placement; 66 stents were covered and 26 were uncovered. Follow-up time was 1 to 1067 days (median: 35 days). Complication rate was 10.1% and mainly involved the patients with tracheal obstruction (6). Complications included stent fractures (2), migration (2), granuloma (1), and infectious tracheitis (2). One early death within 24 hours after the procedure was not related to stent placement. Five patients required follow-up therapeutic bronchoscopy to treat the complications. 4
26. Xiong M, Zhang W, Wang D, Xu J. CT virtual bronchoscopy: imaging method and clinical application. Chin Med J. 113(11):1022-5, 2000 Nov. Observational-Dx 52 patients To evaluate the imaging method and clinical application of CT virtual bronchoscopy (CTVB). CTVB could reveal vividly the tracheobronchial lumens, the cartilage rings, the carina and the left and right main bronchi, down to the fourth order of bronchial orifices, mimicing fiberoptic bronchoscopy. Among 46 patients with lung cancers of center type, fiberoptic bronchoscopy showed the masses in 45 patients and CTVB displayed the masses in 42. The sensitivity of CTVB was 93.3% and its accuracy was 93.5% (chi 2 = 1.33, 0.10 < P < 0.25). The tumors appeared as masses or nodules, causing bronchial stenosis (n = 35) or occlusion (n = 7). The bronchial rings near the masses were blurred, smooth or absent in contrast to the findings of fiberoptic endoscopy. Postoperative bronchial stump (n = 4) appeared to be smooth. Bronchial diverticulum exhibited a local concavity on CTVB and local protrusion on surface shadow display (SSD). CTVB could pass through the stenotic bronchi and detect the occlusive bronchi from the distal end. 2
27. Wang SY, Wang SX, Liao JQ, Chen G. 18F-FDG PET/CT and Contrast-Enhanced CT of Primary Malignant Tracheal Tumor. Clin Nucl Med. 41(8):595-605, 2016 Aug. Observational-Dx 13 patients To summarize F-FDG PET/CT and CE-CT findings on histologically confirmed primary malignant tracheal tumors in 13 patients. Tracheal soft tissue lesions with increased F-FDG uptake were observed in all patients. Five squamous cell carcinomas, 5 adenoid cystic carcinomas, 2 adenocarcinomas, and 1 mucosa-associated lymphoid tumor were histopathologically observed. The maximum SUV of the malignant tracheal tumors ranged from 2.7 to 20.5 (mean ± SD, 6.8 ± 4.8; median, 5.7). All SUVmax lesion values were greater than 2.5. Homogeneous enhancement was observed in all lesions, with three exhibiting evident enhancement, nine demonstrating moderate enhancement, and one showing mild enhancement. 2
28. Shao D, Gao Q, Cheng Y, Du DY, Wang SY, Wang SX. The Prognostic Value of 18F-Fluorodeoxyglucose PET/CT in the Initial Assessment of Primary Tracheal Malignant Tumor: A Retrospective Study. Korean J Radiol. 22(3):425-434, 2021 03. Observational-Dx 37 patients To investigate the potential value of 18F-fluorodeoxyglucose (FDG) PET/CT in predicting the survival of patients with primary tracheal malignant tumors. The median survival time of the 37 patients with tracheal tumors was 38.0 months, with a 95% confidence interval of 10.8 to 65.2 months. The 3-year, 5-year and 10-year survival rate were 54.1%, 43.2%, and 16.2%, respectively. The metabolic tumor volume (MTV), total lesion glycolysis (TLG), maximum standardized uptake value, age, pathological type, extension categories, and lymph node stage were included in multivariate analyses. Multivariate analysis showed MTV (p = 0.011), TLG (p = 0.020), pathological type (p = 0.037), and extension categories (p = 0.038) were independent prognostic factors for OS. Additionally, assessment of the survival curve using the Kaplan-Meier method showed that our prognosis prediction model can effectively stratify patients with different risks factors (p < 0.001). 2
29. Baroni RH, Feller-Kopman D, Nishino M, et al. Tracheobronchomalacia: comparison between end-expiratory and dynamic expiratory CT for evaluation of central airway collapse. Radiology. 235(2):635-41, 2005 May. Observational-Dx 34 patients To compare dynamic expiratory and end-expiratory computed tomography (CT) for depicting central airway collapse in patients with acquired tracheobronchomalacia (TBM). Dynamic expiratory CT elicited a significantly greater degree of airway collapse than end-expiratory CT at all three levels (P < .005). The mean percentages of airway collapse at each of the three levels were as follows: aortic arch, 53.9% with dynamic expiration versus 35.7% with end expiration (P = .0046); carina, 53.6% with dynamic expiration versus 30.9% with end expiration (P < .0001); and bronchus intermedius, 57.5% with dynamic expiration versus 28.6% with end expiration (P = .0022). 2
30. Heussel CP, Hafner B, Lill J, Schreiber W, Thelen M, Kauczor HU. Paired inspiratory/expiratory spiral CT and continuous respiration cine CT in the diagnosis of tracheal instability. Eur Radiol. 11(6):982-9, 2001. Observational-Dx 29 patients To compare inspiratory and expiratory spiral CT, cine CT, bronchoscopy, exemplary cine MR, and evaluated the clinical relevance. Twenty-nine patients (2 follow-ups; mean age 61 years, age range 27-85 years) with suspected or verified tracheal stenosis or collapse (post-tracheotomy: n = 17; neoplasm: n = 5; other: n = 7) underwent paired breath-hold inspiratory and expiratory spiral CT. Forty-five additional cine CT were performed at 1-4 levels (mean 1.5) during continuous respiration (increment 100 ms) to clarify respiratory collapse. The tracheal cross-sectional diameters of both techniques were calculated. Comparison with bronchoscopy, follow-up, and influence upon therapy were evaluated retrospectively. Exemplary comparison with cine MR (8 frames/s) was done in 3 cases. In addition to bronchoscopy, further information concerning localisation, extent, collapse, stability of the tracheal wall, distal portions of the stenosis and extraluminal compressions were obtained. A significantly higher degree and more pathological collapses (> 50%) were seen using cine CT (38%) compared with paired spiral CT (13%; degree: p < 0.0001; number: p < 0.001). The findings changed the further therapeutic procedure in 16 of 29 patients. Further stenoses were excluded and bronchoscopy was verified in another 13 of 29. Temporal resolution of cine CT and cine MR is sufficient; however, spatial resolution of cine MR is inferior. Paired inspiratory and expiratory spiral CT localises tracheal stenoses and demonstrates relevant extraluminal compression. Significantly improved evaluation of respiratory collapse and further information of localised tracheal instability is obtained by cine CT. Cine MR promises more functional information especially due to free choice of imaging plane. 2
31. O'Donnell CR, Bankier AA, O'Donnell DH, Loring SH, Boiselle PM. Static end-expiratory and dynamic forced expiratory tracheal collapse in COPD. Clin Radiol. 69(4):357-62, 2014 Apr. Observational-Dx 100 patients To determine the range of tracheal collapse at end-expiration among chronic obstructive pulmonary disease (COPD) patients and to compare the extent of tracheal collapse between static end-expiratory and dynamic forced-expiratory multidetector-row computed tomography (MDCT). Mean percentage expiratory collapse among COPD patients was 17 +/- 18% at end-expiration compared to 62 +/- 16% during forced expiration. Over the observed range of end-expiratory tracheal collapse (approximately 10-50%), the positive predictive value of end-expiratory collapse to predict excessive (>/=80%) forced expiratory tracheal collapse was <0.3. 3
32. Ciet P, Boiselle PM, Heidinger B, et al. Cine MRI of Tracheal Dynamics in Healthy Volunteers and Patients With Tracheobronchomalacia. AJR Am J Roentgenol. 209(4):757-761, 2017 Oct. Observational-Dx 12 patients To assess cine MRI airway dynamics during various breathing conditions and compare cine MRI and MDCT measurements in healthy volunteers and patients with suspected TBM. No results was stated 2
33. Heussel CP, Ley S, Biedermann A, et al. Respiratory lumenal change of the pharynx and trachea in normal subjects and COPD patients: assessment by cine-MRI. Eur Radiol. 14(12):2188-97, 2004 Dec. Observational-Dx 15 patients To use cine-MRI during continuous respiration to measure the respiratory lumenal diameter change in the pharynx and at an upper tracheal level. Fifteen non-smokers and 23 chronic obstructive pulmonary disease (COPD) patients with smoking history (median 50 pack-years) were included. Cine-MRI with seven frames/s was performed during continuous respiration. Minimal and maximal cross-sectional lumenal diameters within the pharynx and the upper tracheal lumen area were measured. The median diameter change in the pharynx (tracheal area) was 70% (1.4 cm(2)) in volunteers and 76% (1.7 cm(2)) in smokers (P=0.98, P=0.04). Tracheal lumenal collapse was a median of 43% in volunteers and 64% in smokers (P=0.011). No clear disease-related difference of the pharynx-lumen was found. The maximal cross-sectional area of the upper trachea lumen as well as the respiratory collapse was larger in COPD patients than in normal subjects. This information is important for the modelling of ventilation and prediction of drug deposition, which are influenced by the airway diameter. 2
34. Watase S, Sonoda A, Matsutani N, et al. Evaluation of intrathoracic tracheal narrowing in patients with obstructive ventilatory impairment using dynamic chest radiography: A preliminary study. Eur J Radiol. 129:109141, 2020 Aug. Observational-Dx 12 patients To examine the relationship between changes in tracheal diameter during deep breathing and obstructive ventilation disorders using DCR. Tracheal diameter was significantly narrowed in subjects with obstructive ventilatory impairment compared to normal subjects (P < 0.01). When subjects were divided into narrowing (tracheal narrowing rate [TNr] = 41.5 ± 7.7 %, n = 9) and non-narrowing groups (TNr = 9.1 ± 7.0 %, n = 31, p < 0.01), FEV1%-G, and %V25 were significantly smaller in the narrowing group than in the non-narrowing group (p < 0.01). 2
35. Baroni RH, Ashiku S, Boiselle PM. Dynamic CT evaluation of the central airways in patients undergoing tracheoplasty for tracheobronchomalacia. AJR Am J Roentgenol. 184(5):1444-9, 2005 May. Review/Other-Dx 5 PATIENTS To describe the role of pre- and postoperative dynamic CT in patients undergoing tracheoplasty, a novel surgical method for treatment of severely symptomatic tracheobronchomalacia. Five patients were referred for dynamic MDCT before and after undergoing tracheoplasty at our institution. Preoperatively, all patients showed signs of tracheobronchomalacia (> or = 50% airway collapse) on bronchoscopy, and four (80%) of these five patients showed evidence of malacia on dynamic forceful expiratory CT scans. In all five cases, postoperative CT showed a reduction in the degree of airway collapse during expiration, changes in shape of the trachea during inspiration, and posterior wall thickening related to the procedure. Our preliminary results suggest a potentially important role for CT in the pre- and postoperative assessments of patients with tracheobronchomalacia referred for tracheoplasty. 4
36. Lee KS, Ashiku SK, Ernst A, et al. Comparison of expiratory CT airway abnormalities before and after tracheoplasty surgery for tracheobronchomalacia. J Thorac Imaging. 23(2):121-6, 2008 May. Observational-Dx 16 patients To assess the prevalence and severity of expiratory multidetector computer tomography airway abnormalities, including central airway collapse and peripheral air trapping, before and after tracheoplasty, a novel surgical treatment for tracheomalacia. The study cohort was comprised of 16 patients, 12 men and 4 women, with mean age of 60 years (range: 41 to 80). Mean percentage expiratory tracheal collapse pretracheoplasty was 70%+/-28 compared with 36%+/-27 posttracheoplasty (P<0.0001). Fifteen (94%) of sixteen patients demonstrated air trapping both pretracheoplasty and posttracheoplasty. Median total air-trapping scores were similar between preoperative (median 6, range: 0 to 9) and postoperative (median 6, range: 0 to 10) scans (P=0.43). All patients experienced symptomatic improvement after surgery. 2
37. Hansell DM, Bankier AA, MacMahon H, McLoud TC, Muller NL, Remy J. Fleischner Society: glossary of terms for thoracic imaging. Radiology. 2008; 246(3):697-722. Review/Other-Dx N/A Glossary of terms for thoracic imaging. N/A 4
38. Cartier Y, Kavanagh PV, Johkoh T, Mason AC, Muller NL. Bronchiectasis: accuracy of high-resolution CT in the differentiation of specific diseases. AJR Am J Roentgenol. 173(1):47-52, 1999 Jul. Observational-Dx 82 patients To determine whether various causes of bronchiectasis can be differentiated by the pattern and distribution of abnormalities seen on high-resolution CT. The two independent observers made a correct diagnosis in 61% of cases (100/164 interpretations). On average, a correct diagnosis was made in 19 (68%) of 28 cases of cystic fibrosis, 16 (67%) of 24 cases of previous tuberculosis, six (43%) of 14 cases of previous childhood infection, five (56%) of nine cases of allergic bronchopulmonary aspergillosis, and four (57%) of seven cases of other causes of bronchiectasis. We found moderate agreement between the observers for the correct diagnosis (kappa = .53) and good agreement for the presence or absence of bronchiectasis in each lobe (kappa = .71). 2
39. Lee PH, Carr DH, Rubens MB, Cole P, Hansell DM. Accuracy of CT in predicting the cause of bronchiectasis. Clin Radiol. 50(12):839-41, 1995 Dec. Observational-Dx 108 patients To determine whether experienced chest radiologists could confidently and accurately diagnose various aetiologies of bronchiectasis from the computed tomography (CT) pattern of disease alone. CT scans of 108 patients with bronchiectasis of various causes (67 with idiopathic bronchiectasis, 10 with allergic bronchopulmonary aspergillosis, 12 with syndromes of impaired mucociliary clearance, 12 with hypogammaglobulinaemia and seven with adult cystic fibrosis) were assessed by three chest radiologists without knowledge of clinical data. Each observer listed the three most likely diagnoses in order of probability. In addition, a level of confidence on a 3-point scale was assigned to the first choice diagnosis. A correct first-choice diagnosis was made in 45% of readings. A high confidence level was given in only 9% of the first choice readings. Of these, a correct diagnosis was reached in 35%. There was poor interobserver agreement (mean kappa = 0.20). In conclusion, we found that the causes of bronchiectasis cannot be reliably diagnosed on the basis of CT appearances alone. 2
40. Pasteur MC, Bilton D, Hill AT. British Thoracic Society guideline for non-CF bronchiectasis. [Review] [549 refs]. Thorax. 65 Suppl 1:i1-58, 2010 Jul. Review/Other-Dx N/A (1) to identify relevant studies in non-cystic fibrosis (CF) bronchiectasis; (2) to provide guidelines on management based on published studies where possible or a consensus view; and (3) to identify gaps in our knowledge and identify areas for future study No results state din the abstract 4
41. Reiff DB, Wells AU, Carr DH, Cole PJ, Hansell DM. CT findings in bronchiectasis: limited value in distinguishing between idiopathic and specific types. AJR Am J Roentgenol. 165(2):261-7, 1995 Aug. Observational-Dx 168 patients To determine whether the pattern and distribution of bronchiectasis shown on CT scans can be used to discriminate between idiopathic cases and those with an identifiable cause. Compared with idiopathic bronchiectasis, no significant lobar predominance was seen in any of the known-cause groups, apart from a higher frequency of lower lobe involvement in the patients with syndromes of impaired mucociliary clearance (p < .02). The bronchiectasis of allergic bronchopulmonary aspergillosis and adult cystic fibrosis was more often widespread (five or six lobes involved (p < .001 and p < .01, respectively) than idiopathic bronchiectasis. Central bronchiectasis was more common in allergic bronchopulmonary aspergillosis (p < .005), although the sensitivity when this was used as a diagnostic feature was only 37%. In all groups, cylindrical bronchiectasis was the most common type, with varicose and cystic bronchiectasis occurring more frequently in allergic bronchopulmonary aspergillosis (p < .01). On multiple regression analysis, allergic bronchopulmonary aspergillosis and adult cystic fibrosis showed more extensive disease than idiopathic bronchiectasis (p < .0005 and p < .001, respectively), independent of other CT features. In hypogammaglobulinemia, dilatation of the bronchial lumen was less than in idiopathic bronchiectasis (p < .02) independent of disease extent and bronchial wall thickness. 2
42. Garcia B, Wilmskoetter J, Grady A, Mingora C, Dorman S, Flume P. Chest Computed Tomography Features of Nontuberculous Mycobacterial Pulmonary Disease Versus Asymptomatic Colonization: A Cross-sectional Cohort Study. J Thorac Imaging. 37(3):140-145, 2022 May 01. Observational-Dx 84 patients 2
43. Meerburg JJ, Veerman GDM, Aliberti S, Tiddens HAWM. Diagnosis and quantification of bronchiectasis using computed tomography or magnetic resonance imaging: A systematic review. Respir Med. 170:105954, 2020 Aug - Sep. Review/Other-Dx 122 studies To review diagnostic criteria and quantification methods for bronchiectasis. We screened 4182 abstracts, selected 972 full texts, and included 122 studies. The most often used criterion for bronchiectasis was an inner airway-artery ratio =1.0 (42%), however no validation studies for this cut-off value were found. Importantly, studies showed that airway-artery ratios are influenced by age. To quantify bronchiectasis, 42 different scoring methods were described. 4
44. Chalmers JD, Goeminne P, Aliberti S, et al. The bronchiectasis severity index. An international derivation and validation study. Am J Respir Crit Care Med. 189(5):576-85, 2014 Mar 01. Observational-Dx 608 patients To describe the derivation and validation of the Bronchiectasis Severity Index (BSI). Independent predictors of future hospitalization were prior hospital admissions, Medical Research Council dyspnea score greater than or equal to 4, FEV1 < 30% predicted, Pseudomonas aeruginosa colonization, colonization with other pathogenic organisms, and three or more lobes involved on high-resolution computed tomography. Independent predictors of mortality were older age, low FEV1, lower body mass index, prior hospitalization, and three or more exacerbations in the year before the study. The derived BSI predicted mortality and hospitalization: area under the receiver operator characteristic curve (AUC) 0.80 (95% confidence interval, 0.74-0.86) for mortality and AUC 0.88 (95% confidence interval, 0.84-0.91) for hospitalization, respectively. There was a clear difference in exacerbation frequency and quality of life using the St. George's Respiratory Questionnaire between patients classified as low, intermediate, and high risk by the score (P < 0.0001 for all comparisons). In the validation cohorts, the AUC for mortality ranged from 0.81 to 0.84 and for hospitalization from 0.80 to 0.88. 2
45. Lynch DA, Newell J, Hale V, et al. Correlation of CT findings with clinical evaluations in 261 patients with symptomatic bronchiectasis. AJR Am J Roentgenol. 173(1):53-8, 1999 Jul. Observational-Dx 261 patients To evaluate the relationships between the extent and severity of bronchiectasis on CT and clinical symptoms, spirometric abnormality, and sputum characteristics. Scores for the severity and extent of bronchiectasis correlated with the forced expiratory volume in 1 sec (FEV1) (r = -.362, p < .0001) and with the forced vital capacity (FVC) (r = -.362, p < .0001). Scores for bronchial wall thickening correlated with the FEV1 (r = -.367, p < .0001) and FVC (r = -.239, p < .001). Patients with cystic bronchiectasis were significantly more likely to grow Pseudomonas from their sputa and to have purulent sputa than were patients with cylindric or varicose bronchiectasis. Patients with cystic bronchiectasis had significantly lower FEV1 and FVC values than did patients with cylindric or varicose bronchiectasis. 2
46. Dimakou K, Triantafillidou C, Toumbis M, Tsikritsaki K, Malagari K, Bakakos P. Non CF-bronchiectasis: Aetiologic approach, clinical, radiological, microbiological and functional profile in 277 patients. Respir Med. 116:1-7, 2016 07. Observational-Dx 277 patients 2
47. Arslan S, Poyraz N, Ucar R, Yesildag M, Yesildag A, Caliskaner AZ. Magnetic Resonance Imaging May Be a Valuable Radiation-Free Technique for Lung Pathologies in Patients with Primary Immunodeficiency. J Clin Immunol. 36(1):66-72, 2016 Jan. Observational-Dx 23 patients To investigate the use of lung Magnetic resonance imaging (MRI) instead of Computed Tomography (CT) for the diagnosis and follow-up of various lesions in the lung parenchyma and airways, especially in PID patients in whom x-ray exposure should be limited. MRI performance was weaker at detecting bronchiectasis extension, and a low concordance was found between MRI and CT in the assessment of the number of bronchial generations. CT better identified peripheral airway abnormalities, while CT and MRI gave similar results for detecting the presence and extension of consolidation, bullae, mucus plugging, bronchial wall thickening, bronchiectasis severity and nodules. 2
48. Chung JH, Huitt G, Yagihashi K, et al. Proton Magnetic Resonance Imaging for Initial Assessment of Isolated Mycobacterium avium Complex Pneumonia. Annals of the American Thoracic Society. 13(1):49-57, 2016 Jan. Observational-Dx 25 patients 2
49. Furuuchi K, Ito A, Hashimoto T, Kumagai S, Ishida T. Clinical significance of the radiological severity score in Mycobacterium avium complex lung disease patients. Int J Tuberc Lung Dis. 21(4):452-457, 2017 04 01. Observational-Dx 218 patients 2
50. Mehrian P, Farnia P, Karamad M. The association between computed tomography scan findings of pulmonary infection caused by atypical mycobacteria and bacillus count in sputum samples. Int J Mycobacteriol. 7(4):355-357, 2018 Oct-Dec. Observational-Dx 50 patients 2
51. Hwang JA, Kim S, Jo KW, Shim TS. Natural history of Mycobacterium avium complex lung disease in untreated patients with stable course. Eur Respir J. 49(3), 2017 03. Observational-Dx 488 patients 2
52. Park TY, Chong S, Jung JW, et al. Natural course of the nodular bronchiectatic form of Mycobacterium Avium complex lung disease: Long-term radiologic change without treatment. PLoS ONE. 12(10):e0185774, 2017. Observational-Dx 104 patients 2
53. Lee G, Kim HS, Lee KS, et al. Serial CT findings of nodular bronchiectatic Mycobacterium avium complex pulmonary disease with antibiotic treatment. AJR Am J Roentgenol. 201(4):764-72, 2013 Oct. Observational-Dx 475 patients 2
54. Asakura T, Yamada Y, Namkoong H, et al. Impact of cavity and infiltration on pulmonary function and health-related quality of life in pulmonary Mycobacterium avium complex disease: A 3-dimensional computed tomographic analysis. Respir Med. 126:9-16, 2017 05. Observational-Dx 67 patients 2
55. Kwak N, Lee JH, Kim HJ, Kim SA, Yim JJ. New-onset nontuberculous mycobacterial pulmonary disease in bronchiectasis: tracking the clinical and radiographic changes. BMC polm. med.. 20(1):293, 2020 Nov 10. Observational-Dx 35 patients. 2
56. Park J, Yoon SH, Kim JY, Gu KM, Kwak N, Yim JJ. Radiographic severity and treatment outcome of Mycobacterium abscessus complex pulmonary disease. Respir Med. 187:106549, 2021 10. Observational-Dx 101 patients 2
57. Svenningsen S, Guo F, McCormack DG, Parraga G. Noncystic Fibrosis Bronchiectasis: Regional Abnormalities and Response to Airway Clearance Therapy Using Pulmonary Functional Magnetic Resonance Imaging. Academic Radiology. 24(1):4-12, 2017 01. Observational-Dx 15 patients to evaluate the ability of magnetic resonance imaging (MRI) to detect regional ventilation impairment and response to airway clearance therapy (ACT) in patients with noncystic fibrosis (CF) bronchiectasis, providing a new way to objectively and regionally evaluate response to therapy. CT evidence of bronchiectasis and abnormal VDP (14 ± 7%) was observed for all bronchiectasis patients and no healthy volunteers. There was CT evidence of bronchiectasis in all lobes for 3 patients and in 3 ± 1 lobes (range = 1-4) for 12 patients. VDP in lobes with CT evidence of bronchiectasis (19 ± 12%) was significantly higher than in lobes without CT evidence of bronchiectasis (8 ± 5%, P = .001). For patients, VDP in lung lobes with (P < .0001) and without CT evidence of bronchiectasis (P = .006) was higher than in healthy volunteers (3 ± 1%). For all patients, mean PEQ-ease-bringing-up-sputum (P = .048) and PEQ-patient-global-assessment (P = .01) were significantly improved post-oscillatory positive expiratory pressure. An improvement in regional VDP greater than the minimum clinical important difference was observed for 8 of the 14 patients evaluated. 2
58. American College of Radiology. ACR Appropriateness Criteria® Radiation Dose Assessment Introduction. Available at: https://www.acr.org/-/media/ACR/Files/Appropriateness-Criteria/RadiationDoseAssessmentIntro.pdf. Review/Other-Dx N/A To provide evidence-based guidelines on exposure of patients to ionizing radiation. No abstract available. 4
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