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Diagnostics
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Diagnosis of Cardio-Thoracic Diseases
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Diagnosis of Cardio-Thoracic Diseases

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 30 April 2025 | Viewed by 4502

Special Issue Editor

Dr. Tilman Emrich

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Guest Editor
Department of Diagnostic and Interventional Radiology, University Medical Center of Johannes Gutenberg-University, 55131 Mainz, Germany
Interests: cardiac imaging, magnetic resonance imaging, cardiothoracic CT; spectral imaging

Special Issue Information

Dear Colleagues,

Cardiothoracic diseases are a leading cause of death worldwide and their early and accurate diagnosis is crucial for effective treatment and management. Non-invasive imaging has revolutionized the way cardiothoracic diseases are diagnosed and evaluated. The use of imaging techniques such as echocardiography, computed tomography (CT), and magnetic resonance imaging (MRI) has greatly improved the accuracy and speed of diagnosis, and therefore patient management and outcomes.

The articles in this Special Issue will provide valuable insights for clinicians, researchers, and technicians involved in the field of cardiothoracic imaging. It is a pleasure to invite you to contribute to this Special Issue entitled “Diagnosis of Cardio-Thoracic Diseases” with original contributions and review articles focused on imaging to demonstrate the continued progress being made in this area and highlight the importance of utilizing these techniques for improving patient outcomes.

We are looking forward to receiving your submissions.

Dr. Tilman Emrich
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cardiac disease
  • aortic disease
  • lung disease
  • computed tomography
  • magnetic resonance imaging
  • echocardiography
  • quantitative imaging
  • multiparametric imaging

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Published Papers (4 papers)

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Research

13 pages, 2349 KiB  
Article
Fluoroscopy-Guided Percutaneous Transthoracic Needle Lung Biopsy with the Aid of Planning Cone-Beam CT: Diagnostic Accuracy and Complications
by Sang Hyun Cho, Hyun Jung Yoon, Young Lee, Injoong Kim, Je Ryung Gil and Yeo Jin Kim
Diagnostics 2024, 14(21), 2441; https://doi.org/10.3390/diagnostics14212441 - 31 Oct 2024
Viewed by 461
Abstract
Background: Fluoroscopy-guided PTNB for fluoroscopy-identifiable lung lesions has been suggested as a useful method for the pathological diagnosis of lung lesions; however, it is lacking in accuracy and safety compared to CT-guided PTNB. Thus, we aimed to investigate the diagnostic accuracy and complications [...] Read more.
Background: Fluoroscopy-guided PTNB for fluoroscopy-identifiable lung lesions has been suggested as a useful method for the pathological diagnosis of lung lesions; however, it is lacking in accuracy and safety compared to CT-guided PTNB. Thus, we aimed to investigate the diagnostic accuracy and complications of fluoroscopy-guided percutaneous transthoracic needle biopsy (PTNB) with the aid of pre-procedural planning cone-beam computed tomography (CBCT) in order to take advantage of their respective strengths. Methods: A total of 255 fluoroscopy-guided PTNBs with the aid of planning CBCT were performed. Pre-procedural planning CBCT was conducted to calculate the shortest length from the skin puncture site to the margin of the target lesion for the needle trajectory. No intra-procedural CBCT was performed. The diagnostic performance of fluoroscopy-guided PTNB with the aid of planning CBCT was calculated. The prognostic factors for diagnostic failures and complications were evaluated using logistic regression analysis. Results: The accuracy, sensitivity, specificity, PPV, and NPV were 97.3%, 88.0%, 90.9%, 100%, and 62.5%, respectively. There were 29 diagnostic failures (11.8%), and the multivariable analysis showed that a longer lesion depth on CBCT and a shorter specimen length were each associated with diagnostic failure (p = 0.010 and 0.012, respectively). Complications occurred in 34 PTNBs (13.3%). The multivariable analysis showed that an increased total number of biopsies per lesion, a longer length of lung aeration via needle insertion, a smaller lesion size on CT imaging (≤20 mm), and the presence of an air bronchogram were associated with the occurrence of complications (p = 0.027, <0.001, 0.003, and 0.020, respectively). Conclusions: Excellent diagnostic accuracy was obtained by fluoroscopy-guided PTNB with the aid of planning CBCT. Compared to that of CT- or CBCT-guided PTNB, the procedure-related complication rate was acceptably low, but the radiation dose to patients could be potentially reduced. Full article
(This article belongs to the Special Issue Diagnosis of Cardio-Thoracic Diseases)
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12 pages, 1374 KiB  
Article
Sarcoid Nodule or Lung Cancer? A High-Resolution Computed Tomography-Based Retrospective Study of Pulmonary Nodules in Patients with Sarcoidosis
by Chiara Catelli, Susanna Guerrini, Miriana D’Alessandro, Paolo Cameli, Antonio Fabiano, Giorgio Torrigiani, Cristiana Bellan, Maria Antonietta Mazzei, Piero Paladini and Luca Luzzi
Diagnostics 2024, 14(21), 2389; https://doi.org/10.3390/diagnostics14212389 - 26 Oct 2024
Viewed by 488
Abstract
Background: The objective of this retrospective study was to compare the characteristics of sarcoid nodules and neoplastic nodules using high-resolution computed tomography (HRCT) in sarcoidosis patients. Methods: This is a single-center retrospective study. From 2010 to 2023, among 685 patients affected [...] Read more.
Background: The objective of this retrospective study was to compare the characteristics of sarcoid nodules and neoplastic nodules using high-resolution computed tomography (HRCT) in sarcoidosis patients. Methods: This is a single-center retrospective study. From 2010 to 2023, among 685 patients affected by pulmonary sarcoidosis, 23 patients developed pulmonary nodules of a suspicious malignant nature. The HRCT characteristics of biopsy-proven malignant (Group A) vs. inflammatory (Group B) nodules were analyzed and compared. Results: A significant difference was observed between the groups in terms of age (p = 0.012). With regard to HRCT features, statistical distinctions were observed in the appearance of the nodule, more frequently spiculated in the case of lung cancer (p < 0.01), in the diameter of the nodule (Group A: 23.5 mm; Group B: 12.18 mm, p < 0.02), in the median nodule density (Group A: 60.0 HU, Group B: −126.7 HU, p < 0.01), and in the number of pulmonary nodules, as a single parenchymal nodule was more frequently observed in the neoplastic patient group (p = 0.043). In Group A, the 18-PET-CT demonstrated hilar/mediastinal lymphadenopathy in 100% of cases; histology following surgery did not report any cases of malignant lymph node involvement. Conclusions: An accurate clinical evaluation and HRCT investigation are crucial for diagnosing lung cancer in patients with sarcoidosis in order to determine who requires surgical resection. The spiculated morphology of the nodule, greater size, the number of pulmonary nodules, and density using HRCT appear to correlate with the malignant nature of the lesion. Full article
(This article belongs to the Special Issue Diagnosis of Cardio-Thoracic Diseases)
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12 pages, 3068 KiB  
Article
Artificial Intelligence Provides Accurate Quantification of Thoracic Aortic Enlargement and Dissection in Chest CT
by Nicola Fink, Basel Yacoub, U. Joseph Schoepf, Emese Zsarnoczay, Daniel Pinos, Milan Vecsey-Nagy, Saikiran Rapaka, Puneet Sharma, Jim O’Doherty, Jens Ricke, Akos Varga-Szemes and Tilman Emrich
Diagnostics 2024, 14(9), 866; https://doi.org/10.3390/diagnostics14090866 - 23 Apr 2024
Viewed by 1425
Abstract
This study evaluated a deep neural network (DNN) algorithm for automated aortic diameter quantification and aortic dissection detection in chest computed tomography (CT). A total of 100 patients (median age: 67.0 [interquartile range 55.3/73.0] years; 60.0% male) with aortic aneurysm who underwent non-enhanced [...] Read more.
This study evaluated a deep neural network (DNN) algorithm for automated aortic diameter quantification and aortic dissection detection in chest computed tomography (CT). A total of 100 patients (median age: 67.0 [interquartile range 55.3/73.0] years; 60.0% male) with aortic aneurysm who underwent non-enhanced and contrast-enhanced electrocardiogram-gated chest CT were evaluated. All the DNN measurements were compared to manual assessment, overall and between the following subgroups: (1) ascending (AA) vs. descending aorta (DA); (2) non-obese vs. obese; (3) without vs. with aortic repair; (4) without vs. with aortic dissection. Furthermore, the presence of aortic dissection was determined (yes/no decision). The automated and manual diameters differed significantly (p < 0.05) but showed excellent correlation and agreement (r = 0.89; ICC = 0.94). The automated and manual values were similar in the AA group but significantly different in the DA group (p < 0.05), similar in obese but significantly different in non-obese patients (p < 0.05) and similar in patients without aortic repair or dissection but significantly different in cases with such pathological conditions (p < 0.05). However, in all the subgroups, the automated diameters showed strong correlation and agreement with the manual values (r > 0.84; ICC > 0.9). The accuracy, sensitivity and specificity of DNN-based aortic dissection detection were 92.1%, 88.1% and 95.7%, respectively. This DNN-based algorithm enabled accurate quantification of the largest aortic diameter and detection of aortic dissection in a heterogenous patient population with various aortic pathologies. This has the potential to enhance radiologists’ efficiency in clinical practice. Full article
(This article belongs to the Special Issue Diagnosis of Cardio-Thoracic Diseases)
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13 pages, 2488 KiB  
Article
Optimization of the Reconstruction Settings for Low-Dose Ultra-High-Resolution Photon-Counting Detector CT of the Lungs
by Dirk Graafen, Moritz C. Halfmann, Tilman Emrich, Yang Yang, Michael Kreuter, Christoph Düber, Roman Kloeckner, Lukas Müller and Tobias Jorg
Diagnostics 2023, 13(23), 3522; https://doi.org/10.3390/diagnostics13233522 - 24 Nov 2023
Cited by 5 | Viewed by 1315
Abstract
Photon-counting detector computed tomography (PCD-CT) yields improved spatial resolution. The combined use of PCD-CT and a modern iterative reconstruction method, known as quantum iterative reconstruction (QIR), has the potential to significantly improve the quality of lung CT images. In this study, we aimed [...] Read more.
Photon-counting detector computed tomography (PCD-CT) yields improved spatial resolution. The combined use of PCD-CT and a modern iterative reconstruction method, known as quantum iterative reconstruction (QIR), has the potential to significantly improve the quality of lung CT images. In this study, we aimed to analyze the impacts of different slice thicknesses and QIR levels on low-dose ultra-high-resolution (UHR) PCD-CT imaging of the lungs. Our study included 51 patients with different lung diseases who underwent unenhanced UHR-PCD-CT scans. Images were reconstructed using three different slice thicknesses (0.2, 0.4, and 1.0 mm) and three QIR levels (2–4). Noise levels were determined in all reconstructions. Three raters evaluated the delineation of anatomical structures and conspicuity of various pulmonary pathologies in the images compared to the clinical reference reconstruction (1.0 mm, QIR-3). The highest QIR level (QIR-4) yielded the best image quality. Reducing the slice thickness to 0.4 mm improved the delineation and conspicuity of pathologies. The 0.2 mm reconstructions exhibited lower image quality due to high image noise. In conclusion, the optimal reconstruction protocol for low-dose UHR-PCD-CT of the lungs includes a slice thickness of 0.4 mm, with the highest QIR level. This optimized protocol might improve the diagnostic accuracy and confidence of lung imaging. Full article
(This article belongs to the Special Issue Diagnosis of Cardio-Thoracic Diseases)
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