Differential diagnosis of infectious diseases, drug-induced lung injury, and pulmonary infiltration due to underlying malignancy in patients with hematological malignancy using HRCT
Purpose To differentiate among infectious diseases, drug-induced lung injury (DILI) and pulmonary infiltration due to underlying malignancy (PIUM) based on high-resolution computed tomographic (HRCT) findings from patients with hematological malignancies who underwent chemotherapy or hematopoietic s...
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| Veröffentlicht in: | Japanese journal of radiology 2023-01, Vol.41 (1), p.27-37 |
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| creator | Tanaka, Nobuyuki Kunihiro, Yoshie Kawano, Reo Yujiri, Toshiaki Ueda, Kazuhiro Gondo, Toshikazu Kobayashi, Taiga Matsumoto, Tsuneo |
| description | Purpose
To differentiate among infectious diseases, drug-induced lung injury (DILI) and pulmonary infiltration due to underlying malignancy (PIUM) based on high-resolution computed tomographic (HRCT) findings from patients with hematological malignancies who underwent chemotherapy or hematopoietic stem cell transplantation.
Materials and methods
A total of 221 immunocompromised patients with hematological malignancies who had proven chest complications (141 patients with infectious diseases, 24 with DILI and 56 with PIUM) were included. Two chest radiologists evaluated the HRCT findings, including ground-glass opacity, consolidation, nodules, and thickening of bronchovascular bundles (BVBs) and interlobular septa (ILS). After comparing these CT findings among the three groups using the
χ
2
test, multiple logistic regression analyses (infectious vs noninfectious diseases, DILI vs non-DILI, and PIUM vs non-PIUM) were performed to detect useful indicators for differentiation.
Results
Significant differences were detected in many HRCT findings by the
χ
2
test. The results from the multiple logistic regression analyses identified several indicators: nodules without a perilymphatic distribution [
p
= 0.012, odds ratio (95% confidence interval): 4.464 (1.355–11.904)], nodules with a tree-in-bud pattern [
p
= 0.011, 8.364 (1.637–42.741)], and the absence of ILS thickening[
p
= 0.003, 3.621 (1.565–8.381)] for infectious diseases, the presence of ILS thickening [
p
= 0.001, 7.166 (2.343–21.915)] for DILI, and nodules with a perilymphatic distribution [
p
= 0.011, 4.256 (1.397–12.961)] and lymph node enlargement (
p
= 0.008, 3.420 (1.385–8.441)] for PIUM.
Conclusion
ILS thickening, nodules with a perilymphatic distribution, tree-in-bud pattern, and lymph node enlargement could be useful indicators for differentiating among infectious diseases, DILI, and PIUM in patients with hematological malignancies. |
| doi_str_mv | 10.1007/s11604-022-01328-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9813166</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2712850588</sourcerecordid><originalsourceid>FETCH-LOGICAL-c428t-caf8860e27e53ca156a0ef43c7e83341d3da6ce40fba28a0aa1a682d0915b0c73</originalsourceid><addsrcrecordid>eNp9kkuLFDEUhQtRnHH0D7iQgBsXU5pHPdIbYWgfIwwIMoK7cDu5VZ0mlbRJRekfNv9v0vbYji5cJSTfuTknnKp6zuhrRmn_JjHW0aamnNeUCS7r5kF1ymTX14zKbw-P-56dVE9S2lDaNaJpHlcnoqNSNEycVjfv7DBgRD9bcMRYGH1INpEwEOsH1LMNOZXzhJAwnRMT81hbb7JGQ1z2Y8E2Oe7OCXhDttlNwUPc7cXWzRGK3hOTkcyBZG8wup0togmcHT14vSfJtmDFQSI_7bwma5xgDi6MVhdL98ic9tLLL8vrp9WjAVzCZ3frWfX1w_vr5WV99fnjp-XFVa0bLudawyBlR5H32AoNrO2A4tAI3aMUJb8RBjqNDR1WwCVQAAad5IYuWLuiuhdn1dvD3G1eTWh0MRnBqW20UwmpAlj19423azWGH2ohmWBdVwa8uhsQw_eMaVaTTRqdA4_lYxXvGZctbaUs6Mt_0E3I0Zd4issFFUK2LSsUP1A6hpQiDkczjKp9K9ShFaq0Qv1qhWqK6MX9GEfJ7xoUQByAVK78iPHP2_8ZewvN_8jS</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2890338551</pqid></control><display><type>article</type><title>Differential diagnosis of infectious diseases, drug-induced lung injury, and pulmonary infiltration due to underlying malignancy in patients with hematological malignancy using HRCT</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Tanaka, Nobuyuki ; Kunihiro, Yoshie ; Kawano, Reo ; Yujiri, Toshiaki ; Ueda, Kazuhiro ; Gondo, Toshikazu ; Kobayashi, Taiga ; Matsumoto, Tsuneo</creator><creatorcontrib>Tanaka, Nobuyuki ; Kunihiro, Yoshie ; Kawano, Reo ; Yujiri, Toshiaki ; Ueda, Kazuhiro ; Gondo, Toshikazu ; Kobayashi, Taiga ; Matsumoto, Tsuneo</creatorcontrib><description>Purpose
To differentiate among infectious diseases, drug-induced lung injury (DILI) and pulmonary infiltration due to underlying malignancy (PIUM) based on high-resolution computed tomographic (HRCT) findings from patients with hematological malignancies who underwent chemotherapy or hematopoietic stem cell transplantation.
Materials and methods
A total of 221 immunocompromised patients with hematological malignancies who had proven chest complications (141 patients with infectious diseases, 24 with DILI and 56 with PIUM) were included. Two chest radiologists evaluated the HRCT findings, including ground-glass opacity, consolidation, nodules, and thickening of bronchovascular bundles (BVBs) and interlobular septa (ILS). After comparing these CT findings among the three groups using the
χ
2
test, multiple logistic regression analyses (infectious vs noninfectious diseases, DILI vs non-DILI, and PIUM vs non-PIUM) were performed to detect useful indicators for differentiation.
Results
Significant differences were detected in many HRCT findings by the
χ
2
test. The results from the multiple logistic regression analyses identified several indicators: nodules without a perilymphatic distribution [
p
= 0.012, odds ratio (95% confidence interval): 4.464 (1.355–11.904)], nodules with a tree-in-bud pattern [
p
= 0.011, 8.364 (1.637–42.741)], and the absence of ILS thickening[
p
= 0.003, 3.621 (1.565–8.381)] for infectious diseases, the presence of ILS thickening [
p
= 0.001, 7.166 (2.343–21.915)] for DILI, and nodules with a perilymphatic distribution [
p
= 0.011, 4.256 (1.397–12.961)] and lymph node enlargement (
p
= 0.008, 3.420 (1.385–8.441)] for PIUM.
Conclusion
ILS thickening, nodules with a perilymphatic distribution, tree-in-bud pattern, and lymph node enlargement could be useful indicators for differentiating among infectious diseases, DILI, and PIUM in patients with hematological malignancies.</description><identifier>ISSN: 1867-1071</identifier><identifier>EISSN: 1867-108X</identifier><identifier>DOI: 10.1007/s11604-022-01328-4</identifier><identifier>PMID: 36083413</identifier><language>eng</language><publisher>Singapore: Springer Nature Singapore</publisher><subject>Chemotherapy ; Chest ; Chi-square test ; Communicable Diseases ; Complications ; Computed tomography ; Diagnosis, Differential ; Differential diagnosis ; Enlargement ; Hematologic Neoplasms - complications ; Hematologic Neoplasms - diagnostic imaging ; Hematology ; Hematopoietic stem cells ; Humans ; Imaging ; Immunocompromised hosts ; Indicators ; Infectious diseases ; Infiltration ; Lung ; Lung diseases ; Lung Injury - chemically induced ; Lung Injury - diagnostic imaging ; Lung Neoplasms ; Lungs ; Lymph nodes ; Lymphatic system ; Malignancy ; Medicine ; Medicine & Public Health ; Nodules ; Nuclear Medicine ; Opacity ; Original ; Original Article ; Radiology ; Radiotherapy ; Regression analysis ; Retrospective Studies ; Statistical analysis ; Stem cell transplantation ; Stem cells ; Thickening ; Tomography, X-Ray Computed - methods ; Transplantation</subject><ispartof>Japanese journal of radiology, 2023-01, Vol.41 (1), p.27-37</ispartof><rights>The Author(s) 2022</rights><rights>2022. The Author(s).</rights><rights>The Author(s) 2022. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c428t-caf8860e27e53ca156a0ef43c7e83341d3da6ce40fba28a0aa1a682d0915b0c73</citedby><cites>FETCH-LOGICAL-c428t-caf8860e27e53ca156a0ef43c7e83341d3da6ce40fba28a0aa1a682d0915b0c73</cites><orcidid>0000-0002-6608-285X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11604-022-01328-4$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11604-022-01328-4$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,315,781,785,886,27929,27930,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36083413$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tanaka, Nobuyuki</creatorcontrib><creatorcontrib>Kunihiro, Yoshie</creatorcontrib><creatorcontrib>Kawano, Reo</creatorcontrib><creatorcontrib>Yujiri, Toshiaki</creatorcontrib><creatorcontrib>Ueda, Kazuhiro</creatorcontrib><creatorcontrib>Gondo, Toshikazu</creatorcontrib><creatorcontrib>Kobayashi, Taiga</creatorcontrib><creatorcontrib>Matsumoto, Tsuneo</creatorcontrib><title>Differential diagnosis of infectious diseases, drug-induced lung injury, and pulmonary infiltration due to underlying malignancy in patients with hematological malignancy using HRCT</title><title>Japanese journal of radiology</title><addtitle>Jpn J Radiol</addtitle><addtitle>Jpn J Radiol</addtitle><description>Purpose
To differentiate among infectious diseases, drug-induced lung injury (DILI) and pulmonary infiltration due to underlying malignancy (PIUM) based on high-resolution computed tomographic (HRCT) findings from patients with hematological malignancies who underwent chemotherapy or hematopoietic stem cell transplantation.
Materials and methods
A total of 221 immunocompromised patients with hematological malignancies who had proven chest complications (141 patients with infectious diseases, 24 with DILI and 56 with PIUM) were included. Two chest radiologists evaluated the HRCT findings, including ground-glass opacity, consolidation, nodules, and thickening of bronchovascular bundles (BVBs) and interlobular septa (ILS). After comparing these CT findings among the three groups using the
χ
2
test, multiple logistic regression analyses (infectious vs noninfectious diseases, DILI vs non-DILI, and PIUM vs non-PIUM) were performed to detect useful indicators for differentiation.
Results
Significant differences were detected in many HRCT findings by the
χ
2
test. The results from the multiple logistic regression analyses identified several indicators: nodules without a perilymphatic distribution [
p
= 0.012, odds ratio (95% confidence interval): 4.464 (1.355–11.904)], nodules with a tree-in-bud pattern [
p
= 0.011, 8.364 (1.637–42.741)], and the absence of ILS thickening[
p
= 0.003, 3.621 (1.565–8.381)] for infectious diseases, the presence of ILS thickening [
p
= 0.001, 7.166 (2.343–21.915)] for DILI, and nodules with a perilymphatic distribution [
p
= 0.011, 4.256 (1.397–12.961)] and lymph node enlargement (
p
= 0.008, 3.420 (1.385–8.441)] for PIUM.
Conclusion
ILS thickening, nodules with a perilymphatic distribution, tree-in-bud pattern, and lymph node enlargement could be useful indicators for differentiating among infectious diseases, DILI, and PIUM in patients with hematological malignancies.</description><subject>Chemotherapy</subject><subject>Chest</subject><subject>Chi-square test</subject><subject>Communicable Diseases</subject><subject>Complications</subject><subject>Computed tomography</subject><subject>Diagnosis, Differential</subject><subject>Differential diagnosis</subject><subject>Enlargement</subject><subject>Hematologic Neoplasms - complications</subject><subject>Hematologic Neoplasms - diagnostic imaging</subject><subject>Hematology</subject><subject>Hematopoietic stem cells</subject><subject>Humans</subject><subject>Imaging</subject><subject>Immunocompromised hosts</subject><subject>Indicators</subject><subject>Infectious diseases</subject><subject>Infiltration</subject><subject>Lung</subject><subject>Lung diseases</subject><subject>Lung Injury - chemically induced</subject><subject>Lung Injury - diagnostic imaging</subject><subject>Lung Neoplasms</subject><subject>Lungs</subject><subject>Lymph nodes</subject><subject>Lymphatic system</subject><subject>Malignancy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nodules</subject><subject>Nuclear Medicine</subject><subject>Opacity</subject><subject>Original</subject><subject>Original Article</subject><subject>Radiology</subject><subject>Radiotherapy</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Statistical analysis</subject><subject>Stem cell transplantation</subject><subject>Stem cells</subject><subject>Thickening</subject><subject>Tomography, X-Ray Computed - methods</subject><subject>Transplantation</subject><issn>1867-1071</issn><issn>1867-108X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kkuLFDEUhQtRnHH0D7iQgBsXU5pHPdIbYWgfIwwIMoK7cDu5VZ0mlbRJRekfNv9v0vbYji5cJSTfuTknnKp6zuhrRmn_JjHW0aamnNeUCS7r5kF1ymTX14zKbw-P-56dVE9S2lDaNaJpHlcnoqNSNEycVjfv7DBgRD9bcMRYGH1INpEwEOsH1LMNOZXzhJAwnRMT81hbb7JGQ1z2Y8E2Oe7OCXhDttlNwUPc7cXWzRGK3hOTkcyBZG8wup0togmcHT14vSfJtmDFQSI_7bwma5xgDi6MVhdL98ic9tLLL8vrp9WjAVzCZ3frWfX1w_vr5WV99fnjp-XFVa0bLudawyBlR5H32AoNrO2A4tAI3aMUJb8RBjqNDR1WwCVQAAad5IYuWLuiuhdn1dvD3G1eTWh0MRnBqW20UwmpAlj19423azWGH2ohmWBdVwa8uhsQw_eMaVaTTRqdA4_lYxXvGZctbaUs6Mt_0E3I0Zd4issFFUK2LSsUP1A6hpQiDkczjKp9K9ShFaq0Qv1qhWqK6MX9GEfJ7xoUQByAVK78iPHP2_8ZewvN_8jS</recordid><startdate>20230101</startdate><enddate>20230101</enddate><creator>Tanaka, Nobuyuki</creator><creator>Kunihiro, Yoshie</creator><creator>Kawano, Reo</creator><creator>Yujiri, Toshiaki</creator><creator>Ueda, Kazuhiro</creator><creator>Gondo, Toshikazu</creator><creator>Kobayashi, Taiga</creator><creator>Matsumoto, Tsuneo</creator><general>Springer Nature Singapore</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TK</scope><scope>7U7</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-6608-285X</orcidid></search><sort><creationdate>20230101</creationdate><title>Differential diagnosis of infectious diseases, drug-induced lung injury, and pulmonary infiltration due to underlying malignancy in patients with hematological malignancy using HRCT</title><author>Tanaka, Nobuyuki ; Kunihiro, Yoshie ; Kawano, Reo ; Yujiri, Toshiaki ; Ueda, Kazuhiro ; Gondo, Toshikazu ; Kobayashi, Taiga ; Matsumoto, Tsuneo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c428t-caf8860e27e53ca156a0ef43c7e83341d3da6ce40fba28a0aa1a682d0915b0c73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Chemotherapy</topic><topic>Chest</topic><topic>Chi-square test</topic><topic>Communicable Diseases</topic><topic>Complications</topic><topic>Computed tomography</topic><topic>Diagnosis, Differential</topic><topic>Differential diagnosis</topic><topic>Enlargement</topic><topic>Hematologic Neoplasms - complications</topic><topic>Hematologic Neoplasms - diagnostic imaging</topic><topic>Hematology</topic><topic>Hematopoietic stem cells</topic><topic>Humans</topic><topic>Imaging</topic><topic>Immunocompromised hosts</topic><topic>Indicators</topic><topic>Infectious diseases</topic><topic>Infiltration</topic><topic>Lung</topic><topic>Lung diseases</topic><topic>Lung Injury - chemically induced</topic><topic>Lung Injury - diagnostic imaging</topic><topic>Lung Neoplasms</topic><topic>Lungs</topic><topic>Lymph nodes</topic><topic>Lymphatic system</topic><topic>Malignancy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nodules</topic><topic>Nuclear Medicine</topic><topic>Opacity</topic><topic>Original</topic><topic>Original Article</topic><topic>Radiology</topic><topic>Radiotherapy</topic><topic>Regression analysis</topic><topic>Retrospective Studies</topic><topic>Statistical analysis</topic><topic>Stem cell transplantation</topic><topic>Stem cells</topic><topic>Thickening</topic><topic>Tomography, X-Ray Computed - methods</topic><topic>Transplantation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tanaka, Nobuyuki</creatorcontrib><creatorcontrib>Kunihiro, Yoshie</creatorcontrib><creatorcontrib>Kawano, Reo</creatorcontrib><creatorcontrib>Yujiri, Toshiaki</creatorcontrib><creatorcontrib>Ueda, Kazuhiro</creatorcontrib><creatorcontrib>Gondo, Toshikazu</creatorcontrib><creatorcontrib>Kobayashi, Taiga</creatorcontrib><creatorcontrib>Matsumoto, Tsuneo</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection (ProQuest)</collection><collection>Natural Science Collection (ProQuest)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Japanese journal of radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tanaka, Nobuyuki</au><au>Kunihiro, Yoshie</au><au>Kawano, Reo</au><au>Yujiri, Toshiaki</au><au>Ueda, Kazuhiro</au><au>Gondo, Toshikazu</au><au>Kobayashi, Taiga</au><au>Matsumoto, Tsuneo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Differential diagnosis of infectious diseases, drug-induced lung injury, and pulmonary infiltration due to underlying malignancy in patients with hematological malignancy using HRCT</atitle><jtitle>Japanese journal of radiology</jtitle><stitle>Jpn J Radiol</stitle><addtitle>Jpn J Radiol</addtitle><date>2023-01-01</date><risdate>2023</risdate><volume>41</volume><issue>1</issue><spage>27</spage><epage>37</epage><pages>27-37</pages><issn>1867-1071</issn><eissn>1867-108X</eissn><abstract>Purpose
To differentiate among infectious diseases, drug-induced lung injury (DILI) and pulmonary infiltration due to underlying malignancy (PIUM) based on high-resolution computed tomographic (HRCT) findings from patients with hematological malignancies who underwent chemotherapy or hematopoietic stem cell transplantation.
Materials and methods
A total of 221 immunocompromised patients with hematological malignancies who had proven chest complications (141 patients with infectious diseases, 24 with DILI and 56 with PIUM) were included. Two chest radiologists evaluated the HRCT findings, including ground-glass opacity, consolidation, nodules, and thickening of bronchovascular bundles (BVBs) and interlobular septa (ILS). After comparing these CT findings among the three groups using the
χ
2
test, multiple logistic regression analyses (infectious vs noninfectious diseases, DILI vs non-DILI, and PIUM vs non-PIUM) were performed to detect useful indicators for differentiation.
Results
Significant differences were detected in many HRCT findings by the
χ
2
test. The results from the multiple logistic regression analyses identified several indicators: nodules without a perilymphatic distribution [
p
= 0.012, odds ratio (95% confidence interval): 4.464 (1.355–11.904)], nodules with a tree-in-bud pattern [
p
= 0.011, 8.364 (1.637–42.741)], and the absence of ILS thickening[
p
= 0.003, 3.621 (1.565–8.381)] for infectious diseases, the presence of ILS thickening [
p
= 0.001, 7.166 (2.343–21.915)] for DILI, and nodules with a perilymphatic distribution [
p
= 0.011, 4.256 (1.397–12.961)] and lymph node enlargement (
p
= 0.008, 3.420 (1.385–8.441)] for PIUM.
Conclusion
ILS thickening, nodules with a perilymphatic distribution, tree-in-bud pattern, and lymph node enlargement could be useful indicators for differentiating among infectious diseases, DILI, and PIUM in patients with hematological malignancies.</abstract><cop>Singapore</cop><pub>Springer Nature Singapore</pub><pmid>36083413</pmid><doi>10.1007/s11604-022-01328-4</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-6608-285X</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1867-1071 |
| ispartof | Japanese journal of radiology, 2023-01, Vol.41 (1), p.27-37 |
| issn | 1867-1071 1867-108X |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9813166 |
| source | MEDLINE; SpringerNature Journals |
| subjects | Chemotherapy Chest Chi-square test Communicable Diseases Complications Computed tomography Diagnosis, Differential Differential diagnosis Enlargement Hematologic Neoplasms - complications Hematologic Neoplasms - diagnostic imaging Hematology Hematopoietic stem cells Humans Imaging Immunocompromised hosts Indicators Infectious diseases Infiltration Lung Lung diseases Lung Injury - chemically induced Lung Injury - diagnostic imaging Lung Neoplasms Lungs Lymph nodes Lymphatic system Malignancy Medicine Medicine & Public Health Nodules Nuclear Medicine Opacity Original Original Article Radiology Radiotherapy Regression analysis Retrospective Studies Statistical analysis Stem cell transplantation Stem cells Thickening Tomography, X-Ray Computed - methods Transplantation |
| title | Differential diagnosis of infectious diseases, drug-induced lung injury, and pulmonary infiltration due to underlying malignancy in patients with hematological malignancy using HRCT |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-13T14%3A03%3A41IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Differential%20diagnosis%20of%20infectious%20diseases,%20drug-induced%20lung%20injury,%20and%20pulmonary%20infiltration%20due%20to%20underlying%20malignancy%20in%20patients%20with%20hematological%20malignancy%20using%20HRCT&rft.jtitle=Japanese%20journal%20of%20radiology&rft.au=Tanaka,%20Nobuyuki&rft.date=2023-01-01&rft.volume=41&rft.issue=1&rft.spage=27&rft.epage=37&rft.pages=27-37&rft.issn=1867-1071&rft.eissn=1867-108X&rft_id=info:doi/10.1007/s11604-022-01328-4&rft_dat=%3Cproquest_pubme%3E2712850588%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2890338551&rft_id=info:pmid/36083413&rfr_iscdi=true |