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Master's Dissertation
DOI
https://doi.org/10.11606/D.17.2020.tde-12022020-173217
Document
Author
Full name
Camila Vilas Boas Machado
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2019
Supervisor
Committee
Santos, Marcel Koenigkam (President)
Cetlin, Andrea de Cassia Vernier Antunes
Menezes, Marcelo Bezerra de
Title in Portuguese
Atualização do banco de imagens de nódulos pulmonares e análise das características tomográficas dos nódulos representando neoplasia pulmonar em pacientes com outra neoplasia conhecida
Keywords in Portuguese
Metástases
Neoplasia pulmonar
Nódulo pulmonar
Tomografia computadorizada
Abstract in Portuguese
Objetivamos neste trabalho, primeiramente, atualizar o banco de imagens de nódulos pulmonares do Centro de Ciências das Imagens e Física Médica (CCIFM) e, posteriormente, descrever as características tomográficas dos nódulos que representam neoplasia pulmonar primária, identificados em exames de pacientes com outra neoplasia primária extrapulmonar em avaliação. Após a atualização e revisão do banco de nódulos, foram selecionados os casos consecutivos de neoplasia pulmonar diagnosticados em pacientes com outra neoplasia conhecida em avaliação clínica (estadiamento ou seguimento). As imagens de tomografia computadorizada (TC) dos casos identificados nos últimos 5 anos foram avaliadas retrospectivamente por dois radiologistas com experiência em imagem torácica, com o objetivo de descrever as características das lesões pulmonares quanto à posição, número, forma, margens, realce pós-contraste, presença de broncogramas aéreos, angiogramas, cavidades, invasão brônquica e "tags" pleurais, assim como a associação com enfisema radiológico e exposição a outros fatores de risco clínicos. As características tomográficas mais prevalentes foram: lesão periférica, sólida, redonda/oval, com contornos espiculados ou lobulados, realce homogêneo pós-contraste, associada a presença de "tag" pleural. Enfisema pulmonar estava presente na maioria dos exames (52%). Em apenas 12% foi observada a apresentação mais típica do câncer pulmonar, ou seja, paciente com antecedente de tabagismo, enfisema pulmonar e nódulo espiculado no lobo superior. Além da apresentação típica, outras características morfológicas de maior especificidade têm sido descritas na literatura médica para reconhecimento das neoplasias pulmonares, especialmente para os adenocarcinomas. Desta maneira, neste trabalho foram revisadas estas características tomográficas em uma série de casos diagnosticados em nossa instituição, reforçando que, apesar de todos os avanços recentes na análise funcional e quantitativa por imagem das neoplasias pulmonares, a análise morfológica ainda é importante para o diagnóstico e adequado manejo destes pacientes.
Title in English
Database of lung nodules update and analysis of the tomographic characteristics of pulmonary nodules representing new primary lung cancer in patients with known malignancy
Keywords in English
Computed tomography
Lung cancer
Metastases
Pulmonary nodule
Abstract in English
Firstly, the aim of this study was to update the pulmonary nodule image bank of the Center for Imaging Sciences and Medical Physics (CCIFM) and, later, to describe the tomographic characteristics of the nodules that represent primary lung cancer, identified in examinations of patients with another extrapulmonary cancer in evaluation. After updating and reviewing the nodule bank, consecutive cases of pulmonary neoplasia diagnosed in patients with another known neoplasia in clinical evaluation (staging or follow-up) were selected. Computed tomography (CT) images of the cases identified in the last 5 years were retrospectively evaluated by two radiologists with chest imaging experience, with the objective of describing the characteristics of the lung lesions in terms of position, number, shape, margins, and postcontrast enhancement, presence of air bronchograms, angiograms, cavities, bronchial invasion and pleural tags, as well as association with radiological emphysema and exposure to other clinical risk factors. The most prevalent tomographic characteristics were: peripheral, solid, round / oval lesion with spiculated or lobulated contours, homogeneous post-contrast enhancement, associated with the presence of pleural tag. Pulmonary emphysema was present in most examinations (52%). Only 12% had the most typical presentation of lung cancer, that is, a patient with a history of smoking, pulmonary emphysema and spiculated nodule in the upper lobe. In addition to the typical presentation, other morphological features of greater specificity have been described in the medical literature to recognize pulmonary neoplasms, especially for adenocarcinomas. Thus, in this work, these tomographic characteristics were reviewed in a series of cases diagnosed at our institution, reinforcing that, despite all recent advances in functional and quantitative imaging analysis of lung neoplasms, morphological analysis is still important for the diagnosis and proper management of these patients.
 
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Publishing Date
2020-04-29
 
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