Pitfalls in diagnosis of infiltrative lung disease by CT

Abstract

The diagnosis of interstitial lung disease may be challenging, especially in atypical disease. Various factors must be considered when performing and reading a chest CT examination for interstitial lung disease, because each of them may represent a source of misinterpretation. Firstly, technical aspects must be mastered, including acquisition and reconstruction parameters as well as post-processing. Secondly, mistakes in interpretation related to the inaccurate description of predominant features, potentially leading to false-positive findings, as well as satisfaction of search must be avoided. In all cases, clinical context, coexisting chest abnormalities and previous examinations must be integrated into the analysis to suggest the most appropriate differential diagnosis.

Effect of lateral decubitus acquisition in accuracy and lung severity estimation of chest computed tomography in children with suspected COVID-19

“…(11,12) In images acquired in the supine position, inadequate inspiration in uncooperative patients may result in artifacts that mimic ground-glass opacities (respiratory motion or atelectasis in dependent lung segments). (13) Lateral decubitus imaging can be used to distinguish between such respiratory artifacts and true ground-glass opacity. (11) Despite their potential to enhance the precision of lung lesion severity estimation, additional lateral chest CT image acquisitions did not increase the diagnostic accuracy for COVID-19 in this study.…”

“…There are two alternatives to overcome this issue: to sedate such patients and acquire images at the end of full inspiration or to acquire additional images in lateral decubitus. (11)(12)(13) Despite the countless publications on COVID-19, the impact of chest CT techniques on diagnostic accuracy, inter-rater agreement, lung lesion extension estimation and radiation exposure in children has seldom been discussed, if at all.…”