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The Clinical Role of Imaging in Lung Diseases
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The Clinical Role of Imaging in Lung Diseases

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Respiratory Medicine".

Deadline for manuscript submissions: 10 August 2025 | Viewed by 3116

Special Issue Editors

Dr. Isabelle Fitton

E-Mail Website
Guest Editor
Department of Radiology, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, 75015 Paris, France
Interests: medical imaging; test objects; segmentation; radiation; mammography; computed tomography; magnetic resonance imaging
Dr. Claire Van Ngoc Ty

E-Mail
Guest Editor
Department of Radiology, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, 75015 Paris, France
Interests: interventional radiology; computed tomography; medical imaging

Special Issue Information

Dear Colleagues,

The lungs are susceptible to a wide range of diseases. Three types of lung disease prevent the lung from working properly: airway diseases such as chronic obstructive pulmonary disease or bronchiectasis, tissue diseases such as pulmonary fibrosis, and circulation diseases such as pulmonary hypertension. Imaging plays an essential role in the detection and treatment of these diseases, providing both anatomical and functional information. Several modalities can be used to assess the lungs: computed tomography, magnetic resonance imaging, ultrasonography, nuclear medicine and radiography. The applications are many and varied and can be used, for example, in computed tomography from cancer screening to treatment planning in radiotherapy. Nuclear medicine is a useful tool for characterising nodules and providing metabolic activity data. Technological advances, ongoing research in radiogenomics and artificial intelligence will enable rapid advances in the management of lung disease.

In this Special Issue, we welcome authors to submit papers on the clinical advance of lung imaging in terms of both diagnosis and treatment. This Special Issue should contribute to our collective knowledge and ultimately benefit patients worldwide.

Dr. Isabelle Fitton
Dr. Claire Van Ngoc Ty
Guest Editors

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. Journal of Clinical Medicine 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

  • lung screening
  • lung cancer
  • acute respiratory distress
  • pulmonary embolism
  • chronic obstructive pulmonary disease
  • imaging

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Published Papers (3 papers)

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11 pages, 2515 KiB  
Article
18F-FDG PET/CT in the Preoperative Diagnostic and Staging of Lung Cancer and as a Predictor of Lymph Node Involvement
by Nathalie Viohl, Matthias Steinert, Martin Freesmeyer, Christian Kühnel and Robert Drescher
J. Clin. Med. 2025, 14(4), 1324; https://doi.org/10.3390/jcm14041324 - 17 Feb 2025
Viewed by 869
Abstract
Background/Objectives: The aim of this study was to evaluate the efficacy and accuracy of PET imaging and performance in defining the preoperative TNM classification, especially the intrathoracic lymph node staging, of patients with lung cancer. Methods: A retrospective, single-institution study of [...] Read more.
Background/Objectives: The aim of this study was to evaluate the efficacy and accuracy of PET imaging and performance in defining the preoperative TNM classification, especially the intrathoracic lymph node staging, of patients with lung cancer. Methods: A retrospective, single-institution study of consecutive patients with surgical therapy of lung cancer that were undergoing preoperative PET/CT scanning at the same center was conducted. A total of 104 patients were included. All patients underwent surgical evaluation with mediastinal and hilar lymph node sampling. Five patients with preoperative suspicion of N3 nodal status who were only tested for N2 were excluded from the observations and analyses of nodal status. Results: PET/CT staged the nodal status correctly in 85 out of 99 patients (85.9%); overstaging occurred in 7 patients (7.1%) and understaging in 7 patients (7.1%). The overall prevalence of lymph node metastases was 42.3%. When preoperative T classification was compared with postoperative histopathological T classification, 75% patients were correctly staged, 13.5% were overstaged, and 11.5% were understaged by PET/CT. In univariate analysis, lymph node involvement was significantly associated (p < 0.05) with the following primary tumor characteristics: increasing diameter (>35 mm), a maximum standardized uptake value > 9.5, and higher grading. The tumor diameter and the degree of differentiation were found to be factors influencing the SUVmax of the primary tumor as well. Conclusions: Our data show that integrated PET/CT provides high accuracy in the intrathoracic nodal staging and tumor expansion of lung cancer patients and emphasizes the continued need for surgical staging. Full article
(This article belongs to the Special Issue The Clinical Role of Imaging in Lung Diseases)
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12 pages, 774 KiB  
Article
A Proposal for a Process from as Low as Reasonably Achievable to an Ultra-Low-Level Goal in Chest Computed Tomography
by Isabelle Fitton, Etienne Charpentier, Emina Arsovic, Jennifer Isaia, Manon Guillou, Aurélien Saltel-Fulero, Laure Fournier and Claire Van Ngoc Ty
J. Clin. Med. 2024, 13(16), 4597; https://doi.org/10.3390/jcm13164597 - 6 Aug 2024
Cited by 1 | Viewed by 1191
Abstract
Background/Objectives: To define and evaluate a radiation dose optimization process for chest computed tomography (CT) imaging. Methods: Data from unenhanced and enhanced chest CT acquisitions performed between June 2018 and January 2020 in adult patients were included in the study. Images were acquired [...] Read more.
Background/Objectives: To define and evaluate a radiation dose optimization process for chest computed tomography (CT) imaging. Methods: Data from unenhanced and enhanced chest CT acquisitions performed between June 2018 and January 2020 in adult patients were included in the study. Images were acquired on a Siemens SOMATOM® Definition Edge CT. Dose values, including Dose.Length Product (DLP) and Volume CT Dose Index (CTDIvol), were collected. Low doses (LDs, 25th percentiles), achievable doses (ADs, 50th percentiles), and diagnostic reference levels (DRLs, 75th percentiles) were calculated before and after parameter modifications. A process was defined and applied to patient data. For unenhanced chest CT, data were differentiated according to three groups: high dose (HD), optimized dose (OD), and ultra-low dose (ULD). Dosimetric changes between protocols were expressed as mean CTDIvol % (CI95%). A Mann and Whitney statistical test was used. The diagnostic quality score (DQS) of a subset of 70 randomly selected CT examinations was evaluated by one radiologist. The DQS was scored according to a three-point Likert scale: (1) poor (definite diagnosis impossible), (2) fair (evaluation of major findings possible), and (3) excellent (exact diagnosis possible). Results: Data were collected from 1929 patients. For unenhanced chest CT protocols, only one process loop was run. A dose comparison between the chest CT protocol before the use of the process and the three groups showed a decrease of −38.3% (9.7%) and −93.4% (24.2%) for OD and ULD, respectively, and an increase of +29.4% (4.7%) for HD. For the enhanced chest CT protocol, two optimization loops were performed, and they resulted in a mean dose reduction of −50.0% (2.6%) compared to the pre-optimization protocol. For all protocols, the DQS was greater than or equal to 2. Conclusions: We proposed a radiation dose optimization process for chest CT that could significantly reduce the dose without compromising diagnosis. Full article
(This article belongs to the Special Issue The Clinical Role of Imaging in Lung Diseases)
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Other

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10 pages, 2507 KiB  
Case Report
On the Use of 4D-PET/CT for the Safe SBRT Re-Irradiation of Central Lung Recurrence Within Radiation-Induced Fibrosis: A Clinical Case
by Paul Retif, Emilie Verrecchia-Ramos, Motchy Saleh, Abdourahamane Djibo Sidikou, Romain Letellier, Anwar Al Salah, Estelle Pfletschinger, Fabian Taesch, Sinan Ben-Mahmoud and Xavier Michel
J. Clin. Med. 2025, 14(12), 4015; https://doi.org/10.3390/jcm14124015 - 6 Jun 2025
Viewed by 377
Abstract
Background: The re-irradiation of centrally located lung tumors poses substantial risks due to prior dose exposure and proximity to critical structures. Accurate target delineation is crucial to minimize toxicity and ensure tumor coverage. Four-dimensional positron emission tomography/computed tomography (4D-PET/CT) integrates respiratory motion and [...] Read more.
Background: The re-irradiation of centrally located lung tumors poses substantial risks due to prior dose exposure and proximity to critical structures. Accurate target delineation is crucial to minimize toxicity and ensure tumor coverage. Four-dimensional positron emission tomography/computed tomography (4D-PET/CT) integrates respiratory motion and metabolic data, offering improved delineation over static imaging. Its clinical utility in re-irradiation remains under-reported. Methods: A 67-year-old male presented with the central recurrence of squamous cell carcinoma in the right upper lobe, embedded in radiation-induced fibrosis, following prior chemoradiotherapy. Delineation using static PET underestimated tumor motion. A 4D-PET/CT-guided Stereotactic Body Radiation Therapy (SBRT) plan was developed with a prescription of 60 Gy in eight fractions. A comparative plan using static PET was generated to assess the dosimetric differences. Results: The internal target volume (ITV) from 4D-PET/CT was nearly double the size of the GTV from static PET, with a 5.1 mm discrepancy in the craniocaudal axis. The 4D-PET-based plan achieved 95.0% PTV coverage, while the static PET-based plan covered only 61.7%, illustrating the risk of underdosage without motion-resolved imaging. The patient completed the treatment without acute or late toxicity and showed a sustained metabolic response at one year (SUVmax from 13.4 to 5.8). Conclusions: This case demonstrates the clinical value of 4D-PET/CT in the SBRT re-irradiation of centrally located lung tumors, particularly in fibrotic regions where anatomical imaging is insufficient. It enabled accurate delineation, improved dosimetric coverage, and safe, effective retreatment. These findings support its integration into planning for complex thoracic re-irradiation. Full article
(This article belongs to the Special Issue The Clinical Role of Imaging in Lung Diseases)
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