Lung Cancer Screening: Low-Dose Thoracic Computed Tomography Performed in a High-Risk Portuguese Population.

INTRODUCTION: The Urgeiriça mines were once the main uranium producer in Portugal. The aim of this study was to estimate the benefit of low-dose chest computed tomography (LDCT) for lung cancer screening in former miners that were considered as being at high-risk. METHODS: A subgroup of former miners of the Uranium National Company exposed to uranium and with a smoking load greater than 20 pack-years, agreed to perform a LDCT. The Fleischner Society Guidelines were used to classify the nodules and establish follow-up. RESULTS: Initially, 265 former employees of the Uranium National Company were included. The mean time of employment was 15 (0 - 45) years. The non-smokers represented 50.9% and 30.2% were ever smokers; the remaining chose not to respond. One diagnosis of lung cancer was initially made. In the second phase, a subgroup of 66 former miner underwent a LDCT, 37 of whom presented pulmonary nodules. Most computed tomography (CT) scans revealed one single nodule (n = 13) and the mean size was 5 (1 - 16) mm. A suspicious 16 mm spiculated nodule was evaluated with PET/CT, and percutaneous and surgical biopsies, ultimately revealing a benign lesion. CONCLUSION: The data highlights the importance of lung cancer screening in high-risk populations. This was, to the best of our knowledge, the first study performed in Portugal and can act as a bridge towards a wider implementation in the country.

Advanced hepatic vasculobiliary imaging segmentation and 3D reconstruction as an aid in the surgical management of high biliary stenosis.

BACKGROUND: Three-dimensional (3D) models are increasingly used to help surgeons, guiding them through the complex hepatic vasculobiliary anatomy. The biliary tract is a relatively untapped territory with only a few case reports described in medical literature. Our aim is to present an innovative 3D reconstruction methodology for biliary imaging and surgical planning, applied to a case of iatrogenic biliary stricture, with fusion of segmented CT and MRI images. CASE PRESENTATION: A selected case of Bismuth type III iatrogenic biliary stenosis for 3D planning. CT and MR studies were acquired with dedicated protocols for segmentation. Two radiologists performed segmentation and 3D model post-processing, fusing both imaging techniques to faithfully render the anatomical structures. Measurements of anatomical landmarks were taken in both the CT/MRI and the 3D model to assure its accuracy and differences in measurement were calculated. The 3D model replicates anatomical structures and pathology with high accuracy, with only 2.2% variation between STL, CT and MRI measurements. The model was discussed with the surgical team and used in the surgical planning, improving confidence in this delicate procedure, due to the detailed prior knowledge of the patient's anatomy. CONCLUSION: Three-dimensional reconstructions are a rapidly growing area of research with a significant impact in the personalized and precision medicine. The construction of 3D models that combine vascular and biliary anatomy, using different imaging techniques, respectively CT and MRI, will predictably contribute to a more rigorous planning of complex liver surgeries.

Schwannoma of the tongue-A common tumour in a rare location: A case report.

Schwannoma is a benign tumour that arises from Schwann cells of the peripheral nerve sheath, and is a common tumour of the head and neck. However, intraoral location is very uncommon (only 1% of all head and neck schwannomas). We report a rare case of lingual schwannoma in a 20-year-old male patient who presented with a small, slow-growing mass over the right lateral border of the tongue with 1 year of evolution and that became recently ulcerated. The patient underwent MRI examination and complete surgical excision. Histopathological and immunohistochemical examination confirmed the diagnosis.

Diffuse pulmonary ossification: A case report.

Diffuse pulmonary ossification (DPO) is a rarely diagnosed entity that may present with characteristic imaging features. It is listed in the differential diagnosis of lung parenchymal calcifications and should be considered by the radiologist if the appropriate findings are identified. We report a case of DPO secondary to mitral stenosis in a patient whose severe cardiac pathology lead to death few weeks after a chest CT was done. To date, there are no specific treatments with proved benefit in this pathology.

An unusual case of extensive peritoneal calcification: A case report.

The peritoneum is the largest serous membrane of the body and can be exposed to several injuries that may cause abnormal findings on imaging exams. Linear peritoneal calcification is remarkably rare, usually secondary to long duration peritoneal dialysis. We report an uncommon case of extensive peritoneal calcification in a 39-year-old female without long exposure to peritoneal dialysis solutions, in which peritoneal calcification could be linked to Alport syndrome and previous adverse reaction to intraperitoneal iodinated contrast. Radiologist should be aware of this and related imaging findings, know when to search for them as well as understand their clinical value.