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1.
Sci Rep ; 10(1): 21774, 2020 12 11.
Artigo em Inglês | MEDLINE | ID: mdl-33311596

RESUMO

Tuberculosis (TB) preclinical testing relies on in vivo models including the mouse aerosol challenge model. The only method of determining colony morphometrics of TB infection in a tissue in situ is two-dimensional (2D) histopathology. 2D measurements consider heterogeneity within a single observable section but not above and below, which could contain critical information. Here we describe a novel approach, using optical clearing and a novel staining procedure with confocal microscopy and mesoscopy, for three-dimensional (3D) measurement of TB infection within lesions at sub-cellular resolution over a large field of view. We show TB morphometrics can be determined within lesion pathology, and differences in infection with different strains of Mycobacterium tuberculosis. Mesoscopy combined with the novel CUBIC Acid-Fast (CAF) staining procedure enables a quantitative approach to measure TB infection and allows 3D analysis of infection, providing a framework which could be used in the analysis of TB infection in situ.


Assuntos
Microscopia/métodos , Coloração e Rotulagem/métodos , Tuberculose/diagnóstico por imagem , Animais , Modelos Animais de Doenças , Humanos , Camundongos , Mycobacterium tuberculosis/isolamento & purificação , Tuberculose/microbiologia , Tuberculose/patologia
2.
PLoS Biol ; 18(12): e3000879, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33382684

RESUMO

Correlative light, electron, and ion microscopy (CLEIM) offers huge potential to track the intracellular fate of antibiotics, with organelle-level resolution. However, a correlative approach that enables subcellular antibiotic visualisation in pathogen-infected tissue is lacking. Here, we developed correlative light, electron, and ion microscopy in tissue (CLEIMiT) and used it to identify the cell type-specific accumulation of an antibiotic in lung lesions of mice infected with Mycobacterium tuberculosis. Using CLEIMiT, we found that the anti-tuberculosis (TB) drug bedaquiline (BDQ) is localised not only in foamy macrophages in the lungs during infection but also accumulate in polymorphonuclear (PMN) cells.


Assuntos
Pulmão/diagnóstico por imagem , Microscopia/métodos , Tuberculose/diagnóstico por imagem , Animais , Antituberculosos , Diarilquinolinas/metabolismo , Diarilquinolinas/farmacologia , Feminino , Pulmão/citologia , Pulmão/microbiologia , Masculino , Camundongos , Camundongos Endogâmicos C3H , Testes de Sensibilidade Microbiana , Microscopia Eletrônica/métodos , Mycobacterium tuberculosis/patogenicidade
4.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1552-1555, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018288

RESUMO

The introduction of deep learning techniques for the computer-aided detection scheme has shed a light for real incorporation into the clinical workflow. In this work, we focus on the effect of attention in deep neural networks on the classification of tuberculosis x-ray images. We propose a Convolutional Block Attention Module (CBAM), a simple but effective attention module for feed-forward convolutional neural networks. Given an intermediate feature map, our module infers attention maps and multiplied it to the input feature map for adaptive feature refinement. It achieves high precision and recalls while localizing objects with its attention. We validate the performance of our approach on a standard-compliant data set, including a dataset of 4990 x-ray chest radiographs from three hospitals and show that our performance is better than the models used in previous work.


Assuntos
Redes Neurais de Computação , Radiografia Torácica , Tuberculose , Humanos , Tuberculose/diagnóstico por imagem
5.
Rev. inf. cient ; 99(5): 425-434, tab
Artigo em Espanhol | LILACS | ID: biblio-1139204

RESUMO

RESUMEN Introducción: La tuberculosis extrapulmonar muestra una complejidad diagnóstica que influye sobre la morbilidad y mortalidad. Objetivo: Caracterizar desde una perspectiva clínico-imagenológica a los pacientes diagnosticados con tuberculosis extrapulmonar, en el Hospital Neumológico Benéfico Jurídico de La Habana, en el período 2016-2019. Método: Se realizó un estudio descriptivo, retrospectivo y transversal en 34 pacientes con diagnóstico de tuberculosis extrapulmonar. Las variables medidas fueron: edad, sexo, factores de riesgo para padecer la enfermedad, síntomas y signos clínicos, hallazgos radiológicos, métodos diagnósticos utilizados y su localización. Resultados: Predominaron pacientes del sexo masculino con edad entre 26 a 35 años (29,4 %). El 73,5 % de los pacientes presentó factores de riesgos para esta enfermedad, los más frecuentes fueron: ser contactos de pacientes con tuberculosis (29,4 %), los exreclusos (17,6 %) y los alcohólicos (14,7 %). El 58,8 % presentó fiebre y síntomas o signos generales como anorexia (44,1 %), pérdida de peso (41,2 %) y astenia (38,2 %). El hallazgo radiológico más común fue el derrame pleural (47 %) y la forma extrapulmonar más frecuente dada por 15 casos (44,1 %) fue la pleuritis tuberculosa. El método clínico-radiológico posibilitó el diagnóstico en el 50 % de los pacientes. Conclusiones: Las manifestaciones clínicas más evidentes fueron la fiebre, la pérdida de peso y la astenia. El método diagnóstico clínico-radiológico es el más utilizado y el hallazgo radiológico más reportado es el derrame pleural. La localización pleural es la forma extrapulmonar más frecuente.


ABSTRACT Introduction: Extrapulmonary tuberculosis shows a complexity that can influence in its morbidity and mortality rates. Objective: To characterize the patients with extrapulmonary tuberculosis from a clinical-imaging perspective in the Hospital Neumológico Benéfico Jurídico in Havana in the period 2016-2019. Method: A descriptive, retrospective and cross-sectional study was carried out in 34 patients with the diagnosis of extrapulmonary tuberculosis. The variables taken into account were: age, gender, risk factors for the disease, symptoms and clinical signs, radiological findings, diagnosis methods used, and location. Results: Male patients with ages ranging between 26 to 35 years predominated in the study (29.4%). 73.5% of the patients presented risk factors of the disease, being most common: contact of previous tuberculosis patients (29.4%), ex-inmates (17.6%) and alcoholics (14.7%). 58.8% of the patients presented fever and general symptoms like anorexia (44.1%), weight loss (41.2%) and asthenia (38.2%). The most common radiological finding was pleural effusion (47%), and the most frequent extrapulomary form of the disease was tuberculous pleurisy (15 cases representing a 44.1%). The clinical-radiological method made diagnose possible in 50% of the patients. Conclusions: The most common clinical manifestations were fever, weight loss and asthenia. The clinical-radiological method is the most frequently used, and the most frequent radiological finding was the pleural effusion. Pleural location was the most common extrapulmonary form of tuberculosis.


Assuntos
Tuberculose/diagnóstico por imagem , Tuberculose Pleural/diagnóstico por imagem , Epidemiologia Descritiva , Estudos Retrospectivos
6.
Clin Nucl Med ; 45(11): 865-867, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32969904

RESUMO

Extrapulmonary tuberculosis (TB) is difficult to diagnose. Here, we report a case of extrapulmonary TB in a 68-year-old woman presented with mental fatigue, poor appetite, and weight loss. F-FDG PET/CT revealed elevated F-FDG uptake in the left inferior cervical, left supraclavicular, mediastinal, and splenic hilum lymph nodes and spleen, which were suspected of malignant tumor. To further differentiate benign and malignant diseases, Ga-FAPI PET/CT was performed. Ga-FAPI PET/CT also showed intense Ga-FAPI uptake in the previously mentioned FDG-avid lesions. However, biopsy of the left supraclavicular lymph node demonstrated the presence of TB.


Assuntos
Fluordesoxiglucose F18 , Neoplasias/diagnóstico por imagem , Neoplasias/patologia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Quinolinas , Tuberculose/diagnóstico por imagem , Idoso , Diagnóstico Diferencial , Feminino , Humanos
7.
J Infect Dev Ctries ; 14(7): 721-725, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32794460

RESUMO

INTRODUCTION: The novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the coronavirus disease 2019 (COVID-19). First COVID-19 case was detected in March, 10, 2020 in Turkey and as of May, 18, 2020 148,067 cases have been identified and 4096 citizens have died. Tuberculosis (TB) is a worldwide public health concern, incidence of tuberculosis (per 100,000 people) in Turkey was reported at 14, 1 in 2018. During pandemic COVID-19 was the main concern in every clinic and as we discuss here overlapping respiratory diseases may result in delaying of the diagnosis and treatment. METHODOLOGY: There were 4605 respiratory samples examined between March 23 and May 18 for COVID-19 and 185 samples for Mycobacterium tuberculosis in our laboratory. The Xpert Ultra assay was performed for the diagnosis of pulmonary tuberculosis; SARS-CoV-2 RNA was determined by real-time PCR (RT-PCR) analysis in combined nasopharyngeal and deep oropharyngeal swabs of suspected cases of COVID-19. RESULTS: Both of SARS-CoV-2 and M. tuberculosis tests were requested on the clinical and radiological grounds in 30 patients. Here we discussed 2 patients who were both COVID-19 and TB positive. One patient already diagnosed with tuberculosis become COVID-19 positive during hospitalization and another patient suspected and treated for COVID-19 received the final diagnosis of pulmonary TB and Human Immunodeficiency Virus infection. CONCLUSIONS: We want to emphasize that while considering COVID-19 primarily during these pandemic days, we should not forget one of the "great imitators", tuberculosis within differential diagnoses.


Assuntos
Betacoronavirus , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Tuberculose/diagnóstico , Adulto , Idoso , Betacoronavirus/genética , Técnicas de Laboratório Clínico , Coinfecção , Infecções por Coronavirus/complicações , Feminino , Humanos , Masculino , Pandemias , Pneumonia Viral/complicações , Reação em Cadeia da Polimerase em Tempo Real , Tomografia Computadorizada por Raios X , Tuberculose/complicações , Tuberculose/diagnóstico por imagem
8.
Praxis (Bern 1994) ; 109(8): 608-614, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32517593

RESUMO

In resource limited settings with limited tests and diagnostic tools, most of diagnoses are based on clinical findings, and patients are managed empirically, e.g. with anti-tuberculosis drugs. This article aims at describing the use of point-of-care ultrasound in diagnosing the most important conditions in Africa, in addition to clinical work-up. Different protocols exist for the diagnosis of trauma-related disorders, tuberculosis, schistosomiasis, thromboembolism, causes of dyspnea, and non- traumatic shock. Point-of-care ultrasound might be a beneficial tool in Africa, aiding diagnostics and management of patients with these conditions. However, studies must be done to assess the impact of point-of-care ultrasound on mortality.


Assuntos
Sistemas Automatizados de Assistência Junto ao Leito , Ultrassonografia , África , Dispneia/diagnóstico por imagem , Humanos , Tuberculose/diagnóstico por imagem
9.
BMC Infect Dis ; 20(1): 349, 2020 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-32414338

RESUMO

BACKGROUND: Patients with clinically suspected tuberculosis are often treated empirically, as diagnosis - especially of extrapulmonary tuberculosis - remains challenging. This leads to an overtreatment of tuberculosis and to underdiagnosis of possible differential diagnoses. METHODS: This open-label, parallel-group, superiority randomized controlled trial is done in a rural and an urban center in Tanzania. HIV-positive and -negative adults (≥18 years) with clinically suspected extrapulmonary tuberculosis are randomized in a 1:1 ratio to an intervention- or control group, stratified by center and HIV status. The intervention consists of a management algorithm including extended focused assessment of sonography for HIV and tuberculosis (eFASH) in combination with chest X-ray and microbiological tests. Treatment with anti-tuberculosis drugs is started, if eFASH is positive, chest X-ray suggests tuberculosis, or a microbiological result is positive for tuberculosis. Patients in the control group are managed according national guidelines. Treatment is started if microbiology is positive or empirically according to the treating physician. The primary outcome is the proportion of correctly managed patients at 6 months (i.e patients who were treated with anti-tuberculosis treatment and had definite or probable tuberculosis, and patients who were not treated with anti-tuberculosis treatment and did not have tuberculosis). Secondary outcomes are the proportion of symptom-free patients at two and 6 months, and time to death. The sample size is 650 patients. DISCUSSION: This study will determine, whether ultrasound in combination with other tests can increase the proportion of correctly managed patients with clinically suspected extrapulmonary tuberculosis, thus reducing overtreatment with anti-tuberculosis drugs. TRIAL REGISTRATION: PACTR, Registration number: PACTR201712002829221, registered December 1st 2017.


Assuntos
Tuberculose/diagnóstico por imagem , Ultrassonografia/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Tanzânia
10.
Clin Nucl Med ; 45(7): e323-e324, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32433172

RESUMO

We report the case of a 64-year-old man who presented with back pain, anorexia, and weight loss 9 months following bacillus Calmette-Guérin immunotherapy for high-grade transitional cell carcinoma of the bladder. A FDG PET/CT was performed, which demonstrated osteolysis and intense FDG avidity of the T6/T7 and T8/T9 vertebral endplates. In addition, an aneurysm with FDG-avid soft tissue was present of the distal left common iliac artery. The provisional diagnosis was disseminated bacillus Calmette-Guérin infection, resulting in spondylodiscitis and a mycotic aneurysm. A CT-guided vertebral biopsy confirmed the presence of Mycobacterium tuberculosis DNA on polymerase chain reaction testing.


Assuntos
Vacina BCG/efeitos adversos , Fluordesoxiglucose F18 , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Tuberculose/diagnóstico por imagem , Administração Intravesical , Vacina BCG/administração & dosagem , Vacina BCG/uso terapêutico , Carcinoma de Células de Transição/imunologia , Carcinoma de Células de Transição/terapia , Humanos , Imunoterapia/efeitos adversos , Masculino , Pessoa de Meia-Idade , Tuberculose/complicações , Neoplasias da Bexiga Urinária/imunologia , Neoplasias da Bexiga Urinária/terapia
12.
PLoS One ; 15(4): e0231372, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32324750

RESUMO

BACKGROUND: Rwanda conducted a national tuberculosis (TB) prevalence survey to determine the magnitude of TB in the country and determine to what extent the national surveillance system captures all TB cases. In addition we measured the patient diagnostic rate, comparing the measured TB burden data with the routine surveillance data to gain insight into how well key population groups are being detected. METHODS: A national representative nationwide cross-sectional survey was conducted in 73 clusters in 2012 whereby all enrolled participants (residents aged 15 years and above) were systematically screened for TB by symptoms and chest X-ray (CXR). Those with either clinical symptoms (cough of any duration) and/or CXR abnormalities suggestive of TB disease were requested to provide two sputum samples (one spot and one morning) for smear examination and solid culture. RESULTS: Of the 45,058 eligible participants, 43,779 were enrolled in the survey. Participation rate was high at 95.7% with 99.8% of participants undergoing both screening procedures and 99.0% of those eligible for sputum examination submitting at least one sputum sample. Forty cases of prevalent mycobacterium tuberculosis (MTB) and 16 mycobacteria other than tuberculosis (MOTT) cases were detected during the survey. Chest x-ray as screening tool had 3 and 5 times greater predictive odds for smear positive and bacteriological confirmed TB than symptom screening alone respectively. A TB prevalence of 74.1 (95% CI 48.3-99.3) per 100,000 adult population for smear positive TB and 119.3 (95% CI 78.8-159.9) per 100,000 adult population for bacteriological confirmed MTB was estimated for Rwanda. CONCLUSIONS: The survey findings indicated a lower TB prevalence than previously estimated by WHO providing key lessons for national TB control, calling for more sensitive screening and diagnostic tools and a focus on key populations. Use of chest x-ray as screening tool was introduced to improve the diagnostic yield of TB.


Assuntos
Tuberculose/diagnóstico , Adolescente , Adulto , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Mycobacterium/isolamento & purificação , Mycobacterium tuberculosis/isolamento & purificação , Prevalência , Ruanda/epidemiologia , Escarro/microbiologia , Tuberculose/diagnóstico por imagem , Tuberculose/epidemiologia , Adulto Jovem
14.
Int J Infect Dis ; 92S: S85-S90, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32114199

RESUMO

Tuberculosis (TB) is one of the leading causes of death worldwide. Although the disease is curable and preventable, it is underdiagnosed in many parts of the world. Positron emission tomography (PET) imaging using 18 F-FDG in TB can localise disease sites and the extent of disease. 18F-FDG accumulates in the immune cells that participate in inflammation and granuloma formation, such as activated macrophages and lymphocytes. Therefore, FDG PET/CT scanning is now being evaluated for its usefulness in the diagnosis of extrapulmonary TB and in monitoring the response to treatment. FDG PET/CT imaging is positive and has high sensitivity in active TB, complementing conventional radiological imaging (X-ray, computed tomography, magnetic resonance imaging) in the diagnosis of primary pulmonary, extrapulmonary, and post-primary or miliary TB. FDG PET/CT has low specificity when it is used for solitary pulmonary nodule characterization, and its ability to differentiate TB from malignancy is limited in this setting. Dual point imaging has been proposed as a way to overcome this limitation. FDG PET/CT can reliably differentiate active from inactive disease, and there is promising evidence that it can contribute to the assessment of the response to treatment with an impact on patient management. FDG PET/CT has been found positive in cases of latent TB infection and its ability to identify activation early is currently being explored. More studies are needed to establish the utility of this method in recognizing multidrug-resistant TB cases. Furthermore, other PET radiotracers might prove useful in the functional imaging of TB infection in the future.


Assuntos
Fluordesoxiglucose F18 , Tuberculose Latente/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Tuberculose/diagnóstico por imagem , Adulto , Feminino , Humanos , Masculino
15.
Clin Nucl Med ; 45(4): 276-282, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32108701

RESUMO

PURPOSE OF THE REPORT: Tuberculosis (TB) is a major health problem. Activated macrophages in TB lesions show high metabolic activity and can be assessed using F-FDG PET/CT. This retroprospective study was done to evaluate the utility of F-FDG PET/CT in initial assessment and therapeutic response in patients with TB. MATERIALS AND METHODS: Eighty-seven patients (male-to-female ratio, 46:41) diagnosed with pulmonary TB and extrapulmonary TB underwent whole-body F-FDG PET/CT for initial assessment and a follow-up scan 3 to 4 months after initiation of antitubercular therapy (ATT). Visual and semiquantitative (SUVmax) analyses were used for scan assessment. Treatment responses on interim scans were categorized as complete metabolic response (CMR), favorable response to therapy (FRT), stable disease (SD), and disease progression (DP). CMR, FRT, and SD cases were considered as responders and DP cases as nonresponders. Treatment response was correlated with clinical outcome (mortality) and ATT duration. RESULTS: Baseline F-FDG PET/CT scans were positive in all the patients and detected additional disease sites than suspected clinically in 72% patients. On interim PET/CT, 13 patients showed CMR, 43 showed FRT, 8 showed SD, and 23 showed DP. A longer duration of ATT was seen in nonresponders (P ≤ 0.001) than responders. During follow-up, 9/87 patients died, out of which 8 patients were of DP group and 1 patient belonged to SD. Nonresponders showed 35% mortality compared with 1.6% in the responder group (P ≤ 0.001). CONCLUSIONS: F-FDG PET/CT is a valuable imaging modality for disease mapping and assessing therapeutic response. Treatment response in the interim PET/CT done at 3 to 4 months predicted the duration of ATT and clinical outcome of the patients.


Assuntos
Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/normas , Tuberculose/diagnóstico por imagem , Adulto , Idoso , Feminino , Fluordesoxiglucose F18 , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos , Resultado do Tratamento , Tuberculose/terapia
16.
Clin Nucl Med ; 45(3): 238-240, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31977467

RESUMO

A 71-year-old man with a history of high-risk prostate adenocarcinoma (Gleason score 4 + 5 = 9) treated with brachytherapy in 2016 was referred for a Ga-prostate-specific membrane antigen (PSMA)-HBED-CC PET/CT scan for suspected cancer recurrence on a background of slowly rising serum prostate-specific antigen (0.95 ng/mL; reference, <0.2 ng/mL). This revealed PSMA-avid dura-based hyperdense lesions in the brain, suggestive of cerebral metastases. Biopsy demonstrated the presence of acid-fast bacilli, and with further clinical and microbiological testing, a diagnosis of PSMA-avid cerebral tuberculous mycobacterium infection was made.


Assuntos
Glicoproteínas de Membrana/metabolismo , Compostos Organometálicos/metabolismo , Tuberculose/diagnóstico por imagem , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/radioterapia , Idoso , Transporte Biológico , Braquiterapia , Humanos , Masculino , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/radioterapia , Recidiva
17.
PLoS One ; 15(1): e0224445, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31978149

RESUMO

Availability of trained radiologists for fast processing of CXRs in regions burdened with tuberculosis always has been a challenge, affecting both timely diagnosis and patient monitoring. The paucity of annotated images of lungs of TB patients hampers attempts to apply data-oriented algorithms for research and clinical practices. The TB Portals Program database (TBPP, https://TBPortals.niaid.nih.gov) is a global collaboration curating a large collection of the most dangerous, hard-to-cure drug-resistant tuberculosis (DR-TB) patient cases. TBPP, with 1,179 (83%) DR-TB patient cases, is a unique collection that is well positioned as a testing ground for deep learning classifiers. As of January 2019, the TBPP database contains 1,538 CXRs, of which 346 (22.5%) are annotated by a radiologist and 104 (6.7%) by a pulmonologist-leaving 1,088 (70.7%) CXRs without annotations. The Qure.ai qXR artificial intelligence automated CXR interpretation tool, was blind-tested on the 346 radiologist-annotated CXRs from the TBPP database. Qure.ai qXR CXR predictions for cavity, nodule, pleural effusion, hilar lymphadenopathy was successfully matching human expert annotations. In addition, we tested the 12 Qure.ai classifiers to find whether they correlate with treatment success (information provided by treating physicians). Ten descriptors were found as significant: abnormal CXR (p = 0.0005), pleural effusion (p = 0.048), nodule (p = 0.0004), hilar lymphadenopathy (p = 0.0038), cavity (p = 0.0002), opacity (p = 0.0006), atelectasis (p = 0.0074), consolidation (p = 0.0004), indicator of TB disease (p = < .0001), and fibrosis (p = < .0001). We conclude that applying fully automated Qure.ai CXR analysis tool is useful for fast, accurate, uniform, large-scale CXR annotation assistance, as it performed well even for DR-TB cases that were not used for initial training. Testing artificial intelligence algorithms (encapsulating both machine learning and deep learning classifiers) on diverse data collections, such as TBPP, is critically important toward progressing to clinically adopted automatic assistants for medical data analysis.


Assuntos
Tuberculose Extensivamente Resistente a Medicamentos/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Derrame Pleural/diagnóstico por imagem , Tuberculose/diagnóstico por imagem , Algoritmos , Inteligência Artificial , Gerenciamento de Dados , Bases de Dados Factuais , Aprendizado Profundo , Tuberculose Extensivamente Resistente a Medicamentos/diagnóstico , Tuberculose Extensivamente Resistente a Medicamentos/fisiopatologia , Feminino , Humanos , Pulmão/fisiopatologia , Masculino , Derrame Pleural/diagnóstico , Derrame Pleural/fisiopatologia , Radiografia Torácica/métodos , Radiologistas , Tuberculose/diagnóstico , Tuberculose/fisiopatologia
18.
J Bras Pneumol ; 46(2): e20190024, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31859704

RESUMO

OBJECTIVE: To determine the CT findings of multiple cavitary lung lesions that allow the differentiation between benign and malignant etiologies. METHODS: We reviewed CT scans, including patients with two or more cavitary lung lesions. We evaluated the number of cavitary lesions, their location, cavity wall thickness, and additional findings, correlating the variables with the diagnosis of a benign or malignant lesion. RESULTS: We reviewed the chest CT scans of 102 patients, 58 (56.9%) of whom were male. The average age was 50.5 ± 18.0 years. Benign and malignant lesions were diagnosed in 74 (72.6%) and 28 (27.4%) of the patients, respectively. On the CT scans, the mean number of cavities was 3, the mean wall thickness of the largest lesions was 6.0 mm, and the mean diameter of the largest lesions was 27.0 mm. The lesions were predominantly in the upper lobes, especially on the right (in 43.1%). In our comparison of the variables studied, a diagnosis of malignancy was not found to correlate significantly with the wall thickness of the largest cavity, lymph node enlargement, emphysema, consolidation, bronchiectasis, or bronchial obstruction. The presence of centrilobular nodules correlated significantly with the absence of malignant disease (p < 0.05). In contrast, a greater number of cavities correlated significantly with malignancy (p < 0.026). CONCLUSIONS: A larger number of cavitary lung lesions and the absence of centrilobular nodules may be characteristic of a malignant etiology. However, on the basis of our evaluation of the lesions in our sample, we cannot state that wall thickness is a good indicator of a benign or malignant etiology.


Assuntos
Pneumopatias/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Estudos Transversais , Diagnóstico Diferencial , Feminino , Humanos , Tolerância Imunológica , Pneumopatias/etiologia , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tuberculose/diagnóstico por imagem , Tuberculose/etiologia
19.
Acad Radiol ; 27(1): 71-75, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31759796

RESUMO

Tuberculosis is a leading cause of death from infectious disease worldwide, and is an epidemic in many developing nations. Countries where the disease is common also tend to have poor access to medical care, including diagnostic tests. Recent advancements in artificial intelligence may help to bridge this gap. In this article, we review the applications of artificial intelligence in the diagnosis of tuberculosis using chest radiography, covering simple computer-aided diagnosis systems to more advanced deep learning algorithms. In so doing, we will demonstrate an area where artificial intelligence could make a substantial contribution to global health through improved diagnosis in the future.


Assuntos
Inteligência Artificial , Radiologia , Tuberculose , Diagnóstico por Computador , Humanos , Radiografia , Tuberculose/diagnóstico por imagem
20.
Clin Nucl Med ; 45(3): 206-208, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31652162

RESUMO

A 65-year-old man underwent FDG PET/CT for evaluation of vertebral lesions, radiologically suspected to be metastases. The scan showed hypermetabolism in D8 to D9 vertebrae, retroperitoneal lymph nodes, and both the lobes of prostate. Transrectal ultrasound-guided biopsy of prostate was performed with suspicion of prostate malignancy. The biopsy revealed caseating granulomatous lesions in prostate suggestive of tuberculosis. Post antitubercular treatment patient showed excellent clinical response. Possibility of infective pathologies mimicking malignancy should be kept in mind while evaluating hypermetabolic foci seen on PET/CT. Although rare, tuberculosis of prostate needs consideration in differential diagnosis of FDG-avid foci seen in prostate.


Assuntos
Carcinoma/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Neoplasias da Próstata/diagnóstico por imagem , Tuberculose/diagnóstico por imagem , Idoso , Carcinoma/patologia , Diagnóstico Diferencial , Fluordesoxiglucose F18 , Humanos , Masculino , Metástase Neoplásica , Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologia , Compostos Radiofarmacêuticos , Coluna Vertebral/diagnóstico por imagem
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