Biomedical subjects

J David Godwin

Publications and source records attributed to J David Godwin.

5 recordsLinked to original sources

PubMed2005

High-resolution computed tomography in idiopathic pulmonary fibrosis: diagnosis and prognosis.

RATIONALE: High-resolution computed tomography (HRCT) is an integral aspect of the evaluation of patients with suspected idiopathic pulmonary fibrosis (IPF). However, few studies have evaluated its use in a large cohort. OBJECTIVES: To describe HRCT features in patients with mild to moderate IPF, compare diagnostic evaluations by a radiology core (three thoracic radiologists) with those by study-site radiologists, correlate baseline clinical and physiologic variables with HRCT findings, and evaluate their association with mortality. METHODS: We assessed HRCT scans from patients with IPF (n = 315) enrolled in a randomized controlled study evaluating IFN-gamma1b. MEASUREMENTS AND MAIN RESULTS: There was concordance between study-site and core radiologists regarding the diagnosis of IPF in 86% of cases. Diffusing capacity of carbon monoxide (DLCO) was the physiologic characteristic most highly correlated with HRCT findings. Multivariate analysis identified three independent predictors of mortality: a higher extent of fibrosis score increased the risk of death (p < 0.0001), whereas a higher percent-predicted DLCO (p = 0.004) and treatment assignment to IFN-gamma1b rather than placebo (p = 0.04) reduced the risk of death. CONCLUSIONS: A study-site diagnosis of IPF on HRCT was regularly confirmed by core radiologists. Extent of reticulation and honeycombing on HRCT is an important independent predictor of mortality in patients with IPF.

Female↗

PubMed2004

Imaging of interstitial lung disease.

This article provides a comprehensive summary of typical imaging features of common interstitial lung diseases with an emphasis on high-resolution computed tomography (HRCT). The classification of interstitial lung disease that is used is in accordance with the consensus statement of the American Thoracic Society. The secondary pulmonary lobule is the basic anatomic unit that is used for standard description of findings on HRCT. Sarcoidosis, Langerhans' cell histiocytosis, lymphangioleiomyomatosis, collagen vascular diseases, and hypersensitivity pneumonitis are some of the common interstitial lung diseases that are addressed.

Alveolitis, Extrinsic Allergic↗

PubMed2004

Imaging of the chest: idiopathic interstitial pneumonia.

This article continues the discussion of imaging of interstitial lung diseases that was begun in the last issue. We summarize the typical imaging features of idiopathic interstitial pneumonias, emphasizing high-resolution CT. Based on the American Thoracic Society classification system, the idiopathic interstitial pneumonias are discussed under these sections: idiopathic pulmonary fibrosis/usual interstitial pneumonitis, nonspecific interstitial pneumonitis, cryptogenic organizing pneumonia, desquamative interstitial pneumonitis, respiratory bronchiolitis-associated interstitial lung disease, acute interstitial pneumonitis, and lymphoid interstitial pneumonitis.

Diagnosis, Differential↗

PubMed2004

Diffuse pulmonary ossification.

Diffuse pulmonary ossification (DPO) is an uncommon condition that is characterized by metaplastic bone formation in the lung parenchyma. It is usually not diagnosed clinically and may be apparent radiographically only when extensive. However, it is occasionally encountered at autopsy or on pathologic evaluation of surgical specimens. This article will review the clinical, histologic, and radiographic manifestations of DPO, focusing primarily on the chest radiograph and CT findings, both of which may be underappreciated, for even experienced radiologists may confuse DPO with other entities such as metastatic calcification as seen in chronic renal failure or chronic granulomatous disease.

Calcinosis↗

PubMedDate not supplied

Imaging evaluation of pulmonary and abdominal complications following hematopoietic stem cell transplantation.

Hematopoietic stem cell transplantation is used to treat hematologic disorders and as an adjunct treatment for solid organ malignancies. After undergoing transplantation, patients are at risk for opportunistic infections and other complications caused by dysfunction of the immune system. Pulmonary complications include cryptogenic organizing pneumonia, opportunistic pneumonias caused by Aspergillus and Zygomycetes species and cytomegalovirus, alveolar hemorrhage, and constrictive bronchiolitis. Abdominal complications include hepatic veno-occlusive disease, graft-versus-host disease (GVHD), colitis, and hemorrhagic cystitis. Allogeneic transplant recipients are at risk for developing GVHD. Autologous and syngeneic transplant recipients are less likely to have chronic or late posttransplantation complications. Nonmyeloablative transplant recipients are less likely to develop opportunistic infections and other complications in the period immediately following transplantation, but are at risk for developing chronic GVHD and other chronic complications. Radiologic evaluation serves as the cornerstone for timely diagnosis of these complications, which is essential to reduce patient morbidity and mortality. Combining clinical factors-including the type of transplant and the point of time during the posttransplantation course-with characteristic imaging features yields the most specific and accurate differential diagnosis for radiologic findings in stem cell transplant recipients.

Abdomen↗