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Diagnostics
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Novel Advances in Diagnostic Work-Up of Respiratory Diseases
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Novel Advances in Diagnostic Work-Up of Respiratory Diseases

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (31 May 2022) | Viewed by 17686

Special Issue Editor

Prof. Dr. Martina Bonifazi

E-Mail Website
Guest Editor
1. Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
2. Respiratory Diseases Unit, “Ospedali Riuniti”, Ancona, Italy
Interests: interstitial lung diseases; interventional pulmonology; pleural diseases; chronic obstructive lung diseases; epidemiology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Benign and malignant respiratory diseases have become a global health issue due to the increasing exposure to environmental risk factors as well as to aging of the general population. The huge progresses in the field of respiratory medicine over the last decades have been coupled with outstanding advances in technology, leading to development of innovative, more accurate, and less invasive diagnostic tools. For example, new sophisticated guidance systems have been developed and adopted in interventional pulmonology’s practice to approach peripheral pulmonary lesions, and these include navigation technology, confocal microscopy, cone-beam computed tomography, and other tools. Moreover, the ultrasound technique has been increasingly implemented as a diagnostic tool as well as guidance system as it offers the advantage of being non-ionizing, faster, and easily available at a patient’s bedside – aspects that have been particularly useful during the COVID-19 pandemic. The main goal of this Special Issue it to update on and summarize the innovations in diagnostic approaches for major respiratory diseases, including COVID-19 pneumonia, lung cancer, diffuse parenchymal lung diseases, pleural diseases, chronic obstructive lung diseases, and asthma.Leaders in the different fields will be invited to provide comprehensive reviews on these topics.

Prof. Martina Bonifazi
Guest Editor

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. Diagnostics 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

  • Innovations
  • New diagnostic tools
  • Guidance systems
  • COVID-19 pneumonia
  • Lung cancer
  • Diffuse parenchymal lung diseases
  • Pleural diseases
  • Interventional pulmonology
  • Severe asthma
  • Chronic obstructive lung diseases

Published Papers (7 papers)

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Research

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9 pages, 1929 KiB  
Article
Recognition of Connective Tissue Disease-Related Interstitial Pneumonia Based on Histological Score—A Validation Study of an Online Diagnostic Decision Support Tool
by Mutsumi Ozasa, Yoshiaki Zaizen, Kazuhiro Tabata, Kensuke Kataoka, Shuntaro Sato, Andrey Bychkov, Noriho Sakamoto, Hiroshi Mukae, Yasuhiro Kondoh and Junya Fukuoka
Diagnostics 2021, 11(8), 1359; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11081359 - 28 Jul 2021
Viewed by 1488
Abstract
Objectives: to evaluate the number of cases of idiopathic pulmonary fibrosis (IPF) that included histological features of connective tissue disease (CTD) and to check whether they demonstrated the clinical features of CTD, using a previously reported CTD-interstitial pneumonia (IP) index that histologically differentiates [...] Read more.
Objectives: to evaluate the number of cases of idiopathic pulmonary fibrosis (IPF) that included histological features of connective tissue disease (CTD) and to check whether they demonstrated the clinical features of CTD, using a previously reported CTD-interstitial pneumonia (IP) index that histologically differentiates CTD-associated and idiopathic IP. Methods: patients diagnosed with IPF following video-assisted thoracoscopic biopsy through multidisciplinary team diagnosis between 2014 and 2017 were selected. Pathological observation was made by four pathologists who scored eight observational items needed for the CTD-IP index. Cases determined as CTD, by the CTD-IP index, were extracted, and their clinical features were compared. Results: a total of 94 cases of IPF were identified, of which 20 were classified into the CTD group using the CTD-IP index with reasonable interobserver agreement (k = 0.76). Cases pathologically classified into the CTD group were significantly associated with female sex, non-smoking history, autoantibody positivity, and CTD symptoms (p = 0.01, 0.03, 0.01, and 0.04, respectively). Conclusions: patients with IPF with pathological findings of CTD showed clinical characteristics similar to those of patients with CTD. Full article
(This article belongs to the Special Issue Novel Advances in Diagnostic Work-Up of Respiratory Diseases)
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11 pages, 1962 KiB  
Article
Validation of Remote Dielectric Sensing (ReDS) in Monitoring Adult Patients Affected by COVID-19 Pneumonia
by Federico Mei, Alessandro Di Marco Berardino, Martina Bonifazi, Lara Letizia Latini, Lina Zuccatosta and Stefano Gasparini
Diagnostics 2021, 11(6), 1003; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11061003 - 31 May 2021
Cited by 5 | Viewed by 2349
Abstract
Remote dielectric sensing (ReDS) is a non-invasive electromagnetic wave technology which provides an accurate reading of lung fluid content, and it has been reported as a valid tool in monitoring heart failure patients. Considering that morphological alterations in COVID-19 include pulmonary edema, the [...] Read more.
Remote dielectric sensing (ReDS) is a non-invasive electromagnetic wave technology which provides an accurate reading of lung fluid content, and it has been reported as a valid tool in monitoring heart failure patients. Considering that morphological alterations in COVID-19 include pulmonary edema, the purpose of the present study was to evaluate the reliability of ReDS technology in assessing the excess of lung fluid status in COVID-19 pneumonia, as compared to CT scans. In this pilot single center study, confirmed COVID-19 patients were enrolled on admission to an intermediate care unit. Measurements with the ReDS system and CT scans were performed on admission and at weeks 1 and 2. Eleven patients were recruited. The average change in ReDS was −3.1 ± 1.7 after one week (p = 0.001) and −4.6 ± 2.9 after two weeks (p = 0.006). A similar trend was seen in total CT score (−3.3 ± 2.1, p = 0.001). The level of agreement between ReDS and CT changes yielded a perfect result. Statistically significant changes were observed in lactate dehydrogenase, lymphocytes, and c-reactive protein over 2 weeks. This pilot study shows that ReDS can track changes in lung involvement according to the severity of COVID-19. Further studies to detect early clinical deterioration are needed. Full article
(This article belongs to the Special Issue Novel Advances in Diagnostic Work-Up of Respiratory Diseases)
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10 pages, 874 KiB  
Article
Distinct Mechanical Properties of the Respiratory System Evaluated by Forced Oscillation Technique in Acute Exacerbation of COPD and Acute Decompensated Heart Failure
by Silvia Terraneo, Rocco Francesco Rinaldo, Giuseppe Francesco Sferrazza Papa, Fulvia Ribolla, Carlo Gulotta, Laura Maugeri, Emiliano Gatti, Stefano Centanni and Fabiano Di Marco
Diagnostics 2021, 11(3), 554; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11030554 - 19 Mar 2021
Cited by 6 | Viewed by 1802
Abstract
Discriminating between cardiac and pulmonary dyspnea is essential for patients’ management. We investigated the feasibility and ability of forced oscillation techniques (FOT) in distinguishing between acute exacerbation of COPD (AECOPD), and acute decompensated heart failure (ADHF) in a clinical emergency setting. We enrolled [...] Read more.
Discriminating between cardiac and pulmonary dyspnea is essential for patients’ management. We investigated the feasibility and ability of forced oscillation techniques (FOT) in distinguishing between acute exacerbation of COPD (AECOPD), and acute decompensated heart failure (ADHF) in a clinical emergency setting. We enrolled 49 patients admitted to the emergency department (ED) for dyspnea and acute respiratory failure for AECOPD, or ADHF, and 11 healthy subjects. All patients were able to perform bedside FOT measurement. Patients with AECOPD showed a significantly higher inspiratory resistance at 5 Hz, Xrs5 (179% of predicted, interquartile range, IQR 94–224 vs. 100 IQR 67–149; p = 0.019), and a higher inspiratory reactance at 5 Hz (151%, IQR 74–231 vs. 57 IQR 49–99; p = 0.005) than patients with ADHF. Moreover, AECOPD showed higher heterogeneity of ventilation (respiratory system resistance difference at 5 and 19 Hz, Rrs5-19: 1.49 cmH2O/(L/s), IQR 1.03–2.16 vs. 0.44 IQR 0.22–0.76; p = 0.030), and a higher percentage of flow limited breaths compared to ADHF (10%, IQR 0–100 vs. 0 IQR 0–12; p = 0.030). FOT, which resulted in a suitable tool to be used in the ED setting, has the ability to identify distinct mechanical properties of the respiratory system in AECOPD and ADHF. Full article
(This article belongs to the Special Issue Novel Advances in Diagnostic Work-Up of Respiratory Diseases)
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Review

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17 pages, 956 KiB  
Review
Volumetric Imaging of Lung Tissue at Micrometer Resolution: Clinical Applications of Micro-CT for the Diagnosis of Pulmonary Diseases
by Andreana Bompoti, Andreas S. Papazoglou, Dimitrios V. Moysidis, Nikolaos Otountzidis, Efstratios Karagiannidis, Nikolaos Stalikas, Eleftherios Panteris, Vijayakumar Ganesh, Thomas Sanctuary, Christos Arvanitidis, Georgios Sianos, James S. Michaelson and Markus D. Herrmann
Diagnostics 2021, 11(11), 2075; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11112075 - 10 Nov 2021
Cited by 5 | Viewed by 2706
Abstract
Micro-computed tomography (micro-CT) is a promising novel medical imaging modality that allows for non-destructive volumetric imaging of surgical tissue specimens at high spatial resolution. The aim of this study is to provide a comprehensive assessment of the clinical applications of micro-CT for the [...] Read more.
Micro-computed tomography (micro-CT) is a promising novel medical imaging modality that allows for non-destructive volumetric imaging of surgical tissue specimens at high spatial resolution. The aim of this study is to provide a comprehensive assessment of the clinical applications of micro-CT for the tissue-based diagnosis of lung diseases. This scoping review was conducted in accordance with the PRISMA Extension for Scoping Reviews, aiming to include every clinical study reporting on micro-CT imaging of human lung tissues. A literature search yielded 570 candidate articles, out of which 37 were finally included in the review. Of the selected studies, 9 studies explored via micro-CT imaging the morphology and anatomy of normal human lung tissue; 21 studies investigated microanatomic pulmonary alterations due to obstructive or restrictive lung diseases, such as chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, and cystic fibrosis; and 7 studies examined the utility of micro-CT imaging in assessing lung cancer lesions (n = 4) or in transplantation-related pulmonary alterations (n = 3). The selected studies reported that micro-CT could successfully detect several lung diseases providing three-dimensional images of greater detail and resolution than routine optical slide microscopy, and could additionally provide valuable volumetric insight in both restrictive and obstructive lung diseases. In conclusion, micro-CT-based volumetric measurements and qualitative evaluations of pulmonary tissue structures can be utilized for the clinical management of a variety of lung diseases. With micro-CT devices becoming more accessible, the technology has the potential to establish itself as a core diagnostic imaging modality in pathology and to enable integrated histopathologic and radiologic assessment of lung cancer and other lung diseases. Full article
(This article belongs to the Special Issue Novel Advances in Diagnostic Work-Up of Respiratory Diseases)
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18 pages, 3160 KiB  
Review
Lung Ultrasound: Its Findings and New Applications in Neonatology and Pediatric Diseases
by Elio Iovine, Raffaella Nenna, Silvia Bloise, Domenico Paolo La Regina, Daniela Pepino, Laura Petrarca, Antonella Frassanito, Riccardo Lubrano and Fabio Midulla
Diagnostics 2021, 11(4), 652; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11040652 - 03 Apr 2021
Cited by 22 | Viewed by 5266
Abstract
Lung ultrasound has become increasingly used in both adult and pediatric populations, allowing the rapid evaluation of many lung and pleura diseases. This popularity is due to several advantages of the method such as the low cost, rapidity, lack of ionizing radiation, availability [...] Read more.
Lung ultrasound has become increasingly used in both adult and pediatric populations, allowing the rapid evaluation of many lung and pleura diseases. This popularity is due to several advantages of the method such as the low cost, rapidity, lack of ionizing radiation, availability of bedside and repeatability of the method. These features are even more important after the outbreak of the SARS-CoV-2 pandemic, given the possibility of recognizing through ultrasound the signs of interstitial lung syndrome typical of pneumonia caused by the virus. The purpose of this paper is to review the available evidence of lung ultrasound (LUS) in children and its main applications in pediatric diseases. Full article
(This article belongs to the Special Issue Novel Advances in Diagnostic Work-Up of Respiratory Diseases)
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Other

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3 pages, 372 KiB  
Interesting Images
Long-Standing Lambert–Eaton Myasthenic Syndrome Caused by Undetectable Small-Cell Lung Cancer: Why We Should Follow-Up LEMS
by Bo Young Hong, Ho Jung An and Seong Hoon Lim
Diagnostics 2022, 12(7), 1542; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12071542 - 24 Jun 2022
Cited by 4 | Viewed by 1363
Abstract
Physicians often encounter patients with unexplained muscle weakness and dysphagia. Lambert–Eaton myasthenic syndrome (LEMS) can cause unexplained weakness or dysphagia and is often accompanied by neoplastic conditions. A 64-year-old man who had several risk factors—14 kg weight loss over the last 4 years, [...] Read more.
Physicians often encounter patients with unexplained muscle weakness and dysphagia. Lambert–Eaton myasthenic syndrome (LEMS) can cause unexplained weakness or dysphagia and is often accompanied by neoplastic conditions. A 64-year-old man who had several risk factors—14 kg weight loss over the last 4 years, 20 years of experience working as a coal miner, and being a 50 pack-year ex-smoker—complained of dysphagia, intermittent diplopia, mild weakness, and hypotonia. The initial computed tomography (CT) and follow-up positron emission tomography (PET) CT did not reveal any malignancy. After continuous follow-up for this LEMS, small-cell lung cancer (SCLC, cTxN1M0) was found on a serial follow-up chest CT 21 months after the LEMS diagnosis. The patient was treated with chemotherapy. LEMS is rare and is often accompanied by malignancy. This case highlights the importance of being concerned about LEMS diagnoses and of long-term follow-up for unexplained LEMS. Full article
(This article belongs to the Special Issue Novel Advances in Diagnostic Work-Up of Respiratory Diseases)
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9 pages, 2225 KiB  
Case Report
Pleural Involvement in IgG4-Related Disease: Case Report and Review of the Literature
by Federico Mei, Massimiliano Mancini, Giulio Maurizi, Andrea Vecchione, Lina Zuccatosta, Erino Angelo Rendina and Stefano Gasparini
Diagnostics 2021, 11(12), 2177; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11122177 - 23 Nov 2021
Cited by 4 | Viewed by 1789
Abstract
Diagnostic work-up of IgG4-related disease (IgG4-RD) pleural involvement is a complex task, as there is a broad spectrum of differential diagnoses to consider. We report the case of a patient presenting with relapsing pleural effusion, discussing the main challenges for achievement of a [...] Read more.
Diagnostic work-up of IgG4-related disease (IgG4-RD) pleural involvement is a complex task, as there is a broad spectrum of differential diagnoses to consider. We report the case of a patient presenting with relapsing pleural effusion, discussing the main challenges for achievement of a definite diagnosis. A 63-year-old man was admitted for pleural effusion prevalent on the ride side, initially labeled as idiopathic non-specific pleuritis, based on tissue evaluation after a medical thoracoscopy. He was started on steroids with initial improvement, but a later CT scan showed a relapse of pleural effusion associated with diffuse pleural thickening; a subsequent surgical pleural biopsy revealed features suggestive for IgG4-RD, with a marked increase of IgG4 positive plasma cells. High IgG4 serum levels were also found. The present case underlines the importance of increasing awareness of this potential condition among physicians in order to properly guide the diagnostic work-up, as it is likely that IgG4-RD accounts for a proportion of patients with pleural effusions, labeled as idiopathic. In particular, in patients with unexplained pleural effusion, IgG4-RD should be included among differential diagnoses when lymphoplasmacytic infiltration is observed, and a multidisciplinary interaction between clinicians and pathologists appears crucial for an accurate diagnosis and an appropriate management. Full article
(This article belongs to the Special Issue Novel Advances in Diagnostic Work-Up of Respiratory Diseases)
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