### 1.1 An overview of the ILD guideline

Since the publication of the first BTS guidelines for diffuse lung disease nearly 10 years ago,1 the specialty has seen considerable change. The early discussions of the Guideline Group centred upon whether the revised document might consist of the 1999 document with minor adaptations. However, it was considered that too much change had taken place in the intervening years to justify a simple editorial approach. The last decade had seen the development of a new consensus terminology for the idiopathic interstitial pneumonias (IIP)2 stimulated, in part, by the identification of non-specific interstitial pneumonia (NSIP) as a discrete histological pattern with increasingly recognised clinical correlates.3 The better prognosis seen in fibrotic NSIP than in idiopathic pulmonary fibrosis (IPF)4 5 fuelled a more intense approach to diagnosis in cases of suspected IPF. This in turn has led to a radical change in accepted diagnostic gold standards, which have become increasingly multidisciplinary and dependent equally upon the skills of pathologists, radiologists and clinicians.6 NSIP, as a new entity, has posed particular difficulties. With more detailed studies of outcome specific to individual IIPs, especially IPF and fibrotic NSIP, the prognostic weighting given to pulmonary function impairment has been refined, especially with regard to longitudinal functional trends.7 Most important, with the standardisation of terminology, it became possible to recruit patients into multicentre treatment studies.8–10 With regard to IPF in particular, the last 3 years have seen more studies of treatment than in the previous history of the speciality, yet there is no universally accepted “best current treatment”.

### 1.2 Methodology for constructing guidelines and making recommendations

The overall process for generating BTS guidelines has been addressed in numerous recently published documents (available at http://www.brit-thoracic.org.uk/guidelines.html). The methodology applied herein is broadly similar and is not therefore described in detail. However, there are specific aspects in the …

https://thorax.bmj.com/content/thoraxjnl/63/Suppl_5/v1.full.pdf

Interstitial lung disease guideline: the British Thoracic Society in collaboration with the Thoracic Society of Australia and New Zealand and the Irish Thoracic Society.

This paper was guest edited by Dr. E. Fleck. Deutsches Herzzentrum Berlin, Germany

Cardiovascular magnetic resonance (CMR) is established in clinical practice for the diagnosis and management of diseases of the cardiovascular system. However, current guidelines for when this technique should be employed in clinical practice have not been revised since a Task Force report of 1998.1 Considerable technical and practice advances have been made in the intervening years and the level of interest from clinicians in this field is at an unprecedented level. Therefore the aim of this report from a Consensus Panel of established experts in the field of CMR is to update these guidelines. As CMR is a multi-disciplinary technique with international interest, the Consensus Panel was composed of European and American cardiologists and radiologists with major input from members with additional established expertise in paediatric cardiology, nuclear cardiology, magnetic resonance physics and spectroscopy, as well as health economics. The Consensus Panel was originated, approved and funded in its activities by the Working Group on CMR of the European Society of Cardiology and the Society for Cardiovascular Magnetic Resonance.

The Consensus Panel recommendations are based on evidence compiled from the literature and expert experience. If there is insufficient evidence in the literature, this is indicated in the report but usually no recommendations are made under these circumstances. The appropriateness of using CMR is described for the frequent disease entities where imaging information may be warranted. The diagnostic use of CMR will be described in the context of other, competing imaging techniques, with particular emphasis on the differential indications with respect to echocardiography.

The usefulness of CMR in specific diseases is summarized by means of the following classification:

/pdf/clinical-indications-for-cardiovascular-magnetic-resonance-2ac8qd9w41.pdf

Clinical indications for cardiovascular magnetic resonance (CMR): Consensus Panel report.

https://journal.chestnet.org/article/S0012-3692(15)31113-2/pdf

Tracheomalacia and tracheobronchomalacia in children and adults: an in-depth review.

Cardiovascular magnetic resonance (CMR) is established in clinical practice for the diagnosis and management of diseases of the cardiovascular system. However, current guidelines for when this tech...

These guidelines have been developed at the request of the Standards of Care Committee of the British Thoracic Society (BTS) and with the agreement of the Royal College of Radiologists and the British Society of Interventional Radiology, and approval of the Royal College of Pathologists in respect of the pathology recommendations and the Society of Cardiothoracic Surgeons of Great Britain and Ireland.

Lung biopsy is a relatively frequently performed procedure with considerable benefit for patient management but it may, on rare occasions, result in the death of the patient. It is a multidisciplinary procedure involving respiratory physicians, surgeons, and radiologists with an interest in chest diseases.

The aim of the group was to produce formal evidence based guidelines for subsequent use by those referring patients for the procedure and for those performing it.

The areas covered by these guidelines are as follows:





The following areas are not covered by these guidelines:





### Validity and grading of recommendations

The criteria for assessing the levels of evidence and grading of recommendations were based on those recommended in the Scottish Intercollegiate Guidelines Network in 19951 using the Agency of Health Care Policy and Research model used in some other BTS guidelines (tables 1 and 2).

View this table:

 Table 1 
Categories of evidence185



View this table:

 Table 2 
Grading of recommendations



It should be noted that there are very few randomised trials comparing the various aspects of lung biopsy and, for that reason, more detailed systems of categorisation such as that of the Scottish Intercollegiate Guidelines Network published in 2001 were not used.2

The papers selected by searching PubMed and Medline were assessed by the members of the working group and decisions on levels of evidence for each paper were made by …

https://thorax.bmj.com/content/thoraxjnl/58/11/920.full.pdf

Guidelines for radiologically guided lung biopsy

The purpose of this study was to define the range of normal intrathoracic tracheal diameters and cross-sectional areas during forced respiration. A report of tracheomalacia is also presented. Ten volunteers were studied in the supine position with dynamic computed tomography (CT), at a level at or between the brachiocephalic vein and the aortic arch, with 3-mm collimation and with image reconstruction by means of a high-spatial-frequency algorithm. Ten 100-msec dynamic scans were obtained at 500-msec intervals during a 6-second period as the patient performed forced inspiration and expiration vital capacity maneuvers. The mean cross-sectional area of the trachea decreased dynamically from 280 mm2 at end inspiration (standard deviation, 50.5; range, 221-388 mm2) to 178 mm2 at end expiration (standard deviation, 40.2; range, 115-236 mm2; P < .001) (mean decrease, 35% between inspiration and expiration; standard deviation, 18%; range, 11%-61%). The percentage decrease in cross-sectional area of the trachea c...

Normal trachea during forced expiration: dynamic CT measurements.

RATIONALE AND OBJECTIVES. Nine patients were examined using dynamic electron beam computed tomography to assess the utility of this technique in detecting airway obstruction and air trapping, and to compare this technique with pulmonary physiologic testing. METHODS. Dynamic computed tomography (C-100 Ultrafast CT scanner, Imatron Inc., South San Francisco, CA) was performed, with a series of ten, 100-msec images obtained in a 6-second period during forced inhalation and exhalation. Time-attenuation curves were calculated from the observed changes in lung attenuation. Estimates of the percentage of each lung that showed air trapping were made at each level scanned, using a 5-point scale. Specific correlations were made for pulmonary function test results and air-trapping score. RESULTS. In all nine patients, dynamic computed tomography demonstrated one or more sites that failed to show a normal increase in lung attenuation during forced exhalation. Four of these 9 patients showed a paradoxical decrease in lung attenuation during exhalation in at least one region of the lung. Extent of air-trapping correlated well with forced expiratory volume in one second (r = –.92). CONCLUSIONS. Based on this small sample, the authors believe that this technique will prove sensitive for detecting abnormalities of ventilation and may be a useful adjunct to conventional diagnostic procedures in the management of disorders of airway obstruction.

Dynamic quantitative computed tomography. A predictor of pulmonary function in obstructive lung diseases.

High-resolution CT appearance of diffuse alveolar septal amyloidosis.

/pdf/bronchopulmonary-sequestration-dynamic-ultrafast-high-s0z3sgyuaz.pdf

Bronchopulmonary sequestration: dynamic, ultrafast, high-resolution CT evidence of air trapping.

We report a case of pulmonary artery dissection imaged by MR. Dissection of a markedly dilated pulmonary artery is a rare and usually fatal complication of chronic pulmonary arterial hypertension. The diagnosis is made at autopsy, with only two cases having previously been documented (by Doppler echocardiography) during life. The hallmark of an arterial dissection is the finding of an intimal flap and a false lumen. In our case, spin echo MR imaging failed to show either the intimal flap or any intraluminal signal defects. The dissection was presumably obscured by nonhomogeneous intraluminal signal caused by the slow blood flow associated with severe pulmonary arterial hypertension. Cine MR imaging, however, demonstrated different signal intensity within the true and false lumens of the dissection, thereby outlining the intimal flap between the two channels.

Pulmonary artery dissection: MR findings.

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

E J Stern

Author Tools

Chat about Author