Residents Radiology IQ Special Feature

Oct 19, 2010
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Emphysema progression with hole changes, with holes colored according to their diameter in 2-mm increments. (A) Baseline inspiratory nonenhanced axial CT scans in a 48-year-old man with chronic obstructive pulmonary disease show emphysema holes with hyperexpansion of secondary pulmonary lobules (white arrows) and thin alveolar walls visible in the right upper lobe. This emphysematous lesion is filled with holes of varying sizes. A single large air cyst was observed in the left upper lobe (black arrows), classified as a single emphysema hole of 20 mm or greater (bright green). (B) At six-year follow-up inspiratory nonenhanced axial CT, the holes in the right upper lobe have merged (white arrows), with no visible alveolar septa remaining, resulting in the formation of a large new hole of 20 mm or greater (bright green). Meanwhile, the hole in the left upper lobe also enlarged, merging with adjacent holes (black arrows). The size of other holes in the paramedian left upper lobe decreased.
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CT reveals changes in lung holes in emphysema patients
By Will Morton
CT imaging of lung holes could offer a new way to visualize and quantify the natural course of emphysema.
July 15, 2025
Emphysema progression with hole changes, with holes colored according to their diameter in 2-mm increments. (A) Baseline inspiratory nonenhanced axial CT scans in a 48-year-old man with chronic obstructive pulmonary disease show emphysema holes with hyperexpansion of secondary pulmonary lobules (white arrows) and thin alveolar walls visible in the right upper lobe. This emphysematous lesion is filled with holes of varying sizes. A single large air cyst was observed in the left upper lobe (black arrows), classified as a single emphysema hole of 20 mm or greater (bright green). (B) At six-year follow-up inspiratory nonenhanced axial CT, the holes in the right upper lobe have merged (white arrows), with no visible alveolar septa remaining, resulting in the formation of a large new hole of 20 mm or greater (bright green). Meanwhile, the hole in the left upper lobe also enlarged, merging with adjacent holes (black arrows). The size of other holes in the paramedian left upper lobe decreased.
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By Kate Madden Yee
The model could help clinicians determine the best care for women with the disease.
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By Amerigo Allegretto
CMS has proposed its MPFS rule for 2026, and if finalized, it would affect imaging services in radiology, nuclear medicine, and radiation oncology.
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Opportunistic use of chest x-rays can help screen for osteoporosis
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Women living in rural areas are more likely to be diagnosed with advanced-stage breast cancer, but regular mammography helps decrease mortality rates.
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Peripheral vision training improves lesion detection
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Enhancing students' peripheral visual perception improved their lesion detection skills.
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Digital variance angiography (DVA) shows promise in reducing radiation doses to patients during certain interventional radiology procedures.
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Pelvic (A), femoral and popliteal (B), and cruro-pedal (C) region. The summated digital variance angiography (DVA) image significantly enhances image quality compared to the digital subtraction angiography (DSA) series I–IV (depicting 4 out of 28 (A), 48 (B) and 28 (C) DSA images) of the low dose (LD) acquisitions. Enhancements of iodinated contrast medium (ICM) by DVA depict small vessel structures in detail while the conventional DSA offers a reduced contrast-to-noise ratio (CNR) using LD acquisitions for standalone diagnostic interpretations.
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