Dr. Daniel S. Berman

Nuclear Medicine
Screening for CAD in diabetics: Which patient? Which test?
Screening for coronary artery disease (CAD) in any population is controversial. In this editorial opinion, Dr. Daniel Berman of Cedars-Sinai Medical Center points out what he believes are shortcomings in the Detection of Ischemia in Asymptomatic Diabetics (DIAD) study published this week in the Journal of the American Medical Association.
April 16, 2009
2007 04 11 12 05 10 706
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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
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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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