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Transient pneumonia

KADRI ZN

Med J Malaya, 1959 Jun;13:292-7.
PMID: 14408341
Matched MeSH terms: Radiography, Thoracic*
Fulltext Imaging recommendations and algorithms for pediatric tuberculosis: part 1-thoracic tuberculosis

Concepcion NDP, Laya BF, Andronikou S, Abdul Manaf Z, Atienza MIM, Sodhi KS

Pediatr Radiol, 2023 Aug;53(9):1773-1781.
PMID: 37081179 DOI: 10.1007/s00247-023-05654-1

Tuberculosis (TB) remains a global health problem and is the second leading cause of death from a single infectious agent, behind the novel coronavirus disease of 2019. Children are amongst the most vulnerable groups affected by TB, and imaging manifestations are different in children when compared to adults. TB primarily involves the lungs and mediastinal lymph nodes. Clinical history, physical examination, laboratory examinations and various medical imaging tools are combined to establish the diagnosis. Even though chest radiography is the accepted initial radiological imaging modality for the evaluation of children with TB, this paper, the first of two parts, aims to discuss the advantages and limitations of the various medical imaging modalities and to provide recommendations on which is most appropriate for the initial diagnosis and assessment of possible complications of pulmonary TB in children. Practical, evidence-based imaging algorithms are also presented.

Matched MeSH terms: Radiography, Thoracic/methods
Fulltext An unusual presentation of adult onset Still's disease

Ghosal A, Pal RB, Das SK, Das T

Med J Malaysia, 2012 Oct;67(5):532-3.
PMID: 23770876

Adult onset still's disease usually presents with high grade intermittent fever, polyarthritis, salmon pink evanescent rash and hepatosplenomegaly. Pulmonary involvement in the form of pneumonitis, as a presenting feature is very rare. We report a case of a young lady who presented with fever, cough and respiratory distress. Chest X-ray revealed patchy infiltration in left upper lung zone. She was subsequently diagnosed as Adult onset Still's disease. There was no improvement in clinical condition despite five days of antibiotics. On trans-bronchial lung biopsy (TBLB) proved she had interstitial pneumonitis and responded dramatically to steroid treatment.

Matched MeSH terms: Radiography, Thoracic*
[Mycobacterial lung infection in 8 patients with AIDS: clinical and radiological features]

Kawana A, Toyota E, Kobayashi N, Kudo K, Genka I, Aoki M, et al.

Kansenshogaku Zasshi, 1998 Mar;72(3):238-44.
PMID: 9585697

The prevalence of mycobacterial infection in AIDS patients has increased in Japan. This report describes details of the clinical and radiological features of eight AIDS patients with mycobacterial disease (6 with M. tuberculosis infection and 2 with M. kansasii infection) in our hospital during the period from October 1995 through February 1997. Six of the 8 were men, and two were women. The mean age was 36.5 years. Six were Japanese, one was from Myanmar, and one was Malaysian. The median CD4 positive T lymphocyte counts (CD4 count) at the time of diagnosis of the M. tuberculosis was 75.5 (range 14-569/microliter, and the M. kansasii was 21.5 (range 19-24)/microliter. Clinical findings and symptoms of all patients were non-specific, but almost all patients had a cough and fever. In the radiographic findings, the patients of the M. tuberculosis group presented multiple hilar and mediastinal lymphadenopathy, miliary shadow, and obstructive pneumonia. Both M. kansasii patients showed a multiple infiltration shadow. There were no drug resistant strains in M. tuberculosis except on isolate with moderate resistant. to Streptomycin. These observations suggest that AIDS-associated mycobacterial disease shows atypical clinical and radiological features in some cases, especially in advanced stages of AIDS. Therefore, we need to recognize the characteristics of the clinical and radiological features of the patients with mycobacterial diseases and AIDS.

Matched MeSH terms: Radiography, Thoracic
Fulltext Chest x-ray as an essential part of routine medical examination: is it necessary?

Izamin I, Rizal AM

Med J Malaysia, 2012 Dec;67(6):606-9.
PMID: 23770954 MyJurnal

INTRODUCTION: Various studies in primary care and hospitalized patients have discouraged routine use of chest x-ray (CXR) in medical examination.
PURPOSE: The study aims to determine the prevalence of abnormal routine CXR and cost of one CXR at a public health clinic and discuss the rationale of CXR in routine medical examination.
METHODOLOGY: Data of patients who visited Klinik Kesihatan Bandar Kota Bharu (KKBKB), a public health clinic, from 1 January until 31 December 2010 were examined. The study used cross-sectional design. All patients who came for medical examination and CXR at KKBKB were included. Cost analysis was performed from the perspective of provider.
FINDINGS: About 63.1% of 8315 CXR films in KKBKB were produced as part of routine medical examination. Prevalence of abnormal CXR was 0.25%. The cost of producing one CXR ranges from RM15.87 to RM32.34.
DISCUSSION: Low yield from CXR screening and high cost of CXR are the main concern. CXR screening would also lead to unnecessary radiation; and false-positive screening resulting in physical risk, unwarranted anxiety and more expenditure. CXR screening is appropriately reserved for high-risk patients and those with relevant clinical findings.

Matched MeSH terms: Radiography, Thoracic*
Determination of chest x-ray cost using activity based costing approach at Penang General Hospital, Malaysia

Atif M, Sulaiman SA, Shafie AA, Saleem F, Ahmad N

Pan Afr Med J, 2012;12:40.
PMID: 22891098

Activity based costing (ABC) is an approach to get insight of true costs and to solve accounting problems. It provides more accurate information on product cost than conventional accounting system. The purpose of this study was to identify detailed resource consumption for chest x-ray procedure.

Matched MeSH terms: Radiography, Thoracic/economics*
A discrimination method for the detection of pneumonia using chest radiograph

Noor NM, Rijal OM, Yunus A, Abu-Bakar SA

Comput Med Imaging Graph, 2010 Mar;34(2):160-6.
PMID: 19758785 DOI: 10.1016/j.compmedimag.2009.08.005

This paper presents a statistical method for the detection of lobar pneumonia when using digitized chest X-ray films. Each region of interest was represented by a vector of wavelet texture measures which is then multiplied by the orthogonal matrix Q(2). The first two elements of the transformed vectors were shown to have a bivariate normal distribution. Misclassification probabilities were estimated using probability ellipsoids and discriminant functions. The result of this study recommends the detection of pneumonia by constructing probability ellipsoids or discriminant function using maximum energy and maximum column sum energy texture measures where misclassification probabilities were less than 0.15.

Matched MeSH terms: Radiography, Thoracic*
Fulltext The effect of a user-guided request form for chest radiographs in a neonatal intensive care unit

Lai MW, Yong SC, Boo NY

Med J Malaysia, 2004 Dec;59(5):598-603.
PMID: 15889561

The objectives of this prospective, observational study were to determine the current indications of requesting chest radiograph in sick infants in a neonatal intensive care unit (NICU) and the effect of a user-guided request form for chest radiographs of sick infants. During the three-month study period, a total of 423 chest radiographs were requested on 159 sick newborn infants in the intensive area of this NICU. A majority (55.6%) of these chest radiographs were performed to verify positions tips of either central catheters (27.4%) or endotracheal tubes (28.1%). The number of chest radiographs done during the period when the user-guided request forms were utilised was significantly lower (1.24 per patient) than before (1.37 per patient) or after (1.58 per patients) the period when these forms were in use (p=0.01). The rate of radiological abnormalities detected in radiographs requested to verify position of tips of endotracheal tubes were significantly greater during the period when user-guided forms were used than when they were not (p=0.01). A significantly higher proportion of changes in management were instituted when the user-guided forms were in use than during the period when they were not used (p=0.03). We conclude that a user-guided radiographic request form helps doctors in NICU to carry out their management more effectively.

Matched MeSH terms: Radiography, Thoracic*
Fulltext Systematic review of artificial intelligence techniques in the detection and classification of COVID-19 medical images in terms of evaluation and benchmarking: Taxonomy analysis, challenges, future solutions and methodological aspects

Albahri OS, Zaidan AA, Albahri AS, Zaidan BB, Abdulkareem KH, Al-Qaysi ZT, et al.

J Infect Public Health, 2020 Oct;13(10):1381-1396.
PMID: 32646771 DOI: 10.1016/j.jiph.2020.06.028

This study presents a systematic review of artificial intelligence (AI) techniques used in the detection and classification of coronavirus disease 2019 (COVID-19) medical images in terms of evaluation and benchmarking. Five reliable databases, namely, IEEE Xplore, Web of Science, PubMed, ScienceDirect and Scopus were used to obtain relevant studies of the given topic. Several filtering and scanning stages were performed according to the inclusion/exclusion criteria to screen the 36 studies obtained; however, only 11 studies met the criteria. Taxonomy was performed, and the 11 studies were classified on the basis of two categories, namely, review and research studies. Then, a deep analysis and critical review were performed to highlight the challenges and critical gaps outlined in the academic literature of the given subject. Results showed that no relevant study evaluated and benchmarked AI techniques utilised in classification tasks (i.e. binary, multi-class, multi-labelled and hierarchical classifications) of COVID-19 medical images. In case evaluation and benchmarking will be conducted, three future challenges will be encountered, namely, multiple evaluation criteria within each classification task, trade-off amongst criteria and importance of these criteria. According to the discussed future challenges, the process of evaluation and benchmarking AI techniques used in the classification of COVID-19 medical images considered multi-complex attribute problems. Thus, adopting multi-criteria decision analysis (MCDA) is an essential and effective approach to tackle the problem complexity. Moreover, this study proposes a detailed methodology for the evaluation and benchmarking of AI techniques used in all classification tasks of COVID-19 medical images as future directions; such methodology is presented on the basis of three sequential phases. Firstly, the identification procedure for the construction of four decision matrices, namely, binary, multi-class, multi-labelled and hierarchical, is presented on the basis of the intersection of evaluation criteria of each classification task and AI classification techniques. Secondly, the development of the MCDA approach for benchmarking AI classification techniques is provided on the basis of the integrated analytic hierarchy process and VlseKriterijumska Optimizacija I Kompromisno Resenje methods. Lastly, objective and subjective validation procedures are described to validate the proposed benchmarking solutions.

Matched MeSH terms: Radiography, Thoracic/classification*
Fulltext GraphCovidNet: A graph neural network based model for detecting COVID-19 from CT scans and X-rays of chest

Saha P, Mukherjee D, Singh PK, Ahmadian A, Ferrara M, Sarkar R

Sci Rep, 2021 04 15;11(1):8304.
PMID: 33859222 DOI: 10.1038/s41598-021-87523-1

COVID-19, a viral infection originated from Wuhan, China has spread across the world and it has currently affected over 115 million people. Although vaccination process has already started, reaching sufficient availability will take time. Considering the impact of this widespread disease, many research attempts have been made by the computer scientists to screen the COVID-19 from Chest X-Rays (CXRs) or Computed Tomography (CT) scans. To this end, we have proposed GraphCovidNet, a Graph Isomorphic Network (GIN) based model which is used to detect COVID-19 from CT-scans and CXRs of the affected patients. Our proposed model only accepts input data in the form of graph as we follow a GIN based architecture. Initially, pre-processing is performed to convert an image data into an undirected graph to consider only the edges instead of the whole image. Our proposed GraphCovidNet model is evaluated on four standard datasets: SARS-COV-2 Ct-Scan dataset, COVID-CT dataset, combination of covid-chestxray-dataset, Chest X-Ray Images (Pneumonia) dataset and CMSC-678-ML-Project dataset. The model shows an impressive accuracy of 99% for all the datasets and its prediction capability becomes 100% accurate for the binary classification problem of detecting COVID-19 scans. Source code of this work can be found at GitHub-link .

Matched MeSH terms: Radiography, Thoracic/methods*
Fulltext Routine chest radiograph interpretation skills of medical officers at an outpatient setting

Norwati Daud, Harmy Mohd Yusoff, Mohd Ezane Aziz

Asian Journal of Medicine and Biomedicine, 2018;2(1):0-0.
MyJurnal

In Malaysia, chest radiograph is a part of compulsory investigations during routine medical examination. Majority of these chest radiographs are interpreted by medical officers at the outpatient clinic. This study was to determine the concordance of chest radiograph interpretations between medical officers and radiologist. Medical officers' report of routine chest radiographs at the outpatient clinic Hospital Universiti Sains Malaysia over a 6-month period were compared to that of a radiologist. Of 408 chest radiographs reported, the concordance of interpretation between medical officers and radiologist was 93.6% (382 of 408). Medical officers correctly interpret 98.2% (378/385) of normal chest radiograph compared to 17.4% of abnormal chest radiographs (4/23). Therefore, routine chest radiograph interpretations of normal radiographs by medical officers were generally accurate. However, they were weak in interpreting abnormal chest radiographs. Medical officers need to be trained on detecting abnormalities on chest X-ray since most routine chest X-ray reporting is done based on their interpretation.

Study site: outpatient clinic Hospital Universiti Sains Malaysia

Matched MeSH terms: Radiography, Thoracic
Applying a statistical PTB detection procedure to complement the gold standard

Noor NM, Yunus A, Bakar SA, Hussin A, Rijal OM

Comput Med Imaging Graph, 2011 Apr;35(3):186-94.
PMID: 21036539 DOI: 10.1016/j.compmedimag.2010.10.002

This paper investigates a novel statistical discrimination procedure to detect PTB when the gold standard requirement is taken into consideration. Archived data were used to establish two groups of patients which are the control and test group. The control group was used to develop the statistical discrimination procedure using four vectors of wavelet coefficients as feature vectors for the detection of pulmonary tuberculosis (PTB), lung cancer (LC), and normal lung (NL). This discrimination procedure was investigated using the test group where the number of sputum positive and sputum negative cases that were correctly classified as PTB cases were noted. The proposed statistical discrimination method is able to detect PTB patients and LC with high true positive fraction. The method is also able to detect PTB patients that are sputum negative and therefore may be used as a complement to the gold standard.

Matched MeSH terms: Radiography, Thoracic/methods*; Radiography, Thoracic/standards*
Fulltext Predictors of delayed sputum smear conversion among pulmonary tuberculosis patients in Kota Kinabalu, Malaysia: A retrospective cohort study

Mokti K, Md Isa Z, Sharip J, Abu Bakar SN, Atil A, Hayati F, et al.

Medicine (Baltimore), 2021 Aug 06;100(31):e26841.
PMID: 34397855 DOI: 10.1097/MD.0000000000026841

Smear-positive pulmonary tuberculosis (SPPTB) is the major contributor to the spread of tuberculosis (TB) infection, and it creates high morbidity and mortality worldwide. The objective of this study was to determine the predictors of delayed sputum smear conversion at the end of the intensive phase of TB treatment in Kota Kinabalu, Malaysia.This retrospective study was conducted utilising data of SPPTB patients treated in 5 TB treatment centres located in Kota Kinabalu, Malaysia from 2013 to 2018. Pulmonary TB (PTB) patients included in the study were those who had at least completed the intensive phase of anti-TB treatment with sputum smear results at the end of the 2nd month of treatment. The factors associated with delayed sputum smear conversion were analyzed using multiple logistic regression analysis. Predictors of sputum smear conversion at the end of intensive phase were evaluated.A total of 2641 patients from the 2013 to 2018 periods were included in this study. One hundred eighty nine (7.2%) patients were identified as having delayed sputum smear conversion at the end of the intensive phase treatment. Factors of moderate (advanced odd ratio [aOR]: 1.7) and advanced (aOR: 2.7) chest X-ray findings at diagnosis, age range of >60 (aOR: 2.1), year of enrolment 2016 (aOR: 2.8), 2017 (aOR: 3.9), and 2018 (aOR: 2.8), smokers (aOR: 1.5), no directly observed treatment short-course (DOTS) supervisor (aOR: 6.9), non-Malaysian citizens (aOR: 1.5), and suburban home locations (aOR: 1.6) were associated with delayed sputum smear conversion at the end of the intensive phase of the treatment.To improve sputum smear conversion success rate, the early detection of PTB cases has to be fine-tuned so as to reduce late or severe case presentation during diagnosis. Efforts must also be in place to encourage PTB patients to quit smoking. The percentage of patients assigned with DOTS supervisors should be increased while at the same time ensuring that vulnerable groups such as those residing in suburban localities, the elderly and migrant TB patients are provided with proper follow-up treatment and management.

Matched MeSH terms: Radiography, Thoracic/methods; Radiography, Thoracic/statistics & numerical data
Fulltext Chest Radiograph Findings In Novel Swine-Origin Influenza A (H1N1) Virus (S-OIV) Infection: A UKMMC Experience

Norzailin AB, Norhafizah E

Med J Malaysia, 2015 Apr;70(2):93-7.
PMID: 26162384 MyJurnal

OBJECTIVE: 1.To evaluates and recognizes findings in chest radiograph in patients with laboratory-confirmed S-OIV (H1N1) infection treated at UKMMC. 2. To evaluate whether the findings on initial chest radiographs of influenza A (H1N1) patients can help to predict the prognosis.

MATERIAL AND METHODS: Total of 109 adult patients presenting to the Universiti Kebangsaan Malaysia Medical Centre (UKMMC) with flu-like symptoms who were positive for influenza A and these patients had underwent chest radiographs (CXR). The initial CXRs were evaluated for the pattern (consolidation, ground-glass, and reticulation), distribution, and extend of abnormality. The disease is classifies by the clinical severity (mild, moderate or severe illness) and adverse outcome (ventilated, death or recovered well).

RESULTS: The initial CXRs were normal in 56% of cases. The predominant radiographic finding was consolidation, most commonly involving the middle and lower zones (35% of cases). There is no significant association between initial CXR findings with the patient clinical outcome either fully recovered or death/ ventilated.

CONCLUSION: Normal chest radiographs is the most common radiographic finding in S-OIV (H1N1) infection and the most common abnormal lung finding is consolidation. Initial chest radiographs did not determine the patient clinical outcome and a normal initial radiograph could not exclude adverse outcome.

Matched MeSH terms: Radiography, Thoracic
Pulmonary tuberculosis in the University of Malaya students

Kadri ZN

Dis Chest, 1959 Dec;36:612-5.
PMID: 14408342 DOI: 10.1378/chest.36.6.612

The overall incidence of clinical pulmonary tuberculosis in the University of Malaya students was found to be 3.15 per cent. This higher incidence of clinical tuberculosis is in keeping with the general morbidity and mortality figures of tuberculosis in the general public. Among students who were originally enrolled as inactive cases 26.5 per cent developed activity while in university and required treatment. No significant difference was found in the incidence and rate of reactivation of disease in students of various races. No student was obliged to quit studies permanently on account of the breakdown

Matched MeSH terms: Radiography, Thoracic
Fulltext Application of phase congruency for discriminating some lung diseases using chest radiograph

Rijal OM, Ebrahimian H, Noor NM, Hussin A, Yunus A, Mahayiddin AA

Comput Math Methods Med, 2015;2015:424970.
PMID: 25918551 DOI: 10.1155/2015/424970

A novel procedure using phase congruency is proposed for discriminating some lung disease using chest radiograph. Phase congruency provides information about transitions between adjacent pixels. Abrupt changes of phase congruency values between pixels may suggest a possible boundary or another feature that may be used for discrimination. This property of phase congruency may have potential for deciding between disease present and disease absent where the regions of infection on the images have no obvious shape, size, or configuration. Five texture measures calculated from phase congruency and Gabor were shown to be normally distributed. This gave good indicators of discrimination errors in the form of the probability of Type I Error (δ) and the probability of Type II Error (β). However, since 1 - δ is the true positive fraction (TPF) and β is the false positive fraction (FPF), an ROC analysis was used to decide on the choice of texture measures. Given that features are normally distributed, for the discrimination between disease present and disease absent, energy, contrast, and homogeneity from phase congruency gave better results compared to those using Gabor. Similarly, for the more difficult problem of discriminating lobar pneumonia and lung cancer, entropy and homogeneity from phase congruency gave better results relative to Gabor.

Matched MeSH terms: Radiography, Thoracic
Computed and conventional chest radiography: a comparison of image quality and radiation dose

Ramli K, Abdullah BJ, Ng KH, Mahmud R, Hussain AF

Australas Radiol, 2005 Dec;49(6):460-6.
PMID: 16351609

The aim of this study was to compare the image quality and entrance skin dose (ESD) for film-screen and computed chest radiography. Analysis of the image quality and dose on chest radiography was carried out on a conventional X-ray unit using film-screen, storage phosphor plates and selenium drum direct chest radiography. For each receptor, ESD was measured in 60 patients using thermoluminescent dosemeters. Images were printed on 35 x 43 cm films. Image quality was assessed subjectively by evaluation of anatomic features and estimation of the image quality, following the guidelines established by the protocols of the Commission of the European Communities. There was no statistically significant difference noted between the computed and conventional images (Wilcoxon rank sum test, P > 0.05). Imaging of the mediastinum and peripheral lung structures were better visualized with the storage phosphor and selenium drum technique than with the film-screen combination. The patients' mean ESD for chest radiography using the storage phosphor, film-screen combination and selenium drum was 0.20, 0.20 and 0.25 mGy, respectively, with no statistically significant difference with P > 0.05 (chi(2) tests).

Matched MeSH terms: Radiography, Thoracic/methods*
Fulltext Lung segmentation on standard and mobile chest radiographs using oriented Gaussian derivatives filter

Wan Ahmad WS, Zaki WM, Ahmad Fauzi MF

Biomed Eng Online, 2015;14:20.
PMID: 25889188 DOI: 10.1186/s12938-015-0014-8

Unsupervised lung segmentation method is one of the mandatory processes in order to develop a Content Based Medical Image Retrieval System (CBMIRS) of CXR. The purpose of the study is to present a robust solution for lung segmentation of standard and mobile chest radiographs using fully automated unsupervised method.

Matched MeSH terms: Radiography, Thoracic/instrumentation*
Chest Radiograph (CXR) Manifestations of the Novel Coronavirus Disease 2019 (COVID-19): A Mini-review

Chan WY, Hamid MTR, Gowdh NFM, Rahmat K, Yaakup NA, Chai CS

Curr Med Imaging, 2021;17(6):677-685.
PMID: 33390122 DOI: 10.2174/1573405616666201231103312

BACKGROUND: Coronavirus disease 2019 (COVID-19) is highly contagious and has claimed more than one million lives, besides causing hardship and disruptions. The Fleischner Society has recommended chest X-ray (CXR) in detecting cases at high risk of disease progression, for triaging suspected patients with moderate-to-severe illness, and for eliminating false negatives in areas with high pre-test probability or limited resources. Although CXR is less sensitive than real-- time reverse transcription-polymerase chain reaction (RT-PCR) in detecting mild COVID-19, it is nevertheless useful because of equipment portability, low cost and practicality in serial assessments of disease progression among hospitalized patients.
OBJECTIVE: This study aims to review the typical and relatively atypical CXR manifestations of COVID-19 pneumonia in a tertiary care hospital.
METHODS: The CXRs of 136 COVID-19 patients confirmed through real-time RT-PCR from March to May 2020 were reviewed. A literature search was performed using PubMed.
RESULTS: A total of 54 patients had abnormal CXR whilst the others were normal. Typical CXR findings included pulmonary consolidation or ground-glass opacities in a multifocal, bilateral peripheral, or lower zone distribution, whereas atypical CXR features comprised cavitation and pleural effusion.
CONCLUSION: Typical findings of COVID-19 infection in chest computed tomography studies can also be seen in CXR. The presence of atypical features associated with worse disease outcome. Recognition of these features on CXR will improve the accuracy and speed of diagnosing COVID-19 patients.

Matched MeSH terms: Radiography, Thoracic*
Histoplasmosis in Malaya

Ponnampalam JT

Br J Dis Chest, 1964 Apr;58:49-55.
PMID: 14152216

A survey of 227 patients from 5-60 years of age revealed the presence of positive histoplasmin skin tests in 10.5 per cent. and positive complement-fixation tests in 19-8 per cent. Sputum from 13 of the 37 patients who had a positive complement-fixation test were cultured for H. capsulatum but with negative results. Exposure to infection by the fungus is equally distributed among the different race and age groups. A careful and constant watch should be kept for histoplasmosis in all chest hospitals as a certain number of cases may be present. It tends to elude diagnosis unless specially sought as it resembles the clinical picture of tuberculosis or other granulomatous disease. It presents a field for further investigation and research in Malaya.

Matched MeSH terms: Radiography, Thoracic*

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