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Can X-rays effectively diagnose pulmonary fibrosis?

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Posted on Fri, 14 Oct 2016
Question: Can the following pulmonary conditions be diagnosed effectively by x-ray imaging or by nuclear medicine imaging with technetium contrast?

Pulmonary fibrosis
Airway remodling
Pulmonary hypertension
doctor
Answered by Dr. Shafi Ullah Khan (2 hours later)
Brief Answer:
Explained .

Detailed Answer:
Thank you for asking

I read your question and i understand your concern. For pulmonary fibrosis, high resolution computed tomography scans are ideal, chest x rays can help but findings are less specific. Pulmonary hypertension associated with it is best assessed with transthoracic echocardiography. One can go for bronchoscopies and Video assisted thoracoscopic surgeries to study it further.

Airway remodeling is diagnosed with both invasive and noninvasive ones. Invasive is bronchoscopy and biopsy and noninvasive is markers associated with it like cytokines in blood etc. It usually is associated with asthma patients.

And for pulmonary hypertension , again chest x rays, echocardiographic and doppler studies and transthoracic studies are helpful.

To summaries, x rays have major role compared to nuclear imaging in diagnosing these three studies.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shafi Ullah Khan (48 hours later)
Thank you very much Dr. Khan! I appreciate the info a lot.

Follow-up questions on airway remodeling:

I. What are the cytokine thresholds above which airway remodeling would be considered probable in asthma patients?

II. How long would uncontrolled, severe persistent asthma have to occur before airway remodeling was a consequence?

III. Is airway remodeling reversible with physical therapy or other modalities - that is, once airway remodeling has occurred in a negative sense in the wrong direction, can airway remodeling occur again but in a positive sense in the right direction?



doctor
Answered by Dr. Shafi Ullah Khan (1 hour later)
Brief Answer:
Explained

Detailed Answer:
Thank you for getting back

Remodeling for asthma means when airways get hypertrophied and smooth muscle cells migrate to epithelium in airways and they do it by releasing chemokines and cytokines. So there is no threshold of cytokines to induce remodeling. To make it simpler for you, any uncontrolled asthma or noncompliant medicine use will lead to cytokines production enough to induce remodeling.

As far as how long is concerned , that part is highly variable to every subject and can vary from a few months to years subjected to every patient and can not be quantified.

Remodeling is a fibrosis, it is preventable but once remodeled, not reversible.

for more self guidance purposes read this following article
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/

I hope it helps.
Regards
Khan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shafi Ullah Khan (2 days later)
Thank you very much for the information Dr. XXXXXXX That was a great article. I think I have two last follow up questions:

I. How are emphysema, COPD, and pulmonary pneumonitis effectively diagnosed via imaging or other means?

II. What are typical medical-grade O2 inhalation protocols for people with breathing difficulties due to pulmonary pathology?

doctor
Answered by Dr. Shafi Ullah Khan (8 hours later)
Brief Answer:
Beyond scope of discussion

Detailed Answer:
Thank you for getitng back to me

I am afraid the answers to above mentioned questions are beyond the scope of discussion of this forum. Imaging modalities and pulmonary functions tests are mainstay of diagnosis and oxygen is given either in short term or Long term we call that long term oxygen therapy.

I believe that is enough to explain as beyond it, explanation surpasses the scope of discussion of this forum.

Thank you
Regards
Khan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Shafi Ullah Khan

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Practicing since :2012

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Can X-rays effectively diagnose pulmonary fibrosis?

Brief Answer: Explained . Detailed Answer: Thank you for asking I read your question and i understand your concern. For pulmonary fibrosis, high resolution computed tomography scans are ideal, chest x rays can help but findings are less specific. Pulmonary hypertension associated with it is best assessed with transthoracic echocardiography. One can go for bronchoscopies and Video assisted thoracoscopic surgeries to study it further. Airway remodeling is diagnosed with both invasive and noninvasive ones. Invasive is bronchoscopy and biopsy and noninvasive is markers associated with it like cytokines in blood etc. It usually is associated with asthma patients. And for pulmonary hypertension , again chest x rays, echocardiographic and doppler studies and transthoracic studies are helpful. To summaries, x rays have major role compared to nuclear imaging in diagnosing these three studies.