Differentiating Lung Nodules Due to <i>Coccidioides</i> from Those Due to Lung Cancer Based on Radiographic Appearance
Background: Coccidioidomycosis (cocci) is an endemic fungal disease that can cause asymptomatic or post-symptomatic lung nodules which are visible on chest CT scanning. Lung nodules are common and can represent early lung cancer. Differentiating lung nodules due to cocci from those due to lung cance...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-06-01
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| Series: | Journal of Fungi |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2309-608X/9/6/641 |
| _version_ | 1797593988841078784 |
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| author | Michael W. Peterson Ratnali Jain Kurt Hildebrandt William Keith Carson Mohamed A. Fayed |
| author_facet | Michael W. Peterson Ratnali Jain Kurt Hildebrandt William Keith Carson Mohamed A. Fayed |
| author_sort | Michael W. Peterson |
| collection | DOAJ |
| description | Background: Coccidioidomycosis (cocci) is an endemic fungal disease that can cause asymptomatic or post-symptomatic lung nodules which are visible on chest CT scanning. Lung nodules are common and can represent early lung cancer. Differentiating lung nodules due to cocci from those due to lung cancer can be difficult and lead to invasive and expensive evaluations. Materials and Methods: We identified 302 patients with biopsy-proven cocci or bronchogenic carcinoma seen in our multidisciplinary nodule clinic. Two experienced radiologists who were blinded to the diagnosis read the chest CT scans and identified radiographic characteristics to determine their utility in differentiating lung cancer nodules from those due to cocci. Results: Using univariate analysis, we identified several radiographic findings that differed between lung cancer and cocci infection. We then entered these variables along with age and gender into a multivariate model and found that age, nodule diameter, nodule cavitation, presence of satellite nodules and radiographic presence of chronic lung disease differed significantly between the two diagnoses. Three findings, cavitary nodules, satellite nodules and chronic lung disease, have sufficient discrimination to potentially be useful in clinical decision-making. Conclusions: Careful evaluation of the three obtained radiographic findings can significantly improve our ability to differentiate benign coccidioidomycosis infection from lung cancer in an endemic region for the fungal disease. Using these data may significantly reduce the cost and risk associated with distinguishing the cause of lung nodules in these patients by preventing unnecessary invasive studies. |
| first_indexed | 2024-03-11T02:16:19Z |
| format | Article |
| id | doaj.art-54d613586aea436cb64d6b680223ece1 |
| institution | Directory Open Access Journal |
| issn | 2309-608X |
| language | English |
| last_indexed | 2024-03-11T02:16:19Z |
| publishDate | 2023-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Fungi |
| spelling | doaj.art-54d613586aea436cb64d6b680223ece12023-11-18T11:08:49ZengMDPI AGJournal of Fungi2309-608X2023-06-019664110.3390/jof9060641Differentiating Lung Nodules Due to <i>Coccidioides</i> from Those Due to Lung Cancer Based on Radiographic AppearanceMichael W. Peterson0Ratnali Jain1Kurt Hildebrandt2William Keith Carson3Mohamed A. Fayed4Fresno Department of Medicine, University of California (San Francisco), San Francisco, CA 93701, USAFresno Department of Medicine, University of California (San Francisco), San Francisco, CA 93701, USACommunity Medical Imaging Radiology Group, Fresno, CA 93721, USACommunity Medical Imaging Radiology Group, Fresno, CA 93721, USAFresno Department of Medicine, University of California (San Francisco), San Francisco, CA 93701, USABackground: Coccidioidomycosis (cocci) is an endemic fungal disease that can cause asymptomatic or post-symptomatic lung nodules which are visible on chest CT scanning. Lung nodules are common and can represent early lung cancer. Differentiating lung nodules due to cocci from those due to lung cancer can be difficult and lead to invasive and expensive evaluations. Materials and Methods: We identified 302 patients with biopsy-proven cocci or bronchogenic carcinoma seen in our multidisciplinary nodule clinic. Two experienced radiologists who were blinded to the diagnosis read the chest CT scans and identified radiographic characteristics to determine their utility in differentiating lung cancer nodules from those due to cocci. Results: Using univariate analysis, we identified several radiographic findings that differed between lung cancer and cocci infection. We then entered these variables along with age and gender into a multivariate model and found that age, nodule diameter, nodule cavitation, presence of satellite nodules and radiographic presence of chronic lung disease differed significantly between the two diagnoses. Three findings, cavitary nodules, satellite nodules and chronic lung disease, have sufficient discrimination to potentially be useful in clinical decision-making. Conclusions: Careful evaluation of the three obtained radiographic findings can significantly improve our ability to differentiate benign coccidioidomycosis infection from lung cancer in an endemic region for the fungal disease. Using these data may significantly reduce the cost and risk associated with distinguishing the cause of lung nodules in these patients by preventing unnecessary invasive studies.https://www.mdpi.com/2309-608X/9/6/641lung nodulecocci noduleincidental nodulelung cancerpulmonary coccidioidomycosisvalley fever |
| spellingShingle | Michael W. Peterson Ratnali Jain Kurt Hildebrandt William Keith Carson Mohamed A. Fayed Differentiating Lung Nodules Due to <i>Coccidioides</i> from Those Due to Lung Cancer Based on Radiographic Appearance Journal of Fungi lung nodule cocci nodule incidental nodule lung cancer pulmonary coccidioidomycosis valley fever |
| title | Differentiating Lung Nodules Due to <i>Coccidioides</i> from Those Due to Lung Cancer Based on Radiographic Appearance |
| title_full | Differentiating Lung Nodules Due to <i>Coccidioides</i> from Those Due to Lung Cancer Based on Radiographic Appearance |
| title_fullStr | Differentiating Lung Nodules Due to <i>Coccidioides</i> from Those Due to Lung Cancer Based on Radiographic Appearance |
| title_full_unstemmed | Differentiating Lung Nodules Due to <i>Coccidioides</i> from Those Due to Lung Cancer Based on Radiographic Appearance |
| title_short | Differentiating Lung Nodules Due to <i>Coccidioides</i> from Those Due to Lung Cancer Based on Radiographic Appearance |
| title_sort | differentiating lung nodules due to i coccidioides i from those due to lung cancer based on radiographic appearance |
| topic | lung nodule cocci nodule incidental nodule lung cancer pulmonary coccidioidomycosis valley fever |
| url | https://www.mdpi.com/2309-608X/9/6/641 |
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