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  1. Article ; Online: The Evolution of COVID-19: Omicron and Subvariants.

    Hammer, Mark M

    Radiology

    2023  Volume 308, Issue 1, Page(s) e231540

    MeSH term(s) Humans ; COVID-19/virology ; SARS-CoV-2/genetics ; Evolution, Molecular
    Language English
    Publishing date 2023-07-05
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 80324-8
    ISSN 1527-1315 ; 0033-8419
    ISSN (online) 1527-1315
    ISSN 0033-8419
    DOI 10.1148/radiol.231540
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  2. Article ; Online: Risk and Time to Diagnosis of Lung Cancer in Incidental Pulmonary Nodules.

    Hammer, Mark M

    Journal of thoracic imaging

    2023  

    Abstract: Purpose: To determine the risk of lung cancer in incidental pulmonary nodules, as well as the time until cancer growth is detected.: Patients and methods: This retrospective study examined patients with incidental nodules detected on chest computed ... ...

    Abstract Purpose: To determine the risk of lung cancer in incidental pulmonary nodules, as well as the time until cancer growth is detected.
    Patients and methods: This retrospective study examined patients with incidental nodules detected on chest computed tomography (CT) in 2017. Characteristics of the dominant nodule were automatically extracted from CT reports, and cancer diagnoses were manually verified by a thoracic radiologist. Nodules were categorized per Fleischner Society guideline categories: solid <6 mm, solid 6 to 8 mm, solid >8 mm, subsolid <6 mm, ground glass nodules ≥6 mm, and part-solid nodules ≥6 mm. The time to nodule growth was determined by CT reports.
    Results: A total of 3180 patients (nodules) were included, of which 155 (5%) were diagnosed with lung cancer. By category, 7/1601 (0.4%) solid nodules <6 mm, 11/713 (1.5%) solid nodules 6 to 8 mm, 71/446 (15.9%) solid nodules >8 mm, 1/124 (0.8%) subsolid nodules <6 mm, 29/202 (14.4%) ground glass nodules ≥6 mm, and 36/94 (37.9%) part-solid nodules ≥6 mm were malignant. Of solid lung cancers <6 mm, growth was observed in 1/4 imaged by 1 year and 2/5 by 2 years; of solid lung cancers 6 to 8 mm, growth was observed in 3/10 imaged by 1 year and 6/10 by 2 years.
    Conclusion: Solid nodules <6 mm have a very low risk of malignancy and may not require routine follow-up. However, when malignant, growth is often not observed until 2 or more years later; therefore, stability at 1 to 2 years does not imply benignity.
    Language English
    Publishing date 2023-11-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632900-7
    ISSN 1536-0237 ; 0883-5993
    ISSN (online) 1536-0237
    ISSN 0883-5993
    DOI 10.1097/RTI.0000000000000768
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  3. Article ; Online: Imaging Diagnosis of Thoracic Elastofibroma Dorsi.

    Pi, Yeli / Hammer, Mark M

    Journal of computer assisted tomography

    2024  

    Abstract: Objective: Elastofibroma dorsi (ED) is an uncommon benign tumor that is commonly incidentally discovered on thoracic imaging and at times misinterpreted as a more aggressive lesion. The objective of the study is to characterize the typical cross- ... ...

    Abstract Objective: Elastofibroma dorsi (ED) is an uncommon benign tumor that is commonly incidentally discovered on thoracic imaging and at times misinterpreted as a more aggressive lesion. The objective of the study is to characterize the typical cross-sectional imaging findings of elastofibroma dorsi and quantify the risk of masquerading malignancy.
    Methods: Retrospective search of radiology and pathology reports over a 12-year period identified 409 cases of suspected ED. Pertinent imaging was reviewed with a focus on computed tomography (CT) and magnetic resonance imaging (MRI), specifically assessing lesion location, presence of interspersed fat, and appearances on follow-up.
    Results: Typical imaging appearances of 310 ED, including 10% with pathologic confirmation, were that of a mass deep to the serratus anterior (98%) and near the scapular tip (98%). Intralesional interspersed fat was present in 87% of cases imaged with CT and in 90% of cases imaged with MRI. In the 43 cases imaged with both modalities, 8 (19%) did not have interspersed fat on CT, but 7 (88%) of these did have interspersed fat on MRI. Twelve tumors (benign and malignant) were included, of which only 17% were deep to serratus anterior and 25% were at the scapular tip, P = 0.0001 and P < 0.0001 versus ED. Only a single tumor contained interspersed fat, P < 0.001 versus ED, which had benign pathology on biopsy.
    Conclusions: Elastofibroma dorsi can be diagnosed with a high degree of certainty in the presence of classic location and imaging characteristics, obviating the need for further imaging or biopsy.
    Language English
    Publishing date 2024-05-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80392-3
    ISSN 1532-3145 ; 0363-8715
    ISSN (online) 1532-3145
    ISSN 0363-8715
    DOI 10.1097/RCT.0000000000001626
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  4. Article ; Online: Beyond the

    Hammer, Mark M / Raptis, Constantine A

    AJR. American journal of roentgenology

    2023  

    Language English
    Publishing date 2023-08-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 82076-3
    ISSN 1546-3141 ; 0361-803X ; 0092-5381
    ISSN (online) 1546-3141
    ISSN 0361-803X ; 0092-5381
    DOI 10.2214/AJR.23.30091
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  5. Article ; Online: Real-World Diagnostic Performance of RSNA Consensus Reporting Guidelines for Findings Related to COVID-19 on Chest CT.

    Hammer, Mark M

    AJR. American journal of roentgenology

    2021  Volume 218, Issue 1, Page(s) 75–76

    Abstract: This study evaluated the real-world diagnostic performance of Radiological Society of North America COVID-19 consensus reporting guidelines among 2618 chest CT reports from the author's health care network from April 2020 through March 2021; reverse- ... ...

    Abstract This study evaluated the real-world diagnostic performance of Radiological Society of North America COVID-19 consensus reporting guidelines among 2618 chest CT reports from the author's health care network from April 2020 through March 2021; reverse-transcriptase polymerase chain reaction served as the reference. Typical findings exhibited sensitivity of 68% and specificity of 91%, similar to performance reported in research settings. PPV of 52% was lower than previously reported, attributed to low COVID-19 prevalence. Accuracy improved from 84% in April 2020 to 92% in March 2021 (
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; COVID-19/diagnostic imaging ; Child ; Child, Preschool ; Consensus ; Female ; Humans ; Lung/diagnostic imaging ; Male ; Middle Aged ; North America ; Retrospective Studies ; SARS-CoV-2 ; Sensitivity and Specificity ; Societies, Medical ; Tomography, X-Ray Computed/methods ; Young Adult
    Language English
    Publishing date 2021-08-04
    Publishing country United States
    Document type Journal Article ; Practice Guideline
    ZDB-ID 82076-3
    ISSN 1546-3141 ; 0361-803X ; 0092-5381
    ISSN (online) 1546-3141
    ISSN 0361-803X ; 0092-5381
    DOI 10.2214/AJR.21.26560
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  6. Article ; Online: Cost-effectiveness of Follow-up CT for Incidental Ascending Aortic Dilatation.

    Hammer, Mark M / Kong, Chung Yin

    Radiology. Cardiothoracic imaging

    2023  Volume 5, Issue 2, Page(s) e220169

    Abstract: Purpose: To evaluate the cost-effectiveness of CT follow-up strategies for incidental aortic dilatation.: Materials and methods: In this cost-effectiveness analysis, a simulation model was developed with 1 000 000 adult patients aged 55-75 years with ...

    Abstract Purpose: To evaluate the cost-effectiveness of CT follow-up strategies for incidental aortic dilatation.
    Materials and methods: In this cost-effectiveness analysis, a simulation model was developed with 1 000 000 adult patients aged 55-75 years with incidentally detected dilated aortas measuring 40-50 mm. Follow-up CT strategies were evaluated for various patient age- and aortic size-based cutoffs. Follow-up frequency ranged from 1 to 3 years, as well as a single follow-up CT examination at 1 year. Patient survival was determined by risk of aortic dissection or rupture and surgical- and age-based mortality. Costs and quality-adjusted life-years (QALYs) were calculated for each strategy within the simulated cohort. A probabilistic sensitivity analysis was performed by varying model parameters.
    Results: The cost-effective strategy with the highest QALYs under a willingness-to-pay threshold of $100 000 per QALY was follow-up CT for patients younger than 60 years with aortas measuring at least 40 mm in diameter every 3 years (incremental cost-effectiveness ratio, $62 511; 95% CI: $52 168, $77 739). With this strategy, follow-up imaging was needed for only 17% of dilated aortas in the cohort. Probabilistic sensitivity analysis demonstrated that the cost-effective strategies at $100 000 per QALY threshold included the following: no follow-up for patients with aortas smaller than 50 mm (39% of simulations), follow-up every 3 years for patients younger than 55 years with aortas measuring at least 45 mm (21%), and follow-up every 3 years for patients older than 65 years with aortas measuring at least 40 mm (14%).
    Conclusion: Follow-up CT for an incidentally detected dilated ascending aorta smaller than 50 mm is likely not cost-effective in patients older than 60-65 years.
    Language English
    Publishing date 2023-04-27
    Publishing country United States
    Document type Journal Article
    ISSN 2638-6135
    ISSN (online) 2638-6135
    DOI 10.1148/ryct.220169
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  7. Article ; Online: Growth Rates of Pulmonary Carcinoid Tumors and Hamartomas.

    Ryan, James W / Hammer, Mark M

    Journal of computer assisted tomography

    2023  Volume 47, Issue 3, Page(s) 396–401

    Abstract: Background: Pulmonary nodule growth is often measured by volume doubling time (VDT), which may guide management. Most malignant nodules have a VDT of 20 to 400 days, with longer VDTs typically observed in indolent nodules. We assessed the utility of VDT ...

    Abstract Background: Pulmonary nodule growth is often measured by volume doubling time (VDT), which may guide management. Most malignant nodules have a VDT of 20 to 400 days, with longer VDTs typically observed in indolent nodules. We assessed the utility of VDT in differentiating pulmonary carcinoids and hamartomas.
    Methods: A review was performed from January 2012 to October 2021 to identify patients with pathologic diagnoses and at least 2 chest computed tomography scans obtained 6 or more months apart. Visualization software was used to segment nodules and calculate diameter and volume. Volume doubling time was calculated for scans with 1-mm slices. For the remainder, estimated nodule volume doubling time (eVDT) was calculated using nodule diameter. Volume doubling times/eVDTs were placed into growth categories: less than 400 days; 400-600 days; and more than 600 days.
    Results: Sixty nodules were identified, 35 carcinoids and 25 hamartomas. Carcinoids were larger than hamartomas (median diameter, 13.5 vs 11.5 mm; P = 0.05). For carcinoid tumors, median VDT (n = 15) was 1485 days, and median eVDT (n = 32) was 1309 days; for hamartomas, median VDT (n = 8) was 2040 days and median eVDT (n = 25) was 2253 days. Carcinoid tumor eVDT was significantly shorter than hamartomas ( P = 0.03). By growth category, 1 of 25 hamartomas and 5 of 35 carcinoids had eVDT less than 400 days and 24 of 25 hamartomas and 27 of 35 carcinoids had eVDT more than 600 days. Of 4 carcinoid tumors with metastases, 2 had eVDT less than 400 days and 2 had eVDT more than 600 days.
    Conclusions: Growth rate was not a reliable differentiator of pulmonary hamartomas and carcinoids. Slow growing carcinoids can metastasize. Radiologists should be cautious when discontinuing computed tomography follow-up based on growth rates alone.
    MeSH term(s) Humans ; Lung Neoplasms/diagnostic imaging ; Lung Neoplasms/pathology ; Tomography, X-Ray Computed/methods ; Carcinoid Tumor/diagnostic imaging ; Carcinoma, Neuroendocrine ; Hamartoma/diagnostic imaging
    Language English
    Publishing date 2023-01-14
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80392-3
    ISSN 1532-3145 ; 0363-8715
    ISSN (online) 1532-3145
    ISSN 0363-8715
    DOI 10.1097/RCT.0000000000001413
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  8. Article ; Online: Factors Associated With Delay in Lung Cancer Diagnosis and Surgery in a Lung Cancer Screening Program.

    El Alam, Raquelle / Hammer, Mark M / Byrne, Suzanne C

    Journal of thoracic imaging

    2024  

    Abstract: Purpose: Delays to biopsy and surgery after lung nodule detection can impact survival from lung cancer. The aim of this study was to identify factors associated with delay in a lung cancer screening (LCS) program.: Materials and methods: We evaluated ...

    Abstract Purpose: Delays to biopsy and surgery after lung nodule detection can impact survival from lung cancer. The aim of this study was to identify factors associated with delay in a lung cancer screening (LCS) program.
    Materials and methods: We evaluated patients in an LCS program from May 2015 through October 2021 with a malignant lung nodule classified as lung CT screening reporting and data system (Lung-RADS) 4B/4X. A cutoff of more than 30 days between screening computed tomography (CT) and first tissue sampling and a cutoff of more than 60 days between screening CT and surgery were considered delayed. We evaluated the relationship between delays to first tissue sampling and surgery and patient sex, age, race, smoking status, median income by zip code, language, Lung-RADS category, and site of surgery (academic vs community hospital).
    Results: A total of 185 lung cancers met the inclusion criteria, of which 150 underwent surgical resection. The median time from LCS CT to first tissue sampling was 42 days, and the median time from CT to surgery was 52 days. 127 (69%) patients experienced a first tissue sampling delay and 60 (40%) had a surgical delay. In multivariable analysis, active smoking status was associated with delay to first tissue sampling (odds ratio: 3.0, CI: 1.4-6.6, P = 0.005). Only performing enhanced diagnostic CT of the chest before surgery was associated with delayed lung cancer surgery (odds ratio: 30, CI: 3.6-252, P = 0.02). There was no statistically significant difference in delays with patients' sex, age, race, language, or Lung-RADS category.
    Conclusion: Delays to first tissue sampling and surgery in a LCS program were associated with current smoking and performing diagnostic CT before surgery.
    Language English
    Publishing date 2024-03-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632900-7
    ISSN 1536-0237 ; 0883-5993
    ISSN (online) 1536-0237
    ISSN 0883-5993
    DOI 10.1097/RTI.0000000000000778
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  9. Article ; Online: Abnormal Gas at Chest Radiography: A Primer with CT and 3D Reconstruction Correlation.

    Singhal, Sameer / Jairam, Meghan P / Jhala, Khushboo / Hammer, Mark M

    Radiographics : a review publication of the Radiological Society of North America, Inc

    2024  Volume 44, Issue 3, Page(s) e230146

    MeSH term(s) Humans ; Imaging, Three-Dimensional ; Radiography ; Radiography, Thoracic ; Tomography, X-Ray Computed
    Language English
    Publishing date 2024-02-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 603172-9
    ISSN 1527-1323 ; 0271-5333
    ISSN (online) 1527-1323
    ISSN 0271-5333
    DOI 10.1148/rg.230146
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  10. Article ; Online: Strategies for Reducing False-Positive Screening Results for Intermediate-Size Nodules Evaluated Using Lung-RADS: A Secondary Analysis of National Lung Screening Trial Data.

    Hammer, Mark M / Hunsaker, Andetta R

    AJR. American journal of roentgenology

    2022  Volume 219, Issue 3, Page(s) 397–405

    Abstract: BACKGROUND. ...

    Abstract BACKGROUND.
    MeSH term(s) Early Detection of Cancer/methods ; Female ; Humans ; Lung/diagnostic imaging ; Lung/pathology ; Lung Neoplasms/diagnostic imaging ; Lung Neoplasms/pathology ; Male ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed/methods
    Language English
    Publishing date 2022-03-23
    Publishing country United States
    Document type Clinical Trial ; Journal Article
    ZDB-ID 82076-3
    ISSN 1546-3141 ; 0361-803X ; 0092-5381
    ISSN (online) 1546-3141
    ISSN 0361-803X ; 0092-5381
    DOI 10.2214/AJR.22.27595
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