Preliminary Diagnosis: Cryptogenic Organizing Pneumonia

I. What imaging technique is first-line for this diagnosis?

Chest X-ray, PA, and lateral view.

II. Describe the advantages and disadvantages of this technique for diagnosing cryptogenic organizing pneumonia.

Advantages
  • Inexpensive.

  • Fast imaging modality.

  • Exposes patients to minimal ionizing radiation.

  • Highly portable.

Disadvantages

Less sensitive and specific in detailing any primary parenchymal and/or pleural process or any secondary complication compared to companion cross sectional imaging.

III. What are the contraindications for the first-line imaging technique?

No specific contraindications to plain radiography exist.

IV. What alternative imaging techniques are available?

CT of the chest with IV contrast and/or high resolution CT of the chest.

V. Describe the advantages and disadvantages of the alternative techniques for diagnosing cryptogenic organizing pneumonia.

Advantages
  • More sensitive and specific in detailing a primary parenchymal or pleural abnormality and in detecting and characterizing any secondary complication than plain radiographs.

  • May help guide treatment.

  • High resolution CT imaging offers exquisite detail of the underlying brain parenchyma, surrounding vasculature, and adjacent mediastinal structures.

Disadvantages
  • Exposes patients to larger amounts of ionizing radiation.

  • More expensive and less portable compared to plain radiography.

VI. What are the contraindications for the alternative imaging techniques?

May be contraindicated in pregnant patients.

This article originally appeared on Cancer Therapy Advisor