Department of radiology and Radiological Science

Thoracic Radiology

Lung Nodule
             Lung Nodule Volumetric Analysis

The Section of Thoracic Radiology is responsible for the interpretation of all chest radiographs, chest CT and chest MR.  This includes over 45,000 chest x-rays and 10,000 CT’s per year.  Chest radiographs are all obtained digitally with either computed or digital radiography allowing for rapid transmission of images to the section even at off-site imaging centers.  CT exams are performed on advanced multi-detector imaging platforms.  All studies are reconstructed with thick and thin images so that volumetric data is available whenever necessary.  All protocols undergo periodic review as well as an assessment of radiation used to ensure the lowest possible dose while maintaining diagnostic image quality.  Each request is individually tailored to the specific question asked by the ordering physician.  It is our belief that for the majority of indication, intravenous contrast is not necessary for interpretation.  Therefore, we only give intravenous contrast when we believe it is necessary to obtain a correct diagnosis (evaluation for pulmonary embolism, aortic disease, and hilar masses). Intravenous contrast is generally given when the exam is combined with other body parts (the neck or abdomen).  We now offer lung cancer screening exams and we are the only site in South Carolina to participate in the National Lung Screening Trial, the seminal study showing the value of CT screening in high risk smokers.  TeraRecon workstations are used to produce multi-planar and 3-D images when clinically necessary and nodule volumes can be obtained to assess growth.  MR imaging is used primarily as a problem solving tool typically the evaluation of the chest wall in mesothelioma and other neoplasms.  All images are read via the AGFA PACS system and reported using voice recognition software so that final reports are available the same day.

Research in Thoracic Radiology

The Section of Thoracic Radiology is an active participant in research both within the department and institution.  Currently, the core focus is on the detection and management of small pulmonary nodules.  The hope is to use specific characteristics of pulmonary nodules to predict behavior which will in turn lead to more rapid diagnosis of malignancy and less frequent scans and cost savings for noldules which are benign.

Dr. Ravenel has been the site primary investigator on three multi-institutional ACRIN trials most notably ACRIN 6654, part of the National Lung Screening Trial (NLST).  Similarly, the section supports the Hollings Cancer Center in its clinical trials and the Division of Pulmonary and Critical Care Medicine in clinical trials involving Idiopathic Pulmonary Fibrosis, Scleroderma, Emphysema, and Rare Lung Diseases.

Current research interests of the section include the projects above as well as the use of CT for the detection of pulmonary embolism, the evaluation of acute traumatic aortic injury, and the relationship of radiation dose to image quality and dose reduction techniques.

Thoracic Imaging Faculty
James Ravenel, M.D.
Director, Thoracic Imaging

Philip Costello, M.D.
Chairman, Radiology

Stephen Schabel, M.D.
Pal Suranyi, M.D., Ph.D.

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