Imaging plays a role in the evaluation, although there is lack of high-quality evidence guiding which modalities are useful and at what time point in the clinical evaluation they should be performed. Further research may be needed to evaluate which imaging modalities performed earlier in the clinical assessment are beneficial in long-term outcomes. Special Imaging Considerations Our literature review has identified several studies investigating thoracic ultrasound (US) in the evaluation of the noncardiac chest pain. Noncardiac thoracic US performed better than radiography in small prospective cohorts staged in the postoperative intensive care unit [18] and primary care setting [19], confidently identifying findings such as pneumothorax, pleural effusion, consolidation, and interstitial patterns of lung disease. US was shown to correlate well with high-resolution CT (HRCT) and pulmonary function test (PFT) abnormalities [20], and it performed well in several small studies of patients with known interstitial lung disease [21-23]. US may be prone to diminished specificity. For instance, Moazedi-Fuerst et al [24] showed that up to 12% of patients with normal HRCT studies had sonographic findings of an interstitial pattern based on B-lines and artifacts. Adequate US evaluation is operator dependent and requires experience to perform and interpret examination findings. To our knowledge, there is no relevant literature to support the use of thoracic US in the evaluation of chronic cough; however, it is included in this section for awareness and to promulgate future research into this particular topic. Reprint requests to: publications@acr.org Chronic Cough Low-dose chest CT (LDCT) has been clinically validated in the National Lung Screening Trial Research Team for early detection of lung cancer [25]. LDCT has been investigated for early detection of pulmonary infection in elderly patients with normal or equivocal chest radiographs.
Chronic Cough. Imaging plays a role in the evaluation, although there is lack of high-quality evidence guiding which modalities are useful and at what time point in the clinical evaluation they should be performed. Further research may be needed to evaluate which imaging modalities performed earlier in the clinical assessment are beneficial in long-term outcomes. Special Imaging Considerations Our literature review has identified several studies investigating thoracic ultrasound (US) in the evaluation of the noncardiac chest pain. Noncardiac thoracic US performed better than radiography in small prospective cohorts staged in the postoperative intensive care unit [18] and primary care setting [19], confidently identifying findings such as pneumothorax, pleural effusion, consolidation, and interstitial patterns of lung disease. US was shown to correlate well with high-resolution CT (HRCT) and pulmonary function test (PFT) abnormalities [20], and it performed well in several small studies of patients with known interstitial lung disease [21-23]. US may be prone to diminished specificity. For instance, Moazedi-Fuerst et al [24] showed that up to 12% of patients with normal HRCT studies had sonographic findings of an interstitial pattern based on B-lines and artifacts. Adequate US evaluation is operator dependent and requires experience to perform and interpret examination findings. To our knowledge, there is no relevant literature to support the use of thoracic US in the evaluation of chronic cough; however, it is included in this section for awareness and to promulgate future research into this particular topic. Reprint requests to: publications@acr.org Chronic Cough Low-dose chest CT (LDCT) has been clinically validated in the National Lung Screening Trial Research Team for early detection of lung cancer [25]. LDCT has been investigated for early detection of pulmonary infection in elderly patients with normal or equivocal chest radiographs.