Daisy Ochoa

University of California, Merced

METHODS IN DIAGNOSING PNEUMONIA FOR THE IMPROVEMENT OF RADIOGRAPHS

BACKGROUND • Community acquired Pneumonia (CAP) is a

respiratory infection of the lungs in which the air sacks become swollen due to foreign micro-organisms: bacteria and viruses [1].

• One of the leading causes of death with an estimation of about 12 cases per 1000 adults each year [3].

• 600 people under the age of 65 were admitted to the hospital for CAP [5]

• Chest x-rays, blood and phlegm samples are used in the diagnosis

Fig 1. Consolidation:Inflammation of the lung tissue [4].

METHODS• Process of Identifying the microorganism: Blood and phlegm samples are collected for lab

tests. White blood cell count (WBC), C-reactive protein (CRP), and the rate of red blood cell’s sedimentation is also done in the lab [3].

• ELISA test

RESULTS FROM THE ELISA TEST• Blood samples: 3 patients out of the 10 test positive for pneumococcal pneumonia. The

blood cultures drops that were used in the ELISA did show pneumococcal capsular antigens.

• Other samples, such as sputum, showed that the infections were caused by Staphylococcus aureus in patients with flu-like symptoms.

C-REACTIVE PROTEIN • High expression of CPR shown by the ELISA test. A correlating factor that is used as a

diagnosing tool for pneumonia.

• CRP is a protein released as a inflammation signaling response from the liver.

• Consolidation of the lungs results in high expression of CRP [3].

Fig 3. CRP structure Fig 4. Patchy consolidation CXR [4]

MORE METHODS . . .• Radiographs from chest x-ray (CXR) or a computed tomography scan (CT scan) are

exposed to patients with suspected pneumonia.

• Upright position with protective radiation shielding

• Radiographs: short x-ray pulse is exposed to the patient in which the bones absorb due to the calcium's high absorbency [2]. Bone and air are seen clearly on radiographs unlike tissue due to the density differences of each tissue.

• Radiographs sometimes are unclear and difficult to read due to the interference of consolidation.

FUTURE RESEARCH • Silicon based detectors (lower radiation exposure) vs silver based detectors • Researchers Hilt, B., Fessler, P., & Prevot, G conducted single x-ray exposures to

phantom body parts using regular silver based radiation and silicon based detector of x-rays but produce a low quality image.

• A future goal: use lower exposure of radiation but to produce high quality images.• Future holds improvement to the lab apparatus for researchers to increasing the spatial

resolution, remove unwanted regions, and keep a good contrast within the images.

IN SUMMARY• Multiple methods used in the diagnosis of pneumonia

• Blood samples

• Phlegm samples

• CRP expression

• ELISA test

• Chest x-rays and CT scans

• Future research for radiograph quality

REFERENCES1. Hilt, B., Fessler, P., & Prevot, G. (2000). New quantum detection system for very low dose x-ray radiology.

Nuclear Instruments and Methods in Physics Research, A(421), 38-44.

2. Hayden, G. E., & Wrenn, K. W. (2009). Chest radiograph vs. computed tomography scan in the evaluation for pneumonia. The Journal of Emergency Medicine, 36(3), 266-270. doi: 10.1016/j.jemermed.2007.11.042

3. Castro-Guardiola, A., Armengou-Arxe et al. (2000). Differential diagnosis between community-acquired ́pneumonia and non- pneumonia diseases of the chest in the emergency ward. European Journal of Internal Medicine, 11, 334-339.

4. Das, D., & Howlett, D. C. (2009). Chest x-ray manifestations of pneumonia. 27(10), 453-455.

5. Tang, C. M., & Macfarlane, J. T. (1993). Early management of younger adults dying of community acquired pneumonia. Respiratory Medicine, 87, 289-294.

ANY QUESTIONS?