Mylene T Truong

University of Texas MD Anderson Cancer Center, Houston, Texas, United States

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Publications (113)320.11 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study is to evaluate the rate of overdiagnosis of pulmonary embolism (PE) by pulmonary CT angiography (CTA) in a tertiary-care university hospital. This study is a retrospective review of all pulmonary CTA examinations performed in a tertiary-care university hospital over a 12-month period. Studies originally reported as positive for PE were retrospectively reinterpreted by three subspecialty chest radiologists with more than 10 years' experience. A pulmonary CTA was considered negative for PE when all three chest radiologists were in agreement that the pulmonary CTA study was negative for PE. The location and potential causes for PE overdiagnosis were recorded. A total of 937 pulmonary CTA studies were performed over the study period. PE was diagnosed in the initial report in 174 of these cases (18.6%). There was discordance between the chest radiologists and the original radiologist in 45 of 174 (25.9%) cases. Discordance occurred more often where the original reported PE was solitary (46.2% of reported solitary PEs were considered negative on retrospective review) and located in a segmental or subsegmental pulmonary artery (26.8% of segmental and 59.4% of subsegmental PE diagnoses were considered negative on retrospective review). The most common cause of diagnostic difficulty was breathing motion artifact, followed by beam-hardening artifact. In routine clinical practice, PEs diagnosed by pulmonary CTA are frequently overdiagnosed, when compared with the consensus opinion of a panel of expert chest radiologists. Improvements in the quality of pulmonary CTA examination and increased familiarity with potential diagnostic pitfalls in pulmonary CTA are recommended to minimize misdiagnosis of PE.
    American Journal of Roentgenology 08/2015; 205(2):271-7. DOI:10.2214/AJR.14.13938 · 2.73 Impact Factor
  • Magnetic Resonance Imaging Clinics of North America 05/2015; 23(2). DOI:10.1016/j.mric.2015.01.005 · 0.99 Impact Factor
  • Mylene T Truong
    Seminars in Roentgenology 04/2015; 50(2):67. DOI:10.1053/ · 0.71 Impact Factor
  • Seminars in Roentgenology 04/2015; 50(2):68-71. DOI:10.1053/ · 0.71 Impact Factor
  • Seminars in Roentgenology 02/2015; DOI:10.1053/ · 0.71 Impact Factor
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    ABSTRACT: Despite recent technological advances that enable high diagnostic accuracy for pulmonary nodule detection and characterization, numerous pitfalls exist that may result in misdiagnosis. This pictorial review outlines the most common potential pitfalls in the characterization of lung nodules that include artifacts in chest radiography, benign nodules that mimic lung cancer on chest CT, and causes of false negative evaluations of lung cancer with CT and PET/CT studies. Awareness of the spectrum of potential pitfalls in pulmonary nodule detection and characterization, including equivocal or atypical presentations, is important for avoiding misinterpretation that can alter patient management.
    Seminars in Roentgenology 02/2015; 50(3). DOI:10.1053/ · 0.71 Impact Factor
  • Seminars in Roentgenology 02/2015; 50(3). DOI:10.1053/ · 0.71 Impact Factor
  • Mylene T. Truong
    Seminars in Roentgenology 02/2015; 50(3). DOI:10.1053/ · 0.71 Impact Factor
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    ABSTRACT: Hematopoietic stem cell transplantation (HSCT) is a widely used treatment indicated in a variety of malignant and non-malignant hematologic diseases, as well as metabolic and autoimmune conditions. Several infectious and noninfectious complications are commonly seen. Imaging, particularly CT, plays an important role in the diagnosis of life-threatening pulmonary infections and other non-infectious complications. In this article, we review the potential pitfalls in evaluating the most common complications at different phases following transplantation and their main CT findings, as well as their differential diagnosis.
    Seminars in Roentgenology 02/2015; 50(3). DOI:10.1053/ · 0.71 Impact Factor
  • Seminars in Roentgenology 02/2015; 50(3). DOI:10.1053/ · 0.71 Impact Factor
  • Seminars in Roentgenology 02/2015; 50(3). DOI:10.1053/ · 0.71 Impact Factor
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    ABSTRACT: Small cell lung carcinoma (SCLC) is the most common primary pulmonary neuroendocrine malignancy and is characterized by a rapid doubling time and high growth fraction. Approximately 60%-70% of patients present with metastatic disease at the time of diagnosis, and their prognosis is poor. However, improved survival has been demonstrated when SCLC is diagnosed early and specific treatment strategies are used. A modified version of the Veterans Administration Lung Cancer Study Group (VALSG) staging system has traditionally been used to categorize SCLC as limited-stage or extensive-stage disease to guide therapy. However, the International Association for the Study of Lung Cancer has recommended that the current seventh edition of the American Joint Committee on Cancer tumor-node-metastasis staging system for lung cancer replace the VALSG system for staging of SCLC. Appropriate staging and patient management require knowledge of imaging manifestations of SCLC across multiple imaging modalities, the strengths and weaknesses of specific examinations, the correlation of these findings with the staging criteria used in clinical practice, and the impact of appropriate staging on patient treatment and survival. Computed tomography (CT) is primarily used to evaluate the primary tumor and the extent of intrathoracic disease. In recent years, however, 2-[fluorine-18]fluoro-2-deoxy-d-glucose positron emission tomography/CT has proved to be more accurate than conventional imaging in the staging of SCLC and can be used to guide therapy and assess treatment response. ©RSNA, 2014.
    Radiographics 10/2014; 34(6):1707-1721. DOI:10.1148/rg.346140178 · 2.60 Impact Factor
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    ABSTRACT: A solitary pulmonary nodule (SPN) is defined as a round opacity that is smaller than 3 cm. It may be solid or subsolid in attenuation. Semisolid nodules may have purely ground-glass attenuation or be partly solid (mixed solid and ground-glass attenuation). The widespread use of multidetector computed tomography (CT) has increased the detection of SPNs. Although clinical assessment of patients' risk factors for malignancy-such as age, smoking history, and history of malignancy-is important to determine appropriate treatment, in the recently published Fleischner guidelines for subsolid nodules, smoking history does not factor into their recommendations for management because there is an increasing incidence of lung adenocarcinoma in younger and nonsmoking patients. At imaging evaluation, obtaining prior chest radiographs or CT images is useful to assess nodule growth. Further imaging evaluation, including CT enhancement studies and positron emission tomography (PET), helps determine the malignant potential of solid SPNs. For subsolid nodules, initial follow-up CT is performed at 3 months to determine persistence, because lesions with an infectious or inflammatory cause can resolve in the interval. CT enhancement studies are not applicable for subsolid nodules, and PET is of limited utility because of the low metabolic activity of these lesions. Because of the likelihood that persistent subsolid nodules represent adenocarcinoma with indolent growth, serial imaging reassessment for a minimum of 3 years and/or obtaining tissue samples for histologic analysis are recommended. In the follow-up of subsolid SPNs, imaging features that indicate an increased risk for malignancy include an increase in size, an increase in attenuation, and development of a solid component. ©RSNA, 2014.
    Radiographics 10/2014; 34(6):1658-1679. DOI:10.1148/rg.346130092 · 2.60 Impact Factor
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    ABSTRACT: Oncologic therapy is constantly evolving to improve patient outcomes, especially with regard to chemotherapy. The use of combination therapies and development and implementation of molecular targeted therapy lead to iatrogenic conditions that the radiologist must be aware of in interpreting studies of and caring for the oncologic patient. Knowledge of the chemotherapeutic agents and the imaging appearances of associated toxicities can impact patient management and decrease patient morbidity and mortality.
    Radiologic Clinics of North America 09/2014; 52(5):1029-1040. DOI:10.1016/j.rcl.2014.05.008 · 1.98 Impact Factor
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    ABSTRACT: Oncologic patients are treated with a combination of chemotherapy, radiation therapy, and surgery. Advances in therapeutic options have greatly improved the survival of patients with cancer. Examples of these advances are newer chemotherapeutic agents that target the cell receptors and advanced radiation therapy delivery systems. It is imperative that radiologists be aware of the variety of imaging findings seen after therapy in patients with cancer. Complications may occur with classic cytotoxic therapies (eg, 5-fluorouracil), usually at higher or prolonged doses or when administered to radiosensitive areas. Newer targeted systemic agents, such as bevacizumab and imatinib, have associated characteristic toxicities because their effects on cells do not depend on dose. Radiation may induce early and late effects in local normal tissues that may be seen at imaging. Imaging findings after chemotherapy include fatty liver, pseudocirrhosis, hepatic veno-occlusive disease, and splenic rupture. Complications of radiation therapy include large and small bowel strictures and radiation-induced hepatitis and tumors. Awareness of the various therapeutic options and knowledge of the spectrum of posttherapeutic complications allows radiologists to provide a comprehensive report that may impact patient management. ©RSNA, 2014.
    Radiographics 07/2014; 34(4):941-961. DOI:10.1148/rg.344140082 · 2.60 Impact Factor
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    ABSTRACT: Richter's syndrome (RS) is associated with poor outcome. The prognosis of patients with histologically aggressive chronic lymphocytic leukemia (CLL), HAC, has not been studied. We aimed to correlate 2-Deoxy-2-[(18)F]fluoroglucose/positron emission tomography (FDG/PET) data, histological diagnosis, clinical characteristics and survival in patients with CLL. 332 patients with CLL were histologically classified as: 95 RS, 117 HAC, and 120 histologically indolent CLL (HIC). HAC and RS patients had higher maximum standardized uptake value (SUVmax), more frequent constitutional symptoms, poorer PS, lower hemoglobin and platelets, higher LDH and beta-2-microglobulin. A SUVmax≥10 strongly correlated with mortality (overall survival, OS, 56.7 vs 6.9 months in patients with SUVmax<10 vs ≥10). Survival of patients with RS and HAC was similar among patients with SUVmax<10 or ≥10. SUVmax≥10, PS≥2, bulky disease, and age≥65 were independently associated with shorter OS. In patients undergoing both fine-needle aspiration (FNA) and biopsy, FNA proved diagnostically inadequate in 23%, 29% and 53% of HIC, HAC and RS, respectively. FDG/PET is a useful diagnostic tool in patients with CLL and suspected transformation. Patients with HAC show different characteristics and worse prognosis compared to those with HIC. Patients with different CLL phases, but similar SUVmax have similar outcome. Tissue biopsy should be preferred for diagnosing RS.
    Blood 03/2014; 123(18). DOI:10.1182/blood-2013-11-536169 · 10.45 Impact Factor
  • Radiologic Clinics of North America 01/2014; 52(1):85–103. · 1.98 Impact Factor
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    ABSTRACT: Thoracotomy with lung resection produces postoperative changes that can be challenging for the radiologist. Complications related to anatomic and physiologic changes, infection, and breakdown of surgical anastomoses can significantly increase morbidity and mortality. Prompt and accurate diagnosis of serious postoperative complications is essential.
    Radiologic Clinics of North America 01/2014; 52(1):85-103. DOI:10.1016/j.rcl.2013.08.008 · 1.98 Impact Factor
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    ABSTRACT: PET/CT is widely used in the staging and assessment of therapeutic response in patients with malignancies. Accurate interpretation of PET/CT requires knowledge of the normal physiologic distribution of [18F]-fluoro-2-deoxy-d-glucose, artifacts due to the use of CT for attenuation correction of the PET scan and potential pitfalls due to malignancies that are PET negative and benign conditions that are PET positive. Awareness of these artifacts and potential pitfalls is important in preventing misinterpretation that can alter patient management.
    Radiologic Clinics of North America 01/2014; 52(1):17-25. DOI:10.1016/j.rcl.2013.08.005 · 1.98 Impact Factor
  • Radiologic Clinics of North America 01/2014; 52(1):17–25. · 1.98 Impact Factor

Publication Stats

3k Citations
320.11 Total Impact Points


  • 2000–2015
    • University of Texas MD Anderson Cancer Center
      • • Division of Diagnostic Imaging
      • • Department of Surgical Oncology
      • • Department of Radiology
      Houston, Texas, United States
  • 2006–2008
    • University of Houston
      Houston, Texas, United States