Diagnosis of pulmonary alveolar microlithiasis

Radiol Bras. 2015 Set/Out;48(5):IX–X In previous issue of Radiologia Brasileira, readers can find a very interesting article published by Francisco et al. about pulmonary alveolar microlithiasis (PAM). The authors describe the highresolution computed tomography (HRCT) findings in chest exams of 13 patients with PAM, independently evaluated by two observers. According to the authors, diagnoses of PAM can be made on basis of clinical data compatible with the typical imaging findings, with no need for confirmation by biopsy. Thus, the mentioned article is quite interesting and current as, besides describing findings in an optimum sample of patients with a quite rare disease, utilizing a scientific methodological process recommended for this type of study, the authors highlight the increasing relevance of our specialty in recent years, as imaging findings associated with clinical data are sufficient to formulate a diagnosis, with no need for interventional procedures. PAM is a very rarely observed disease, and the few studies describing its radiological findings are restricted to case reports or case series with a small number of patients. The study of 13 well documented cases certainly adds information about tomographic assessment of this disease. For the purpose of comparison, we can mention, for example, the study developed by Deniz et al., published in an important European radiology journal, in which the authors evaluated 10 patients with PAM and described imaging findings at HRCT. The methodological process is another positive point to be considered. Even considering that it is a case review article, it is necessary to highlight the relevance of an appropriate scientific method and of the correct way to present and discuss results in a text written for publication in a medical journal. In this article by Francisco et al., two experienced observers have independently evaluated the images with later consensual decision in cases of disagreement. Such analysis carries a lower chance of biases and is more reliable and reproducible as compared, for example, with a review undertaken by a single observer. There are texts from different societies offering guidance not only regarding methods applied to research in radiology, but also regarding results presentation techniques, writing of scientific texts and education in research. Scientific research in the field of radiology has developed a lot in recent years, following the trend of changes and modernization of scientific methods in other areas of medicine.