Make sure you proof read your stuff and follow these guidelines. He will literally stay up until midnight editing all your reports if you don't dictate like he asks.
Just say the finding without using "there is/are... there have been..." Use active form.
Don't use the word "prominent", use conspicuous instead
Don't say "markings"
Don't say interstitial thickening (histologic), use reticular opacities
Don't say infiltrate
Don't say "no significant change" - simply say "no change"
Don't abbreviate (except COPD, and select other words)
Don't say "enlarged cardiomediastinal silhouettes" - separate them.
Layering of pleural effusion should be "posterior layering..."
"Chest x-ray" is slang.  Chest radiograph is correct.
"Portable" is slang.  Bedside radiograph is correct.
Use "gas" not air
Use "volume overload" not "fluid overload"
Use pleural effusion not pleural fluid
use frontal radiograph, not PA radiograph (in the report) 
Use "pleural effusion" rather than "pleural fluid"
Only give pertinent negatives that ordering physician's specifically ask for (R/O PNA - no pneumonia seen)
Use streaky opacities rather than streaking opacities
Don't say "negative for _____"
For rib studies - use "no acute displaced rib-fractures seen"
Don't refer to radiographs as "Chest X-rays", CXR, or "films". 
Treat every report as unique and describe what you see without initially relating to the prior study.  Only towards the end of the report you compare with the prior study (and mention by date).
Don't use "lung fields", use "lung zone(s)", "lung lobe(s)", "lung segment(s)", or just "lungs".
Never use "Cannot rule out". Mention the findings and provide a differential diagnosis in order of probability. You cannot rule out thousands of diseases...
"Never use BIBASILAR! ALWAYS USE BIBASAL OR BASAL INSTEAD OF BASILAR! Only in the case of the basilar artery in the skull use the term basilar."
Include a ddx when you mention an opacity/consolidation
when you mention a calcified nodule, explain that it's likely a granuloma
Don't just say CABG, say CABG with single saphenous bypass graft or with LIMA
don't just say pacemaker, say dual lumen AICD/Pacer combination with intact leads in the ____ and _____
Don't say "inferior heart border" but rather the "posterior heart contour."
In the case of pathology that requires immediate treatment, you need to reemphasize at the end of the report the diagnosis and ask for
follow-up to complete resolution. And don't forget to code (1001 for c/f pna, 1003 for c/f cancer). Be generous with coding.
Whenever you mention saber sheath trachea you need to add "consistent with COPD on pulmonary function tests".  Otherwise most
clinicians don't know what to do with this entity.
Describe emphysema, in findings (lucencies)
Don't just say dilated pulmonary arteries, say "dilated central pulmonary arteries"

imaging of the pt with non-small cell lung cancer

overall 5yr survival rate in pts with lung cancer remains dismal at 14% for all stages (clinical staging): 61% for stage 1A, 38% for stage 1B, 34% for stage IIA, 24% for stage IIB, 13^ for stage IIIA, 5% for stage IIIB, and 1% for stage IV.
staging is done according to the "International system for staging lung cancer" (TNM; imaging important because it determines tx).
Pts with good performance status and clinical stage I or II dz (and some IIIA) are considered for surgical removal.
Those with IIIB (except those with T4N0) and IV dz are not surgical candidates.
CT is first for staging, then PET. However, BAC is often not FDG avid and a false-neg rate of 40% has been reported in PET studies.
T1 <3cm and are in lung parenchyma; mention whether its near the main PA, bc pneumonectomy or pulmonary arterioplasty may be indicated. Also mention whether it crosses a fissure (and whether the fissure is complete or not). If it involves a complete fissure = T3.
T2>3cm and may involve the main bronchus, but shouldn't be closer than 2cm to the carina. If <2cm from the carina, they may require a carinal pneumonectomy, a complicated procedure. 

Nodes - Although the American Thoracic Society description of nodal stations is the most commonly used, others, such as proposed by Naruke et al., are also used. The presence of nodes w/i the ipsilateral peribronchial region or hilum indicates N1. N1 LNs can usually be resected at surgery, but technically, they are more difficult to remove if they involve the PA. Involving the PA may require pneumonectomy rather than lobectomy to obtain clear surgical margins. Ipsilateral mediastinal or subcarinal adenopathy constitutes N2 disease and may be resectable. However, contralateral mediastinal adenopathy or any scalene or supraclavicular adenopathy constitutes N3 dz. Some surgeons do mediastinoscopy for all T1 lesions (CT has a sensitivity of 77% in ruling out mets).

Mets - Mets to the adrenals, liver, brain, bone, and LNs. Pts c early stage (T1-2, N0) have M1% incidence of occult mets; so routine eval isn't warrented. Adrenals should be evaluated (mets are common, 20%). But adrenal adenomas are also common (2-10%; remember HU<10 or a reduction of >50% HU on a 10-min delay). MR and PET can help further characterize indeterminate adrenal lesions; chemical shift analysis can determine if benign. Improved survival has been a/w resection of isolated adrenal mets (surgical resection or RF ablastion). Routine CT of the brain isn't recommended (although 18% have mets there) bc they'll have signs/sxs. Occult skeletal mets aren't very common, so bone scan or XR or MR aren't indicated unless there are signs/sxs (may be challenged 2/2 recent study showing 13% skeletal mets on PET).

post-op - portable CXR to R/O tension ptx, collapse, pulmonary edema, and other acute processes.For pts S/P pneumonectomy, most surgeons prefer to have the fluid w/i the pleural space cover the bronchial stump prior to DC (so it's helpful to note this). Pts c pneumonectomy will usually have complete opacification of the hemithorax c shift of the mediastinum into the surgical side w/i 6-8 mo. Occasionally, a hydropneumothorax persists, and, as long as it's stable/asx, its not clinically important.

gross tumor volume - volume that's visible on imaging. Clinical target volume - volume that's likely to contain microscopic dz. Planning target volume - includes clinical tumor volume with a margin to account for daily setup error and target motion. Tumor edges cannot be accurately identified with PET. 

For decades the tx for unresectable stage III NSCLC was thoracic radiation therapy, with a 5-10% long-term survival rate. More recently, however, a combination of chemotherapy and radiation therapy was shown to improve survival in these patients. In addition, pre-op chemo in pts with resectable stage

"Where are they all hiding? Common Blind spots on chest radiography."

1. Upper lobes (usually RUL); due to high frequency, overlapping shadows from clavicles, ribs, and vascular structures.
2. Mediastinum
3. Hila
4. retrocardiac space
5. extrapulmonary structures

Necrotizing PNA, pulmonary abscess, and lung gangrene: Multiple pathways to lung parenchymal destruction

Contrast reactions
Urticaria - mild: consider benadryl 25-50mg PO/IM/IV; severe: epinephrine auto injector (1:1000) 0.15 to 0.3mg IM or epinephrine (1:1000) 0.1 to 0.3mg IM/SC
Bronchospasm - O2 by mask (6-10L/min); Albuterol 1-2 deep inhalations; epinephrine (see above; repeat as needed up to a maximum of 1mg, with proper pt monitoring)
Facial/laryngeal edema - O2 by mask; epinephrine (see above)
Hypotension c tachycardia - O2; legs elevated>60deg; IVF (rapid); if poor response: epinephrine (1:10,000) 0.1 to 0.3mg IV, slowly. Repeat as needed up to a maximum of 1mg
Vasovagal response - O2; legs elevated>60deg; IVF; if poor response: atropine 0.6-1mg IV, slowly. Repeat up to a total of 2-3mg in adults
HTN, severe - O2; NG 0.4mg tablet, SL (may repeat up to X3); If poor response: labetalol 20mg IV, then 20-80mg IV q10m up to 300mg
Pulmonary edema - O2; sit up; furosemide 20-40mg IV, slow push, consider morphine 1-3mg IV