Chest X-ray versus chest computed tomography for outcome prediction in hospitalized patients with COVID-19.

The purpose of this study was to compare the prognostic value of chest X-ray (CXR) and chest computed tomography (CT) in a group of hospitalized patients with COVID-19. For this study, we retrospectively selected a cohort of 106 hospitalized patients with COVID-19 who underwent both CXR and chest CT at admission. For each patient, the pulmonary involvement was ranked by applying the Brixia score for CXR and the percentage of well-aerated lung (WAL) for CT. The Brixia score was assigned at admission (A-Brixia score) and during hospitalization. During hospitalization, only the highest score (H-Brixia score) was considered. At admission, the percentage of WAL (A-CT%WAL) was quantified using a dedicated software. On logistic regression analyses, H-Brixia score was the most effective radiological marker for predicting in-hospital mortality and invasive mechanical ventilation. Additionally, A-CT%WAL did not provide substantial advantages in the risk stratification of hospitalized patients with COVID-19 compared to A-Brixia score.

Value of [18F]FDG PET-CT in the follow-up of surgically treated oral tongue squamous cell carcinoma: single centre cohort analysis on 87 patients.

BACKGROUND: To evaluate the diagnostic performance of [¹8F]fluorodeoxyglucose positron emission tomography/computed tomography ([¹8F]FDG-PET/CT) scan in detecting local recurrences in patients with surgically treated oral tongue squamous cell cancer (OTSCC). MATERIAL AND METHODS: Eighty-seven patients who had undergone surgery for OTSCC were monitored clinically and [¹8F]FDGPET/CT and magnetic resonance (MR). PET uptakes were classified as functional (Type A), suspicious (Type B), or highly suggestive of local recurrence (Type C). A multidisciplinary team (MDT) evaluated case-by-case the surveillance strategy based on PET uptake. RESULTS: Fifty-nine patients presented FDG-PET uptake during follow-up: this report was significantly more frequent in patients who received flap reconstruction than in those without (73% vs 50%; p = 0.05). In 13 patients with Type A (n = 1), Type B (n = 9), and Type C (n = 3) uptakes an additional MR was considered preferable and discovered recurrence in 12.PET-CT had 9 true positives, 17 false positives, 71 true negatives, and no false-negative, resulting in sensitivity, specificity, positive (PPV) and negative predictive values (NPV) of 100%, 80.7%, 34.6%, and 100%. CONCLUSIONS: The present results demonstrated a change in diagnostic strategy, as decided by the MDT, in about one-fifth of patients. The results should prompt in designing a rational surveillance schedule in surgically treated OTSCC.

Lombardy, Northern Italy: COVID-19 second wave less severe and deadly than the first? A preliminary investigation.

BACKGROUND: The much-heralded second wave of coronavirus disease (COVID-19) has arrived in Italy. Right now, one of the main questions about COVID-19 is whether the second wave is less severe and deadly than the first wave. In order to answer this challenging question, we decided to evaluate the chest X-ray (CXR) severity of COVID-19 pneumonia, the mechanical ventilation (MV) use, the patient outcome, and certain clinical/laboratory data during the second wave and compare them with those of the first wave. METHODS: During the two COVID-19 waves two independent groups of hospitalised patients were selected. The first group consisted of the first 100 COVID-19 patients admitted to our hospital during the first wave. The second group consisted of another 100 consecutive COVID-19 patients admitted to our hospital during the second wave. We enlisted only Caucasian male patients over the age of fifty for whom the final outcome was available. For each patient, the CXR severity of COVID-19 pneumonia, the MV use, the patient outcome, comorbidities, corticosteroid use, and C-reactive protein (CRP) levels were considered. Nonparametric statistical tests were used to compare the data obtained from the two waves. RESULTS: The CXR severity of COVID-19 pneumonia, the in-hospital mortality, and CRP levels were significantly higher in the first wave than in the second wave (p ≤ .041). Although not statistically significant, the frequency of MV use was higher in the first wave. CONCLUSIONS: This preliminary investigation seems to confirm that the COVID-19 second wave is less severe and deadly than the first wave.

Radiographic severity index in COVID-19 pneumonia: relationship to age and sex in 783 Italian patients.

PURPOSE: To improve the risk stratification of patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), an experimental chest X-ray (CXR) scoring system for quantifying lung abnormalities was introduced in our Diagnostic Imaging Department. The purpose of this study was to retrospectively evaluate correlations between the CXR score and the age or sex of Italian patients infected with SARS-CoV-2. MATERIALS AND METHODS: Between March 4, 2020, and March 18, 2020, all CXR reports containing the new scoring system were retrieved. Only hospitalized patients with SARS-CoV-2 infection were enrolled. For each patient, age, sex, and the CXR report containing the highest score were considered for the analysis. Patients were also divided into seven groups according to age. Nonparametric statistical tests were used to examine the relationship between the severity of lung disease and the age or sex. RESULTS: 783 Italian patients (532 males and 251 females) with SARS-CoV-2 infection were enrolled. The CXR score was significantly higher in males than in females only in groups aged 50 to 79 years. A significant correlation was observed between the CXR score and age in both males and females. Males aged 50 years or older and females aged 80 years or older with coronavirus disease 2019 showed the highest CXR score (median ≥ 8). CONCLUSIONS: Males aged 50 years or older and females aged 80 years or older showed the highest risk of developing severe lung disease. Our results may help to identify the highest-risk patients and those who require specific treatment strategies.

Chest X-ray severity index as a predictor of in-hospital mortality in coronavirus disease 2019: A study of 302 patients from Italy.

OBJECTIVES: This study aimed to assess the usefulness of a new chest X-ray scoring system - the Brixia score - to predict the risk of in-hospital mortality in hospitalized patients with coronavirus disease 2019 (COVID-19). METHODS: Between March 4, 2020 and March 24, 2020, all CXR reports including the Brixia score were retrieved. We enrolled only hospitalized Caucasian patients with COVID-19 for whom the final outcome was available. For each patient, age, sex, underlying comorbidities, immunosuppressive therapies, and the CXR report containing the highest score were considered for analysis. These independent variables were analyzed using a multivariable logistic regression model to extract the predictive factors for in-hospital mortality. RESULTS: 302 Caucasian patients who were hospitalized for COVID-19 were enrolled. In the multivariable logistic regression model, only Brixia score, patient age, and conditions that induced immunosuppression were the significant predictive factors for in-hospital mortality. According to receiver operating characteristic curve analyses, the optimal cutoff values for Brixia score and patient age were 8 points and 71 years, respectively. Three different models that included the Brixia score showed excellent predictive power. CONCLUSIONS: Patients with a high Brixia score and at least one other predictive factor had the highest risk of in-hospital death.

Three-rooted maxillary first premolars incidentally detected on cone beam CT: an in vivo study.

PURPOSE: To explore the incidence and analyze the morphology of three-rooted maxillary first premolars (MFPs) incidentally detected on cone beam computed tomography (CBCT) scans. METHODS: Of 1328 patients who underwent CBCT scans of the maxilla, only patients with three-rooted MFPs were selected. Morphological features, including the lengths and diameters of palatal, mesiobuccal (MB) and distobuccal (DB) roots, the positions of bucco-palatal (B-P) bifurcations, the distances between root canal bifurcations and cementoenamel junctions (CEJs) and the distances between the apical thirds of the roots, were measured. The canal configuration and the visibility of root canals were also evaluated. RESULTS: A total of 16/1328 (1.2%) patients had one or two three-rooted MFPs, and a total of 22/2656 (0.8%) three-rooted MFPs were enrolled. The lengths and diameters of palatal roots were significantly greater than those of other roots. The positions of B-P bifurcations were located mainly at the middle third of the root. The median distances between root canal bifurcations and CEJs were 3 mm for B-P bifurcations and 5.2 mm for MB-DB bifurcations. The distance between MB and DB roots was significantly shorter than the distances between other root pairs. All teeth had a type VIII canal configuration. Palatal roots exhibited the best visibility of root canals, whereas the worst visibility was observed within DB roots. A gender-related relationship was observed only for the lengths of the roots. CONCLUSIONS: The occurrence of three-rooted MFPs is not unusual; therefore, preoperative CBCT evaluation could be suggested whenever endodontic procedures are planned on an MFP.