Sonographic Measurements of Rectus Femoris Muscle Thickness Strongly Predict Neutropenia in Cancer Patients Receiving Chemotherapy.

The objective of this study was to explore the possible association between low skeletal muscle mass (SMM)-assessed by computed tomography (CT) and ultrasound (US)-and hematologic toxicity in cancer patients. A prospective cohort study was conducted in cancer patients who received anthracycline-based chemotherapy between 2018 and 2020 and who had baseline abdominal CT including L3 level for measuring SMM. Regional muscle measurements were carried out using US. A total of 65 patients (14 males, 51 females) were included. ROC (receiver operating characteristic) analysis identified threshold values of 18.0 mm [AUC (area under the curve) = 0.765] for females and 20.0 mm (AUC = 0.813) for males, predicting severe neutropenia. Using these cut-offs, females with low rectus femoris (RF) thickness (<18.0 mm) had a significantly higher incidence of grade ≥3 neutropenia (50.0% vs. 10.8%, p = 0.005), and males with low RF values (<20.0 mm) had a higher incidence (80.0% vs. 22.2%, p = 0.063). A regression analysis, irrespective of age, gender, and body mass index, revealed that only low RF muscle thickness increased the risk of grade 3-4 neutropenia by 9.210 times (95% CI = 2.401-35.326, p = 0.001). Utilizing US to measure RF muscle thickness aids in identifying cancer patients at an elevated risk of developing neutropenia. Needless to say, US can serve as a convenient and easily accessible tool for assessing low SMM, providing repeat point-of-care evaluations in clinical practice.

Two in one: Overlapping CT findings of COVID-19 and underlying lung diseases.

Coronavirus disease 2019 (COVID-19) is associated with pneumonia and has various pulmonary manifestations on computed tomography (CT). Although COVID-19 pneumonia is usually seen as bilateral predominantly peripheral ground-glass opacities with or without consolidation, it can present with atypical radiological findings and resemble the imaging findings of other lung diseases. Diagnosis of COVID-19 pneumonia is much more challenging for both clinicians and radiologists in the presence of pre-existing lung disease. The imaging features of COVID-19 and underlying lung disease can overlap and obscure the findings of each other. Knowledge of the radiological findings of both diseases and possible complications, correct diagnosis, and multidisciplinary consensus play key roles in the appropriate management of diseases. In this pictorial review, the chest CT findings are presented of patients with underlying lung diseases and overlapping COVID-19 pneumonia and the various reasons for radiological lung abnormalities in these patients are discussed.

Predictors of mortality in rheumatoid arthritis-associated lung disease: A retrospective study on ten years.

OBJECTIVES: Rheumatoid arthritis (RA)-associated lung involvement is a cause of mortality. This study aimed to evaluate mortality rate and mortality-associated factors in RA patients with high-resolution computed tomography (HRCT)-proven lung involvement. METHODS: Patients followed-up for RA between 2010 and 2018 were evaluated regarding HRCT-proven lung involvement. The present study was designed as a single-centre, retrospective and descriptive study. The HRCT reports of patients were re-evaluated for three major patterns: UIP, nonspecific interstitial pneumonia (NSIP), and isolated airway disease (AD). Mortality rates and its associated factors (demographic characteristics, RA-related factors and lung-involvement-related factors) were determined. RESULTS: The study included 156 patients (females, 68.3%) with radiologically confirmed RA-associated lung disease. The mean age was 55.5 (12.1) years at RA diagnosis and 62.7 (9.7) years at the diagnosis of lung involvement. The patterns of lung involvement on HRCT were UIP in 89 (57.0%) patients, NSIP in 51 (32.7%) patients, and isolated AD in 16 (10.3%) patients. The RA patients were followed-up for a mean of 10.2 (7.4) years and they were followed-up for a mean of 4.5 (3.7) years after interstitial lung disease (ILD) diagnosis. Overall, 40 (25.6%) patients died. The 5-year survival rate was 78%. Multivariate analysis revealed UIP pattern (log-rank test, P<0.01), pleural effusion (log-rank test, P<0.05), and a shorter time interval (<3 years) between the diagnoses of RA and RA-ILD (log-rank test, P<0.01) to be independent predictors of mortality. CONCLUSIONS: In addition to the UIP, a known risk factor, pleural effusion and the short time between the diagnoses of RA and ILD were also found to be associated with mortality.