A Multicenter Survey on the Trend of Chest CT Scan Utilization: Tracing the First Footsteps of COVID-19 in Iran.

BACKGROUND: Chest computed tomography (CT) scan has been used widely to diagnose COVID-19 in Iran. OBJECTIVES: To trace the footsteps of COVID-19 in Iran by exploring the trend in using chest CT scans and its economic impact on radiology departments. Methods: In this cross-sectional study, the number of imaging examinations from 33 tertiary radiology departments in 9 large cities of Iran was collected from September 23, 2019 to March 20, 2020 (Months 1 to 6) and the corresponding months in 2018-2019. RESULTS: A 50.2% increase was noted in the chest CT scan utilization in 2019-2020 compared to 2018-2019. This increase was +15%, +15%, +27%, +2%, +1% in Months 1-5 of 2019-2020, respectively. In Month 6 of 2019-2020, a 251% increase in the acquisition of chest CT scans was observed compared to the Month 6 of 2018-2019. Following negative balance of revenue from Month 1 to 5 with respect to the inflation rate, the total income in Month 6 was further 1.5% less than the same Month in 2018-19. CONCLUSION: The observed peak in chest CT utilization in Month 3 prior to the surge in Month 6 could be explained by the seasonal influenza. However, unawareness about an emerging viral disease, i.e. COVID-19, might have underutilized chest CT in Months 4 and 5 before the official announcement in Month 6. The unbalanced increase in the workload of radiology departments in the shortage of cardiothoracic radiologists with the simultaneous decrease in income initiated a vicious cycle that worsened the economic repercussions of the pandemic.

Assessment of Abdominal Fat Distribution in Non-Alcoholic Fatty Liver Disease by Magnetic Resonance Imaging: a Population-based Study.

BACKGROUND: To investigate the association between non-alcoholic fatty liver disease (NAFLD) and quantitative measures of central adiposity in the general population using a semi-automated method on magnetic resonance imaging (MRI) data. METHODS: Subjects were recruited from Golestan Cohort Study. Two groups of 120 individuals with and without fatty liver were randomly selected based on findings of ultrasound. Non-invasive diagnosis of NAFLD was made by combination of ultrasound and MRI. Various anthropometric indices including body mass index (BMI), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were measured. Segmentation and calculation of visceral (VFA) and subcutaneous fat area (SFA) were performed on three levels of MRI slices using semi-automated software. RESULTS: A total of 109 individuals fulfilled the NAFLD criteria, while 92 subjects were selected as the control group. All obesity measures, except for SFA, were significantly higher in subjects with NAFLD compared to controls. Significant associations were found between NAFLD and adiposity indices, except for SFA, with the highest odds ratio observed in WHR (OR: 3.37, CI: 1.40-3.70, P < 0.001). VFA also had the greatest correlation with ultrasound (r = 0.523, P < 0.001) and MRI (r = 0.546, P < 0.001) indicators of NAFLD. CONCLUSIONS: Quantitative measures of visceral adiposity are associated with NAFLD, while subcutaneous fat measures are poor indicators for identifying NAFLD. Compared to conventional anthropometric indices, VFA best correlates with ultrasound and MRI criteria of fatty liver.