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BackgroundThe Radiological Society of North America (RSNA) recently published a chest CT classification system and Dutch Association for Radiology has announced Coronavirus disease 2019 (COVID-19) reporting and data system (CO-RADS) to provide guidelines to radiologists who interpret chest CT images of patients with suspected COVID-19 pneumonia. This study aimed to compare CO-RADS and RSNA classification with respect to their sensitivity and reliability for diagnosis of COVID-19 pneumonia.ResultsA retrospective study assessed consecutive CT chest imaging of 359 COVID-19-positive patients. Three experienced radiologists who were aware of the final diagnosis of all patients, independently categorized each patient according to CO-RADS and RSNA classification. RT-PCR test performed within one week of chest CT scan was used as a reference standard for calculating sensitivity of each system. Kappa statistics and intraclass correlation coefficient were used to assess reliability of each system. The study group included 359 patients (180 men, 179 women; mean age, 45 ± 16.9 years). Considering combination of CO-RADS 3, 4 and 5 and combination of typical and indeterminate RSNA categories as positive predictors for COVID-19 diagnosis, the overall sensitivity was the same for both classification systems (72.7%). Applying both systems in moderate and severe/critically ill patients resulted in a significant increase in sensitivity (94.7% and 97.8%, respectively). The overall inter-reviewer agreement was excellent for CO-RADS (κ = 0.801), and good for RSNA classification (κ = 0.781).ConclusionCO-RADS and RSNA chest CT classification systems are comparable in diagnosis of COVID-19 pneumonia with similar sensitivity and reliability.

Objective The American College of Radiology (ACR) recently published the ovarian-adnexal reporting and data system (O-RADS) to provide guidelines to physicians who interpret ultrasound (US) examinations of adnexal masses (AM). This study aimed to compare the O-RADS with two other well-established US classification systems for diagnosis of AM. Methods This retrospective multicenter study between May 2016 and December 2019 assessed consecutive women with AM detected by the US. Five experienced consultant radiologists independently categorized each AM according to O-RADS, gynecologic imaging reporting and data system (GI-RADS), and international ovarian tumor analysis (IOTA) simple rules. Pathology and adequate follow-up were used as reference standards for calculating the validity of three US classification systems for diagnosis of AM. Kappa statistics were used to assess the inter-reviewer agreement (IRA). Results A total of 609 women (mean age, 48 ± 13.7 years; range, 18–72 years) with 647 AM were included. Of the 647 AM, 178 were malignant and 469 were benign. Malignancy rates were comparable to recommended rates by previous literature in O-RADS and IOTA, but higher in GI-RADS. O-RADS had significantly higher sensitivity for malignancy than GI-RAD and IOTA ( p = 0.003 and 0.0007, respectively), but non-significant slightly lower specificity ( p > 0.05). O-RADS, GI-RADS, and IOTA showed similar overall IRA ( κ = 0.77, 0.69, and 0.63, respectively) with a tendency toward higher IRA with O-RADS than with GI-RADS and IOTA. Conclusions O-RADS compares favorably with GI-RADS and IOTA. O-RADS had higher sensitivity than GI-RADS and IOTA simple rules with relatively similar specificity and reliability. Key Points • The malignancy rates were comparable to recommended rates by previous literature in O-RADS and IOTA, but higher in GI-RADS. • The O-RADS had significantly higher sensitivity for malignancy than GI-RADS and IOTA (96.8% vs 92.7% and 92.1%; p = 0.003 and 0.0007, respectively), but non-significant slightly lower specificity (92.8% vs 93.6% and 93.2%, respectively; p > 0.05). • The O-RADS, GI-RADS, and IOTA showed similar overall inter-reviewer agreement (IRA) (κ = 0.77, 0.69, and 0.63, respectively), with a tendency toward higher IRA with O-RADS than with GI-RADS and IOTA.

Leukemia is one of the most common fatal diseases in pediatric oncology. Recently, advances in drug therapy have improved the prognosis of acute leukemia with event-free survival of up to 60%; however, complications and adverse effects of the disease and anti-leukemic treatment have also increased. The CNS complications of leukemia can be classified into those that developed directly or indirectly from the underlying leukemic process and those that can be related to antileukemic therapy. MRI had improved early detection of CNS complications and proper management. The study aims to characterize the MRI findings caused by the leukemic involvement of CNS structures and treatment-associated CNS complications and assess its value in early management and avoidance of long-term side effects. The patient's age ranged from 2 to 18 years with different types of leukemia classified regarding the time of presentation as pretreatment, during treatment phases, and post-treatment. Different MRI abnormalities were recorded and clinically correlated. The neurological complications of leukemia have common presenting symptoms but varying imaging abnormalities. To reach the correct diagnosis, the presenting signs, symptoms, and laboratory data must be considered along with the radiologic findings. A diagnostic algorithm using conventional, post-contrast MRI, MR venography, along with diffusion-weighted MRI was of great value in early detection and differentiation of different CNS lesions detected in pediatric patients with leukemia and post-treatment CNS complications.

Background Diverse imaging systems can be utilized for the evaluation of chest issues in ICU patients; ultrasound (US) is a decent analytic instrument without exposing the patients to radiation and risk of transfer. Objectives To compare the diagnostic performance of transthoracic US and bedside chest radiography (CXR) for the detection of various pathological abnormalities in fundamentally sick patients, using chest computed tomography as a gold standard. Patients and methods Two hundred and fifty-six patients who were admitted in the Respiratory Care Unit were included in this study. CXR, computed tomography, and transthoracic US were done to all the patients. Six pathological entities were evaluated: pleural effusion, pneumothorax, consolidation, interstitial lung diseases, pulmonary embolism, and neoplasms. Results All patients were evaluated by the three imaging techniques. The sensitivity and specificity of CXR were 42.1, 84.4% for pneumonia 50.0, 90.0% for pleural effusion, 45.5, 90.6% for interstitial syndrome, 50.0, 94.8% for pneumothorax, 60, 100% for pulmonary embolism, and 66, 94% for neoplasm, while the values for chest US were 89.47, 100% for pneumonia, 60, 100% for pulmonary embolism, 100, 100% for pleural effusion, pneumothorax, interstitial syndrome, and neoplasm. Conclusion US examination of the chest is a noninvasive and promising bedside tool in the evaluation of patients in the Respiratory Care Unit.

IntroductionThe goal of this study is to evaluate the effectiveness of single-incision mini-sling in the surgical treatment of postmenopausal urodynamic stress urinary incontinence (SUI) compared to the standard trans-obturator mid-urethral sling.Material and methodsThis prospective study was carried out in two tertiary centres; Al-Azhar University Maternity & Urology Hospitals. A total of 120 postmenopausal women with urodynamic SUI were randomized to undergo either single-incision mini-sling (n = 60) or standard trans-obturator mid-urethral sling procedure (n = 60) from May 2019 until Oct 2021. Main outcome measures: efficacy was evaluated utilizing objective cure rate (cough stress test) and subjective cure rate (Sandvik incontinence severity index and International Consultations on Incontinence Questionnaire – Short Form), intraoperative and postoperative complications, and postoperative pain (using a visual analogue scale).ResultsThe single-incision mini-sling (SIMS) and transobturator tape (TOT) groups had no statistically significant difference in subjective and objective cure rates (p > 0.05). Compared with the transvaginal tape O group, patients in the SIMS group had significantly less postoperative pain, shorter operative duration, and less intraoperative blood loss (all p-values < 0.05). No significant difference in perioperative complications was observed between both groups.ConclusionsSingle-incision mini-sling was superior to TOT in postmenopausal as SIMS is of similar effectiveness, more safe and minimally invasive with earlier ambulance.