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Evaluation of the current status, significance and availability of multiparametric prostate MRI and MRI-guided biopsy in Germany.A voluntary web-based questionnaire with 26 distinct items was emailed to members of the German Radiological Society (DRG) and the Professional Association of German Radiologists (BDR). The questions referred to personal qualification, acquisition, quality, and management of prostate MRI, and assessment of the importance of the method.In total 182 questionnaires were captured from all 10 german postal regions (over 60% of the university hospitals, almost 50% of the maximum care hospitals and approx. 12% of the practices or medical service centers). 43% of the respondents had a Q1 or Q2 quality certificate from the DRG, 10% had a certificate from the BDR, respectively. The majority (90%) criticized inadequate reimbursement of the examination. In 47% MRI cases were discussed in an interdisciplinary tumor board, in 44% case discussions happened rarely, and 12% never had interdisciplinary discussions. On a scale from 0-100 (0%: low; 100%: high) the estimation of the clinical relevance of prostate MRIs received an average of 84% (± 16%) and the estimated approval by urologists was 75% (± 21%). Lacking clinical feedback (59%) and clinical information (42%) were perceived as the largest problems.In this representative survey the respondents estimated multiparametric MRI of the prostate as highly diagnostic and relevant with an increased approval by urologists. There is still a perceived need for continuous professional education of the method for urologists and for more widespread coverage of fusion biopsy. Prostate MRI is currently primarily offered by high volume centers. Current challenges are particularly insufficient interdisciplinary communication and inadequate reimbursement. · Prostate MRI is perceived as highly diagnostic and clinically relevant.The method is currently primarily offered by high volume centers.. · Bigger current problems are insufficient interdisciplinary communication (e.g., clinical information, biopsy results) and inadequate reimbursement.. · Continuous education for urologists and expanded coverage by fusion biopsy are desirable.. · Ullrich T, Boschheidgen M, Schweyen CM et al. Evaluation of the current status, significance, and availability of prostate MRI und MRI guided biopsy in germany. Fortschr Röntgenstr 2024; DOI 10.1055/a-2416-1343., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Purpose: To assess whether it is possible to reliably detect patients with strong suspicion of COVID-19 despite initially negative quantitative polymerase-chain-reaction (qPCR) tests by means of computed tomography (CT)., Materials and Methods: 437 patients with suspected COVID-19 but initially negative qPCR and subsequent chest CT between March 13 and November 30, 2020 were included in this retrospective study. CT findings were compared to results of successive qPCR tests (minimum of 3 qPCR tests if CT suggested infection) to determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CT for diagnosing COVID-19., Results: COVID-19 was diagnosed correctly with a sensitivity of 100 % [95 % confidence interval (CI): 65-100] and a specificity of 88 % [95 % CI: 84-90]. A PPV of 12 % [95 % CI: 6-22] and an NPV of 100 % [95 % CI: 99-100] were determined., Conclusion: CT is able to detect COVID-19 before qPCR in initially negative patients in this special study setting. Similar CT findings in COVID-19 and other atypical pneumonias can lead to high numbers of false-positive patients, reducing the specificity of CT., Key Points: · Low-dose chest CT is able to diagnose COVID-19 in symptomatic patients even in cases of an initially negative quantitative PCR result and therefore is a fast support method to detect COVID-19, especially in early disease.. · Low-dose chest CT can reliably exclude COVID-19 in a pandemic setting.. · CT does not always ensure a reliable differentiation from other viral diseases.., Citation Format: · Valentin B, Steuwe A, Wienemann T, et al. CT Findings in Patients with COVID-19-Compatible Symptoms but Initially Negative qPCR Test. Fortschr Röntgenstr 2022; 194: 1110 - 1118., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Purpose: Classifications were created to facilitate radiological evaluation of the novel coronavirus disease 2019 (COVID-19) on computed tomography (CT) images. The categorical CT assessment scheme (CO-RADS) categorizes lung parenchymal changes according to their likelihood of being caused by SARS-CoV-2 infection. This study investigates the diagnostic accuracy of diagnosing COVID-19 with CO-RADS compared to the Thoracic Imaging Section of the German Radiological Society (DRG) classification and Radiological Society of North America (RSNA) classification in an anonymized patient cohort. To mimic advanced disease stages, follow-up examinations were included as well., Method: This study includes all patients undergoing chest CT in the case of a suspected SARS-CoV-2 infection or an already confirmed infection between March 13 and November 30, 2020. During the study period, two regional lockdowns occurred due to high incidence values, increasing the pre-test probability of COVID-19. Anonymized CT images were reviewed retrospectively and in consensus by two radiologists applying CO-RADS, DRG, and RSNA classification. Afterwards, CT findings were compared to results of sequential real-time reverse transcriptase polymerase chain reaction (qPCR) test performed during hospitalization to determine statistical analysis for diagnosing COVID-19., Results: 536 CT examinations were included. CO-RADS, DRG and RSNA achieved an NPV of 96 %/94 %/95 % (CO-RADS/DRG/RSNA), PPV of 83 %/80 %/88 %, sensitivity of 86 %/76 %/80 %, and specificity of 96 %/95 %/97 %. The disease prevalence was 20 %., Conclusion: All applied classifications can reliably exclude a SARS-CoV-2 infection even in an anonymous setting. Nevertheless, pre-test probability was high in our study setting and has a great influence on the classifications. Therefore, the applicability of the individual classifications will become apparent in the future with lower prevalence and incidence of COVID-19., Key Points: · CO-RADS, DRG, and RSNA classifications help to reliably detect infected patients in an anonymized setting. · Pre-test probability has a great influence on the individual classifications. · Difficulties in an anonymized study setting are severe pulmonary changes and residuals.., Citation Format: · Valentin B, Steuwe A, Wienemann T et al. Applicability of CO-RADS in an Anonymized Cohort Including Early and Advanced Stages of COVID-19 in Comparison to the Recommendations of the German Radiological Society and Radiological Society of North America. Fortschr Röntgenstr 2022; 194: 862 - 872., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Competing Interests: The authors declare that they have no conflict of interest.

Objectives: Demographic change, rising co-morbidity and an increasing number of emergencies are the main challenges that emergency medical services (EMS) in several countries worldwide are facing. In order to improve quality in EMS, highly trained personnel and well-equipped ambulances are essential. However several studies have shown a deficiency in qualified EMS physicians. Telemedicine emerges as a complementary system in EMS that may provide expertise and improve quality of medical treatment on the scene. Hence our aim is to develop and test a specific teleconsultation system., Methods: During the development process several use cases were defined and technically specified by medical experts and engineers in the areas of: system administration, start-up of EMS assistance systems, audio communication, data transfer, routine tele-EMS physician activities and research capabilities. Upon completion, technical field tests were performed under realistic conditions to test system properties such as robustness, feasibility and usability, providing end-to-end measurements., Results: Six ambulances were equipped with telemedical facilities based on the results of the requirement analysis and 55 scenarios were tested under realistic conditions in one month. The results indicate that the developed system performed well in terms of usability and robustness. The major challenges were, as expected, mobile communication and data network availability. Third generation networks were only available in 76.4% of the cases. Although 3G (third generation), such as Universal Mobile Telecommunications System (UMTS), provides beneficial conditions for higher bandwidth, system performance for most features was also acceptable under adequate 2G (second generation) test conditions., Conclusions: An innovative concept for the use of telemedicine for medical consultations in EMS was developed. Organisational and technical aspects were considered and practical requirements specified. Since technical feasibility was demonstrated in these technical field tests, the next step would be to prove medical usefulness and technical robustness under real conditions in a clinical trial.