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Introduction: Early‐stage lung cancer diagnosis through detection of nodules on computed tomography (CT) remains integral to patient survivorship, promoting national screening programmes and diagnostic tools using artificial intelligence (AI) convolutional neural networks (CNN); the software of AI‐Rad Companion™ (AIRC), capable of self‐optimising feature recognition. This study aims to demonstrate the practical value of AI‐based lung nodule detection in a clinical setting; a limited body of research. Methods: One hundred and eighty‐three non‐contrast CT chest studies from a single centre were assessed for AIRC software analysis. Prospectively collected data from AIRC detection and characterisation of lung nodules (size: ≥3 mm) were assessed against the reference standard; reported findings of a blinded consultant radiologist. Results: One hundred and sixty‐seven CT chest studies were included; 52% indicated for nodule or lung cancer surveillance. Of 289 lung nodules, 219 (75.8%) nodules (mean size: 10.1 mm) were detected by both modalities, 28 (9.7%) were detected by AIRC alone and 42 (14.5%) by radiologist alone. Solid nodules missed by AIRC were larger than those missed by radiologist (11.5 mm vs 4.7 mm, P < 0.001). AIRC software sensitivity was 87.3%, with significant false positive and negative rates demonstrating 12.5% specificity (PPV 0.6, NPV 0.4). Conclusion: In a population of high nodule prevalence, AIRC lung nodule detection software demonstrates sensitivity comparable to that of consultant radiologist. The clinical significance of larger sized nodules missed by AIRC software presents a barrier to current integration in practice. We consider this research highly relevant in providing focus for ongoing software development, potentiating the future success of AI‐based tools within diagnostic radiology. [ABSTRACT FROM AUTHOR]

Introduction: To compare the radiation dose exposure and diagnostic efficiency of computed tomographic pulmonary angiography (CTPA) and ventilation/perfusion imaging (V/Q) for clinically suspected pulmonary embolism (PE) in pregnant and postpartum women in a tertiary hospital setting. Methods: A retrospective cohort study of 473 pregnant and postpartum women referred for CTPA or V/Q for clinically suspected PE between January 2013 and December 2018 at a tertiary hospital. Maternal effective radiation dose, breast‐absorbed radiation dose and fetal‐absorbed dose estimates were calculated. Diagnostic yield was evaluated from radiological findings. Results: Computed tomographic pulmonary angiography (CTPA) was more commonly used for the imaging of suspected PE in pregnant and postpartum populations (51.9% vs. 48.1% and 77.1% vs. 22.9%, respectively). CTPA was associated with higher maternal effective and breast‐absorbed doses (maternal effective CTPA 4.7 (±2.9) mSv (millisievert), V/Q 1.7(±0.8) mSv (mean difference 2.93 mSv P < 0.001), and breast‐absorbed CTPA 8.0 (±5.2) mGy (milligray), V/Q 0.3 (±0.1) (mean difference 7.67 mGy P < 0.001), respectively). Fetal radiation dose exposure was low. The incidence of positive PE was 5.5%. Indeterminate rates of CTPA and V/Q were 3.0% and 5.5% (P = 0.176), respectively. Conclusions: Compared to V/Q, CTPA is associated with higher maternal and breast radiation dose; however, modern CT scanners achieve lower radiation doses than historically described. Fetal radiation dose was comparably low. The diagnostic yield of the imaging modalities in pregnant and postpartum women is similar. Revision of guidelines should occur with the advances in CT technology. [ABSTRACT FROM AUTHOR]

Introduction: Coronavirus disease 2019 (COVID‐19) has infected over 215 million individuals worldwide. Chest radiographs (CXR) and computed tomography (CT) have assisted with diagnosis and assessment of COVID‐19. Previous reports have described peripheral and lower zone predominant opacities on chest radiographs. Whilst the most common patterns on CT are bilateral, peripheral basal predominant ground glass opacities (Wong et al., Radiology, 296, 2020, E72; Karimian and Azami, Pol J Radiol, 86, 2021, e31). This study describes the imaging findings in an Australian tertiary hospital population. Methods: COVID‐PCR‐positive patients who had chest imaging (CXR, CT and ventilation perfusion (V/Q) scans) from January 2020 to August 2020 were included. Distribution, location and pattern of involvement was recorded. Evaluation of the assessors was performed using Fleiss Kappa calculations for review of radiographic findings and qualitative analysis of CT findings. Results: A total of 681 studies (616 CXRs, 59 CTs, 6 V/Q) from 181 patients were reviewed. The most common chest radiograph finding was bilateral lower lobe predominant diffuse opacification and most common CT pattern being ground glass opacities. Of the CT imaging, 33 were CT Pulmonary Angiograms of which five demonstrated acute pulmonary emboli. There was good inter‐rater agreement between radiologists in assessment of imaging appearances on CXR (kappa 0.29–0.73) and CT studies. Conclusion: A review of imaging in an Australian tertiary hospital demonstrates similar patterns of COVID‐19 infection on chest X‐ray and CT imaging when compared to the international population. [ABSTRACT FROM AUTHOR]

Guideline-based strategies for evaluation of solitary pulmonary nodules are tailored to the likelihood of malignancy. Surveillance, biopsy, and resection are all reasonable approaches in fit individuals when the likelihood of malignancy is intermediate. Given the paucity of data demonstrating superior outcomes and important trade-offs among strategies, guidelines emphasize the importance of eliciting patient preferences and engaging in shared decision making; however, there is little literature on what patient preferences actually are. This study conducted a cross-sectional, interview-administered questionnaire survey in 100 adults recruited from a metropolitan teaching hospital (The Royal Melbourne Hospital, Parkville, Victoria, Australia). The questionnaire used a hypothetical scenario designed to elicit patient preferences for different management strategies of solitary pulmonary nodules with a probability of malignancy between 10% and 70%. The mean age of participants was 62 years (range, 45 to 80 years), 56% were male, and 94% were current smokers or ex-smokers. Ninety-four percent completed all questions. At 10% probability of malignancy, 36.3% preferred surveillance, 42.4% preferred needle biopsy, and 21.2% preferred surgical resection. Preference for surgical resection increased to 53.5% and 86.2% when the probability of malignancy was 30% and 70%, respectively. Changes in the diagnostic yield of computed tomography biopsy significantly altered preferences when the probability of malignancy was 10% or 30%. The majority of participants surveyed expressed a preference for some type of biopsy over observation at all levels of solitary pulmonary nodule probability of malignancy evaluated. In an era of increasing solitary pulmonary nodule detection and patient-centered care, if confirmed in broader studies, these findings have considerable implications for processes of care and resource allocation. [ABSTRACT FROM AUTHOR]

The article discusses the importance of mentorship, focusing on the need for employee coaching and work flexibility. It states that quality connections prove to be the key to any successful business. It emphasizes on young entrepreneurs Alex Kolodkin and his business partner Lidia Bit-Yunan who focused on creating a friendly work environment and company culture, handled employee relations problems, and empowered employees during difficult business circumstances.

Background and Objectives Methods Results Conclusion Coronary artery calcification (CAC) is a frequent additional finding on lung cancer screening (LCS) low‐dose computed tomography (LDCT). Cardiovascular disease (CVD) is a major cause of death in LCS participants. We aimed to describe prevalence of incidental CAC detected on LDCT in LCS participants without prior history of coronary artery disease (CAD), evaluate their CVD risk and describe subsequent investigation and management.Prospective observational nested cohort study including all participants enrolled at a single Australian site of the International Lung Screen Trial. Baseline LDCTs were reviewed for CAC, and subsequent information collected regarding cardiovascular health. 5‐year CVD risk was calculated using the AusCVD risk calculator.55% (226/408) of participants had CAC on LDCT and no prior history of CAD, including 23% with moderate–severe CAC. Mean age of participants with CAC was 65 years, 68% were male. 53% were currently smoking. Majority were high risk (51%) or intermediate risk (32%) of a cardiovascular event in 5 years. 21% of participants were re‐stratified to a higher CVD risk group when CAC detected on LCS was incorporated. Only 10% of participants with CAC received lifestyle advice (only 3% currently smoking received smoking cessation advice). 80% of participants at high‐risk did not meet guideline recommendations, with 47% of this group remaining without cholesterol lowering therapy.LCS with LDCT offers the potential to identify and communicate CVD risk in this population. This may improve health outcomes for high‐risk LCS participants and further personalize management once screening results are known. [ABSTRACT FROM AUTHOR]

Object: Chronic low-back pain of discal origin is linked strongly to disc degeneration. Current nonsurgical treatments are palliative and fail to restore the disc extracellular matrix. In this study the authors examined the capacity of ovine mesenchymal precursor cells (MPCs) to restore the extracellular matrix of degenerate discs in an ovine model., Methods: Three adjacent lumbar discs of 24 adult male sheep were injected intradiscally with chondroitinase-ABC (cABC) to initiate disc degeneration. The remaining lumbar discs were used as normal controls. Three months after cABC injection, the L3-4 discs of all animals were injected with either a high dose (4 × 10(6) cells, in 12 sheep) or low dose (0.5 × 10(6) cells, in 12 sheep) of MPCs suspended in hyaluronic acid (HA). The adjacent L4-5 degenerate discs remained untreated; the L5-6 discs were injected with HA only. The animals were euthanized at 3 or 6 months after MPC injections (6 sheep from each group at each time point), and histological sections of the lumbar discs were prepared. Radiographs and MR images were obtained prior to cABC injection (baseline), 3 months after cABC injection (pretreatment), and just prior to necropsy (posttreatment)., Results: Injection of cABC decreased the disc height index (DHI) of target discs by 45%-50%, confirming degeneration. Some recovery in DHI was observed 6 months after treatment in all cABC-injected discs, but the DHI increased to within baseline control values only in the MPC-injected discs. This improvement was accompanied by a reduction in MRI degeneration scores. The histopathology scores observed at 3 months posttreatment for the high-dose MPC-injected discs and at 6 months posttreatment for the low-dose MPC-injected discs were significantly different from those of the noninjected and HA-injected discs (p <0.001) but not from the control disc scores., Conclusions: On the basis of the findings of this study, the authors conclude that the injection of MPCs into degenerate intervertebral discs can contribute to the regeneration of a new extracellular matrix.