Purpose To assess the sensitivity of radiologists and a CAD system for the detection of lung metastases on thin-section computed tomographic (CT) scans prior to pulmonary metastasectomy. Materials and Methods All patients scheduled for resection of lung metastases were eligible for this prospective single-center trial. 95 patients with 115 surgical procedures (pulmonary metastasectomy using thoracotomy) were included. An experienced radiologist examined the CT scans for pulmonary metastases and documented his findings. A commercial CAD system was used as a second reader; additional CAD findings were recorded. A comparison of the sensitivity of the radiologist alone and with CAD was performed. Intraoperatively surgeons tried to identify the documented lesions and resected them as well as additionally palpable lesions. The standard of reference consisted of surgery and histopathology. Follow-up information for radiologically detected lesions missed during surgery was sought. Results 693 lesions (262 metastases) were detected radiologically or surgically, 646 of them were resected. The sensitivity of radiologists without CAD was 67.5 % for all lesions (87.4 % for metastases). CAD highly significantly (p < 0.001) increased the sensitivity to 77.9 % (92.7 %). During surgery, 143 additional lesions (19 metastases) were detected. 49 radiologically detected lesions were not palpable during surgery: 4 metastases, 5 benign lesions, and 40 lesions of an unknown nature. Conclusion CAD provides significant additional sensitivity for detecting lung metastases using MDCT compared to the performance of a radiologist alone. CT reveals a relevant number of non-palpable pulmonary lesions. Key Points:  Citation Format

Eine akute COVID-19-Pneumonie kann zu anhaltenden Veränderungen der Lunge mit unterschiedlichen bildgebenden und histopathologischen Mustern führen. Darüber hinaus ist eine SARS-CoV-2-Infektion mit einem erhöhten Risiko für pulmonal-vaskuläre Endothelialitis und Thrombose verbunden. Basierend auf einer selektiven Literaturrecherche werden in dieser Übersicht aktuelle Erkenntnisse zu pulmonalen Folgen von COVID-19 mit Implikationen für das klinische Management zusammengefasst. Einleitung Belastungsdyspnoe gehört zu den häufigsten prolongierten Symptomen nach überstandener SARS-CoV-2-Infektion, auch nach mildem Verlauf. Bei stationär behandelten COVID-19-Patienten wird nach aktuellen Leitlinien eine Untersuchung auf Langzeitfolgen nach 8-12 Wochen empfohlen [1]. Die akute COVID-19-Pneumonie kann in persistierende Veränderungen mit unterschiedlichen CT-morphologischen und histopathologischen Mustern übergehen, dazu gehören unter anderem die postinfektiöse organisierende Pneumonie und fibrosierende Lungenparenchymveränderungen [2]. Letztere werden im folgenden Text als Post-COVID-ILD ("interstitial lung disease") bezeichnet. Darüber hinaus haben insbesondere hospitalisierte COVID-19-Patienten ein erhöhtes Risiko für Lungenarterienembolien sowie autochthone Makro-und Mikrothrombosierungen der Lungengefäße, mit möglichen Implikationen für die COVID-19-Nachsorge [3].

Spinal epidural lipomatosis (SEL) of the thoracic and lumbar spine is a rare entity, which leads to compression of the spinal canal. The exact pathogenesis is still unknown. It most commonly occurs in patients with long-term exogenous or endogenous glucocorticoid excess or morbid obesity but there are also idiopathic forms. The symptoms depend on the severity of the SEL and can manifest as clinically asymptomatic, non-specific back pain, radiculopathy up to spinal cord compression. The diagnosis is usually achieved by magnetic resonance imaging (MRI) of the affected spinal segments. The treatment varies between discontinuation of glucocorticoids, weight reduction up to multisegmental decompressive laminectomy. The following case report presents the findings of SEL in a patient with steroid-dependent Jo-1 antibody syndrome and provides a current literature review on this rare disease.

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