Background: To investigate the distribution of CT features and also to introduce a novel described CT feature of coronavirus disease-19 (COVID-19) pneumonia. Methods: A series of radiologic signs in 11 COVID-19 patients were summarized and made morphometric analysis. Results: A special sign termed as "the arch bridge sign" owing to its morphological mimicking an arch bridge was firstly introduced. Statistical analyze showed that the subpleural area is the priority distribution location (14/14) and the sign inclined to perform in those patients in a relatively early stage (6/8) and with moderate clinical severity (8/8). Segment VI in lower lobe involved most (6/14). In this retrospective study, other characteristic radiologic signs of COVID-19 pneumonia were analyzed synchronously. A series of radiologic signs were identified in bilateral lungs with a bias towards segment VI, I + II and X. Segment VI had the largest number of each sign. Ground-glass opacities (GGOs), subpleural distribution pattern and vessels dilatation were the top three most common signs among them. Conclusions: The recognition of the arch bridge sign may benefit patient care by earlier definitive diagnosis of COVID-19 pneumonia. The lesions of COVID-19 pneumonia distributed mainly in the backlung segments, which characteristic may light new ideas in clinical treatment and nursing strategy.

Local radiotherapy (LRT) is reported to be of survival benefit for advanced non-small cell lung cancer (NSCLC) in accumulating evidence, but research on the optimal initial time point remains scarce. This IRB-approved retrospective analysis identified patients diagnosed with stage IIIb–IV unresectable lung adenocarcinoma who initiated front-line LRT at our institution between 2017 and 2020. The receiver operating characteristic (ROC) curve analyses were used to cut off the initial time of LRT (before and beyond 53 days). Patients were divided into two groups: one early to initiate radiotherapy group (≤53 days, EAR group) and one deferred radiotherapy group (>53 days, DEF group). The Kaplan–Meier method was used to estimate time-to-event endpoints; the Cox proportional hazard model was used to find out predictors of progression-free survival (PFS) and overall survival (OS). A total of 265 patients with a median age of 57 were enrolled. The median follow-up time was 26.4 months (ranging from 2.2 to 69.7 months). The mOS was 38.6 months and mPFS was 12.7 months. Age >60, bone and brain metastases, multisite metastases, and EGFR 19 mutation were independent predictors associated with OS. Early initiation of local radiotherapy within 53 days after diagnosis resulted in better PFS, but not in OS. A better OS was observed in patients with bone metastasis who underwent local radiotherapy initiated within 53 days.

Abstract:The mechanism of radiation-induced delayed brain injuries remains poorly understood, and few treatment options are available. The aim of this study was to investigate whether temporal lobe necrosis can be reversed by anti-mycobacterium therapy (AMT). We conducted this prospective, controlled study in southern China. Ten patients with symptomatic delayed radiation injury were monitored during AMT and compared with a control group of 11 patients who received current standard therapies. Activities of daily living were assessed by the Barthel Index (BI) at study entry and after 2 years of therapy. Magnetic resonance imaging (MRI) was performed before treatment, and changes were monitored during the study. Kaplan-Meier analysis was employed to delineate time-related mortality. A significant treatment effect was observed in the AMT group. The patients' headaches, seizures, dizziness, and cognitive deterioration rapidly improved. BI improved in the AMT treatment group compared with the control group after 2 years (Mann-Whitney U test; P=0·001). Abnormalities of the temporal lobes, observed by MRI, markedly decreased over time in eight patients, whereas in the control group significant BI deterioration was observed (Wilcoxon signed-rank test; P=0·003) and the patients did not show favorable MRI changes. By 24 months, there was a significant difference between the AMT and control groups with respect to survival time (log-rank test; P=0·011). The results of the present study suggest that radiation necrosis of the brain can be successfully managed by AMT. These findings must be confirmed in large, double-blind, randomized clinical trials.