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OBJECTIVE: To compare inter-rater reliability, diagnostic accuracy, and extension of pulmonary involvement in children with suspected COVID-19 submitted to supine or supine and lateral decubitus computed tomography imaging. METHODS: Retrospective study carried out between March 2020 and March 2021 with patients submitted to reverse transcription-polymerase chain reaction testing and chest computed tomography. Patients were divided into two groups: supine or supine and lateral decubitus imaging. Standardized reporting systems of computed tomographic findings in COVID-19 and chest computed tomography score were used. RESULTS: One hundred and seventeen patients were enrolled. Moderate to substantial inter-rater reliability was observed for standardized reporting systems (weighted kappa, 0.553-0.764; p<0.001). Inter-rater reliability for the chest computed tomography score was substantial (weighted kappa, 0.620-0.670; p<0.001). Standardized reporting systems failed to predict COVID-19 in children, regardless of additional lateral decubitus imaging (area under the receiver operating characteristic curve, 0.491-0.608). Chest computed tomography scores assigned to lateral decubitus images were significantly lower. CONCLUSION: Additional lateral decubitus imaging does not improve the accuracy of standardized reporting systems of computed tomographic findings in COVID-19 but may provide a more accurate estimation of lung involvement in uncooperative patients.

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ABSTRACT Objective To compare inter-rater reliability, diagnostic accuracy, and extension of pulmonary involvement in children with suspected COVID-19 submitted to supine or supine and lateral decubitus computed tomography imaging. Methods Retrospective study carried out between March 2020 and March 2021 with patients submitted to reverse transcription-polymerase chain reaction testing and chest computed tomography. Patients were divided into two groups: supine or supine and lateral decubitus imaging. Standardized reporting systems of computed tomographic findings in COVID-19 and chest computed tomography score were used. Results One hundred and seventeen patients were enrolled. Moderate to substantial inter-rater reliability was observed for standardized reporting systems (weighted kappa, 0.553-0.764; p<0.001). Inter-rater reliability for the chest computed tomography score was substantial (weighted kappa, 0.620-0.670; p<0.001). Standardized reporting systems failed to predict COVID-19 in children, regardless of additional lateral decubitus imaging (area under the receiver operating characteristic curve, 0.491-0.608). Chest computed tomography scores assigned to lateral decubitus images were significantly lower. Conclusion Additional lateral decubitus imaging does not improve the accuracy of standardized reporting systems of computed tomographic findings in COVID-19 but may provide a more accurate estimation of lung involvement in uncooperative patients.

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BACKGROUND: Appropriate mammary positioning is an important factor in optimizing image quality in mammography (MMG). PURPOSE: To study the correlation of quality criteria and breast density classification proposed by the American College of Radiology (ACR) and European Guidelines and its influence to achieve a proper positioning, therefore an adequate MMG. MATERIAL AND METHODS: A total of 128 routine MMG examinations were reviewed for the definition of breast composition parenchyma and assessment of several quality criteria proposed by the ACR and European Guidelines to achieve an adequate MMG. Adequate MMG was defined as a difference between the posterior nipple line (PNL), difference of the mediolateral oblique (MLO) and craniocaudal (CC) incidences > 1 cm. The quality criteria were analyzed as a function of correlation coefficient in order to evaluate the individual impact of each factor and analysis of variance (ANOVA) for all criteria. Receiver operating characteristic (ROC) curves were plotted to evaluate the performance of the criteria on each type of parenchyma. RESULTS: Negative correlation of fatty breasts and visibility of the mammary angle, a greater number of skin folds and PNL > 1 cm (r < 0). Dense MMG presented less visibility of the lateral tissue compared with other categories. Area under the curve of ROC analysis revealed values of 53.1% and 54.7% for the right and left breasts, respectively. CONCLUSION: Several factors influenced in the MMG process, but we find that breast parenchyma has a substantial role in affecting these criteria and therefore a correct position for diagnosis, which could compromise MMG diagnostic performance.

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Brain trauma patients who underwent decompressive craniectomy make several computed tomography (CT) scans until cranioplasty. Despite several recommendations to avoid unnecessary radiological exposure, few studies systematically analyzed the technical parameters employed. CT exams of 14 patients were retrospectively analyzed to find display field of view (DFOV), dose length product (DLP), volume computed tomography dose index (CTDIvol) and effective dose (ED). The values obtained were: 120 kVp [95% confidence interval (CI) of 0.5], 297 mA (95% CI of 5.6), scan range 20.8 cm (95% CI of 1.3), DFOV 24.5 cm (95% CI of 1.6), CTDIvol 67.5 mGy (95% CI of 10.17), DLP 1404.8 mGy.cm (95% CI of 235.0) and ED 2.9 mSv (95% CI of 0.5). In conclusion, these values were above the recommendations of several guidelines and raise concern for excessive radiological exposure in trauma patients despite being previously reported in the literature.

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O objetivo desta pesquisa foi avaliar os níveis de concentração de radônio 222Rn em águas de poços da região metropolitana de Curitiba, Paraná. O trabalho apresenta os resultados das concentrações das medidas feitas em águas de poços da região. As concentrações de 222Rn nas amostras das águas de poços foram medidas por meio do monitor de radônio AlphaGUARD. Os cálculos das concentrações de atividade iniciais de radônio na água foram feitos a partir da curva de decaimento do 222Rn e do equilíbrio secular entre o 222Rn e o 226Ra, observados depois de 30 dias. Os resultados indicaram que cerca de 70% dos valores das concentrações de 222Rn ficaram acima do valor recomendado pela USEPA, de 11,1 Bq.L-1, representando risco radiológico causado por este radionuclídeo. O estudo de caso apresentado mostrou que medidas prévias de radônio são recomendadas para que um projeto de construção seja implementado. No caso em questão, observa-se que as concentrações de radônio diminuem cerca de 56% na primeira caixa d'água e 83% na segunda em relação ao poço. Esse fato mostra que as ações para mitigação de radônio são viáveis e não exigem grandes modificações nos sistemas usuais da construção civil.

This research objective was to assess the level of randon-222 concentration in well water of the metropolitan region of Curitiba, Paraná. Current work presents the results of indoor 222Rn activity ground water samples from artesian wells from aquifers of the region. The studies of radon activity in water were performed using the radon detector AlphaGUARD. The calculations of initial radon activity in water were done considering the 222Rn decay correction as well as equilibrium level of 222Rn and 226Ra observed after 30 days of measurements. Obtained results show that about 70% of measured activity levels of 222Rn are higher than the recommended value of 11.1 Bq.L-1, which represent the risk for the human health associated with this radionuclide. The case study showed that previous measurements of radon are recommended for a construction project is implemented. In this case, it is observed that the radon concentrations decrease about 56% in the first water tank and 83% in the second water tank over the well. This fact shows that the actions for mitigation of radon are viable and do not require major modifications to the usual systems of construction.