Page 66 - ECBIP 2021_Program

6th European Congress ECBIP 15 - 17
Book of Abstracts
for Bronchology and
Interventional Pulmonology ATHENS - GREECE 2021
OCTOBER
MODERATED e-POSTER SESSION 05:
Imaging,Guiding,Training and Navigation modalities
BENEFITS OF SIMPLIFIED CORADS CLASSIFICATION OF CT PULMONARY LESIONS
Liubou Varanitskaya1,2
1 Romed Klinikum, Rosenheim, Germany,
2 UAMS Baptist Health Hospital, North Little Rock, USA
PP36
Introduction: In March 2020 a new pandemic infection was officially declared by the World Health Organization (WHO). Since then, millions of people around the globe where hospitalized and diagnosed with COVID 19 pneumonia. Low dose CT of the chest was established as a reliable diagnostic tool, which helps significantly assess the state of a patient and create the best possible management plan. CORADS classification of lung lesions was developed to systemize radiological findings of this disease.
Methods: The CORADS classification was created by the Dutch Radiological Society. Its purpose is to assess the level of probability of give pulmonary lesions to be caused by COVID 19 infection on a scale from 1 (very low) to 5 (very high).The system should be used in patients with moderate to severe typical symptoms. However, classical CORADS classification could be challenging in busy clinical practice of an ICU routine. On the request of our internal medicine department our team created a simplified CORADS classification, which was proven to be very practical and easy in use. In an anonymous survey more than 35 clinicians preferred our classification over classical CORADS in terms of usability. On the other hand, all our radiology resident physicians (11 in total) disclosed significant increase in number reports of CTs Chest low dose they can perform during the day using the simplified classification.
Results: On the base of images from our medical record system we created a pictural review of the classical CORADS and our simplified CORADS classifications with multiple examples of each grade and severity and discussed the differences of both systems. Furthermore, we would like to emphasize importance of some incidental findings, which are recently proven to be of significant prognostic value and should not be overlooked.
Conclusions: COVID 19 states an unique challenge to the global health, in particular to the radiological community.The golden standard in radiological reporting is the CORADS classification, however we believe that our simplified CORADS classification could significantly increase efficiency and efficacy in clinical practice.
PP55*
* Abstract moved to current position due to last minute change of Program flow
Background: Pneumothorax is one of the main complications of transbronchial lung cryobiopsy (TBLC). Chest ultrasound (CUS) is a radiation free alternative method for pneumothorax detection.
Objective: We tested CUS diagnostic accuracy for pneumothorax and assessed its role in the decision algorithm for pneumothorax management. Secondary objectives were to evaluate the post-procedure pneumothorax occurrence and risk factors.
Methods: Eligible patients underwent TBLC, followed by chest X-ray (CXR) evaluation 2 hours after the procedure, as our standard protocol. Bedside CUS was performed within 30 min and 2 hours after TBLC. Pneumothorax by CUS was defined by the absence of lung sliding and comet-tail artefacts, and confirmed with the stratosphere sign on M mode. Pneumothorax size was determined through lung point projection on CUS and interpleural distance on CXR, and properly managed according to clinical status.
Results: Sixty-seven patients were included. Nineteen pneumothoraces were detected at 2h post-procedure, of which 8 (42.1%) were already present at the first CUS evaluation. All CXR-detected pneumothorax had a positive CUS detection. There were 3 discordant cases (─=0.88, 95%CI: 0.76-1.00, p<0.001), which were detected by CUS, but not by inspiration CXR. We calculated a specificity of 97.5% (95% CI: 86.8-99.9) and sensitivity of 100.0% (95% CI: 87.2-100.0) for CUS. Pneumothorax rate was higher when biopsies were taken in two lobes and if histology had pleural representation. Final diagnosis was achieved in 79.1% of patients, with the most frequent diagnosis being hypersensitivity pneumonitis.The proportion of CUS- determined large volume pneumothorax that required drainage was comparable to those determined by CXR.
Conclusion: CUS can replace CXR in detecting the presence of pneumothorax post-TBLC, and the lung point site can reliably indicate its size. This useful method optimizes time spent at the bronchology unit, allows immediate response in symptomatic patients, helping to choose optimal treatment strategies, while preventing ionizing radiation exposure.
THE ROLE OF ULTRASONOGRAPHY IN THE DIAGNOSIS AND DECISION ALGORITHM FOR THE MANAGEMENT OF PNEUMOTHORAX AFTER TRANSBRONCHIAL LUNG CRYOBIOPSY
Helder Novais Bastos1,2,3, Rita Boaventura1, David Coelho1, Leonor Meira1, Susana Guimarães1, Conceição Souto Moura1, Patrícia Mota1,2, Natália Melo1, José Miguel Pereira1,Adriana Magalhães1,António Morais1,2
1 Centro Hospitalar Universitário S. João, Porto, Portugal, 2 Faculty of Medicine, University of Porto, Porto, Portugal
3 IBMC/i3S - Instituto de Biologia Molecular e Celular / Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal
66 6th European Congress for Bronchology and Interventional Pulmonology