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Covid-19 infection in cancer patients: the management in a diagnostic unit Cover

Figures & Tables

Figure 1

Man, 64 year. Chest x-ray shows patchy consolidation and strip-like opacities in a patient with confirmed COVID-19 infection by reverse transcriptase-polymerase chain reaction (RT-PCR).
Man, 64 year. Chest x-ray shows patchy consolidation and strip-like opacities in a patient with confirmed COVID-19 infection by reverse transcriptase-polymerase chain reaction (RT-PCR).

Figure 2

Man 53 y. CT shows multiple focal ground-glass opacities. (A) Axial plane, (B) multiplanar reconstruction in coronal plane.
Man 53 y. CT shows multiple focal ground-glass opacities. (A) Axial plane, (B) multiplanar reconstruction in coronal plane.

Figure 3

Man, 61 year. CT shows ground-glass opacities separated by thickened interlobular septa. (A-F) Axial planes.
Man, 61 year. CT shows ground-glass opacities separated by thickened interlobular septa. (A-F) Axial planes.

Figure 4

Woman, 54 year. CT shows patchy consolidation in apical segment of left lower lung. (A) Multiplanar reconstruction in sagittal plane; (B) multiplanar reconstruction in coronal plane; (C) axial plane.
Woman, 54 year. CT shows patchy consolidation in apical segment of left lower lung. (A) Multiplanar reconstruction in sagittal plane; (B) multiplanar reconstruction in coronal plane; (C) axial plane.

Figure 5

Man, 76 year. CT shows strip-like opacity, grid-like thickening of interlobular septa, thickening and strip-like twist of bronchial walls and patchy consolidations. (A) Axial plane; (B) multiplanar reconstruction in coronal plane; (C) multiplanar reconstruction in sagittal plane.
Man, 76 year. CT shows strip-like opacity, grid-like thickening of interlobular septa, thickening and strip-like twist of bronchial walls and patchy consolidations. (A) Axial plane; (B) multiplanar reconstruction in coronal plane; (C) multiplanar reconstruction in sagittal plane.

Recommendations for second scenario – suspected COVID-19 cancer patient, according to Italian Society of Radiology and Interventional Radiology (SIRM) guidelines10

PatientsHealthcare staff
Isolated, controlled, and diagnostic confirmation should be as quick as possible
Wear • N95 mask [strong recommendation]Wear • N95 mask [strong recommendation]
• or surgical mask [weak recommendation]• goggles or face shield [strong recommendation]
• gloves [strong recommendation]
• surgical cap [weak recommendation]
• shoe covers [weak recommendation]
Stay away from other people (at least 6 feet of distance) [strong recommendation]Clean and disinfect with 500 mg/L chlorine-containing disinfectant the radiological equipment used, clean their hands properly, and the room should be opened for appropriate ventilation [strong recommendation]
Diagnostic tool
• Chest radiography (CXR; not very sensitive), with portable equipment in the isolation room [strong recommendation]
• Computed tomography (CT; greater sensitivity) for early pneumonic change, disease progression, and alternative diagnoses;
the administration of the intravenous contrast medium for the diagnosis of pulmonary thromboembolism

Fourth scenario -Cancer Patients with incidental COVID-19 diagnosis, according to Italian Society of Radiology and Interventional Radiology (SIRM) guidelines10

PatientsHealthcare staff
Controlled
• diagnostic confirmation should be as quick as possible [strong recommendation]
WearWear
• N95 mask [strong recommendation]• N95 mask [strong recommendation]
• or surgical mask [weak recommendation]• goggles or face shield [strong recommendation]
• gloves [strong recommendation]
• surgical cap [weak recommendation]
• shoe covers [weak recommendation]
Stay away from other people (at least 6 feet of distance) [strong recommendation]Clean and disinfect with 500 mg/L chlorine-containing disinfectant the radiological equipment used, clean their hands properly, and the room should be opened for appropriate ventilation [strong recommendation]

Recommendations for third scenario - confirmed Covid-19 cancer patient, according to Italian Society of Radiology and Interventional Radiology (SIRM) guidelines10

PatientsHealthcare staff
Isolated and controlledMedical personnel enter into the isolation area through
• treated in designated hospitals with isolation and protection conditions [strong recommendation]designated channels (strongrecommendation]
Wear
• N95 mask (strong recommendation]
Wear• goggles or face shield (strong recommendation]
• N95 mask [strong recommendation]• gloves (strong recommendation]
• or surgical mask [weak recommendation]• surgical cap (weak recommendation]
• shoe covers(weak recommendation]
Stay away from other people (at least 6 feet of distance) [strong recommendation]Clean and disinfect with 500 mg/L chlorine-containing disinfectant the radiological equipment used, clean their hands properly, and the room should be opened for appropriate ventilation [strong recommendation]
Diagnostic tool
• daily chest radiographs are not indicated
• CT scan is indicated for the evaluation of the stage of
infection, for defining complications and for a correct
differential diagnosis
• The chest ultrasound (POCUS – point-of-care ultrasound) a
monitoring tool to evaluate the effectiveness of the prono-
supination manoeuvres

Recommendations for first scenario – non COVID-19 cancer patient, according to Italian Society of Radiology and Interventional Radiology (SIRM) guidelines10

PatientsHealth care staff
WearWear
• N95 mask [strong recommendation]• N95 mask [strong recommendation]
• or surgical mask [weak recommendation]• goggles or face shield [strong recommendation]
• gloves [strong recommendation]
• surgical cap [weak recommendation]
• shoe covers [weak recommendation]
Stay away from other people (at least 6 feet of distance) [strong recommendation]Clean and disinfect with 500 mg/L chlorine-containing disinfectant the radiological equipment used, clean their hands properly, and the room should be opened for appropriate ventilation [strong recommendation]
DOI: https://doi.org/10.2478/raon-2021-0010 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
Language: English
Page range: 121 - 129
Submitted on: Sep 17, 2020
|
Accepted on: Dec 19, 2020
|
Published on: Mar 5, 2021
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2021 Vincenza Granata, Roberta Fusco, Francesco Izzo, Sergio Venanzio Setola, Michele Coppola, Roberta Grassi, Alfonso Reginelli, Salvatore Cappabianca, Roberto Grassi, Antonella Petrillo, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.