Background The role and performance of chest CT in the diagnosis of the coronavirus disease 2019 (COVID-19) pandemic remains under active investigation. Purpose To evaluate the French national experience using Chest CT for COVID-19, results of chest CT and RT-PCR were compared together and with the final discharge diagnosis used as reference standard. Materials and Methods A structured CT scan survey (NCT04339686) was sent to 26 hospital radiology departments in France between March 2 and April 24 2020. These dates correspond to the peak of the national COVID-19 epidemic. Radiology departments were selected to reflect the estimated geographical prevalence heterogeneities of the epidemic. All symptomatic patients suspected of having a COVID-19 pneumonia who underwent within 48 hours both initial chest CT and at least one RT-PCR testing were included. The final discharge diagnosis, based on multiparametric items, was recorded. Data for each center were prospectively collected and gathered each week. Test efficacy was determined by using Mann-Whitney Test, Student’s t-test, Chi-square test and Pearson’s correlation. A p value <.05 determined statistical significance. Results Twenty-six of 26 hospital radiology departments responded to the survey with 7500 patients entered; 2652 did not have RT-PCR results or had unknown or excess delay between RT-PCR and CT. After exclusions, 4824 patients (mean age 64, ± 19 yrs, 2669 males) were included. Using final diagnosis as the reference, 2564 of the 4824 patients were positive for COVID-19 (53%). Sensitivity, specificity, NPV and PPV of chest CT for diagnosing COVID-19 were 2319/2564 (90%, 95% confidence interval [CI]: 89, 91), 2056/2260 (91%, 95%CI: 91, 92%), 2056/2300 (89%, 95%CI; 87, 90%) and 2319/2524 (92%, 95%CI 91, 93%) respectively. There was no significant difference for chest CT efficacy among the 26 geographically separate sites, each with varying amounts of disease prevalence. Conclusion Use of chest CT for the initial diagnosis and triage of suspected COVID-19 patients was successful.

This new standardized molecular test showed a lack of detection when the bacterial inoculum was low (number of positive media per sample and number of colonies per media) but can be useful when patients have received antibiotic therapy previously.

: The results of 67 transjugular liver biopsies are described. Two failures were encountered due to inability to pass the needle into acutely angulated hepatic veins. Thirty‐four patients underwent a liver aspiration biopsy using a Colapinto needle, while the remainder were biopsied using a trucut needle. The success rate with the Colapinto needle was 68% and with the trucut model, 97%. Capsular perforation occurred in three cases, but without significant morbidity or mortality. It is concluded that the trucut needle biopsy is more reliable than aspiration biopsy, when the transjugular approach is mandated, in obtaining optimal liver tissue for histopathological diagnosis.

Intrathoracic fibromas are rare tumours, but as might be expected they have been described in many different situations within the chest in relation to areas of connective tissue. In a personal series of 198 primary intrathoracic neoplasms, excluding carcinoma of the lung and oesophagus, Harrington (1950) encountered 13 fibromas or lipofibromas, all of which arose in the posterior mediastinum, but most of those which have been fully described appear in single case reports. Study of the available literature suggests that these tumours may be classified in four groups depending upon their position. Some have been found in the larger bronchi and occasionally diagnosed after biopsy through a bronchoscope. Others have been identified in relation to the parietal pleura, although some of these are undoubtedly fibrous tumours of neural origin. The third gi oup occurs in the mediastinum and the fourth comprises those which appear to arise beneath the visceral pleura. The growth may assume giant size before the onset of symptoms referable to the chest, and may obtain additional blood supply through adhesion to neighbouring structures. It is then difficult-and sometimes impossible-to define its origin. Clagett and Hausmann (1944) claim the biggest fibroma yet removed from the chest, a mass weighing 5 kg., filling the lower part of the right pleural cavity and extending behind the heart to the left side. This was so densely adherent that it was not possible to decide whether it arose beneath the visceral or parietal pleura. This paper is intended to describe our findings in some examples which fall in the fourth group, i.e., those which we believe arise in close relation to the visceral pleura. CASE REPORTS CASE 1.-The patient was a man of 62 years of age when surgical operation was advised in 1947. At the age of 13 he developed right-sided pleurisy. When he was 21 years of age he spent two months in a sanatorium *Based on a paper read to the Thoracic Society at the Royal College of Surgeons in London on

Objectives Value of chest CT was mainly studied in area of high COVID-19 incidence. The aim of this study was therefore to evaluate chest CT performances to diagnose COVID-19 pneumonia with regard to RT-PCR as reference standard in a low incidence area. Methods A survey was sent to radiology department in 4 hospitals in an administrative French region of weak disease prevalence (3.4%). Study design was approved by the local institutional review board and recorded on the clinicaltrial.gov website (NCT04339686). Written informed consent was waived due to retrospective anonymized data collection. Patients who underwent a RT-PCR and a chest CT scan within 48 h for COVID-19 pneumonia suspicion were consecutively included. Diagnostic accuracy including the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of chest CT regarding RT-PCR as reference standard were calculated. Results One hundred twenty-nine patients had abnormal chest CT findings compatible with a COVID-19 pneumonia (26%, 129/487). Among the 358 negative chest CT findings, 3% (10/358) were RT-PCR positive. Chest CT sensitivity, specificity, positive, and negative predictive value were respectively 87% (IC95: 85, 89; 69/79), 85% (IC95: 83, 87; 348/408), 53% (IC95: 50, 56; 69/129), and 97% (IC95: 95, 99; 348/358). Conclusions In a low prevalence area, chest CT scan is a good diagnostic tool to rule out COVID-19 infection among symptomatic suspected patients. Key Points • In a low prevalence area (3.4% in the administrative area and 5.8% at mean in the study) chest CT sensitivity and specificity for diagnosing COVID-19 pneumonia were 87% and 85% respectively. • In patients with negative chest CT for COVID-19 pneumonia, the negative predictive value of COVID-19 infection was 97% (348/358 subjects). • Performance of CT was equivalent between the 4 centers participating to this study. Supplementary Information The online version contains supplementary material available at 10.1007/s00330-021-07863-4.

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