Implementation of a harmonized approach for monitoring exposure to engineered and incidental nanoparticles and their potential health effects: First results from the EU-LIFE project NanoExplore

Introduction: We aimed at validating a harmonized protocol for monitoring occupational exposure to engineered/incidental nanoparticles (EINP) and to assess their health effects. Materials and Methods: A multicentric prospective cohort study was designed involving repeated field campaigns of 4-day exposure monitoring and two biological samplings, at the beginning (T1) and at the end (T2) of working week. To detect a significant difference in effect biomarkers of at least 25%, a sample size of 120 workers (60 exposed, 60 non-exposed) was determined, along with two control groups, internal and external to company. The protocol feasibility was tested in three countries: Switzerland, Spain, and Italy. Number and mass concentration, morphology, size distribution and surface area of EINP were measured, and effect biomarkers (oxidative stress and inflammation) were assessed in exhaled breath condensate (EBC) and/or urine samples. Results: The preliminary results of 42 external controls showed no significant change in effect biomarker levels between T1 and T2, with the exception of malondialdehyde and 8-Isoprostane in EBC. The biomarkers levels were within the ranges reported in healthy adults. The analysis of data and samples collected in 60 exposed workers and 36 internal controls recruited at six EINP-handling facilities are ongoing. Conclusions: These findings confirm the feasibility of the harmonized protocol. For its implementation, a particular effort on organization, coordination and communication between each team was mandatory, particularly during COVID time

Radiological pulmonary sequelae after COVID-19 and correlation with clinical and functional pulmonary evaluation: results of a prospective cohort

International audienceObjectives: Whether COVID-19 leads to long-term pulmonary sequelae or not remains unknown. The aim of this study was to assess the prevalence of persisting radiological pulmonary fibrotic lesions in patients hospitalized for COVID-19. Materials and methods: We conducted a prospective single-center study among patients hospitalized for COVID-19 between March and May 2020. Patients with residual symptoms or admitted into intensive care units were investigated 4 months after discharge by a chest CT (CCT) and pulmonary function tests (PFTs). The primary endpoint was the rate of persistent radiological fibrotic lesions after 4 months. Secondary endpoints included further CCT evaluation at 9 and 16 months, correlation of fibrotic lesions with clinical and PFT evaluation, and assessment of predictive factors. Results: Among the 1151 patients hospitalized for COVID-19, 169 patients performed a CCT at 4 months. CCTs showed pulmonary fibrotic lesions in 19% of the patients (32/169). These lesions were persistent at 9 months and 16 months in 97% (29/30) and 95% of patients (18/19) respectively. There was no significant clinical difference based on dyspnea scale in patients with pulmonary fibrosis. However, PFT evaluation showed significantly decreased diffusing lung capacity for carbon monoxide (p < 0.001) and total lung capacity (p < 0.001) in patients with radiological lesions. In multivariate analysis, the predictive factors of radiological pulmonary fibrotic lesions were pulmonary embolism (OR = 9.0), high-flow oxygen (OR = 6.37), and mechanical ventilation (OR = 3.49). Conclusion: At 4 months, 19% of patients investigated after hospitalization for COVID-19 had radiological pulmonary fibrotic lesions; they persisted up to 16 months. Clinical relevance statement: Whether COVID-19 leads to long-term pulmonary sequelae or not remains unknown. The aim of this study was to assess the prevalence of persisting radiological pulmonary fibrotic lesions in patients hospitalized for COVID-19. The prevalence of persisting lesions after COVID-19 remains unclear. We assessed this prevalence and predictive factors leading to fibrotic lesions in a large cohort. The respiratory clinical impact of these lesions was also assessed. Key Points: • Nineteen percent of patients hospitalized for COVID-19 had radiological fibrotic lesions at 4 months, remaining stable at 16 months. • COVID-19 fibrotic lesions did not match any infiltrative lung disease pattern. • COVID-19 fibrotic lesions were associated with pulmonary function test abnormalities but did not lead to clinical respiratory manifestation

Three artificial intelligence data challenges based on CT and MRI

International audiencePurpose: The second edition of the artificial intelligence (AI) data challenge was organized by the French Society of Radiology with the aim to: (i), work on relevant public health issues; (ii), build large, mul-ticentre, high quality databases; and (iii), include three-dimensional (3D) information and prognostic questions. Materials and methods: Relevant clinical questions were proposed by French subspecialty colleges of radiology. Their feasibility was assessed by experts in the field of AI. A dedicated platform was set up for inclusion centers to safely upload their anonymized examinations in compliance with general data protection regulation. The quality of the database was checked by experts weekly with annotations performed by radiologists. Multidisciplinary teams competed between September 11 th and October 13 th 2019. Results: Three questions were selected using different imaging and evaluation modalities, including: pulmonary nodule detection and classification from 3D computed tomography (CT), prediction of expanded disability status scale in multiple sclerosis using 3D magnetic resonance imaging (MRI) and segmentation of muscular surface for sarcopenia estimation from two-dimensional CT. A total of 4347 examinations were gathered of which only 6% were excluded. Three independent databases from 24 individual centers were created. A total of 143 participants were split into 20 multidisciplinary teams. Conclusion: Three data challenges with over 1200 general data protection regulation compliant CT or MRI examinations each were organized. Future challenges should be made with more complex situations combining histopathological or genetic information to resemble real life situations faced by radiologists in routine practice