Detection and Classification of Bronchiectasis Based on Improved Mask-RCNN.

Bronchiectasis is defined as a permanent dilation of the bronchi that can cause pulmonary ventilation dysfunction. CT examination is an important means of diagnosing bronchiectasis. It can also be used in severity scoring. Current studies on bronchiectasis have focused on high-resolution CT (HRCT), ignoring the more common low-dose CT (LDCT). Methodologically, existing studies have not adopted an authoritative standard to classify the severity of bronchiectasis. In effect, the accuracy of detection and classification needs to be improved for practical application. In this paper, the ACER image enhancement method, RDU-Net lung lobe segmentation method and HDC Mask R-CNN model were proposed to detect and classify bronchiectasis. Moreover, a Python-based system was developed: after inputing an LDCT image of a patient's lung, it can automatically perform a series of processing, then call on the trained deep learning model for detection and classification, and automatically obtain the patient's bronchiectasis final score according to the Reiff and BRICS scoring criteria. In this paper, the mapping relationship between original lung CT image data and bronchiectasis scoring system was established. The accuracy of the method proposed in this paper was 91.4%; the IOU, sensitivity and specificity were 88.8%, 88.6% and 85.4%, respectively; and the recognition speed of one picture was about 1 s. Compared to a human doctor, the system can process large amounts of data simultaneously, quickly and efficiently, with the same judgment accuracy as a human doctor. Doctors only need to judge the uncertain cases, which significantly reduces the burden of doctors and provides a useful reference for doctors to diagnose the disease.

SWOT Analysis and Preliminary Study on Prevention and Control Management of Temporary Integrated Isolation Ward During COVID-19 Outbreak.

Background: The world faced crises of prevention and control and shortage of medical resources during the COVID-19 (Corona Virus Disease 2019) outbreak. The establishment of temporary integrated isolation wards in hospitals, which is universal and representative in China, is one of the most-effective strategies in solving these problems according to China's experiences. Aim: To conduct a preliminary study on the establishment of a temporary integrated isolation ward during the outbreak of COVID-19 and to evaluate related impact. Methods: SWOT analysis was used to analyze the advantages, disadvantages, opportunities, and risks in the establishment of the temporary integrated isolation ward, and corresponding corrective measures were made according to the analysis results. Findings: The ward has formulated more than 10 related work procedures and prevention and control measures. A total of 93 patients with 18 critically ill patients were admitted for treatment and isolation. They were all evaluated based on established procedures and protocols. Twenty-four supplementary nucleic acid tests were ordered and conducted. One new patient with COVID-19 was confirmed and was successfully transferred to the designated COVID-19 infectious control hospital. There were no missed diagnosis or misdiagnosis, no cross-infection of patients, no cluster outbreak, and no infection of medical workers during the entire process. Conclusion: SWOT analysis is helpful in guiding the establishment of a temporary integrated isolation ward and the formulation of prevention and control measures in Hebei General Hospital during the COVID-19 outbreak. It provides the guidance and reference of significance for the establishment of similar types of wards in the future.

The Impact of COVID-19 on Brachytherapy During the Pandemic: A Rutgers-Robert Wood Johnson Barnabas Health Multisite Experience.

PURPOSE: This study aimed to evaluate whether the coronavirus disease of 2019 (COVID-19) pandemic resulted in treatment delays in patients scheduled for or undergoing brachytherapy. METHODS AND MATERIALS: A retrospective cohort study was conducted across 4 affiliated sites after local institutional review board approval. The eligibility criteria were defined as all patients with cancer whose treatment plan included brachytherapy during the COVID-19 pandemic from February 24, 2020 to June 30, 2020. Treatment delays, cancellations, alterations of fractionation regimens, and treatment paradigm changes were evaluated. RESULTS: A total of 47 patients were eligible for the analysis. Median patient age at the time of treatment was 62 years (interquartile range, 56-70 years). Endometrial, cervical, and prostate cancers were the most common sites included in this analysis. Three patients (6.4%) with cervical cancer were diagnosed with COVID-19 during the course of their treatment. Interruptions of external beam radiation therapy (EBRT), cancellations of EBRT, cancellations of brachytherapy, and treatment delays due to COVID occurred in 5 (10.6%), 3 (6.4%), 8 (17%), and 9 (19%) patients, respectively. The mean and median number of days delayed for patients who experienced treatment interruptions were 16.3 days (standard deviation: 13.9 days) and 14 days (interquartile range, 5.75-23.75 days), respectively. For patients with cervical cancer, the mean and median overall treatment times defined as the time from the start of EBRT to the end of brachytherapy were 56 and 49 days, respectively. CONCLUSIONS: Despite the challenges the health care system faced during the pandemic, most patients with cancer were safely treated with minor treatment delays and interruptions. Long-term follow up is needed to assess the impact of COVID-19 and treatment interruptions on oncologic outcomes.