Caution warranted for low-dose radiation therapy for Covid-19

Covid-19 is a morbid respiratory disease that has caused desperate times on a global scale due to the lack of any effective medical treatment. Some in the radiation community are actively proposing low-dose radiation therapy (LDRT) for managing the viral pneumonia associated with Covid-19. This commentary provides a rationale for exercising caution against such a decision as the efficacy of LDRT for viral diseases is unknown, while its long-term adverse risks are well known.     

Imaging for infection: Caution required with the charcot joint

Scintigraphic techniques for detecting bone infection can be misleading in neuroarthropathy (Charcot joint). Three patients showed strongly positive three phase bone and ⁶⁷Ga imaging despite absence of osteitis. Indium labelled white cell imaging provided the correct information on each patient. The findings have important implications for the investigation of diabetic patients with suspected bone infection.     

Ablation Zones and Weight-Bearing Bones: Points of Caution for the Palliative Interventionalist

PurposeTo evaluate and classify underlying mechanisms of adverse outcomes after percutaneous computed tomography (CT)–guided cryoablation for palliation of painful musculoskeletal metastatic disease.Materials and MethodsData were collected for patients who underwent CT-guided percutaneous palliative cryoablation for painful musculoskeletal metastatic disease between January 2010 and December 2012. Cases with adverse outcomes or suboptimal response were identified and classified according to the Society of Interventional Radiology (SIR) classification system for complications by outcome and according to underlying mechanism of the outcome as delineated on follow-up examination.ResultsThere were 61 patients who received ablation for painful musculoskeletal metastatic disease. Six patients with adverse outcomes were identified. Two were minor complications (A, n = 1; B, n = 1), and four were major complications (C, n = 1; D, n = 3). Four patients incurred sequelae related to damage of ancillary structures included in the ablation zone, and two patients developed complete fractures after ablation of lesions in weight-bearing bones.ConclusionsComplete cryoablation of a painful musculoskeletal metastatic lesion may lead to ancillary damage of adjacent structures or fracture in weight-bearing bones.