Background

The Radiological Society of North America (RSNA) recently published a chest CT classification system and Dutch Association for Radiology has announced Coronavirus disease 2019 (COVID-19) reporting and data system (CO-RADS) to provide guidelines to radiologists who interpret chest CT images of patients with suspected COVID-19 pneumonia. This study aimed to compare CO-RADS and RSNA classification with respect to their sensitivity and reliability for diagnosis of COVID-19 pneumonia.

Results

A retrospective study assessed consecutive CT chest imaging of 359 COVID-19-positive patients. Three experienced radiologists who were aware of the final diagnosis of all patients, independently categorized each patient according to CO-RADS and RSNA classification. RT-PCR test performed within one week of chest CT scan was used as a reference standard for calculating sensitivity of each system. Kappa statistics and intraclass correlation coefficient were used to assess reliability of each system. The study group included 359 patients (180 men, 179 women; mean age, 45 ± 16.9 years). Considering combination of CO-RADS 3, 4 and 5 and combination of typical and indeterminate RSNA categories as positive predictors for COVID-19 diagnosis, the overall sensitivity was the same for both classification systems (72.7%). Applying both systems in moderate and severe/critically ill patients resulted in a significant increase in sensitivity (94.7% and 97.8%, respectively). The overall inter-reviewer agreement was excellent for CO-RADS (κ = 0.801), and good for RSNA classification (κ = 0.781).

Conclusion

CO-RADS and RSNA chest CT classification systems are comparable in diagnosis of COVID-19 pneumonia with similar sensitivity and reliability.

Recent developments in the literature have demonstrated that curcumin exhibit antioxidant properties
supporting its anti-inflammatory, chemopreventive and antitumoral activities against aggressive and
recurrent cancers. Despite the valuable findings of curcumin against different cancer cells, the clinical
use of curcumin in cancer treatment is limited due to its extremely low aqueous solubility and instability,
which lead to poor in vivo bioavailability and limited therapeutic effects. We therefore focused in the present
study to evaluate the anti-tumor potential of curcumin analogues on the human breast carcinoma
cell lines MDA-MB-231 and MCF-7, as well as their effects on non-tumorigenic normal breast epithelial
cells (MCF-10). The IC50 values of curcumin analogue J1 in these cancer cell lines were determined to be 5
ng/ml and 10 ng/ml, in MDA-MB-231 and MCF-7 cells respectively. Interestingly, at these concentrations,
the J1 did not affect the viability of non-tumorigenic normal breast epithelial cells MCF-10. Furthermore,
we found that J1 strongly induced growth arrest of these cancer cells by modulating the mitochondrial
membrane potentials without significant effect on normal MCF-10 cells using JC-1 staining and flow
cytometry analysis. Using annexin-V/PI double staining assay followed by flow cytometry analysis, we
found that J1 robustly enhanced the induction of apoptosis by increasing the activity of caspases in
MDA-MB-231 and MCF-7 cancer cells. In addition, treatment of breast cancer cells with J1 revealed that,
in contrast to the expression of cyclin B1, this curcumin analogue vigorously decreased the expression of
cyclin A, CDK2 and cyclin E and subsequently sensitized tumor cells to cell cycle arrest. Most importantly,
the phosphorylation of AKT, mTOR and PKC-theta in J1-treated cancer cells was markedly decreased and
hence affecting the survival of these cancer cells. Most interestingly, J1-treated cancer cells exhibited a
significant inhibition in the activation of RhoA followed by reduction in actin polymerization and
cytoskeletal rearrangement in response to CXCL12. Our data reveal the therapeutic potential of the
curcumin analogue J1 and the underlying mechanisms to fight breast cancer cells.