Background: The aim of this study was to analyze the lung ultrasound (LUS) patterns in combination with clinical-laboratory profiles of children hospitalized for COVID-19 infection in relation to temporal trend of the Italian epidemic. Methods: This was a retrospective study conducted at a pediatric tertiary referral hospital from 15th March 2020 to 15th March 2021. We compared the characteristics of two periods of the pandemic outbreak, the first one in spring and summer (15th March-30th September 2020) and the second one in autumn and winter (1st October 2020-15th March 2021). Results: 28 patients (53.85%) were in the first period, 24 patients (46.15%) were in the second period. The disease severity score was significantly higher in the second period (p=0.02). We observed that the occurrence of the irregular pleural line was seen more frequently in the second period (87.5% vs 60.71%; p=0.03). The B-lines were significantly more frequent in children in the second period (87.5% vs 60%; p=0.03). The several but not-coalescent B-lines were significantly more frequent in the second period (80% vs 41.7%; p=0.05). The LUS score correlated significantly with the disease severity score with a strong relationship (r=0.51, p=0.002). The second phase of the COVID-19 epidemic outbreak had a higher disease severity score than the first phase with a moderate correlation (r= 0.42; p=0.01). Conclusion: The LUS plays an important role in the evaluation of pulmonary involvement in children affected by COVID-19 during different periods of the pandemic in combination with clinical-laboratory findings.

Background: MYCN amplification represents a powerful prognostic factor in neuroblastoma (NB) and may occasionally account for intratumoral heterogeneity. Radiomics is an emerging field of advanced image analysis that aims to extract a large number of quantitative features from standard radiological images, providing valuable clinical information Procedure: In this retrospective study, we aimed to create a radiogenomics model by correlating computed tomography (CT) radiomics analysis with MYCN status and overall survival (OS). NB lesions were segmented on pre-therapy CT scans and radiomics features subsequently extracted using a dedicated library. Dimensionality reduction/features selection approaches were then used for features procession and logistic regression models have been developed for the considered outcome. Results: Seventy-eight patients were included in this study, 24 presented MYCN amplification. In total, 232 radiomics features were extracted. Eight features were selected through Boruta algorithm and 2 features were lastly chosen through Pearson correlation analysis: mean of voxel intensity histogram (p=0.0082) and zone size non-uniformity (p=0.038). Five-times repeated 3-fold cross-validation logistic regression models yielded an Area Under the Curve (AUC) value of 0.879 on the training and 0.865 on the testing set for MYCN. No statistical significant difference has been observed comparing radiomics predicted and actual OS data. Conclusions: CT based radiomics is able to predict MYCN amplification status and OS in NB, paving the way to the in depth analysis of imaging based biomarkers that could enhance outcomes prediction.

Background: The Coronavirus Disease 2019 (COVID-19) is causing of the new global pandemic and is responsible for millions of infections and thousands of deaths in the world. The lung ultrasound is a non-invasive and easily repeatable tool and can be carried out by the pediatrician at the bedside of children with a consequent reduction in the risk of transmission of the virus. Objective: To determine whether the lung ultrasound is a useful tool in identifying the signs of lung involvement in children with COVID-19 and whether can monitor the course of the disease. Methods: The study was made in the emergency department in a tertiary level pediatric hospital. All patients with swab-confirmed COVID-19 infection were subjected a lung ultrasound within 6 hours from admission and after 96 hours. Results: Among a total of 30 children, 18 (60%) were males, 4 reported exertional dyspnea and only 1 chest pain. The mean oxygen saturation was 98.8 ± 1.0 % in ambient air in emergency department and no patient needed oxygen therapy during hospitalization. After 96 hours we had observed ultrasound abnormality al the lung ultrasound only in 20% of the children. We found a statistically significant reduction in pleural irregularities (30% vs 16.7; p: .001) and in B lines (50% vs 20%; p: .008). Conclusions: lung ultrasound is safe and useful tool in detecting lung involvement in children with COVID-19 and in monitoring these patients during the course of disease.

Lung cancer is the leading cause of cancer-related death. NSCLC accounts for 80-90% of cases. In younger patients, adenocarcinoma is the most frequent histotype and 3-7% expresses the rearrange-ment of ALK oncogene, sensitive to TKIs. Crizotinib is the first ALK inhibitor approved by FDA. We present the case of a 17-year-old male with metastatic naïve ALK-positive adenocarcinoma, treated with crizotinib. He received crizotinib and obtained a prolonged response with PFS of 33 months. Crizotinib can be extremely effective in adolescent with naïve ALK-positive NSCLC but it hardly penetrates blood-brain barrier. Resistance mechanisms will be investigated for a better man-agement.