Summary: Objectives: Patients with acute respiratory distress syndrome (ARDS) due to viral infection are at risk for secondary complications like invasive aspergillosis. Our study evaluates coronavirus disease 19 (COVID‐19) associated invasive aspergillosis at a single centre in Cologne, Germany.Methods: A retrospective chart review of all patients with COVID‐19 associated ARDS admitted to the medical or surgical intensive care unit at the University Hospital of Cologne, Cologne, Germany.Results: COVID‐19 associated invasive pulmonary aspergillosis was found in five of 19 consecutive critically ill patients with moderate to severe ARDS.Conclusion: Clinicians caring for patients with ARDS due to COVID‐19 should consider invasive pulmonary aspergillosis and subject respiratory samples to comprehensive analysis to detect co‐infection.

Background: Artificial intelligence (AI) is gaining increasing importance in many medical specialties, yet data on patients’ opinions on the use of AI in medicine are scarce. Objective: This study aimed to investigate patients’ opinions on the use of AI in different aspects of the medical workflow and the level of control and supervision under which they would deem the application of AI in medicine acceptable. Methods: Patients scheduled for computed tomography or magnetic resonance imaging voluntarily participated in an anonymized questionnaire between February 10, 2020, and May 24, 2020. Patient information, confidence in physicians vs AI in different clinical tasks, opinions on the control of AI, preference in cases of disagreement between AI and physicians, and acceptance of the use of AI for diagnosing and treating diseases of different severity were recorded. Results: In total, 229 patients participated. Patients favored physicians over AI for all clinical tasks except for treatment planning based on current scientific evidence. In case of disagreement between physicians and AI regarding diagnosis and treatment planning, most patients preferred the physician’s opinion to AI (96.2% [153/159] vs 3.8% [6/159] and 94.8% [146/154] vs 5.2% [8/154], respectively; P=.001). AI supervised by a physician was considered more acceptable than AI without physician supervision at diagnosis (confidence rating 3.90 [SD 1.20] vs 1.64 [SD 1.03], respectively; P=.001) and therapy (3.77 [SD 1.18] vs 1.57 [SD 0.96], respectively; P=.001). Conclusions: Patients favored physicians over AI in most clinical tasks and strongly preferred an application of AI with physician supervision. However, patients acknowledged that AI could help physicians integrate the most recent scientific evidence into medical care. Application of AI in medicine should be disclosed and controlled to protect patient interests and meet ethical standards.

GPT-4 (ChatGPT; OpenAI) matched the performance of radiologists in detecting errors in radiology reports and has the potential to reduce processing time and cost.

Background: iRECIST for the objective monitoring of immunotherapies was published by the official RECIST working group in 2017. Main body: Immune-checkpoint inhibitors represent one of the most important therapy advancements in modern oncology. They are currently used for treatment of multiple malignant diseases especially at advanced, metastatic stages which were poorly therapeutically accessible in the past. Promising results of recent studies suggest that their application will further grow in the near future, particularly when used in combination with chemotherapy. A challenging aspect of these immunotherapies is that they may show atypical therapy response patterns such as pseudoprogression and demonstrate a different imaging spectrum of adverse reactions, both of which are crucial for radiologists to understand. In 2017 the RECIST working group published a modified set of response criteria, iRECIST, for immunotherapy, based on RECIST 1.1 which was developed for cytotoxic therapies and adapted for targeted agents. Conclusion: This article provides guidance for response assessment of oncologic patients under immunotherapy based on iRECIST criteria.