PULMONARY BIRT-HOGG-DUBE SYNDROME: A GOOD REASON TO ROUTINELY PERFORM A LOW DOSE CHEST CT SCAN IN PATIENTS WITH PRIMARY SPONTANEOUS PNEUMOTHORAX?

CHEST Journal ◽  
2018 ◽  
Vol 154 (4) ◽  
pp. 576A
Author(s):  
JINCEY SRIRAM ◽  
IRMA VAN DE BEEK ◽  
PAUL JOHANNESMA ◽  
MICHIEL VAN WERKUM ◽  
TIJMEN VAN DER WEL ◽  
...  
Author(s):  
Hooman Bahrami-Motlagh ◽  
Yashar Moharamzad ◽  
Golnaz Izadi Amoli ◽  
Sahar Abbasi ◽  
Alireza Abrishami ◽  
...  

Abstract Background Chest CT scan has an important role in the diagnosis and management of COVID-19 infection. A major concern in radiologic assessment of the patients is the radiation dose. Research has been done to evaluate low-dose chest CT in the diagnosis of pulmonary lesions with promising findings. We decided to determine diagnostic performance of ultra-low-dose chest CT in comparison to low-dose CT for viral pneumonia during the COVID-19 pandemic. Results 167 patients underwent both low-dose and ultra-low-dose chest CT scans. Two radiologists blinded to the diagnosis independently examined ultra-low-dose chest CT scans for findings consistent with COVID-19 pneumonia. In case of any disagreement, a third senior radiologist made the final diagnosis. Agreement between two CT protocols regarding ground-glass opacity, consolidation, reticulation, and nodular infiltration were recorded. On low-dose chest CT, 44 patients had findings consistent with COVID-19 infection. Ultra-low-dose chest CT had sensitivity and specificity values of 100% and 98.4%, respectively for diagnosis of viral pneumonia. Two patients were falsely categorized to have pneumonia on ultra-low-dose CT scan. Positive predictive value and negative predictive value of ultra-low-dose CT scan were respectively 95.7% and 100%. There was good agreement between low-dose and ultra-low-dose methods (kappa = 0.97; P < 0.001). Perfect agreement between low-dose and ultra-low-dose scans was found regarding diagnosis of ground-glass opacity (kappa = 0.83, P < 0.001), consolidation (kappa = 0.88, P < 0.001), reticulation (kappa = 0.82, P < 0.001), and nodular infiltration (kappa = 0.87, P < 0.001). Conclusion Ultra-low-dose chest CT scan is comparable to low-dose chest CT for detection of lung infiltration during the COVID-19 outbreak while maintaining less radiation dose. It can also be used instead of low-dose chest CT scan for patient triage in circumstances where rapid-abundant PCR tests are not available.


2020 ◽  
Vol 17 (2) ◽  
Author(s):  
Feng Ao ◽  
Xueguo Liu ◽  
Mingzhu Liang ◽  
Jiebing Gao

Background: Breast cancer and lung cancer are the leading causes of cancer-related mortality in women. Computed tomography (CT) plays an important role in lung cancer examination but an unidentified role in breast examination. Objectives: To investigate the feasibility of breast composition categorization according to the fifth edition of Breast Imaging-Reporting and Data System (BI-RADS) atlas in low-dose CT screening. Patients and Methods: This was a cross-sectional study completed in The 5th Affiliated Hospital of Sun Yat-sen University, Zhuhai, China. We collected the imaging data of 57 women, who underwent low-dose chest CT scan and mammography within one week from 1st October 2013 to 31st March 2015. Two radiologists independently interpreted the mammograms and chest CT scans and classified the breast composition into categories a, b, c, and d. We also summarized the distribution of breast composition categories by collecting, observing, and classifying the chest CT scans from 1916 female examinees from 1st October 2013 to 31st March 2016. Results: Excellent agreement was observed between the two radiologists, using both low-dose CT scan (κ = 0.91) and mammography (κ = 0.86). Agreement between low-dose chest CT scan and mammography was moderate for radiologist A (κ = 0.50) and radiologist B (κ = 0.43). More breasts were classified in categories a and b on the chest CT scan compared to mammography according to both radiologist A (P < 0.01) and radiologist B (P < 0.01). The proportion of non-dense breast tissues (categories a & b) increased with advancing age, while the proportion of dense breast tissues (categories c & d) decreased (P < 0.05). With advancing age, the probability of non-dense breasts increased, while the probability of dense breasts decreased. Conclusions: Based on the findings, it is feasible to categorize breast composition using low-dose chest CT. In the older age group, the probability of non-dense breasts increased.


CHEST Journal ◽  
2017 ◽  
Vol 152 (5) ◽  
pp. e109-e114
Author(s):  
Kathryn H. Melamed ◽  
Fereidoun Abtin ◽  
Igor Barjaktarevic ◽  
Christopher B. Cooper

2020 ◽  
Vol 17 (4) ◽  
Author(s):  
Hooman Bahrami-Motlagh ◽  
Sahar Abbasi ◽  
Maryam Haghighimorad ◽  
Babak Salevatipour ◽  
Ilad Alavi Darazam ◽  
...  

Background: Chest computed tomography (CT) scan is frequently used for diagnosis of coronavirus disease 2019 (COVID-19), especially in regions with limited availability of reverse-transcription polymerase chain reaction test (RT-PCR) test. Low-dose CT of chest offers acceptable image quality with lower radiation dose, particularly important in younger patients. Objectives: We have designed the current study to evaluate the diagnostic efficacy of low-dose chest CT versus early RT-PCR results, for triage of COVID-19 patients. Patients and Methods: From February 20 to April 15, 2020, 163 patients including 100 males (61.3%) with the median age of 65 years (21 to 97), who underwent both RT-PCR and chest CT were registered in the study. Low-dose chest CT protocol was applied with parameters modified from the lung cancer screening protocol. The accuracy of low-dose chest CT for COVID-19 diagnosis was evaluated, considering first RT-PCR results as reference. Results: Of 163 patients, 89 cases (54.6%) were presented with positive initial RT-PCR result. Lymphocyte percentage and lymphocyte count were significantly lower in the positive RT-PCR group (15% versus 19%, and 0.98 vs. 1.3, respectively); while, erythrocyte sedimentation rate (ESR) was significantly higher (53 vs. 22). Positive chest CT findings were present in 133/163 cases (81.6%). The sensitivity, specificity, positive and negative predictive values (PPV and NPV) and accuracy of low-dose chest CT scan were 96.6% (95% confidence interval [CI], 90% - 99%), 36.5% (95% CI, 26% - 49%), 64.7% (95% CI, 56% - 73%), 90% (95% CI, 72% - 97%) and 69.3% (95% CI, 61% - 76%), respectively based on positive RT-PCR results. Conclusion: Low-dose chest CT scan provides both high sensitivity and negative predictive value in diagnosing COVID-19 compared to initial RT-PCR as the gold standard. It can be used as an alternate to standard-dose CT scan in areas with high prevalence of COVID-19 disease and limited availability of RT-PCR for early triage.


2020 ◽  
Vol 2 (3) ◽  
pp. e200256
Author(s):  
Hooman Bahrami-Motlagh ◽  
Morteza Sanei Taheri ◽  
Sahar Abbasi ◽  
Maryam Haghighimorad ◽  
Babak Salevatipour ◽  
...  
Keyword(s):  
Ct Scan ◽  
Low Dose ◽  
Chest Ct ◽  

Author(s):  
Javid Azadbakht ◽  
Daryoush Khoramian ◽  
Zahra Sadat Lajevardi ◽  
Fateme Elikaii ◽  
Amir Hossein Aflatoonian ◽  
...  

Abstract Background This study aims to review chest computed tomography (CT) scanning parameters which are utilized to evaluate patients for COVID-19-induced pneumonia. Also, some of radiation dose reduction techniques in CT would be mentioned, because using these techniques or low-dose protocol can decrease the radiation burden on the population. Main body Chest CT scan can play a key diagnostic role in COVID-19 patients. Additionally, it can be useful to monitor imaging changes during treatment. However, CT scan overuse during the COVID-19 pandemic raises concerns about radiation-induced adverse effects, both in patients and healthcare workers. Conclusion By evaluating the CT scanning parameters used in several studies, one can find the necessity for optimizing these parameters. It has been found that chest CT scan taken using low-dose CT protocol is a reliable diagnostic tool to detect COVID-19 pneumonia in daily practice. Moreover, the low-dose chest CT protocol results in a remarkable reduction (up to 89%) in the radiation dose compared to the standard-dose protocol, not lowering diagnostic accuracy of COVID-19-induced pneumonia in CT images. Therefore, its employment in the era of the COVID-19 pandemic is highly recommended.


2021 ◽  
Author(s):  
Liwei Deng ◽  
Yuanzhang Li ◽  
Chunyang Yang ◽  
Yongkai Lin ◽  
Jieyao Wu ◽  
...  

2021 ◽  
Vol 123 (4) ◽  
pp. 815-822
Author(s):  
Joanne Guerlain ◽  
Fabienne Haroun ◽  
Alexandra Voicu ◽  
Charles Honoré ◽  
Franck Griscelli ◽  
...  

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Fatemeh Khatami ◽  
Mohammad Saatchi ◽  
Seyed Saeed Tamehri Zadeh ◽  
Zahra Sadat Aghamir ◽  
Alireza Namazi Shabestari ◽  
...  

AbstractNowadays there is an ongoing acute respiratory outbreak caused by the novel highly contagious coronavirus (COVID-19). The diagnostic protocol is based on quantitative reverse-transcription polymerase chain reaction (RT-PCR) and chests CT scan, with uncertain accuracy. This meta-analysis study determines the diagnostic value of an initial chest CT scan in patients with COVID-19 infection in comparison with RT-PCR. Three main databases; PubMed (MEDLINE), Scopus, and EMBASE were systematically searched for all published literature from January 1st, 2019, to the 21st May 2020 with the keywords "COVID19 virus", "2019 novel coronavirus", "Wuhan coronavirus", "2019-nCoV", "X-Ray Computed Tomography", "Polymerase Chain Reaction", "Reverse Transcriptase PCR", and "PCR Reverse Transcriptase". All relevant case-series, cross-sectional, and cohort studies were selected. Data extraction and analysis were performed using STATA v.14.0SE (College Station, TX, USA) and RevMan 5. Among 1022 articles, 60 studies were eligible for totalizing 5744 patients. The overall sensitivity, specificity, positive predictive value, and negative predictive value of chest CT scan compared to RT-PCR were 87% (95% CI 85–90%), 46% (95% CI 29–63%), 69% (95% CI 56–72%), and 89% (95% CI 82–96%), respectively. It is important to rely on the repeated RT-PCR three times to give 99% accuracy, especially in negative samples. Regarding the overall diagnostic sensitivity of 87% for chest CT, the RT-PCR testing is essential and should be repeated to escape misdiagnosis.


2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Vikram rao Bollineni ◽  
Koenraad Hans Nieboer ◽  
Seema Döring ◽  
Nico Buls ◽  
Johan de Mey

Abstract Background To evaluate the clinical value of the chest CT scan compared to the reference standard real-time polymerase chain reaction (RT-PCR) in COVID-19 patients. Methods From March 29th to April 15th of 2020, a total of 240 patients with respiratory distress underwent both a low-dose chest CT scan and RT-PCR tests. The performance of chest CT in diagnosing COVID-19 was assessed with reference to the RT-PCR result. Two board-certified radiologists (mean 24 years of experience chest CT), blinded for the RT-PCR result, reviewed all scans and decided positive or negative chest CT findings by consensus. Results Out of 240 patients, 60% (144/240) had positive RT-PCR results and 89% (213/240) had a positive chest CT scans. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of chest CT in suggesting COVID-19 were 100% (95% CI: 97–100%, 144/240), 28% (95% CI: 19–38%, 27/240), 68% (95% CI: 65–70%) and 100%, respectively. The diagnostic accuracy of the chest CT suggesting COVID-19 was 71% (95% CI: 65–77%). Thirty-three patients with positive chest CT scan and negative RT-PCR test at baseline underwent repeat RT-PCR assay. In this subgroup, 21.2% (7/33) cases became RT-PCR positive. Conclusion Chest CT imaging has high sensitivity and high NPV for diagnosing COVID-19 and can be considered as an alternative primary screening tool for COVID-19 in epidemic areas. In addition, a negative RT-PCR test, but positive CT findings can still be suggestive of COVID-19 infection.


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