scholarly journals Comparison of epicardial adipose tissue volume quantification between cardiac and chest computed tomography scans

2020 ◽  
Author(s):  
Lingyu Xu ◽  
Yuancheng Xu ◽  
Stanislau Hrybouski ◽  
D Ian Paterson ◽  
Richard B. Thompson ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Adipose Tissue ◽  
Cardiac Ct ◽  
Epicardial Adipose Tissue ◽  
Hounsfield Unit ◽  
Chest Ct ◽  
Strongly Correlated ◽  
Imaging Protocol ◽  
Chest Computed Tomography ◽  
Contrast Enhanced Ct

ABSTRACTBackgroundThis study investigated accuracy and consistency of epicardial adipose tissue (EAT) quantification in chest computed tomography (CT) scans.Methods and resultsEAT volume was quantified semi-automatically using a standard Hounsfield unit threshold (-190U, -30) in three independent cohorts: (1) Cohort 1 (N = 30) consisted of paired 120 KV cardiac non-contrast CT (NCCT) and 120 KV chest NCCT; (2) Cohort 2 (N = 20) consisted of paired 120 KV cardiac NCCT and 100 KV chest NCCT; (3) Cohort 3 (N = 20) consisted of paired chest NCCT and chest contrast-enhanced CT (CECT) datasets. Images were reconstructed with the slice thicknesses of 1.25 mm and 5 mm in the chest CT datasets, and 3 mm in the cardiac NCCT datasets. In Cohort 1, the chest NCCT-1.25 mm EAT volume was similar to the cardiac NCCT EAT volume, whilst chest NCCT-5 mm underestimated the EAT volume by 7.0%. In Cohort 2, 100 KV chest NCCT-1.25mm and -5 mm EAT volumes were 9.7% and 6.4% larger than corresponding 120 KV cardiac NCCT EAT volumes. In Cohort 3, the chest CECT dataset underestimated EAT volumes by ∼25%, relative to chest NCCT datasets. All chest CT-derived EAT volumes were strongly correlated with their cardiac CT counterparts.ConclusionsThe chest NCCT-1.25 mm EAT volume with the 120 KV tube energy produced EAT volumes that are comparable to cardiac NCCT. All chest CT EAT volumes were strongly correlated with EAT volumes obtained from cardiac CT, if imaging protocol is consistently applied to all participants.

scholarly journals Correlation between age, sex, and severity of Coronavirus disease-19 based on chest computed tomography severity scoring system

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Shimaa Farghaly ◽  
Marwa Makboul
Keyword(s):  
Computed Tomography ◽  
Scoring System ◽  
Fatal Outcome ◽  
Age Groups ◽  
Significant Risk ◽  
Chest Ct ◽  
Age Group ◽  
Severity Scoring ◽  
Chest Computed Tomography ◽  
Severity Of The Disease

Abstract Background Coronavirus disease 2019 (COVID-19) is the most recent global health emergency; early diagnosis of COVID-19 is very important for rapid clinical interventions and patient isolation; chest computed tomography (CT) plays an important role in screening, diagnosis, and evaluating the progress of the disease. According to the results of different studies, due to high severity of the disease, clinicians should be aware of the different potential risk factors associated with the fatal outcome, so chest CT severity scoring system was designed for semi-quantitative assessment of the severity of lung disease in COVID-19 patients, ranking the pulmonary involvement on 25 points severity scale according to extent of lung abnormalities; this study aims to evaluate retrospectively the relationship between age and severity of COVID-19 in both sexes based on chest CT severity scoring system. Results Age group C (40–49 year) was the commonest age group that was affected by COVID-19 by 21.3%, while the least affected group was group F (≥ 70 years) by only 6.4%. As regards COVID-RADS classification, COVID-RADS-3 was the most commonly presented at both sexes in all different age groups. Total CT severity lung score had a positive strong significant correlation with the age of the patient (r = 0.64, P < 0.001). Also, a positive strong significant correlation was observed between CT severity lung score and age in both males and females (r = 0.59, P < 0.001) and (r = 0.69, P < 0.001) respectively. Conclusion We concluded that age can be considered as a significant risk factor for the severity of COVID-19 in both sexes. Also, CT can be used as a significant diagnostic tool for the diagnosis of COVID-19 and evaluation of the progression and severity of the disease.

scholarly journals Feasible Dose Reduction in Routine Chest Computed Tomography Maintaining Constant Image Quality Using the Last Three Scanner Generations: From Filtered Back Projection to Sinogram-affirmed Iterative Reconstruction and Impact of the Novel Fully Integrated Detector Design Minimizing Electronic Noise

2014 ◽  
Vol 4 ◽  
pp. 38 ◽  
Author(s):  
Lukas Ebner ◽  
Felix Knobloch ◽  
Adrian Huber ◽  
Julia Landau ◽  
Daniel Ott ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Soft Tissue ◽  
Radiation Dose ◽  
Dose Reduction ◽  
Integrated Circuit ◽  
Chest Ct ◽  
Back Projection ◽  
Dose Length Product ◽  
Chest Computed Tomography ◽  
Tube Current

Objective: The aim of the present study was to evaluate a dose reduction in contrast-enhanced chest computed tomography (CT) by comparing the three latest generations of Siemens CT scanners used in clinical practice. We analyzed the amount of radiation used with filtered back projection (FBP) and an iterative reconstruction (IR) algorithm to yield the same image quality. Furthermore, the influence on the radiation dose of the most recent integrated circuit detector (ICD; Stellar detector, Siemens Healthcare, Erlangen, Germany) was investigated. Materials and Methods: 136 Patients were included. Scan parameters were set to a thorax routine: SOMATOM Sensation 64 (FBP), SOMATOM Definition Flash (IR), and SOMATOM Definition Edge (ICD and IR). Tube current was set constantly to the reference level of 100 mA automated tube current modulation using reference milliamperes. Care kV was used on the Flash and Edge scanner, while tube potential was individually selected between 100 and 140 kVp by the medical technologists at the SOMATOM Sensation. Quality assessment was performed on soft-tissue kernel reconstruction. Dose was represented by the dose length product. Results: Dose-length product (DLP) with FBP for the average chest CT was 308 mGy*cm ± 99.6. In contrast, the DLP for the chest CT with IR algorithm was 196.8 mGy*cm ± 68.8 (P = 0.0001). Further decline in dose can be noted with IR and the ICD: DLP: 166.4 mGy*cm ± 54.5 (P = 0.033). The dose reduction compared to FBP was 36.1% with IR and 45.6% with IR/ICD. Signal-to-noise ratio (SNR) was favorable in the aorta, bone, and soft tissue for IR/ICD in combination compared to FBP (the P values ranged from 0.003 to 0.048). Overall contrast-to-noise ratio (CNR) improved with declining DLP. Conclusion: The most recent technical developments, namely IR in combination with integrated circuit detectors, can significantly lower radiation dose in chest CT examinations.

scholarly journals The role of chest computed tomography in the management of COVID-19: A review of results and recommendations

2020 ◽  
Vol 245 (13) ◽  
pp. 1096-1103 ◽  
Author(s):  
Molly D Wong ◽  
Theresa Thai ◽  
Yuhua Li ◽  
Hong Liu
Keyword(s):  
Computed Tomography ◽  
Early Detection ◽  
Technology Development ◽  
Early Stage ◽  
Chest Ct ◽  
High Rate ◽  
Chest Computed Tomography ◽  
Severity Of The Disease ◽  
The Impact

The rapid and dramatic increase in confirmed cases of COVID-19 has led to a global pandemic. Early detection and containment are currently the most effective methods for controlling the outbreak. A positive diagnosis is determined by laboratory real-time reverse transcriptase polymerase chain reaction (rRT-PCR) testing, but the use of chest computed tomography (CT) has also been indicated as an important tool for detection and management of the disease. Numerous studies reviewed in this paper largely concur in their findings that the early hallmarks of COVID-19 infection are ground-glass opacities (GGOs), often with a bilateral and peripheral lung distribution. In addition, most studies demonstrated similar CT findings related to the progression of the disease, starting with GGOs in early disease, followed by the development of crazy paving in middle stages and finally increasing consolidation in the later stages of the disease. Studies have reported a low rate of misdiagnosis by chest CT, as well as a high rate of misdiagnosis by the rRT-PCR tests. Specifically, chest CT provides more accurate results in the early stages of COVID-19, when it is critical to begin treatment as well as isolate the patient to avoid the spread of the virus. While rRT-PCR will probably remain the definitive final test for COVID-19, until it is more readily available and can consistently provide higher sensitivity, the use of chest CT for early stage detection has proven valuable in avoiding misdiagnosis as well as monitoring the progression of the disease. With the understanding of the role of chest CT, researchers are beginning to apply deep learning and other algorithms to differentiate between COVID-19 and non-COVID-19 CT scans, determine the severity of the disease to guide the course of treatment, and investigate numerous additional COVID-19 applications. Impact statement The impact of the COVID-19 pandemic has been worldwide, and clinicians and researchers around the world have been working to develop effective and efficient methods for early detection as well as monitoring of the disease progression. This minireview compiles the various agency and expert recommendations, along with results from studies published in numerous countries, in an effort to facilitate the research in imaging technology development to benefit the detection and monitoring of COVID-19. To the best of our knowledge, this is the first review paper on the topic, and it provides a brief, yet comprehensive analysis.

scholarly journals Efficacy of chest computed tomography prediction of the pathological TNM stage of thymic epithelial tumours†

2019 ◽  
Vol 56 (2) ◽  
pp. 285-293 ◽  
Author(s):  
Darin B White ◽  
Megan J Hora ◽  
Sarah M Jenkins ◽  
Randolph S Marks ◽  
Yolanda I Garces ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Neoadjuvant Therapy ◽  
Tnm Staging ◽  
Chest Ct ◽  
Tnm Stage ◽  
Kappa Statistics ◽  
Chest Computed Tomography ◽  
Staging Systems ◽  
Epithelial Tumours ◽  
Preoperative Chest

Abstract OBJECTIVES The aim of this study is to evaluate the efficacy of chest computed tomography (CT) to predict the pathological stage of thymic epithelial tumours (TET) using the recently introduced tumour, node and metastasis (TNM) staging with comparison to the modified Masaoka staging. METHODS Preoperative chest CT examinations in cases of resected TET with sampled lymph nodes (2006–2016) were retrospectively reviewed by 2 thoracic radiologists and radiologically (r) staged using both staging systems. A thoracic pathologist reviewed all cases for the pathological (p) stage. Concordance between r-staging and p-staging was assessed by % agreement and unweighted kappa statistics. Associations between r-stage and p-stage with outcomes were assessed using the Cox proportional hazards regression. RESULTS Sixty patients with TET were included (47 thymomas, 12 thymic carcinomas and 1 atypical carcinoid tumour). Sixteen patients (26.7%) had received neoadjuvant therapy. Fifty-four patients (90.0%) had complete resection. The overall agreement between the r-stage and p-stage was 66.7% (κ = 0.46) for TNM staging and 46.7% (κ = 0.30) for modified Masaoka staging. Agreement between r-assessment and p-assessment of the T, N and M components of the TNM stage was 61.7% (κ = 0.28), 86.7% (κ = 0.48) and 98.3% (κ = 0.88), respectively. CT overstaged 12 patients (20.0%) for TNM staging and 12 patients (20.0%) for modified Masaoka staging and understaged 8 (13.3%) and 20 (33.3%) patients for TNM staging modified Masaoka staging, respectively. The r-TNM staging accuracy was lower for patients with neoadjuvant therapy (50.0% with vs 72.7% without). During a median follow-up of 2.6 years (range 0.1–10.5 years), 12 patients had metastases and/or recurrence; 11 patients died (4 of disease). The r-TNM stage and modified Masaoka stage were associated with overall survival and progression-free survival (P < 0.001). CONCLUSIONS Preoperative chest CT is able to accurately predict p-TNM stage in two-thirds of surgically resected TET, with an agreement between radiological staging and pathological staging superior to the modified Masaoka staging.

scholarly journals Clinical outcomes of hemodialysis patients infected with severe acute respiratory syndrome coronavirus 2 and impact of proactive chest computed tomography scans

2020 ◽  
Vol 13 (3) ◽  
pp. 328-333 ◽  
Author(s):  
Rui Wang ◽  
Hong He ◽  
Cong Liao ◽  
Hongtao Hu ◽  
Chun Hu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Invasive Mechanical Ventilation ◽  
Case Series ◽  
Ground Glass Opacity ◽  
High Sensitivity ◽  
Chest Ct ◽  
Maintenance Hemodialysis ◽  
Rt Pcr ◽  
Chest Computed Tomography ◽  
Reactive Protein

Abstract Background Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that first manifested in humans in Wuhan, Hubei Province, China, in December 2019, and has subsequently spread worldwide. Methods We conducted a retrospective, single-center case series of the seven maintenance hemodialysis (HD) patients infected with COVID-19 at Zhongnan Hospital of Wuhan University from 13 January to 7 April 2020 and a proactive search of potential cases by chest computed tomography (CT) scans. Results Of 202 HD patients, 7 (3.5%) were diagnosed with COVID-19. Five were diagnosed by reverse transcription polymerase chain reaction (RT-PCR) because of compatible symptoms, while two were diagnosed by RT-PCR as a result of screening 197 HD patients without respiratory symptoms by chest CT. Thirteen of 197 patients had positive chest CT features and, of these, 2 (15%) were confirmed to have COVID-19. In COVID-19 patients, the most common features at admission were fatigue, fever and diarrhea [5/7 (71%) had all these]. Common laboratory features included lymphocytopenia [6/7 (86%)], elevated lactate dehydrogenase [3/4 (75%)], D-dimer [5/6 (83%)], high-sensitivity C-reactive protein [4/4 (100%)] and procalcitonin [5/5 (100%)]. Chest CT showed bilateral patchy shadows or ground-glass opacity in the lungs of all patients. Four of seven (57%) received oxygen therapy, one (14%) received noninvasive and invasive mechanical ventilation, five (71%) received antiviral and antibacterial drugs, three (43%) recieved glucocorticoid therapy and one (14%) received continuous renal replacement therapy. As the last follow-up, four of the seven patients (57%) had been discharged and three patients were dead. Conclusions Chest CT may identify COVID-19 patients without clear symptoms, but the specificity is low. The mortality of COVID-19 patients on HD was high.

P6429Epicardial adipose tissue is a robust measure of increased risk of myocardial infarction, a meta-analysis on over 6.600 patients

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Hendricks ◽  
I Dykun ◽  
B Balcer ◽  
T Rassaf ◽  
A A Mahabadi
Keyword(s):  
Myocardial Infarction ◽  
Computed Tomography ◽  
Adipose Tissue ◽  
Patient Management ◽  
Epicardial Adipose Tissue ◽  
Meta Analysis ◽  
Free Text ◽  
Emergency Setting ◽  
3 Dimensional ◽  
Coronary Events

Abstract Background Epicardial adipose tissue surrounds the heart and the coronary arteries. Endocrine and paracrine activity is accredited to EAT. Studies descripted the association between increased EAT and traditional cardiovascular risk factors as well as coronary events. While computed tomography is the gold standard for the assessment of 3-dimensional EAT-volume, echocardiography based EAT thickness is an easy accessible alternative in particular in an emergency setting. So far, little is known, how quantification of EAT in patients presenting with chest pain could alter patient management. Purpose To perform a meta-analysis on existing studies, comparing EAT in patients with and without myocardial infarction, stratifying by imaging technique. Methods We performed a systematic search using the Pubmed, Cochrane, SCOPUS, and Web of Science databases for studies, describing EAT in patients with and without myocardial infarction. Manuscripts, published until 1st of October 2018, were included. We made our search specific and sensitive using Medical Subject Headings terms and free text and considered studies published in English language. Search terms used were “epicardial adipose tissue” or “pericardial adipose tissue” and “myocardial infarction”, “coronary events”, or “acute coronary syndrome”. For comparability, EAT measures were normalized to mean values for patients without myocardial infarction for each study separately. Random effect models were calculated. All analyses were performed using Review Manager 5.3. Results Overall, 6.641 patients (mean aged 58.9 years, 53% male) from 7 studies were included. Patients with myocardial infarction had 37% higher measures of EAT compared to patients without myocardial infarction (95% CI: 21–54%, Figure A). Comparing studies using echocardiography for assessment of EAT thickness with studies using computed tomography based EAT volume, similar relative differences in EAT with wide overlap of confidence intervals were observed (Echo measures: 40 [4–76]%, CT measures: 36 [16–57]%, Figure B and C). No relevant heterogeneity and inconsistency between groups was present in all analyses (detailed data not shown). Figure 1 Conclusion EAT is increased in patients with myocardial infarction. Our data suggests that quantification of EAT thickness using echocardiography distinguishes equally between patients with and without myocardial infarction as compared to 3-dimensional EAT volume from computed tomography. Therefore, it may be an easy accessible alternative in clinical settings. However, further studies are warranted to determine, whether quantification of EAT may lead to improved patient management.

scholarly journals The utility of chest computed tomography (CT) and RT-PCR screening of asymptomatic patients for SARS-CoV-2 prior to semiurgent or urgent hospital procedures

2020 ◽  
Vol 41 (12) ◽  
pp. 1375-1377 ◽  
Author(s):  
Aditya S. Shah ◽  
Lara A. Walkoff ◽  
Ronald S. Kuzo ◽  
Matthew R. Callstrom ◽  
Michael J. Brown ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Tertiary Care ◽  
Case Series ◽  
Chest Ct ◽  
Study Cohort ◽  
Rt Pcr ◽  
Chest Computed Tomography ◽  
Tertiary Care Medical Center ◽  
Asymptomatic Patients

AbstractObjective:Presently, evidence guiding clinicians on the optimal approach to safely screen patients for coronavirus disease 2019 (COVID-19) to a nonemergent hospital procedure is scarce. In this report, we describe our experience in screening for SARS-CoV-2 prior to semiurgent and urgent hospital procedures.Design:Retrospective case series.Setting:A single tertiary-care medical center.Participants:Our study cohort included patients ≥18 years of age who had semiurgent or urgent hospital procedures or surgeries.Methods:Overall, 625 patients were screened for SARS-CoV-2 using a combination of phone questionnaire (7 days prior to the anticipated procedure), RT-PCR and chest computed tomography (CT) between March 1, 2020, and April 30, 2020.Results:Of the 625 patients, 520 scans (83.2%) were interpreted as normal; 1 (0.16%) had typical features of COVID-19; 18 scans (2.88%) had indeterminate features of COVID-19; and 86 (13.76%) had atypical features of COVID-19. In total, 640 RT-PCRs were performed, with 1 positive result (0.15%) in a patient with a CT scan that yielded an atypical finding. Of the 18 patients with chest CTs categorized as indeterminate, 5 underwent repeat negative RT-PCR nasopharyngeal swab 1 week after their initial swab. Also, 1 patient with a chest CT categorized as typical had a follow-up repeat negative RT-PCR, indicating that the chest CT was likely a false positive. After surgery, none of the patients developed signs or symptoms suspicious of COVID-19 that would indicate the need for a repeated RT-PCR or CT scan.Conclusion:In our experience, chest CT scanning did not prove provide valuable information in detecting asymptomatic cases of SARS-CoV-2 (COVID-19) in our low-prevalence population.

scholarly journals Complementary Diagnostic and Prognostic Contributions of Cardiac Computed Tomography for Infective Endocarditis Surgery

2020 ◽  
Vol 13 (9) ◽  
Author(s):  
Tom Kai Ming Wang ◽  
Mnahi Bin Saeedan ◽  
Nicholas Chan ◽  
Nancy A. Obuchowski ◽  
Nabin Shrestha ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Infective Endocarditis ◽  
Cardiac Ct ◽  
Cardiac Computed Tomography ◽  
Cleveland Clinic ◽  
Total Mortality ◽  
Adverse Outcomes ◽  
Imaging Biomarker ◽  
Imaging Biomarkers ◽  
Contrast Enhanced Ct

Background: Cardiac computed tomography (CT) is emerging as an adjunctive modality to echocardiography in the evaluation of infective endocarditis (IE) and surgical planning. CT studies in IE have, however, focused on its diagnostic rather than prognostic utility, the latter of which is important in high-risk diseases like IE. We evaluated the associations between cardiac CT and transesophageal echocardiography (TEE) findings and adverse outcomes after IE surgery. Methods: Of 833 consecutive patients with surgically proven IE during May 1, 2014 to May 1, 2019, at Cleveland Clinic, 155 underwent both preoperative ECG-gated contrast-enhanced CT and TEE. Multivariable analyses were performed to identify CT and TEE biomarkers that predict adverse outcomes after IE surgery, adjusting for EuroSCORE II (European System for Cardiac operative Risk Evaluation II). Results: CT and TEE were positive for IE in 123 (75.0%) and 124 (75.6%) of patients, respectively. Thirty-day mortality occurred in 3 (1.9%) patients and composite mortality or morbidities in 72 (46.5%). Pseudoaneurysm or abscess detected on TEE was the only imaging biomarker to show independent association with composite mortality or morbidities in-hospital, with odds ratio (95% CI) of 3.66 (1.76–7.59), P =0.001. There were 17 late deaths, and both pseudoaneurysm or abscess detected on CT and fistula detected on CT were the only independent predictors of total mortality during follow-up, with hazards ratios (95% CI) of 3.82 (1.25–11.7), P <0.001 and 9.84 (1.89–51.0), P =0.007, respectively. Conclusions: We identified cardiac CT and TEE features that predicted separate adverse outcomes after IE surgery. Imaging biomarkers can play important roles incremental to conventional clinical factors for risk stratification in patients undergoing IE surgery.

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