A Study of a New Technique of the CT Scan View and Disease Classification Protocol Based on Level Challenges in Cases of Coronavirus Disease

The chest Computer Tomography (CT scan) is used in the diagnosis of coronavirus disease 2019 (COVID-19) and is an important complement to the Reverse Transcription Polymerase Chain Reaction (RT-PCR) test. The paper aims to improve the radiological diagnosis in the case of coronavirus disease COVID-19 pneumonia on forms of noninvasive approaches with conventional and high-resolution computer tomography (HRCT) scan images upon chest CT images of patients confirmed with mild to severe findings. The preliminary study is to compare the radiological findings of COVID-19 pneumonia in conventional chest CT images with images processed by a new tool and reviewed by expert radiologists. The researchers used a new filter called Golden Key Tool (GK-Tool) which has confirmed the improvement in the quality and diagnostic efficacy of images acquired using our modified images. Further, Convolution Neural Networks (CNNs) architecture called VGG face was used to classify chest CT images. The classification has been performed by using VGG face on various datasets which are considered as a protocol to diagnose COVID-19, Non-COVID-19 (other lung diseases), and normal cases (no findings on chest CT). Accordingly, the performance evaluation of the GK-Tool was fairly good as shown in the first set of results, where 80–95% of participants show a good to excellent assessment of the new images view in the case of COVID-19 patients. The results, in general, illustrate good recognition rates in the diagnosis and, therefore, would be significantly higher in normal cases with COVID-19. These results could reduce the radiologist’s workload burden and play a major role in the decision-making process.

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A meta-analysis of accuracy and sensitivity of chest CT and RT-PCR in COVID-19 diagnosis

Scientific Reports ◽

10.1038/s41598-020-80061-2 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Fatemeh Khatami ◽

Mohammad Saatchi ◽

Seyed Saeed Tamehri Zadeh ◽

Zahra Sadat Aghamir ◽

Alireza Namazi Shabestari ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Reverse Transcriptase ◽

Ct Scan ◽

Predictive Value ◽

Meta Analysis ◽

Chest Ct ◽

Rt Pcr ◽

Chain Reaction ◽

Polymerase Chain ◽

Chest Ct Scan

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.

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The exact place of PCR and chest CT in screening, staging, and diagnosis of Covid-19: A meta-analysis

10.21203/rs.3.rs-32961/v1 ◽

2020 ◽

Author(s):

Fatemeh Khatami ◽

Mohammad Saatchi ◽

Seyed Saeed Tamehri Zadeh ◽

Zahra Sadat Aghamir ◽

Alireza Namazi Shabestari ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Reverse Transcriptase ◽

Ct Scan ◽

Predictive Value ◽

Meta Analysis ◽

Chest Ct ◽

Rt Pcr ◽

Chain Reaction ◽

Polymerase Chain ◽

Chest Ct Scan

Abstract Introduction: Nowadays there is an ongoing acute respiratory outbreak causing by the novel highly contagious coronavirus (nCoV). There are two diagnostic protocol based on chest CT scan and quantitative reverse-transcription polymerase chain reaction (RT-PCR) which their diagnostic accuracy is under the debate. We designed this meta-analysis study to determine the diagnostic value of initial chest CT scan in patients with nCoV infection in comparison with RT- PCR.Search strategy and statistical analysis: Three main databases the PubMed (MEDLINE), Scopus, and EMBASE was systematically searched for all published literatures from January 1st, 2019, to the 27th march 2020 with key grouping of “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 was done in Excel 2007 (Microsoft Corporation, Redmond, CA) and their analysis was performed using STATA v.14.0SE (College Station, TX, USA) and RevMan 5.Result: From first recruited 668 articles we end up to the final 47 studies, which comprised a total sample size of 4238 patients. In compare to RT-PCR, the overall sensitivity, specificity, positive predictive value, and negative predictive value of chest CT scan were 86% (95% CI: 83% -90%), 43 % (95% CI: 26% -60%), 67% (95% CI: 57% -78%), and 84% (95% CI: 74% -95%) respectively. However the RT-PCR should be repeated for three times in order to give the 99% accuracy especially in negative samples.Conclusion: According to the acceptable sensitivity of chest CT scan, it can be employed complement to RT-PCR to diagnosis patients who are clinically suspicious for nCoV.

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Performance of Low-Dose Chest CT Scan for Initial Triage of COVID-19

Iranian Journal of Radiology ◽

10.5812/iranjradiol.104950 ◽

2020 ◽

Vol 17 (4) ◽

Author(s):

Hooman Bahrami-Motlagh ◽

Sahar Abbasi ◽

Maryam Haghighimorad ◽

Babak Salevatipour ◽

Ilad Alavi Darazam ◽

...

Keyword(s):

Ct Scan ◽

Low Dose ◽

Standard Dose ◽

Chest Ct ◽

Polymerase Chain Reaction Test ◽

Rt Pcr ◽

Diagnostic Efficacy ◽

Predictive Values ◽

Limited Availability ◽

Chest Ct Scan

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.

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Descriptive Analysis of Chest Computed Tomography Scan in Coronavirus Disease 2019 Pneumonia: Correlation with Reverse Transcription-polymerase Chain Reaction and Clinical Features

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.6224 ◽

2021 ◽

Vol 9 (B) ◽

pp. 865-871

Author(s):

Rusli Muljadi ◽

Mira Yuniarti ◽

Ricardo Tan ◽

Teodorus Alfons Pratama ◽

Ignatius Bima Prasetya ◽

...

Keyword(s):

Social Sciences ◽

Ct Scan ◽

Cross Sectional Study ◽

Chest Ct ◽

Rt Pcr ◽

Chain Reaction ◽

Cross Sectional ◽

The Social ◽

Polymerase Chain ◽

Chest Ct Scan

BACKGROUND: Reverse transcriptase-polymerase chain reaction (RT-PCR) is the primary diagnostic tool to confirm coronavirus disease 2019 (COVID-2019) due to its high specificity. However, it has relatively low sensitivity and time consuming. In contrast, chest computed tomography (CT) has high sensitivity and achieves quick results. It may, therefore, play a critical role in screening and diagnosing COVID-19. A cross-sectional study was done in 212 patients with confirmed cases and patients under surveillance for COVID-19 tested for RT-PCR and chest CT scan. Statistical analysis was performed using SPSS Version 23 (Statistical Package for the Social Sciences, IBM Corp., Armonk, NY, USA). AIM: We aim to investigate the diagnostic value of chest CT in correlation to RT-PCR in Indonesia. METHODS: A cross-sectional study was done in 212 patients with confirmed cases and patients under surveillance for COVID-19 tested for RT-PCR and chest CT scan. Statistical analysis was performed using SPSS Version 23 (Statistical Package for the Social Sciences, IBM Corp., Armonk, NY, USA). RESULTS: From a total of 212 patients, 92% of them were diagnosed as confirmed cases of COVID-19. It was found that the sensitivity of CT scan for COVID-19 patients was 72.3% (65.5% and 78.5%) with positive predictive value (PPV) of 93.9% (90.9% and 96.0%) and the sensitivity and PPV improve in symptomatic patients. Typical chest CT scan lesions were 8.0 times which were more likely (3.9–16.4; p <0.001) to be detected in symptomatic patients while patients with severe CT scan findings were 4.4 times more likely (3.0–6.5; p <0.001) to be admitted to the intensive care unit. CONCLUSION: A high PPV suggests that a chest CT scan can detect COVID-19 lesions, but the absence of the lesions would not exclude the disease’s presence.

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Cancer surgery during the COVID‐19 pandemic: The experience of a comprehensive cancer center performing preoperative screening by RT‐PCR and chest CT scan

Journal of Surgical Oncology ◽

10.1002/jso.26335 ◽

2021 ◽

Vol 123 (4) ◽

pp. 815-822

Author(s):

Joanne Guerlain ◽

Fabienne Haroun ◽

Alexandra Voicu ◽

Charles Honoré ◽

Franck Griscelli ◽

...

Keyword(s):

Ct Scan ◽

Chest Ct ◽

Cancer Surgery ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Preoperative Screening ◽

Rt Pcr ◽

Chest Ct Scan

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CT findings of 795 COVID-19 positive cases: a multicenter study in Egypt

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-020-00351-7 ◽

2020 ◽

Vol 51 (1) ◽

Author(s):

Youssriah Yahia Sabri ◽

Mohamed Mohsen Tolba Fawzi ◽

Eman Zaki Nossair ◽

Safaa Mohamed El-Mandooh ◽

Amira Aly Hegazy ◽

...

Keyword(s):

Virus Disease ◽

Chest Ct ◽

Imaging Features ◽

Rt Pcr ◽

Relevant Research ◽

Non Invasive ◽

Ct Findings ◽

Global Pandemic ◽

Polymerase Chain ◽

Ct Studies

Abstract Background Corona Virus Disease 2019 (COVID-19) outbreak was officially announced as a global pandemic by the WHO on March 11th 2020. Thorough understanding of CT imaging features of COVID-19 is essential for effective patient management; rationalizing the need for relevant research. The aim of this study was to analyze the chest CT findings of patients with real-time polymerase chain reaction (RT-PCR) proved COVID-19 admitted to four Egyptian hospitals. The recently published RSNA expert consensus statement on reporting COVID-19 chest CT findings was taken into consideration. Results Normal CT “negative for COVID-19” was reported in 26.1% of our RT-PCR proved COVID-19 cases. In descending order of prevalence, imaging findings of the positive CT studies (73.9%) included GGO (69%), consolidation (49.7%), crazy paving (15.4%), and peri-lobular fibrosis (40.6%). These showed a dominantly bilateral (68.2%), peripheral (72.4%), and patchy (64.7%) distribution. Remarkably, thymic hyperplasia was identified in 14.3% of studies. According to the RSNA consensus, CT findings were classified as typical in 68.9%, indeterminate in 3.6%, and atypical in 1.4% of the evaluated CT studies. Conclusion Although COVID-19 cannot be entirely excluded by chest CT, it can be distinguished in more than two-thirds of cases; making CT a widely available, non-invasive, and rapid diagnostic tool.

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The role of CT imaging for management of COVID-19 in epidemic area: early experience from a University Hospital

Insights into Imaging ◽

10.1186/s13244-020-00957-5 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Vikram rao Bollineni ◽

Koenraad Hans Nieboer ◽

Seema Döring ◽

Nico Buls ◽

Johan de Mey

Keyword(s):

Ct Scan ◽

Predictive Value ◽

Ct Imaging ◽

Chest Ct ◽

University Hospital ◽

Rt Pcr ◽

Ct Findings ◽

Epidemic Area ◽

Chest Ct Scan ◽

Pcr Test

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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Chest CT texture-based radiomics analysis in differentiating COVID-19 from other interstitial pneumonia

La radiologia medica ◽

10.1007/s11547-021-01402-3 ◽

2021 ◽

Author(s):

Damiano Caruso ◽

Francesco Pucciarelli ◽

Marta Zerunian ◽

Balaji Ganeshan ◽

Domenico De Santis ◽

...

Keyword(s):

Interstitial Pneumonia ◽

Potential Role ◽

Texture Features ◽

Roc Curves ◽

Chest Ct ◽

Preliminary Evaluation ◽

Rt Pcr ◽

Mean Intensity ◽

Polymerase Chain

Abstract Purpose To evaluate the potential role of texture-based radiomics analysis in differentiating Coronavirus Disease-19 (COVID-19) pneumonia from pneumonia of other etiology on Chest CT. Materials and methods One hundred and twenty consecutive patients admitted to Emergency Department, from March 8, 2020, to April 25, 2020, with suspicious of COVID-19 that underwent Chest CT, were retrospectively analyzed. All patients presented CT findings indicative for interstitial pneumonia. Sixty patients with positive COVID-19 real-time reverse transcription polymerase chain reaction (RT-PCR) and 60 patients with negative COVID-19 RT-PCR were enrolled. CT texture analysis (CTTA) was manually performed using dedicated software by two radiologists in consensus and textural features on filtered and unfiltered images were extracted as follows: mean intensity, standard deviation (SD), entropy, mean of positive pixels (MPP), skewness, and kurtosis. Nonparametric Mann–Whitney test assessed CTTA ability to differentiate positive from negative COVID-19 patients. Diagnostic criteria were obtained from receiver operating characteristic (ROC) curves. Results Unfiltered CTTA showed lower values of mean intensity, MPP, and kurtosis in COVID-19 positive patients compared to negative patients (p = 0.041, 0.004, and 0.002, respectively). On filtered images, fine and medium texture scales were significant differentiators; fine texture scale being most significant where COVID-19 positive patients had lower SD (p = 0.004) and MPP (p = 0.004) compared to COVID-19 negative patients. A combination of the significant texture features could identify the patients with positive COVID-19 from negative COVID-19 with a sensitivity of 60% and specificity of 80% (p = 0.001). Conclusions Preliminary evaluation suggests potential role of CTTA in distinguishing COVID-19 pneumonia from other interstitial pneumonia on Chest CT.

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Assessment of Aggregatibacter actinomycetemcomitans and Prevotella intermedia Counts around Healthy Implants, Diseased Implants and Sound Teeth: A Preliminary Study

Journal of Periodontology & Implant Dentistry ◽

10.15171/jpid.2017.004 ◽

2017 ◽

Vol 9 (1) ◽

pp. 18-25 ◽

Cited By ~ 1

Author(s):

Siamak Yaghobee ◽

Afshin Khorsand ◽

Nojan Jahedmanesh ◽

Mahdi Kadkhodazadeh

Keyword(s):

Polymerase Chain Reaction ◽

Gingival Crevicular Fluid ◽

Aggregatibacter Actinomycetemcomitans ◽

Prevotella Intermedia ◽

Rt Pcr ◽

Chain Reaction ◽

Standard Curve ◽

Preliminary Study ◽

Polymerase Chain ◽

Crevicular Fluid

Background. This study aimed to assess Aggregatibacter actinomycetemcomitans (Aa) and Prevotella intermedia (PI) counts in gingival crevicular fluid (GCF) around healthy implants, diseased implants and sound teeth. Methods. Eight patients (four males and four females), who had healthy implants, implants with peri-implantitis and sound teeth, were selected. Samples (GCF) were analyzed using real-time polymerase chain reaction (RT-PCR). The above-mentioned bacteria were detected and counted. Data analysis in RT-PCR was carried out based on the standard curve using Prism software to compare Pi and Aa counts between the three areas (GCF around sound teeth, healthy implants and implants with peri-implantitis). Results. Pi counts were significantly higher in GCF around implants with peri-implantitis (8 implants) than around healthy implants (8 implants) (P<0.001) and sound teeth (8) (P=0.012). No significant differences were found in Pi counts in GCF around healthy implants and sound teeth (P=0.063). Aa counts in GCF around implants with peri-implantitis were significantly higher than those around healthy implants (P=0.002) and sound teeth (P=0.024). No significant differences were noted in Aa counts in GCF around healthy implants and sound teeth (P=0.57). Conclusion. Aa and Pi counts in GCF around diseased implants were higher than around healthy implants and sound teeth. Also, Aa counts were significantly higher than Pi counts.

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Chest CT as a Complement to RT-PCR to Confirm and Follow-up COVID-19 Patients

Medicinus ◽

10.19166/med.v8i1.3122 ◽

2021 ◽

Vol 8 (1) ◽

pp. 31

Author(s):

Aziza Ghanie Icksan ◽

Muhammad Hafiz ◽

Annisa Dian Harlivasari

Keyword(s):

Chest Ct ◽

Rt Pcr ◽

High Resolution Computed Tomography ◽

X Ray ◽

First Case ◽

Chest X Ray ◽

Polymerase Chain

Background : The first case of COVID-19 in Indonesia was recorded in March 2020. Limitation of reverse-transcription polymerase chain reaction (RT-PCR) has put chest CT as an essential complementary tool in the diagnosis and follow up treatment for COVID-19. Literatures strongly suggested that High-Resolution Computed Tomography (HRCT) is essential in diagnosing typical symptoms of COVID-19 at the early phase of disease due to its superior sensitivity (97%) compared to chest x-ray (CXR).The two cases presented in this case study showed the crucial role of chest CT with HRCT to establish the working diagnosis and follow up COVID-19 patients as a complement to RT-PCR, currently deemed a gold standard.

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