Diagnostic performance of chest CT in differentiating COVID-19 from other causes of ground-glass opacities

Abstract Background To evaluate the diagnostic performance of chest CT in differentiating coronavirus disease 2019 (COVID-19) and non-COVID-19 causes of ground-glass opacities (GGO). Results A total of 80 patients (49 males and 31 females, 46.48 ± 16.09 years) confirmed with COVID-19 by RT-PCR and who underwent chest CT scan within 2 weeks of symptoms, and 100 patients (55 males and 45 females, 48.94 ± 18.97 years) presented with GGO on chest CT were enrolled in the study. Three radiologists reviewed all CT chest exams after removal of all identifying data from the images. They expressed the result as positive or negative for COVID-19 and recorded the other pulmonary CT features with mention of laterality, lobar affection, and distribution pattern. The clinical data and laboratory findings were recorded. Chest CT offered diagnostic accuracy ranging from 59 to 77.2% in differentiating COVID-19- from non-COVID-19-associated GGO with sensitivity from 76.25 to 90% and specificity from 45 to 67%. The specificity was lower when differentiating COVID-19 from non-COVID-19 viral pneumonias (30.5–61.1%) and higher (53.1–70.3%) after exclusion of viral pneumonia from the non-COVID-19 group. Patients with COVID-19 were more likely to have lesions in lower lobes (p = 0.005), peripheral distribution (p < 0.001), isolated ground-glass opacity (p = 0.043), subpleural bands (p = 0.048), reverse halo sign (p = 0.005), and vascular thickening (p = 0.013) but less likely to have pulmonary nodules (p < 0.001), traction bronchiectasis (p = 0.005), pleural effusion (p < 0.001), and lymphadenopathy (p < 0.001). Conclusions Chest CT offered reasonable sensitivity when differentiating COVID-19- from non-COVID-19-associated GGO with low specificity when differentiating COVID-19 from other viral pneumonias and moderate specificity when differentiating COVID-19 from other causes of GGO.

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Chest CT features of COVID-19 in the region of Abu Dhabi, UAE- A single institute study

10.1101/2020.11.14.20229096 ◽

2020 ◽

Author(s):

Ghufran Aref Saeed ◽

Abeer Ahmed Al Helali ◽

Safaa Almazrouei ◽

Asad Shah ◽

Luai A. Ahmed

Keyword(s):

Ct Scan ◽

Diagnostic Performance ◽

Chest Ct ◽

Abu Dhabi ◽

Ground Glass ◽

Rt Pcr ◽

Negative Results ◽

Chest Ct Scan ◽

Ct Features ◽

Pcr Test

AbstractOBJECTIVEOur aim is to investigate high resolution CT features of COVID-19 infection in Abu Dhabi, UAE, and to compare the diagnostic performance of CT scan with RT-PCR test.METHODSData of consecutive patients who were suspected to have COVID-19 infection and presented to our hospital, was collected from March 2, 2020, until April 12, 2020. All patients underwent RT-PCR test; out of which 53.8% had chest CT scan done. Using RT-PCR as a standard reference, the sensitivity and specify of CT scan was calculated. We also analyzed the most common imaging findings in patients with positive RT-PCR results.RESULTSThe typical HRCT findings were seen in 50 scans (65.8%) out of total positive ones; 44 (77.2%) with positive RT-PCR results and 6 (31.6%) with negative results. The peripheral disease distribution was seen in 86%, multilobe involvement in 70%, bilateral in 82%, and posterior in 82% of the 50 scans.The ground glass opacities were seen in 50/74 (89.3%) of positive RT-PCR group. The recognized GGO patterns in these scans were: rounded 50%, linear 38%, and crazy-paving 24%.Using RT-PCR as a standard of reference, chest HRCT scan revealed sensitivity of 68.8% and specificity of 70%.CONCLUSIONThe commonest HRCT findings in patients with COVID-19 pneumonia were peripheral, posterior, bilateral, multilobe rounded ground glass opacities.

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Diagnostic Performance of Chest CT-Scan and First RT-PCR Testing for COVID-19 in Iranian Population

Iranian Journal of Public Health ◽

10.18502/ijph.v50i8.6842 ◽

2021 ◽

Author(s):

Ramin Hamidi Farahani ◽

Meysam Mosallaei ◽

Ebrahim Hazrati ◽

Naeim Ehtesham ◽

Bahram Pakzad ◽

...

Keyword(s):

Ct Scan ◽

Diagnostic Performance ◽

Chest Ct ◽

Iranian Population ◽

Rt Pcr ◽

Chest Ct Scan

The article's abstract is not available.

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Early chest computed tomography to diagnose COVID-19 from suspected patients: A multicenter retrospective study

10.1101/2020.03.24.20042432 ◽

2020 ◽

Cited By ~ 3

Author(s):

Congliang Miao ◽

Mengdi Jin ◽

Li Miao ◽

Xinying Yang ◽

Peng Huang ◽

...

Keyword(s):

Ground Glass Opacity ◽

High Specificity ◽

Diagnostic Value ◽

Chest Ct ◽

Imaging Features ◽

Rt Pcr ◽

Polymerase Chain ◽

Low Sensitivity ◽

Chest Ct Scan ◽

Ct Features

AbstractObjectiveThe purpose of this study is to distinguish the imaging features of COVID-19 with other chest infectious diseases and evaluate diagnostic value of chest CT for suspected patients.MethodsAdult suspected patients aged>18 years within 14 days who underwent chest CT scan and reverse-transcription polymerase-chain-reaction (RT-PCR) tests were enrolled. The enrolled patients were confirmed and grouped according to results of RT-PCR tests. The data of basic demographics, single chest CT features, and combined chest CT features were analyzed for confirmed and non-confirmed groups.ResultsA total of 130 patients were enrolled with 54 cases positive and 76 cases negative. The typical CT imaging features of positive group were ground glass opacity (GGO), crazy-paving pattern and air bronchogram. The lesions were mostly distributed bilaterally, close to the lower lungs or the pleura. When features combined, GGO with bilateral pulmonary distribution and GGO with pleural distribution were more common, of which were 31 cases (57.4%) and 30 cases (55.6%) respectively. The combinations were almost presented statistically significant (P<0.05) except for the combination of GGO with consolidation. Most combinations presented relatively low sensitivity but extremely high specificity. The average specificity of these combinations is around 90%.ConclusionsThe combinations of GGO could be useful in the identification and differential diagnosis of COVID-19, which alerts clinicians to isolate patients for treatment promptly and repeat RT-PCR tests until incubation ends.

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Chest CT changes in COVID-19 patients with hypertension comorbidities

10.21203/rs.3.rs-30394/v1 ◽

2020 ◽

Author(s):

Wei Li ◽

Wenjun Yu ◽

Jianwei Liao ◽

Yijie Fang ◽

Lin Yao ◽

...

Keyword(s):

Global Health ◽

Clinical Features ◽

Clinical Data ◽

Clinical Characteristics ◽

Ground Glass Opacity ◽

Chest Ct ◽

Ground Glass ◽

Rt Pcr ◽

Relationship Of ◽

Pcr Test

Abstract AIMTo summarize the chest CT and clinical features of COVID-19 pneumonia patients with hypertension comorbidities.METHODSThe initial chest CT imaging and clinical data of 15 confirmed COVID-19 patients with hypertension comorbidities treated in our hospital were analyzed retrospectively from January 1, 2019 to February 14, 2020. The chest CT images and clinical data were reviewed and their relationship of the disease was analyzed.RESULTSTotally 15 COVID-19 patients diagnosed with hypertension comorbidities were included. In terms of clinical characteristics, 14/15 (93.3%) of patients had characteristics of clustering onset, and the positive rates of the first RT-PCR test and the initial CT were 80% and 93% respectively. The most frequent CT abnormality observed was ground glass opacity (GGO) (13/15, 86.7%), including patchy/ punctate GGO and large/multiple GGO. Most of the lesions were multiple, and 60% of them involved 4-5 lobes. Most patients present with bilateral CT onset (12,80.0%), and most present with subpleural distribution (10,66.7%). The average CT score is 13.7, and 40% of the patients exceeded 20 points.CONCLUSIONThe common chest CT findings in COVID-19 patients with hypertension comorbidities are GGO, most of which at present with bilateral CT onset and subpleural distribution. CT is indispensable in the diagnosis and evaluation of this global health emergency.

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Chest Computed Tomography Findings in a Case Series of Coronavirus Disease 2019 (COVID-19) Patients at Siriraj Hospital

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2021.05.12395 ◽

2021 ◽

Vol 104 (5) ◽

pp. 866-871

Keyword(s):

Computed Tomography ◽

Medical Records ◽

Case Series ◽

Ground Glass Opacity ◽

Chest Ct ◽

Ground Glass ◽

Chest Computed Tomography ◽

Ct Findings ◽

Siriraj Hospital ◽

Chest Ct Scan

Background: Recent evidence has demonstrated the high sensitivity of chest computed tomography (CT) in coronavirus disease 2019 (COVID-19) case detection. However, considering the cost and infection control issues, the experience of chest CT for COVID-19 diagnosis in Thailand is still limited. Objective: To present the characteristics of chest CT findings in COVID-19 patients at Siriraj Hospital and compare them with other reports. Materials and Methods: The authors retrospectively reviewed the COVID-19 patients’ medical records between April and May 2020. All cases with the presence of chest CT performed during admission were recruited. Clinical data were retrieved from the patients’ medical records. All chest imaging results were reported by consensus between the authors. Results: From 103 cases, four cases with a chest CT scan during the admission were recruited. Consistent with previous reports, the common chest CT findings included a ground-glass opacity and consolidation with bilateral involvement. A round-shaped ground-glass opacity or consolidation was evidenced in half of the cases. The only case with the presence of chest CT scan, which was done 77 days after the onset of COVID-19 symptoms, revealed resolution of the abnormal findings. Conclusion: Chest CT findings in four COVID-19 cases at Siriraj Hospital are consistent with previous reports. Common findings include bilateral ground-glass opacity and consolidation. Keywords: COVID-19, SARS-CoV-2, Computed tomography, Case series

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Can chest CT improve sensitivity of COVID-19 diagnosis in comparison to PCR? A meta-analysis study

The Egyptian Journal of Otolaryngology ◽

10.1186/s43163-020-00039-9 ◽

2020 ◽

Vol 36 (1) ◽

Author(s):

Heba Mahmoud ◽

Mohamed Shehata Taha ◽

Anas Askoura ◽

Mohammed Aleem ◽

Azza Omran ◽

...

Keyword(s):

Computed Tomography ◽

Meta Analysis ◽

Chest Ct ◽

Main Body ◽

Inclusion Criteria ◽

Rt Pcr ◽

Laboratory Findings ◽

Analysis Study ◽

Patient Presentation ◽

Chest Ct Scan

Abstract Background In December 2019, SARS-CoV-2 was identified as the causative agent of pneumonia cases in China. This virus is spread by coughing or sneezing and can infect other persons by on contacting mucous membranes. SARS-Cov-2 most frequent serious manifestation is pneumonia. Chest computed tomography in COVID-19 patients usually shows ground-glass opacities that may be accompanied by consolidation lesions. Early diagnosis of the disease and rapid isolation of the patient is of great importance. So far, confirmation of COVID-19 infection is made by RT-PCR of nasopharyngeal or respiratory specimens. Recent research reported that the sensitivity of computed tomography in diagnosing COVID-19 is 98% while RT-PCR sensitivity is 71%. Herein, we compare the sensitivity of both chest CT and RT-PCR in diagnosing COVID-19 at initial patient presentation through a meta-analysis study. Main body Using MEDLINE database a systematic literature search was conducted to identify relevant published studies within from November 2019 to April 2020. Only articles with full text were examined to determine eligibility and extract data by two reviewers. It was decided to include studies mentioning sensitivity of chest CT scan and sensitivity of RT-PCR and both done at the same time. Results Potentially relevant 15,300 studies were identified in our search in MEDLINE whose titles were quickly reviewed. Potentially eligible studies missing any of the forementioned inclusion criteria were excluded. This process left 7 eligible articles that fulfilled the inclusion criteria and were thus included in the meta-analysis and used for further analyses. Conclusion The meta-analysis study showed that chest CT may be beneficial in early detection of cases of COVID-19. Imaging, in adjunct to clinical and laboratory findings, should be used for monitoring of disease course, until further evidence is available.

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Overuse of Follow-up Chest Computed Tomography in Patients With Incidentally Identified Nodules Suspicious for Lung Cancer

10.21203/rs.3.rs-259864/v1 ◽

2021 ◽

Author(s):

Ran Guo ◽

Yang Zhang ◽

Zelin Ma ◽

Chaoqiang Deng ◽

Fangqiu Fu ◽

...

Keyword(s):

Lung Cancer ◽

Pulmonary Nodules ◽

Ground Glass Opacity ◽

Cost Effective ◽

Chest Ct ◽

Ground Glass ◽

Ct Screening ◽

Effective Care ◽

Mixed Ground

Abstract Purpose: Regardless of professional societies agreed that CT screening inconsistent with recommendation leads to radiation-related cancer and unexpected cost, many patients undergo unnecessary chest CT before treatment. The goal of this study was to assess the overuse of Chest CT in different type of patients.Methods: Data on 1853 patients who underwent pulmonary resection from May 2019 to May 2020 were retrospectively analyzed. Data collected include age, sex, follow-up time, density and size of nodules and frequency of undergoing Chest CT. Pearson χ2 test and logistic regression were conducted to compare the receipt of CT screening.Results: Among 1853 patients in the study, 689 (37.2%) had overused Chest CT during follow-up of the lung cancer. This rate was 16.2% among patients with solid nodules, 57.5% among patients with pure ground glass opacity (pGGO), and 41.4% among patients with mixed ground glass opacity (mGGO) (P<.001). 50.7% in the “age ≤40” group, 39.8% in the “41≤age ≤50” group, 38.7% in the “51≤age ≤60” group, 32.3% in the “61≤age ≤70” group, 27.8% in the “>70” group underwent unnecessary CT (P<.001). Female get more unnecessary CT than male (40.6% vs 32.8%, P<.001). Factors associated with a greater likelihood of Chest CT is the density of nodules (odds ratios [ORs] of 0.53 for mGGO; 0.15 for solid nodule, P<.0001, vs patients with pGGO).Conclusion: roughly 37% patients with pulmonary nodules received Chest CT too frequently despite national recommendations against the practice. Closer adherence to clinical guidelines is likely to result in more cost-effective care.

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Diagnosis of Coronavirus Disease 2019 (COVID-19): Neither Chest CT nor RT-PCR Fits All

10.21203/rs.3.rs-27336/v1 ◽

2020 ◽

Author(s):

Yue Teng ◽

Hui Dai ◽

Yalei Shang ◽

Jianguo Xia ◽

Yuehua Chen ◽

...

Keyword(s):

False Negative ◽

Ground Glass Opacity ◽

Chest Ct ◽

Ct Scans ◽

Imaging Features ◽

Rt Pcr ◽

Negative Results ◽

Halo Sign ◽

Solid Nodule ◽

Ct Findings

Abstract BackgroundComputed tomography (CT) and reverse-transcription polymerase chain reaction (RT-PCR) are the recommended tools for the diagnosis of coronavirus disease 2019 (COVID-19). The present study aimed to investigate the correlation between chest CT and RT-PCR while describing the atypical CT imaging features of COVID-19.MethodsIn this study, 418 patients in Jiangsu, China, clinically diagnosed with COVID-19 from January 10 to February 17, 2020, were included. Patients who fulfilled the following conditions were evaluated further: (1) Patients had positive RT-PCR and negative CT; (2) Patients had initial negative RT-PCR and positive CT, and follow-up PT-PCR tests were positive; (3) Patients had atypical CT findings.ResultsOf the 418 initial chest CT scans, 30 (7.2%) patients had normal CT presentation, and 6 (1.4%) patients had initial negative RT-PCR results and positive CT scans. Next, 10 (2.4%) cases of patients showed atypical CT findings, including 2 case of solid nodule, 4 cases of halo sign (solid nodule or mass surrounded by ground glass opacity), and 4 cases of predominant fibrous stripes.ConclusionsFalse-negative results can be found on both chest CT and RT-PCR; hence, the diagnosis of COVID-19 should consider both CT and RT-PCR. CT manifestations, such as solitary nodule, halo sign, and pulmonary fibrous stripes, might indicate the possibility of COVID-19 to the radiologists.

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HRCT Chest Evaluation of COVID-19 Patients: Experience in Combined Military Hospital Dhaka, Bangladesh

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v38i0.47441 ◽

2020 ◽

pp. 21-28

Author(s):

Syed Zoherul Alam ◽

SMA Al Muid ◽

Afroza Akhter ◽

AKM Sharifur Rahman ◽

Md Al Emran ◽

...

Keyword(s):

Lower Lobe ◽

Ground Glass Opacity ◽

Ground Glass ◽

Military Hospital ◽

Rt Pcr ◽

Chain Reaction ◽

Pulmonary Lesions ◽

Halo Sign ◽

Polymerase Chain ◽

Patients Experience

Background: HRCT Chest is an important tool in both diagnosis and management of COVID-19 patient, as well as it is an important complement to the reverse-transcription polymerase chain reaction (RT-PCR) tests. Purpose: The purpose of this study is to assess different patterns of manifestation in HRCT chest in COVID-19 infection & to grade the severity by observing a sample of 128 after the symptoms began. Method: From 11 April 2020 to 27 May 2020, 128 patients who were admitted in Combined Military Hospital Dhaka and underwent both HRCT chest and RT-PCR for COVID- 19 were included. Distribution and patterns of pulmonary lesions like ground glass opacity (GGO), consolidation, reverse halo sign, crazy paving, thickened vascular marking, lymphadenopathy and pleural effusion were evaluated. Result: Total 128 patients diagnosed (RT-PCR Positive) with COVID-19 were included. Among them, 112(87.5%) patients had fever, and 58(45.31%) patients had fatigability. The most frequent CT abnormality was ground glass opacity in 123(96.09%) cases. Amongst them 81(63.28%) cases had GGO plus consolidation and ground glass opacity alone were 42(32.81%) cases. Crazy-paving pattern was in 65(50.78%) cases. Most patients had multiple lesions and involved all the 5 lobes in 96(75.00%) cases. The lesions were mostly peripheral (123,96.09%) and posterior (103,80.47%) and in 65(50.78%) cases the distribution were diffuse but predominantly peripheral. Most commonly involved lobe is right lower lobe (120,93.75%) and left lower lobe(117,91.41%). Conclusion: HRCT chest can play an important role in the early diagnosis and prompt management of this global health emergency. J Bangladesh Coll Phys Surg 2020; 38(0): 21-28

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Early Chest CT Features of Patients with 2019 Novel Coronavirus (COVID-19) Pneumonia: Relationship to Diagnosis and Prognosis

10.21203/rs.3.rs-16702/v1 ◽

2020 ◽

Cited By ~ 1

Author(s):

Hui Juan Chen ◽

Jie Qiu ◽

Biao Wu ◽

Tao Huang ◽

Yunsuo Gao ◽

...

Keyword(s):

Early Stage ◽

Clinical Manifestations ◽

Ground Glass Opacity ◽

Chest Ct ◽

Ground Glass ◽

Rt Pcr ◽

Icu Patients ◽

Clinical Prognosis ◽

Discharged Patients ◽

Ct Features

Abstract Objective: To elucidate the consistency between CT findings and real time reverse-transcription–polymerase chain- reaction (RT-PCR) results and investigate the relationship between CT features and clinical prognosis in COVID-19.Methods: The clinical manifestations, laboratory parameters and CT imaging findings were analyzed in thirty-four patients with COVID-19 confirmed by RT-PCR from January 20 to February 4 in Hainan province. CT score was compared between the discharged patients and ICU patients.Results: Fever (85%) and cough (79%) were most commonly seen. 10 (29%) patients demonstrated negative results on their first RT-PCR.22/34(65%) patients showed pure ground glass opacity (GGO). 17/34 (50%) patients had five lobes of lung involvement, while the 23(68%) patients had lower lobes were involved and 24/34 (71%) were subpleural. Lesions of 24 (71%) patients were distributed mainly in the subpleural. During follow-up, the initial CT lesions of ICU patients are distributed in both subpleural and parenchyma (80%) and the lesions are scattered. 60% of ICU patients had five lobes involved, while this was seen in only 25% discharged patients. Lesions of discharged patients are mainly in the subpleural (75%). 62.5% of discharged patients showed pure ground-glass opacity. 80% ICU demonstrated progressive stage on their first CT scan. 75 % discharged patients were at an early stage. CT score of ICU patients were significantly higher than that of the discharged patients.Conclusion: Chest CT plays a crucial role in the early diagnosis of COVID-19, particularly for those patients with negative RT-PCR. The initial features in CT may be associated with prognosis.Authors Hui Juan Chen and Jie Qiu contributed equally to this work.

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