The Impact of Chest Computed Tomography in a COVID-19 Reference Hospital - First Wave - Distrito Federal - Brazil

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.

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Risk of tuberculosis after lung transplantation: the value of pretransplant chest computed tomography and the impact of mTOR inhibitors and azathioprine use

Transplant Infectious Disease ◽

10.1111/tid.12555 ◽

2016 ◽

Vol 18 (4) ◽

pp. 512-519 ◽

Cited By ~ 16

Author(s):

E. Guirao-Arrabal ◽

F. Santos ◽

J. Redel-Montero ◽

J.M. Vaquero ◽

S. Cantisán ◽

...

Keyword(s):

Computed Tomography ◽

Lung Transplantation ◽

Mtor Inhibitors ◽

Chest Computed Tomography ◽

The Impact

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A Pilot Study to Estimate the Impact of High Matrix Image Reconstruction on Chest Computed Tomography

Journal of Clinical Imaging Science ◽

10.25259/jcis_143_2021 ◽

2021 ◽

Vol 11 ◽

pp. 52

Author(s):

Akitoshi Inoue ◽

Tucker F. Johnson ◽

Benjamin A. Voss ◽

Yong S. Lee ◽

Shuai Leng ◽

...

Keyword(s):

Computed Tomography ◽

Image Reconstruction ◽

Pulmonary Nodules ◽

Chest Ct ◽

Imaging Findings ◽

Chest Computed Tomography ◽

Matrix Image ◽

High Matrix ◽

The Impact

Objectives: The objectives of the study were to estimate the impact of high matrix image reconstruction on chest computed tomography (CT) compared to standard image reconstruction. Material and Methods: This retrospective study included patients with interstitial or parenchymal lung disease, airway disease, and pulmonary nodules who underwent chest CT. Chest CT images were reconstructed using high matrix (1024 × 1024) or standard matrix (512 × 512), with all other parameters matched. Two radiologists, blinded to reconstruction technique, independently examined each lung, viewing image sets side by side and rating the conspicuity of imaging findings using a 5-point relative conspicuity scale. The presence of pulmonary nodules and confidence in classification of internal attenuation was also graded. Overall image quality and subjective noise/artifacts were assessed. Results: Thirty-four patients with 68 lungs were evaluated. Relative conspicuity scores were significantly higher using high matrix image reconstruction for all imaging findings indicative of idiopathic lung fibrosis (peripheral airway visualization, interlobular septal thickening, intralobular reticular opacity, and end-stage fibrotic change; P ≤ 0.001) along with emphysema, mosaic attenuation, and fourth order bronchi for both readers (P ≤ 0.001). High matrix reconstruction did not improve confidence in the presence or classification of internal nodule attenuation for either reader. Overall image quality was increased but not subjective noise/artifacts with high matrix image reconstruction for both readers (P < 0.001). Conclusion: High matrix image reconstruction significantly improves the conspicuity of imaging findings reflecting interstitial lung disease and may be useful for diagnosis or treatment response assessment.

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Evaluation of the impact of organ-specific dose reduction on image quality in pediatric chest computed tomography

Pediatric Radiology ◽

10.1007/s00247-014-2950-z ◽

2014 ◽

Vol 44 (9) ◽

pp. 1065-1069 ◽

Cited By ~ 6

Author(s):

Johannes Boos ◽

Patric Kröpil ◽

Dirk Klee ◽

Philipp Heusch ◽

Lars Schimmöller ◽

...

Keyword(s):

Computed Tomography ◽

Image Quality ◽

Dose Reduction ◽

Chest Computed Tomography ◽

Organ Specific ◽

Pediatric Chest ◽

The Impact

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On-demand Rather than Daily-routine Chest Radiography Prescription May Change Neither the Number Nor the Impact of Chest Computed Tomography and Ultrasound Studies in a Multidisciplinary Intensive Care Unit

Yearbook of Diagnostic Radiology ◽

10.1016/s0098-1672(09)79344-0 ◽

2009 ◽

Vol 2009 ◽

pp. 27-29

Author(s):

M.L. Rosado de Christenson

Keyword(s):

Computed Tomography ◽

Intensive Care Unit ◽

Intensive Care ◽

Chest Radiography ◽

Daily Routine ◽

Ultrasound Studies ◽

Chest Computed Tomography ◽

On Demand ◽

The Impact ◽

Routine Chest

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Baseline Chest Computed Tomography as Standard of Care in High-Risk Hematology Patients

Journal of Fungi ◽

10.3390/jof6010036 ◽

2020 ◽

Vol 6 (1) ◽

pp. 36 ◽

Cited By ~ 1

Author(s):

Jannik Stemler ◽

Caroline Bruns ◽

Sibylle C. Mellinghoff ◽

Nael Alakel ◽

Hamdi Akan ◽

...

Keyword(s):

Computed Tomography ◽

High Risk ◽

Hematopoietic Cell Transplantation ◽

Invasive Pulmonary Aspergillosis ◽

Standard Of Care ◽

Web Based ◽

Chest Computed Tomography ◽

X Ray ◽

The Impact

Baseline chest computed tomography (BCT) in high-risk hematology patients allows for the early diagnosis of invasive pulmonary aspergillosis (IPA). The distribution of BCT implementation in hematology departments and impact on outcome is unknown. A web-based questionnaire was designed. International scientific bodies were invited. The estimated numbers of annually treated hematology patients, chest imaging timepoints and techniques, IPA rates, and follow-up imaging were assessed. In total, 142 physicians from 43 countries participated. The specialties included infectious diseases (n = 69; 49%), hematology (n = 68; 48%), and others (n = 41; 29%). BCT was performed in 57% (n = 54) of 92 hospitals. Upon the diagnosis of malignancy or admission, 48% and 24% performed BCT, respectively, and X-ray was performed in 48% and 69%, respectively. BCT was more often used in hematopoietic cell transplantation and in relapsed acute leukemia. European centers performed BCT in 59% and non-European centers in 53%. Median estimated IPA rate was 8% and did not differ between BCT (9%; IQR 5–15%) and non-BCT centers (7%; IQR 5–10%) (p = 0.69). Follow-up computed tomography (CT) for IPA was performed in 98% (n = 90) of centers. In high-risk hematology patients, baseline CT is becoming a standard-of-care. Chest X-ray, while inferior, is still widely used. Randomized, controlled trials are needed to investigate the impact of BCT on patient outcome.

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Chest computed tomography and chest X-ray in the diagnosis of community-acquired pneumonia: a retrospective observational study

Journal of International Medical Research ◽

10.1177/03000605211039791 ◽

2021 ◽

Vol 49 (8) ◽

pp. 030006052110397

Author(s):

Dima Ibrahim ◽

Abdul Rahman Bizri ◽

Mohammad Ali El Amine ◽

Zeina Halabi

Keyword(s):

Computed Tomography ◽

Medical Records ◽

Community Acquired Pneumonia ◽

Chest Ct ◽

Chest Computed Tomography ◽

X Ray ◽

Combined Use ◽

Chest X Ray ◽

Large Benefit ◽

The Impact

Objectives To compare the yield of early combined use of chest X-ray (CXR) and chest computed tomography (CT) in patients diagnosed with community-acquired pneumonia (CAP) presenting to the emergency department (ED) and assess the impact of chest CT on the initial diagnosis. Methods The medical records of 900 patients who presented to the ED and were diagnosed with CAP over a 1-year period were reviewed, and 130 patients who underwent CXR and chest CT within 48 hours were selected. CXR findings were classified as positive, negative, or inconclusive for CAP. Chest CT findings were defined as positive, negative, inconclusive, or positive with add-on to the CXR findings. CT was classified as having no benefit, large benefit, or moderate benefit based on the chest CT and CXR findings. Results Chest CT results were positive in 90.7% of patients, with 41.5% being newly diagnosed after negative or inconclusive CXR and 21.5% being diagnosed with add-on to the CXR findings. CT had large, moderate, and no benefit over CXR in diagnosing or excluding CAP in 45.3%, 21.5%, and 33.1% of patients, respectively. Conclusion Early chest CT may be used to compliment CXR in the early diagnosis of CAP among patients in the ED.

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