scholarly journals Chest CT Imaging Characteristics of COVID-19 Pneumonia in Surviving and Non-Surviving Hospitalized Patients: A Retrospective Study in a Referral Center in Tehran, Iran

2021 ◽  
Vol 18 (2) ◽  
Author(s):  
Sara Besharat ◽  
Fatemehsadat Rahimi ◽  
Siamak Afaghi ◽  
Farzad Esmaeili Tarki ◽  
Fatemeh Pourmotahari ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Ct Scan ◽  
Chest Ct ◽  
Ct Scans ◽  
Early Management ◽  
Ct Findings ◽  
Imaging Characteristics ◽  
Significant Difference ◽  
Chest Ct Scan ◽  
Lung Lobes

Background: Coronavirus disease 2019 (COVID-19) has several chest computed tomography (CT) characteristics, which are important for the early management of this disease, because viral detection via RT-PCR can be time-consuming, resulting in a delayed pneumonia diagnosis. The Radiological Society of North America (RSNA) proposed a reporting language for CT findings related to COVID-19 and defined four CT categories: typical, indeterminate, atypical, and negative. Objectives: To retrospectively evaluate the chest CT characteristics of patients with COVID-19 pneumonia. Patients and Methods: A total of 115 hospitalized laboratory-verified COVID-19 cases, underdoing chest CT scan, were included in this study from April 30 to May 15, 2020. Of 115 cases, 53 were discharged from the hospital, and 62 expired. The initial clinical features and chest CT scans were assessed for the type, pattern, distribution, and frequency of lesions. Moreover, the findings were compared between ward-hospitalized, ICU-admitted, and non-surviving (expired) patients. Results: Of four CT categories, typical CT findings for COVID-19 were more frequent in the expired group (77.4%), compared to the ward-admitted (44.8%) and ICU-admitted (70.8%) groups (P = 0.017). However, no significant difference was observed in the prevalence of intermediate or atypical CT findings between the groups. Negative CT scans for the diagnosis of COVID-19 were significantly fewer in the expired group (0%) as compared to the ward-admitted (10.3%) and ICU-admitted (8.3%) groups (P = 0.0180). Also, the mean number of involved lung lobes and segments was significantly higher in the expired group compared to the other two groups (P = 0.032 and 0.010, respectively). The right upper lobe involvement, right middle lobe involvement, bilateral involvement, central lesion, air bronchogram, and pleural effusion were among CT scan findings with a significantly higher prevalence in non-surviving cases (P < 0.0001, 0.047, 0.01, 0.036, 0.038, and 0.047, respectively). Conclusion: The increased number of involved lung lobes and segments, bilateral and central distribution patterns, air bronchogram, and severe pleural effusion in the initial chest CT scan can be related to the increased severity and poor prognosis of COVID-19.

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

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.

scholarly journals (F)utility of computed tomography of the chest in the presence of pleural effusion

2017 ◽  
Vol 2 (4) ◽  
pp. 181-186 ◽  
Author(s):  
Tilak Pathak ◽  
Malvinder S. Parmar
Keyword(s):  
Computed Tomography ◽  
Pleural Effusion ◽  
Ct Scan ◽  
Clinical Management ◽  
Chest Ct ◽  
X Ray ◽  
Contrast Enhanced ◽  
Plain Chest ◽  
Chest X Ray ◽  
Chest Ct Scan

AbstractBackgroundPleural effusion is common and can cause significant morbidity. The chest X-ray is often the initial radiological test, but additional tests may be required to reduce uncertainty and to provide additional diagnostic information. However, additional exposure and unnecessary costs should be prevented. The objective of the study was to assess the clinical benefit of an additional chest computed tomography (CT) scan over plain chest X-ray alone in the management of patients with pleural effusion.MethodsRetrospective analysis in 94 consecutive patients with pleural effusion who underwent chest X-ray and CT scan over an 18-month period in a single institution. All chest X-ray and CT scan reports were compared and correlated with clinical parameters in order to assess their utility in the clinical management. No blinding was applied.ResultsIn 75 chest CT scan reports (80 %), information provided by the radiologist did not change clinical management when compared to plain chest X-ray alone and did not provide any additional information over chest X-ray. Only 2/49 (4 %) of the native chest CT scan reports provided clinically relevant information as compared to 17/45 (38 %) contrast-enhanced chest CT scan reports (p<0.001).ConclusionsIn this retrospective cohort of patients with pleural effusion, an additional chest CT scan was not useful in the majority of patients. However, if a chest CT scan is required, then a contrast-enhanced study after pleural aspiration should be performed. Further prospective studies are required to confirm these findings.

Early Radiographic and Tomographic Manifestations of Legionnaires' Disease

2017 ◽  
Vol 68 (3) ◽  
pp. 328-333 ◽  
Author(s):  
Rémi Poirier ◽  
Jean Rodrigue ◽  
Jasmin Villeneuve ◽  
Yves Lacasse
Keyword(s):  
Ct Scan ◽  
Legionella Pneumophila ◽  
Community Acquired Pneumonia ◽  
Chest Ct ◽  
Quebec City ◽  
Bacterial Origin ◽  
Increased Risk ◽  
Significant Difference ◽  
Legionnaires Disease ◽  
Chest Ct Scan

Purpose Legionnaires' disease (LD) may occur sporadically or in the course of outbreaks, where the typical radiological manifestations of the disease may better be delineated. We took advantage of a rare community-based epidemic of LD (181 patients) that occurred in 2012 in Quebec City, Canada, to describe the radiographic features of LD and compare the its tomographic presentation with that of community-acquired pneumonia caused by common bacteria other than Legionella pneumophila. Methods From the 181 individuals affected in the outbreak, we obtained the chest radiographs of 159 individuals (mean 63 ± 15 years of age) for detailed analysis; 33 patients had a computed tomography (CT) scan performed during the course of their illness. In a case-control study, we compared the CT scans of patients with LD with those of patients who had received a diagnosis of community-acquired pneumonia caused by a pathogen other than Legionella and confirmed by chest CT scan. Results Overall, LD most often presented as an airspace consolidation involving 1 of the lower lobes. Pleural effusion and mediastinal adenopathies were apparent only in a minority, whereas no pneumothorax or cavitation was noted. We did not find any significant difference in chest CT scan findings in patients with LD vs those with community-acquired pneumonia from other bacterial origin. No radiological finding was clearly associated with an increased risk of intensive care unit admission or mortality. Conclusions The early radiographic and tomographic manifestations of LD are nonspecific and similar to those found in community-acquired pneumonia from other bacterial origin.

scholarly journals Agreement between low-dose and ultra-low-dose chest CT for the diagnosis of viral pneumonia imaging patterns during the COVID-19 pandemic

2022 ◽  
Vol 53 (1) ◽  
Author(s):  
Hooman Bahrami-Motlagh ◽  
Yashar Moharamzad ◽  
Golnaz Izadi Amoli ◽  
Sahar Abbasi ◽  
Alireza Abrishami ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Ct Scan ◽  
Predictive Value ◽  
Low Dose ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Viral Pneumonia ◽  
Ct Scans ◽  
Low Dose Ct ◽  
Chest Ct Scan

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.

scholarly journals The Spectrum of Chest CT-Scans in the Hospitalized Patients with the Coronavirus Disease

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Maria Shirvani ◽  
Alireza Janbakhsh ◽  
Feizollah Mansouri ◽  
Babak Sayad ◽  
Siavash Vaziri ◽  
...  
Keyword(s):  
Ct Scan ◽  
Clinical Symptoms ◽  
Large Family ◽  
Chest Ct ◽  
Hospitalized Patients ◽  
Ct Scans ◽  
Ground Glass ◽  
Sample Population ◽  
Ground Glass Opacification ◽  
Chest Ct Scan

Background: Coronaviruses are a large family of RNA viruses, which range from the common cold virus to the causative agent of more severe diseases. Coronavirus was declared a pandemic in December 2019 in Wuhan, China. Iran has been an endemic zone for the spread of the coronavirus since the outset of this global epidemic and has remained among the countries largely affected by high rates of the disease. Objectives: The present study aimed to investigate the range of the chest computed tomography (CT) scan findings among the hospitalized patients with COVID-19 in Kermanshah, Iran during March-April 2020 to contribute to the accurate diagnosis of the infected patients. Methods: The sample population consisted of 286 hospitalized patients diagnosed with or suspected of the coronavirus disease. Chest CT-scan images and clinical data were reviewed, and their correlation was analyzed. Results: In total, 176 patients (61.53%) were male, and 110 (38.47%) were female. The mean age of the patients was 56 years. Polymerase chain reaction (PCR) results showed that 35.31% of the cases had coronavirus, while the results were negative in 64.69% of the cases. In addition, the CT-scan findings indicated 77.27% abnormal and 22.73% normal chest CT-scans. Among the patients, 75.87% recovered completely, and 18.53% died. The major CT abnormalities were diffuse ground-glass opacification (35.66%), peripheral ground-glass opacification (bilateral; 21.33%), and a combination of diffuse and peripheral ground-glass lesions (18.88%). The consolidation lesion of one lobe was detected in 16 patients, and the consolidation lesion of more than one lobe was observed in 40 patients. Conclusions: According to the results, the most common chest CT-scan findings in COVID-19 include diffuse ground-glass opacification, peripheral ground-glass opacification (bilateral), central ground-glass opacification (bilateral), a combination of diffuse and peripheral ground-glass opacification, a combination of central and peripheral ground-glass opacification, the consolidation lesion of one lobe, and the consolidation lesion of more than one lobe. Furthermore, significant correlations were observed between the CT-scans and the main clinical symptoms, while no significant correlations were denoted between the chest CT-scan and PCR results.

scholarly journals Use of Low-dose Chest CT Scan in the Evaluation of Breast Composition According to the Recommendations of BI-RADS Atlas-Fifth Edition

2020 ◽  
Vol 17 (2) ◽  
Author(s):  
Feng Ao ◽  
Xueguo Liu ◽  
Mingzhu Liang ◽  
Jiebing Gao
Keyword(s):  
Lung Cancer ◽  
Ct Scan ◽  
Low Dose ◽  
Chest Ct ◽  
Dense Breast ◽  
Ct Scans ◽  
Low Dose Ct ◽  
Dense Breasts ◽  
Breast Tissues ◽  
Chest Ct Scan

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.

Pleural Effusion as a Sign of Coronavirus Disease 2019 (COVID-19) Pneumonia: A Case Report

2020 ◽  
Vol 20 ◽  
Author(s):  
Zahra Ahmadinejad ◽  
Faeze Salahshour ◽  
Omid Dadras ◽  
Hesan Rezaei ◽  
SyyedAhmad Alinaghi
Keyword(s):  
Lung Cancer ◽  
Differential Diagnosis ◽  
Pleural Effusion ◽  
Oxygen Saturation ◽  
Ct Scan ◽  
Chest Ct ◽  
Health Concern ◽  
Lung Involvement ◽  
Diagnosis Of Lung Cancer ◽  
Chest Ct Scan

Background: Recently, COVID-19 infection has become a public health concern. On March 12th, 2020, the World Health Organization (WHO) announced it as a global pandemic. Early diagnosis of atypical cases of COVID-19 infection is critical in reducing the transmission and controlling the present pandemic. In the present report, we described a patient with the chief complaints of dyspnea and dry cough referred to the oncology center at Imam Khomeini Hospital, Tehran with the differential diagnosis of lung cancer who was diagnosed and treated for COVID-19 infection in follow up. Case presentation: A 59-year-old patient complained of fever, dry cough, and dyspnea from two weeks ago. The patient had been referred to this center with the differential diagnosis of lung cancer due to the massive pleural effusion in initial chest CT scan. Dyspnea was the patient’s main complaint at the time of admission in this center and the oxygen saturation was 84%. In the new chest CT scan, similar findings were observed. Due to the severe respiratory distress, a chest tube was placed in the chest cavity to remove the pleural effusion fluid on day one. The patient’s felt relieved immediately after the procedure; however, the oxygen saturation did not raise above 85% despite the oxygen therapy. The cytology of pleural fluid was negative for malignant cells. On day 2, the lymphopenia and high level of CRP suggested the COVID-19 infection. Therefore, a control chest CT scan was conducted and the test for COVID-19 was performed. The CT report indicated the clear pattern of COVID-19’s lung involvement in the absence of pleural effusion. Thus, the treatment for COVID-19 was immediately initiated. On day 4, the test reported positive for COVID-19. Conclusion: Currently, it is important to bear in mind the COVID-19 infection in evaluating the patients with respiratory symptoms. This report indicated how misleading the presentation of chest CT scan could be in clinical judgment. Therefore, we recommend ruling out the COVID-19 infection in all the patients with any pattern of lung involvement to avoid missing the potential cases of this vicious infection.

scholarly journals ai-corona: Radiologist-Assistant Deep Learning Framework for COVID-19 Diagnosis in Chest CT Scans

2020 ◽  
Author(s):  
M. Yousefzadeh ◽  
P. Esfahanian ◽  
S. M. S. Movahed ◽  
S. Gorgin ◽  
R. Lashgari ◽  
...  
Keyword(s):  
Deep Learning ◽  
Ct Scan ◽  
Chest Ct ◽  
The Other ◽  
Ct Scans ◽  
Lower Sensitivity ◽  
Imaging Features ◽  
Learning Framework ◽  
Experienced Radiologist ◽  
Chest Ct Scan

AbstractBackgroundWith the global outbreak of COVID-19 epidemic since early 2020, there has been considerable attention on CT-based diagnosis as an effective and reliable method. Recently, the advent of deep learning in medical diagnosis has been well proven. Convolutional Neural Networks (CNN) can be used to detect the COVID-19 infection imaging features in a chest CT scan. We introduce ai-corona, a radiologist-assistant deep learning framework for COVID-19 infection diagnosis using the chest CT scans.MethodOur dataset comprises 2121 cases of axial spiral chest CT scans in three classes; COVID-19 abnormal, non COVID-19 abnormal, and normal, from which 1764 cases were used for training and 357 cases for validation. The training set was annotated using the reports of two experienced radiologists. The COVID-19 abnormal class validation set was annotated using the general consensus of a collective of criteria that indicate COVID-19 infection. Moreover, the validation sets for the non COVID-19 abnormal and the normal classes were annotated by a different experienced radiologist. ai-corona constitutes a CNN-based feature extractor conjoined with an average pooling and a fully-connected layer to classify a given chest CT scan into the three aforementioned classes.ResultsWe compare the diagnosis performance of ai-corona, radiologists, and model-assisted radiologists for six combinations of distinguishing between the three mentioned classes, including COVID-19 abnormal vs. others, COVID-19 abnormal vs. normal, COVID-19 abnormal vs. non COVID-19 abnormal, non COVID-19 abnormal vs. others, normal vs. others, and normal vs. abnormal. ai-corona achieves an AUC score of 0.989 (95% CI: 0.984, 0.994), 0.997 (95% CI: 0.995, 0.999), 0.986 (95% CI: 0.981, 0.991), 0.959 (95% CI: 0.944, 0.974), 0.978 (95% CI: 0.968, 0.988), and 0.961 (95% CI: 0.951, 0.971) in each combination, respectively. By employing Bayesian statistics to calculate the accuracies at a 95% confidence interval, ai-corona surpasses the radiologists in distinguishing between the COVID-19 abnormal class and the other two classes (especially the non COVID-19 abnormal class). Our results show that radiologists’ diagnosis performance improves when incorporating ai-corona’s prediction. In addition, we also show that RT-PCR’s diagnosis has a much lower sensitivity compared to all the other methods.Conclusionai-corona is a radiologist-assistant deep learning framework for fast and accurate COVID-19 diagnosis in chest CT scans. Our results ascertain that our framework, as a reliable detection tool, also improves experts’ diagnosis performance and helps especially in diagnosing non-typical COVID-19 cases or non COVID-19 abnormal cases that manifest COVID-19 imaging features in chest CT scan. Our framework is available at: ai-corona.com

Typical, rare and atypical CT findings in COVID-19 pneumonia: A pictorial review

2021 ◽  
Vol 2 (4) ◽  
Author(s):  
Charlotte M Biebaû ◽  
◽  
Adriana Dubbeldam ◽  
Johan Coolen ◽  
Johny A Verschakelen ◽  
...  
Keyword(s):  
Ct Scan ◽  
Daily Practice ◽  
Chest Ct ◽  
Ct Findings ◽  
Pictorial Review ◽  
Risk Of Disease ◽  
X Ray Computed ◽  
Test Probability ◽  
Chest Ct Scan

Objectives: The objective of this pictorial review is to make radiologists and clinicians familiar with the typical, atypical and rare CT findings of COVID-19 pneumonia to help in diagnosis as well as in monitoring disease. Main text: Bilateral ground-glass opacities, whether isolated or coexisting with consolidations, and typically in basal, posterior and peripheral lungs are the key findings in COVID-19 pneumonia. With further analysis other typical, atypical and rare CT findings are described and we need to keep in mind that the radiological presentation is dynamic with a rapid evolutive phase, peaking at 10-11 days, and a subsequent absorption phase after 14 days with a decrease in opacities and increase in repairing signs. Conclusion: The presence of typical findings of COVID-19 pneumonia on a chest CT scan during the pandemic outbreak of SARSCoV-2 helps in diagnostic analysis. Chest CT scan has a reported sensitivity of 97-98% in times with a high pre-test probability. Some CT findings (crazy paving pattern and pleural effusion) as well as an increasing percentage of lung opacities are associated with a worse patient outcome, emphasizing the role of chest CT in determining the risk of disease progression. Furthermore chest CT scan is also useful in monitoring disease control. With these acknowledgement we want to give a useful overview of the chest CT manifestations in COVID-19 pneumonia to help decision making in daily practice. Keywords: COVID-19; SARS-CoV-2; tomography; X Ray computed; diagnosis.

scholarly journals A Multicenter Survey on the Trend of Chest CT Scan Utilization: Tracing the First Footsteps of COVID-19 in Iran

2020 ◽  
Vol 23 (11) ◽  
pp. 787-793
Author(s):  
Amir Reza Radmard ◽  
Ali Gholamrezanezhad ◽  
Seyed Ali Montazeri ◽  
Amir Kasaeian ◽  
Nemat Nematollahy ◽  
...  
Keyword(s):  
Ct Scan ◽  
Viral Disease ◽  
Cross Sectional Study ◽  
Chest Ct ◽  
Ct Scans ◽  
Cross Sectional ◽  
Large Cities ◽  
Multicenter Survey ◽  
Negative Balance ◽  
Chest Ct Scan

Background: Chest computed tomography (CT) scan has been used widely to diagnose COVID-19 in Iran. Objectives: To trace the footsteps of COVID-19 in Iran by exploring the trend in using chest CT scans and its economic impact on radiology departments. Methods: In this cross-sectional study, the number of imaging examinations from 33 tertiary radiology departments in 9 large cities of Iran was collected from September 23, 2019 to March 20, 2020 (Months 1 to 6) and the corresponding months in 2018–2019. Results: A 50.2% increase was noted in the chest CT scan utilization in 2019–2020 compared to 2018–2019. This increase was +15%, +15%, +27%, +2%, +1% in Months 1–5 of 2019–2020, respectively. In Month 6 of 2019–2020, a 251% increase in the acquisition of chest CT scans was observed compared to the Month 6 of 2018–2019. Following negative balance of revenue from Month 1 to 5 with respect to the inflation rate, the total income in Month 6 was further 1.5% less than the same Month in 2018–19. Conclusion: The observed peak in chest CT utilization in Month 3 prior to the surge in Month 6 could be explained by the seasonal influenza. However, unawareness about an emerging viral disease, i.e. COVID-19, might have underutilized chest CT in Months 4 and 5 before the official announcement in Month 6. The unbalanced increase in the workload of radiology departments in the shortage of cardiothoracic radiologists with the simultaneous decrease in income initiated a vicious cycle that worsened the economic repercussions of the pandemic.

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