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Ultra-Low Dose CT Chest in Acute COVID-19 Pneumonia: A Pilot Study from India

The rapid increase in the number of CT acquisitions during the COVID-19 pandemic raised concerns about increased radiation exposure to patients and the resultant radiation-induced health risks. It prompted researchers to explore newer CT techniques like ultra-low dose CT (ULDCT), which could improve...

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Autores principales: Garg, Mandeep, Devkota, Shritik, Prabhakar, Nidhi, Debi, Uma, Kaur, Maninder, Sehgal, Inderpaul S., Dhooria, Sahajal, Bhalla, Ashish, Sandhu, Manavjit Singh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9914217/
https://www.ncbi.nlm.nih.gov/pubmed/36766456
http://dx.doi.org/10.3390/diagnostics13030351
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author Garg, Mandeep
Devkota, Shritik
Prabhakar, Nidhi
Debi, Uma
Kaur, Maninder
Sehgal, Inderpaul S.
Dhooria, Sahajal
Bhalla, Ashish
Sandhu, Manavjit Singh
author_facet Garg, Mandeep
Devkota, Shritik
Prabhakar, Nidhi
Debi, Uma
Kaur, Maninder
Sehgal, Inderpaul S.
Dhooria, Sahajal
Bhalla, Ashish
Sandhu, Manavjit Singh
author_sort Garg, Mandeep
collection PubMed
description The rapid increase in the number of CT acquisitions during the COVID-19 pandemic raised concerns about increased radiation exposure to patients and the resultant radiation-induced health risks. It prompted researchers to explore newer CT techniques like ultra-low dose CT (ULDCT), which could improve patient safety. Our aim was to study the utility of ultra-low dose CT (ULDCT) chest in the evaluation of acute COVID-19 pneumonia with standard-dose CT (SDCT) chest as a reference standard. This was a prospective study approved by the institutional review board. 60 RT-PCR positive COVID-19 patients with valid indication for CT chest underwent SDCT and ULDCT. ULDCT and SDCT were compared in terms of objective (noise and signal-to-noise ratio) and subjective (noise, sharpness, artifacts and diagnostic confidence) image quality, various imaging patterns of COVID-19, CT severity score and effective radiation dose. The sensitivity, specificity, positive and negative predictive value, and diagnostic accuracy of ULDCT for detecting lung lesions were calculated by taking SDCT as a reference standard. The mean age of subjects was 47.2 ± 10.7 years, with 66.67% being men. 90% of ULDCT scans showed no/minimal noise and sharp images, while 93.33% had image quality of high diagnostic confidence. The major imaging findings detected by SDCT were GGOs (90%), consolidation (76.67%), septal thickening (60%), linear opacities (33.33%), crazy-paving pattern (33.33%), nodules (30%), pleural thickening (30%), lymphadenopathy (30%) and pleural effusion (23.33%). Sensitivity, specificity and diagnostic accuracy of ULDCT for detecting most of the imaging patterns were 100% (p < 0.001); except for GGOs (sensitivity: 92.59%, specificity: 100%, diagnostic accuracy: 93.33%), consolidation (sensitivity: 100%, specificity: 71.43%, diagnostic accuracy: 93.33%) and linear opacity (sensitivity: 90.00%, specificity: 100%, diagnostic accuracy: 96.67%). CT severity score (range: 15–25) showed 100% concordance on SDCT and ULDCT, while effective radiation dose was 4.93 ± 1.11 mSv and 0.26 ± 0.024 mSv, respectively. A dose reduction of 94.38 ± 1.7% was achieved with ULDCT. Compared to SDCT, ULDCT chest yielded images of reasonable and comparable diagnostic quality with the advantage of significantly reduced radiation dose; thus, it can be a good alternative to SDCT in the evaluation of COVID-19 pneumonia.
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spelling pubmed-99142172023-02-11 Ultra-Low Dose CT Chest in Acute COVID-19 Pneumonia: A Pilot Study from India Garg, Mandeep Devkota, Shritik Prabhakar, Nidhi Debi, Uma Kaur, Maninder Sehgal, Inderpaul S. Dhooria, Sahajal Bhalla, Ashish Sandhu, Manavjit Singh Diagnostics (Basel) Article The rapid increase in the number of CT acquisitions during the COVID-19 pandemic raised concerns about increased radiation exposure to patients and the resultant radiation-induced health risks. It prompted researchers to explore newer CT techniques like ultra-low dose CT (ULDCT), which could improve patient safety. Our aim was to study the utility of ultra-low dose CT (ULDCT) chest in the evaluation of acute COVID-19 pneumonia with standard-dose CT (SDCT) chest as a reference standard. This was a prospective study approved by the institutional review board. 60 RT-PCR positive COVID-19 patients with valid indication for CT chest underwent SDCT and ULDCT. ULDCT and SDCT were compared in terms of objective (noise and signal-to-noise ratio) and subjective (noise, sharpness, artifacts and diagnostic confidence) image quality, various imaging patterns of COVID-19, CT severity score and effective radiation dose. The sensitivity, specificity, positive and negative predictive value, and diagnostic accuracy of ULDCT for detecting lung lesions were calculated by taking SDCT as a reference standard. The mean age of subjects was 47.2 ± 10.7 years, with 66.67% being men. 90% of ULDCT scans showed no/minimal noise and sharp images, while 93.33% had image quality of high diagnostic confidence. The major imaging findings detected by SDCT were GGOs (90%), consolidation (76.67%), septal thickening (60%), linear opacities (33.33%), crazy-paving pattern (33.33%), nodules (30%), pleural thickening (30%), lymphadenopathy (30%) and pleural effusion (23.33%). Sensitivity, specificity and diagnostic accuracy of ULDCT for detecting most of the imaging patterns were 100% (p < 0.001); except for GGOs (sensitivity: 92.59%, specificity: 100%, diagnostic accuracy: 93.33%), consolidation (sensitivity: 100%, specificity: 71.43%, diagnostic accuracy: 93.33%) and linear opacity (sensitivity: 90.00%, specificity: 100%, diagnostic accuracy: 96.67%). CT severity score (range: 15–25) showed 100% concordance on SDCT and ULDCT, while effective radiation dose was 4.93 ± 1.11 mSv and 0.26 ± 0.024 mSv, respectively. A dose reduction of 94.38 ± 1.7% was achieved with ULDCT. Compared to SDCT, ULDCT chest yielded images of reasonable and comparable diagnostic quality with the advantage of significantly reduced radiation dose; thus, it can be a good alternative to SDCT in the evaluation of COVID-19 pneumonia. MDPI 2023-01-18 /pmc/articles/PMC9914217/ /pubmed/36766456 http://dx.doi.org/10.3390/diagnostics13030351 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Garg, Mandeep
Devkota, Shritik
Prabhakar, Nidhi
Debi, Uma
Kaur, Maninder
Sehgal, Inderpaul S.
Dhooria, Sahajal
Bhalla, Ashish
Sandhu, Manavjit Singh
Ultra-Low Dose CT Chest in Acute COVID-19 Pneumonia: A Pilot Study from India
title Ultra-Low Dose CT Chest in Acute COVID-19 Pneumonia: A Pilot Study from India
title_full Ultra-Low Dose CT Chest in Acute COVID-19 Pneumonia: A Pilot Study from India
title_fullStr Ultra-Low Dose CT Chest in Acute COVID-19 Pneumonia: A Pilot Study from India
title_full_unstemmed Ultra-Low Dose CT Chest in Acute COVID-19 Pneumonia: A Pilot Study from India
title_short Ultra-Low Dose CT Chest in Acute COVID-19 Pneumonia: A Pilot Study from India
title_sort ultra-low dose ct chest in acute covid-19 pneumonia: a pilot study from india
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9914217/
https://www.ncbi.nlm.nih.gov/pubmed/36766456
http://dx.doi.org/10.3390/diagnostics13030351
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