Diagnostic yield, safety, and advantages of ultra-low dose chest CT compared to chest radiography in early stage suspected SARS-CoV-2 pneumonia: A retrospective observational study

Medicine (Baltimore). 2021 May 28;100(21):e26034. doi: 10.1097/MD.0000000000026034.

Abstract

To determine the role of ultra-low dose chest computed tomography (uld CT) compared to chest radiographs in patients with laboratory-confirmed early stage SARS-CoV-2 pneumonia.Chest radiographs and uld CT of 12 consecutive suspected SARS-CoV-2 patients performed up to 48 hours from hospital admission were reviewed by 2 radiologists. Dosimetry and descriptive statistics of both modalities were analyzed.On uld CT, parenchymal abnormalities compatible with SARS-CoV-2 pneumonia were detected in 10/12 (83%) patients whereas on chest X-ray in, respectively, 8/12 (66%) and 5/12 (41%) patients for reader 1 and 2. The average increment of diagnostic performance of uld CT compared to chest X-ray was 29%. The average effective dose was, respectively, of 0.219 and 0.073 mSv.Uld CT detects substantially more lung injuries in symptomatic patients with suspected early stage SARS-CoV-2 pneumonia compared to chest radiographs, with a significantly better inter-reader agreement, at the cost of a slightly higher equivalent radiation dose.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • COVID-19 / diagnosis*
  • COVID-19 / virology
  • COVID-19 Nucleic Acid Testing
  • Female
  • Humans
  • Lung / diagnostic imaging*
  • Male
  • Middle Aged
  • Observer Variation
  • Predictive Value of Tests
  • RNA, Viral / isolation & purification
  • Radiation Dosage
  • Radiography, Thoracic / adverse effects
  • Radiography, Thoracic / methods
  • Radiography, Thoracic / statistics & numerical data*
  • Radiometry / statistics & numerical data
  • Retrospective Studies
  • SARS-CoV-2 / genetics
  • SARS-CoV-2 / isolation & purification*
  • Tomography, X-Ray Computed / adverse effects
  • Tomography, X-Ray Computed / methods
  • Tomography, X-Ray Computed / statistics & numerical data*

Substances

  • RNA, Viral