Dose-optimised chest computed tomography for diagnosis of Coronavirus Disease 2019 (COVID-19) - Evaluation of image quality and diagnostic impact.
J Radiol Prot
; 40(3): 877-891, 2020 09.
Article
in English
| MEDLINE | ID: covidwho-723319
ABSTRACT
OBJECTIVES:
The detection of Coronavirus Disease 2019 (COVID-19) by reverse transcription polymerase chain reaction (RT-PCR) has varying sensitivity. Computed tomography (CT) of the chest can verify infection in patients with clinical symptoms and a negative test result, accelerating treatment and actions to prevent further contagion. However, CT employs ionising radiation. The purpose of this study was to evaluate protocol settings, associated radiation exposure, image quality and diagnostic performance of a low-dose CT protocol in a university hospital setting. MATERIALS ANDMETHODS:
Chest CT examinations were performed on a single scanner (Somatom Definition Edge, Siemens Healthineers, Germany) in 105 symptomatic patients (60 male, 45 female). Images were evaluated with regard to protocol parameters, image quality, radiation exposure and diagnostic accuracy. Serial RT-PCR served as the standard of reference. Based on this reference standard sensitivity, specificity, positive and negative predictive values of CT with 95% confidence interval were calculated.RESULTS:
The mean effective dose was 1.3 ± 0.4 mSv (0.7-2.9 mSv) for the patient cohort (mean age 66.6 ± 16.7 years (19-94 years), mean body mass index (BMI) 26.6 ± 5.3 kg m-2 (16-46 kg/m2)). A sensitivity of 100 [95% CI 82-100]%, a specificity of 78 [95% CI 68-86]%, a positive predictive value of 50 [95% CI 33-67]% and a negative predictive value of 100 [95% CI 95-100]% were obtained. No COVID-19 diagnoses were missed by CT. Image noise did not strongly correlate with BMI or patient diameter and was rated as average.CONCLUSIONS:
We presented a robust imaging procedure with a chest CT protocol for confident diagnosis of COVID-19. Even for an overweight patient cohort, an associated radiation exposure of only 1.3 ± 0.4 mSv was achieved with sufficient diagnostic quality to exclude COVID-19.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Radiation Dosage
/
Radiography, Thoracic
/
Tomography, X-Ray Computed
/
Coronavirus Infections
Type of study:
Cohort study
/
Diagnostic study
/
Experimental Studies
/
Observational study
/
Prognostic study
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
English
Journal:
J Radiol Prot
Journal subject:
Radiology
Year:
2020
Document Type:
Article
Affiliation country:
1361-6498
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