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1.
J Thorac Dis ; 16(5): 2975-2982, 2024 May 31.
Article in English | MEDLINE | ID: mdl-38883626

ABSTRACT

Background: In early-stage non-small cell lung cancer (NSCLC), the presence of a ground-glass opacity (GGO) component in the primary lesion on high-resolution computed tomography (CT) is recognized as a favorable prognostic factor. Even in NSCLC with a GGO component, lymph node metastases are occasionally detected during or after surgery. However, the prognostic impact of GGO components in these patients has not been clarified. We aimed to examine the prognostic significance of GGO components as radiological findings of primary lesions of completely resected NSCLC with pathological nodal involvement. Methods: This study included 290 patients (11%) with pathological nodal involvement among 2,546 patients who underwent complete resection of NSCLC at our institution. Patients with an unknown primary lesion (T0) or centrally located lung cancer were excluded. The 290 patients were divided into two groups [i.e., the part-solid ("PS") and "Solid" groups] according to the radiological findings of the primary lesion, and their clinicopathological characteristics and prognoses were compared. Furthermore, a multivariate analysis was performed using the Cox proportional hazards model to examine the factors affecting the overall survival (OS). Results: The OS in the PS group (n=58) was significantly longer than that in the Solid group (n=232; P=0.039). However, multivariate analysis only revealed age [hazard ratio (HR) =1.77; 95% confidence interval (CI): 1.15-2.72] and the clinical T factor (HR =1.58; 95% CI: 1.01-2.47), but not the radiological findings of primary lesions, as the independent prognostic factors. Furthermore, the OS did not differ significantly between the PS and Solid groups matched for the clinical T and N factors (n=58 patients each). Conclusions: GGO components in the primary lesion, considered a decisive prognostic factor in early-stage NSCLC, did not affect the prognosis of patients with NSCLC and pathological nodal involvement.

2.
Infect Drug Resist ; 17: 1763-1769, 2024.
Article in English | MEDLINE | ID: mdl-38736434

ABSTRACT

Background: Auxiliaries, a mixed chemicals, for printing and dyeing characterized by their diverse range and complex chemical compositions are commonly utilized in the textile industry. These chemicals can lead to environmental contamination and pose health risks to humans. Case Description: A 29-year-old man who worked in a printing and dyeing factory in Suzhou, China, reported having tightness in his chest and coughing. Despite seeking medical treatment at several hospitals, the initial diagnosis remained elusive. High-resolution chest CT scans showed multifocal lesions in both lungs. The patient had no significant medical history, and the respiratory symptoms only surfaced after exposure to dyeing auxiliaries. Physicians initially suspected chemical pneumonitis due to occupational exposure. However, a subsequent evaluation at a hospital specializing in occupational diseases led to a diagnosis of AIDS and pneumocystis pneumonia. Conclusion: This case underscores the importance of comprehensive clinical diagnosis to avoid biases and reduce the incidence of misdiagnosis.

3.
Article in English | MEDLINE | ID: mdl-38702271

ABSTRACT

BACKGROUND: Direct coronary arterial evaluation via computed tomography (CT) angiography is the most accurate noninvasive test for the diagnosis of coronary artery disease (CAD). However, diagnostic accuracy is limited in the setting of severe coronary calcification or stents. Ultra-high-resolution CT (UHR-CT) may overcome this limitation, but no rigorous study has tested this hypothesis. METHODS: The CORE-PRECISION is an international, multicenter, prospective diagnostic accuracy study testing the non-inferiority of UHR-CT compared to invasive coronary angiography (ICA) for identifying patients with hemodynamically significant CAD. The study will enroll 150 patients with history of CAD, defined as prior documentation of lumen obstruction, stenting, or a calcium score ≥400, who will undergo UHR-CT before clinically prompted ICA. Assessment of hemodynamically significant CAD by UHR-CT and ICA will follow clinical standards. The reference standard will be the quantitative flow ratio (QFR) with <0.8 defined as abnormal. All data will be analyzed in independent core laboratories. RESULTS: The primary outcome will be the comparative diagnostic accuracy of UHR-CT vs. ICA for detecting hemodynamically significant CAD on a patient level. Secondary analyses will focus on vessel level diagnostic accuracy, quantitative stenosis analysis, automated contour detection, in-depth plaque analysis, and others. CONCLUSION: CORE-PRECISION aims to investigate if UHR-CT is non-inferior to ICA for detecting hemodynamically significant CAD in high-risk patients, including those with severe coronary calcification or stents. We anticipate this study to provide valuable insights into the utility of UHR-CT in this challenging population and for its potential to establish a new standard for CAD assessment.

4.
Mod Rheumatol ; 2024 May 30.
Article in English | MEDLINE | ID: mdl-38813668

ABSTRACT

OBJECTIVE: To investigate clinical relevance of performing lung ultrasound (LUS) in patients with connective tissue disease (CTD)-associated interstitial lung disease (ILD) in comparison with high-resolution computed tomography (HRCT). METHODS: This single-centre study enrolled eligible patients with CTD-ILD from the prospective LUS registry. Total B-lines were detected by assessment at 14 sites via LUS. Forced vital capacity, diffusing lung capacity for carbon monoxide (DLCO), DLCO/alveolar volume, 6-minute walking distance, and the ILD-GAP index were used as ILD prognostic parameters. Correlations were examined using single and multiple regression analyses. RESULTS: Sixty-seven patients were enrolled, including 29 with idiopathic inflammatory myopathy or anti-synthetase syndrome, 25 with systemic sclerosis (SSc), 10 with rheumatoid arthritis, and 3 with mixed connective tissue disease. The total number of B-lines correlated with ILD extent on HRCT in patients with CTD-ILD (r = 0.66; P < 0.001), particularly in patients with SSc-ILD (r = 0.78; P < 0.001). Total B-lines and ILD extent on HRCT showed comparable correlations with prognostic parameters, while multiple regression analysis revealed the limited benefit of performing LUS in addition to HRCT in predicting correlations with prognostic factors. CONCLUSIONS: LUS serves as an alternative tool for assessing the severity and prognosis of patients with CTD-ILD.

5.
Article in Chinese | MEDLINE | ID: mdl-38686481

ABSTRACT

Objective:To investigate the predictive value of temporal bone high-resolution CT(HRCT) multiplanar reconstruction(MPR) for cerebrospinal fluid(CSF) gusher during cochlear implantation in patients with inner ear malformation. Methods:The clinical data of 33 patients(36 ears) with inner ear malformation who underwent cochlear implantation were retrospectively analyzed. The predictive value of HRCT for cerebrospinal fluid gusher during cochlear implantation was evaluated. Results:The width of the cochlear foramen(P=0.024, OR=1.735) and the diameter of the inner auditory meatus(P=0.022, OR=6.119) were independent risk factors for CSF gusher during cochlear implantation. The area under the curve(AUC) of cochlear foramen width in predicting intraoperative gusher was 0.851, the sensitivity was 93.33%, and the specificity was 61.90%. The AUC of the upper and lower diameter of the internal auditory canal for predicting intraoperative gusher was 0.848, the sensitivity was 80.00%, and the specificity was 80.95%. The AUC of cochlear foramen width combined with the upper and lower diameters of the internal auditory meatus for predicting intraoperative gusher was 0.930, the sensitivity was 80.00%, and the specificity was 95.24%. Conclusion:Based on temporal bone HRCT, the prediction model of cochlear foramen width combined with the upper and lower diameter of the internal auditory canal has crucial predictive value for the "gusher" during cochlear implantation in patients with inner ear malformation.


Subject(s)
Cerebrospinal Fluid Leak , Cochlear Implantation , Ear, Inner , Temporal Bone , Cochlear Implantation/adverse effects , Temporal Bone/diagnostic imaging , Cerebrospinal Fluid Leak/diagnostic imaging , Tomography, X-Ray Computed , Humans , Ear, Inner/abnormalities , Ear, Inner/surgery
6.
Pak J Med Sci ; 40(4): 637-641, 2024.
Article in English | MEDLINE | ID: mdl-38545009

ABSTRACT

Objectives: To identify a correlation between the clinical parameters and CT chest severity score in COVID-19. Methods: A total of 205 RT-PCR positive patients were included in this descriptive cross-sectional study with convenience sampling from November 2020 to June 2021 in KRL Hospital. The study population was stratified in disease severity as per the WHO's guidelines. Clinical and radiological characteristics were compared in survivors and non survivors to draw conclusion. Results: The mean age was 57 years and the majority of the patients 57% were male. Overall mortality was 22% and the mean CT severity score was 18. Non survivors were more tachypneic, hypoxic, had a higher CT chest severity score, higher clinical severity, more comorbid condition and higher TLC, D-Dimers, LDH, CRP, NLR. Raised CT severity score showed a conclusive correlation with greater disease severity. One way ANOVA showed a significant difference between mean CT severity score amongst different disease categories. Conclusion: Higher CT severity score corresponds to a higher clinical severity and higher chances of mortality.

7.
Tohoku J Exp Med ; 263(1): 35-42, 2024 May 25.
Article in English | MEDLINE | ID: mdl-38355111

ABSTRACT

Recent advancements in computed tomography (CT) scanning have improved the detection rates of peripheral pulmonary nodules, including those with ground-glass opacities (GGOs). This study focuses on part-solid pure ground-glass nodules (GGNs) and aims to identify imaging predictors that can reliably differentiate primary lung cancer from nodules with other diagnoses among part-solid GGNs on high-resolution CT (HRCT). A retrospective study was conducted on 609 patients who underwent surgical treatment or observation for lung nodules. Radiological findings from pre-operative HRCT scans were reviewed and several CT imaging features of part-solid GGNs were examined for their positive predictive value to identify primary lung cancer. The proportions of the nodules with a final diagnosis of primary lung cancer were significantly higher in part-solid GGNs (91.9%) compared with solid nodules (70.3%) or pure GGNs (66.7%). Among CT imaging features of part-solid GGNs that were evaluated, consolidation-to-tumor ratio (CTR) < 0.5 (98.1%), pleural indentation (96.4%), and clear tumor border (96.7%) had high positive predictive value to identify primary lung cancer. When two imaging features were combined, the combination of CTR < 0.5 and a clear tumor border was identified to have 100% positive predictive values with a sensitivity of 40.8%. Thus we conclude that part-solid GGNs with a CTR < 0.5 accompanied by a clear tumor border evaluated by HRCT are very likely to be primary lung cancers with an acceptable sensitivity. Preoperative diagnostic procedures to obtain a pathological diagnosis may potentially be omitted in patients harboring such part-solid GGNs.


Subject(s)
Lung Neoplasms , Tomography, X-Ray Computed , Humans , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/pathology , Male , Female , Middle Aged , Aged , Aged, 80 and over , Retrospective Studies , Solitary Pulmonary Nodule/diagnostic imaging , Solitary Pulmonary Nodule/pathology , Adult , ROC Curve
9.
Cureus ; 16(1): e52027, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38344612

ABSTRACT

Hypoattenuated leaflet thickening (HALT), a potential aftereffect of transcatheter aortic valve replacement (TAVR) procedure, may affect valve performance and clinical outcomes. At this moment we describe an elderly patient who, despite being on prophylactic antiplatelet medication for previous percutaneous intervention (PCI) for coronary artery disease (CAD) and a self-expanding valve in-situ for aortic stenosis (TAVR), presented to the emergency room with non-ST-segment elevation myocardial infarction (NSTEMI), probably as a result of a thromboembolic event from HALT. The case highlights the significance of considering HALT-associated thromboembolism as a potential cause of myocardial infarction (MI) in post-TAVR patients.

10.
Skeletal Radiol ; 2024 Feb 03.
Article in English | MEDLINE | ID: mdl-38308721

ABSTRACT

OBJECTIVE: To demonstrate the potential of low-dose ultra-high-resolution CT (UHRCT) images to generate high-quality radiographic images on extremity phantoms and to estimate the radiation dose required for this. MATERIALS AND METHODS: A hand and knee phantom containing real human bones was imaged on an UHRCT scanner at full-dose, half-dose, and quarter-dose levels using a high-resolution extremity protocol. The raw data was reconstructed using both filtered back projection (FBP) and an iterative reconstruction algorithm (AIDR3D). Using custom designed software, each CT volume data set was converted to attenuation coefficients, and then a synthesized radiograph (synDX) was generated by forward projecting the volume data sets from a point source onto a 2D synthetic detector. The signal-to-noise ratio (SNR) was measured in the synDXs across all dose levels and the root-mean-squared error (RMSE) was computed with the FD synDXs as the reference. RESULTS: The proposed workflow generates high-quality synDXs at any arbitrary angle. For FBP, the SNR largely tracked with the radiation dose levels for both the knee and hand phantoms. For the knee phantom, iterative reconstruction provided a 6.1% higher SNR when compared to FBP. The RMSE was overall higher for the lowest dose levels and monotonically decreased with increasing dose. No substantial differences were observed qualitatively in the visualization of skeletal detail of the phantoms. CONCLUSION: The fine detail provided by UHRCT acquisitions of extremities facilitates the ability to generate quality radiographs, potentially eliminating the need for additional scanning on a conventional digital radiography system.

11.
Rheumatology (Oxford) ; 63(1): 103-110, 2024 Jan 04.
Article in English | MEDLINE | ID: mdl-37074923

ABSTRACT

OBJECTIVE: Stratifying the risk of death in SSc-related interstitial lung disease (SSc-ILD) is a challenging issue. The extent of lung fibrosis on high-resolution CT (HRCT) is often assessed by a visual semiquantitative method that lacks reliability. We aimed to assess the potential prognostic value of a deep-learning-based algorithm enabling automated quantification of ILD on HRCT in patients with SSc. METHODS: We correlated the extent of ILD with the occurrence of death during follow-up, and evaluated the additional value of ILD extent in predicting death based on a prognostic model including well-known risk factors in SSc. RESULTS: We included 318 patients with SSc, among whom 196 had ILD; the median follow-up was 94 months (interquartile range 73-111). The mortality rate was 1.6% at 2 years and 26.3% at 10 years. For each 1% increase in the baseline ILD extent (up to 30% of the lung), the risk of death at 10 years was increased by 4% (hazard ratio 1.04, 95% CI 1.01, 1.07, P = 0.004). We constructed a risk prediction model that showed good discrimination for 10-year mortality (c index 0.789). Adding the automated quantification of ILD significantly improved the model for 10-year survival prediction (P = 0.007). Its discrimination was only marginally improved, but it improved prediction of 2-year mortality (difference in time-dependent area under the curve 0.043, 95% CI 0.002, 0.084, P = 0.040). CONCLUSION: The deep-learning-based, computer-aided quantification of ILD extent on HRCT provides an effective tool for risk stratification in SSc. It might help identify patients at short-term risk of death.


Subject(s)
Lung Diseases, Interstitial , Scleroderma, Systemic , Humans , Prognosis , Reproducibility of Results , Vital Capacity , Lung Diseases, Interstitial/diagnostic imaging , Lung Diseases, Interstitial/etiology , Lung Diseases, Interstitial/epidemiology , Lung , Scleroderma, Systemic/complications , Scleroderma, Systemic/diagnostic imaging , Tomography, X-Ray Computed
12.
Radiol Med ; 128(10): 1262-1270, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37658197

ABSTRACT

PURPOSE: Follow-up examinations after flow diverter (FD) treatment for cerebral aneurysms typically involve magnetic resonance imaging (MRI) or digital subtraction angiography (DSA). However, MRI is prone to vascular defects due to metal artifacts from FD, and DSA carries a risk of ischemic complications. In the context of computed tomography angiography (CTA), this study compares the efficacy of ultra-high-resolution CT (UHRCT) and novel reconstruction techniques, such as model-based iterative reconstruction (MBIR), against conventional methods such as filtered back projection (FBP) and hybrid iterative reconstruction (IR), to determine if they are a viable alternative to DSA in clinical settings. MATERIALS AND METHODS: A phantom study was conducted with the full-width half-maximum considered as the FD thickness. This study compared three reconstruction methods: MBIR, FBP, and hybrid IR. A clinical study was also conducted with 21 patients who underwent follow-up CTA after FD treatment. The FD's visibility was assessed using a 4-point scale in FBP, hybrid IR, and MBIR compared to cone-beam CT (CBCT) with angiographic systems. RESULTS: In the phantom study, FBP, hybrid IR, and MBIR visualized thinner FD thicknesses and improved detail rendering in that order. MBIR proved to be significantly superior in both the phantom and clinical study. CONCLUSION: UHRCT with MBIR is highly effective for follow-up evaluations after FD treatment and may become the first-choice modality in the future.


Subject(s)
Computed Tomography Angiography , Intracranial Aneurysm , Humans , Intracranial Aneurysm/diagnostic imaging , Intracranial Aneurysm/surgery , Follow-Up Studies , Radiographic Image Interpretation, Computer-Assisted/methods , Tomography, X-Ray Computed/methods , Angiography, Digital Subtraction , Algorithms , Radiation Dosage
13.
J Neurosurg Case Lessons ; 6(9)2023 Aug 28.
Article in English | MEDLINE | ID: mdl-37728326

ABSTRACT

BACKGROUND: High-resolution computed tomography (CT), outfitted with a 0.25-mm detector, has superior capability for identifying microscopic anatomical structures compared to conventional CT. This study describes the use of high-resolution computed tomography angiography (CTA) for preoperative microvascular decompression (MVD) assessment and explores the potential effectiveness of three-dimensional (3D) image fusion with magnetic resonance imaging (MRI) by comparing it with traditional imaging methods. OBSERVATIONS: Four patients who had undergone preoperative high-resolution CTA and MRI for MVD at Osaka University Hospital between December 2020 and March 2022 were included in this study. The 3D-reconstructed images and intraoperative findings were compared. One patient underwent conventional CTA, thus allowing for a comparison between high-resolution and conventional CTA in terms of radiation exposure and vascular delineation. Preoperative simulations reflected the intraoperative findings for all cases; small vessel compression of the nerve was identified preoperatively in two cases. LESSONS: Compared with conventional CTA, high-resolution CTA showed superior vascular delineation with no significant change in radiation exposure. The use of high-resolution CTA with reconstructed 3D fusion images can help to simulate prior MVD. Knowing the location of the nerves and blood vessels can perioperatively guide neurosurgeons.

14.
J Cardiovasc Comput Tomogr ; 17(5): 341-344, 2023.
Article in English | MEDLINE | ID: mdl-37567802

ABSTRACT

BACKGROUND: Recent improvements in CT detector technology have led to smaller detector pixels resolving frequencies beyond 20 lp/cm and enabled ultra-high-resolution CT. Silicon-based photon-counting detector (PCD) CT is one such technology that promises improved spatial and spectral resolution. However, when the detector pixel sizes are reduced, the impact of cardiac motion on CT images becomes more pronounced. Here, we investigated the effects cardiac motion on the image quality of a clinical prototype Si-PCD scanner in a dynamic heart phantom. METHODS: A series of 3D-printed vessels were created to simulate coronary arteries with diameter in the 1-3.5 â€‹mm range. Four coronary stents were set inside the d â€‹= â€‹3.5 â€‹mm vessels and all vessels were filled with contrast agents and were placed inside a dynamic cardiac phantom. The phantom was scanned in motion (60 bpm) and at rest on a prototype clinical Si-PCD CT scanner in 8-bin spectral UHR mode. Virtual monoenergetic images (VMI) were generated at 70 â€‹keV and CT number accuracy and effective spatial resolution (blooming) of rest and motion VMIs were compared. RESULTS: Linear regression analysis of CT numbers showed excellent agreement (r â€‹> â€‹0.99) between rest and motion. We did not observe a significant difference (p â€‹> â€‹0.48) in estimating free lumen diameters. Differences in in-stent lumen diameter and stent strut thickness were non-significant with maximum mean difference of approximately 70 â€‹µm. CONCLUSION: We found no significant degradation in CT number accuracy or spatial resolution due to cardiac motion. The results demonstrate the potential of spectral UHR coronary CT angiography enabled by Si-PCD.


Subject(s)
Computed Tomography Angiography , Silicon , Humans , Computed Tomography Angiography/methods , Predictive Value of Tests , Tomography, X-Ray Computed/methods , Coronary Angiography/methods , Phantoms, Imaging
15.
Respir Investig ; 61(5): 660-667, 2023 Sep.
Article in English | MEDLINE | ID: mdl-37541165

ABSTRACT

BACKGROUND: The ATS/JRS/ALAT Guidelines for the Diagnosis of Hypersensitivity Pneumonitis (GL for HP) were published in 2020. Humidifier lung and summer-type HP are forms of HP, but it is unclear whether they can be diagnosed using GL for HP. This study examined the level of confidence where humidifier lung and summer-type HP can be diagnosed with GL for HP. METHODS: Data from 23 patients with humidifier lung and 20 patients with summer-type HP (mean age, 67.3 and 57.4 years, respectively) diagnosed between October 2012 and January 2022 were retrospectively reviewed. We evaluated high resolution computed tomography (HRCT) patterns, bronchoalveolar lavage fluid (BALF) findings, exposures, and histopathological findings to determine the level of confidence where a diagnosis of HP could be made using the GL for HP. RESULTS: HRCT pattern was classified as typical HP in 5 (22%) and compatible with HP in 18 (78%) patients with humidifier lung and considered as typical HP in 17 (85%) and compatible with HP in 3 (15%) patients with summer-type. The confidence level for diagnosis of HP was definite in 2 (8.7%), moderate in 14 (60.9%), and low in 7 (30.4%) patients with humidifier lung. It was definite in 12 (60%), high in 3 (15%), and moderate in 5 (25%) patients with summer-type HP. CONCLUSIONS: GL for HP showed utility in diagnosing humidifier lung in many patients with a moderate to low confidence. However, there was a definite to high confidence for patients with summer-type HP.


Subject(s)
Alveolitis, Extrinsic Allergic , Trichosporonosis , Humans , Trichosporonosis/pathology , Humidifiers , Retrospective Studies , Alveolitis, Extrinsic Allergic/diagnostic imaging , Alveolitis, Extrinsic Allergic/pathology , Lung/diagnostic imaging , Lung/pathology
16.
Cureus ; 15(5): e39254, 2023 May.
Article in English | MEDLINE | ID: mdl-37342730

ABSTRACT

Pulmonary alveolar proteinosis (PAP) is an extremely rare pulmonary disease that can be classified into primary, secondary, or congenital types. It typically presents with a pattern of interstitial lung disease. This rare condition is even rare in the adolescent or pediatric age group, making this case particularly rare and interesting. We report a case of a 15-year-old girl who presented with a four-month history of dry cough and exertional dyspnea. After performing a high-resolution computed tomography (HRCT) scan and bronchoalveolar lavage (BAL) with analysis of the BAL fluid, she was eventually diagnosed with PAP. She was then referred to a higher qualified center, where a whole lung lavage (WLL) was performed, resulting in significant improvement of her symptoms.

17.
Clin Imaging ; 101: 156-160, 2023 Sep.
Article in English | MEDLINE | ID: mdl-37369143

ABSTRACT

The atoll sign describes ring-shaped opacities surrounding central ground glass attenuation seen on chest CT and was first associated with organizing pneumonia. The name is derived from the Maldives' language, denoting a ring or crescentic-shaped coral reef island surrounding a central lagoon. Although biopsy is usually required for diagnosis, understanding some of the more common pathologies associated with the atoll sign may help narrow a differential and guide management.


Subject(s)
Pneumonia , Humans , Tomography, X-Ray Computed , Maldives
18.
World J Nucl Med ; 22(2): 87-99, 2023 Jun.
Article in English | MEDLINE | ID: mdl-37342239

ABSTRACT

Pulmonary metastases in thyroid carcinoma demonstrates varying imaging characteristics and disease biology and the outcome. The valuable complimentary role of high-resolution CT (HRCT) in conjunction with functional imaging such as radioiodine scan has been discussed and illustrated in this review along with the varied clinical and imaging presentations of lung metastases from differentiated thyroid cancer (DTC). A multi-modality patient-specific diagnostic approach and awareness about the atypical presentations helps in early identification as well as effective management of these patients, and especially in certain situations that could need multi-disciplinary management. While HRCT of the lungs as an added tool provides detailed visualization of the lung parenchyma, in the era of hybrid imaging, the routine adoption of SPECT-CT in patients with pulmonary metastases (in diagnostic or post-treatment settings) could provide equivalent or even incremental information from further management viewpoint.

19.
AJR Am J Roentgenol ; 221(3): 363-371, 2023 09.
Article in English | MEDLINE | ID: mdl-37095666

ABSTRACT

BACKGROUND. Photon-counting detector (PCD) CT has been shown to reduce radiation dose and improve image quality in adult chest CT examinations; its potential impact in pediatric CT is not well documented. OBJECTIVE. The purpose of our study was to compare radiation dose, objective image quality, and subjective image quality of PCD CT and energy-integrating detector (EID) CT in children undergoing high-resolution CT (HRCT) of the chest. METHODS. This retrospective study included 27 children (median age, 3.9 years; 10 girls, 17 boys) who underwent PCD CT between March 1, 2022, and August 31, 2022, and 27 children (median age, 4.0 years; 13 girls, 14 boys) who underwent EID CT between August 1, 2021, and January 31, 2022; all examinations comprised clinically indicated chest HRCT. The patients in the two groups were matched by age and water-equivalent diameter. Radiation dose parameters were recorded. One observer placed ROIs to measure objective parameters (lung attenuation, image noise, and SNR). Two radiologists independently assessed subjective measures (overall image quality and motion artifacts) using 5-point Likert scales (1 = highest quality). Groups were compared. RESULTS. PCD CT, in comparison with EID CT, showed lower median CTDIvol (0.41 vs 0.71 mGy, p < .001), DLP (10.2 vs 13.7 mGy × cm, p = .008), size-specific dose estimate (0.82 vs 1.34 mGy, p < .001), and tube current-exposure time product (48.0 vs 202.0 mAs, p < .001). PCD CT and EID CT showed no significant difference in right upper lobe (RUL) lung attenuation (mean, -793 vs -750 HU; p = .09), right lower lobe (RLL) lung attenuation (mean, -745 vs -716 HU; p = .23), RUL image noise (mean, 55 vs 51 HU; p = .27), RLL image noise (mean, 59 vs 57 HU; p = .48), RUL SNR (mean, -14.9 vs -15.8; p = .89), or RLL SNR (mean, -13.1 vs -13.6; p = .79). PCD CT and EID CT showed no significant difference in median overall image quality for reader 1 (1.0 vs 1.0, p = .28) or reader 2 (1.0 vs 1.0, p = .17) or median motion artifacts for reader 1 (1.0 vs 1.0, p = .07) or reader 2 (1.0 vs 1.0, p = .22). CONCLUSION. PCD CT showed significantly reduced dose levels without a significant difference in objective or subjective image quality compared with EID CT. CLINICAL IMPACT. These data expand understanding of the capabilities of PCD CT and support its routine use in children.


Subject(s)
Photons , Tomography, X-Ray Computed , Male , Adult , Female , Humans , Child , Child, Preschool , Retrospective Studies , Tomography, X-Ray Computed/methods , Lung , Phantoms, Imaging , Radiation Dosage
20.
Inflammopharmacology ; 31(2): 565-571, 2023 Apr.
Article in English | MEDLINE | ID: mdl-36961666

ABSTRACT

COVID-19 is often associated with long-lasting pulmonary symptoms. Data are scarce about interstitial lung disease (ILD) in patients following COVID-19 hospitalization with persistent symptoms. We retrospectively reviewed all cases sent to pulmonary post-COVID evaluation due to persistent symptoms between February 2021 and February 2022 (N = 318). All patients with suspected ILD (N = 44) were reviewed at the multidisciplinary discussion. Patient characteristics, symptoms, time since hospitalization, detailed lung function measurements and 6-min walk test (6MWT) were evaluated. The post-COVID ILD suspected group included more men (68.2 vs. 31.8%) with significantly older age compared to the control group (64.0 ± 12.3 vs. 51.3 ± 14.9 years). Most patient needed hospital care for COVID-19 pneumonia (68.6% of all patients and 84.1% of ILD suspected group) and average time since hospitalization was 2.4 ± 2.3 months. Persisting symptoms included fatigue (34%), dyspnoea (25.2%), cough (22.6%), and sleep disorders (insomnia 13.2%; sleepiness 8.2%). Post-COVID ILD presented more often with new symptoms of cough and sleepiness. Functional impairment, especially decreased walking distance and desaturation during 6-min walk test (6MWT) were detected in the ILD-suspected group. Respiratory function test in the post-COVID ILD group showed slight restrictive ventilatory pattern (FVC: 76.7 ± 18.1%, FEV1: 83.5 ± 19.1%, TLC: 85.6 ± 28.1%) and desaturation during 6MWT were detected in 41% of patients. LDCT changes were mainly ground glass opacities (GGO) and/or reticular abnormalities in most cases affecting < 10% of the lungs. Our data indicate that suspected post-COVID ILD is affecting 13.8% of symptomatic patients. High resolution chest CT changes were mainly low extent GGO/reticulation, while long-term lung structural changes need further evaluation.


Subject(s)
COVID-19 , Lung Diseases, Interstitial , Male , Humans , Cough/complications , Retrospective Studies , Sleepiness , COVID-19/complications , Lung Diseases, Interstitial/complications , Lung Diseases, Interstitial/diagnosis , Lung/diagnostic imaging
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