Ultra-low-dose vs. standard-of-care-dose CT of the chest in patients with post-COVID-19 conditions—a prospective intra-patient multi-reader study.
Saved in:
| Title: | Ultra-low-dose vs. standard-of-care-dose CT of the chest in patients with post-COVID-19 conditions—a prospective intra-patient multi-reader study. |
|---|---|
| Authors: | Wassipaul, Christian1 (AUTHOR), Kifjak, Daria1,2 (AUTHOR), Milos, Ruxandra-Iulia1 (AUTHOR), Prayer, Florian1,3 (AUTHOR), Roehrich, Sebastian1,4 (AUTHOR), Winter, Melanie1 (AUTHOR), Beer, Lucian1 (AUTHOR), Watzenboeck, Martin L.1 (AUTHOR), Pochepnia, Svitlana1 (AUTHOR), Weber, Michael1 (AUTHOR), Tamandl, Dietmar1 (AUTHOR), Homolka, Peter5 (AUTHOR), Birkfellner, Wolfgang5 (AUTHOR), Ringl, Helmut1,6 (AUTHOR), Prosch, Helmut1 (AUTHOR), Heidinger, Benedikt H.1 (AUTHOR) benedikt.heidinger@meduniwien.ac.at |
| Source: | European Radiology. Nov2024, Vol. 34 Issue 11, p7244-7254. 11p. |
| Subjects: | COVID-19 pandemic, Computed tomography, COVID-19, Chest X rays, Radiation exposure |
| Abstract: | Objectives: To conduct an intrapatient comparison of ultra-low-dose computed tomography (ULDCT) and standard-of-care-dose CT (SDCT) of the chest in terms of the diagnostic accuracy of ULDCT and intrareader agreement in patients with post-COVID conditions. Methods: We prospectively included 153 consecutive patients with post-COVID-19 conditions. All participants received an SDCT and an additional ULDCT scan of the chest. SDCTs were performed with standard imaging parameters and ULDCTs at a fixed tube voltage of 100 kVp (with tin filtration), 50 ref. mAs (dose modulation active), and iterative reconstruction algorithm level 5 of 5. All CT scans were separately evaluated by four radiologists for the presence of lung changes and their consistency with post-COVID lung abnormalities. Radiation dose parameters and the sensitivity, specificity, and accuracy of ULDCT were calculated. Results: Of the 153 included patients (mean age 47.4 ± 15.3 years; 48.4% women), 45 (29.4%) showed post-COVID lung abnormalities. In those 45 patients, the most frequently detected CT patterns were ground-glass opacities (100.0%), reticulations (43.5%), and parenchymal bands (37.0%). The accuracy, sensitivity, and specificity of ULDCT compared to SDCT for the detection of post-COVID lung abnormalities were 92.6, 87.2, and 94.9%, respectively. The median total dose length product (DLP) of ULDCTs was less than one-tenth of the radiation dose of our SDCTs (12.6 mGy*cm [9.9; 15.5] vs. 132.1 mGy*cm [103.9; 160.2]; p < 0.001). Conclusion: ULDCT of the chest offers high accuracy in the detection of post-COVID lung abnormalities compared to an SDCT scan at less than one-tenth the radiation dose, corresponding to only twice the dose of a standard chest radiograph in two views. Clinical relevance statement: Ultra-low-dose CT of the chest may provide a favorable, radiation-saving alternative to standard-dose CT in the long-term follow-up of the large patient cohort of post-COVID-19 patients. Key Points: CT is the modality of choice for follow-up of patients with post-COVID-19 conditions but is associated with radiation exposure. Ultra-low-dose CT of the chest offers excellent intrareader agreement and high accuracy compared to standard-dose CT in this population. Ultra-low-dose CT of the chest provides a radiation-saving alternative to standard-dose CT in the follow-up of post-COVID patients. [ABSTRACT FROM AUTHOR] |
| Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Engineering Source |
|
Full text is not displayed to guests.
Login for full access.
|
|
| Abstract: | Objectives: To conduct an intrapatient comparison of ultra-low-dose computed tomography (ULDCT) and standard-of-care-dose CT (SDCT) of the chest in terms of the diagnostic accuracy of ULDCT and intrareader agreement in patients with post-COVID conditions. Methods: We prospectively included 153 consecutive patients with post-COVID-19 conditions. All participants received an SDCT and an additional ULDCT scan of the chest. SDCTs were performed with standard imaging parameters and ULDCTs at a fixed tube voltage of 100 kVp (with tin filtration), 50 ref. mAs (dose modulation active), and iterative reconstruction algorithm level 5 of 5. All CT scans were separately evaluated by four radiologists for the presence of lung changes and their consistency with post-COVID lung abnormalities. Radiation dose parameters and the sensitivity, specificity, and accuracy of ULDCT were calculated. Results: Of the 153 included patients (mean age 47.4 ± 15.3 years; 48.4% women), 45 (29.4%) showed post-COVID lung abnormalities. In those 45 patients, the most frequently detected CT patterns were ground-glass opacities (100.0%), reticulations (43.5%), and parenchymal bands (37.0%). The accuracy, sensitivity, and specificity of ULDCT compared to SDCT for the detection of post-COVID lung abnormalities were 92.6, 87.2, and 94.9%, respectively. The median total dose length product (DLP) of ULDCTs was less than one-tenth of the radiation dose of our SDCTs (12.6 mGy*cm [9.9; 15.5] vs. 132.1 mGy*cm [103.9; 160.2]; p < 0.001). Conclusion: ULDCT of the chest offers high accuracy in the detection of post-COVID lung abnormalities compared to an SDCT scan at less than one-tenth the radiation dose, corresponding to only twice the dose of a standard chest radiograph in two views. Clinical relevance statement: Ultra-low-dose CT of the chest may provide a favorable, radiation-saving alternative to standard-dose CT in the long-term follow-up of the large patient cohort of post-COVID-19 patients. Key Points: CT is the modality of choice for follow-up of patients with post-COVID-19 conditions but is associated with radiation exposure. Ultra-low-dose CT of the chest offers excellent intrareader agreement and high accuracy compared to standard-dose CT in this population. Ultra-low-dose CT of the chest provides a radiation-saving alternative to standard-dose CT in the follow-up of post-COVID patients. [ABSTRACT FROM AUTHOR] |
|---|---|
| ISSN: | 09387994 |
| DOI: | 10.1007/s00330-024-10754-z |
