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.

Autor: Wassipaul C; Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria., Kifjak D; Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.; Department of Radiology, UMass Memorial Medical Center and University of Massachusetts Chan Medical School, Worcester, MA, USA., Milos RI; Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria., Prayer F; Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.; Imaging Verbund, Vienna, Austria., Roehrich S; Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.; contextflow GmbH, Vienna, Austria., Winter M; Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria., Beer L; Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria., Watzenboeck ML; Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria., Pochepnia S; Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria., Weber M; Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria., Tamandl D; Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria., Homolka P; Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria., Birkfellner W; Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria., Ringl H; Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.; Department of Diagnostic and Interventional Radiology, Clinic Donaustadt, Vienna Healthcare Group, Vienna, Austria., Prosch H; Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria., Heidinger BH; Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria. benedikt.heidinger@meduniwien.ac.at.
Jazyk: angličtina
Zdroj: European radiology [Eur Radiol] 2024 Nov; Vol. 34 (11), pp. 7244-7254. Date of Electronic Publication: 2024 May 09.
DOI: 10.1007/s00330-024-10754-z
Abstrakt: 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.
(© 2024. The Author(s).)
Databáze: MEDLINE
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