Evaluating Lung Changes in Long COVID: Ultra-Low-Dose vs. Standard-Dose CT Chest.

IF 2.7 4区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY British Journal of Biomedical Science Pub Date : 2024-09-10 eCollection Date: 2024-01-01 DOI:10.3389/bjbs.2024.13385
Shritik Devkota, Mandeep Garg, Uma Debi, Sahajal Dhooria, Ashish Dua, Nidhi Prabhakar, Saumya Soni, Muniraju Maralakunte, Ajay Gulati, Tarvinder Singh, Manavjit Singh Sandhu
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Abstract

Background: Frequent chest CTs within a short period during follow-up of long COVID patients may increase the risk of radiation-related health effects in the exposed individuals. We aimed to assess the image quality and diagnostic accuracy of ultra-low-dose CT (ULDCT) chest compared to standard-dose CT (SDCT) in detecting lung abnormalities associated with long COVID.

Methods: In this prospective study, 100 long COVID patients with respiratory dysfunction underwent SDCT and ULDCT chest that were compared in terms of objective (signal-to-noise ratio, SNR) and subjective image quality (image graininess, sharpness, artifacts, and diagnostic accuracy along with the European guidelines on image quality criteria for CT chest), detection of imaging patterns of long COVID, CT severity score, and effective radiation dose. Additionally, the diagnostic performance of ULDCT was compared among obese (BMI≥30 kg/m2) and non-obese (BMI<30 kg/m2) subjects.

Results: The mean age of study participants was 53 ± 12.9 years, and 68% were male. The mean SNR was 31.4 ± 5.5 and 11.3 ± 4.6 for SDCT and ULDCT respectively (p< 0.0001). Common findings seen on SDCT included ground-glass opacities (GGOs, 77%), septal thickening/reticulations (67%), atelectatic/parenchymal bands (63%) and nodules (26%). ULDCT provided sharp images, with no/minimal graininess, and high diagnostic confidence in 81%, 82% and 80% of the cases respectively. The sensitivity of ULDCT for various patterns of long COVID was 72.7% (GGOs), 71.6% (interlobular septal thickening/reticulations), 100% (consolidation), 81% (atelectatic/parenchymal bands) and 76.9% (nodules). ULDCT scans in non-obese subjects exhibited a significantly higher sensitivity (88% vs. 60.3%, p < 0.0001) and diagnostic accuracy (97.7% vs. 84.9%, p < 0.0001) compared to obese subjects. ULDCT showed very strong correlation with SDCT in terms of CT severity score (r = 0.996, p < 0.0001). The mean effective radiation dose with ULDCT was 0.25 ± 0.02 mSv with net radiation dose reduction of 94.8% ± 1.7% (p < 0.0001) when compared to SDCT (5.5 ± 1.96 mSv).

Conclusion: ULDCT scans achieved comparable diagnostic accuracy to SDCT for detecting long COVID lung abnormalities in non-obese patients, while significantly reducing radiation exposure.

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评估长 COVID 的肺部变化:超低剂量与标准剂量胸部 CT。
背景:在长COVID患者的随访期间,短期内频繁进行胸部CT检查可能会增加受辐射者受到辐射相关健康影响的风险。我们旨在评估超低剂量胸部 CT(ULDCT)与标准剂量 CT(SDCT)相比在检测与长 COVID 相关的肺部异常方面的图像质量和诊断准确性:在这项前瞻性研究中,100 名呼吸功能障碍的长 COVID 患者分别接受了 SDCT 和超低剂量 CT 胸部检查,并在客观(信噪比、SNR)和主观图像质量(图像颗粒度、清晰度、伪影和诊断准确性,参照欧洲胸部 CT 图像质量标准指南)、长 COVID 影像模式检测、CT 严重程度评分和有效辐射剂量等方面进行了比较。此外,还比较了肥胖(BMI≥30 kg/m2)和非肥胖(BMI2)受试者的 ULDCT 诊断性能:研究对象的平均年龄为(53 ± 12.9)岁,68%为男性。SDCT和ULDCT的平均信噪比分别为(31.4 ± 5.5)和(11.3 ± 4.6)(P< 0.0001)。SDCT 的常见发现包括磨玻璃不透光(GGOs,77%)、室间隔增厚/网状结构(67%)、无电/胸膜带(63%)和结节(26%)。ULDCT 可提供清晰的图像,无/极少颗粒感,诊断可信度高的病例分别占 81%、82% 和 80%。ULDCT 对各种形态的长 COVID 的敏感性分别为 72.7%(GGOs)、71.6%(小叶间隔增厚/网状)、100%(合并)、81%(无脑/脑膜带)和 76.9%(结节)。与肥胖受试者相比,非肥胖受试者的 ULDCT 扫描敏感性(88% 对 60.3%,P < 0.0001)和诊断准确性(97.7% 对 84.9%,P < 0.0001)明显更高。在 CT 严重程度评分方面,ULDCT 与 SDCT 显示出非常强的相关性(r = 0.996,p < 0.0001)。与SDCT(5.5 ± 1.96 mSv)相比,ULDCT的平均有效辐射剂量为0.25 ± 0.02 mSv,净辐射剂量减少了94.8% ± 1.7% (p < 0.0001):在检测非肥胖患者长COVID肺部异常方面,ULDCT扫描的诊断准确性与SDCT相当,同时显著降低了辐射剂量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
British Journal of Biomedical Science
British Journal of Biomedical Science 医学-医学实验技术
CiteScore
4.40
自引率
15.80%
发文量
29
审稿时长
>12 weeks
期刊介绍: The British Journal of Biomedical Science is committed to publishing high quality original research that represents a clear advance in the practice of biomedical science, and reviews that summarise recent advances in the field of biomedical science. The overall aim of the Journal is to provide a platform for the dissemination of new and innovative information on the diagnosis and management of disease that is valuable to the practicing laboratory scientist.
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