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Evaluation of Ultra-Low-Dose Chest Computed Tomography Images in Detecting Lung Lesions Related to COVID-19: A Prospective Study

Zarei, F and Jalli, R and Chatterjee, S and Haghighi, RR and Iranpour, P and Chatterjee, VV and Emadi, S (2022) Evaluation of Ultra-Low-Dose Chest Computed Tomography Images in Detecting Lung Lesions Related to COVID-19: A Prospective Study. In: Iranian Journal of Medical Sciences, 47 (4). pp. 338-349.

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Official URL: https://doi.org/10.30476/ijms.2021.90665.2165


Background: The present study aimed to evaluate the effectiveness of ultra-low-dose (ULD) chest computed tomography (CT) in comparison with the routine dose (RD) CT images in detecting lung lesions related to COVID-19. Methods: A prospective study was conducted during April-September 2020 at Shahid Faghihi Hospital affiliated with Shiraz University of Medical Sciences, Shiraz, Iran. In total, 273 volunteers with suspected COVID-19 participated in the study and successively underwent RD-CT and ULD-CT chest scans. Two expert radiologists qualitatively evaluated the images. Dose assessment was performed by determining volume CT dose index, dose length product, and size-specific dose estimate. Data analysis was performed using a ranking test and kappa coefficient (κ). P<0.05 was considered statistically significant. Results: Lung lesions could be detected with both RD-CT and ULD-CT images in patients with suspected or confirmed COVID-19 (κ=1.0, P=0.016). The estimated effective dose for the RD-CT protocol was 22-fold higher than in the ULD-CT protocol. In the case of the ULD-CT protocol, sensitivity, specificity, accuracy, and positive predictive value for the detection of consolidation were 60, 83, 80, and 20, respectively. Comparably, in the case of RD-CT, these percentages for the detection of ground-glass opacity (GGO) were 62, 66, 66, and 18, respectively. Assuming the result of real-time polymerase chain reaction as true-positive, analysis of the receiver-operating characteristic curve for GGO detected using the ULD-CT protocol showed a maximum area under the curve of 0.78. Conclusion: ULD-CT, with 94 dose reduction, can be an alternative to RD-CT to detect lung lesions for COVID-19 diagnosis and follow-up. An earlier preliminary report of a similar work with a lower sample size was submitted to the arXive as a preprint.

Item Type: Journal Article
Publication: Iranian Journal of Medical Sciences
Publisher: Shriaz University of Medical Sciences
Additional Information: The copyright for this article belongs to the Shriaz University of Medical Sciences.
Keywords: diagnostic imaging; human; lung; procedures; prospective study; radiation dose; x-ray computed tomography, COVID-19; COVID-19 Testing; Humans; Lung; Prospective Studies; Radiation Dosage; Tomography, X-Ray Computed
Department/Centre: Division of Physical & Mathematical Sciences > Instrumentation Appiled Physics
Date Deposited: 30 Aug 2022 11:56
Last Modified: 30 Aug 2022 11:56
URI: https://eprints.iisc.ac.in/id/eprint/76280

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