Do submillisievert-chest CT protocols impact diagnostic quality in suspected COVID-19 patients?. (8th January 2022)

• Record Type: Journal Article
• Authors: Thieß, Hans-Martin; Bressem, Keno K; Adams, Lisa; Böning, Georg; Vahldiek, Janis L; Niehues, Stefan M
• Is Part Of: Acta radiologica open. Volume 11:Number 1(2022)
• Publication Date: 2022-01-08
• Subjects: Lung -- COVID-19 -- low-dose CT -- adults -- radiation safety -- image quality; Radiology -- Periodicals; Diagnostic Imaging -- Periodicals; Radiology; Periodicals; 616.075705
• DOI: 10.1177/20584601211073864
• Languages: English
• ISSNs: 2058-4601

Abstract

Background: During the ongoing global SARS-CoV-2 pandemic, there is a high demand for quick and reliable methods for early identification of infected patients. Due to its widespread availability, chest-CT is commonly used to detect early pulmonary manifestations and for follow-ups. Purpose: This study aims to analyze image quality and reproducibility of readings of scans using low-dose chest CT protocols in patients suspected of SARS-CoV-2 infection. Materials and Methods: Two radiologists retrospectively analyzed 100 low-dose chest CT scans of patients suspected of SARS-CoV-2 infection using two protocols on devices from two vendors regarding image quality based on a Likert scale. After 3 weeks, quality ratings were repeated to allow for analysis of intra-reader in addition to the inter-reader agreement. Furthermore, radiation dose and presence as well as distribution of radiological features were noted. Results: The exams' effective radiation doses were in median in the submillisievert range (median of 0.53 mSv, IQR: 0.35 mSv). While most scans were rated as being of optimal quality, 38% of scans were scored as suboptimal, yet only one scan was non-diagnostic. Inter-reader and intra-reader reliability showed almost perfect agreement with Cohen's kappa of 0.82 and 0.87. Conclusion: Overall, in this study, we present two protocols for submillisievert low-dose chest CT demonstrating appropriate or better image quality with almost perfect inter-reader and intra-reader agreement in patients suspected of SARS-CoV-2 infection.