Do submillisievert-chest CT protocols impact diagnostic quality in suspected COVID-19 patients?

Thieß, Hans-Martin; Bressem, Keno K.; Adams, Lisa C.; Böning, Georg; Vahldiek, Janis L.; Niehues, Stefan M.

doi:10.1177/20584601211073864

Cited by 4 publications

(2 citation statements)

References 25 publications

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“…Thieß HM et al . [ 13 ] demonstrated appropriate image quality with good inter-reader and intra-reader agreement in patients undergoing low-dose chest CT for detection of SARS-CoV-2 infection.…”

Section: Discussionmentioning

confidence: 99%

Development and implementation of optimized chest CT protocol in COVID-19

Pandya

Shinde²,

Patel

et al. 2022

Journal of Family Medicine and Primary Care

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Background: Several studies have justified use of chest computed tomography (CT) in diagnosis, evaluation of severity, treatment response, and complications of coronavirus disease 2019 (COVID-19) pneumonia. Increased utilization of CT in patients with known or suspected COVID-19 pneumonia has resulted in concerns of overuse, lack of protocol optimization, and radiation exposure. Aims: The study was conducted to develop and implement optimized protocol for chest CT for reducing radiation dose in adult patients suspected or diagnosed to have COVID-19 infection. Setting and Design: The study was conducted in the department of radiology of a rural tertiary care teaching hospital in western India. Clinical audit was used as a tool to impart and assess the impact of optimized chest CT protocol. Methods and Material: The pre-intervention audit included radiation dosimetry data, number of phases and length of scan of 50 adult patients, undergoing non-contrast chest CT scans in March 2021. A brief educational intervention outlining the parameters of optimized protocol was conducted on April 1, 2021.The post-intervention audit consisted of two cycles for 109 and 67 chest CT scans in the months April and May 2021. Results: The optimized protocol was found clinically adequate with a good inter-rater reliability. The compliance to the optimized protocol was weak in audit cycle 2, which improved significantly in audit cycle 3 after reinforcement. The mean (SD) per scan Computed Tomography Dose Index-Volume (CTDI-vol) reduced significantly across audit cycles [22.06 (12. 31) Vs. 10.58 (7.58) Vs. 4.51 (2.90) milli Gray, respectively, P < 0.001]. Similar findings were noted for Dose Length Product (DLP). Conclusion: Clinical audit of chest CT protocol and resultant radiation doses provided adequate feedback for dose optimization. A simple educational intervention helped achieve dose optimization.

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Section: Discussionmentioning

confidence: 99%

Development and implementation of optimized chest CT protocol in COVID-19

Pandya

Shinde²,

Patel

et al. 2022

Journal of Family Medicine and Primary Care

View full text Add to dashboard Cite

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“…To assess subjective image quality, we evaluated noise on a 5-point Likert scale (1, unacceptable noise; 2, above-average noise; 3, average noise; 4, less-than-average noise; 5, minimal noise). Disagreements were resolved by consensus [ 25 , 26 ].…”

Section: Methodsmentioning

confidence: 99%

X-ray Microtomography to Assess Determinants of In Vivo N-Butyl Cyanoacrylate Glubran®2 Polymerization: A Rabbit-Model Study

et al. 2022

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Although introduced decades ago, few cyanoacrylate glues have been approved for endovascular use, despite evidence of their usefulness, notably for complex procedures suchas hemostatic embolization. Indications include massive bleeding requiring emergent hemostasis and prevention of severe bleeding during scheduled surgery to remove a hypervascular tumor. Adding radiopaque Lipiodol Ultra Fluid® (LUF) modulates glue polymerization and allows fluoroscopic guidance, but few comparative in vivo studies have assessed the impact of the resulting change in glue concentration or of other factors such as target-vessel blood flow. In a rabbit model, we used ex vivo X-ray microtomography to assess the results of in vivo renal-artery embolization by various mixtures of N-butyl cyanoacrylate (NBCA), metacryloxysulfolane, and LUF. Overall, penetration to the superficial interlobular arteries was achieved in about two-thirds of cases and into the capillaries in nearly half the cases, while cast fragmentation was seen in slightly more than half the cases. Greater NBCA dilution and the blocked-blood-flow technique were independently associated with greater distality of penetration. Blocked-blood-flow injection was independently associated with absence of fragmentation, capillary penetration, a shorter cast-to-capsule distance, and higher cast attenuation. A larger mixture volume was independently associated with higher indexed cast ratio and deeper penetration. Finally, microtomography is an adapted tool to assess ex vivo distribution of glue cast.

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Low-dose ionizing radiation as a factor increasing cardiovascular mortality: is there a risk from multiple computed tomographies in the context of COVID-19 pandemic?

Koterov

Ushenkova

2022

Russ J Cardiol

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The review aim was to familiarize biomedical professionals with the latest evidence-based data on the effect of sparsely ionizing radiation (X-ray, γ- and β-radiation) on cardiovascular mortality (ICD-9: 390-459; ICD-10: I00-I99), which is especially important during the coronavirus disease 2019 (COVID-19) pandemic due to the increased use of computed tomography (CT) and X-ray procedures. Information is presented on the officially accepted range of radiation doses (very low doses — 0-0,01 Gy, low doses — 0,01-0,1 Gy, moderate doses — 0,1- 1,0 Gy, high doses — over 1 Gy). The evolution of ideas about the effects of radiation on the prevalence of cardiovascular diseases is discussed: from high and very high doses to the declaration in recent years of the possible effect of low doses. The statements from the documents of authoritative radiation organizations (UNSCEAR, ICRP, NCRP, EPA, etc.) are given, according to which the threshold for increasing cardiovascular mortality is 0,5 Gy (range of moderate doses), and there are no epidemiological justifications for the effects of low doses. According to a data for six countries, the maximum cumulative doses from multiple CT scans for COVID-19 diagnosis are one order less than the threshold dose, and the average cumulative doses are two orders less. Data on the absence or low risk of cancer after CT for this reason are also presented.

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Do submillisievert-chest CT protocols impact diagnostic quality in suspected COVID-19 patients?

Cited by 4 publications

References 25 publications

Development and implementation of optimized chest CT protocol in COVID-19

Development and implementation of optimized chest CT protocol in COVID-19

X-ray Microtomography to Assess Determinants of In Vivo N-Butyl Cyanoacrylate Glubran®2 Polymerization: A Rabbit-Model Study

Low-dose ionizing radiation as a factor increasing cardiovascular mortality: is there a risk from multiple computed tomographies in the context of COVID-19 pandemic?

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