Recommendation of low-dose CT in the detection and management of COVID-2019
Identifieur interne : 000102 ( Pmc/Corpus ); précédent : 000101; suivant : 000103Recommendation of low-dose CT in the detection and management of COVID-2019
Auteurs : Zhen Kang ; Xu Li ; Shuchang ZhouSource :
- European Radiology [ 0938-7994 ] ; 2020.
Url:
DOI: 10.1007/s00330-020-06809-6
PubMed: NONE
PubMed Central: 7088271
Links to Exploration step
PMC:7088271Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Recommendation of low-dose CT in the detection and management of COVID-2019</title><author><name sortKey="Kang, Zhen" sort="Kang, Zhen" uniqKey="Kang Z" first="Zhen" last="Kang">Zhen Kang</name><affiliation><nlm:aff id="Aff1">Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Technology and Science, Jiefang Avenue, #1095, Wuhan, 430030 China</nlm:aff></affiliation></author><author><name sortKey="Li, Xu" sort="Li, Xu" uniqKey="Li X" first="Xu" last="Li">Xu Li</name><affiliation><nlm:aff id="Aff1">Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Technology and Science, Jiefang Avenue, #1095, Wuhan, 430030 China</nlm:aff></affiliation></author><author><name sortKey="Zhou, Shuchang" sort="Zhou, Shuchang" uniqKey="Zhou S" first="Shuchang" last="Zhou">Shuchang Zhou</name><affiliation><nlm:aff id="Aff1">Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Technology and Science, Jiefang Avenue, #1095, Wuhan, 430030 China</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmc">7088271</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7088271</idno><idno type="RBID">PMC:7088271</idno><idno type="doi">10.1007/s00330-020-06809-6</idno><idno type="pmid">NONE</idno><date when="2020">2020</date><idno type="wicri:Area/Pmc/Corpus">000102</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000102</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Recommendation of low-dose CT in the detection and management of COVID-2019</title><author><name sortKey="Kang, Zhen" sort="Kang, Zhen" uniqKey="Kang Z" first="Zhen" last="Kang">Zhen Kang</name><affiliation><nlm:aff id="Aff1">Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Technology and Science, Jiefang Avenue, #1095, Wuhan, 430030 China</nlm:aff></affiliation></author><author><name sortKey="Li, Xu" sort="Li, Xu" uniqKey="Li X" first="Xu" last="Li">Xu Li</name><affiliation><nlm:aff id="Aff1">Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Technology and Science, Jiefang Avenue, #1095, Wuhan, 430030 China</nlm:aff></affiliation></author><author><name sortKey="Zhou, Shuchang" sort="Zhou, Shuchang" uniqKey="Zhou S" first="Shuchang" last="Zhou">Shuchang Zhou</name><affiliation><nlm:aff id="Aff1">Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Technology and Science, Jiefang Avenue, #1095, Wuhan, 430030 China</nlm:aff></affiliation></author></analytic><series><title level="j">European Radiology</title><idno type="ISSN">0938-7994</idno><idno type="eISSN">1432-1084</idno><imprint><date when="2020">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Huang, C" uniqKey="Huang C">C Huang</name></author><author><name sortKey="Wang, Y" uniqKey="Wang Y">Y Wang</name></author><author><name sortKey="Li, X" uniqKey="Li X">X Li</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><pmc article-type="editorial"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Eur Radiol</journal-id><journal-id journal-id-type="iso-abbrev">Eur Radiol</journal-id><journal-title-group><journal-title>European Radiology</journal-title></journal-title-group><issn pub-type="ppub">0938-7994</issn><issn pub-type="epub">1432-1084</issn><publisher><publisher-name>Springer Berlin Heidelberg</publisher-name><publisher-loc>Berlin/Heidelberg</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmc">7088271</article-id><article-id pub-id-type="publisher-id">6809</article-id><article-id pub-id-type="doi">10.1007/s00330-020-06809-6</article-id><article-categories><subj-group subj-group-type="heading"><subject>Editorial</subject></subj-group></article-categories><title-group><article-title>Recommendation of low-dose CT in the detection and management of COVID-2019</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Kang</surname><given-names>Zhen</given-names></name><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Li</surname><given-names>Xu</given-names></name><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Zhou</surname><given-names>Shuchang</given-names></name><address><email>zhoushuchang2020@163.com</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><aff id="Aff1">Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Technology and Science, Jiefang Avenue, #1095, Wuhan, 430030 China</aff></contrib-group><pub-date pub-type="epub"><day>19</day><month>3</month><year>2020</year></pub-date><fpage>1</fpage><lpage>2</lpage><history><date date-type="received"><day>25</day><month>2</month><year>2020</year></date><date date-type="rev-recd"><day>10</day><month>3</month><year>2020</year></date><date date-type="accepted"><day>13</day><month>3</month><year>2020</year></date></history><permissions><copyright-statement>© European Society of Radiology 2020</copyright-statement><license><license-p>This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.</license-p></license></permissions></article-meta></front><body><p id="Par1">CT imaging plays an important role in the diagnosis of COVID-2019, especially in the early stages of the disease or with a low viral load; swab tests may be negative [<xref ref-type="bibr" rid="CR1">1</xref>]. Fang Y et al reported a sensitivity of 98% for chest CT diagnosis of COVID-2019, while RT-PCR serves as the gold standard; its early sensitivity was only 71% [<xref ref-type="bibr" rid="CR2">2</xref>]. The vast majority, 98%, show bilateral lung involvement. The typical chest CT findings of non-ICU patients are bilateral ground-glass opacity and sub-segmental consolidation, while the typical chest CT findings of ICU patients are bilateral multi-lobe and sub-segmental consolidation [<xref ref-type="bibr" rid="CR3">3</xref>]. The affected lungs are mostly located in the peripheral zone. Other imaging features include linear opacities, “crazy-paving” pattern, and the “reverse halo” sign [<xref ref-type="bibr" rid="CR4">4</xref>]. According to the COVID-2019 pneumonia diagnosis and treatment scheme of the People’s Republic of China (trial version 5), imaging features can upgrade suspected cases of new coronavirus pneumonia to clinical diagnosis.</p><p id="Par2">In the face of the sudden, rapid progress of the outbreak, patients need close clinical observation. This includes recurrent CT to determine the progression or absorption of lesions in the lung within a short period of time, especially for severe cases. Inflammatory absorption of the lungs on CT imaging is also one of the criteria for release from isolation and discharge in the guidelines from the first edition to the sixth edition. Actually, the number of CT scans ranges from 3 to 6 [<xref ref-type="bibr" rid="CR5">5</xref>] within a short period of time. Even healthy people may get one CT or even two to ensure they do not have COVID-2019. Medical radiation exposure is therefore a concern, because the population is made of patients of all ages, including young individuals, infants, and puerperae, for whom the radiation dose is even a greater concern.</p><p id="Par3">With the advantages of an improved detector, high-pitch settings, lower tube voltage (80–100 kVp) and current (10–25 mAs), iterative reconstruction, and dose-reduction options, it is now feasible to minimize the radiation dose. We implemented a low-dose scanning protocol that reduced the patient’s dose to 1/8 to 1/9 of the standard dose. In addition to all the abovementioned reduction dose strategy, we used energy spectrum tin-filtering technology (Sn100 low-dose protocol, Turbo Flash, SOMATOM Force, Siemens Healthineers).</p><p id="Par4">The dose-length product (DLP) and effective dose (ED) were 14.5 mGy cm and 0.203 mSv compared with 129.1 mGy cm and 1.8074 mSv in a standard-dose protocol, without significant sacrifice of signal-to-noise (SNR) or contrast-to-noise (CNR) ratios (Table <xref rid="Tab1" ref-type="table">1</xref> and Fig. <xref rid="Fig1" ref-type="fig">1</xref>). Thus, the cumulative radiation dose of serial CT examinations during the acute period might be inferior or equivalent to that of a conventional CT.<table-wrap id="Tab1"><label>Table 1</label><caption><p>Parameters of protocols of low-dose vs. standard-dose</p></caption><table frame="hsides" rules="groups"><thead><tr><th>Parameters</th><th>Low-dose protocol</th><th>Standard-dose protocol</th></tr></thead><tbody><tr><td>Kv</td><td>Sn100</td><td>100</td></tr><tr><td>mAs/ref.</td><td>112/96</td><td>85/62</td></tr><tr><td>CTDIvol*, mGy</td><td>0.39 L</td><td>3.44 L</td></tr><tr><td>DLP, mGy cm</td><td>14.5</td><td>129.1</td></tr><tr><td>TI, s</td><td>0.25</td><td>0.5</td></tr><tr><td>cSL, mm</td><td>0.6</td><td>0.6</td></tr><tr><td>ED, mSv</td><td>0.203</td><td>1.8074</td></tr><tr><td>SNR</td><td>0.47</td><td>0.78</td></tr><tr><td>CNR</td><td>1.09</td><td>3.79</td></tr></tbody></table><table-wrap-foot><p><italic>cSL</italic>, collimation slice; <italic>TI</italic>, inversion time</p></table-wrap-foot></table-wrap><fig id="Fig1"><label>Fig. 1</label><caption><p>COVID-2019 pneumonia was diagnosed in two adults of similar height, body size, and age, with typical CT manifestation of ground-glass opacification in the peripheral zone. Excellent image quality is obtained both in low-dose protocol (<bold>a</bold>) and standard-dose protocol (<bold>b</bold>)</p></caption><graphic xlink:href="330_2020_6809_Fig1_HTML" id="MO1"></graphic></fig></p><p id="Par5">As the main expected lesions are within the lung parenchyma, a low-dose protocol is certainly the way to go.</p></body><back><fn-group><fn><p><bold>Publisher’s note</bold></p><p>Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.</p></fn></fn-group><notes notes-type="funding-information"><title>Funding information</title><p>The authors state that this work has not received any funding.</p></notes><notes notes-type="ethics"><title>Compliance with ethical standards</title><notes><title>Guarantor</title><p id="Par6">The scientific guarantor of this publication is Shuchang Zhou.</p></notes><notes notes-type="COI-statement"><title>Conflict of interest</title><p id="Par7">The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.</p></notes><notes><title>Statistics and biometry</title><p id="Par8">No complex statistical methods were necessary for this paper.</p></notes><notes><title>Informed consent</title><p id="Par9">Written informed consent was waived by the Institutional Review Board.</p></notes><notes><title>Ethical approval</title><p id="Par10">Institutional Review Board approval was obtained.</p></notes><notes><title>Methodology</title><p>• Not applicable</p></notes></notes><ref-list id="Bib1"><title>References</title><ref id="CR1"><label>1.</label><mixed-citation publication-type="other">Xie X, Zhong Z, Zhao W, Zheng C, Wang F, Liu J (2020) Chest CT for typical 2019-nCoV pneumonia: relationship to negative RT-PCR testing. Radiology. 10.1148/radiol.2020200343:200343</mixed-citation></ref><ref id="CR2"><label>2.</label><mixed-citation publication-type="other">Fang Y, Zhang H, Xie J et al (2020) Sensitivity of chest CT for COVID-19: comparison to RT-PCR. Radiology. 10.1148/radiol.2020200432:200432</mixed-citation></ref><ref id="CR3"><label>3.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Huang</surname><given-names>C</given-names></name><name><surname>Wang</surname><given-names>Y</given-names></name><name><surname>Li</surname><given-names>X</given-names></name><etal></etal></person-group><article-title>Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China</article-title><source>Lancet</source><year>2020</year><volume>395</volume><fpage>497</fpage><lpage>506</lpage><pub-id pub-id-type="doi">10.1016/S0140-6736(20)30183-5</pub-id><pub-id pub-id-type="pmid">31986264</pub-id></element-citation></ref><ref id="CR4"><label>4.</label><mixed-citation publication-type="other">Bernheim A, Mei X, Huang M et al (2020) Chest CT findings in coronavirus disease-19 (COVID-19): relationship to duration of infection. Radiology. 10.1148/radiol.2020200463:200463</mixed-citation></ref><ref id="CR5"><label>5.</label><mixed-citation publication-type="other">Pan F, Ye T, Sun P et al (2020) Time course of lung changes on chest CT during recovery from 2019 novel coronavirus (COVID-19) pneumonia. Radiology. 10.1148/radiol.2020200370:200370</mixed-citation></ref></ref-list></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/CovidV2/Data/Pmc/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000102 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd -nk 000102 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Sante
|area= CovidV2
|flux= Pmc
|étape= Corpus
|type= RBID
|clé= PMC:7088271
|texte= Recommendation of low-dose CT in the detection and management of COVID-2019
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/RBID.i -Sk "pubmed:NONE" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd \
| NlmPubMed2Wicri -a CovidV2
| This area was generated with Dilib version V0.6.33. |  |