Imaging algorithm for COVID-19: A practical approach

Ghosh, Subha; Deshwal, Himanshu; Saeedan, Mnahi Bin; Khanna, Vineet; Raoof, Suhail; Mehta, Atul C.

doi:10.1016/j.clinimag.2020.11.022

Cited by 15 publications

(8 citation statements)

References 40 publications

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“…Despite showing promise as a useful imaging modality in COVID-19 patients, the main evidence for the use of ultrasound come from small case series, tutorials, and opinion articles, and there are no large-scale studies examining its utility. The current guidelines from the major radiological societies for lung imaging in COVID-19 state no official role for the use of ultrasound and it is mainly an investigational tool at this time[ 39 ]. The use of point of care ultrasound (POCUS) will be further discussed in a later section.…”

Section: Current State Of Affairsmentioning

confidence: 99%

COVID-19 imaging: Diagnostic approaches, challenges, and evolving advances

Pezzutti

Wadhwa

Makary

2021

WJR

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The role of radiology and the radiologist have evolved throughout the coronavirus disease-2019 (COVID-19) pandemic. Early on, chest computed tomography was used for screening and diagnosis of COVID-19; however, it is now indicated for high-risk patients, those with severe disease, or in areas where polymerase chain reaction testing is sparsely available. Chest radiography is now utilized mainly for monitoring disease progression in hospitalized patients showing signs of worsening clinical status. Additionally, many challenges at the operational level have been overcome within the field of radiology throughout the COVID-19 pandemic. The use of teleradiology and virtual care clinics greatly enhanced our ability to socially distance and both are likely to remain important mediums for diagnostic imaging delivery and patient care. Opportunities to better utilize of imaging for detection of extrapulmonary manifestations and complications of COVID-19 disease will continue to arise as a more detailed understanding of the pathophysiology of the virus continues to be uncovered and identification of predisposing risk factors for complication development continue to be better understood. Furthermore, unidentified advancements in areas such as standardized imaging reporting, point-of-care ultrasound, and artificial intelligence offer exciting discovery pathways that will inevitably lead to improved care for patients with COVID-19.

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Section: Current State Of Affairsmentioning

confidence: 99%

COVID-19 imaging: Diagnostic approaches, challenges, and evolving advances

Pezzutti

Wadhwa

Makary

2021

WJR

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“…The disease associated with an acute infection by SARS-CoV-2 was coined COVID-19 and became a pandemic by March 2020, causing over 5.5 million deaths worldwide as of December 2021 [ 1 , 2 ]. The clinical manifestations of COVID-19 typically include respiratory involvement with cough and dyspnea, as well as systemic signs and symptoms such as fever, fatigue, myalgia, and arthralgia, among others [ 1 ]. Some degree of cardiovascular involvement is observed in 20–30% of hospitalized cases, raising to 55% in the presence of a pre-existing cardiovascular disease [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Advanced Imaging Supports the Mechanistic Role of Autoimmunity and Plaque Rupture in COVID-19 Heart Involvement

Laino

Ammirabile

Motta

et al. 2022

Clinic Rev Allerg Immunol

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The cardiovascular system is frequently affected by coronavirus disease-19 (COVID-19), particularly in hospitalized cases, and these manifestations are associated with a worse prognosis. Most commonly, heart involvement is represented by myocarditis, myocardial infarction, and pulmonary embolism, while arrhythmias, heart valve damage, and pericarditis are less frequent. While the clinical suspicion is necessary for a prompt disease recognition, imaging allows the early detection of cardiovascular complications in patients with COVID-19. The combination of cardiothoracic approaches has been proposed for advanced imaging techniques, i.e., CT scan and MRI, for a simultaneous evaluation of cardiovascular structures, pulmonary arteries, and lung parenchyma. Several mechanisms have been proposed to explain the cardiovascular injury, and among these, it is established that the host immune system is responsible for the aberrant response characterizing severe COVID-19 and inducing organ-specific injury. We illustrate novel evidence to support the hypothesis that molecular mimicry may be the immunological mechanism for myocarditis in COVID-19. The present article provides a comprehensive review of the available evidence of the immune mechanisms of the COVID-19 cardiovascular injury and the imaging tools to be used in the diagnostic workup. As some of these techniques cannot be implemented for general screening of all cases, we critically discuss the need to maximize the sustainability and the specificity of the proposed tests while illustrating the findings of some paradigmatic cases.

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“…In addition to gold-standard imaging (CT and LDCT), chest radiography (CXR), lung ultrasound (LUS), and magnetic resonance imaging (MRI) can also be used for COVID-19associated pneumonia detection [41,42]. LUS has emerged as a radiation-free alternative to CT and LDCT, but its practical applicability is controversial.…”

Section: Discussionmentioning

confidence: 99%

“…CXR is readily available and operator independent. Ghosh et al suggest CXR as the initial imaging modality in every suspected case of COVID-19 regardless of laboratory status [42]. Finally, several studies show chest MRI to be promising in COVID-19-associated pneumonia diagnosis and severity assessment [46,47], but its limitations include poor availability, longer examination times, and high susceptibility of the MRI equipment to contamination [48].…”

Section: Discussionmentioning

confidence: 99%

Inter-Observer Agreement between Low-Dose and Standard-Dose CT with Soft and Sharp Convolution Kernels in COVID-19 Pneumonia

Blokhin¹,

Gombolevskiy²,

Chernina³

et al. 2022

JCM

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Computed tomography (CT) has been an essential diagnostic tool during the COVID-19 pandemic. The study aimed to develop an optimal CT protocol in terms of safety and reliability. For this, we assessed the inter-observer agreement between CT and low-dose CT (LDCT) with soft and sharp kernels using a semi-quantitative severity scale in a prospective study (Moscow, Russia). Two consecutive scans with CT and LDCT were performed in a single visit. Reading was performed by ten radiologists with 3-25 years’ experience. The study included 230 patients, and statistical analysis showed LDCT with a sharp kernel as the most reliable protocol (percentage agreement 74.35 ± 43.77%), but its advantage was marginal. There was no significant correlation between radiologists’ experience and average percentage agreement for all four evaluated protocols. Regarding the radiation exposure, CTDIvol was 3.6 ± 0.64 times lower for LDCT. In conclusion, CT and LDCT with soft and sharp reconstructions are equally reliable for COVID-19 reporting using the “CT 0-4” scale. The LDCT protocol allows for a significant decrease in radiation exposure but may be restricted by body mass index.

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Imaging algorithm for COVID-19: A practical approach

Cited by 15 publications

References 40 publications

COVID-19 imaging: Diagnostic approaches, challenges, and evolving advances

COVID-19 imaging: Diagnostic approaches, challenges, and evolving advances

Advanced Imaging Supports the Mechanistic Role of Autoimmunity and Plaque Rupture in COVID-19 Heart Involvement

Inter-Observer Agreement between Low-Dose and Standard-Dose CT with Soft and Sharp Convolution Kernels in COVID-19 Pneumonia

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