Radiation dose reduction considerations and imaging patterns of ground glass opacities in coronavirus: risk of over exposure in computed tomography

Abstract

This article aims to summarize the available data on the severe acute respiratory syndrome coronavirus 2 (SAR-CoV-2) imaging patterns as well as reducing radiation dose exposure in chest computed tomography (CT) protocols. First, the general aspects of radiation dose in CT and radiation risk are discussed, followed by the effect of changing parameters on image quality. This article attempts to highlight some of the common chest CT signs that radiologists and emergency physicians are likely to encounter. With the increasing trend of using chest CT scans as an imaging tool to diagnose and monitor SAR-CoV-2, we emphasize that pattern recognition is the key, and this pictorial essay should serve as a guide to help establish correct diagnosis coupled with correct scanner parameters to reduce radiation dose without affecting imaging quality in this tragic pandemic the world is facing.

Ground-glass opacity (GGO): a review of the differential diagnosis in the era of COVID-19

“…Typical HRCT pattern in the acute phase of COVID-19 is characterized by the presence of peripheral, subpleural, bilateral, and basal GGOs and consolidations, in some cases also with a super-imposed interlobular/ intralobular septal thickening (the so-called "crazy-paving" pattern) (Fig. 2) [24][25][26][27][28]. Additional findings are vascular enlargement, air bronchograms, and halo or reversed halo signs.…”

“…The typical GGO appearance in the acute phase of COVID-19 is defined as "rounded-GGO", even if it could be extensively present as subpleural and bilateral alteration [24][25][26][27][28][29][30]. Sometimes, GGO may be the only radiological manifestation of the early lung involvement in the 1-5 days after the onset of symptoms or also in asymptomatic subjects [31][32][33].…”

Covid-19 infection in cancer patients: the management in a diagnostic unit

“…The panel assessed 39 papers that met the document criteria. 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 …”

“…A surgical cap and shoe covers may be added. 17 , 46 Radiological equipment, such as CT and Magnetic Resonance (MR), ultrasound probes, and image viewing station should be disinfected after every contact with suspected patients. Health personnel with suspicious exposure, without adequate personal protective equipment, should be observed for 14-day, starting from the last day of contact with the COVID-19 infected patients.…”

COVID-19 molecular level laboratory diagnoses

“…Another drawbacks of differential diagnosis can be expected for examination of infected children, who have either different or no manifestation than the adult patients and overall impact of COVID-19 on child ren is fortunately very mild (10). The differential diagnosis of COVID-19 can be further improved by instrumental techniques like computed tomography scan (11)(12)(13)(14). Though these instruments do not plausibly confi rm the particular disease, they make the diagnosis specifi c and they can also reveal related pathologies.…”