Role of HRCT Thorax in pre-operative assessment of RT-PCR COVID-19 negative oral cancer patients

Abstract

Background: Oral cancer accounts for 30% of all types of cancer in India. Surgery is the mainstay of treatment but due to the recent outbreak of COVID-19, there is a partial or complete disruption of health services in the country. The initial delay in the treatment was due to cancellations of planned surgeries as per government regulations and reduction in public transportation. In the latter half of the initial relaxation of the lockdown, we formulated our institutional protocol for the surgical treatment of oral cancer patients. On admission, all patients were kept in isolated wards followed by RT-PCR (Reverse Transcriptase-Polymerase Chain Reaction) testing on the same day. RT-PCR negative patients are subjected to HRCT Thorax (High-resolution Computer Tomography). This ensured the safety of health care workers, patients, and patient attendees. Keeping this in mind, we did an observational study on the role of HRCT in the pre-operative screening of asymptomatic oral cancer patients. Materials and methods: Retrospective analysis of prospectively collected data of 150 patients was done. HRCT reporting was done by two experienced senior radiologists of the Department of Radiology at our hospital. Results: The number of patients under the CO-RADS 1 category was 121 and CO-RADS 2 category was 29, according to CO-RADS classification. The results of RT-PCR and HRCT were compared and there was a 100% positive correlation between RT-PCR and HRCT Thorax. Conclusion: Our study supported the use of HRCT Thorax as a diagnostic tool in pre-operative screening of oral cancer patients for COVID 19, particularly in RT-PCR negative cases.

HRCT Thorax as a tool for preoperative assessment of RT-PCR Covid-19 negative patients with malignancies

“…The findings in our study were substantiated by study conducted by Ai Tao, et al, [7] where patients with negative RT-PCR tests, more than 70% had typical CT manifestations due to the overlap of CT imaging features between COVID-19 and other viral pneumonia and false-positive cases of COVID-19 can be identified with chest CT. manifestations, and dynamic CT follow-up. The findings of our study are also consistent with study conducted by Ganta R, et al, [8] which showed that 60 patients showed minor abnormalities on HRCT thorax. The purpose of this study was to ensure safety of Front liners which was done by excluding false negative cases by subjecting them to Ct scan thorax which was considered more accurate and sensitive than viral nucleic acid assay and the findings were also proven by FANG, et al, compare the sensitivity of chest CT and viral nucleic acid assay at initial patient presentation and found 51 patients with chest CT and RT-PCR assay performed within 3 days, the sensitivity of CT for COVID-19 infection was 98% compared to RT-PCR sensitivity of 71% (p<.001).…”