Value of minimum intensity projections for chest CT in COVID-19 patients

Abstract

To investigate whether minimum intensity projection (MinIP) reconstructions enable more accurate depiction of pulmonary ground-glass opacity (GGO) compared to standard transverse sections and multiplanar reformat (MPR) series in patients with suspected coronavirus disease 2019 . Method: In this multinational study, chest CT scans of 185 patients were retrospectively analyzed. Diagnostic accuracy, diagnostic confidence, image quality regarding the assessment of GGO, as well as subjective timeefficiency of MinIP and standard MPR series were analyzed based on the assessment of six radiologists. In addition, the suitability for COVID-19 evaluation, image quality regarding GGO and subjective time-efficiency in clinical routine was assessed by five clinicians. Results: The reference standard revealed a total of 149 CT scans with pulmonary GGO. MinIP reconstructions yielded significantly higher sensitivity (99.9 % vs 95.6 %), specificity (95.8 % vs 86.1 %) and accuracy (99.1 % vs 93.8 %) for assessing of GGO compared with standard MPR series. MinIP reconstructions achieved significantly higher ratings by radiologists concerning diagnostic confidence (medians, 5.00 vs 4.00), image quality (medians, 4.00 vs 4.00), contrast between GGO and unaffected lung parenchyma (medians, 5.00 vs 4.00) as well as subjective time-efficiency (medians, 5.00 vs 4.00) compared with MPR-series (all P < .001). Clinicians preferred MinIP reconstructions for COVID-19 assessment (medians, 5.00 vs 3.00), image quality regarding GGO (medians, 5.00 vs 3.00) and subjective time-efficiency in clinical routine (medians, 5.00 vs 3.00). Conclusions: MinIP reconstructions improve the assessment of COVID-19 in chest CT compared to standard images and may be suitable for routine application.

Comparing radiological presentations of first and second strains of COVID-19 infections in a low-resource country

“…The next commonest radiological finding was ground glass attenuation seen in 8 patients in 2020, and 7 patients in 2021. Christian Booz et al reported in a recent study that minimum intensity projection chest CT reconstructions demonstrate ground glass attenuation better than standard CT scan axial and multiplanar image reformats [ 23 ]. Tables 2 and 3 shows that more than half of the patients in each group presented with bilateral lung involvement, 29 (58%) and 37 (74%) in the 2020 and 2021 groups, respectively.…”

Pulmonary barotrauma in patient suffering from COVID-19

“…CXR and CT are crucial for diagnosis and typical signs of tension include mediastinal shift, displacement of anterior junction line, azygoesophageal recess, and flattening of heart [ 14 ].…”

Extracorporeal membrane oxygenation (ECMO) in COVID-19 patients: a pocket guide for radiologists

“…While the reference standard for diagnosis is real-time reverse-transcription polymerase chain reaction (rt-PCR) test applied on respiratory tract specimens, chest multidetector computed tomography (CT) may help in the early detection, management, and follow-up of COVID-19 pneumonia [ 5 – 9 ]. Typical CT features of COVID-19 pneumonia include bilateral ground glass opacities with a predominant posterior and peripheral distribution, parenchymal consolidations with or without air bronchogram, interlobular septal thickening and crazy paving pattern, usually without pleural effusion or enlarged mediastinal lymph nodes [ 10 – 12 ].…”