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Simple quantitative chest CT for pulmonary edema.

ABSTRACT: Purpose:To determine the accuracy of quantitative CT to diagnose pulmonary edema compared to qualitative CT and CXR and to determine a threshold Hounsfield unit (HU) measurement for pulmonary edema on CT examinations. Method:Electronic medical records were searched for patients with a billing diagnosis of heart failure and a Chest CT and CXR performed within three hours between 1/1/2016 to 10/1/2016, yielding 100 patients. CXR and CT examinations were scored for the presence and severity of edema, using a 0-5 scale, and CT HU measurements were obtained in each lobe. Polyserial correlation coefficients evaluated the association between CT HUs and CXR scores, and receiver operating characteristic (ROC) curve analysis determined a cutoff CT HU value for identification of pulmonary edema. Results:Correlation between CT HU and CXR score was moderately strong (r?=?0.585-0.685) with CT HU measurements demonstrating good to excellent accuracy in differentiating between no edema (grade 0) and mild to severe edema (grades 1-5) in every lobe, with AUCs ranging between 0.869 and 0.995. The left upper lobe demonstrated the highest accuracy, using a cutoff value of -825 HU (AUC of 0.995, sensitivity?=?100 % and specificity?=?95.1 %). Additionally, qualitative CT evaluation was less sensitive (84 %) than portable CXR in identifying pulmonary edema. However, quantitative CT evaluation was as sensitive as portable CXR (100 %) and highly specific (95 %). Conclusions:Quantitative CT enables the identification of pulmonary edema with high accuracy and demonstrates a greater sensitivity than qualitative CT in assessment of pulmonary edema.

SUBMITTER: Barile M

PROVIDER: S-EPMC7607389 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Simple quantitative chest CT for pulmonary edema.

Barile Maria M Hida Tomoyuki T Hammer Mark M Hatabu Hiroto H

European journal of radiology open 20201030

<h4>Purpose</h4>To determine the accuracy of quantitative CT to diagnose pulmonary edema compared to qualitative CT and CXR and to determine a threshold Hounsfield unit (HU) measurement for pulmonary edema on CT examinations.<h4>Method</h4>Electronic medical records were searched for patients with a billing diagnosis of heart failure and a Chest CT and CXR performed within three hours between 1/1/2016 to 10/1/2016, yielding 100 patients. CXR and CT examinations were scored for the presence and s ...[more]

PMID: 33163584

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Project description:INTRODUCTION:COVID-19 pneumonia is characterized by ground-glass opacities (GGOs) and consolidations on Chest CT, although these CT features cannot be considered specific, at least on a qualitative analysis. The aim is to evaluate if Quantitative Chest CT could provide reliable information in discriminating COVID-19 from non-COVID-19 patients. MATERIALS AND METHODS:From March 31, 2020 until April 18, 2020, patients with Chest CT suggestive for interstitial pneumonia were retrospectively enrolled and divided into two groups based on positive/negative COVID-19 RT-PCR results. Patients with pulmonary resection and/or CT motion artifacts were excluded. Quantitative Chest CT analysis was performed with a dedicated software that provides total lung volume, healthy parenchyma, GGOs, consolidations and fibrotic alterations, expressed both in liters and percentage. Two radiologists in consensus revised software analysis and adjusted areas of lung impairment in case of non-adequate segmentation. Data obtained were compared between COVID-19 and non-COVID-19 patients and p?<?0.05 were considered statistically significant. Performance of statistically significant parameters was tested by ROC curve analysis. RESULTS:Final population enrolled included 190 patients: 136 COVID-19 patients (87 male, 49 female, mean age 66?±?16) and 54 non-COVID-19 patients (25 male, 29 female, mean age 63?±?15). Lung quantification in liters showed significant differences between COVID-19 and non-COVID-19 patients for GGOs (0.55?±?0.26L vs 0.43?±?0.23L, p?=?0.0005) and fibrotic alterations (0.05?±?0.03 L vs 0.04?±?0.03 L, p?<?0.0001). ROC analysis of GGOs and fibrotic alterations showed an area under the curve of 0.661 (cutoff 0.39 L, 68% sensitivity and 59% specificity, p?<?0.001) and 0.698 (cutoff 0.02 L, 86% sensitivity and 44% specificity, p?<?0.001), respectively. CONCLUSIONS:Quantification of GGOs and fibrotic alterations on Chest CT could be able to identify patients with COVID-19.

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Simple quantitative chest CT for pulmonary edema.

Publications

Simple quantitative chest CT for pulmonary edema.

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