CHEST CT USAGE IN COVID-19 PNEUMONIA: MULTICENTER STUDY ON RADIATION DOSES AND DIAGNOSTIC QUALITY IN BRAZIL

Area of Science:

• Radiology
• Medical Imaging
• Infectious Diseases

Background:

• Chest computed tomography (CT) is crucial for diagnosing COVID-19 pneumonia.
• Standardization of CT protocols and image quality assessment is essential for reliable diagnosis and patient safety.

Purpose of the Study:

• To evaluate variations in chest CT utilization, radiation dose metrics (CTDIvol, DLP), and image quality among different healthcare facilities in Brazil.
• To identify the prevalence and impact of artifacts on diagnostic quality in COVID-19 pneumonia CT scans.

Main Methods:

• Retrospective analysis of 533 patients undergoing chest CT for COVID-19 pneumonia across 6 Brazilian healthcare sites.
• Data collection included patient demographics, CT scan parameters, and radiation doses (CTDIvol, DLP).
• Six radiologists assessed pulmonary findings, classified COVID-19 appearance, and evaluated image quality and artifact presence.

Main Results:

• Substantial inter-site variability observed in CT usage, patient weight, CTDIvol, and DLP.
• Artifacts were frequent (43.6%), predominantly due to respiratory motion (93.7% of artifact cases).
• Suboptimal image quality occurred in 20.9% of scans, impacting mid-to-lower lung evaluations (40.7%) or entire lungs (7.3%).

Conclusions:

• Significant heterogeneity exists in chest CT practices for COVID-19 pneumonia in Brazil.
• Respiratory motion artifacts are a major cause of suboptimal image quality, potentially affecting diagnostic accuracy.
• Addressing these variations is crucial for optimizing CT protocols, radiation safety, and diagnostic performance.