Chest CT utilization in COVID-19: a dosimetric and diagnostic-quality study

Area of Science:

• Radiology
• Medical Imaging
• Infectious Diseases

Background:

• The 2019 novel coronavirus (COVID-19) pandemic led to increased use of medical imaging.
• Chest computed tomography (CT) is a key tool for diagnosing and monitoring COVID-19 pneumonia.
• Variations in CT protocols and radiation doses are a concern in clinical practice.

Purpose of the Study:

• To investigate variations in chest CT utilization, radiation dose, and image quality.
• To assess CT scanner performance and diagnostic quality in COVID-19 pneumonia patients.
• To identify areas for CT protocol optimization in Saudi Arabia.

Main Methods:

• Retrospective analysis of 402 COVID-19 patients treated between February and October 2021.
• Radiation dose estimation using CTDIvol and SSDE metrics.
• Evaluation of scanner performance using an ACR-CT accreditation phantom and assessment of diagnostic quality and artifacts by radiologists.

Main Results:

• The majority of scanner sites (80%) met suggested acceptance limits for image quality parameters.
• Ground-glass opacities were the most common CT finding (54%).
• Respiratory motion artifacts were prevalent in chest CT exams with typical COVID-19 appearance (56.3%).
• Significant differences in CT utilization, CTDIvol, and SSDE were observed across sites.

Conclusions:

• Chest CT utilization and radiation doses varied significantly among participating Saudi Arabian sites.
• While image quality was generally acceptable, common artifacts highlight the need for protocol optimization.
• Standardizing CT protocols can improve consistency and potentially reduce radiation exposure in COVID-19 patient management.