Low Dose Chest CT and Lung Ultrasound for the Diagnosis and Management of COVID-19

doi:10.3390/jcm10102196

Review

. 2021 May 19;10(10):2196.

doi: 10.3390/jcm10102196.

Low Dose Chest CT and Lung Ultrasound for the Diagnosis and Management of COVID-19

Julie Finance^{1

2}, Laurent Zieleskewicz^{3

4}, Paul Habert^{5

6}, Alexis Jacquier^{5

7}, Philippe Parola^{8

9}, Alain Boussuges⁴, Fabienne Bregeon^{1

2}, Carole Eldin^{8

9}

Affiliations

¹ IRD, APHM, MEPHI, IHU Méditerranée Infection, Aix Marseille University, 13005 Marseille, France.
² Service des Explorations Fonctionnelles Respiratoires, APHM, 13005 Marseille, France.
³ Department of Anaesthesiology and Intensive Care Medicine, Hôpital Nord, APHM, Aix Marseille Université, 13005 Marseille, France.
⁴ INRA, INSERM, Centre for Cardiovascular and Nutrition Research (C2VN), Aix Marseille Université, 13005 Marseille, France.
⁵ Service de Radiologie Cardio-Thoracique, Hôpital La Timone, APHM, 13005 Marseille, France.
⁶ LIIE, Aix Marseille University, 13005 Marseille, France.
⁷ CNRS, CRMBM-CEMEREM (Centre de Résonance Magnétique Biologique et Médicale-Centre d'Exploration Métaboliques par Résonance Magnétique), APHM, Aix-Marseille University, UMR 7339, 13005 Marseille, France.
⁸ IRD, APHM, SSA, VITROME, Aix Marseille University, 13005 Marseille, France.
⁹ IHU-Méditerranée Infection, Aix Marseille University, 13005 Marseille, France.

PMID: 34069557
PMCID: PMC8160936
DOI: 10.3390/jcm10102196

Review

Low Dose Chest CT and Lung Ultrasound for the Diagnosis and Management of COVID-19

Julie Finance et al. J Clin Med. 2021.

. 2021 May 19;10(10):2196.

doi: 10.3390/jcm10102196.

Authors

Julie Finance^{1

2}, Laurent Zieleskewicz^{3

4}, Paul Habert^{5

6}, Alexis Jacquier^{5

7}, Philippe Parola^{8

9}, Alain Boussuges⁴, Fabienne Bregeon^{1

2}, Carole Eldin^{8

9}

Affiliations

¹ IRD, APHM, MEPHI, IHU Méditerranée Infection, Aix Marseille University, 13005 Marseille, France.
² Service des Explorations Fonctionnelles Respiratoires, APHM, 13005 Marseille, France.
³ Department of Anaesthesiology and Intensive Care Medicine, Hôpital Nord, APHM, Aix Marseille Université, 13005 Marseille, France.
⁴ INRA, INSERM, Centre for Cardiovascular and Nutrition Research (C2VN), Aix Marseille Université, 13005 Marseille, France.
⁵ Service de Radiologie Cardio-Thoracique, Hôpital La Timone, APHM, 13005 Marseille, France.
⁶ LIIE, Aix Marseille University, 13005 Marseille, France.
⁷ CNRS, CRMBM-CEMEREM (Centre de Résonance Magnétique Biologique et Médicale-Centre d'Exploration Métaboliques par Résonance Magnétique), APHM, Aix-Marseille University, UMR 7339, 13005 Marseille, France.
⁸ IRD, APHM, SSA, VITROME, Aix Marseille University, 13005 Marseille, France.
⁹ IHU-Méditerranée Infection, Aix Marseille University, 13005 Marseille, France.

PMID: 34069557
PMCID: PMC8160936
DOI: 10.3390/jcm10102196

Abstract

Background: The COVID-19 pandemic has provided an opportunity to use low- and non-radiating chest imaging techniques on a large scale in the context of an infectious disease, which has never been done before. Previously, low-dose techniques were rarely used for infectious diseases, despite the recognised danger of ionising radiation.

Method: To evaluate the role of low-dose computed tomography (LDCT) and lung ultrasound (LUS) in managing COVID-19 pneumonia, we performed a review of the literature including our cases.

Results: Chest LDCT is now performed routinely when diagnosing and assessing the severity of COVID-19, allowing patients to be rapidly triaged. The extent of lung involvement assessed by LDCT is accurate in terms of predicting poor clinical outcomes in COVID-19-infected patients. Infectious disease specialists are less familiar with LUS, but this technique is also of great interest for a rapid diagnosis of patients with COVID-19 and is effective at assessing patient prognosis.

Conclusions: COVID-19 is currently accelerating the transition to low-dose and "no-dose" imaging techniques to explore infectious pneumonia and their long-term consequences.

Keywords: COVID-19; SARS-CoV-2; low-dose CT; lung ultrasound; pneumonia.

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Conflict of interest statement

All authors declare no conflict of interest.

Figures

**Figure 1**
Low-dose non-contrast chest CT scans with 3D volumetric reconstruction in patients with proven COVID-19 infection: (a) minimal lung involvement; (b) moderate lung involvement; and (c) severe lung involvement.

**Figure 2**
Low-dose non-contrast CT scan of the chest at Day 21 and then six months after the first SARS-CoV-2 PCR-positive result, in a 69-year-old patient. The black and white arrows indicate bronchiectasis.

**Figure 3**
Lung ultrasound images in patients with proven COVID-19 infection: (a) longitudinal scan with a high-frequency linear probe, where the white arrows indicate pleural line irregularities; and (b) longitudinal scan with a low-frequency convex probe, where the dark arrow indicates a subpleural consolidation.

See this image and copyright information in PMC

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References

1. Zhou F., Yu T., Du R., Fan G., Liu Y., Liu Z., Xiang J., Wang Y., Song B., Gu X., et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet. 2020;395:1054–1062. doi: 10.1016/S0140-6736(20)30566-3. - DOI - PMC - PubMed
1. Woodhead M., Blasi F., Ewig S., Garau J., Huchon G., Ieven M., Ortqvist A., Schaberg T., Torres A., van der Heijden G., et al. Guidelines for the management of adult lower respiratory tract infections—Full version. Clin. Microbiol. Infect. 2011;17:E1–E59. doi: 10.1111/j.1469-0691.2011.03672.x. - DOI - PMC - PubMed
1. Gibbons R.C., Magee M., Goett H., Murrett J., Genninger J., Mendez K., Tripod M., Tyner N., Costantino T.G. Lung Ultrasound vs. Chest X-Ray Study for the Radiographic Diagnosis of COVID-19 Pneumonia in a High-Prevalence Population. J. Emerg. Med. 2021 doi: 10.1016/j.jemermed.2021.01.041. - DOI - PMC - PubMed
1. Schauer D.A., Linton O.W. NCRP Report No. 160, Ionizing Radiation Exposure of the Population of the United States, medical exposure—Are we doing less with more, and is there a role for health physicists? Health Phys. 2009;97:1–5. doi: 10.1097/01.HP.0000356672.44380.b7. - DOI - PubMed
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[1] Zhou F., Yu T., Du R., Fan G., Liu Y., Liu Z., Xiang J., Wang Y., Song B., Gu X., et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet. 2020;395:1054–1062. doi: 10.1016/S0140-6736(20)30566-3. - DOI - PMC - PubMed

[2] Zhou F., Yu T., Du R., Fan G., Liu Y., Liu Z., Xiang J., Wang Y., Song B., Gu X., et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet. 2020;395:1054–1062. doi: 10.1016/S0140-6736(20)30566-3. - DOI - PMC - PubMed

[3] Woodhead M., Blasi F., Ewig S., Garau J., Huchon G., Ieven M., Ortqvist A., Schaberg T., Torres A., van der Heijden G., et al. Guidelines for the management of adult lower respiratory tract infections—Full version. Clin. Microbiol. Infect. 2011;17:E1–E59. doi: 10.1111/j.1469-0691.2011.03672.x. - DOI - PMC - PubMed

[4] Woodhead M., Blasi F., Ewig S., Garau J., Huchon G., Ieven M., Ortqvist A., Schaberg T., Torres A., van der Heijden G., et al. Guidelines for the management of adult lower respiratory tract infections—Full version. Clin. Microbiol. Infect. 2011;17:E1–E59. doi: 10.1111/j.1469-0691.2011.03672.x. - DOI - PMC - PubMed

[5] Gibbons R.C., Magee M., Goett H., Murrett J., Genninger J., Mendez K., Tripod M., Tyner N., Costantino T.G. Lung Ultrasound vs. Chest X-Ray Study for the Radiographic Diagnosis of COVID-19 Pneumonia in a High-Prevalence Population. J. Emerg. Med. 2021 doi: 10.1016/j.jemermed.2021.01.041. - DOI - PMC - PubMed

[6] Gibbons R.C., Magee M., Goett H., Murrett J., Genninger J., Mendez K., Tripod M., Tyner N., Costantino T.G. Lung Ultrasound vs. Chest X-Ray Study for the Radiographic Diagnosis of COVID-19 Pneumonia in a High-Prevalence Population. J. Emerg. Med. 2021 doi: 10.1016/j.jemermed.2021.01.041. - DOI - PMC - PubMed

[7] Schauer D.A., Linton O.W. NCRP Report No. 160, Ionizing Radiation Exposure of the Population of the United States, medical exposure—Are we doing less with more, and is there a role for health physicists? Health Phys. 2009;97:1–5. doi: 10.1097/01.HP.0000356672.44380.b7. - DOI - PubMed

[8] Schauer D.A., Linton O.W. NCRP Report No. 160, Ionizing Radiation Exposure of the Population of the United States, medical exposure—Are we doing less with more, and is there a role for health physicists? Health Phys. 2009;97:1–5. doi: 10.1097/01.HP.0000356672.44380.b7. - DOI - PubMed

[9] Brenner D.J. Computed Tomography—An Increasing Source of Radiation Exposure. N. Engl. J. Med. 2007 doi: 10.1056/NEJMra072149. - DOI - PubMed

[10] Brenner D.J. Computed Tomography—An Increasing Source of Radiation Exposure. N. Engl. J. Med. 2007 doi: 10.1056/NEJMra072149. - DOI - PubMed

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Low Dose Chest CT and Lung Ultrasound for the Diagnosis and Management of COVID-19

Affiliations

Low Dose Chest CT and Lung Ultrasound for the Diagnosis and Management of COVID-19

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

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Cited by

References

Publication types

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