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. 2024 Feb 22;11(3):207.
doi: 10.3390/bioengineering11030207.

Standardization of a CT Protocol for Imaging Patients with Suspected COVID-19-A RACOON Project

Andrea Steuwe  1 , Benedikt Kamp  1 , Saif Afat  2 , Alena Akinina  3 , Schekeb Aludin  4 , Elif Gülsah Bas  5 , Josephine Berger  2 , Evelyn Bohrer  6 , Alexander Brose  6 , Susanne Martina Büttner  7 , Constantin Ehrengut  8 , Mirjam Gerwing  9 , Sergio Grosu  10 , Alexander Gussew  3 , Felix Güttler  11 , Andreas Heinrich  11 , Petra Jiraskova  12 , Christopher Kloth  7 , Jonathan Kottlors  13 , Marc-David Kuennemann  9 , Christian Liska  14 , Nora Lubina  14 , Mathias Manzke  15 , Felix G Meinel  15 , Hans-Jonas Meyer  8 , Andreas Mittermeier  10 , Thorsten Persigehl  13 , Lars-Patrick Schmill  4 , Manuel Steinhardt  12 , The Racoon Study Group, Gerald Antoch  1 , Birte Valentin  1
Affiliations

Standardization of a CT Protocol for Imaging Patients with Suspected COVID-19-A RACOON Project

Andrea Steuwe et al. Bioengineering (Basel). .

Abstract

CT protocols that diagnose COVID-19 vary in regard to the associated radiation exposure and the desired image quality (IQ). This study aims to evaluate CT protocols of hospitals participating in the RACOON (Radiological Cooperative Network) project, consolidating CT protocols to provide recommendations and strategies for future pandemics. In this retrospective study, CT acquisitions of COVID-19 patients scanned between March 2020 and October 2020 (RACOON phase 1) were included, and all non-contrast protocols were evaluated. For this purpose, CT protocol parameters, IQ ratings, radiation exposure (CTDIvol), and central patient diameters were sampled. Eventually, the data from 14 sites and 534 CT acquisitions were analyzed. IQ was rated good for 81% of the evaluated examinations. Motion, beam-hardening artefacts, or image noise were reasons for a suboptimal IQ. The tube potential ranged between 80 and 140 kVp, with the majority between 100 and 120 kVp. CTDIvol was 3.7 ± 3.4 mGy. Most healthcare facilities included did not have a specific non-contrast CT protocol. Furthermore, CT protocols for chest imaging varied in their settings and radiation exposure. In future, it will be necessary to make recommendations regarding the required IQ and protocol parameters for the majority of CT scanners to enable comparable IQ as well as radiation exposure for different sites but identical diagnostic questions.

Keywords: COVID-19; computed tomography; image quality; radiation exposure.

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Conflict of interest statement

Dr. Meinel has received a research grant from GE Healthcare and Speaker honoraria from GE Healthcare, Circle Cardiovascular Imaging, and Bayer Vital. The other authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Central anterior–posterior and lateral diameter measured on the CT images (lung window) at the height of the heart.
Figure 2
Figure 2
Boxplot graphs presenting the volumetric computed tomography dose index (CTDIvol), effective diameter, and size-specific dose equivalent (SSDE) of the evaluated sites. Effective diameters and SSDE were not measurable for 2/37 (site B), 5/30 (site I), and 22/64 (site K) patients due to restricted reconstructed field of view.
Figure 2
Figure 2
Boxplot graphs presenting the volumetric computed tomography dose index (CTDIvol), effective diameter, and size-specific dose equivalent (SSDE) of the evaluated sites. Effective diameters and SSDE were not measurable for 2/37 (site B), 5/30 (site I), and 22/64 (site K) patients due to restricted reconstructed field of view.
See this image and copyright information in PMC

References

    1. Agostini A., Borgheresi A., Carotti M., Ottaviani L., Badaloni M., Floridi C., Giovagnoni A. Third-generation iterative reconstruction on a dual-source, high-pitch, low-dose chest CT protocol with tin filter for spectral shaping at 100 kV: A study on a small series of COVID-19 patients. Radiol. Med. 2021;126:388–398. doi: 10.1007/s11547-020-01298-5. - DOI - PMC - PubMed
    1. Atli E., Uyanik S.A., Oguslu U., Cenkeri H.C., Yilmaz B., Gumus B. The Feasibility of Low-dose Chest CT Acquisition Protocol for the Imaging of COVID-19 Pneumonia. Curr. Med. Imaging. 2022;18:38–44. doi: 10.2174/1573405617666210623124108. - DOI - PubMed
    1. Gombolevskiy V., Morozov S., Chernina V., Blokhin I., Vassileva J. A phantom study to optimise the automatic tube current modulation for chest CT in COVID-19. Eur. Radiol. Exp. 2021;5:21. doi: 10.1186/s41747-021-00218-0. - DOI - PMC - PubMed
    1. Hosseini Nasab S.M.B., Deevband M.R., Rahimi R., Nasiri S., Ahangaran M.R., Morshedi M. Optimization of Lung Ct Protocol for the Diagnostic Evaluation of Covid-19 Lung Disease. Radiat. Prot. Dosim. 2021;196:120–127. doi: 10.1093/rpd/ncab140. - DOI - PMC - PubMed
    1. Kalra M.K., Homayounieh F., Arru C., Holmberg O., Vassileva J. Chest CT practice and protocols for COVID-19 from radiation dose management perspective. Eur. Radiol. 2020;30:6554–6560. doi: 10.1007/s00330-020-07034-x. - DOI - PMC - PubMed

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