Lung – COVID-19

Imaging has a crucial role in the diagnosis of COVID-19, chest X-ray being the first imaging modality to be performed. More recently, it has been shown that CT has an extremely high sensitivity in detecting areas of interstitial pneumonia and above all in defining the severity of the disease.

A quantitative score of the severity of lung parenchymal involvement in COVID-19 patients was developed in our department, which showed correlation with clinical-laboratory data and with patient outcome.

Artificial intelligence algorithms have been shown to have diagnostic potential in the diagnosis of COVID-19. Computational tools have since been developed with the aim of automatically assessing chest CT based on the assessment of the typical findings (ground-glass opacities, consolidation, interlobular septal thickening).

We hypothesized that MRI could represent an accurate diagnostic tool for COVID-19. We are therefore currently investigating the role of chest MRI as a radiation-free alternative modality to CT in the management of COVID-19. Due to the much higher scanning times of MRI compared to CT, MRI might not be suitable in a critical epidemic setting as a diagnostic tool, instead we focused on implementing chest MRI in the follow-up of patients recovered from COVID-19. We demonstrated that MRI is both sensitive and specific for evaluating imaging findings of lung involvement in recovered patients recovered, with accuracy comparable to CT.

 

References: 

  1. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506. doi: 10.1016/S0140-6736(20)30183-5. - DOI - PMC - PubMed
  2. WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19%2D%2D-11-march-2020. Accessed 27 Mar 2020
  3. Francone M, Iafrate F, Masci GM, et al. Chest CT score in COVID-19 patients: correlation with disease severity and short-term prognosis [published online ahead of print, 2020 Jul 4]. Eur Radiol. 2020;1-10. doi:10.1007/s00330-020-07033-y  
  4. Remuzzi A, Remuzzi G (2020) COVID-19 and Italy: what next? Lancet 0: 10.1016/S0140-6736(20)30627-9
  5. Ai T, Yang Z, Hou H et al (2020) Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. Radiology 200642. 10.1148/radiol.2020200642  
  6. Laghi A, Grassi R. Italian Radiology's Response to the COVID-19 Outbreak. J Am Coll Radiol. 2020;17(6):699-700. doi:10.1016/j.jacr.2020.04.012  

© Università degli Studi di Roma "La Sapienza" - Piazzale Aldo Moro 5, 00185 Roma