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Role of Ultra-Low Dose Chest CT and Chest Radiography for the Management of Coronavirus Disease 2019 (COVID-19) in the Emergency Setting

Argentieri Gianluca*, Bellesi Luca, Pagnamenta Alberto, Gianluca Vanini, Presilla Stefano, Del Grande Filippo and Gianella Pietro

Objectives: To determine the role of ultra-low dose chest CT compared to chest radiographs in patients with laboratory-confirmed SARS-CoV-2.

Methods: Chest radiographs and uldCT of 12 consecutive patients performed up to 48 hours from hospital admission were reviewed by 2 radiologists. Dosimetry and descriptive statistics of both modalities were analyzed.

Results and Discussion: On uldCT, parenchymal abnormalities compatible with SARS-CoV-2 pneumonia were detected in 10/12 (83%) patients whereas on chest x-ray in 8/12 (66%) and 5/12 (41%) for reader 1 and 2.

The average increment of diagnostic performance of uldCT was 29% higher than chest x-ray. The average effective dose was respectively of 0.219 and 0.073 mSv.

Conclusion: UldCT detects a substantially larger burden of inflammatory changes in symptomatic patients with suspected SARS-CoV-2 pneumonia compared to chest radiographs at the cost of a slightly higher equivalent radiation dose. It could be used as the first imaging method in an emergency department.