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Khattak, Nadia, Najm us Samawat, Hafeez ur Rehman, Muhammad Nauman Akram, Jawad Ali Memon, and Abid Rafiq Chaudhry. "Diagnostic Accuracy of CT-Scan Chest in Distinguishing Ground-Glass Opacities from Covid-19 Causes and Other Causes of Ground-Glass Opacities." Pakistan Journal of Medical and Health Sciences 16, no. 4 (2022): 538–41. http://dx.doi.org/10.53350/pjmhs22164538.
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Introduction: Evaluation of the effectiveness of diagnostic computed tomography of the chest in differentiating between coronavirus 2019 (COVID-19) ground glass opacities and other reasons of ground glass opacities (GGO) not related to COVID-19. Place and Duration: In the department of Radiology, Miangul Abdul Haq Jahenzeb Kidney Hospital Swat for six-months duration from March 2021 to August 2021. Methods: 90 total covid-19 confirmed patients by RT-PCR having GGO (53 males and 37 females, with 47.20 ± 15.10 years mean age) and 110 patients (63 males and 47 males) who were confirmed GGO on chest CT but not due to Covid-19 were selected for the study. The experienced radiologists studied all chest CT scans after removing all descriptive information from the images. They tested negative or positive for COVID-19 and noted other features of CT of the lungs, including laterality, distribution pattern and lobe involvement. The laboratory results and clinical data were documented. Results: This study consisted of 90 COVID19 patients and 100 non-COVID-19 with ground glass opacities on CT chest. In terms of age; no statistically significant alteration was noted amid the 2 groups (p-value = 0.129). Non-COVID-19 cases with GGO; 6 patients have atypical bacterial pneumonia, 42 patients have GGO after viral pneumonia, 14 patients have interstitial pneumonia, 5 patients have PJP, eosinophilic pneumonia in 3 patients, 9 patients have hypersensitivity pneumonia, 6 patients have drug-induced lung injury, 5 patients have pulmonary alveolar hemorrhage and pulmonary edema in 11 patients (cardiogenic and noncardiogenic). Conclusion: Chest CT is rational for distinguishing ground glass opacities form COVID-19 and non-COVID-19 reasons, with less specificity for distinguishing COVID-19 from viral pneumonia and intermediate specificity for distinguishing COVID-19 from other reasons of ground glass opacities. Keywords: SARS-COV2, COVID-19, Diagnosis, Computed tomography and ground glass opacities.
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Yanto, Musli, and Yogi Wiyandra. "Optimization Ground Glass Opacities (GGO) Detection Using Multipixel Interpolation Techniques." Jurnal RESTI (Rekayasa Sistem dan Teknologi Informasi) 6, no. 5 (2022): 847–54. http://dx.doi.org/10.29207/resti.v6i5.4433.
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Ground Glass Opacities (GGO) are a picture of abnormal lung conditions characterized by white or gray areas. This picture of GGO in the lungs could previously be detected based on the results of medical examinations such as Computerized Tomography (CT scan) and Magnetic Resonance Imaging (MRI) images of patients suffering from Covid-19. However, from the results of the examination, it can be seen that the CT scan and MRI images still have a noise level that is too high, causing difficulties in describing the distribution pattern of the GGO itself. The purpose of this study was to optimize the detection of GGO on MRI images using the Multipixel Interpolation technique. The detection process adopts several stages including image preprocessing, edge detection process, and gradient morphological segmentation. Image preprocessing is done to remove noise and improve the MRI input image. The edge detection process is carried out to detect lung organs automatically using the Canny method which is optimized with the multipixel interpolation technique. The final stage of the research is the segmentation process using a gradient morphology technique to see the spread of GGO in patients with Covid-19 contained in the MRI image. The results of this study present an overview of the GGO pattern with fairly good results. The results of the GGO pattern description will also measure the level of spread to see the severity of pneumonia. Based on the results presented, this research is useful as an alternative solution in the process of diagnosis and treatment of Covid-19 patients.
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Habib, Erum, Muhammad Nabi, Iqbal Ahmad, Muzaffar Shah, Zarlakhta Zahir, and Hamid Ali Khan. "The Accuracy 0f CT Chest in Determining Between Ground Glass Opacities And Those Caused by Covid-19 And Other Medications." Pakistan Journal of Medical and Health Sciences 16, no. 10 (2022): 532–34. http://dx.doi.org/10.53350/pjmhs221610532.
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Introduction: Diagnostic ct scanning of the chest is currently being investigated for its ability to distinguish between ground glass opacities (GGO) caused by coronavirus 2019 (COVID-19) and GGO produced by other causes. Place and Duration: From January 2022 until June 2022, I will work as a Radiologist at Qazi Hussain Ahmad Hospital in Nowshera. Methods: This study was cross sectional study carried out at the Qazi Hussain Ahmad Hospital, Nowshera for a period of six months. The overall sample size in the current study was100 non-contrast chest CTs. Eexperienced radiologists analyzed the CT images of the chest after redacting any personal information. laboratory results and the patient's medical history were noted. Results: The participants comprised 46 people with COVID19 and 100 without COVID19 who also had ground glass opacities on chest CT. There was no statistically significant difference in age between the groups (p-value = 0.212). Out of the non-COVID-19 GGO cases, three patients have hypersensitivity pneumonia in 3, eosinophilic pneumonia in 3, interstitial pneumonia in 7, pulmonary pneumonia in 3, pulmonary fibrosis in 7, drug-induced lung damage in 7, pulmonary alveolar hemorrhage in 3, and pulmonary emphysema in 11. Practical implication: This study will provide physician with the data to compare the likelihood that COVID-19 causes ground glass opacities on a chest CT scan versus the likelihood that they are caused by other probable causes Conclusion: Moreover, the specificity of chest CT in differentiating COVID-19 from viral pneumonia is only intermediate, and the specificity of chest CT in distinguishing COVID-19 from other reasons of ground glass opacities is poor. Keywords: CT Chest, Determining, Ground-Glass Opacities, Covid-19, Medications
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Tezcan, Mehmet Engin, and Sevtap Acer Kasman. "GROUND GLASS OPACITIES: SIGN OF CAUTION IN TYPICAL INTERSTITIAL PNEUMONIA." Central Asian Journal of Medical Hypotheses and Ethics 3, no. 4 (2023): 241–44. http://dx.doi.org/10.47316/cajmhe.2022.3.4.03.
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Typical interstitial pneumonia (IP) is mainly the fibrotic form of interstitial lung disease. In some cases with typical IP, a certain amount of ground-glass opacity (GGO) can be detected on high-resolution computed tomography, however, some important issues, such as the co-existence of GGO and typical IP, still require further investigation by biopsy. After the diagnosis of typical IP, anti-fibrosis treatment is usually considered. Here, we hypothesized that GGO in typical IP could be a manifestation of an acute inflammatory attack requiring immunosuppressive therapy or an indicator of ongoing contact with trigger factors that initiate pathological reactions in typical IP.
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Ullah, Inayat, Imran Khan Memon, Muhammad Rashid Rasul, Bhagwan Das, Din Muhammad Sohu, and Akhtar Hussain Phul. "Comparison of Chest Computed Tomography Differential Diagnosis of Ground Glass Opacities in the COVID-19 Patients." Pakistan Journal of Medical and Health Sciences 16, no. 5 (2022): 137–39. http://dx.doi.org/10.53350/pjmhs22165137.
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Aim: To compare chest computed tomography (CT) diagnosis of ground glass opacities in the COVID-19 patients. Study design: Retrospective study. Place and duration of study: Department of Radiology, Ghulam Muhammad Mahar Medical College Sukkur from 1st July 2020 to 31 August 2021. Methodology: Fifty patients on differential CT diagnosis of ground glass opacities seen in COVID 19 patients were enrolled. Thoracic CT images by applying auto exposure-control settings and ranges of scan were done. The noise-index was kept as 12.3. Using helical 16 slice Alexion CT-Toshiba. Keeping a comparison with viral infection CT images a list of 7 signs which were positive for Covid CT scan were recorded. Peripheral lesions meant any lesions which effects peripheral area up to 3 to 4 cm lung periphery with/without having central dispersal. A hazy-opacity was termed as ground glass. Results: Mean age of the patients was 49.1±10.2 years with 27 (54%) males and 23(46%) females. Mix ground glass opacitites and consolidation were also the features of the CT imaging in coronavirus posisitve cases. Man-Whitney test results showed that combined-CT scoring had a SE value as 0.044 with a confidence interval between 0.756-0.927. Comparing the differential CT values within COVID and non COVID patients based on RT PCR results it was observed that posterior region lower lobe involvement was a feature of COVID-19 patients while crazy paving pattern and peripheral distribution was also seen in corona patients. Conclusion: Present study highlights that chest CT helps in differentitaing corona virus from other causes of pneumonias and grond glass opacities. Key words: Chest CT; Differential diagnosis; COVID-19; Ground glass opacities (GGO)
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Somanth Samineni, Jenson Isac John, and Praveen Kumar John. "Spectrum of computed tomography manifestations post COVID." International Journal of Frontiers in Medicine and Surgery Research 3, no. 2 (2023): 001–8. http://dx.doi.org/10.53294/ijfmsr.2023.3.2.0063.
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Introduction: Chest CT is an important diagnostic, prognostic and follow up technique used for COVID 19 infections. It can detect ground glass opacities (GGO) as early as 5th day following symptoms with maximum CT findings at around 10 days of symptoms. Initially detected as unilateral lesions, it acutely progresses bilaterally. Hence, in this study, we evaluated the CT findings in COVID 19 illness, and correlated the same with severity. Methodology: It is a hospital based ambispective cross-sectional study conducted among 1544 patients attending the Department of Radio-diagnosis with symptomatic COVID-19 infections. Sociodemographic characteristics were taken, followed by history and HRCT imaging. This was followed by reporting of CT imaging with CO-RADS staging and CT severity scoring. Results: The most common lesions noted were ground glass opacities (87.7%), consolidation (44.2%), hilar/mediastinal lymphadenopathy (20.1%), reticular opacities (14.3%), septal thickening (9.1%), pleural effusion (4.5%), bronchiectasis (4.5%), emphysematous changes (1.3%), pleural thickening (2, 1.6%) and reticulonodular opacities (0.6%). Conclusion: Bilateral, multifocal, and peripheral distribution of lesions are common in HRCT of symptomatic COVID cases. GGO is the most common lesion noted.
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Afat, Saif, Ahmed E. Othman, Konstantin Nikolaou, and Sebastian Gassenmaier. "Dual-Energy Computed Tomography of the Lung in COVID-19 Patients: Mismatch of Perfusion Defects and Pulmonary Opacities." Diagnostics 10, no. 11 (2020): 870. http://dx.doi.org/10.3390/diagnostics10110870.
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To evaluate contrast-enhanced dual-energy computed tomography (DECT) chest examinations regarding pulmonary perfusion patterns and pulmonary opacities in patients with confirmed COVID-19 disease. Fourteen patients with 24 DECT examinations performed between April and May 2020 were included in this retrospective study. DECT studies were assessed independently by two radiologists regarding pulmonary perfusion defects, using a Likert scale ranging from 1 to 4. Furthermore, in all imaging studies the extent of pulmonary opacities was quantified using the same rating system as for perfusion defects. The main pulmonary findings were ground glass opacities (GGO) in all 24 examinations and pulmonary consolidations in 22 examinations. The total lung scores after the addition of the scores of the single lobes showed significantly higher values of opacities compared to perfusion defects, with a median of 12 (9–18) for perfusion defects and a median of 17 (15–19) for pulmonary opacities (p = 0.002). Furthermore, mosaic perfusion patterns were found in 19 examinations in areas with and without GGO. Further studies will be necessary to investigate the pathophysiological background of GGO with maintained perfusion compared to GGO with reduced perfusion, especially regarding long-term lung damage and prognosis.
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Huang, Kevin X., and Barry C. Gibney. "Pure ground-glass opacities (GGO) lung adenocarcinoma: surgical resection is curative." Journal of Thoracic Disease 16, no. 5 (2024): 3518–21. http://dx.doi.org/10.21037/jtd-23-1983.
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Merchant, Natalie N., Robert McKenna, Rachel Sier, and Osita Onugha. "Retrospective Review of Preoperative Wire Localization for Peripheral Ground Glass Opacities." American Surgeon 86, no. 10 (2020): 1385–90. http://dx.doi.org/10.1177/0003134820964490.
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Video-assisted thoracoscopy (VATS) is performed for diagnosis and treatment of peripheral lung nodules. Localization of peripherally located ground-glass opacities (GGOs) can be challenging. We report the results and usefulness of preoperative computed tomography (CT)-guided wire localization. Records for patients who underwent CT-guided wire localization prior to VATS resection for peripherally located GGOs were analyzed. Our technique for targeting the GGOs, complications, and histopathology of GGOs is reviewed. Forty patients (mean age 68 years) underwent pulmonary resections following CT-guided wire localization. The mean diameter of the GGO was 11.0 mm. The mean distance from the pleural surface to the peripheral margin of the GGO was 18.6 mm. Complications from the wire localization included pneumothorax in 5 patients (12.5%), none of whom required insertion of a chest tube; parenchymal hemorrhage in 3 patients (7.5%); and pleural effusion requiring chest tube drainage (unrelated to the wire) in 1 patient (2.5%). The mean operative time was 74 (range: 21-186 ) minutes. Pathological examination revealed lung malignancy in 36 patients (90%). The diagnostic yield was 100%. Preoperative CT-guided wire localization for solitary or multiple peripherally located GGOs allows for determination of histopathologic diagnosis and high diagnostic yield.
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Li, Yong, Yanxin Sun, Jingqi Han, Hualong Yu, Chuanyu Zhang, and Cuini Yu. "Pathological Examination and Differential Diagnosis of Pulmonary Ground-Glass Opacities by CT-Guided Percutaneous Needle Biopsy." Journal of Medical Imaging and Health Informatics 11, no. 3 (2021): 912–20. http://dx.doi.org/10.1166/jmihi.2021.3522.
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In order to explore the pathological examination and differential diagnosis of pulmonary ground-glass opacities (GGO) with CT-guided percutaneous needle biopsy (CTPNB), this study retrospectively analyzed the medical records of 120 cases of patients who were diagnosed with pulmonary GGO and underwent CTPNB in a hospital designated by this study from December 2014 to December 2018. The results showed that all the 120 cases of patients were successfully punctured at one time and obtained sufficient tissue specimens with the puncture success rate and diagnostic accuracy both of 100%, being able to make a clear qualitative diagnosis. Among them, 30 cases were malignant lesions including 14 cases of bronchioloalveolar carcinoma and 16 cases of metastatic carcinoma; 90 cases were benign lesions including 52 cases of hematogenous pulmonary tuberculosis, 14 cases of sarcoidosis, 12 cases of silicosis and coal workers’ pneumoconiosis, 6 cases of interstitial pneumonia, 4 cases of alveolar proteinosis, and 2 case of allergic pneumonia. The complications of the 120 patients during the treatment included 8 cases of pneumothorax with an incidence of 6.67% (8/120), in which 2 case had the pulmonary tissue compression rate of about 25% and the other cases had no obvious perceived symptoms and required no special treatment, and 10 cases of hemoptysis with an incidence of 8.33% (10/120), whose symptoms disappeared after the treatment with batroxobin, and had no serious symptoms such as air embolism complication. The sensitivity, specificity, and accuracy of CTPNB in the diagnosis of malignant pulmonary GGO were 83.67% (82/98), 100% (22/22), and 86.67% (104/120), respectively, without statistically significant differences in diagnostic efficacy (P > 0.05). In summary, the CTPNB for the diagnosis of malignant pulmonary GGO has high sensitivity, specificity, and accuracy, and the CTPNB is also the simplest and most important approach to obtain effective pathological examinations and differential diagnoses of pulmonary GGO, which has simple operation, high accuracy and few complications, and has high application value for the qualitative diagnosis of pulmonary GGO.
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Shah, Henil P., Agha SAH Naqvi, Parth Rajput, et al. "Artificial intelligence-based deep learning algorithms for ground-glass opacity nodule detection: A review." Narra J 5, no. 1 (2025): e1361. https://doi.org/10.52225/narra.v5i1.1361.
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Ground-glass opacities (GGOs) are hazy opacities on chest computed tomography (CT) scans that can indicate various lung diseases, including early COVID-19, pneumonia, and lung cancer. Artificial intelligence (AI) is a promising tool for analyzing medical images, such as chest CT scans. The aim of this study was to evaluate AI models' performance in detecting GGO nodules using metrics like accuracy, sensitivity, specificity, F1 score, area under the curve (AUC) and precision. We designed a search strategy to include reports focusing on deep learning algorithms applied to high-resolution CT scans. The search was performed on PubMed, Google Scholar, Scopus, and ScienceDirect to identify studies published between 2016 and 2024. Quality appraisal of included studies was conducted using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool, assessing the risk of bias and applicability concerns across four domains. Two reviewers independently screened studies reporting the diagnostic ability of AI-assisted CT scans in early GGO detection, where the review results were synthesized qualitatively. Out of 5,247 initially identified records, we found 18 studies matching the inclusion criteria of this study. Among evaluated models, DenseNet achieved the highest accuracy of 99.48%, though its sensitivity and specificity were not reported. WOANet showed an accuracy of 98.78%, with a sensitivity of 98.37% and high specificity of 99.19%, excelling particularly in specificity without compromising sensitivity. In conclusion, AI models can potentially detect GGO on chest CT scans. Future research should focus on developing hybrid models that integrate various AI approaches to improve clinical applicability.
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Pejic, Nina, Milica Stojkovic Lalosevic, Milos Stulic, Milica Culafic, and Djordje Culafic. "Evaluating ground glass opacities (GGO) in the COVID-19 era. Do autoantibodies help?" Journal of Infection in Developing Countries 16, no. 09 (2022): 1530–32. http://dx.doi.org/10.3855/jidc.16401.
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Introduction: COVID-19 is an infectious disease, caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and there have been outbreaks worldwide. The presentation may include unspecific and mild symptoms, myalgia, headaches, high fever, dry cough, severe dyspnea and acute respiratory distress syndrome (ARDS).
 Case study: We present a rare case of microscopic polyangiitis (MPA) with interstitial lung disease and without renal involvement misdiagnosed as COVID-19.
 Conclusions: Differential diagnosis of COVID-19 is extremely important, and must be correctly identified in order to proceed with correct treatment.
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Parry, Arshed H., Haseeb A. Wani, Naseer A. Choh, Naveed N. Shah, and Majid Jehangir. "Spectrum of chest CT manifestations of coronavirus disease (COVID-19): A pictorial essay." Indian Journal of Radiology and Imaging 31, S 01 (2021): S170—S177. http://dx.doi.org/10.4103/ijri.ijri_303_20.
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AbstractCoronavirus disease (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is an enveloped single-stranded RNA virus belonging to the family of betacoronaviruses. Chest computed tomography (CT) has helped us in understanding this new disease. Typical CT features of COVID-19 pneumonia are ground-glass opacities (GGO), crazy paving pattern and GGO with superimposed consolidation with a basal, posterior and peripheral lung predilection. Less commonly bronchial wall thickening, bronchial dilatation and pleural thickening are seen. Presence of pleural effusion, pericardial effusion and mediastinal lymphadenopathy is seen in severe cases. Reticulations, fibrous stripes, reverse halo sign and perilobular opacities are seen late (>2 weeks) in the course of illness. We aim to present a pictorial review of CT imaging findings in COVID-19 to illustrate the typical and atypical manifestations of this disease in a bid to familiarize radiologists with the myriad imaging manifestations of this disease.
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Garcia Alvarado, Francisco Javier, Melisa Alejandra Muñoz Hernández, Fany Karina Segura Lopez, Héctor Alberto Delgado-Aguirre, Yazmín Esmeralda Gaona Hernández, and Jaime Suriel Arellano Rosales. "Lung involvement by chest CT images in covid-19 patients in a Specialty Hospital in the Northeast of Mexico." Acta Universitaria 32 (February 2, 2022): 1–12. http://dx.doi.org/10.15174/au.2022.3277.
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Chest imaging (CT) plays an important role in the detection and diagnosis of covid-19. The objective of this study is the local experience of CT-based semi-quantitative score of lung involvement as well as the clinical staging in covid-19 patients at the Specialty Medical Institution No. 71 (UMAE, from its Spanish acronym). This is a single- center, retrospective study, in which 71 patients (44 men, 27 women; mean age 50 ± 14.1, range 25-84 years) were selected with positive tests of RT-PCR for SARS-CoV-2 and a confirmed diagnosis of covid-19. Chest CT images showed as predominant pattern the mixed pattern (n = 26, 36.6%), and other common findings included ground glass opacities (GGO) (n = 25, 35.2%), crazy paving (n = 15, 21.1%), and lung consolidation (n = 5, 7.0%). The chest computed tomography findings were bilateral lesions (n = 64, 90.1%), subpleural distribution (n = 61, 85.9%), and lower lobes (n = 31, 43,6%). The characteristic pulmonary tomographic pattern was ground-glass opacities and a bilateral mixed pattern of peripheral distribution towards the posterior regions.
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Örün, Serhat, and Mustafa Numan Erdem. "Contribution of neutrophil/lymphocyte ratio to the diagnostic efficiency of computed tomography and polymerase chain reaction in COVID-19 patients." SAGE Open Medicine 9 (January 2021): 205031212110464. http://dx.doi.org/10.1177/20503121211046416.
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Background: 6.5% of the country’s population was diagnosed with COVID-19 disease. Computed tomography scanning and polymerase chain reaction tests are considered reliable methods for the detection of COVID-19. However, the specificity and reliability of polymerase chain reaction tests and ground-glass opacity (GGO) on thorax computed tomography images in diagnosing COVID-19 are still being disputed. Our aim was to compare the neutrophil/lymphocyte ratio, whose efficiency in differentiating between viral and bacterial infections has previously been studied, with computed tomography and polymerase chain reaction for COVID-19 diagnosis. Materials and methods: This was a retrospective study that included patients treated in a tertiary care hospital emergency service pandemic polyclinic between 14 March and 1 June 2020. The neutrophil/lymphocyte ratios of patients with polymerase chain reaction tests and ground-glass opacities on computed tomography were calculated. The neutrophil/lymphocyte ratios of polymerase chain reaction-negative patients with computed tomography images were compared with the neutrophil/lymphocyte ratios of polymerase chain reaction-positive patients with computed tomography images. Results: A total of 631 patients were included in this study. Thorax computed tomography scans were obtained from all patients. The mean neutrophil/lymphocyte ratio of patients with ground-glass opacities was 3.50 ± 2.12, whereas that of patients without ground-glass opacities was 2.90 ± 2.01. This difference was also statistically significant. Polymerase chain reaction swab samples were obtained from 282 patients (44.7%). The mean neutrophil/lymphocyte ratio of polymerase chain reaction-positive patients was 2.38 ± 1.02, whereas that of polymerase chain reaction-negative patients was 3.97 ± 2.25. The difference was statistically significant. Conclusion: Many studies are undoubtedly required to determine the efficiency of the neutrophil/lymphocyte ratio in COVID-19 diagnosis. However, we postulate that evaluating the neutrophil/lymphocyte ratio along with computed tomography and polymerase chain reaction can assist in the diagnosis of patients.
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Sarfraz, Saulat, Kh Bilal Waheed, Masood Akhtar, Sarfraz Latif, Muhammad Asif, and Abdus Sami Malik. "Investigation of HRCT Chest Severity in Patients with COVID-19: A Study of Tertiary Care Hospital in Pakistan." Pakistan Journal of Medical and Health Sciences 15, no. 5 (2021): 1084–89. http://dx.doi.org/10.53350/pjmhs211551084.
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Background: High-resolution computed tomography (HRCT) chest has a key role in diagnosis COVID-19, as it provides specific imaging features, i.e., bilateral, peripheral and sub-pleural, ground-glass opacity (GGO), consolidation and many associated findings. Aim: To provide the detailed chest HRCT findings along with clinical information in patients with COVID-19. Methods: A cross-sectional study was conducted in the Department of Radiology SZPGMI, Lahore. Information on clinical data, chest radiography appearance and comorbidities were recorded ona designed proforma. HRCT chest findings were recorded in terms of pattern, distribution, laterality, and other findings. HRCT chest severity was calculated using a 25 point CT severity score. Kendall’s Tau test applied to investigate the correlation between the severity of HRCT chest with clinical severity levels of COVID-19. Results: Fever (74%) was the most reported presenting symptom, followed by dry cough (70%). The majority of patients had abnormal chest X-ray (57%) as well as abnormal HRCT chest (90%). The majority of patients were in mild clinical scoring levels of disease (61%) and mild category (49%) of HRCT chest severity. In majority of the patients (46%), all five pulmonary lobes were involved, whereas the right lower lobe was most frequently affected. The pattern of ground-glass opacity (GGO) was found in 82% of patients. Most common distribution was ‘peripheral’, reported in 90% patients. Multiple lobe involvement was found in 82% of patients. The unilateral pulmonary involvement was observed in 12% of patients, whereas, bilateral was found in 78% of patients. Reticulations were reported in 22% followed by atelectasis in 18% patients. Conclusion: COVID-19 patients usually present with abnormal HRCT chest, mostly with a benign course. Multiple pulmonary lobes are commonly involved, especially basal lobes with ground glass opacities. Clinical severity of the disease is reflected in HRCT findings. Keywords: COVID-19 Pandemic, HRCT Chest Findings, Ground Glass Opacity (GGO), Consolidation
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Congedo, Maria Teresa, Roberto Iezzi, Dania Nachira, et al. "Uniportal VATS Coil-Assisted Resections for GGOs." Journal of Oncology 2019 (May 12, 2019): 1–7. http://dx.doi.org/10.1155/2019/5383086.
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Backgrounds. Although uniportal video-assisted thoracic surgery (VATS) theoretically allows the direct palpation of any zone of the lung through a small incision, sometimes it can be difficult to localize pure ground-glass opacities anyway. The aim of this study is to evaluate the usefulness and safety of preoperative computed tomography (CT)-guided microcoil localization of GGO nodules in patients undergoing uniportal VATS lung resection.Methods. The clinical data and CT images of 30 consecutive patients (30 pulmonary nodules) who underwent preoperative CT-guided coil localization and subsequent uniportal VATS resection, from January 2017 to October 2018, were reviewed.Results. All the CT-localization procedures have been performed with success (30/30) and the mean procedure time was 35±15 minutes. The mean size of the nodules was 15,53±6,72 mm, and the mean distance of the nodules from the pleural surface was 19,08±12,08 mm. Eleven nodules (36,7%) were pure ground-glass opacities and 19 (63,3%) were mixed ground-glass with a solid component of 50% or more. In 5 cases, the localization procedure was complicated by asymptomatic pneumothoraxes and in 1 case the pneumothorax required chest tube insertion. In any case a conversion to thoracotomy was avoided because all nodules were identified and resected through uniportal VATS.Conclusions. Preoperative CT-guided coil localization seems to be a feasible, safe, and accurate procedure. It makes uniportal VATS an easy approach even for resecting small, deep, and impalpable nodules.
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Han, Sung Joon, Jae Hyun Jeon, Woohyun Jung, et al. "Do ground-glass opacity-dominant features have prognostic significance in node-negative adenocarcinomas with invasive components of similar sizes?" European Journal of Cardio-Thoracic Surgery 57, no. 6 (2020): 1189–94. http://dx.doi.org/10.1093/ejcts/ezaa016.
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Abstract OBJECTIVES The purpose of this study was to analyse the prognostic significance of the dominant features of ground-glass opacities (GGOs) in part-solid node-negative adenocarcinomas with invasive components of similar sizes. METHODS From 2004 to 2017, a total of 544 patients with a diagnosis of part-solid pathological node-negative adenocarcinoma with an invasive component <20 mm in size were selected. The enrolled patients were categorized into 2 groups: a GGO-dominant [50% < GGO (%) < 100%, n = 245] group (group 1) and a solid-dominant [0% < GGO (%) ≤ 50%, n = 299] group (group 2). To analyse the prognostic significance of GGO-dominant features, propensity score matching incorporating variables such as age, sex, preoperative pulmonary function, operation methods and size of the solid component was performed. RESULTS Propensity score matching produced 92 patients in each group for the prognostic analysis. The mean size of the solid part was 8.8 mm in the GGO-dominant group and 9.0 mm in the solid-dominant group (P = 0.34); the mean size of the total lesion was 22.2 mm in the GGO-dominant group and 14.9 mm in the solid-dominant group (P < 0.001). The 5-year overall survival rates were 96.7% in group 1 and 96.2% in group 2 (P = 0.52), and the 5-year disease-free survival rates were 96.7% in group 1 and 94.3% in group 2 (P = 0.48). CONCLUSIONS Although the total sizes of the GGO-dominant lesions were larger than those of the solid-dominant lesions, the prognosis of patients with GGO-dominant lesions was not significantly different from that of patients with solid-dominant lesions in node-negative adenocarcinomas with a similar invasive component size <20 mm.
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Lococo, Filippo, Luca Luzzi, Giacomo Cusumano, et al. "Management of pulmonary ground-glass opacities: a position paper from a panel of experts of the Italian Society of Thoracic Surgery (SICT)." Interactive CardioVascular and Thoracic Surgery 31, no. 3 (2020): 287–98. http://dx.doi.org/10.1093/icvts/ivaa096.
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Abstract OBJECTIVES A significant gap in our knowledge of how to manage pulmonary ground-glass opacities (GGOs) still exists. Accordingly, there is a lack of consensus among clinicians on this topic. The Italian Society of Thoracic Surgery (Società Italiana di Chirurgia Toracica, SICT) promoted a national expert meeting to provide insightful guidance for clinical practice. Our goal was to publish herein the final consensus document from this conference. METHODS The working panel of the PNR group (Pulmonary Nodules Recommendation Group, a branch of the SICT) together with 5 scientific supervisors (nominated by the SICT) identified a jury of expert thoracic surgeons who organized a multidisciplinary meeting to propose specific statements (n = 29); 73 participants discussed and voted on statements using a modified Delphi process (repeated iterations of anonymous voting over 2 rounds with electronic support) requiring 70% agreement to reach consensus on a statement. RESULTS Consensus was reached on several critical points in GGO management, in particular on the definition of GGO, radiological and radiometabolic evaluation, indications for a non-surgical biopsy, GGO management based on radiological characteristics, surgical strategies (extension of pulmonary resection and lymphadenectomy) and radiological surveillance. A list of 29 statements was finally approved. CONCLUSIONS The participants at this national expert meeting analysed this challenging topic and provided a list of suggestions for health institutions and physicians with practical indications for GGO management.
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Jafari, Sirous, Mohammadreza Tabary, Sahereh Eshraghi, et al. "CT-scan findings of COVID-19 pneumonia based on the time elapsed from the beginning of symptoms to the CT imaging evaluation: a descriptive study in Iran." Romanian Journal of Internal Medicine 58, no. 4 (2020): 242–50. http://dx.doi.org/10.2478/rjim-2020-0019.
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AbstractBackground. Coronavirus disease 2019 (COVID-19) was initially detected in Wuhan city, China. Chest CT features of COVID-19 pneumonia have been investigated mostly in China, and there is very little information available on the radiological findings occurring in other populations. In this study, we aimed to describe the characteristics of chest CT findings in confirmed cases of COVID-19 pneumonia in an Iranian population, based on a time classification.Methods. Eighty-nine patients with COVID-19 pneumonia, confirmed by a real-time RT-PCR test, who were admitted to non-ICU wards and underwent a chest CT scan were retrospectively enrolled. Descriptive evaluation of radiologic findings was performed using a classification based on the time interval between the initiation of the symptoms and chest CT-scan.Results. The median age of patients was 58.0 years, and the median time interval from the onset of symptoms to CT scan evaluation was 7 days. Most patients had bilateral (94.4%) and multifocal (91.0%) lung involvement with peripheral distribution (60.7%). Also, most patients showed involvement of all five lobes (77.5%). Ground-glass opacities (GGO) (84.3%) and mixed GGO with consolidation (80.9%) were the most common identified patterns. We also found that as the time interval between symptoms and CT scan evaluation increased, the predominant pattern changed from GGO to mixed pattern and then to elongated-containing and band-like-opacities-containing pattern; on the other hand, the percentage of lung involvement increased.Conclusions. Bilateral multifocal GGO, and mixed GGO with consolidation were the most common patterns of COVID-19 pneumonia in our study. However, these patterns might change according to the time interval from symptoms.
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Dhok, Avinash Parashuram, Nitin Suresh Shinde, Simran Rathi, and Kajal Ramendranath Mitra. "HRCT chest: A valuable tool to differentiate other pneumonias from covid-19 pneumonia." Panacea Journal of Medical Sciences 14, no. 1 (2024): 88–91. http://dx.doi.org/10.18231/j.pjms.2024.017.
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To assess how COVID-19 pneumonia differs from other pneumonias in terms of the chest computed tomography features.In this study we included 170 clinically diagnosed cases pneumonia referred to department of radio diagnosis subjected to HRCT thorax which include out patients and in patients out of which 127 patients tested RT-PCR positive for Covid 19 pneumonia for a total duration of 1 year. (March 2020 to March 2021). The parenchymal abnormalities including Ground glass opacities (GGO), ground glass opacities with interlobular septal thickening (crazy paving), GGO with consolidation, consolidation, pulmonary nodules, tree in bud appearances, bronchiolar wall thickening, interlobular septal thickening , halo sign, reverse halo sign, cavitation and pleural effusion and were observed and categorized along with determination of pattern of distribution on chest CT.127 patients who tested positive for COVID 19 and 43 patients with other pneumonia (such as community-acquired pneumonia) were visited, and CT scans were analysed to determine the presence and distribution of the disease pattern.Patients with COVID 19 pneumonia primarily have peripheral-based lesions (90%), whereas patients with other pneumonias primarily have mixed patterns (70%)—a difference that is statistically different (p 0.05).Statistics show that COVID 19 had higher bilateral involvement than other pneumonia (p<0.05). In COVID-19 pneumonia, GGOs, GGOs with interlobular septal thickening (crazy paving), and GGOs with consolidation with peripheral and basal predominance in bilateral lung parenchyma are the most common imaging patterns and findings. These findings will help us distinguish COVID-19 pneumonia from other causes of pneumonia. There is less evidence of tree in bud, pure consolidation, cavitation, and bronchiolar wall thickening.
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Herskovitz, Elissa, Charalamobos Solomides, Julie Barta, Nathaniel Evans, and Gregory Kane. "Detection of lung carcinoma arising from ground glass opacities (GGO) after 5 years - A retrospective review." Respiratory Medicine 196 (May 2022): 106803. http://dx.doi.org/10.1016/j.rmed.2022.106803.
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Kalenchic, T. I., S. L. Kabak, and I. V. Korenevskaya. "Pulmonary fibrosis as an outcome of COVID-19 pneumonia." Proceedings of the National Academy of Sciences of Belarus, Medical series 18, no. 4 (2021): 413–21. http://dx.doi.org/10.29235/1814-6023-2021-18-4-413-421.
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In this study, we report three cases of persistent severe respiratory failure and radiological signs of diffuse pulmonary fibrosis in patients after COVID-19 related pneumonia. Chest CT criteria for a diagnosis of pulmonary fibrosis include the presence of traction bronchiectasis and parenchymal bands (linear opacities), as well as numerous small subpleural cystic air spaces (honeycombing). The study found that all cases of fibrosis were associated with such risk factors as male gender, old age, and multicomorbidity. Chest CT of one patient with acute respiratory distress syndrome showed radiographic characteristics of pulmonary fibrosis together with the presence of ground glass opacities (GGO) – the main CT feature of COVID-19 pneumonia. In two other patients, CT features of pulmonary fibrosis appeared in about 2 months after the hospital stay.Thus, pulmonary fibrosis is severe and rapidly progressive complication of COVID-19 pneumonia with a poor prognosis, especially in patients with multiple risk factors.
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Han, Xiaoyu, Yukun Cao, Nanchuan Jiang, et al. "Novel Coronavirus Disease 2019 (COVID-19) Pneumonia Progression Course in 17 Discharged Patients: Comparison of Clinical and Thin-Section Computed Tomography Features During Recovery." Clinical Infectious Diseases 71, no. 15 (2020): 723–31. http://dx.doi.org/10.1093/cid/ciaa271.
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Abstract Background Our objective was to retrospectively analyze the evolution of clinical features and thin-section computed tomography (CT) imaging of novel coronavirus disease 2019 (COVID-19) pneumonia in 17 discharged patients. Methods Serial thin-section CT scans of 17 discharged patients with COVID-19 were obtained during recovery. Longitudinal changes of clinical parameters and a CT pattern were documented in all patients during the 4 weeks after admission. A CT score was used to evaluate the extent of the disease. Results There were marked improvements of fever, lymphocyte counts, C-reactive proteins, and erythrocyte sedimentation rates within the first 2 weeks after admission. However, the mean CT score rapidly increased from the first to the third week, with a top score of 8.2 obtained in the second week. During the first week, the main CT pattern was ground-glass opacities (GGO; 76.5%). The frequency of GGO (52.9%) decreased in the second week. Consolidation and mixed patterns (47.0%) were noted in the second week. Thereafter, consolidations generally dissipated into GGO, and the frequency of GGO increased in the third week (76.5%) and fourth week (71.4%). Opacities were mainly located in the peripheral (76.5%) and subpleural (47.1%) zones of the lungs; they presented as focal (35.3%) or multifocal (29.4%) in the first week and became more diffuse in the second (47.1%) and third weeks (58.8%), then showed a reduced extent in fourth week (50%). Conclusions The progression course of the CT pattern was later than the progression of the clinical parameters within the first 2 weeks after admission; however, there were synchronized improvements in both the clinical and radiologic features in the fourth week.
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Yu, Fenglei, Jingqun Tang, Wenliang Liu, et al. "Genetic profiling of synchronous multiple primary lung carcinomas presenting as ground-glass opacities." Journal of Clinical Oncology 37, no. 15_suppl (2019): e20034-e20034. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.e20034.
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e20034 Background: An increased incidence of synchronous multifocal pulmonary ground-glass opacities (GGOs) has been found in recent decades as a result of the advances in lung cancer screening techniques. However, little was known about the molecular mechanisms of their carcinogenesis, which may have important diagnostic, prognostic and therapeutic implications. Methods: 10 patients (pts) with clinically designated synchronous multiple primary lung cancers (sMPLC) who underwent surgical resection at our hospital were included in this study (Table). The imaging findings of all lesions were GGOs. Mutation profiles were analyzed using hybridization capture based next-generation sequencing (NGS), enabling the simultaneous detection of mutations in 1021 cancer-associated genes. Tumor mutation burden (TMB) was calculated as the number of non-synonymous SNVs and Indels per Mb in the coding region. Results: The genetic profiles of 21 tumor lesions were analyzed. No common mutations were detected between different tumors from 70% of pts (7/10). These pts had different actionable mutations, which indicate disparate even contradictory therapeutic implications. 20% of pts (2/10) shared one driver mutation of EGFR or KRAS. Only one patient had a highly consistent mutation profiles between different GGOs. Two nodules of the patient shared 55% (6/11) of mutations, including EGFR L858R, supporting the possibility of aerogenic metastasis. The median TMB difference between nodules from one individual was 2 muts/Mb. The highest TMB difference was 16 muts/Mb, which might influence the decision of immunotherapy. Conclusions: NGS reveals independent clonality of multiple GGO lesions in most sMPLC pts, which may have contradictory therapeutic implications. In addition, it could be an auxiliary tool to differentiate intrapulmonary metastasis from multiple primary lung cancers. Therefore, broader molecular profiling is strongly advised for sMPLC pts. [Table: see text]
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Saha, Monjoy, Sagar B. Amin, Ashish Sharma, T. K. Satish Kumar, and Rajiv K. Kalia. "AI-driven quantification of ground glass opacities in lungs of COVID-19 patients using 3D computed tomography imaging." PLOS ONE 17, no. 3 (2022): e0263916. http://dx.doi.org/10.1371/journal.pone.0263916.
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Objectives Ground-glass opacity (GGO)—a hazy, gray appearing density on computed tomography (CT) of lungs—is one of the hallmark features of SARS-CoV-2 in COVID-19 patients. This AI-driven study is focused on segmentation, morphology, and distribution patterns of GGOs. Method We use an AI-driven unsupervised machine learning approach called PointNet++ to detect and quantify GGOs in CT scans of COVID-19 patients and to assess the severity of the disease. We have conducted our study on the “MosMedData”, which contains CT lung scans of 1110 patients with or without COVID-19 infections. We quantify the morphologies of GGOs using Minkowski tensors and compute the abnormality score of individual regions of segmented lung and GGOs. Results PointNet++ detects GGOs with the highest evaluation accuracy (98%), average class accuracy (95%), and intersection over union (92%) using only a fraction of 3D data. On average, the shapes of GGOs in the COVID-19 datasets deviate from sphericity by 15% and anisotropies in GGOs are dominated by dipole and hexapole components. These anisotropies may help to quantitatively delineate GGOs of COVID-19 from other lung diseases. Conclusion The PointNet++ and the Minkowski tensor based morphological approach together with abnormality analysis will provide radiologists and clinicians with a valuable set of tools when interpreting CT lung scans of COVID-19 patients. Implementation would be particularly useful in countries severely devastated by COVID-19 such as India, where the number of cases has outstripped available resources creating delays or even breakdowns in patient care. This AI-driven approach synthesizes both the unique GGO distribution pattern and severity of the disease to allow for more efficient diagnosis, triaging and conservation of limited resources.
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Akoğlu, Handan A., Muhammet Bulut, Dilek K. Alemdar, et al. "Evaluation of Childhood COVID-19 Cases: A Retrospective Analysis." Journal of Pediatric Infectious Diseases 16, no. 03 (2021): 091–98. http://dx.doi.org/10.1055/s-0041-1723957.
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Abstract Objective This study aims to evaluate the demographic, epidemiological, and clinical features of novel coronavirus disease 2019 (COVID-19) cases aged between 0 and 18 years. Methods The demographic characteristics of the patients, admission symptoms, contact and travel histories, clinical onset duration, symptoms, treatments, laboratory findings, radiological images, and polymerase chain reaction (PCR) negation times were evaluated in a retrospective manner. Thirty-eight children (19 boys and 19 girls) were included in the study. Results The mean age of the patients was 10.36 ± 5.59 years. The average admission times of the patients after the onset of the symptoms was determined as 1.84 ± 2.02 days. Thirteen (34.2%) patients were observed as asymptomatic. The most common identified symptoms were fever, cough, and fatigue (55.2, 34.2, and 13.2%, respectively). Febrile convulsions, myalgia, dizziness, and diarrhea were the least common symptoms. Also, 25-hydroxyvitamin D3 (vitamin D3) levels were low and aspartate aminotransferase (AST) values were higher in the moderate group than the mild group and the relationships were statistically significant (p = 0.044and 0.027). Ferritin levels of the patients with ground glass opacity (GGO) were found statistically and significantly higher than the patients without GGO (p = 0,031). There was more than one lobe and segment involvement in five patients, the average number of affected lobes and segments was 3.8 and 8.8, respectively. High-resolution computed tomography of the 24 patients showed that; GGO in five (20.8%), consolidation + GGO (mixed) in three (12.5%), consolidation (alone) in one, subpleural linear opacities in three (12.5%), and pavement stone opacities in one (4.2%) patient. COVID-19, which is seen less frequently in children, may pose a risk in infants and young children. Conclusion Especially high ferritin levels may present with lung involvement and low vitamin D levels may worsen the aggravation of the lung involvement. There is a great need for further research on this subject.
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Sambataro, Domenico, Gianluca Sambataro, Francesca Pignataro, et al. "Quantification of Ground Glass Opacities Can Be Useful to Describe Disease Activity in Systemic Sclerosis." Diagnostics 10, no. 4 (2020): 225. http://dx.doi.org/10.3390/diagnostics10040225.
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Interstitial lung disease (ILD) is the main cause of death in systemic sclerosis (SSc) patients. Usually, patients have lung involvement characterized by ground glass opacities (GGOs), but honeycombing (HC) is also possible. The Wells score is a semi-quantitative index, which is able to assess ILD by distinguishing its main components. The aim of this work is to evaluate the Wells score in relation to the disease activity (DA) index. We enrolled 40 consecutive SSc-ILD patients (26 diffuse cutaneous form, dcSSc, and 14 limited form, lcSSc). All patients were evaluated by the European Scleroderma Study Group (ESSG) index, high-resolution computed tomography, transthoracic echocardiogram, pulmonary function tests (PTSs), and nailfold videocapillaroscopy for the number of microhemorrhages (NEMO) score. In our study, the total extent of ILD (TE-ILD), fibrosis and GGOs correlated with dyspnea (p = 0.03, 0.01 and 0.01 respectively), but not with the ESSG index. Considering only the dcSSc patients, TE-ILD and GGOs correlated with the ESSG index (r = 0.5 p = 0.009), while fibrosis grade correlated with disease duration and systolic pulmonary artery pressure. In conclusion, our data suggest that GGO correlates with DA, while fibrosis may be a sign of disease damage. The quantification of pulmonary involvement using the Wells score can be a useful tool for assessing the appropriate treatment in SSc patients.
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Meng, Fanchen, Yi Zhang, Siwei Wang, et al. "Whole-Exome Sequencing Reveals the Genomic Features of the Micropapillary Component in Ground-Glass Opacities." Cancers 14, no. 17 (2022): 4165. http://dx.doi.org/10.3390/cancers14174165.
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Background: Micropapillary components are observed in a considerable proportion of ground-glass opacities (GGOs) and contribute to the poor prognosis of patients with invasive lung adenocarcinoma (LUAD). However, the underlying mutational processes related to the presence of micropapillary components remain obscure, limiting the development of clinical interventions. Methods: We collected 31 GGOs, which were separated into paired micropapillary and non-micropapillary components using microdissection. Whole-exome sequencing (WES) was performed on the GGO components, and bioinformatics analysis was conducted to reveal the genomic features of the micropapillary component in invasive LUAD. Results: The micropapillary component had more genomic variations, including tumor mutation burden, intratumoral heterogeneity, and copy number variation. We also observed the enrichment of AID/APOBEC mutation signatures and an increased activation of the RTK/Ras, Notch, and Wnt oncogenic pathways within the micropapillary component. A phylogenetic analysis further suggested that ERBB2/3/4, NCOR1/2, TP53, and ZNF469 contributed to the micropapillary component’s progression during the early invasion of LUAD, a finding that was validated in the TCGA cohort. Conclusions: Our results revealed specific mutational characteristics of the micropapillary component of invasive LUAD in an Asian population. These characteristics were associated with the formation of high-grade invasive patterns. These preliminary findings demonstrated the potential of targeting the micropapillary component in patients with early-stage LUAD.
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PASHA, N., MN AKRAM, N. WAQAR, and K. PASHA. "DIFFERENTIAL DIAGNOSIS OF COMMUNITY-ACQUIRED PNEUMONIA FROM COVID-19 BY COMPUTED TOMOGRAPHY." Biological and Clinical Sciences Research Journal 2023, no. 1 (2023): 513. http://dx.doi.org/10.54112/bcsrj.v2023i1.513.
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The retrospective study was conducted on data collected from tertiary Care Hospitals from January 2020 to May 2021 to compare CT manifestations and clinical features of COVID-19 with CAP and evaluate the diagnostic accuracy of CT in patients with COVID-19 and CAP. The study included one hundred sixty patients with COVID-19 and 115 with CAP diagnosed during the same time. Clinical data and CT images of the participants were collected. Results showed that 134 (84.3%) patients in the COVID-19 group had ground glass opacities on CT scans. In the COVID-19 group, the typical early presentation was single or multiple small round lesions. 51 (31.8%) patients had small lesions, and 83 (51.8%) had large patches, areas of fusion, or density shadows with spots. In the CAP group, 69 (60%) patients had consolidation, and 45 (39.1%) had ground glass shadows. There was a significant difference in density between both groups (P <.001). Of observed imaging and clinical manifestations, ground glass shadows, number of leukocytes, and age factor are clinically significant in diagnosing COVID-19. In the CAP group, major characteristics were the thickening of the bronchial wall, accumulation of textures and fibrous cords, and consolidated lung lesions. In COVID-19, common imaging manifestations of GGO and consolidation. Clinically, a CT scan should be used along with history and examination for early and accurate diagnosis of COVID-19.
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Gülbay, Mutlu, Bahadır Orkun Özbay, Bökebatur Ahmet Raşit Mendi, Aliye Baştuğ, and Hürrem Bodur. "A CT radiomics analysis of COVID-19-related ground-glass opacities and consolidation: Is it valuable in a differential diagnosis with other atypical pneumonias?" PLOS ONE 16, no. 3 (2021): e0246582. http://dx.doi.org/10.1371/journal.pone.0246582.
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Purpose To evaluate the discrimination of parenchymal lesions between COVID-19 and other atypical pneumonia (AP) by using only radiomics features. Methods In this retrospective study, 301 pneumonic lesions (150 ground-glass opacity [GGO], 52 crazy paving [CP], 99 consolidation) obtained from nonenhanced thorax CT scans of 74 AP (46 male and 28 female; 48.25±13.67 years) and 60 COVID-19 (39 male and 21 female; 48.01±20.38 years) patients were segmented manually by two independent radiologists, and Location, Size, Shape, and First- and Second-order radiomics features were calculated. Results Multiple parameters showed significant differences between AP and COVID-19-related GGOs and consolidations, although only the Range parameter was significantly different for CPs. Models developed by using the Bayesian information criterion (BIC) for the whole group of GGO and consolidation lesions predicted COVID-19 consolidation and AP GGO lesions with low accuracy (46.1% and 60.8%, respectively). Thus, instead of subjective classification, lesions were reclassified according to their skewness into positive skewness group (PSG, 78 AP and 71 COVID-19 lesions) and negative skewness group (NSG, 56 AP and 44 COVID-19 lesions), and group-specific models were created. The best AUC, accuracy, sensitivity, and specificity were respectively 0.774, 75.8%, 74.6%, and 76.9% among the PSG models and 0.907, 83%, 79.5%, and 85.7% for the NSG models. The best PSG model was also better at predicting NSG lesions smaller than 3 mL. Using an algorithm, 80% of COVID-19 and 81.1% of AP patients were correctly predicted. Conclusion During periods of increasing AP, radiomics parameters may provide valuable data for the differential diagnosis of COVID-19.
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Claudia Bella Laurentia, Tri Harjanto, and Tiarma Saulina. "Diagnostic Imaging of Severe Pneumonia COVID-19: A Comprehensive Systematic Review." International Journal of Medical Science and Health Research 9, no. 2 (2025): 33–56. https://doi.org/10.70070/esrc1540.
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Background: COVID-19, caused by SARS-CoV-2, has become a global health crisis since its emergence in December 2019. Severe pneumonia is a critical manifestation of the disease, often necessitating diagnostic imaging for effective management. This systematic review evaluates the diagnostic imaging features of severe pneumonia in COVID-19 using chest X-ray (CXR), computed tomography (CT), lung ultrasound (LUS), and magnetic resonance imaging (MRI). Methods: This review follows PRISMA 2020 guidelines. Studies from 2019–2024 were screened for peer-reviewed evaluations of imaging findings in severe COVID-19 pneumonia. Results: Eight studies were included. Key findings demonstrated the utility of LUS in detecting early abnormalities like B-lines, critical for bedside monitoring. CXR served as a prognostic tool with radiographic severity scores correlating with adverse outcomes. CT provided detailed anatomical insights, identifying ground-glass opacities (GGO), consolidations, and disease severity markers. MRI, while less commonly used, showed comparable sensitivity and specificity to CT, with advantages in radiation-free imaging for specific populations. Discussion: The reviewed studies highlight the complementary roles of imaging modalities in managing COVID-19 pneumonia. Key imaging features include ground-glass opacities, consolidations, and crazy-paving patterns, predominantly in peripheral and lower lung regions. Conclusion: Imaging modalities play complementary roles in managing severe COVID-19 pneumonia. LUS is ideal for bedside assessments, CXR aids in prognostication, CT remains the gold standard for detailed evaluation, and MRI offers a viable alternative for radiation-sensitive cases. Understanding these modalities' applications can enhance diagnostic accuracy and clinical outcomes.
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Awulachew, Ephrem, Kuma Diriba, Asrat Anja, Eyob Getu, and Firehiwot Belayneh. "Computed Tomography (CT) Imaging Features of Patients with COVID-19: Systematic Review and Meta-Analysis." Radiology Research and Practice 2020 (July 23, 2020): 1–8. http://dx.doi.org/10.1155/2020/1023506.
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Introduction. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly contagious disease, and its first outbreak was reported in Wuhan, China. A coronavirus disease (COVID-19) causes severe respiratory distress (ARDS). Due to the primary involvement of the respiratory system, chest CT is strongly recommended in suspected COVID-19 cases, for both initial evaluation and follow-up. Objective. The aim of this review was to systematically analyze the existing literature on CT imaging features of patients with COVID-19 pneumonia. Methods. A systematic search was conducted on PubMed, Embase, Cochrane Library, Open Access Journals (OAJ), and Google Scholar databases until April 15, 2020. All articles with a report of CT findings in COVID-19 patients published in English from the onset of COVID-19 outbreak to April 20, 2020, were included in the study. Result. From a total of 5041 COVID-19-infected patients, about 98% (4940/5041) had abnormalities in chest CT, while about 2% have normal chest CT findings. Among COVID-19 patients with abnormal chest CT findings, 80% (3952/4940) had bilateral lung involvement. Ground-glass opacity (GGO) and mixed GGO with consolidation were observed in 2482 (65%) and 768 (18%) patients, respectively. Consolidations were detected in 1259 (22%) patients with COVID-19 pneumonia. CT images also showed interlobular septal thickening in about 691 (27%) patients. Conclusion. Frequent involvement of bilateral lung infections, ground-glass opacities, consolidation, crazy paving pattern, air bronchogram signs, and intralobular septal thickening were common CT imaging features of patients with COVID-19 pneumonia.
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Gozzi, Luca, Diletta Cozzi, Giulia Zantonelli, et al. "Lung Involvement in Pulmonary Vasculitis: A Radiological Review." Diagnostics 14, no. 13 (2024): 1416. http://dx.doi.org/10.3390/diagnostics14131416.
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Pulmonary vasculitis identifies a heterogeneous group of diseases characterized by inflammation, damage and necrosis of the wall of pulmonary vessels. The most common approach to classify vasculitis is according to etiology, therefore dividing them into primary and secondary, with a further sub-classification of primary vasculitis based on the size of the affected vessels (large, medium, and small). Pulmonary involvement is frequently observed in patients with systemic vasculitis and radiological presentation is not pathognomonic, but may vary between diseases. The main findings using high-resolution computed tomography (HRCT) include small vessel wall thickening, nodular lesions, cavitary lesions, reticular opacities, ground-glass opacities (GGO), consolidations, interlobular septal thickening, tracheobronchial stenosis, and aneurysmal dilatation of pulmonary arteries, with or without pleural effusion. Radiological diagnosis alone is difficult since signs and symptoms of lung vessel involvement are often non-specific and might overlap with other conditions such as infections, connective tissue diseases and neoplasms. Therefore, the aim of this review is to describe the most common radiological features of lung involvement in pulmonary vasculitis so that, alongside detailed clinical history and laboratory tests, a prompt diagnosis can be performed.
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Wang, Rujia, Shenyun Shi, Ling Chen, et al. "Progressive lymphocytosis in familial hemophagocytic lymphohistiocytosis with lymphocytic interstitial pneumonia: a case report." Journal of Hematopathology 15, no. 1 (2022): 25–28. http://dx.doi.org/10.1007/s12308-022-00483-x.
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AbstractFamilial hemophagocytic lymphohistiocytosis (FHL) is a genetically heterogeneous disorder which is less typical in adults than pediatric patients. In this study, we reported a rare case of adult-onset FHL3 with progressive lymphocytosis and lymphocytic interstitial pneumonia (LIP). A 20-year old female was admitted to our institution for persistent cough with fever. A chest high-resolution computed tomography (HRCT) scan showed diffuse bilateral ground glass opacities (GGO). A lung biopsy revealed infiltration of lymphocyte in the pulmonary interstitium. The patient was treated with corticosteroids and immunosuppressants, followed by significant clinical improvement although lymphocytosis still persisted. The definitive diagnosis of FHL was based on whole genome sequencing by which heterozygous mutations in UNC13D gene were identified. Lymphocytosis may be a remarkable feature of some patients with FHL. Performing gene sequencing is important to improve the recognition of FHL to avoid misdiagnosis.
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Saha, Chinmoy Kumar, RN Sarker, Dipa Saha, et al. "Chest CT findings in COVID 19 disease in relation with duration of illness: A study of two hundred cases." Central Medical College Journal 5, no. 2 (2022): 70–75. http://dx.doi.org/10.3329/cemecj.v5i2.61485.
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Chest CT scans of 200 symptomatic patients infected with COVID 19 from different health facilities and home were reviewed for common CT findings in relationship with their clinical symptoms, comorbidities and the time between symptom onset and the initial CT scan was studied in this cross-sectional study. Cases were categorized into three groups according to the timing of HRCT, 10 cases were in early (0-2days), 56 cases in intermediate (3-5days) and 110 cases were in late (6-12days) groups. Chest CT scan images showed bilateral peripheral ground glass opacities 96.63%, pulmonary consolidations 15.9%. Notably 29.54% patient had normal CT scan chest and 60% of them were imaged at early phase. With a longer duration of symptoms, chest CT findings were more typical including GGO, consolidation with greater total lung involvement. Bilateral peripheral GGO was observed in 20% patients at early phase while 53.57% and 64.54% were observed at intermediate and late phase of illness. Among the symptoms cough and dyspnea were observed more related with typical CT changes (95%). Diabetes and Hypertension (58% of patients) were the leading comorbidities that were found related with GGO and other typical CT findings. Mean time duration between symptom onset and positive RT PCR, CT scan changes were 4.79 and 7.55 respectively.
 Central Medical College Journal Vol 5 No 2 Jul 2021 PP 70-75
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Purbasari, Utami, Nurhayati Adnan Prihartono, Helda Helda, Budhi Antariksa, and Fatira R. Audita. "Optimizing chest X-rays as a leading diagnostic modality for handling COVID-19: a diagnostic study." International Journal of Public Health Science (IJPHS) 14, no. 2 (2025): 799. https://doi.org/10.11591/ijphs.v14i2.24653.
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Recent studies have highlighted that chest CT scans are crucial for accurately diagnosing COVID-19. However, in rural areas of Indonesia, people may have difficulty assessing CT scans, leading to increased undetected cases. To address this issue, we investigated whether chest X-rays (CXR) could replace CT scans in diagnosing COVID-19 patients. A diagnostic cross-sectional-based study was conducted at Fatmawati General Hospital from January to September 2021. The study included suspected COVID-19 patients in isolation wards and ICU who were over 18, with or without comorbidities, and had complete clinical data and laboratory tests. We analyzed imaging data through reverse transcription-polymerase chain reaction (RT-PCR) tests, CXR, and chest CT scans. This study enrolled 150 eligible patients. With RT-PCR as the gold standard, we found that CXR had a sensitivity of 86.6% (95% CI: 78.9-92.3%) and chest CT scan had a sensitivity of 91.1% (95% CI: 84.2-95.6%). Similar performance was observed when detecting ground glass opacities (GGO), bilateral laterobasal, and influenza-like syndrome and dyspnea (ILI) between CXR and CT scans. Receiver operating characteristic (ROC) curves demonstrated that CXR is comparable to CT scan, especially in ground glass opacity (GGO) and consolidation (AUC=0.72; 95% CI: 0.61-0.83 and AUC=0.710; 95% CI: 0.64-0.78). The proposed CXR method can be a reliable primary imaging tool for diagnosing COVID-19 by considering ILI. However, chest CT scans remain the most effective diagnostic method for COVID-19. These findings may be useful for the utilization of CXR for diagnosing COVID-19 in areas with limited access to CT scans.
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Mahidhar, P. M. T., Gayathri Gadiyaram, and Rakhee Kumar Paruchuri. "Role of CT Chest in the Diagnosis and Management of SARS-Cov-2 Pneumonia Patients - Hospital Based Descriptive Study, Hyderabad." Journal of Evidence Based Medicine and Healthcare 8, no. 19 (2021): 1446–52. http://dx.doi.org/10.18410/jebmh/2021/274.
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BACKGROUND The computerised tomography (CT) characteristics of COVID-19 are reported and compared with the CT characteristics of other viruses to familiarise radiologists with potential CT trends and to determine the effectiveness of chest CT in the diagnosis and treatment of COVID-19. METHODS This was a hospital based descriptive study which involved the first 324 patients with a finding of severe acute respiratory syndrome (SARS-CoV-2) infection validated by real-time reverse transcription-polymerase chain reaction (RT – PCR). Monitoring patients (198 males, 126 females with a mean age of 46.50 years ± 8.96 [SD] and age range of 21 - 76 years) from April 2020 to July 2020. We correlated the image reports from the initial CT analysis with the findings of the laboratory studies and established possible CT patterns for viral infection. RESULTS The initial chest CT studies of the 324 SARS-CoV-2 patients showed that the disease affected all 'five lobes' in 248 (76.54 percent) patients, both 'lower lobes' in 49 (15.12 percent) patients, the right lower lobe in 23 patients (7.10 percent), and the left lower lobe and right middle lobe in 2 patients (0.62 percent). In 303 (93.52 percent) patients, the lesions were primarily peripheral and subpleural; and there were fewer lesions along the bronchovascular bundles. Two major patterns of SARS-CoV-2 lesions on CT images are GGO (ground - glass opacity) and consolidation. In 303 of the 324 patients (93.52 percent), CT showed single or multiple abnormal GGO or consolidation, or both. In the remaining 21 (6.48 percent) cases, neither GGO nor consolidation was observed on CT. Follow-up CT showed moderate or pronounced disease worsening in 12 out of 58 (20.69 percent) cases and follow-up CT showed improvement with the appearance of fibrosis and GGO resolution. CONCLUSIONS In conclusion, the use of a chest CT system in SARS-CoV-2 patients can accurately evaluate pneumonia. Most notably follow-up CT scans may help assess patients with SARS-CoV-2 pneumonia in their response to treatment. KEYWORDS SARS-CoV-2, Pneumonia, Chest Computed Tomography, Ground-Glass Opacities
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Lerum, Tøri Vigeland, Trond Mogens Aaløkken, Eivind Brønstad, et al. "Dyspnoea, lung function and CT findings 3 months after hospital admission for COVID-19." European Respiratory Journal 57, no. 4 (2020): 2003448. http://dx.doi.org/10.1183/13993003.03448-2020.
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The long-term pulmonary outcomes of coronavirus disease 2019 (COVID-19) are unknown. We aimed to describe self-reported dyspnoea, quality of life, pulmonary function and chest computed tomography (CT) findings 3 months following hospital admission for COVID-19. We hypothesised outcomes to be inferior for patients admitted to intensive care units (ICUs), compared with non-ICU patients.Discharged COVID-19 patients from six Norwegian hospitals were enrolled consecutively in a prospective cohort study. The current report describes the first 103 participants, including 15 ICU patients. The modified Medical Research Council (mMRC) dyspnoea scale, the EuroQol Group's questionnaire, spirometry, diffusing capacity of the lung for carbon monoxide (DLCO), 6-min walk test, pulse oximetry and low-dose CT scan were performed 3 months after discharge.mMRC score was >0 in 54% and >1 in 19% of the participants. The median (25th–75th percentile) forced vital capacity and forced expiratory volume in 1 s were 94% (76–121%) and 92% (84–106%) of predicted, respectively. DLCO was below the lower limit of normal in 24% of participants. Ground-glass opacities (GGO) with >10% distribution in at least one of four pulmonary zones were present in 25% of participants, while 19% had parenchymal bands on chest CT. ICU survivors had similar dyspnoea scores and pulmonary function as non-ICU patients, but higher prevalence of GGO (adjusted OR 4.2, 95% CI 1.1–15.6) and lower performance in usual activities.3 months after admission for COVID-19, one-fourth of the participants had chest CT opacities and reduced diffusing capacity. Admission to ICU was associated with pathological CT findings. This was not reflected in increased dyspnoea or impaired lung function.
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Dehghani, Sadegh, Fahimeh Zeinalkhani, Mojtaba Amiri, et al. "The Evaluation of Correlation between Clinical Characteristics and Chest CT Findings in Recovered and Dead COVID-19 Patients." EAS Journal of Radiology and Imaging Technology 6, no. 04 (2024): 48–54. http://dx.doi.org/10.36349/easjrit.2024.v06i04.003.
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Objectives: The purpose of this study was to retrospectively investigate the correlation between clinical characteristics and chest CT findings in recovered and dead covid-19 patients. Patients: In this retrospective study, 63 hospitalized patients infected with COVID-19 were reviewed, from 1 May 2020 to 30 Dec 2020. The lobe involvement and infection pattern were evaluated in both groups. A semi-quantitative CT score was calculated based on the extent of lobar involvement (0 indicate no involvement; 1, less than 5% involvement; 2, 5-25% involvement; 3, 26%–50% involvement; 4, 51%–75% involvement; and 5, 76%–100% involvement. Results: In the recovered group, 16 (30.76%) had opacities in two lobes, 10 (19.23%) in three lobes, 20 (38.46%) in four lobes, and 16 (30.76%) in all five lobes. While, in the dead group just four (7, 63.63%) and five (4, 36.36%) affected lobes were shown. The most hallmarks of COVID-19 infection on chest CT images of recovered patients were ground-glass opacities, GGO, (26.92%), consolidation (17.30%), GGO & Consolidation predominance, MIX, (42.30%), and crazy paving (CP) patterns (13.46%). Intubation was performed for 16 patients to be recovered. While in the dead patients the lung infection was completely the MIX pattern (100%) and all of them were intubated. CT score was calculated significantly higher in dead patients than recovered patients (p < 0.01). Conclusions: Our data suggest the potential role of chest CT for predicting the outcome of SARS-CoV-2 patients. According to CT results, patients with more lung involvement, the MIX pattern, and higher CT score in lung infection had less chance for recovery.
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Lang, David, Kaveh Akbari, Stefan Walcherberger, et al. "Computed tomography findings as determinants of pulmonary function tests in fibrotic interstitial lung diseases—Network-analyses and multivariate models." Chronic Respiratory Disease 17 (January 1, 2020): 147997312096702. http://dx.doi.org/10.1177/1479973120967025.
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The aim was to evaluate the impact of multiple high-resolution computed tomography (HRCT) features on pulmonary function test (PFT) biomarkers in fibrotic interstitial lung disease (FILD) patients. HRCT of subsequently ILD-board-discussed FILD patients were semi-quantitatively evaluated in a standardized approach: 18 distinct lung regions were scored for noduli, reticulation, honeycombing, consolidations, ground glass opacities (GGO), traction bronchiectasis (BRK) and emphysema. Total lung capacity (TLC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC, diffusion capacity for carbon monoxide (DLCO) and transfer coefficient (KCO) were assessed. Interactions between each PFT biomarker and all HRCT scores were visualized by network analyses, modeled according to the Schwarz Bayesian Information Criterion and incorporated in uni- and multivariate stepwise regression analyses. Among 108 FILD patients (mean age 67 years, 77% male), BRK extent was a major significant uni- or multivariate determinant of all PFT analyzed. Besides that, diffusion-based variables DLCO and KCO showed a larger dependency on reticulation, emphysema and GGO, while forced expiratory volume-based measures FEV1, FVC and FEV1/FVC were more closely associated with consolidations. For TLC, the only significant multivariate determinant was reticulation. In conclusion, PFT biomarkers derived from spirometry, body plethysmography and diffusion capacity in FILD patients are differentially influenced by semi-quantified HRCT findings.
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Widiatmoko, Mahfud Edy, and Shelsa Ramadanti. "Nilai Hounsfield Unit (HU) CT-Scan pada Lesi Paru-Paru Pasien Suspek COVID-19." Jurnal Kesehatan Vokasional 8, no. 3 (2023): 174. http://dx.doi.org/10.22146/jkesvo.78738.
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Latar Belakang: National Health Commission of China menyatakan bahwa Computed Tomography (CT) memiliki peranan penting dalam hal menegakkan diagnosis dan pemantauan prognosis pada pasien COVID-19 karena memiliki sensitivitas diagnostik tinggi sebesar 97,2% dan menjadi pelengkap dari pengujian RT-PCR. Gambaran CT thorax pada pasien dengan lesi paru-paru suspek COVID-19 terlihat nodul konsolidasi dan Ground Glass Opacities (GGO) di sebagian area. Sebaran nodul GGO pada COVID-19 diklasifikasikan dengan istilah CO-RADS. Karakteristik nodul lesi dapat dianalisis kepadatan jaringan dengan nilai Hounsfield Unit (HU).Tujuan: Mengetahui nilai Houndsfield Unit (HU) CT pada lesi paru-paru pasien suspek COVID-19 berdasarkan kategori CO-RADS.Metode: Penelitian ini menggunakan studi cross‑sectional berdasarkan data sekunder hasil rekonstruksi gambar pemeriksaan CT thorax dengan klinis suspek pneumonia COVID-19 tahun 2021 dan jumlah sampel 40 kasus.Hasil: Hasil rata-rata nilai HU pada kategori CO-RADS 4, 5, dan 6, berturut-turut, -203,00 HU, -168,97 HU), dan -133,57 HU). Berdasarkan uji statistik, nilai p < 0,05 yang artinya bahwa rata-rata nilai HU ketiga kategori CO-RADS berbeda secara signifikan. Kesimpulan: Ada beda tingkatan klasifikasi CO-RADS 4-6, yaitu bahwa semakin tinggi tingkatan kategori CO-RADS, semakin tinggi pula nilai HU CT pada lesi paru-paru.
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Lang, David, Kaveh Akbari, Andreas Horner, et al. "Computed Tomography Findings as Determinants of Local and Systemic Inflammation Biomarkers in Interstitial Lung Diseases: A Retrospective Registry-Based Descriptive Study." Lung 199, no. 2 (2021): 155–64. http://dx.doi.org/10.1007/s00408-021-00434-w.
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Abstract Purpose To evaluate the association of peripheral blood (PBL) and broncho-alveolar lavage (BAL) biomarkers with inflammatory versus fibrotic high-resolution computed tomography (HRCT) findings in interstitial lung disease (ILD) patients. Methods HRCT findings of 127 consecutive ILD-board patients were semi-quantitatively evaluated: reticulation/honeycombing (RET), traction bronchiectasis (TBR) and emphysema (EMP) were classified as non-inflammatory/fibrotic; consolidations (CON), ground glass opacities (GGO), parenchymal nodules (NDL) and mosaic attenuation (MOS) as active inflammatory. Each HRCT finding was assessed in six distinct lung regions, resulting scores were graded as minimal (0–1 regions involved), medium (2–4) or extensive (5–6). Associations of routinely assessed PBL/BAL biomarkers with these HRCT scores were evaluated using Spearman correlation coefficients and graphical presentation; significance was tested by applying Kruskal–Wallis tests. Results Blood neutrophil, lymphocyte and eosinophil fraction, neutrophil to lymphocyte ratio (NLR) and BAL lymphocyte fraction consistently showed opposite correlations with inflammatory versus non-inflammatory/fibrotic HRCT finding scores. Blood lymphocyte fraction significantly differed by graded GGO (p = 0.032) and CON (p = 0.027) extent, eosinophil fraction by TBR (p = 0.006) and NLR by CON (p = 0.009). C-reactive protein was significantly related to GGO (p = 0.023) and CON (p = 0.004), BAL lymphocyte fraction to GGO (p = 0.017) extent. Conclusion Blood lymphocyte and eosinophil fraction, NLR, CRP and BAL lymphocyte fraction may aid to differentiate inflammatory from non-inflammatory/fibrotic ILD patterns. Trial registration This evaluation was based on data from the ILD registry of Kepler University Hospital Linz, as approved by the ethics committee of the Federal State of Upper-Austria (EK Number. I-26-17).
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Aaløkken, Trond Mogens, Haseem Ashraf, Gunnar Einvik, et al. "CT abnormalities 3 and 12 months after hospitalization for COVID-19 and association with disease severity: A prospective cohort study." PLOS ONE 19, no. 5 (2024): e0302896. http://dx.doi.org/10.1371/journal.pone.0302896.
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Objectives To investigate changes in chest CT between 3 and 12 months and associations with disease severity in patients hospitalized for COVID-19 during the first wave in 2020. Materials and methods Longitudinal cohort study of patients hospitalized for COVID-19 in 2020. Chest CT was performed 3 and 12 months after admission. CT images were evaluated using a CT severity score (CSS) (0–12 scale) and recoded to an abbreviated version (0–3 scale). We analyzed determinants of the abbreviated CSS with multivariable mixed effects ordinal regression. Results 242 patients completed CT at 3 months, and 124 (mean age 62.3±13.3, 78 men) also at 12 months. Between 3 and 12 months (n = 124) CSS (0–12 scale) for ground-glass opacities (GGO) decreased from median 3 (25th–75th percentile: 0–12) at 3 months to 0.5 (0–12) at 12 months (p<0.001), but increased for parenchymal bands (p<0.001). In multivariable analysis of GGO, the odds ratio for more severe abbreviated CSS (0–3 scale) at 12 months was 0.11 (95%CI 0.11 0.05 to 0.21, p<0.001) compared to 3 months, for WHO severity category 5–7 (high-flow oxygen/non-invasive ventilation/ventilator) versus 3 (non-oxygen use) 37.16 (1.18 to 43.47, p = 0.032), and for age ≥60 compared to <60 years 4.8 (1.33 to 17.6, p = 0.016). Mosaicism was reduced at 12 compared to 3 months, OR 0.33 (95%CI 0.16 to 0.66, p = 0.002). Conclusions GGO and mosaicism decreased, while parenchymal bands increased from 3 to 12 months. Persistent GGO were associated with initial COVID-19 severity and age ≥60 years.
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Malguria, Nagina, Li-Hsiang Yen, Tony Lin, Amira Hussein, and Elliot Fishman. "Role of Chest CT in COVID-19." Journal of Clinical Imaging Science 11 (June 3, 2021): 30. http://dx.doi.org/10.25259/jcis_138_2020.
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In December 2019, a disease attributed to a new severe acute respiratory syndrome coronavirus 2, and named coronavirus disease 2019 (COVID-19), broke out in Wuhan, China and has spread rapidly throughout the world. CT has been advocated in selected indications as a tool toward rapid and early diagnosis. The CT patterns of COVID-19 include ground glass opacities GGO, consolidation, and crazy paving. Additional signs include a “rounded morphology” of lesions, vascular enlargement sign, nodules, and fibrous stripe. Signs of healing and organization include subpleural bands, a reticular pattern, reversed halo sign and traction bronchiectasis. Cavitation and tree in bud signs are absent and pleural effusions are rare. There is a high incidence of pulmonary embolism associated with COVID-19. CT findings in COVID-19 appear to follow a predictable timeline with maximal involvement approximately 6–11 days after symptom onset. The stages of evolution include early stage (days 0–4) with GGO being the predominant abnormality, progressive stage (days 5–8) with increasing crazy paving; and peak stage (days 9–13) with predominance of consolidation and absorption phase (after day 14) with gradual absorption of consolidation with residual GGO and subpleural bands. CT findings in COVID-19 have a high sensitivity and low specificity, determined to be 98% and 25% in a retrospective study of 1014 patients. The low specificity of CT for the diagnosis of COVID-19 pneumonia is due to the overlap of CT findings with other viral pneumonias and other infections, lung involvement in connective tissue disorders, drug reaction, pulmonary edema, and hemorrhage.
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Li, Yuan, Yue Peng, Xiaoyu Zhang, et al. "Evaluation of unimodal and multimodal information in health communication on GGO-related lung cancer screening: An eye-tracking study." Journal of Cancer Research and Therapeutics 19, no. 1 (2023): 124–31. http://dx.doi.org/10.4103/jcrt.jcrt_2013_22.
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ABSTRACT Aims: To find out a better propaganda and education plan for the popularization of the ground-glass opacities-related (GGO-related) lung cancer screening. Methods and Material: The control group took a lung cancer screening knowledge test directly before receiving the health education. By contrast, the experimental group took the same knowledge test after receiving health education. This study designed unimodal and multimodal materials about GGO-related lung cancer. The text and graph were considered unimodal information, while the video was multimodal information. According to the different information forms they were exposed to, the experimental group was further divided into text, graphic, and video groups. An eye-tracking system was performed to record eye-tracking data synchronously. Results: Compared with the control group, the knowledge test scores of each experimental group were remarkably improved. Furthermore, the graphic group had a significantly higher correct rate on the No. 7 question, while the video group had the lowest. In terms of saccades, the video group had significantly higher speed and amplitude of saccades than the other two groups. In terms of fixation, the interval duration, total duration of whole fixations, and a number of whole fixations of the graphic group were significantly lower than those of the other two groups, while the video group had the highest values for these variables. Conclusions: It was on the unimodal information, such as text and graphics, that people can spend less time and cost to achieve effective acquisition of GGO-related lung cancer screening knowledge.
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Afiifah, Elok Nur, Shinta Gunawati, Guntur Winarno, Muhammad Irsal, Fahrizal, and Rizal Akbar. "Quality of Thorax CT Scan Images among Covid-19 Cases using Variations of Filter." JURNAL INFO KESEHATAN 20, no. 2 (2022): 251–59. http://dx.doi.org/10.31965/infokes.vol20.iss2.821.
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A typical image of the Thorax CT Scan as a sign of the early stages and development of Covid-19 is the finding of Ground Glass Opacities (GGO). GGO is an insignificant increase in the density of the lungs without occlusion of blood vessels and bronchi. In mild cases, GGO tends to be difficult to identify and requires high-resolution CT scanning. In this study, we intend to improve the resolution of the Thorax CT Scan image through filter settings, to analyze the difference in the variations of filters B50s, B70s, and B90s towards the quality of the CT Scan image and obtain the optimal use of filter in the Thorax CT Scan examination among Covid-19 cases. This was a quantitative analytical study conducted at one of the Regional General Hospital in Jakarta on March-April 2022. The samples were secondary data derived from 10 patients by using MSCT Siemens Somatom Perspective 128 slices. Data were collected through observation and experiment. The images collected were further analyzed using Image j software to find values of Signal to Noise Ratio (SNR) and Contrast to Noise Ratio (CNR). Furthermore, the values were compared by assessing the anatomical image information through various filters. The results of this study indicated that there were differences in the SNR and CNR values of the three filters. The higher resolution of the filter used, the more capable it was to sharper and more detailed the image but the noise level was also higher. Thorax CT Scan examination should be carried out using the B70s very sharp filter that was able to produce images with the optimal information and fairly low noise level. A very thin GGO image in the early stage of the manifestation of Covid-19 could be identified in the Thorax CT Scan examinations for diagnosis of Covid-19 case.
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Dzefi-Tettey, Klenam, Emmanuel Kobina Mesi Edzie, Philip Narteh Gorleku, et al. "Pattern of chest computerized tomography scan findings in symptomatic RT-PCR positive Covid-19 patients at the Korle Bu Teaching Hospital, Ghana." African Health Sciences 22, no. 2 (2022): 63–74. http://dx.doi.org/10.4314/ahs.v22i2.8.
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Background: Chest Computerized Tomography (CT) features of Corona Virus Disease 2019 (COVID-19) pneumonia are nonspecific, variable and sensitive in detecting early lung disease. Hence its usefulness in triaging in resource-limited regions.
 Objectives: To assess the pattern of chest CT scan findings of symptomatic COVID-19 patients confirmed by a positive RTPCR in Ghana.
 Methods: This study retrospectively reviewed chest CT images of 145 symptomatic RT-PCR positive COVID-19 patients examined at the Radiology Department of the Korle Bu Teaching Hospital (KBTH) from 8th April to 30th November 2020. Chi-Squared test was used to determine associations among variables. Statistical significance was specified at p≤0.05.
 Results: Males represent 73(50.3%). The mean age was 54.15±18.09 years. The age range was 5 months-90 years. Consolidation 88(60.7%), ground glass opacities (GGO) 78(53.8%) and crazy paving 43(29.7%) were the most predominant features. These features were most frequent in the elderly (≥65years). Posterobasal, peripheral and multilobe disease were found bilaterally. The most common comorbidities were hypertension 72(49.7%) and diabetes mellitus 42(29.2%) which had significant association with lobar involvement above 50%.
 Conclusion: The most predominant Chest CT scan features of COVID-19 pneumonia were GGO, consolidation with air bronchograms, crazy paving, and bilateral multilobe lung disease in peripheral and posterior basal distribution.
 Keywords: Computerized Tomography Scan; COVID-19 Pneumonia; Ghana.
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Kohli, Anirudh, Pradipta C. Hande, and Shivam Chugh. "Role of chest radiography in the management of COVID-19 pneumonia: An overview and correlation with pathophysiologic changes." Indian Journal of Radiology and Imaging 31, S 01 (2021): S70—S79. http://dx.doi.org/10.4103/ijri.ijri_967_20.
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Abstract Background: Chest radiography (CXR) is a widely available baseline radiological modality in evaluating symptomatic patients with suspected or confirmed Covid-19 disease. Serial changes can help in monitoring the patients in conjunction with the clinical status of these patients in a hospital setting. Purpose: The purpose of this study was to analyse the patterns of radiological findings on chest radiograph (CXR) for suspected and confirmed COVID-19 patients on initial presentation to the emergency medical services (EMS) on admission and to assess the progression and resolution. Materials and Methods: In this study, patients who presented to EMS of a multispeciality hospital as suspected or confirmed Covid-19 on consecutive reverse transcriptase polymerase chain reaction (RT-PCR). CXR was examined for findings of haziness, patterns and distribution of opacities. Progression and regression of findings in serial CXR were studied and evaluated with the clinical and laboratory parameters. High resolution CT (HRCT) chest was performed initially for some patients. Results: 756 RT-PCR confirmed COVID-19 patients were included in our study who had initial CXR. 510 (67.46%) of our patients with positive initial RT-PCR showed abnormal baseline CXR. The abnormal findings were described as haziness akin to ground glass opacities (GGO) on CT, peripheral opacities, patchy parenchymal opacities and consolidation. Peripheral opacities and lower zone distribution were the commonest pattern of CXR abnormalities with bilateral involvement. The severity of findings on serial CXR and radiographic regression was studied along with follow-up to assess response to treatment. Forty-six patients showed features of acute lung injury (ALI). Complications and new CXR findings were reported for patients who were given ventilator support. Conclusion: CXR is a valuable baseline radiological investigation on hospital admission in symptomatic patients with suspected or confirmed Covid-19 presenting to the EMS as it helps to monitor the progress and regression of the disease in conjunction with clinical findings.
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Watanabe, Satoshi, Takeshi Ota, Masachika Hayashi, et al. "Prognostic significance of radiologic features of pneumonitis induced by anti-PD-1 therapy." Journal of Clinical Oncology 37, no. 15_suppl (2019): 9065. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.9065.
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9065 Background: Anti-PD-1 therapy is now a standard treatment for patients with NSCLCs. Pneumonitis induced by immune-check point inhibitors is potentially fatal; however, some studies have shown that antitumor effects were enhanced in patients with pneumonitis. Although several radiologic patterns of pneumonitis induced by anti-PD-1 therapy have been reported, the association between radiologic features and clinical outcomes, especially enhancement of antitumor effects remains unclear. Methods: We retrospectively evaluated data of NSCLC patients treated in 1st to 3rd line with anti-PD-1 antibodies (nivolumab or pembrolizumab) at Niigata Lung Cancer Treatment Group. Pneumonitis was diagnosed by the treating investigators. The chest CT scans of patients with pneumonitis were independently reviewed by one radiologist and two pulmonologists to classify pneumonitis into 5 subtypes: cryptogenic organizing pneumonia-like (COP), ground glass opacities (GGO), interstitial, hypersensitivity and pneumonitis not otherwise specified (NOS). Results: Of 231 patients who received anti-PD-1 antibodies, pneumonitis developed in 33 patients (14.3%) at 7 institutions between January 2016 to October 2017. Of 33 patients with pneumonitis, the median age was 66 (range 45 to 82 years), 7 were female, 25 received nivolumab, and 8 received pembrolizumab. Sixteen patients were classified as GGO, 16 patients had COP-like appearance and one patient had NOS. The median survival time was significantly longer among patients with COP than among those with GGO (not reached vs. 7.8 months; HR 0.29, 95% CI 0.09-0.81; p = 0.0071). Pneumonitis improved in 94% (31 of 33) of cases, and one patient died from pneumonitis. The overall response ratio (CR+PR) was 44% in patients with COP and 31% in patients with GGO (p = 0.47). There was no statistical difference in OS between patients with systemic corticosteroid therapy for pneumonitis and those without (not reached vs. 14.8 months; HR 1.4, 95% CI 0.52-4.1; p = 0.51). Conclusions: Patients with pneumonitis classified as COP had significantly longer survival time than those with pneumonitis classified as GGO. Radiologic features of pneumonitis may reflect clinical outcomes after anti-PD-1 therapy.