Clinical Scorecard: Advanced Chest CT Segmentation for Evaluating the Effects of COVID-19 Infection

At a Glance

Key Highlights

• Chest CT imaging can assist in presumptive diagnosis, monitoring disease progression, and evaluating therapeutic efficacy in COVID-19.
• 3D segmentation of CT images allows volumetric quantification of lung pathology, aiding clinical assessment.
• Automatic segmentation methods reduce time consumption and variability compared to manual segmentation but have limitations in sensitivity and accuracy.

Guideline-Based Recommendations

Diagnosis

• Use RT-PCR as the reference standard for COVID-19 diagnosis.
• Consider chest CT imaging for patients with high suspicion of COVID-19, especially when RT-PCR results are negative or inconclusive.
• Apply RSNA guidelines to categorize CT imaging findings related to COVID-19.

Management

• Perform non-contrast-enhanced chest CT using low-radiation-dose protocols to minimize radiation exposure.
• Utilize 3D segmentation techniques to assess extent and distribution of lung pathology for clinical decision-making.

Monitoring & Follow-up

• Use chest CT imaging to monitor disease evolution and therapeutic response.
• Apply volumetric quantification from segmented CT images to track changes in affected lung areas.

Risks

• Recognize that CT imaging findings are non-specific and may overlap with other viral pneumonias.
• Be aware of false-negative RT-PCR results and limitations in CT sensitivity and specificity.
• Consider radiation exposure risks when performing repeated CT scans.

Patient & Prescribing Data

Patients with suspected or confirmed COVID-19 infection undergoing chest imaging

Chest CT imaging, combined with advanced segmentation, provides detailed assessment of lung involvement, supporting diagnosis and management decisions.

Clinical Best Practices

• Employ low-dose, non-contrast chest CT protocols to reduce radiation burden.
• Use automatic segmentation methods to improve efficiency while validating results with manual review when necessary.
• Interpret CT findings in conjunction with clinical and laboratory data due to non-specific imaging features.
• Apply 3D volumetric analysis to quantify lung involvement and support clinical communication.
• Be cautious of segmentation errors caused by image artefacts, airway size, and pulmonary abnormalities.

References

• Identification of SARS-CoV-2 as causative agent
• Radiological Society of North America (RSNA) COVID-19 Reporting Guidelines
• Chest CT manifestations in COVID-19