REVIEW Open Access
A review on chest CT scanning parameters
implemented in COVID-19 patients:
bringing low-dose CT protocols into play
Javid Azadbakht
1
, Daryoush Khoramian
2
, Zahra Sadat Lajevardi
3
, Fateme Elikaii
3
, Amir Hossein Aflatoonian
3
,
Bagher Farhood
4*
, Masoud Najafi
5*
and Hamed Bagheri
6
Abstract
Background: This study aims to review chest computed tomography (CT) scanning parameters which are utilized
to evaluate patients for COVID-19-induced pneumonia. Also, some of radiation dose reduction techniques in CT
would be mentioned, because using these techniques or low-dose protocol can decrease the radiation burden on
the population.
Main body: Chest CT scan can play a key diagnostic role in COVID-19 patients. Additionally, it can be useful to
monitor imaging changes during treatment. However, CT scan overuse during the COVID-19 pandemic raises
concerns about radiation-induced adverse effects, both in patients and healthcare workers.
Conclusion: By evaluating the CT scanning parameters used in several studies, one can find the necessity for
optimizing these parameters. It has been found that chest CT scan taken using low-dose CT protocol is a reliable
diagnostic tool to detect COVID-19 pneumonia in daily practice. Moreover, the low-dose chest CT protocol results
in a remarkable reduction (up to 89%) in the radiation dose compared to the standard-dose protocol, not lowering
diagnostic accuracy of COVID-19-induced pneumonia in CT images. Therefore, its employment in the era of the
COVID-19 pandemic is highly recommended.
Keywords: COVID-19 pneumonia, Computed tomography, Radiation dose, Low dose
Background
New coronavirus (commonly known as COVID-19)
pneumonia, which was first reported in Wuhan, Hubei
Province, China, in December 2019, followed rapid
spread across China and worldwide [1]. This virus is
highly contagious and can be spread from person to per-
son by either an infected person or an asymptomatic
carrier. The virus can spread in communities and cross
borders rapidly. Respiratory droplets (in most of the
cases), close contact, and transmission via the digestive
tract are possible routes of transmission [2, 3]. Thus far,
no curative drug or effective vaccine for COVID-19 is
available; therefore, diagnosing the disease at an early
stage and to quarantine the infected patients are the
most rational approaches to alleviate. China government
has published a guideline on Diagnosis and Treatment
of Pneumonitis Caused by 2019-nCoV; its latest version
says reverse transcription-polymerase chain reaction
(RT-PCR) or gene sequencing for samples extracted
from the respiratory tract or blood is needed to confirm
the diagnosis of COVID-19, which in turn is the main
indicator of the need for hospitalization [4]. Though,
limitations related to kit performance, sample extraction
and sample transportation resulted in about 30 to 60%
of RT-PCR tests done on throat swab samples to be
positive at initial presentation. This lack of sensitivity
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* Correspondence: bffarhood@gmail.com; najafi_ma@yahoo.com
4
Department of Medical Physics and Radiology, Kashan University of Medical
Sciences, Kashan, Iran
5
Radiology and Nuclear Medicine Department, School of Paramedical
Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran
Full list of author information is available at the end of the article
Egyptian Journal of Radiology
and Nuclear Medicine
Azadbakht et al. Egyptian Journal of Radiology and Nuclear Medicine
(2021) 52:13
https://doi.org/10.1186/s43055-020-00400-1