Utilization of flat-panel detector computed tomography for evaluation of COVID-19 pneumonia during neurointerventional procedures.

Abstract

Introduction: This study aimed to evaluate the imaging findings of the chest flat panel detector computed tomography (FDCT) among coronavirus disease-2019 (COVID-19) positive patients during urgent/emergent interventional neuroradiologic procedures.

Materials and methods: Chest FDCT examinations were performed using a C-arm mounted FDCT within the interventional radiology (IR) suite if the reverse transcription polymerase chain reaction (RT-PCR) results were pending in patients with clinical findings suggestive of COVID-19. In those who already had positive RT-PCR results, FDCT was performed for acute evaluation only if an acute unexpected cardiopulmonary event occurred during the procedure. FDCT images were evaluated retrospectively by a thoracic radiologist based on Radiological Society of North America classification.

Result: Eleven patients (four males, four females, one boy and two girls) with positive RT-PCR test results were included. Six presented for acute ischemic stroke treatment, three children had retinoblastomas, and two patients had hemorrhagic strokes. One (9.1%) patient had typical CT findings of COVID19, whereas 4 (36.4%) patients had indeterminate findings. Six (54.5%) patients had no findings suggestive of COVID-19. The most common parenchymal finding was atelectasis (eight patients), followed by consolidation (five patients), pleural effusion (two patient) and pulmonary mass lesion (one patient).

Conclusions: This study is the first in the literature utilizing C-arm FDCT for dedicated thoracic imaging at the IR suite. Ability to perform on-site chest CT without a need to transfer the patient to a regular CT scan may be helpful in both the management of acute pulmonary complications that occur during interventional procedures and pre-interventional assessment for pulmonary conditions like COVID-19 in the IR suite in emergent interventions.