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ORIGINAL RESEARCH article
Front. Radiol.
Sec. Cardiothoracic Imaging
Volume 4 - 2024 |
doi: 10.3389/fradi.2024.1487895
Comparison of Dark-field Chest Radiography and CT for the Assessment of COVID-19 Pneumonia
Provisionally accepted
Florian Tilman Gassert
1*
Henriette Bast
1
Theresa Urban
1
Manuela Frank
1
Felix G Gassert
1
Konstantin Willer
2
Rafael Schick
2
Bernhard Renger
1
Thomas Köhler
3
Alexandra Karrer
1
Andreas P Sauter
1
Alexander Fingerle
1
Marcus R Makowski
1
Franz Pfeiffer
1,2
Daniela Pfeiffer
1- 1 University Hospital rechts der Isar, Technical University of Munich, Munich, Germany
- 2 Chair of Biomedical Physics, Department of Physics, School of Natural Sciences, Technical University of Munich, Garching, Germany, Munich, Bavaria, Germany
- 3 Philips, Hamburg, Hamburg, Germany
Background: Dark-field chest radiography allows the assessment of the structural integrity of the alveoli by exploiting the wave properties of x-rays. Purpose: To compare the qualitative and quantitative features of dark-field chest radiography in patients with COVID-19 pneumonia with conventional CT imaging. Materials and Methods: In this prospective study conducted from May 2020 to December 2020, patients aged at least 18 years who underwent chest CT for clinically suspected COVID-19 infection were screened for participation. Inclusion criteria were a CO-RADS score ≥ 4, the ability to consent to the procedure and to stand upright without help. Participants were examined with a clinical dark-field chest radiography prototype. For comparison, a healthy control cohort of 40 subjects was evaluated. Using Spearman’s correlation coefficient, correlation was tested between dark-field coefficient and CT-based COVID-19 index and visual total CT score as well as between the visual total dark-field score and the visual total CT score. Results: A total of 98 participants (mean age 58 ± 14 [standard deviation] years; 59 men) were studied. The areas of signal intensity reduction observed in dark-field images showed a strong correlation with infiltrates identified on CT scans. The dark-field coefficient had a negative correlation with both the quantitative CT-based COVID-19 index (r = -.34, p = .001) and the overall CT score used for visual grading of COVID-19 severity (r = -.44, p < .001). The total visual dark-field score for the presence of COVID-19 was positively correlated to the total CT score for visual COVID-19 severity grading (r = .85, p < .001). Conclusion: COVID-19 pneumonia-induced signal intensity losses in dark-field chest radiographs are consistent with CT-based findings, showing the technique’s potential for COVID-19 assessment.
Keywords: COVID-19, Radiography, Dark-field, Pneumonia, Lung imaging
Received: 28 Aug 2024; Accepted: 30 Dec 2024.
Copyright: © 2024 Gassert, Bast, Urban, Frank, Gassert, Willer, Schick, Renger, Köhler, Karrer, Sauter, Fingerle, Makowski, Pfeiffer and Pfeiffer. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Florian Tilman Gassert, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany
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