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    A novel use for routine CBCT imaging during radiotherapy to detect COVID-19

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    Authors
    Clough, Abigael
    Sanders, J
    Banfill, Kathryn
    Faivre-Finn, Corinne
    Price, Gareth J
    Eccles, Cynthia L
    Aznar, Marianne Camille
    Van Herk, Marcel
    Affiliation
    The Christie NHSFT, Manchester, United Kingdom. Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.
    Issue Date
    2021
    
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    Abstract
    Introduction: Thoracic CT is a useful tool in the early diagnosis of patients with COVID-19. Typical appearances include patchy ground glass shadowing. Thoracic radiotherapy uses daily cone beam CT imaging (CBCT) to check for changes in patient positioning and anatomy prior to treatment through a qualitative assessment of lung appearance by radiographers. Observation of changes related to COVID-19 infection during this process may facilitate earlier testing improving patient management and staff protection. Methods: A tool was developed to create overview reports for all CBCTs for each patient throughout their treatment. Reports contain coronal maximum intensity projection (MIP's) of all CBCTs and plots of lung density over time. A single therapeutic radiographer undertook a blinded off-line audit that reviewed 150 patient datasets for tool optimisation in which medical notes were compared to image findings. This cohort included 75 patients treated during the pandemic and 75 patients treated between 2014 and 2017. The process was repeated retrospectively on a subset of the 285 thoracic radiotherapy patients treated between January-June 2020 to assess the efficiency of the tool and process. Results: Three patients in the n = 150 optimisation cohort had confirmed COVID-19 infections during their radiotherapy. Two of these were detected by the reported image assessment process. The third case was not detected on CBCT due to minimal density changes in the visible part of the lungs. Within the retrospective cohort four patients had confirmed COVID-19 based on RT-PCR tests, three of which were retrospectively detected by the reported process. Conclusion: The preliminary results indicate that the presence of COVID-19 can be detected on CBCT by therapeutic radiographers.
    Citation
    Clough A, Sanders J, Banfill K, Faivre-Finn C, Price G, Eccles CL, et al. A novel use for routine CBCT imaging during radiotherapy to detect COVID-19. Radiography. 2021 Jul.
    Journal
    Radiography
    URI
    http://hdl.handle.net/10541/624502
    DOI
    10.1016/j.radi.2021.07.011
    PubMed ID
    34332857
    Additional Links
    https://dx.doi.org/10.1016/j.radi.2021.07.011
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.radi.2021.07.011
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