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This article has been cited by other articles in PMC. Abstract Soon after reports of a novel coronavirus capable of causing severe pneumonia surfaced in lateexpeditious global spread of the Severe Acute Respiratory Distress Syndrome Coronavirus 2 SARS-CoV-2 forced the World Health Organization to declare an international state of emergency.
Although best known for causing symptoms of upper respiratory tract infection in mild cases and fulminant pneumonia in severe disease, Coronavirus Disease COVID has also been associated with gastrointestinal, neurologic, cardiac, and hematologic presentations. Despite concerns over poor specificity and undue radiation exposure, chest imaging nonetheless remains central to the initial diagnosis and monitoring of COVID progression, as well as to the evaluation of complications.
Classic features on chest CT include ground-glass and reticular opacities with or without superimposed consolidations, frequently presenting in a bilateral, peripheral, and posterior distribution.
For patients in whom exposure to ionizing radiation should be avoided, particularly pregnant patients and children, pulmonary MRI may represent a suitable alternative to chest CT. Although PET imaging is not typically considered among first-line investigative modalities for the diagnosis of lower respiratory tract infections, numerous reports have noted incidental localization of radiotracer in parenchymal regions of COVIDassociated pulmonary lesions.
These findings are consistent with data from Middle East Respiratory Syndrome-CoV cohorts which suggested an ability for 18F-FDG PET to detect subclinical infection and lymphadenitis in subjects mri prostate cancer staging overt clinical signs of infection.
Even still, decontamination of scanner bays is a time-consuming process, and proper ventilation of scanner suites may additionally require up to an hour of downtime to allow for sufficient air exchange.
Yet, in patients who require nuclear medicine investigations for other clinical indications, PET imaging may yield the earliest detection of nascent infection in otherwise asymptomatic individuals. Especially for patients with concomitant malignancies and other states of immunocompromise, prompt recognition of infection and early initiation of supportive care is crucial to maximizing outcomes and improving survivability.
This especially holds true during times of the year when the flu is epidemic. Nevertheless, chest imaging remains an integral component of the workup and staging of COVID, especially when assessing for complications or disease progression.
CT Chest CT has frequently been used in the imaging of COVID since the start of the pandemic, owing much to its affordability, availability, and detailed anatomic resolution.
GGOs together with focal consolidation are thought to be indicators of organizing pneumonia, where lesion formation may be related to ongoing pulmonary edema with hyaline membrane formation. While not typical features of disease, pleural effusion and mediastinal lymphadenopathy have been reported in a minority of cases and may herald poorer clinical outcomes.