The role of radiology in early detection
Evaluating new techniques for disease prevention-COVID-19 case study
Keywords:
COVID-19, radiology, chest X-ray, computed tomography, ultrasound imaging, diagnostic techniquesAbstract
Introduction: The outbreak of COVID-19, caused by the novel coronavirus SARS-CoV-2, has prompted the use of various diagnostic methods to manage the disease. Although Real-Time Reverse Transcription-Polymerase Chain Reaction (RT-PCR) is the gold standard for COVID-19 diagnosis, its limitations in sensitivity and availability have highlighted the role of radiological techniques. Aim: This study aims to evaluate the effectiveness of different radiological techniques—chest X-ray (CXR), computed tomography (CT), and ultrasound imaging—in the early detection and management of COVID-19. Methods: A review of existing literature and case studies was conducted to assess the diagnostic utility, sensitivity, and limitations of CXR, CT, and ultrasound in COVID-19. Comparative analysis was performed based on imaging characteristics, diagnostic accuracy, and clinical outcomes. Results: CT is identified as the most sensitive modality for detecting COVID-19, showing high sensitivity in identifying lung abnormalities and disease progression. CXR, while cost-effective and widely available, offers lower sensitivity and is less effective for early-stage disease. Ultrasound imaging, though less common, provides useful supplementary information and is beneficial for bedside assessments. Conclusion: CT is crucial for diagnosing and monitoring COVID-19 due to its high sensitivity and detailed imaging capabilities.
Downloads
References
Chen, N., Zhou, M., Dong, X., Qu, J., Gong, F., Han, Y., Qiu, Y., Wang, J., Liu, Y., Wei, Y., Xia, J., Yu, T., Zhang, X., & Zhang, L. (2020). Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A descriptive study. The Lancet, 395(10223), 507-513. https://doi.org/10.1016/S0140-6736(20)30211-7 DOI: https://doi.org/10.1016/S0140-6736(20)30211-7
Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., Zhang, L., Fan, G., Xu, J., Gu, X., Cheng, Z., Yu, T., Xia, J., Wei, Y., Wu, W., Xie, X., Yin, W., Li, H., Liu, M., Xiao, Y., Gao, H., Guo, L., Xie, J., Wang, G., Jiang, R., Gao, Z., Jin, Q., Wang, J., & Cao, B. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet, 395(10223), 497-506. https://doi.org/10.1016/S0140-6736(20)30183-5 DOI: https://doi.org/10.1016/S0140-6736(20)30183-5
Ji, W., Wang, W., Zhao, X., Zai, J., & Li, X. (2020). Cross-species transmission of the newly identified coronavirus 2019-nCoV. Journal of Medical Virology, 92(4), 433-440. https://doi.org/10.1002/jmv.25682 DOI: https://doi.org/10.1002/jmv.25682
Xu, X., Chen, P., Wang, J., Feng, J., Zhou, H., Li, X., Zhong, W., & Hao, P. (2020). Evolution of the novel coronavirus from the ongoing Wuhan outbreak and modeling of its spike protein for risk of human transmission. Science China Life Sciences. https://doi.org/10.1007/s11427-020-1637-5 DOI: https://doi.org/10.1007/s11427-020-1637-5
Chan, J. F.-W., Yuan, S., Kok, K.-H., To, K. K.-W., Chu, H., Yang, J., Xing, F., Liu, J., Yip, C. C.-Y., Poon, R. W. S., Tsoi, H.-W., Lo, S. K., Chan, K. H., Poon, V. K.-M., Chan, W. M., Ip, J. D., Cai, J. P., Cheng, V. C.-C., Chen, H., Hui, C. K.-M., & Yuen, K.-Y. (2020). A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: A study of a family cluster. The Lancet, 395(10223), 514-523. https://doi.org/10.1016/S0140-6736(20)30154-9 DOI: https://doi.org/10.1016/S0140-6736(20)30154-9
Shi, H., Han, X., Jiang, N., Cao, Y., Alwalid, O., Gu, J., Fan, Y., & Zheng, C. (2020). Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: A descriptive study. The Lancet Infectious Diseases, 20(4), 425-434. https://doi.org/10.1016/S1473-3099(20)30255-0 DOI: https://doi.org/10.1016/S1473-3099(20)30086-4
Kanne, J. P. (2020). Chest CT findings in 2019 novel coronavirus (2019-nCoV) infections from Wuhan, China: Key points for the radiologist. Radiology, 295(1), 16-17. https://doi.org/10.1148/radiol.2020200129 DOI: https://doi.org/10.1148/radiol.2020200241
Pan, Y., & Guan, H. (2020). Imaging changes in patients with 2019-nCov. European Radiology. https://doi.org/10.1007/s00330-020-06713-z DOI: https://doi.org/10.1007/s00330-020-06713-z
Xie, X., Zhong, Z., Zhao, W., Zheng, C., Wang, F., & Liu, J. (2020). Chest CT for typical 2019-nCoV pneumonia: Relationship to negative RT-PCR testing. Radiology. https://doi.org/10.1148/radiol.2020200343 DOI: https://doi.org/10.1148/radiol.2020200343
Fang, Y., Zhang, H., Xie, J., Lin, M., Ying, L., Pang, P., & Ji, W. (2020). Sensitivity of chest CT for COVID-19: Comparison to RT-PCR. Radiology. https://doi.org/10.1148/radiol.2020200432 DOI: https://doi.org/10.1148/radiol.2020200432
Song, F., Shi, N., Shan, F., Zhang, Z., Shen, J., Lu, H., Ling, Y., Jiang, Y., & Shi, Y. (2020). Emerging 2019 novel coronavirus (2019-nCoV) pneumonia. Radiology, 295(1), 210-217. https://doi.org/10.1148/radiol.2020200274 DOI: https://doi.org/10.1148/radiol.2020200274
Ai, T., Yang, Z., Hou, H., Zhan, C., Chen, C., Lv, W., Tao, Q., Sun, Z., & Xia, L. (2020). Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: A report of 1014 cases. Radiology. https://doi.org/10.1148/radiol.2020200642 DOI: https://doi.org/10.1148/radiol.2020200642
Peiris, J. S. M., Chu, C. M., Cheng, V. C. C., Chan, K. S., Hung, I. F. N., Poon, L. L. M., Law, K. I., Tang, B. S. F., Hon, T. Y., Chan, C. S., Chan, K. H., Ng, J. S. C., Zheng, B. J., Ng, W. L., Lai, R. W. M., Guan, Y., & Yuen, K. Y. (2003). Clinical progression and viral load in a community outbreak of coronavirus-associated SARS pneumonia: A prospective study. The Lancet, 361(9371), 1767-1772. https://doi.org/10.1016/S0140-6736(03)13412-5 DOI: https://doi.org/10.1016/S0140-6736(03)13412-5
Hui, D. S. C., & Zumla, A. (2019). Severe acute respiratory syndrome: Historical, epidemiologic, and clinical features. Infectious Diseases Clinics of North America, 33(4), 869-889. https://doi.org/10.1016/j.idc.2019.08.003 DOI: https://doi.org/10.1016/j.idc.2019.07.001
Huang, P., Liu, T., Huang, L., Liu, H., Lei, M., Xu, W., Hu, X., Chen, J., & Liu, B. (2020). Use of chest CT in combination with negative RT-PCR assay for the 2019 novel coronavirus but high clinical suspicion. Radiology, 295(1), 22-23. https://doi.org/10.1148/radiol.2020200157 DOI: https://doi.org/10.1148/radiol.2020200330
Chung, M., Bernheim, A., Mei, X., Zhang, N., Huang, M., Zeng, X., Cui, J., Xu, W., Yang, Y., Fayaad, Z. A., Jacobi, A., Li, K., Li, S., & Shan, H. (2020). CT imaging features of 2019 novel coronavirus (2019-nCoV). Radiology, 295(1), 202-207. https://doi.org/10.1148/radiol.2020200230 DOI: https://doi.org/10.1148/radiol.2020200230
Xu, X., Yu, C., Qu, J., Zhang, L., Jiang, S., Huang, D., Chen, B., Zhang, Z., Guan, W., Ling, Z., Jiang, R., Hu, T., Ding, Y., Lin, L., Gan, Q., Luo, L., Tang, X., & Liu, J. (2020). Imaging and clinical features of patients with 2019 novel coronavirus SARS-CoV-2. European Journal of Nuclear Medicine and Molecular Imaging, 47(4), 1275-1280. https://doi.org/10.1007/s00259-020-04729-8 DOI: https://doi.org/10.1007/s00259-020-04735-9
Pan, Y., Guan, H., Zhou, S., Wang, Y., Li, Q., Zhu, T., Hu, Q., & Xia, L. (2020). Initial CT findings and temporal changes in patients with the novel coronavirus pneumonia (2019-nCoV): A study of 63 patients in Wuhan, China. European Radiology. https://doi.org/10.1007/s00330-020-06731-x DOI: https://doi.org/10.1007/s00330-020-06731-x
Pan, F., Ye, T., Sun, P., Gui, S., Liang, B., Li, L., Zheng, D., Wang, J., Hesketh, R. L., Yang, L., & Zheng, C. (2020). Time course of lung changes on chest CT during recovery from 2019 novel coronavirus (COVID-19) pneumonia. Radiology. https://doi.org/10.1148/radiol.2020200370 DOI: https://doi.org/10.1148/radiol.2020200370
Yoon, S. H., Lee, K. H., Kim, J. Y., Lee, Y. K., Ko, H., Kim, K. H., Park, C. M., & Kim, Y. H. (2020). Chest radiographic and CT findings of the 2019 novel coronavirus disease (COVID-19): Analysis of nine patients treated in Korea. Korean Journal of Radiology, 21(4), 494-500. https://doi.org/10.3348/kjr.2020.0138 DOI: https://doi.org/10.3348/kjr.2020.0132
Bernheim, A., Mei, X., Huang, M., Yang, Y., Fayaad, Z. A., Zhang, N., Diao, K., Lin, B., Zhu, X., Li, K., Li, S., Shan, H., Jacobi, A., & Chung, M. (2020). Chest CT findings in coronavirus disease-19 (COVID-19): Relationship to duration of infection. Radiology. https://doi.org/10.1148/radiol.2020200463 DOI: https://doi.org/10.1148/radiol.2020200463
Li, W., Cui, H., Li, K., Fang, Y., & Li, S. (2020). Chest computed tomography in children with COVID-19 respiratory infection. Pediatric Radiology. https://doi.org/10.1007/s00247-020-04656-7 DOI: https://doi.org/10.1007/s00247-020-04656-7
Xu, Y. H., Dong, J. H., An, W. M., Lv, X. Y., Yin, X. P., Zhang, J. Z., Dong, L., Ma, X., Zhang, H. J., & Gao, B. L. (2020). Clinical and computed tomographic imaging features of novel coronavirus pneumonia caused by SARS-CoV-2. Journal of Infection, 80(4), 394-400. https://doi.org/10.1016/j.jinf.2020.02.037 DOI: https://doi.org/10.1016/j.jinf.2020.02.017
Yang, W., Cao, Q., Qin, L., Wang, X., Cheng, Z., Pan, A., Dai, J., Sun, Q., Zhao, F., Qu, J., & Yan, F. (2020). Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID-19): A multi-center study in Wenzhou city, Zhejiang, China. Journal of Infection, 80(4), 388-393. https://doi.org/10.1016/j.jinf.2020.02.016 DOI: https://doi.org/10.1016/j.jinf.2020.02.016
Hu, Z., Song, C., Xu, C., Jin, G., Chen, Y., Xu, X., Ma, H., Chen, W., Lin, Y., Zheng, Y., Wang, J., Hu, Z., Yi, Y., & Shen, H. (2020). Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, China. Science China Life Sciences. https://doi.org/10.1007/s11427-020-1661-4 DOI: https://doi.org/10.1101/2020.02.20.20025619
Cheng, Z., Lu, Y., Cao, Q., Qin, L., Pan, Z., Yan, F., & Yang, W. (2020). Clinical features and chest CT manifestations of Coronavirus disease 2019 (COVID-19) in a single-center study in Shanghai, China. AJR American Journal of Roentgenology. https://doi.org/10.2214/AJR.20.23271 DOI: https://doi.org/10.2214/AJR.20.22959
Xiong, Y., Sun, D., Liu, Y., Fan, Y., Zhao, L., Li, X., & Zhu, W. (2020). Clinical and high-resolution CT features of the COVID-19 infection: Comparison of the initial and follow-up changes. Investigative Radiology. https://doi.org/10.1097/RLI.0000000000000674 DOI: https://doi.org/10.1097/RLI.0000000000000674
Li, Y., & Xia, L. (2020). Coronavirus disease 2019 (COVID-19): Role of chest CT in diagnosis and management. AJR American Journal of Roentgenology. https://doi.org/10.2214/AJR.20.22954 DOI: https://doi.org/10.2214/AJR.20.22954
Zhou, S., Wang, Y., Zhu, T., & Xia, L. (2020). CT features of Coronavirus disease 2019 (COVID-19) pneumonia in 62 patients in Wuhan, China. AJR American Journal of Roentgenology, 215(1), 1-8. https://doi.org/10.2214/AJR.20.22975 DOI: https://doi.org/10.2214/AJR.20.22975
Han, R., Huang, L., Jiang, H., Dong, J., Peng, H., & Zhang, D. (2020). Early clinical and CT manifestations of Coronavirus disease 2019 (COVID-19) pneumonia. AJR American Journal of Roentgenology, 215(2), 1-6. https://doi.org/10.2214/AJR.20.22961 DOI: https://doi.org/10.2214/AJR.20.22961
Xia, W., Shao, J., Guo, Y., Peng, X., Li, Z., & Hu, D. (2020). Clinical and CT features in pediatric patients with COVID-19 infection: Different points from adults. Pediatric Pulmonology. https://doi.org/10.1002/ppul.24718 DOI: https://doi.org/10.1002/ppul.24718
Qin, C., Liu, F., Yen, T. C., & Lan, X. (2020). (18)F-FDG PET/CT findings of COVID-19: A series of four highly suspected cases. European Journal of Nuclear Medicine and Molecular Imaging, 47(5), 1281-1286. https://doi.org/10.1007/s00259-020-04719-2 DOI: https://doi.org/10.1007/s00259-020-04734-w
Liu, D., Li, L., Wu, X., Zheng, D., Wang, J., Yang, L., & Zheng, C. (2020). Pregnancy and perinatal outcomes of women with Coronavirus disease (COVID-19) pneumonia: A preliminary analysis. AJR American Journal of Roentgenology, 215(1), 1-6. https://doi.org/10.2214/AJR.20.23639 DOI: https://doi.org/10.2214/AJR.20.23072
Zhao, W., Zhong, Z., Xie, X., Yu, Q., & Liu, J. (2020). Relation between chest CT findings and clinical conditions of Coronavirus disease (COVID-19) pneumonia: A multicenter study. AJR American Journal of Roentgenology, 215(1), 1-6. https://doi.org/10.2214/AJR.20.22952 DOI: https://doi.org/10.2214/AJR.20.22976
Wang, Y., Dong, C., Hu, Y., Li, C., Ren, Q., Zhang, X., Shi, H., & Zhou, M. (2020). Temporal changes of CT findings in 90 patients with COVID-19 pneumonia: A longitudinal study. Radiology. https://doi.org/10.1148/radiol.2020200843 DOI: https://doi.org/10.1148/radiol.2020200843
Dai, W. C., Zhang, H. W., Yu, J., Xu, H. J., Chen, H., Luo, S. P., Zhang, H., Liang, L. H., Wu, L., Lei, Y., & Lin, F. (2020). CT imaging and differential diagnosis of COVID-19. Canadian Association of Radiologists Journal. https://doi.org/10.1177/0846537120913033 DOI: https://doi.org/10.1177/0846537120913033
Franquet, T. (2011). Imaging of pulmonary viral pneumonia. Radiology, 260(1), 18-39. https://doi.org/10.1148/radiol.2601100453 DOI: https://doi.org/10.1148/radiol.11092149
Hansell, D. M., Bankier, A. A., MacMahon, H., McLoud, T. C., Müller, N. L., & Remy, J. (2008). Fleischner Society: Glossary of terms for thoracic imaging. Radiology, 246(3), 697-722. https://doi.org/10.1148/radiol.2462070712 DOI: https://doi.org/10.1148/radiol.2462070712
Holshue, M. L., DeBolt, C., Lindquist, S., Lo, Y. C., Wiesman, J., Bruce, H., Spitters, C., Erickson, K., Wilkerson, S., Tural, A., Diaz, G., Cohn, A., Fox, L., Patel, A., Gerber, S. I., Kim, L., Tong, S., Lu, X., Lindstrom, S., Pallansch, M. A., Weldon, W. C., Biggs, H. M., Uyeki, T. M., & Pillai, S. K. (2020). First case of 2019 novel coronavirus in the United States. New England Journal of Medicine, 382(10), 929-936. https://doi.org/10.1056/NEJMoa2001191 DOI: https://doi.org/10.1056/NEJMoa2001191
Reali, F., Sferrazzza Papa, G. F., Carlucci, P., Fracasso, P., Di Marco, F., Mandelli, M., Soldi, S., Riva, E., Centanni, S. (2014). Can lung ultrasound replace chest radiography for the diagnosis of pneumonia in hospitalized children? Respiration, 88(2), 112-115. https://doi.org/10.1159/000365377 DOI: https://doi.org/10.1159/000362692
Buonsenso, D., Piano, A., Raffaelli, F., Bonadia, N., De Gaetano Donati, K., Franceschi, F. (2020). Point-of-care lung ultrasound findings in novel coronavirus disease-19 pneumonia: A case report and potential applications during COVID-19 outbreak. European Review for Medical and Pharmacological Sciences, 24(15), 2776-2780. https://doi.org/10.26355/eurrev_202008_23093
Kalra, M. K., Maher, M. M., Rizzo, S., Kanarek, D., & Shepard, J. A. (2004). Radiation exposure from chest CT: Issues and strategies. Journal of Korean Medical Science, 19(2), 159-166. https://doi.org/10.3346/jkms.2004.19.2.159 DOI: https://doi.org/10.3346/jkms.2004.19.2.159
Published
How to Cite
Issue
Section
Copyright (c) 2021 International journal of health sciences

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles published in the International Journal of Health Sciences (IJHS) are available under Creative Commons Attribution Non-Commercial No Derivatives Licence (CC BY-NC-ND 4.0). Authors retain copyright in their work and grant IJHS right of first publication under CC BY-NC-ND 4.0. Users have the right to read, download, copy, distribute, print, search, or link to the full texts of articles in this journal, and to use them for any other lawful purpose.
Articles published in IJHS can be copied, communicated and shared in their published form for non-commercial purposes provided full attribution is given to the author and the journal. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
This copyright notice applies to articles published in IJHS volumes 4 onwards. Please read about the copyright notices for previous volumes under Journal History.