This ppt is all about the test by which we can detect covid virus , RT-PCR, Rapid antigen test,CT Chest all 3 test are properly mentioned . The importance of Ct in covid and how to check the level of severity by CORAD . This also involves comparision between CT and RT-PCCR in case of Covid.

1. CO-RAD
DEEPAK NEGI
MRIT
TMU

2. CONTENT
 COVID-19
 DETECTION OF COVID-19
 RAPID ANTIBODY TEST
 RT-PCR TEST
 CT CHEST SCAN
 CT PROTOCOLS FOR COVID PATIENT
 CO-RAD
 CONCLUSION

3. COVID-19
 COVID-19 (coronavirus disease 2019) is an infectious disease caused by SARS-
CoV-2 (severe acute respiratory syndrome coronavirus 2 ), a strain of
coronavirus.
 The first cases were seen in Wuhan ,CHINA in December 2019.
 Spreads primarily through droplets of saliva or discharge from the nose .

4. DETECTION OF COVID-19
 RT-PCR (reverse transcription-polymerase chain reaction)
 RAPID ANTIBODY TEST
 CHEST CT SCAN

5. RT-PCR
 A PCR is performed to detect genetic material from a specific organism such as a
virus .
 3 key steps to COVID-19 test
SAMPLE COLLECTION
EXTRACTION
PCR (THERMAL CYCLER)

6. RAPID ANTIBODY TEST

7. CT CHEST SCAN
 CT scanning is a fast, painless, noninvasive and accurate radiological examination.
 Computed tomography (CT) of the chest is a cross-sectional evaluation of the
heart, airways, lungs, mediastinum, and associated bones and soft tissues.

8. Continue
 HRCT (High-resolution computed tomography) is the most preferred
method for COVID-19 cases.
 NCCT (non-enhanced computed tomography ) for severe patients .
 CECT (contrast enhanced computed tomography) in case if there is
complain of pulmonary hypertension.
 EVALUATION CRITERIA- (1) Site of lung involvement
(2) Universally agreed CT findings with COVID-19 including
ground-glass opacities (GGO) with or without consolidative changes in
addition to special signs such as “Atoll sign” and “Crazy paving
pattern”
[3] Manifestations of bronchial or pleural involvement.

9. CT PROTOCOLS FOR COVID-19
 Low-radiation-dose CT images by using lower kilovoltage settings
 Helical mode volumetric HRCT with 100-120 kVp and 80-200 Ma
 For CT examinations at risk for motion artifact, lowering the rotation time of the tube
detector system with high pitch and wide collimation values may be considered .
 1 mm slice thickness, 1 mm detector collimation, 0.6-0.9 s tube rotation.
 CT images should be acquired during a single inspiratory breath hold. Expiratory phase
CT increases radiation dose.
 Multi-planner reconstruction (MPR) for image analysis. Post-processing maximum
intensity projection (MIP) and minimum intensity projection (Min-IP) reconstructions
used.
 AI learning–based reconstructions for noise reduction, and spectral shaping of the x-ray
beam to reduce the low-energy component of the x-ray spectrum.

10. CO-RAD
COVID-19 Reporting and Data System
In early March 2020, the Dutch Radiological Society
initiated a COVID-19 network to facilitate
development and nationwide dissemination of
COVID-19–related information and tools.
A COVID-19 standardized reporting working group
was formed.

12. CO-RADS Category 0
If scans are incomplete or of insufficient quality,
for example because of severe artifacts due to
coughing or breathing.

13. CO-RADS Category 1
CO-RADS category 1 implies a very low level of
suspicion for pulmonary involvement by COVID-19
based on normal CT results.
It refers to normal findings.
Mild or severe emphysema, perifissural nodules,
lung tumors, and fibrosis are classified as CO-RADS
category 1 findings.

14. CO-RADS 1. Normal chest CT.

15. CO-RADS Category 2
CO-RADS category 2 implies a low level of
suspicion for pulmonary involvement by COVID-19
based on CT findings.
Involves lung infectious origin that are considered
not compatible with COVID-19.
Examples are bronchitis, infectious bronchiolitis,
bronchopneumonia, lobar pneumonia, and
pulmonary abscess. lobar or segmental
consolidation, and lung cavitation.

16. CO-RADS 2. Non COVID-19 infection

17. CO-RADS 2

18. CO-RADS 2. Bacterial pneumonia with
endobronchial spread (tree-in-bud)

19. CO-RADS Category 3
CO-RADS category 3 implies equivocal findings for
pulmonary involvement of COVID-19 based on CT
features.
Findings include perihilar ground-glass opacity,
homogenous extensive ground-glass opacity or
ground-glass opacity together with smooth
interlobular septal thickening with or without pleural
effusion in the absence of other typical CT findings.

20. CO-RADS 3

21. CO-RADS 3

22. CO-RADS Category 4
CO-RADS category 4 implies a high level of
suspicion for pulmonary involvement by COVID-19
based on CT findings.
Show some overlap with other (viral) pneumonias

23. CO-RAD 4

24. CO-RADS Category 5
CO-RADS category 5 implies a very high level of
suspicion for pulmonary involvement by COVID-19
based on typical CT findings.
Features are ground-glass opacities with or without
consolidations in lung regions close to visceral
pleural surfaces, including the fissures, and a
multifocal bilateral distribution.

25. CO-RAD 5

26. CO-RAD 5

27. CO-RADS Category 6
Introduced to indicate proven COVID-
19, as signified by positive RT-PCR test
results for virus-specific nucleic acid.

28. CO-RAD 6

29. FINDINGS IN CHEST CT

30. Stages of COVID-19 at chest CT
(A) Early stage (0–5 days after symptom onset), which is
characterized by either normal findings or mainly ground-glass
opacities.
(B) Progressive stage (5–8 days after symptom onset), which is
characterized by increased ground-glass opacities and crazy-
paving appearance .
(C) Peak stage (9–13 days after symptom onset), which is
characterized by progressive consolidation .
(D) Late stage (≥14 days after symptom onset), which is
characterized by a gradual decrease of consolidation and
ground-glass opacities, while signs of fibrosis .

31. PROGRESS OF INFECTION

33. CONCLUSION
 Performing CT in patients with suspected or proven COVID-19
requires comprehensive precautionary safety measures.
 Low-radiation-dose chest CT is recommended unless CT pulmonary
angiography is required to evaluate for Pulmonary embolism.
 Chest CT shows (ground-glass opacities, vascular enlargement,
bilateral abnormalities, lower lobe involvement, and posterior
predilection), this may help in diagnostic decision making.
 Chest CT should not be used as an independent diagnostic tool to
exclude or confirm COVID-19. RT-PCR test results are the standard
for diagnosis and key component in clinical decision making.
 Best to know the severity and lung area affected by the virus.

34. REFERENCE
 https://pubs.rsna.org/doi/full/10.1148/radiol.20202040130
 https://www.rsna.org/-/media/Files/RSNA/Covid-19/RSNA-COVID19ChestCT-
ReportExample

35. THANKYOU