Alongside laboratory testing, one of the key diagnostic tools used to identify prevalence of the deadly 2019 human coronavirus (2019-nCoV) on travelers from Wuhan, China, include radiography and computed tomography (CT) imaging. A significant proportion of those diagnosed with the human coronaviruses had lower-respiratory tract illnesses, such as pneumonia or bronchitis.
As more reports are emerging on the initial patients who have contracted the coronavirus, Chinese scientists have shared early findings from the outbreak, to better educate physicians globally. A detailed analysis by medics at the forefront of this epidemic at Jinyintan hospital in Wuhan of the first 99 patients treated has been published in the Lancet Medical Journal. Chinese officials stated common symptoms at onset of the virus include fever, cough and fatigue. All of the 99 patients taken to the hospital had pneumonia with abnormal findings on chest CT, with imaging findings mainly conclusive of bilateral multiple lobular and subsegmental areas of consolidation.
A study published by the New England Journal of Medicine also explores chest radiographs and key clues for radiologists, including two specific patient cases. The diagnosis of pneumonia was confirmed after chest radiographs had been performed. The patients undertook chest X-ray and CT examinations which demonstrated pneumonia-like findings, which the researchers referred to as "novel coronavirus-infected pneumonia."
Another case study of a Vietnamese man who had recently returned from China, and was later diagnosed with the coronavirus, highlighted chest radiographs to be a key indicator of infiltration in the upper lobe of the left lung.
Real crisis drives real solutions
As the death toll of the coronavirus has now reached 213, global apprehension continues to rise in response to the epidemic, with increased measures of quarantine and medical screening, and travellers from China being sanctioned. Mounting pressure and demand for mass screening in China, to the nation which hosts the largest population in the world, is well underway. Current developments in medical imaging show how technology can be engineered to combat major disease to help combat mortality rates.
Evolution of medical imaging: current solutions
Recent ground-breaking and industry-first technologies in diagnostic imaging include algorithms and AI technology embedded in mobile general radiography systems to accurately detect the deadly condition of pneumothorax. For instance, GE Healthcare’s FDA-approved Critical Care System and Fujifilm’s FDR AQRO Mini Mobile DR System demonstrate how AI-powered recognition algorithms can help physicians identify suspicious findings. (Note: Fujifilm AI integration for digital X-ray is in development.) AI recognition will search and map images to help identify pathologies such as pneumothorax and more. Such developments in diagnostic imaging for case prioritization in chest imaging demonstrate how a real crisis— in this case, pneumothorax, which impacts 74,000 Americans a year—drives real solutions.
Within diagnostic imaging, there is increased implementation of AI-based solutions for detection of breast cancer in mammography screening. The countable rise of breast cancer incidence globally has heightened pressure for government screening programs, and therefore, once again has reinforced the message that real crisis drives real solutions. Breast cancer, being the second leading cause of cancer death among women overall, has resulted in increased AI implementation in screening for more accurate detection and a reduction in mortalities.
Another example is the clinical application of CT now placing more focus on early detection. Lung CT scans are most commonly used to detect lung cancer in older adults with a history of smoking. Lung cancer is the leading cause of cancer deaths in the world but screening high risk patients can reduce lung cancer mortality. All of the major CT manufacturers market low-dose CT lung cancer screening protocols that are compatible with their CT portfolio. Lung screening as a clinical application is in high demand and will continue to grow as the population ages. CT solutions powered by AI are increasingly gaining traction to improve diagnostic capabilities and increase workflow speed.
In late 2018, the top three CT suppliers launched AI-powered solutions:
- Siemens Healthineers launched the AI-Rad Companion Chest CT that uses AI technology to automatically perform measurements, prepare results, and highlight abnormalities.
- GE Healthcare debuted its Deep Learning Image Reconstruction (DLIR) engine on its premium CT system. The DLIR uses a dedicated deep neural network to generate higher quality images and improve diagnostic confidence.
- Canon Medical introduced the Advanced Intelligent Clear-IQ Engine that produces CT images through a deep learning reconstruction algorithm, improving image quality, reducing patient dose, and streamlining workflow.
Medical imaging and the coronavirus
According to Chinese officials and the World Health Organization, the number of confirmed cases of the new coronavirus now has risen to 9,692 worldwide. Radiography and CT imaging will play a fundamental role in mass screening and diagnosis of suspected patients of the deadly coronavirus.
In such circumstances, AI-powered recognition to drive case prioritization and identification of key indicators and symptoms of the coronavirus, in particular pneumonia, will provide solace in helping medical professionals to tackle and control the outbreak of this global epidemic.