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COVID-19 progression in hospitalized patients using follow-up in vivo CT and ex vivo microCT

(2023) JOURNAL OF THORACIC DISEASE. 15(7). p.3646-3661
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Abstract
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease-19 (COVID-19) which can lead to acute respiratory distress syndrome (ARDS) and evolve to pulmonary fibrosis. Computed tomography (CT) is used to study disease progression and describe radiological patterns in COVID-19 patients. This study aimed to assess disease progression regarding lung volume and density over time on follow-up in vivo chest CT and give a unique look at parenchymal and morphological airway changes in "end-stage" COVID-19 lungs using ex vivo microCT. Methods: Volumes and densities of the lung/lobes of three COVID-19 patients were assessed using followup in vivo CT and ex vivo whole lung microCT scans. Airways were quantified by airway segmentations on whole lung microCT and small-partition microCT. As controls, three discarded healthy donor lungs were used. Histology was performed in differently affected regions in the COVID-19 lungs. Results: In vivo, COVID-19 lung volumes decreased while density increased over time, mainly in lower lobes as previously shown. Ex vivo COVID-19 lung volumes decreased by 60% and all lobes were smaller compared to controls. Airways were more visible on ex vivo microCT in COVID-19, probably due to fibrosis and increased airway diameter. In addition, small-partition microCT showed more deformation of (small) airway morphology and fibrotic organization in severely affected regions with heterogeneous distributions within the same lung which was confirmed by histology. Conclusions: COVID-19-ARDS and subsequent pulmonary fibrosis alters lung architecture and airway morphology which is described using in vivo CT, ex vivo microCT, and histology.
Keywords
Pulmonary and Respiratory Medicine, Airway morphology, coronavirus disease-19 (COVID-19), ex vivo micro-computed tomography (ex vivo microCT), in vivo chest CT, lung density and volume, CHEST CT, LUNG, INFECTION, FEATURES

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MLA
Geudens, Vincent, et al. “COVID-19 Progression in Hospitalized Patients Using Follow-up in Vivo CT and Ex Vivo MicroCT.” JOURNAL OF THORACIC DISEASE, vol. 15, no. 7, 2023, pp. 3646–61, doi:10.21037/jtd-22-1488.
APA
Geudens, V., Van Slambrouck, J., Aerts, G., Willems, L., Goos, T., Kaes, J., … Vanaudenaerde, B. M. (2023). COVID-19 progression in hospitalized patients using follow-up in vivo CT and ex vivo microCT. JOURNAL OF THORACIC DISEASE, 15(7), 3646–3661. https://doi.org/10.21037/jtd-22-1488
Chicago author-date
Geudens, Vincent, Jan Van Slambrouck, Gitte Aerts, Lynn Willems, Tinne Goos, Janne Kaes, Andrea Zajacova, et al. 2023. “COVID-19 Progression in Hospitalized Patients Using Follow-up in Vivo CT and Ex Vivo MicroCT.” JOURNAL OF THORACIC DISEASE 15 (7): 3646–61. https://doi.org/10.21037/jtd-22-1488.
Chicago author-date (all authors)
Geudens, Vincent, Jan Van Slambrouck, Gitte Aerts, Lynn Willems, Tinne Goos, Janne Kaes, Andrea Zajacova, Iwein Gyselinck, Celine Aelbrecht, Astrid Vermaut, Hanne Beeckmans, Marie Vermant, Charlotte De Fays, Annelore Sacreas, Lucia Aversa, Michaela Orlitova, Arno Vanstapel, Iván Josipovic, Matthieu Boone, John E. McDonough, Birgit Weynand, Charles Pilette, Wim Janssens, Lieven Dupont, Wim A. Wuyts, Geert M. Verleden, Dirk E. Van Raemdonck, Robin Vos, Ghislaine Gayan-Ramirez, Laurens J. Ceulemans, and Bart M. Vanaudenaerde. 2023. “COVID-19 Progression in Hospitalized Patients Using Follow-up in Vivo CT and Ex Vivo MicroCT.” JOURNAL OF THORACIC DISEASE 15 (7): 3646–3661. doi:10.21037/jtd-22-1488.
Vancouver
1.
Geudens V, Van Slambrouck J, Aerts G, Willems L, Goos T, Kaes J, et al. COVID-19 progression in hospitalized patients using follow-up in vivo CT and ex vivo microCT. JOURNAL OF THORACIC DISEASE. 2023;15(7):3646–61.
IEEE
[1]
V. Geudens et al., “COVID-19 progression in hospitalized patients using follow-up in vivo CT and ex vivo microCT,” JOURNAL OF THORACIC DISEASE, vol. 15, no. 7, pp. 3646–3661, 2023.
@article{01HEJKBRZA3XWT4BZXHK0J0E4K,
  abstract     = {{Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease-19 (COVID-19) which can lead to acute respiratory distress syndrome (ARDS) and evolve to pulmonary fibrosis. Computed tomography (CT) is used to study disease progression and describe radiological patterns in COVID-19 patients. This study aimed to assess disease progression regarding lung volume and density over time on follow-up in vivo chest CT and give a unique look at parenchymal and morphological airway changes in "end-stage" COVID-19 lungs using ex vivo microCT.

Methods: Volumes and densities of the lung/lobes of three COVID-19 patients were assessed using followup in vivo CT and ex vivo whole lung microCT scans. Airways were quantified by airway segmentations on whole lung microCT and small-partition microCT. As controls, three discarded healthy donor lungs were used. Histology was performed in differently affected regions in the COVID-19 lungs.

Results: In vivo, COVID-19 lung volumes decreased while density increased over time, mainly in lower lobes as previously shown. Ex vivo COVID-19 lung volumes decreased by 60% and all lobes were smaller compared to controls. Airways were more visible on ex vivo microCT in COVID-19, probably due to fibrosis and increased airway diameter. In addition, small-partition microCT showed more deformation of (small) airway morphology and fibrotic organization in severely affected regions with heterogeneous distributions within the same lung which was confirmed by histology.

Conclusions: COVID-19-ARDS and subsequent pulmonary fibrosis alters lung architecture and airway morphology which is described using in vivo CT, ex vivo microCT, and histology.}},
  author       = {{Geudens, Vincent and Van Slambrouck, Jan and Aerts, Gitte and Willems, Lynn and Goos, Tinne and Kaes, Janne and Zajacova, Andrea and Gyselinck, Iwein and Aelbrecht, Celine and Vermaut, Astrid and Beeckmans, Hanne and Vermant, Marie and De Fays, Charlotte and Sacreas, Annelore and Aversa, Lucia and Orlitova, Michaela and Vanstapel, Arno and Josipovic, Iván and Boone, Matthieu and McDonough, John E. and Weynand, Birgit and Pilette, Charles and Janssens, Wim and Dupont, Lieven and Wuyts, Wim A. and Verleden, Geert M. and Van Raemdonck, Dirk E. and Vos, Robin and Gayan-Ramirez, Ghislaine and Ceulemans, Laurens J. and Vanaudenaerde, Bart M.}},
  issn         = {{2072-1439}},
  journal      = {{JOURNAL OF THORACIC DISEASE}},
  keywords     = {{Pulmonary and Respiratory Medicine,Airway morphology,coronavirus disease-19 (COVID-19),ex vivo micro-computed tomography (ex vivo microCT),in vivo chest CT,lung density and volume,CHEST CT,LUNG,INFECTION,FEATURES}},
  language     = {{eng}},
  number       = {{7}},
  pages        = {{3646--3661}},
  title        = {{COVID-19 progression in hospitalized patients using follow-up in vivo CT and ex vivo microCT}},
  url          = {{http://doi.org/10.21037/jtd-22-1488}},
  volume       = {{15}},
  year         = {{2023}},
}

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