Explainer: Chest X-ray Vs CT scan

CT scan is an efficient tool to diagnose early COVID. However, the cost consideration and limited availability of CT SCAN machines lead to, skyrocketing of the prices. Diagnostic centres charge Rs 10,000 per CT scan. It is unaffordable for poor patients. Plus, repeated tests cause psychological imbalance and fear. We examine the case scenarios.

1. A patient is asymptomatic or has mild symptoms of fever or cough went to a practitioner. Instead of asking the patient for an RT-PCR swab test, he advises him to go for CT SCAN. If the CT scan shows shadow, he advises him RT-PCR. If the swab test is positive, he sends him to a government hospital.

If the swab test is negative, he is again referred to government hospital since 30% of reports may be 'False Negatives'. In the process, the patient not only loses money but also becomes panicky.

2. All viral flues will cause pneumonia, fever, and cough. Mild pneumonia changes and resolves on its own. From CT SCAN we cannot tell it is COVID. Because of the prevailing pandemic, we assume it as COVID. It may or may not. It does not need any treatment. In COVID, the recovery rate is more than 60%.

3. Mild and moderate cases recovery is a rule. It is necessary to detect very early.

4. In AIIMS Delhi, a suspect is advised to go for Chest X-RAY. If it detects patches, he is asked to undergo RTPCR. If Chest X-ray is negative, no treatment is given. If the patient is having symptoms and chest X-ray is negative, then they plan for RTPCR. If RTPCR comes back negative but he is still having breathlessness, they go for CT SCAN as the last mode of investigation and treat him as a suspect for three days before the repeat test.

4. In Maharashtra's Vidarbha region, chest X-RAY is used as a screening test for contacts and mildly symptomatic patients. If there are doubts then RTPCR tests are done. CT SCAN is never used as a screening tool. They are also using ARTIFICIAL INTELLIGENCE in a cloud-based system.

5. CHEST X-ray is the best SCREENING TOOL for CONTACTS, suspects, asymptomatic, mild, and moderate symptoms.

6. This peculiar scenario of advising CT SCAN for all people and denying treatment and admissions results in a panic situation. Most people do not have money due to the loss of jobs and unemployment.

8. Every doctor must judiciously use the investigations. Otherwise, they will lose respect in society.

DR.C.PRABHAKARA REDDY

PROF & HOD CTVS

GGH, KURNOOL

&

SPECIAL OFFICER

STATE COVID CONTROL CENTER

VIJAYAWADA