Perrone F, Balbi M, Casartelli C, Buti S, Milanese G, Sverzellati N, Bersanelli M. Differential diagnosis of COVID-19 at the chest computed tomography scan: A review with special focus on cancer patients. World J Radiol 2021; 13(8): 243-257 [PMID: 34567434 DOI: 10.4329/wjr.v13.i8.243]
Corresponding Author of This Article
Melissa Bersanelli, MD, Adjunct Professor, Chief Doctor, Medical Oncology Unit, University Hospital of Parma, Via Gramsci 14, Parma 43126, Italy. bersamel@libero.it
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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Perrone F, Balbi M, Casartelli C, Buti S, Milanese G, Sverzellati N, Bersanelli M. Differential diagnosis of COVID-19 at the chest computed tomography scan: A review with special focus on cancer patients. World J Radiol 2021; 13(8): 243-257 [PMID: 34567434 DOI: 10.4329/wjr.v13.i8.243]
Fabiana Perrone, Chiara Casartelli, Sebastiano Buti, Melissa Bersanelli, Medical Oncology Unit, University Hospital of Parma, Parma 43126, Italy
Fabiana Perrone, Chiara Casartelli, Melissa Bersanelli, Department of Medicine and Surgery, University of Parma, Parma 43126, Italy
Maurizio Balbi, Gianluca Milanese, Nicola Sverzellati, Department of Surgical Sciences, Institute of Diagnostic and Interventional Radiology, University of Parma, Parma 43126, Italy
Author contributions: Bersanelli M, Perrone F, and Casartelli C designed the work, planned the literature review according to PRISMA methods, and identified the areas of interest to discuss; Perrone F and Casartelli C collected the data; Balbi M prepared the figures; Perrone F and Balbi M wrote the first draft of the manuscript; Bersanelli M revised the manuscript for relevant scientific content and copyediting; Buti S, Milanese G, and Sverzellati N revised the manuscript for relevant scientific content; All authors have read and approved the final version of the manuscript.
Conflict-of-interest statement: Melissa Bersanelli received honoraria as a speaker at scientific events by Bristol-Myers Squibb (BMS), Novartis, Astra Zeneca, Pierre Fabre, and Pfizer and as a consultant for advisory role by Novartis, BMS, IPSEN, and Pfizer; she also received fees for copyright transfer by Sciclone Pharmaceuticals and research funding by Roche S.p.A., Seqirus UK, Pfizer, Novartis, BMS, Astra Zeneca, and Sanofi Genzyme. Sebastiano Buti received honoraria as a speaker at scientific events and advisory role by Bristol-Myers Squibb (BMS), Pfizer; MSD, Ipsen, Roche, Eli-Lilly, AstraZeneca and Novartis; he also received research funding from Novartis. All the other authors declare they have no conflicts of interest to disclose.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Melissa Bersanelli, MD, Adjunct Professor, Chief Doctor, Medical Oncology Unit, University Hospital of Parma, Via Gramsci 14, Parma 43126, Italy. bersamel@libero.it
Received: January 28, 2021 Peer-review started: January 28, 2021 First decision: May 6, 2021 Revised: May 18, 2021 Accepted: August 2, 2021 Article in press: August 2, 2021 Published online: August 28, 2021 Processing time: 208 Days and 14.1 Hours
ARTICLE HIGHLIGHTS
Research background
Several radiological features are shared by coronavirus disease 19 (COVID-19) pneumonia and other infective or non-infective pulmonary diseases.
Research motivation
The differential diagnosis of COVID-19 pneumonia is a radiological challenge.
Research objectives
To identify crucial radiological features of COVID-19 pneumonia reported by the literature and their differential diagnosis.
Research methods
We performed a systematic review with a descriptive aim.
Research results
Ground-glass opacity and consolidations are the most common computed tomography lesions in COVID-19 pneumonia and other respiratory diseases. Of the identified 133 studies, 18 were eligible and included in this review. Single lesion associated with pleural effusion and lymphadenopathies distinguishes COVID-19 pneumonia from early lung cancer. Only two studies included cancer patients, and the differential diagnosis with early lung cancer and radiation pneumonitis was performed. The onset of the lesions in the radiation fields only allows the differential diagnosis between COVID-19 pneumonia and radiation pneumonitis.
Research conclusions
Computed tomography scan is essential for the differential diagnosis of drug-induced pneumonitis, infectious pneumonia, and other conditions such as cancer progression.
Research perspectives
The focus on patients with cancer evidenced a wide lack of data in this field, suggesting at least retrospective collection of data in this population.
