Quantitative spectral computed tomography detects different patterns of airway wall thickening and contrast enhancement in infective lung disease: a feasibility study

OBJECTIVES: We aimed to show that spectral computed tomography (CT) can identify different patterns of airway wall thickening and contrast enhancement in lung-healthy controls, coronavirus disease 2019 (COVID-19), and non-COVID-19 pneumonia patients, reflecting airway inflammation in both pneumonia subtypes and airway neovascularization in COVID-19. MATERIALS AND METHODS: 331 subjects (age 58.9 ± 17.2 years) with 218 arterial and 113 venous phase spectral CT acquisitions were retrospectively recruited: 119 lung-healthy controls, 45 with COVID-19 and 167 with non-COVID-19 pneumonia. Scientific software was used for segmenting the airway tree. Wall thickness (WT(5-10)) and the difference in median maximum airway wall attenuation (slope of the spectral attenuation curve) between 40 keV and 100 keV display energy were calculated and aggregated for subsegmental airway generations 5-10 (

• Konietzke, P.
• Thomä, J.
• Weinheimer, O.
• Do, T. D.
• Wagner, W. L.
• Bodenberger, A. L.
• Stiller, W.
• Weber, T. F.
• Heußel, C. P.
• Kauczor, H. U.
• Wielpütz, M. O.