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Background  Coronavirus disease 2019 (COVID-19) is a highly infectious disease caused by the new coronavirus. Previous studies have shown that the chest CT examination plays an important role in the diagnosis and monitoring of COVID-19. However, some patients with COVID-19 had low white blood cell counts and reduced lymphocyte ratios. Multiple CT examinations may cause radiation damages as well as increase the apoptosis of peripheral blood lymphocytes. A new low-dose CT method should be developed because the regular CT may aggravate the disease.    Method  Sixty cases were randomly divided into the study group ( n  = 30) and control group (n = 30). The lung window was reconstructed by Karl 3D iterative technique in the study group. The image quality was subjectively evaluated by two senior chest group diagnostic physicians using a 5-point double-blind method. The value of CT measurement and its standard deviation (SD) was used as an objective evaluation criteria. The volume of CT dose index (CTDI vol ), dose length product (DLP) and effective dose (ED) from the two groups were compared and analyzed statistically.    Result  There was no significant difference in the occurrence rates of ground glass opacities, consolidation, crazy-paving pattern, fiber cable shadow and axial interstitial thickening between the study group and control group ( p  > 0.05). In addition, no significant difference was found for the subjective score of overall image quality and image noise level (SD) between the two groups ( p  > 0.05). However, significant differences was found in CTDI vol , DLP, and ED between the study group and the control group ( p < 0.05 ). The effective dose of the study group was reduced by 76% compared to the control group.    Conclusion  CareDose 4D low-dose scanning combined with Karl 3D iterative reconstruction technology can not only greatly reduce the radiation dose, but also provide images that meet the diagnostic criteria of COVID-19, which can be used as a routine method for the follow-up of COVID-19 patients.

Application of CareDose 4D combined with Karl 3D technology in the low dose computed tomography for the follow-up of COVID-19