Dataset Information

Structured reporting of chest CT provides high sensitivity and specificity for early diagnosis of COVID-19 in a clinical routine setting.

ABSTRACT:

Objectives

Although chest CT has been widely used in patients with COVID-19, its role for early diagnosis of COVID-19 is unclear. We report the diagnostic performance of chest CT using structured reporting in a routine clinical setting during the early phase of the epidemic in Germany.

Methods

Patients with clinical suspicion of COVID-19 and moderate-to-severe symptoms were included in this retrospective study. CTs were performed and reported before RT-PCR results (reference standard) became available. A structured reporting system was used that concluded in a recently described five-grade score ("CO-RADS"), indicating the level of suspicion for pulmonary involvement of COVID-19 from 1 = very low to 5 = very high. Structured reporting was performed by three Radiologists in consensus.

Results

In 96 consecutive patients (50 male, mean age 64), RT-PCR was positive in 20 (21%) cases. CT features significantly more common in RT-PCR-positive patients were ground-glass opacities as dominant feature, crazy paving, hazy margins of opacities, and multifocal bilateral distribution (p < 0.05). Using a cut-off point between CO-RADS 3 and 4, sensitivity was 90%, specificity 91%, positive predictive value 72%, negative predictive value 97%, and accuracy 91%. ROC analysis showed an AUC of 0.938.

Conclusions

Structured reporting of chest CT with a five-grade scale provided accurate diagnosis of COVID-19. Its use was feasible and helpful in clinical routine.

Advances in knowledge

Chest CT with structured reporting may be a provisional diagnostic alternative to RT-PCR testing for early diagnosis of COVID-19, especially when RT-PCR results are delayed or test capacities are limited.

SUBMITTER: Gross A

PROVIDER: S-EPMC7774695 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

Structured reporting of chest CT provides high sensitivity and specificity for early diagnosis of COVID-19 in a clinical routine setting.

Gross Alexander A Heine Georg G Schwarz Martin M Thiemig Dorina D Gläser Sven S Albrecht Thomas T

The British journal of radiology 20201127 1117

<h4>Objectives</h4>Although chest CT has been widely used in patients with COVID-19, its role for early diagnosis of COVID-19 is unclear. We report the diagnostic performance of chest CT using structured reporting in a routine clinical setting during the early phase of the epidemic in Germany.<h4>Methods</h4>Patients with clinical suspicion of COVID-19 and moderate-to-severe symptoms were included in this retrospective study. CTs were performed and reported before RT-PCR results (reference stand ...[more]

PMID: 33245241

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Project description:BackgroundState-of-the-art thoracic magnetic resonance imaging (MRI) plays a complementary role in the assessment of pulmonary nodules/masses which potentially indicate to cancer. We aimed to evaluate the sensitivity and specificity of MRI in diagnosis of pulmonary nodules/masses.MethodsSixty-eight patients with computed tomography (CT)-detected pulmonary nodules/masses underwent 3T MRI (T1-VIBE, T1-starVIBE, T2-fBLADE turbo spin-echo, and T2-SPACE). The detection rate was calculated for each of the different subgroups of pulmonary nodules according to lung imaging reporting and data system (Lung-RADS). The four MRI sequences were compared in terms of detection rate and image quality-signal to noise ratio (SNR), contrast to noise ratio (CNR) and 5-point scoring scale. Agreement of lesion size measurement between CT and MRI was assessed by intraclass correlation coefficient (ICC). The picture-SNR, lesion-SNR and CNR of each sequence were analyzed by Mann-Whitney U test.ResultsIn total, 232 pulmonary lesions were detected by CT. The CT showed 86 solid nodules (SNs) <6 mm, 15 SNs between 6-8 mm, 35 SNs between 8-15 mm, and 52 SNs between 15-30 mm. The T1-VIBE, T1-starVIBE, T2-fBLADE TSE and T2-SPACE sequences accurately detected 141 SNs (141/188, 75%/83.3%), 150 SNs (150/188, 79.8%/100%), 166 SNs (166/188, 88.3%/66.7%) and 169 SNs (169/188, 89.9%/53.3%), respectively. Four ground glass nodules (GGNs) (4/6) were detected by T2-fBLADE TSE. Twelve part-solid nodules (PSNs) (12/22) were detected by T1-VIBE and 20 PSNs (20/22) by T2-SPACE. A total of 100 lesions (2.2±1.4 cm, 0.8-7.3 cm) were accurately detected and measured by the four MRI sequences with ICC >0.96. The picture-SNR, lesion-SNR and CNR by T1-starVIBE were higher than those by T1-VIBE (P<0.001). The lesion-SNR and CNR by T2-fBLADE TSE were higher than those by T2-SPACE (P=0.006, 0.038). 86% of images by T1-starVIBE, 92% by T2-fBLADE TSE, 90% by T2-SPACE and 93% by T1-VIBE were scored 3 or more.ConclusionsMRI achieves high sensitivity and specificity for different type of pulmonary nodules detection and is an effective alternative to CT as a diagnostic tool for pulmonary nodules.

Project description:Background The role and performance of chest CT in the diagnosis of the coronavirus disease 2019 (COVID-19) pandemic remains under active investigation. Purpose To evaluate the French national experience using chest CT for COVID-19, results of chest CT and reverse transcription polymerase chain reaction (RT-PCR) assays were compared together and with the final discharge diagnosis used as the reference standard. Materials and Methods A structured CT scan survey (NCT04339686) was sent to 26 hospital radiology departments in France between March 2, 2020, and April 24, 2020. These dates correspond to the peak of the national COVID-19 epidemic. Radiology departments were selected to reflect the estimated geographic prevalence heterogeneities of the epidemic. All symptomatic patients suspected of having COVID-19 pneumonia who underwent both initial chest CT and at least one RT-PCR test within 48 hours were included. The final discharge diagnosis, based on multiparametric items, was recorded. Data for each center were prospectively collected and gathered each week. Test efficacy was determined by using the Mann-Whitney test, Student t test, χ2 test, and Pearson correlation coefficient. P < .05 indicated a significant difference. Results Twenty-six of 26 hospital radiology departments responded to the survey, with 7500 patients entered; 2652 did not have RT-PCR test results or had unknown or excess delay between the RT-PCR test and CT. After exclusions, 4824 patients (mean age, 64 years ± 19 [standard deviation], 2669 male) were included. With final diagnosis as the reference, 2564 of the 4824 patients had COVID-19 (53%). Sensitivity, specificity, negative predictive value, and positive predictive value of chest CT in the diagnosis of COVID-19 were 2319 of 2564 (90%; 95% CI: 89, 91), 2056 of 2260 (91%; 95% CI: 91, 92), 2056 of 2300 (89%; 95% CI: 87, 90), and 2319 of 2524 (92%; 95% CI: 91, 93), respectively. There was no significant difference for chest CT efficacy among the 26 geographically separate sites, each with varying amounts of disease prevalence. Conclusion Use of chest CT for the initial diagnosis and triage of patients suspected of having coronavirus disease 2019 was successful. © RSNA, 2021 Online supplemental material is available for this article.

Dataset Information

Structured reporting of chest CT provides high sensitivity and specificity for early diagnosis of COVID-19 in a clinical routine setting.

Objectives

Methods

Results

Conclusions

Advances in knowledge

Publications

Structured reporting of chest CT provides high sensitivity and specificity for early diagnosis of COVID-19 in a clinical routine setting.

Similar Datasets

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