Diagnostic performance of the RSNA-proposed classification for COVID-19 pneumonia versus pre-pandemic controls

Rocha, Cauã Oliveira; Prioste, Tássia A.D.; Faccin, Carlo Sasso; Folador, Luciano; Tonetto, Mateus Samuel; Knijnik, Pedro Glusman; Mainardi, Natália Bocaccio; Borges, Rogério Boff; Garcia, Tiago Severo

doi:10.1016/j.bjid.2021.101665

Cited by 4 publications

References 21 publications

(26 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

Diagnostic performance of standardized typical CT findings for COVID-19: a systematic review and meta-analysis

2023

View full text Add to dashboard Cite

Objective To meta-analyze diagnostic performance measures of standardized typical CT findings for COVID-19 and examine these measures by region and national income. Methods MEDLINE and Embase were searched from January 2020 to April 2022 for diagnostic studies using the Radiological Society of North America (RSNA) classification or the COVID-19 Reporting and Data System (CO-RADS) for COVID-19. Patient and study characteristics were extracted. We pooled the diagnostic performance of typical CT findings in the RSNA and CO-RADS systems and interobserver agreement. Meta-regression was performed to examine the effect of potential explanatory factors on the diagnostic performance of the typical CT findings. Results We included 42 diagnostic performance studies with 6777 PCR-positive and 9955 PCR-negative patients from 18 developing and 24 developed countries covering the Americas, Europe, Asia, and Africa. The pooled sensitivity was 70% (95% confidence interval [CI]: 65%, 74%; I2 = 92%), and the pooled specificity was 90% (95% CI 86%, 93%; I2 = 94%) for the typical CT findings of COVID-19. The sensitivity and specificity of the typical CT findings did not differ significantly by national income and the region of the study (p > 0.1, respectively). The pooled interobserver agreement from 19 studies was 0.72 (95% CI 0.63, 0.81; I2 = 99%) for the typical CT findings and 0.67 (95% CI 0.61, 0.74; I2 = 99%) for the overall CT classifications. Conclusion The standardized typical CT findings for COVID-19 provided moderate sensitivity and high specificity globally, regardless of region and national income, and were highly reproducible between radiologists. Critical relevance statement Standardized typical CT findings for COVID-19 provided a reproducible high diagnostic accuracy globally. Key points Standardized typical CT findings for COVID-19 provide high sensitivity and specificity. Typical CT findings show high diagnosability regardless of region or income. The interobserver agreement for typical findings of COVID-19 is substantial. Graphical abstract

show abstract

Diagnostic performance of standardized typical CT findings for COVID-19: a systematic review and meta-analysis

2023

View full text Add to dashboard Cite

show abstract

Evaluation of the RSNA consensus: is it sufficient for the diagnosis of COVID-19 with CT?

Sozutok

Kaya

Dilek

et al. 2023

Cukurova Medical Journal

View full text Add to dashboard Cite

Purpose: Radiological Society of North America (RSNA) Consensus for coronavirus disease 19 (COVID-19) is developed to evaluate the lung involvement on chest computed tomography (CT) and create a common reporting lexicon. Aim of this study is to determine the frequency of CT features in sex and age groups in patients with COVID-19, compare the findings according to the RSNA consensus classifications, and evaluate the compatibility of the classifications and findings. Materials and Methods: Chest CT images of 281 patients with COVID-19 were evaluated. Patients were noted in the appropriate RSNA consensus class. The patients’ data were analyzed by group according to age and sex. Results: The main findings included ground-glass opacity, consolidation, and air bronchogram. The common involvement patterns were as follows: bilateral, peripheral, and multifocal. The rates for the typical, atypical, and indeterminate classifications, according to the RSNA consensus, were 63.6%, 9.6%, and 27.0%, respectively. Subpleural fibrous streaking was more frequent in males. Air bronchogram, lymphadenopathy, pleural effusion, subpleural fibrous streaking, bilateral involvement, and a typical classification on CT features were more frequent in the ≥ 65-year age group. Conclusion: While the typical appearance classification has results consistent with the findings, we think that the classifications specified as indeterminate and atypical appearance do not show sufficient agreement with the findings and revision is needed for correct diagnostic guidance.

show abstract

The Relation of Polymerase Chain Reaction and Computed Tomography Infiltrations of Suspected Covid-19 Patients in Emergency Department

Karaca

Gülalp

Muratoğlu

et al. 2023

Preprint

View full text Add to dashboard Cite

Purpose This study aimed to investigate the diagnostic performance of T-CT, following Radiological Society of North America (RSNA) recommendations, in patients with suspected Covid-19 and pulmonary infiltrations established in T-CT scans. Methods From March to August 2020, a total of 324 patients who were suspected of having COVID-19 and had undergone T-CT scans for various indications at the emergency department (ED) were included in the study. Two blinded radiologists independently reviewed all T-CT scans and categorized the infiltration features based on the RSNA recommendations. The reference diagnostic test for COVID-19 was the reverse-transcriptase polymerase chain reaction (RT-PCR). To evaluate the diagnostic performance of T-CT, different T-CT categories were considered as thresholds. Results 112 (35%) of 324 patients had positive RT-PCR results. After the LCA, the final T-CT category was typical for 114 patients (35.2%), indeterminate for 154 patients (47.5%), and atypical for 36 patients (11.1%). The results showed that utilizing the typical T-CT category as a positive-negative threshold yielded a sensitivity of 66%, specificity of 81%, positive predictive value (PPV) of 65%, negative predictive value (NPV) of 82%, and accuracy of 76%. In the subgroup analysis of patients who underwent multiple RT-PCR tests, the diagnostic performance improved, with a sensitivity of 80%, specificity of 79%, PPV of 76%, NPV of 83%, and accuracy of 79%. Combined use of RT-PCR and T-CT resulted in a sensitivity of 95.5%, PPV of 79%, and accuracy of 86.4%. Conclusion Based on RSNA consensus guidelines, T-CT shows a moderate sensitivity of 66% and high specificity of 81% for diagnosing Covid-19. In ED settings with suspected cases, T-CT can be helpful in recommending retesting after an initial negative RT-PCR result, facilitating early management, and enabling timely isolation measures. The combined use of RT-PCR and T-CT improves diagnostic performance, highlighting the potential benefits of integrating these methods.

show abstract

Diagnostic performance of the RSNA-proposed classification for COVID-19 pneumonia versus pre-pandemic controls

Cited by 4 publications

References 21 publications

Diagnostic performance of standardized typical CT findings for COVID-19: a systematic review and meta-analysis

Diagnostic performance of standardized typical CT findings for COVID-19: a systematic review and meta-analysis

Evaluation of the RSNA consensus: is it sufficient for the diagnosis of COVID-19 with CT?

The Relation of Polymerase Chain Reaction and Computed Tomography Infiltrations of Suspected Covid-19 Patients in Emergency Department

Contact Info

Product

Resources

About