Evaluation of the RSNA and CORADS classifications for COVID-19 on chest computed tomography in the Brazilian population

Fonseca, Eduardo Kaiser Ururahy Nunes; Loureiro, Bruna Melo Coelho; Strabelli, Daniel Giunchetti; Farias, Lucas de Pádua Gomes de; Garcia, José Vitor Rassi; Gama, Victor Arcanjo Almeida; Ferreira, Lorena Carneiro; Chate, Rodrigo Caruso; Júnior, Antonildes Nascimento Assunção; Sawamura, Márcio Valente Yamada; Nomura, César Higa

doi:10.6061/clinics/2021/e2476

Cited by 8 publications

(1 citation statement)

References 16 publications

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“…In the initial evaluation of patients, it has been proven that chest CT can detect infection-related changes within minutes, unlike PCR and serological tests, which sometimes take days to conclude, and that it is a useful tool as it provides information about prognosis and can guide treatment and follow-up decisions [ 15 ]. In the study conducted by Fonseca et al, it was found that COVID-19 patients, whose initial PCR results were negative and positive in subsequent tests, were correctly diagnosed with the CO-RADS classification according to the initial chest CT images, and thus, no patient was evaluated as false-negative [ 16 ]. In a report from a radiation oncology center, all cancer patients who received radiotherapy treatment during the COVID-19 pandemic were scanned with chest CT due to the high false-negative rates of PCR tests, and the results of the retrospectively evaluated analysis justified the necessity of scanning the patients with CT [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Initial CT Findings and CO-RADS Stage in COVID-19 Patients with PCR, Inflammation and Coagulation Parameters in Diagnostic and Prognostic Perspectives

Ayaz

Coşkun

Kaplan

et al. 2022

Journal of the Belgian Society of Radiology

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Objectives: This study aims to determine whether COVID-19 patients with different initial reverse transcriptase-polymerase chain reaction (RT-PCR), computed tomography (CT) and laboratory findings have different clinical outcomes. Materials and Methods: In this multi-center retrospective cohort study, 895 hospitalized patients with the diagnosis of COVID-19 were included. According to the RT-PCR positivity and presence of CT findings, the patients were divided into four groups. These groups were compared in terms of mortality and need for intensive care unit (ICU). According to the COVID-19 Reporting and Data System (CO-RADS), all patients’ CT images were staged. Multivariate binary logistic regression analysis was used to examine the relationship between CO-RADS and predictive inflammation and coagulation parameters. Results: RT-PCR test positivity was 51.5%, the CT finding was 70.7%, and 49.7% of the patients were in the CO-RADS 5 stage. The need for ICU and mortality rates was higher in the group with only CT findings compared to the group with only RT-PCR positivity, (14.9% vs. 4.0%, p < 0.001; 9.3% vs. 3.3%, p > 0.05; respectively). Mortality was 3.27 times higher in patients with CO-RADS 4 compared to those with CO-RADS 1–2. Being in the CO-RADS 4 stage and LDH were discovered to be the most efficient parameters in determining mortality risk. Conclusion: Performing only the RT-PCR test in the initial evaluation of patients in SARS-CoV-2 infection may lead to overlooking groups that are more at risk for severe disease. The use of a chest CT to perform CO-RADS staging would be beneficial in terms of providing both diagnostic and prognostic information.

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Section: Discussionmentioning

confidence: 99%

Comparison of Initial CT Findings and CO-RADS Stage in COVID-19 Patients with PCR, Inflammation and Coagulation Parameters in Diagnostic and Prognostic Perspectives

Ayaz

Coşkun

Kaplan

et al. 2022

Journal of the Belgian Society of Radiology

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Diagnostic performance of CO-RADS for COVID-19: a systematic review and meta-analysis

Liu

Chen

et al. 2022

Eur Radiol

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Objectives To investigate the diagnostic performance of the coronavirus disease 2019 (COVID-19) Reporting and Data System (CO-RADS) for detecting COVID-19. Methods We searched PubMed, EMBASE, MEDLINE, Web of Science, Cochrane Library, and Scopus database until September 21, 2021. Statistical analysis included data pooling, forest plot construction, heterogeneity testing, meta-regression, and subgroup analyses. Results We included 24 studies with 8382 patients. The pooled sensitivity and specificity and the area under the curve (AUC) of CO-RADS ≥ 3 for detecting COVID-19 were 0.89 (95% confidence interval (CI) 0.85–0.93), 0.68 (95% CI 0.60–0.75), and 0.87 (95% CI 0.84–0.90), respectively. The pooled sensitivity and specificity and AUC of CO-RADS ≥ 4 were 0.83 (95% CI 0.79–0.87), 0.84 (95% CI 0.78–0.88), and 0.90 (95% CI 0.87–0.92), respectively. Cochran’s Q test ( p < 0.01) and Higgins I 2 heterogeneity index revealed considerable heterogeneity. Studies with both symptomatic and asymptomatic patients had higher specificity than those with only symptomatic patients using CO-RADS ≥ 3 and CO-RADS ≥ 4. Using CO-RADS ≥ 4, studies with participants aged < 60 years had higher sensitivity (0.88 vs. 0.80, p = 0.02) and lower specificity (0.77 vs. 0.87, p = 0.01) than studies with participants aged > 60 years. Conclusions CO-RADS has favorable performance in detecting COVID-19. CO-RADS ≥ 3/4 might be applied as cutoff values given their high sensitivity and specificity. However, there is a need for more well-designed studies on CO-RADS. Key Points • CO-RADS shows a favorable performance in detecting COVID-19. • CO-RADS ≥ 3 had a high sensitivity 0.89 (95% CI 0.85–0.93), and it may prove advantageous in screening the potentially infected people to prevent the spread of COVID-19. • CO-RADS ≥ 4 had high specificity 0.84 (95% CI 0.78–0.88) and may be more suitable for definite diagnosis of COVID-19.

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

2023

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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

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Evaluation of the RSNA and CORADS classifications for COVID-19 on chest computed tomography in the Brazilian population

Cited by 8 publications

References 16 publications

Comparison of Initial CT Findings and CO-RADS Stage in COVID-19 Patients with PCR, Inflammation and Coagulation Parameters in Diagnostic and Prognostic Perspectives

Comparison of Initial CT Findings and CO-RADS Stage in COVID-19 Patients with PCR, Inflammation and Coagulation Parameters in Diagnostic and Prognostic Perspectives

Diagnostic performance of CO-RADS 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

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