Radiographers and COVID-19 pneumonia: Diagnostic performance using CO-RADS

Vicini, Simone; Panvini, Nicola; Bellini, Davide; Rengo, Marco; Ciotola, M.; Vivo, M. De; Gambaretto, C.; Caldon, V.; Panno, Stefano; Borgo, Cosmo Del; Carbone, Iacopo

doi:10.1016/j.radi.2021.04.010

Cited by 11 publications

(7 citation statements)

References 18 publications

(22 reference statements)

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“…The results of a sensitivity analysis for 28 studies, including more than 50 subjects among both COVID-19 cases and non-COVID-19 cases, each, were similar to those of the primary analysis [ 9 , 20 – 24 , 26 – 28 , 30 , 33 – 38 , 41 , 45 – 48 , 50 – 52 , 54 – 57 ] (Additional file 1 : Fig. 4).…”

Section: Resultsmentioning

confidence: 53%

“…There were 18 studies from developing countries (4 studies from lower-middle-income and 14 studies from upper-middle-income countries) [ 18 , 19 , 22 , 23 , 30 – 32 , 35 , 37 , 38 , 43 – 45 , 47 , 48 , 50 , 51 , 58 ] and 24 studies from developed countries (high income) [ 9 , 20 , 21 , 24 – 29 , 33 , 34 , 36 , 39 – 42 , 46 , 49 , 52 – 57 ]. The included studies were predominantly from Europe (24 studies) [ 9 , 20 , 21 , 23 – 27 , 29 , 31 , 32 , 34 , 35 , 37 , 38 , 41 , 42 , 47 – 49 , 52 , 55 – 57 ], followed by the Americas (10 studies), Asia (seven studies), and Africa (one study). Nineteen studies for assessing the interobserver agreement are summarized in Additional file 1 : Table 1 .…”

Section: Resultsmentioning

confidence: 99%

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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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Section: Resultsmentioning

confidence: 53%

Section: Resultsmentioning

confidence: 99%

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

2023

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“…CO-RADS was able to distinguish between patients with positive PCR results from those with negative PCR results with an average AUC of 0.91 (95% CI: 0.85, 0.97) [27]. A recent study [28] confirmed that this score is a useful tool allowing radiographers to recognise the classic appearance of COVID-19 on CT in a way comparable to expert radiologists.…”

Section: The Diagnosis Of Covid-19 Pneumonia With Ldctmentioning

confidence: 87%

Low Dose Chest CT and Lung Ultrasound for the Diagnosis and Management of COVID-19

Finance

Zieleskewicz

Habert

et al. 2021

JCM

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Background: The COVID-19 pandemic has provided an opportunity to use low- and non-radiating chest imaging techniques on a large scale in the context of an infectious disease, which has never been done before. Previously, low-dose techniques were rarely used for infectious diseases, despite the recognised danger of ionising radiation. Method: To evaluate the role of low-dose computed tomography (LDCT) and lung ultrasound (LUS) in managing COVID-19 pneumonia, we performed a review of the literature including our cases. Results: Chest LDCT is now performed routinely when diagnosing and assessing the severity of COVID-19, allowing patients to be rapidly triaged. The extent of lung involvement assessed by LDCT is accurate in terms of predicting poor clinical outcomes in COVID-19-infected patients. Infectious disease specialists are less familiar with LUS, but this technique is also of great interest for a rapid diagnosis of patients with COVID-19 and is effective at assessing patient prognosis. Conclusions: COVID-19 is currently accelerating the transition to low-dose and “no-dose” imaging techniques to explore infectious pneumonia and their long-term consequences.

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“…All assays were performed according to the instructions of the manufacturer. Low-dose CT or CT-angiography scans were assessed using CO-RADS, a published and validated score for suspicion of pulmonary involvement, with a score of 1, 2 or 3 (very low, low and equivocal suspicion, respectively) considered negative, and a score of 4 or 5 (high and very high suspicion, respectively) rated positive (21)(22)(23)(24)(25).…”

Section: Methodsmentioning

confidence: 99%

Analysis of Diagnostic Modalities in Hospital-admitted Patients Evaluated for COVID-19

Gereke¹,

Friedl²,

Niemann³

et al. 2022

In Vivo

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Background/Aim: To assess the diagnostic performance of reverse transcriptase polymerase chain reaction (RT-PCR), low-dose chest computed tomography (CT), and serological testing, alone and in combinations, as well as routine inflammatory markers in patients evaluated for COVID-19 during the first wave in early 2020. Patients and Methods: We retrospectively analyzed data of all patients who were admitted to the emergency department due to fever and/or respiratory symptoms. CT scans were rated using the COVID-19 Reporting and Data System (CO-RADS) suspicion score. True disease status (COVID-19 -positive vs. negative) was adjudicated by two independent clinicians. Receiver-operating characteristic curves and areas under the curves were calculated for inflammatory markers. Sensitivities and specificities were calculated for RT-PCR, CT, and serology alone, as well as the combinations of RT-PCR+CT, RT-PCR+serology, CT+serology, and all three modalities. Results: Of 221 patients with a median age of 72 years, 113 were classified as COVID-19 positive. Among 180 patients from which data on CT and RT-PCR were available, RT-PCR had the highest sensitivity to detect . Notably, the addition of CT in the analysis increased sensitivity to 0.89 (95%CI=0.8-0.94), but lowered specificity from 1 (95%CI=0.96-1) to 0.9 (95%CI=0. 83-0.95). The combination of RT-PCR, CT and serology (n=60 patients with complete dataset) yielded a sensitivity of 0.83 (95%CI=0.61-0.94) and specificity of 0.86 (95%CI=0.72-0.93). Conclusion: RT-PCR was the best single test in patients evaluated for COVID-19. Conversely, the routine performance of chest CT adds little sensitivity and decreases specificity.

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Radiographers and COVID-19 pneumonia: Diagnostic performance using CO-RADS

Cited by 11 publications

References 18 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

Low Dose Chest CT and Lung Ultrasound for the Diagnosis and Management of COVID-19

Analysis of Diagnostic Modalities in Hospital-admitted Patients Evaluated for COVID-19

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