Chest CT accuracy in diagnosing COVID-19 during the peak of the Italian epidemic: A retrospective correlation with RT-PCR testing and analysis of discordant cases

Abstract

Highlights In our experience chest CT had a significantly higher specificity and accuracy in detecting COVID-19 pneumonia than previously reported. Chest CT and RT-PCR positive rates were 485/773 (62.7 %) and 462/773 (59.7 %), respectively. CT sensitivity and specificity for COVID 19 with RT-PCR as reference were 90.7 % and 78.8 % respectively. CT PPV, NPV and accuracy were 86.4 %, 85.1 % and 85.9 % respectively.

Diagnostic Performance of CO-RADS and the RSNA Classification System in Evaluating COVID-19 at Chest CT: A Meta-Analysis

“…In one study ( 20 ), there was potential risk of bias with regard to flow and timing, because the time interval between CT and RT-PCR testing was not reported. There was no risk of bias with regard to flow and timing in the other studies, because the maximum time interval between chest CT and RT-PCR did not exceed seven days ( 22 ). There were no applicability concerns.…”

COVID-19 Diagnosis in Case of Two Negative Nasopharyngeal Swabs: Association between Chest CT and Bronchoalveolar Lavage Results

“…This paper differs from the previous one [6] for methodological evaluation of CT scans: in particular, each patient's CT scan was evaluated in consensus by two expert radiologists and for each case the likelihood of COVID-19 pneumonia was reported, based on STR/RSNA and CO-RADS standards [2,3]. The two readers acquired their COVID-19 experience participating in a previous study [4] where they reviewed in consensus 773 CTs for suspected SARS-CoV-2 infection.…”

“…and for each case, the likelihood of COVID-19 pneumonia was reported based on STR/RSNA and CO-RADS standards ( 2 , 3 ). The two readers acquired their COVID-19 experience by participating in a previous study ( 4 ) where they reviewed in consensus 773 CT images in patients suspected of having SARS-CoV-2 infection.…”

“…The Society of Thoracic Radiology/Radiological Society of North America (STR/RSNA) and Prokop et al ( 2 , 3 ) introduced two distinct COVID-19 CT probability scores, here labeled STR/RSNA and COVID-19 Reporting and Data System (CO-RADS). Studies frequently use a single RT-PCR with nasopharyngeal swab as the standard of reference compared with CT ( 4 , 5 ). To our knowledge, no prior study used the more sensitive bronchoalveolar lavage (BAL) as a reference standard for comparison to CT for the diagnosis of COVID-19 infection.…”

Utility of visual coronary artery calcification on non-cardiac gated thoracic CT in predicting clinical severity and outcome in COVID-19

“… [5] , [6] , [7] , [8] , [9] , [10] The reported specificity of CT scan is reportedly moderate to low, it is reported between 25 and 56%. 11 , 12 , 14 , 15 The low reported sensitivity is because the CT features might overlap between COVID-19 and other RNA viral pneumonia like Respiratory Syncytial Virus (RSV) and Human Para influenza virus (HPIV). 16 , 17 Due to low specificity of CT chest the American College of Radiology discourages its systemic use for diagnosing COVID-19.…”