RSNA-STR-ACR Consensus Statement for COVID-19 CT Patterns: Interreader Agreement in 240 Consecutive Patients and Association With RT-PCR Status

Abstract

PurposeThe aim of this study was to study interreader agreement of the RSNA-STR-ACR (Radiological Society of North America/Society of Thoracic Radiology/American College of Radiology) consensus statement on reporting chest computed tomography (CT) findings related to COVID-19 on a sample of consecutive patients confirmed with reverse transcriptase–polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus 2.Materials and MethodsThis institutional review board–approved retrospective study included 240 cases with a mean age of 47.6 ± 15.9 years, ranging from 20 to 90 years, who had a chest CT and RT-PCR performed. Computed tomography images were independently analyzed by 2 thoracic radiologists to identify patterns defined by the RSNA-STR-ACR consensus statement, and concordance was determined with weighted κ tests. Also, CT findings and CT severity scores were tabulated and compared.ResultsOf the 240 cases, 118 had findings on CT. The most frequent on the RT-PCR–positive group were areas of ground-glass opacities (80.5%), crazy-paving pattern (32.2%), and rounded pseudonodular ground-glass opacities (22.9%). Regarding the CT patterns, the most frequent in the RT-PCR–positive group was typical in 75.9%, followed by negative in 17.1%. The interreader agreement was 0.90 (95% confidence interval, 0.80–0.96) in this group. The CT severity score had a mean difference of −0.07 (95% confidence interval, −0.48 to 0.34) among the readers, showing no significant differences regarding visual estimation.ConclusionsThe RSNA-STR-ACR consensus statement on reporting chest CT patterns for COVID-19 presents a high interreader agreement, with the typical pattern being more frequently associated with RT-PCR–positive examinations.

Diagnostic Performance of the Radiological Society of North America Consensus Statement for Reporting COVID-19 Chest CT Findings: A Revisit

“…Our study demonstrated high agreement between the two readers for the typical and negative categories (95.2% and 98.7%, respectively), whereas there was substantial agreement for the indeterminate and atypical categories (78.8% and 76.6%, respectively). This is in accordance with the results obtained by Silva et al [27].…”

“…Multiple findings have been detected in chest CT examinations of patients with COVID-19 infections since the first appearance of the disease in China. While most chest CT findings have been repeated elsewhere, an accurate diagnosis ultimately depends on the reader’s experience [ 27 ].…”

“…The RSNA, with contributions from the STR and ACR, formed an expert team to solve this matter and provided the best method in order to guide radiologists in coherently reporting their CT findings. However, reproducibility and reliability are necessary in order for this process to become widespread [ 27 , 30 ].…”

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

“…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).…”

“…For the overall CT categories, the interobserver agreement was reported in 18 studies: 12 studies reported diagnostic accuracy and the interobserver agreement together [ 9 , 20 , 22 , 25 , 28 , 36 – 39 , 45 , 51 , 54 ] and six studies solely reported the interobserver agreement [ 59 , 61 – 65 ]. They reported κ values ranged from 0.43 to 0.90.…”