OBJECTIVES: Although chest CT has been widely used in patients with COVID-19, its role for early diagnosis of COVID-19 is unclear. We report the diagnostic performance of chest CT using structured reporting in a routine clinical setting during the early phase of the epidemic in Germany. METHODS: Patients with clinical suspicion of COVID-19 and moderate-to-severe symptoms were included in this retrospective study. CTs were performed and reported before RT-PCR results (reference standard) became available. A structured reporting system was used that concluded in a recently described five-grade score ("CO-RADS"), indicating the level of suspicion for pulmonary involvement of COVID-19 from 1 = very low to 5 = very high. Structured reporting was performed by three Radiologists in consensus. RESULTS: In 96 consecutive patients (50 male, mean age 64), RT-PCR was positive in 20 (21%) cases. CT features significantly more common in RT-PCR-positive patients were ground-glass opacities as dominant feature, crazy paving, hazy margins of opacities, and multifocal bilateral distribution (p < 0.05). Using a cut-off point between CO-RADS 3 and 4, sensitivity was 90%, specificity 91%, positive predictive value 72%, negative predictive value 97%, and accuracy 91%. ROC analysis showed an AUC of 0.938. CONCLUSIONS: Structured reporting of chest CT with a five-grade scale provided accurate diagnosis of COVID-19. Its use was feasible and helpful in clinical routine. ADVANCES IN KNOWLEDGE: Chest CT with structured reporting may be a provisional diagnostic alternative to RT-PCR testing for early diagnosis of COVID-19, especially when RT-PCR results are delayed or test capacities are limited.
OBJECTIVES: Although chest CT has been widely used in patients with COVID-19, its role for early diagnosis of COVID-19 is unclear. We report the diagnostic performance of chest CT using structured reporting in a routine clinical setting during the early phase of the epidemic in Germany. METHODS: Patients with clinical suspicion of COVID-19 and moderate-to-severe symptoms were included in this retrospective study. CTs were performed and reported before RT-PCR results (reference standard) became available. A structured reporting system was used that concluded in a recently described five-grade score ("CO-RADS"), indicating the level of suspicion for pulmonary involvement of COVID-19 from 1 = very low to 5 = very high. Structured reporting was performed by three Radiologists in consensus. RESULTS: In 96 consecutive patients (50 male, mean age 64), RT-PCR was positive in 20 (21%) cases. CT features significantly more common in RT-PCR-positive patients were ground-glass opacities as dominant feature, crazy paving, hazy margins of opacities, and multifocal bilateral distribution (p < 0.05). Using a cut-off point between CO-RADS 3 and 4, sensitivity was 90%, specificity 91%, positive predictive value 72%, negative predictive value 97%, and accuracy 91%. ROC analysis showed an AUC of 0.938. CONCLUSIONS: Structured reporting of chest CT with a five-grade scale provided accurate diagnosis of COVID-19. Its use was feasible and helpful in clinical routine. ADVANCES IN KNOWLEDGE: Chest CT with structured reporting may be a provisional diagnostic alternative to RT-PCR testing for early diagnosis of COVID-19, especially when RT-PCR results are delayed or test capacities are limited.
Authors: Sanam Ebrahimzadeh; Nayaar Islam; Haben Dawit; Jean-Paul Salameh; Sakib Kazi; Nicholas Fabiano; Lee Treanor; Marissa Absi; Faraz Ahmad; Paul Rooprai; Ahmed Al Khalil; Kelly Harper; Neil Kamra; Mariska Mg Leeflang; Lotty Hooft; Christian B van der Pol; Ross Prager; Samanjit S Hare; Carole Dennie; René Spijker; Jonathan J Deeks; Jacqueline Dinnes; Kevin Jenniskens; Daniël A Korevaar; Jérémie F Cohen; Ann Van den Bruel; Yemisi Takwoingi; Janneke van de Wijgert; Junfeng Wang; Elena Pena; Sandra Sabongui; Matthew Df McInnes Journal: Cochrane Database Syst Rev Date: 2022-05-16
Authors: Isabela A Woller; Scott C Woller; Scott M Stevens; James F Lloyd; Karen E Conner; Benjamin H Gordon; Greg L Snow; Peter Jones; Joseph R Bledsoe Journal: J Am Coll Emerg Physicians Open Date: 2022-10-03