Vikram Rao Bollineni1, Koenraad Hans Nieboer2, Seema Döring2, Nico Buls2, Johan de Mey2. 1. Department of Radiology, Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090, Brussels, Belgium. bollinenivr@yahoo.com. 2. Department of Radiology, Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090, Brussels, Belgium.
Abstract
BACKGROUND: To evaluate the clinical value of the chest CT scan compared to the reference standard real-time polymerase chain reaction (RT-PCR) in COVID-19 patients. METHODS: From March 29th to April 15th of 2020, a total of 240 patients with respiratory distress underwent both a low-dose chest CT scan and RT-PCR tests. The performance of chest CT in diagnosing COVID-19 was assessed with reference to the RT-PCR result. Two board-certified radiologists (mean 24 years of experience chest CT), blinded for the RT-PCR result, reviewed all scans and decided positive or negative chest CT findings by consensus. RESULTS: Out of 240 patients, 60% (144/240) had positive RT-PCR results and 89% (213/240) had a positive chest CT scans. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of chest CT in suggesting COVID-19 were 100% (95% CI: 97-100%, 144/240), 28% (95% CI: 19-38%, 27/240), 68% (95% CI: 65-70%) and 100%, respectively. The diagnostic accuracy of the chest CT suggesting COVID-19 was 71% (95% CI: 65-77%). Thirty-three patients with positive chest CT scan and negative RT-PCR test at baseline underwent repeat RT-PCR assay. In this subgroup, 21.2% (7/33) cases became RT-PCR positive. CONCLUSION: Chest CT imaging has high sensitivity and high NPV for diagnosing COVID-19 and can be considered as an alternative primary screening tool for COVID-19 in epidemic areas. In addition, a negative RT-PCR test, but positive CT findings can still be suggestive of COVID-19 infection.
BACKGROUND: To evaluate the clinical value of the chest CT scan compared to the reference standard real-time polymerase chain reaction (RT-PCR) in COVID-19patients. METHODS: From March 29th to April 15th of 2020, a total of 240 patients with respiratory distress underwent both a low-dose chest CT scan and RT-PCR tests. The performance of chest CT in diagnosing COVID-19 was assessed with reference to the RT-PCR result. Two board-certified radiologists (mean 24 years of experience chest CT), blinded for the RT-PCR result, reviewed all scans and decided positive or negative chest CT findings by consensus. RESULTS: Out of 240 patients, 60% (144/240) had positive RT-PCR results and 89% (213/240) had a positive chest CT scans. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of chest CT in suggesting COVID-19 were 100% (95% CI: 97-100%, 144/240), 28% (95% CI: 19-38%, 27/240), 68% (95% CI: 65-70%) and 100%, respectively. The diagnostic accuracy of the chest CT suggesting COVID-19 was 71% (95% CI: 65-77%). Thirty-three patients with positive chest CT scan and negative RT-PCR test at baseline underwent repeat RT-PCR assay. In this subgroup, 21.2% (7/33) cases became RT-PCR positive. CONCLUSION: Chest CT imaging has high sensitivity and high NPV for diagnosing COVID-19 and can be considered as an alternative primary screening tool for COVID-19 in epidemic areas. In addition, a negative RT-PCR test, but positive CT findings can still be suggestive of COVID-19infection.
Authors: Felix Chua; Darius Armstrong-James; Sujal R Desai; Joseph Barnett; Vasileios Kouranos; Onn Min Kon; Ricardo José; Rama Vancheeswaran; Michael R Loebinger; Joyce Wong; Maria Teresa Cutino-Moguel; Cliff Morgan; Stephane Ledot; Boris Lams; Wing Ho Yip; Leski Li; Ying Cheong Lee; Adrian Draper; Sze Shyang Kho; Elisabetta Renzoni; Katie Ward; Jimstan Periselneris; Sisa Grubnic; Marc Lipman; Athol U Wells; Anand Devaraj Journal: Lancet Respir Med Date: 2020-03-25 Impact factor: 30.700
Authors: Nikhil Ram-Mohan; David Kim; Elizabeth J Zudock; Marjan M Hashemi; Kristel C Tjandra; Angela J Rogers; Catherine A Blish; Kari C Nadeau; Jennifer A Newberry; James V Quinn; Ruth O'Hara; Euan Ashley; Hien Nguyen; Lingxia Jiang; Paul Hung; Andra L Blomkalns; Samuel Yang Journal: medRxiv Date: 2020-12-22
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: Ahmed Ishfaq; Syed Muhammad Yousaf Farooq; Amber Goraya; Muhammad Yousaf; Syed Amir Gilani; Aafia Kiran; Muhammad Ayoub; Akhter Javed; Raham Bacha Journal: Eur J Radiol Open Date: 2021-05-13
Authors: Clarissa Martin; Nina Cheng; Bryant Chang; Namrata Arya; Michael Joseph Diaz; Keldon Lin; Muhammad Umair; Joseph Waller; Travis Henry Journal: Pol J Radiol Date: 2022-07-12