ACR Appropriateness Criteria® Acute Respiratory Illness in Immunocompetent Patients

Imaging, Expert Panel on Thoracic; Jokerst, Clinton; Chung, Jonathan H.; Ackman, Jeanne B.; Carter, Brett; Colletti, Patrick M.; Crabtree, Traves D.; Groot, Patricia M. de; Iannettoni, Mark D.; Maldonado, Fabien; McComb, Barbara L.; Steiner, Robert M.; Kanne, Jeffrey P.

doi:10.1016/j.jacr.2018.09.012

Cited by 35 publications

(26 citation statements)

References 40 publications

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“…Chest radiography is the primary imaging modality for evaluating acute respiratory illness in immunocompetent patients (10). Although COVID-19 can present with evident abnormalities on chest radiographs (1), in approximately two-thirds of the patients, radiographs were normal (11).…”

Section: N P R E S S I N P R E S S Introductionmentioning

confidence: 99%

Extension of Coronavirus Disease 2019 on Chest CT and Implications for Chest Radiographic Interpretation

Choi¹,

Qi²,

Yoon³

et al. 2020

Radiology: Cardiothoracic Imaging

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In COVID-19 patients, considerable variation was found in the QCTmass (72.4±120.8 g; range, 0.7-420.7 g) and relative 3D opacity extent on CT (3.2±5.8% of lung area; range, 0.1-19.8%). 2. Chest radiographs in patients under investigation for COVID-19 provided a sensitivity of 25% (5/20) and specificity of 90% (18/20) for COVID-19-related opacities. 3. The QCTmass (p<.001) and the 3D opacity volume on CT (p<.001) significantly affected the visibility of COVID-19-related opacities on radiographs. I n p r e s s Summary Statement Quantitative opacity mass and 3D opacity volume on CT were quantifiable metrics affecting the visibility of COVID-19-related opacities on chest radiographs.

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Section: N P R E S S I N P R E S S Introductionmentioning

confidence: 99%

Extension of Coronavirus Disease 2019 on Chest CT and Implications for Chest Radiographic Interpretation

Choi¹,

Qi²,

Yoon³

et al. 2020

Radiology: Cardiothoracic Imaging

View full text Add to dashboard Cite

show abstract

“…This systematic review and meta-analysis was designed to analyze the reported chest CT findings in patients with COVID-19 pneumonia. Although chest radiograph is the first-line imaging modality in most patients with acute respiratory syndrome, lung CT is suggested as the subsequent study or even the imaging modality of choice in selected situations [117,118]. In spite of its relatively low specificity, chest CT has been reported to be a highly sensitive diagnostic tool for detection of COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Chest CT findings of coronavirus disease 2019 (COVID-19): A comprehensive meta-analysis of 9907 confirmed patients

et al. 2021

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We performed a systematic review and meta-analysis of the prevalence of chest CT findings in patients with confirmed COVID-19 infection. Methods: Systematic review of the literature was performed using PubMed, Scopus, Embase, and Google Scholar to retrieve original studies on chest CT findings of patients with confirmed COVID-19, available up to 10 May 2020. Data on frequency and distribution of chest CT findings were extracted from eligible studies, pooled and meta-analyzed using random-effects model to calculate the prevalence of chest CT findings. Results: Overall, 103 studies (pooled population: 9907 confirmed COVID-19 patients) were meta-analyzed. The most common CT findings were ground-glass opacities (GGOs) (77.18%, 95%CI = 72.23-81.47), reticulations (46.24%, 95%CI = 38.51-54.14), and air bronchogram (41.61%, 95%CI = 32.78-51.01). Pleural thickening (33.35%, 95%CI = 21.89-47.18) and bronchial wall thickening (15.48%, 95%CI = 8.54-26.43) were major atypical and airway findings. Lesions were predominantly distributed bilaterally (75.72%, 95%CI = 70.79-80.06) and peripherally (65.64%, 95%CI = 58.21-72.36), while 8.20% (95%CI = 6.30-10.61) of patients had no abnormal findings and pre-existing lung diseases were present in 6.01% (95%CI = 4.37-8.23). Conclusions: The most common CT findings in COVID-19 are GGOs with/without consolidation, reticulations, and air bronchogram, which often involve both lungs with peripheral distribution. However, COVID-19 might present with atypical manifestations or no abnormal findings in chest CT, which deserve clinicians' notice.

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“…Chest X-ray radiograph (CXR) is the primary imaging technique in the diagnosis of pneumonia because of its easy accessibility, low cost, low radiation exposure, and reasonable diagnostic capability (9,10). Therefore, CXR using a portable radiography unit may be considered as a primary radiologic examination for COVID-19 because patient transportation can be minimized and disinfection is relatively easy (7).…”

Section: Introductionmentioning

confidence: 99%

Implementation of a Deep Learning-Based Computer-Aided Detection System for the Interpretation of Chest Radiographs in Patients Suspected for COVID-19

et al. 2020

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Objective: To describe the experience of implementing a deep learning-based computer-aided detection (CAD) system for the interpretation of chest X-ray radiographs (CXR) of suspected coronavirus disease (COVID-19) patients and investigate the diagnostic performance of CXR interpretation with CAD assistance. Materials and Methods: In this single-center retrospective study, initial CXR of patients with suspected or confirmed COVID-19 were investigated. A commercialized deep learning-based CAD system that can identify various abnormalities on CXR was implemented for the interpretation of CXR in daily practice. The diagnostic performance of radiologists with CAD assistance were evaluated based on two different reference standards: 1) real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) results for COVID-19 and 2) pulmonary abnormality suggesting pneumonia on chest CT. The turnaround times (TATs) of radiology reports for CXR and rRT-PCR results were also evaluated. Results: Among 332 patients (male:female, 173:159; mean age, 57 years) with available rRT-PCR results, 16 patients (4.8%) were diagnosed with COVID-19. Using CXR, radiologists with CAD assistance identified rRT-PCR positive COVID-19 patients with sensitivity and specificity of 68.8% and 66.7%, respectively. Among 119 patients (male:female, 75:44; mean age, 69 years) with available chest CTs, radiologists assisted by CAD reported pneumonia on CXR with a sensitivity of 81.5% and a specificity of 72.3%. The TATs of CXR reports were significantly shorter than those of rRT-PCR results (median 51 vs. 507 minutes; p < 0.001). Conclusion: Radiologists with CAD assistance could identify patients with rRT-PCR-positive COVID-19 or pneumonia on CXR with a reasonably acceptable performance. In patients suspected with COVID-19, CXR had much faster TATs than rRT-PCRs.

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ACR Appropriateness Criteria® Acute Respiratory Illness in Immunocompetent Patients

Cited by 35 publications

References 40 publications

Extension of Coronavirus Disease 2019 on Chest CT and Implications for Chest Radiographic Interpretation

Extension of Coronavirus Disease 2019 on Chest CT and Implications for Chest Radiographic Interpretation

Chest CT findings of coronavirus disease 2019 (COVID-19): A comprehensive meta-analysis of 9907 confirmed patients

Implementation of a Deep Learning-Based Computer-Aided Detection System for the Interpretation of Chest Radiographs in Patients Suspected for COVID-19

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