Comparison of the CO-RADS and the RSNA chest CT classification system concerning sensitivity and reliability for the diagnosis of COVID-19 pneumonia

Abdel-Tawab, Mohamed; Basha, Mohammad Abd Alkhalik; Mohamed, Ibrahim A.; Ibrahim, Hamdy; Zaitoun, Mohamed; Elsayed, Saeed Bakry; Sammak, Ahmed A El; Yousef, Hala Y.; Aly, Sameh Abdelaziz; Khater, Hamada; Mosallam, Walid; Shanab, Waleed S. Abo; Hendi, Ali; Hassan, S.

doi:10.1186/s13244-021-00998-4

Cited by 20 publications

(28 citation statements)

References 32 publications

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“…In two other studies, according to the RSNA expert consensus statement, it has been reported that interobserver agreement varies between good and excellent (K = 0.822–0.924). In both studies, interobserver agreement was found to be significantly high in typical and negative categories for RSNA, whereas it was found to be poor or moderate in indeterminate and atypical categories [ 24 , 25 ]. In these studies, the high number of patients in the negative category for RSNA may have led to a partial increase in interobserver agreement.…”

Section: Discussionmentioning

confidence: 99%

RSNA and BSTI grading systems of COVID-19 pneumonia: comparison of the diagnostic performance and interobserver agreement

Kavak

Duymuş

2021

BMC Med Imaging

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Background This study aimed to compare the performance and interobservers agreement of cases with findings on chest CT based on the British Society of Thoracic Imaging (BSTI) guideline statement of COVID-19 and the Radiological Society of North America (RSNA) expert consensus statement. Methods In this study, 903 patients who had admitted to the emergency department with a pre-diagnosis of COVID-19 between 1 and 18 July 2020 and had chest CT. Two radiologists classified the chest CT findings according to the RSNA and BSTI consensus statements. The performance, sensitivity and specificity values of the two classification systems were calculated and the agreement between the observers was compared by using kappa analysis. Results Considering RT-PCR test result as a gold standard, the sensitivity, specificity and positive predictive values were significantly higher for the two observers according to the BSTI guidance statement and the RSNA expert consensus statement (83.3%, 89.7%, 89.0%; % 81.2,% 89.7,% 88.7, respectively). There was a good agreement in the PCR positive group (κ: 0.707; p < 0.001 for BSTI and κ: 0.716; p < 0.001 for RSNA), a good agreement in the PCR negative group (κ: 0.645; p < 0.001 for BSTI and κ: 0.743; p < 0.001 for RSNA) according to the BSTI and RSNA classification between the two radiologists. Conclusion As a result, RSNA and BSTI statement provided reasonable performance and interobservers agreement in reporting CT findings of COVID-19. However, the number of patients defined as false negative and indeterminate in both classification systems is at a level that cannot be neglected.

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Section: Discussionmentioning

confidence: 99%

RSNA and BSTI grading systems of COVID-19 pneumonia: comparison of the diagnostic performance and interobserver agreement

Kavak

Duymuş

2021

BMC Med Imaging

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“…With the rapid spread of the COVID-19 pandemic, the development of a standardized score with fixed criteria is essential to improve the consistency of the interpretations of chest CT images among radiologists [ 13 , 14 ]. Regarding the complexity and time-consuming application of the current scores in clinical practice, we hypothesized a simple score that is a simplification of a well-known current chest CT score.…”

Section: Discussionmentioning

confidence: 99%

A simple chest CT score for assessing the severity of pulmonary involvement in COVID-19

Abdel-Tawab

Basha

Mohamed

et al. 2021

Egypt J Radiol Nucl Med

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Background A major role of CT in COVID-19 pneumonia is to assess disease severity and progress. In this study, we aimed to assess the validity, reliability, and survival outcomes of simple chest computed tomography (CT) score in the evaluation of the severity of lung involvement in coronavirus disease 2019 (COVID-19) compared with the current chest CT score. Results This retrospective analysis included 213 patients (121 men and 92 women; mean age, 46 ± 15.6 years; range, 1–85 years). The ROC curve was used to compare the validity of both scores. Interreader agreement (IRA) for both scores was calculated using Cohen’s kappa statistic. The survival analysis of both scores was investigated using the Kaplan–Meier survival analysis. The simple score showed a comparable validity with the current score (AUC = 0.89 and 0.90, respectively; p = 0.61). The ROC analysis demonstrated that a simple score of > 3 and a current score of > 12 were potential predictors of death with sensitivity values of 81.8% and 86.4% and specificity values of 96.3% and 93.7%, respectively. The simple score showed a higher IRA compared with the current score (κ = 0.645 and 0.458, respectively). Both scores were comparable for predicting survival outcomes. Conclusion The simple score was non-inferior for predicting survival outcome, compared with the current chest CT score. Furthermore, we suggest that the simple score should be used as it is simpler and more consistent.

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“…Accumulation of evidence has enabled radiologists to classify imaging findings by different specificities and establish standard reporting and CT categorization systems based on the probability of COVID-19 [ 48 ]. To date, four major systems have been proposed as summarized in Table 1 [ 49 ].…”

Section: Standard Reporting System Of Covid-19 Pneumoniamentioning

confidence: 99%

The role of chest imaging in the diagnosis, management, and monitoring of coronavirus disease 2019 (COVID-19)

et al. 2021

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Coronavirus disease 2019 (COVID-19) pandemic has posed a major public health crisis all over the world. The role of chest imaging, especially computed tomography (CT), has evolved during the pandemic paralleling the accumulation of scientific evidence. In the early stage of the pandemic, the performance of chest imaging for COVID-19 has widely been debated especially in the context of comparison to real-time reverse transcription polymerase chain reaction. Current evidence is against the use of chest imaging for routine screening of COVID-19 contrary to the initial expectations. It still has an integral role to play, however, in its work up and staging, especially when assessing complications or disease progression. Chest CT is gold standard imaging modality for COVID-19 pneumonia; in some situations, chest X-ray or ultrasound may be an effective alternative. The most important role of radiologists in this context is to be able to identify those patients at greatest risk of imminent clinical decompensation by learning to stratify cases of COVID-19 on the basis of radiologic imaging in the most efficient and timely fashion possible. The present availability of multiple and more refined CT grading systems and classification is now making this task easier and thereby contributing to the recent improvements achieved in COVID-19 treatment and outcomes. In this article, evidence of chest imaging regarding diagnosis, management and monitoring of COVID-19 will be chronologically reviewed.

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Comparison of the CO-RADS and the RSNA chest CT classification system concerning sensitivity and reliability for the diagnosis of COVID-19 pneumonia

Cited by 20 publications

References 32 publications

RSNA and BSTI grading systems of COVID-19 pneumonia: comparison of the diagnostic performance and interobserver agreement

RSNA and BSTI grading systems of COVID-19 pneumonia: comparison of the diagnostic performance and interobserver agreement

A simple chest CT score for assessing the severity of pulmonary involvement in COVID-19

The role of chest imaging in the diagnosis, management, and monitoring of coronavirus disease 2019 (COVID-19)

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