Diagnostic Performance of CO-RADS and the RSNA Classification System in Evaluating COVID-19 at Chest CT: A Meta-Analysis

Kwee, Robert M.; Adams, Hugo J. A.; Kwee, Thomas C.

doi:10.1148/ryct.2021200510

Cited by 32 publications

(41 citation statements)

References 25 publications

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“…Therefore, lower categories could not exclude COVID-19. These results agree with the recent metaanalysis published by Kwee et al [29], which reported that CO-RADS 1 and 2 and RSNA classification categories negative and a typical do not exclude COVID-19.…”

Section: Discussionsupporting

confidence: 93%

“…Our data are congruent with the results mentioned in previous research [15,[23][24][25][26][27][28], which suggested that the CO-RADS and the RSNA chest CT classification system performed very well in predicting COVID-19 in patients with moderate to severe symptoms. Notably, a recent meta-analysis published by Kwee et al [29] concluded that COVID-19 infection frequency was higher in patients categorized with higher CO-RADS and RSNA classification categories. A remarkable finding in our study was the high proportion of false-negative results (n = 100 patients; 27.9%); of these, 98 patients were categorized as CO-RADS 1 and 2 and RSNA classification categories negative and a typical.…”

Section: Discussionmentioning

confidence: 99%

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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

et al. 2021

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Background The Radiological Society of North America (RSNA) recently published a chest CT classification system and Dutch Association for Radiology has announced Coronavirus disease 2019 (COVID-19) reporting and data system (CO-RADS) to provide guidelines to radiologists who interpret chest CT images of patients with suspected COVID-19 pneumonia. This study aimed to compare CO-RADS and RSNA classification with respect to their sensitivity and reliability for diagnosis of COVID-19 pneumonia. Results A retrospective study assessed consecutive CT chest imaging of 359 COVID-19-positive patients. Three experienced radiologists who were aware of the final diagnosis of all patients, independently categorized each patient according to CO-RADS and RSNA classification. RT-PCR test performed within one week of chest CT scan was used as a reference standard for calculating sensitivity of each system. Kappa statistics and intraclass correlation coefficient were used to assess reliability of each system. The study group included 359 patients (180 men, 179 women; mean age, 45 ± 16.9 years). Considering combination of CO-RADS 3, 4 and 5 and combination of typical and indeterminate RSNA categories as positive predictors for COVID-19 diagnosis, the overall sensitivity was the same for both classification systems (72.7%). Applying both systems in moderate and severe/critically ill patients resulted in a significant increase in sensitivity (94.7% and 97.8%, respectively). The overall inter-reviewer agreement was excellent for CO-RADS (κ = 0.801), and good for RSNA classification (κ = 0.781). Conclusion CO-RADS and RSNA chest CT classification systems are comparable in diagnosis of COVID-19 pneumonia with similar sensitivity and reliability.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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“…Up to now, scholars are still exploring and studying. A meta-analysis on evaluating the diagnostic value of CT using methods such as the COVID-19 Reporting and Data System (CO-RADS) and the Radiological Society of North America (RSNA) Classification System [ 14 ]. Smet et al studied the COVID-19 Reporting and Data System (CO-RADS) diagnostic power of CT [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

“…The reference standard for diagnosing COVID-19 is reverse transcription-polymerase chain reaction (RT-PCR) [ 10 ]; however, it suffers from numerous flaws, such as poor sensitivity [ 11 ], producing false negatives, etc., all of which have also been noted in the studies [ 12 , 13 ]. A study indicated that RT-PCR was not a perfect reference standard [ 14 ]. What’s more, a succession of countries [ 15 ] had reported the discovery of COVID-19 variant strains, and the proportion is increasing.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic value of chest computed tomography imaging for COVID-19 based on reverse transcription-polymerase chain reaction: a meta-analysis

et al. 2021

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Background The computed tomography (CT) diagnostic value of COVID-19 is controversial. We summarized the value of chest CT in the diagnosis of COVID-19 through a meta-analysis based on the reference standard. Methods All Chinese and English studies related to the diagnostic value of CT for COVID-19 across multiple publication platforms, was searched for and collected. Studies quality evaluation and plotting the risk of bias were estimated. A heterogeneity test and meta-analysis, including plotting sensitivity (Sen), specificity (Spe) forest plots, pooled positive likelihood ratio (+LR), negative likelihood ratio (-LR), dignostic odds ratio (DOR) values and 95% confidence interval (CI), were estimated. If there was a threshold effect, summary receiver operating characteristic curves (SROC) was further plotted. Pooled area under the receiver operating characteristic curve (AUROC) and 95% CI were also calculated. Results Twenty diagnostic studies that represented a total of 9004 patients were included from 20 pieces of literatures after assessing all the aggregated studies. The reason for heterogeneity was caused by the threshold effect, so the AUROC = 0.91 (95% CI: 0.89–0.94) for chest CT of COVID-19. Pooled sensitivity, specificity, +LR, -LR from 20 studies were 0.91 (95% CI: 0.88–0.94), 0.71 (95% CI: 0.59–0.80), 3.1(95% CI: 2.2–4.4), 0.12 (95% CI: 0.09–0.17), separately. The I2 was 85.6% (P = 0.001) by Q-test. Conclusions The results of this study showed that CT diagnosis of COVID-19 was close to the reference standard. The diagnostic value of chest CT may be further enhanced if there is a unified COVID-19 diagnostic standard. However, please pay attention to rational use of CT. Graphic Abstract

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“…3 ). Confining diagnosis to patients with typical findings results in specificities in the 90% to 95% range with sensitivities in the 65% to 70% range [ 7 ]. Broadening inclusion criteria to include intermediate CT findings increases sensitivity to 90% to 95% and suppresses specificity to 70% to 75%.…”

Section: Coronavirus Disease 2019 Pneumoniamentioning

confidence: 99%

Emerging Pulmonary Infections in Clinical Practice

Febbo

Ketai

2021

Advances in Clinical Radiology

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Diagnostic Performance of CO-RADS and the RSNA Classification System in Evaluating COVID-19 at Chest CT: A Meta-Analysis

Cited by 32 publications

References 25 publications

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

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

Diagnostic value of chest computed tomography imaging for COVID-19 based on reverse transcription-polymerase chain reaction: a meta-analysis

Emerging Pulmonary Infections in Clinical Practice

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