Essentials for Radiologists on COVID-19: An                         Update—<i>Radiology</i> Scientific Expert                     Panel

Kanne, Jeffrey P.; Little, Brent P.; Chung, Jonathan H.; Elicker, Brett M.; Ketai, Loren H.

doi:10.1148/radiol.2020200527

Cited by 709 publications

(719 citation statements)

References 9 publications

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“…13 Features such as pleural effusion, extensive tiny lung nodules, tree in bud, and lymphadenopathy may well suggest bacterial superinfection or an alternative diagnosis. 14…”

Section: Temporal Evolution Of Findingsmentioning

confidence: 99%

An update on COVID-19 for the radiologist - A British society of Thoracic Imaging statement

et al. 2020

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“…13 Features such as pleural effusion, extensive tiny lung nodules, tree in bud, and lymphadenopathy may well suggest bacterial superinfection or an alternative diagnosis. 14…”

Section: Temporal Evolution Of Findingsmentioning

confidence: 99%

An update on COVID-19 for the radiologist - A British society of Thoracic Imaging statement

et al. 2020

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“…CT can play a vital role in the early detection and management of COVID-19 (1,2). However, it is worth emphasizing that a patient with reverse-transcription polymerase chain reaction (RT-PCR)-confirmed COVID-19 infection may have normal chest CT at admission.…”

Section: Editormentioning

confidence: 99%

Patients with RT-PCR-confirmed COVID-19 and Normal Chest CT

2020

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helping medical staff members and radiologists around the world improve their understanding of this disease.CT can play a vital role in the early detection and management of COVID-19 (1,2). However, it is worth emphasizing that a patient with reverse-transcription polymerase chain reaction (RT-PCR) confirmed COVID-19 infection may have normal chest CT findings at admission. Bernheim et al (3) reported 20 (56%) of 36 patients imaged 0-2 days after symptom onset had normal CT findings. Fang et al (4) reported one of 51 (2%) patient imaged 3±3 days after symptom onset with normal CT scans. Ai et al (5) reported 21 of 601 (3%) RT-PCR positive patients with clinical symptoms had normal CT scans. In contrast, Pan et al (6) reported four of 21 (19%) patients with first normal CT had lung abnormalities on the follow-up CT approximately 4 days later. In our experience (7), of 17 of 149 (11.4%) symptomatic patients with normal chest CT on admission, 12 remained negative 10 days later with 2-3 follow-up CT examinations; the chest CT scans of the other five patients became positive over an average of 7 days. These reports confirm that a normal chest CT scan cannot exclude the diagnosis of COVID-19, especially for patients with early onset of symptoms.This copy is for personal use only. To order printed copies, contact reprints@rsna.org

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“…The standard diagnostic method being used is real-time polymerase chain reaction (RT-PCR) to detect viral nucleotides from specimens obtained by oropharyngeal swab, nasopharyngeal swab, bronchoalveolar lavage, or tracheal aspirate (6). However, recent reports have revealed that RT-PCR has a sensitivity as low as 60-71% for detecting COVID-19 (5,7,8), which can possibly be attributed to low viral load present in test specimens or laboratory error (7,9). These false negatives hinder quarantine efforts, necessitate repeat testing and has the potential to overload the current supply of testing kits and related infrastructure (8).…”

Section: Introductionmentioning

confidence: 99%

Performance of Radiologists in Differentiating COVID-19 from Non-COVID-19 Viral Pneumonia at Chest CT

Bai¹,

Hsieh²,

Xiong³

et al. 2020

Radiology

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Key Results: Three Chinese radiologists had a sensitivity of 72%, 72% and 94% and specificity of 94%, 88% and 24% in differentiating 219 COVID-19 from 205 non-COVID-19 pneumonia.  Four United States radiologists had a sensitivity of 93%, 83%, 73% and 73% and specificity of 100%, 93%, 93% and 100%.  The most discriminating features for COVID-19 pneumonia included a peripheral distribution (80% vs. 57%, p<0.001), ground-glass opacity (91% vs. 68%, p<0.001) and vascular thickening (58% vs. 22%, p<0.001). Manuscript type: original researchThe total number of words of the manuscript, including entire text from title page to tables and references: 4364 This copy is for personal use only. To order printed copies, contact reprints@rsna.org I n P r e s s Performance of radiologists in differentiating COVID-19 from viral pneumonia on chest CT Summary: Radiologists had high specificity but moderate sensitivity in differentiating COVID-19 from viral pneumonia on chest CT. Key Results:  Three Chinese radiologists had sensitivities of 72%, 72% and 94% and specificities of 94%, 88% and 24% in differentiating 219 COVID-19 from 205 non-COVID-19 pneumonia.  Four United States radiologists had sensitivities of 93%, 83%, 73% and 73% and specificities of 100%, 93%, 93% and 100%.  The most discriminating features for COVID-19 pneumonia included a peripheral distribution (80% vs. 57%, p<0.001), ground-glass opacity (91% vs. 68%, p<0.001) and vascular thickening (58% vs. 22%, p<0.001). Abstract Background: Despite its high sensitivity in diagnosing COVID-19 in a screening population, chest CT appearances of COVID 19 pneumonia are thought to be non-specific. Purpose: To assess the performance of United States (U.S.) and Chinese radiologists in differentiating COVID-19 from viral pneumonia on chest CT. Methods: A total of 219 patients with both positive COVID-19 by RT-PCR and abnormal chest CT findings were retrospectively identified from 7 Chinese hospitals in Hunan Providence, China from January 6 to February 20, 2020. A total of 205 patients with positive Respiratory Pathogen Panel for viral pneumonia and CT findings consistent with or highly suspicious for pneumonia by original radiology interpretation within 7 days of each other were identified from Rhode Island Hospital in Providence, RI. Three Chinese radiologists blindly reviewed all chest CTs (n=424) to differentiate COVID-19 from viral pneumonia. A sample of 58 age-matched cases was randomly selected and evaluated by 4 U.S. radiologists in a similar fashion. Different CT features were recorded and compared between the two groups. Results: For all chest CTs, three Chinese radiologists correctly differentiated COVID-19 from non-COVID-19 pneumonia 83% (350/424), 80% (338/424), and 60% (255/424) of the time, respectively. The seven radiologists had sensitivities of 80%, 67%, 97%, 93%, 83%, 73% and 70% and specificities of 100%, 93%, 7%, 100%, 93%, 93%, 100%. Compared to non-COVID-19 pneumonia, COVID-19 pneumonia was more likely to have a peripheral distribution (80% vs. 57%, p...

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Essentials for Radiologists on COVID-19: An Update—Radiology Scientific Expert Panel

Cited by 709 publications

References 9 publications

An update on COVID-19 for the radiologist - A British society of Thoracic Imaging statement

An update on COVID-19 for the radiologist - A British society of Thoracic Imaging statement

Patients with RT-PCR-confirmed COVID-19 and Normal Chest CT

Performance of Radiologists in Differentiating COVID-19 from Non-COVID-19 Viral Pneumonia at Chest CT

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