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

Abstract

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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