Abstract
OBJECTIVE:To determine the correlation between the two tomographic classifications for coronavirus disease (COVID-19), COVID-19 Reporting and Data System (CORADS) and Radiological Society of North America Expert Consensus Statement on Reporting Chest Computed Tomography (CT) Findings Related to COVID-19 (RSNA), in the Brazilian population and to assess the agreement between reviewers with different experience levels.METHODS:Chest CT images of patients with reverse transcriptase-polymerase chain reaction (RT-PCR)-positive COVID-19 were categorized according to the CORADS and RSNA classifications by radiologists with different levels of experience and who were initially unaware of the RT-PCR results. The inter- and intra-observer concordances for each of the classifications were calculated, as were the concordances between classifications.RESULTS:A total of 100 patients were included in this study. The RSNA classification showed an almost perfect inter-observer agreement between reviewers with similar experience levels, with a kappa coefficient of 0.892 (95% confidence interval [CI], 0.788-0.995). CORADS showed substantial agreement among reviewers with similar experience levels, with a kappa coefficient of 0.642 (95% CI, 0.491-0.793). There was inter-observer variation when comparing less experienced reviewers with more experienced reviewers, with the highest kappa coefficient of 0.396 (95% CI, 0.255-0.588). There was a significant correlation between both classifications, with a Kendall coefficient of 0.899 (p<0.001) and substantial intra-observer agreement for both classifications.CONCLUSION:The RSNA and CORADS classifications showed excellent inter-observer agreement for reviewers with the same level of experience, although the agreement between less experience reviewers and the reviewer with the most experience was only reasonable. Combined analysis of both classifications with the first RT-PCR results did not reveal any false-negative results for detecting COVID-19 in patients.
Highlights
Initial studies evaluating chest computed tomography (CT) findings in patients with coronavirus disease (COVID-19) showed a high sensitivity of 94% but a low specificity of 37% [1]
Chest CT Findings Related to COVID-19 (RSNA) – which have a high sensitivity and high specificity, even in the Brazilian population [4,5,6,7,8,9]
Laboratory, and tomographic data Analysis of the electronic medical records of all selected patients was performed with a search for clinical characteristics and reverse transcriptase-polymerase chain reaction (RT-PCR) results
Summary
Initial studies evaluating chest computed tomography (CT) findings in patients with coronavirus disease (COVID-19) showed a high sensitivity of 94% but a low specificity of 37% [1]. During the COVID-19 pandemic two classifications for chest CT findings were developed [2,3] – COVID-19 Reporting and Data System (CORADS) and Radiological Society of North America Expert Consensus Statement on Reporting. No potential conflict of interest was reported. Received for publication on October 9, 2020. Accepted for publication on January 22, 2021
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