Abstract
The purpose of this study was to use the Coronavirus Disease 2019 (COVID-19) Reporting and Data System (CO-RADS) to evaluate the chest computed tomography (CT) images of patients suspected of having COVID-19, and to investigate its diagnostic performance and interobserver agreement. The Dutch Radiological Society developed CO-RADS as a diagnostic indicator for assessing suspicion of lung involvement of COVID-19 on a scale of 1 (very low) to 5 (very high). We investigated retrospectively 154 adult patients with clinically suspected COVID-19, between April and June 2020, who underwent chest CT and reverse transcription-polymerase chain reaction (RT-PCR). The patients’ average age was 61.3 years (range, 21–93), 101 were male, and 76 were RT-PCR positive. Using CO-RADS, four radiologists evaluated the chest CT images. Sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) were calculated. Interobserver agreement was calculated using the intraclass correlation coefficient (ICC) by comparing the individual reader’s score to the median of the remaining three radiologists. The average sensitivity was 87.8% (range, 80.2–93.4%), specificity was 66.4% (range, 51.3–84.5%), and AUC was 0.859 (range, 0.847–0.881); there was no significant difference between the readers (p > 0.200). In 325 (52.8%) of 616 observations, there was absolute agreement among observers. The average ICC of readers was 0.840 (range, 0.800–0.874; p < 0.001). CO-RADS is a categorical taxonomic evaluation scheme for COVID-19 pneumonia, using chest CT images, that provides outstanding performance and from substantial to almost perfect interobserver agreement for predicting COVID-19.
Highlights
In the city of Wuhan, Hubei province, China, a highly contagious disease was first identified at the end of 2019, which was later proven to be caused by a novel coronavirus (2019-nCoV or severe acute respiratory syndrome coronavirus 2) [1]
Computed tomography (CT) examination plays an important role in epidemic areas in the diagnosis of COVID-19 because of its high sensitivity [4,5]
It has been reported that patients with negative reverse transcription-polymerase chain reaction (RT-PCR) results may have positive chest computed tomography (CT) findings, and combining RT-PCR with CT scans is expected to improve the diagnosis of COVID-19 [4,5]
Summary
In the city of Wuhan, Hubei province, China, a highly contagious disease was first identified at the end of 2019, which was later proven to be caused by a novel coronavirus (2019-nCoV or severe acute respiratory syndrome coronavirus 2) [1]. As of 10 August 2020, more than 19,718,000 people worldwide have been infected with coronavirus disease 2019 (COVID-19), and more than 728,000 have died [2]. Diagnosis of COVID-19 is crucial for the isolation of patients and prevention of the spread of infection, as well as early patient intervention. Computed tomography (CT) examination plays an important role in epidemic areas in the diagnosis of COVID-19 because of its high sensitivity [4,5]. It has been reported that patients with negative RT-PCR results may have positive chest CT findings, and combining RT-PCR with CT scans is expected to improve the diagnosis of COVID-19 [4,5]. Several CT image findings characteristic of COVID-19 pneumonia have already been reported, the most common of which are bilateral, peripheral/subpleural, or posterior ground-glass opacities with or without consolidations [6,7,8,9]
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