Inter-Observer Agreement between Low-Dose and Standard-Dose CT with Soft and Sharp Convolution Kernels in COVID-19 Pneumonia.

Ivan Blokhin,Roman Reshetnikov,Victor Gombolevskiy,Pavel Gelezhe,Alexander Nikolaev,Nicholas Kulberg,Maxim Gusev,Olga Aleshina,Sergey Morozov,Valeria Chernina

doi:10.3390/jcm11030669

Ivan Blokhin, Roman Reshetnikov + Show 8 more

Open Access

https://doi.org/10.3390/jcm11030669

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Abstract

Computed tomography (CT) has been an essential diagnostic tool during the COVID-19 pandemic. The study aimed to develop an optimal CT protocol in terms of safety and reliability. For this, we assessed the inter-observer agreement between CT and low-dose CT (LDCT) with soft and sharp kernels using a semi-quantitative severity scale in a prospective study (Moscow, Russia). Two consecutive scans with CT and LDCT were performed in a single visit. Reading was performed by ten radiologists with 3–25 years’ experience. The study included 230 patients, and statistical analysis showed LDCT with a sharp kernel as the most reliable protocol (percentage agreement 74.35 ± 43.77%), but its advantage was marginal. There was no significant correlation between radiologists’ experience and average percentage agreement for all four evaluated protocols. Regarding the radiation exposure, CTDIvol was 3.6 ± 0.64 times lower for LDCT. In conclusion, CT and LDCT with soft and sharp reconstructions are equally reliable for COVID-19 reporting using the “CT 0-4” scale. The LDCT protocol allows for a significant decrease in radiation exposure but may be restricted by body mass index.

Highlights

The World Health Organization (WHO) declared a public health emergency on30 January 2020 due to coronavirus disease 2019 (COVID-19) [1]
Studies evaluating computed tomography (CT) applicability for COVID-19 indicate the absence of pathognomonic signs but highlight the frequently occurring findings: bilateral peripheral groundglass opacities and “crazy-paving” pattern with basal predominance [6,7]
We included a consecutive sample of patients aged ≥18 years referred for a chest CT scan by their physician between 6 May 2020, and 22 May 2020, due to suspected viral pneumonia

Summary

Introduction

30 January 2020 due to coronavirus disease 2019 (COVID-19) [1]. While the value of medical imaging in COVID-19 diagnostics remains uncertain [2], computed tomography (CT) is a primary imaging modality used to assess the disease severity in cases of suspected or confirmed COVID-19 pneumonia [3,4,5]. Studies evaluating CT applicability for COVID-19 indicate the absence of pathognomonic signs but highlight the frequently occurring findings: bilateral peripheral groundglass opacities and “crazy-paving” pattern with basal predominance [6,7]. The association between the CT findings and COVID-19 depends on the local prevalence of the disease and could be influenced by individual factors such as exposure history [8]. Several CT severity score systems for the quantitative assessment of pulmonary lesions in COVID-19 have been described

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