RSNA and BSTI grading systems of COVID-19 pneumonia: comparison of the diagnostic performance and interobserver agreement

Seyhmus Kavak,Recai Duymus

doi:10.1186/s12880-021-00668-3

Abstract

BackgroundThis study aimed to compare the performance and interobservers agreement of cases with findings on chest CT based on the British Society of Thoracic Imaging (BSTI) guideline statement of COVID-19 and the Radiological Society of North America (RSNA) expert consensus statement.MethodsIn this study, 903 patients who had admitted to the emergency department with a pre-diagnosis of COVID-19 between 1 and 18 July 2020 and had chest CT. Two radiologists classified the chest CT findings according to the RSNA and BSTI consensus statements. The performance, sensitivity and specificity values of the two classification systems were calculated and the agreement between the observers was compared by using kappa analysis.ResultsConsidering RT-PCR test result as a gold standard, the sensitivity, specificity and positive predictive values were significantly higher for the two observers according to the BSTI guidance statement and the RSNA expert consensus statement (83.3%, 89.7%, 89.0%; % 81.2,% 89.7,% 88.7, respectively). There was a good agreement in the PCR positive group (κ: 0.707; p < 0.001 for BSTI and κ: 0.716; p < 0.001 for RSNA), a good agreement in the PCR negative group (κ: 0.645; p < 0.001 for BSTI and κ: 0.743; p < 0.001 for RSNA) according to the BSTI and RSNA classification between the two radiologists.ConclusionAs a result, RSNA and BSTI statement provided reasonable performance and interobservers agreement in reporting CT findings of COVID-19. However, the number of patients defined as false negative and indeterminate in both classification systems is at a level that cannot be neglected.

Highlights

This study aimed to compare the performance and interobservers agreement of cases with findings on chest computed tomography (CT) based on the British Society of Thoracic Imaging (BSTI) guideline statement of COVID-19 and the Radiological Society of North America (RSNA) expert consensus statement
Ground-glass opacities or consolidation were detected in 45 patients (5.0%) at the isolated upper and middle zone levels
Many radiology associations disapprove of the use of chest CT examination in the diagnostic process of COVID-19. It is widely used for diagnostic purposes and for predicting and monitoring the course of the disease. Since it is a newly defined disease, complete detection and accurate identification of CT findings, eliminating other aetiologies that lead to similar findings, and standardization in reporting to help radiologists and other clinicians are of importance

Summary

Introduction

This study aimed to compare the performance and interobservers agreement of cases with findings on chest CT based on the British Society of Thoracic Imaging (BSTI) guideline statement of COVID-19 and the Radiological Society of North America (RSNA) expert consensus statement. NAATs detect SARS-CoV-2 RNA in patient samples, and they are highly specific. They are able to detect even low levels of viral. RNAs, the sensitivity of these tests in clinical setting is likely to depend on the type and quality of the sample obtained, the duration of the disease at the time point of the test and the individual test. Their estimated falsenegative rates ranges from 5 to 40% [2, 3]. The absence of typical signs in CT or presence of atypical manifestations

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