RSNA Expert Consensus Statement on Reporting Chest CT Findings Related to COVID-19: Interobserver Agreement Between Chest Radiologists.

PURPOSE: To assess the interobserver variability between chest radiologists in the interpretation of the Radiological Society of North America (RSNA) expert consensus statement reporting guidelines in patients with suspected coronavirus disease 2019 (COVID-19) pneumonia in a setting with limited reverse transcription polymerase chain reaction testing availability. METHODS: Chest computed tomography (CT) studies in 303 consecutive patients with suspected COVID-19 were reviewed by 3 fellowship-trained chest radiologists. Cases were assigned an impression of typical, indeterminate, atypical, or negative for COVID-19 pneumonia according to the RSNA expert consensus statement reporting guidelines, and interobserver analysis was performed. Objective CT features associated with COVID-19 pneumonia and distribution of findings were recorded. RESULTS: The Fleiss kappa for all observers was almost perfect for typical (0.815), atypical (0.806), and negative (0.962) COVID-19 appearances (P < .0001) and substantial (0.636) for indeterminate COVID-19 appearance (P < .0001). Using Cramer V analysis, there were very strong correlations between all radiologists' interpretations, statistically significant for all (typical, indeterminate, atypical, and negative) COVID-19 appearances (P < .001). Objective CT imaging findings were recorded in similar percentages of typical cases by all observers. CONCLUSION: The RSNA expert consensus statement on reporting chest CT findings related to COVID-19 demonstrates substantial to almost perfect interobserver agreement among chest radiologists in a relatively large cohort of patients with clinically suspected COVID-19. It therefore serves as a reliable reference framework for radiologists to accurately communicate their level of suspicion based on the presence of evidence-based objective findings.

Chest CT target sign in a couple with COVID-19 pneumonia

We describe a target sign on chest CT characterized by a combination of peripheral ring-like opacity and a central nodular ground-glass opacity surrounding a vessel in a couple with COVID-19 pneumonia confirmed by real-time reverse transcriptase fluorescence polymerase chain reaction sputum analysis. Resumo Descrevemos o sinal do alvo na TC de tórax representando combinação de opacidade com aspecto de anel periférico e componente central nodular em vidro fosco circundando estrutura vascular em um casal com COVID-19 confirmada por reação em cadeia da polimerase com transcrição reversa.

Radiological Society of North America (RSNA) Expert Consensus Statement Related to Chest CT Findings in COVID-19 Versus CO-RADS: Comparison of Reporting System Performance Among Chest Radiologists and End-User Preference.

PURPOSE: The RSNA expert consensus statement and CO-RADS reporting system assist radiologists in describing lung imaging findings in a standardized manner in patients under investigation for COVID-19 pneumonia and provide clarity in communication with other healthcare providers. We aim to compare diagnostic performance and inter-/intra-observer among chest radiologists in the interpretation of RSNA and CO-RADS reporting systems and assess clinician preference. METHODS: Chest CT scans of 279 patients with suspected COVID-19 who underwent RT-PCR testing were retrospectively and independently examined by 3 chest radiologists who assigned interpretation according to the RSNA and CO-RADS reporting systems. Inter-/intra-observer analysis was performed. Diagnostic accuracy of both reporting systems was calculated. 60 clinicians participated in a survey to assess end-user preference of the reporting systems. RESULTS: Both systems demonstrated almost perfect inter-observer agreement (Fleiss kappa 0.871, P < 0.0001 for RSNA; 0.876, P < 0.0001 for CO-RADS impressions). Intra-observer agreement between the 2 scoring systems using the equivalent categories was almost perfect (Fleiss kappa 0.90-0.92, P < 0.001). Positive predictive values were high, 0.798-0.818 for RSNA and 0.891-0.903 CO-RADS. Negative predictive value were similar, 0.573-0.585 for RSNA and 0.573-0.58 for CO-RADS. Specificity differed between the 2 systems, 68-73% for CO-RADS and 52-58% for RSNA with superior specificity of CO-RADS. Of 60 survey participants, the majority preferred the RSNA reporting system rather than CO-RADS for all options provided (66.7-76.7%; P < 0.05). CONCLUSIONS: RSNA and CO-RADS reporting systems are consistent and reproducible with near perfect inter-/intra-observer agreement and excellent positive predictive value. End-users preferred the reporting language in the RSNA system.

Chest CT target sign in a couple with COVID-19 pneumonia.

We describe a target sign on chest CT characterized by a combination of peripheral ring-like opacity and a central nodular ground-glass opacity surrounding a vessel in a couple with COVID-19 pneumonia confirmed by real-time reverse transcriptase fluorescence polymerase chain reaction sputum analysis.

Descrevemos o sinal do alvo na TC de tórax representando combinação de opacidade com aspecto de anel periférico e componente central nodular em vidro fosco circundando estrutura vascular em um casal com COVID-19 confirmada por reação em cadeia da polimerase com transcrição reversa.

The Role of Emergency Radiology in COVID-19: From Preparedness to Diagnosis [Formula: see text].

Emergency trauma radiology, although a relatively new subspecialty of radiology, plays a critical role in both the diagnosis/triage of acutely ill patients, but even more important in providing leadership and taking the lead in the preparedness of imaging departments in dealing with novel highly infectious communicable diseases and mass casualties. This has become even more apparent in dealing with COVID-19, the disease caused by the novel coronavirus SARS-CoV-2, first emerged in late 2019. We review the symptoms, epidemiology, and testing for this disease. We discuss characteristic imaging findings of COVID-19 in relation to other modern coronavirus diseases including SARS and MERS. We discuss roles that community radiology clinics, outpatient radiology departments, and emergency radiology departments can play in the diagnosis of this disease. We review practical methods to reduce spread of infections within radiology departments.