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Accuracy and Reproducibility of Low-Dose Submillisievert Chest CT for the Diagnosis of COVID-19.
Dangis, Anthony; Gieraerts, Christopher; De Bruecker, Yves; Janssen, Lode; Valgaeren, Hanne; Obbels, Dagmar; Gillis, Marc; Van Ranst, Marc; Frans, Johan; Demeyere, Annick; Symons, Rolf.
  • Dangis A; Departments of Radiology (A. Dangis, C.G., Y.D.B., L.J., A. Demeyere, R.S.), Microbiology (H.V., D.O., J.F.), and Emergency Medicine (M.G.), Imelda Hospital, Imeldalaan 9, 2820 Bonheiden, Belgium; and Department of Microbiology, University Hospital Leuven, Leuven, Belgium (M.V.R.).
  • Gieraerts C; Departments of Radiology (A. Dangis, C.G., Y.D.B., L.J., A. Demeyere, R.S.), Microbiology (H.V., D.O., J.F.), and Emergency Medicine (M.G.), Imelda Hospital, Imeldalaan 9, 2820 Bonheiden, Belgium; and Department of Microbiology, University Hospital Leuven, Leuven, Belgium (M.V.R.).
  • De Bruecker Y; Departments of Radiology (A. Dangis, C.G., Y.D.B., L.J., A. Demeyere, R.S.), Microbiology (H.V., D.O., J.F.), and Emergency Medicine (M.G.), Imelda Hospital, Imeldalaan 9, 2820 Bonheiden, Belgium; and Department of Microbiology, University Hospital Leuven, Leuven, Belgium (M.V.R.).
  • Janssen L; Departments of Radiology (A. Dangis, C.G., Y.D.B., L.J., A. Demeyere, R.S.), Microbiology (H.V., D.O., J.F.), and Emergency Medicine (M.G.), Imelda Hospital, Imeldalaan 9, 2820 Bonheiden, Belgium; and Department of Microbiology, University Hospital Leuven, Leuven, Belgium (M.V.R.).
  • Valgaeren H; Departments of Radiology (A. Dangis, C.G., Y.D.B., L.J., A. Demeyere, R.S.), Microbiology (H.V., D.O., J.F.), and Emergency Medicine (M.G.), Imelda Hospital, Imeldalaan 9, 2820 Bonheiden, Belgium; and Department of Microbiology, University Hospital Leuven, Leuven, Belgium (M.V.R.).
  • Obbels D; Departments of Radiology (A. Dangis, C.G., Y.D.B., L.J., A. Demeyere, R.S.), Microbiology (H.V., D.O., J.F.), and Emergency Medicine (M.G.), Imelda Hospital, Imeldalaan 9, 2820 Bonheiden, Belgium; and Department of Microbiology, University Hospital Leuven, Leuven, Belgium (M.V.R.).
  • Gillis M; Departments of Radiology (A. Dangis, C.G., Y.D.B., L.J., A. Demeyere, R.S.), Microbiology (H.V., D.O., J.F.), and Emergency Medicine (M.G.), Imelda Hospital, Imeldalaan 9, 2820 Bonheiden, Belgium; and Department of Microbiology, University Hospital Leuven, Leuven, Belgium (M.V.R.).
  • Van Ranst M; Departments of Radiology (A. Dangis, C.G., Y.D.B., L.J., A. Demeyere, R.S.), Microbiology (H.V., D.O., J.F.), and Emergency Medicine (M.G.), Imelda Hospital, Imeldalaan 9, 2820 Bonheiden, Belgium; and Department of Microbiology, University Hospital Leuven, Leuven, Belgium (M.V.R.).
  • Frans J; Departments of Radiology (A. Dangis, C.G., Y.D.B., L.J., A. Demeyere, R.S.), Microbiology (H.V., D.O., J.F.), and Emergency Medicine (M.G.), Imelda Hospital, Imeldalaan 9, 2820 Bonheiden, Belgium; and Department of Microbiology, University Hospital Leuven, Leuven, Belgium (M.V.R.).
  • Demeyere A; Departments of Radiology (A. Dangis, C.G., Y.D.B., L.J., A. Demeyere, R.S.), Microbiology (H.V., D.O., J.F.), and Emergency Medicine (M.G.), Imelda Hospital, Imeldalaan 9, 2820 Bonheiden, Belgium; and Department of Microbiology, University Hospital Leuven, Leuven, Belgium (M.V.R.).
  • Symons R; Departments of Radiology (A. Dangis, C.G., Y.D.B., L.J., A. Demeyere, R.S.), Microbiology (H.V., D.O., J.F.), and Emergency Medicine (M.G.), Imelda Hospital, Imeldalaan 9, 2820 Bonheiden, Belgium; and Department of Microbiology, University Hospital Leuven, Leuven, Belgium (M.V.R.).
Radiol Cardiothorac Imaging ; 2(2): e200196, 2020 Apr.
Article in English | MEDLINE | ID: covidwho-1155986
ABSTRACT

PURPOSE:

To demonstrate the accuracy and reproducibility of low-dose submillisievert chest CT for the diagnosis of coronavirus disease 2019 (COVID-19) infection in patients in the emergency department. MATERIALS AND

METHODS:

This was a Health Insurance Portability and Accountability Act-compliant, institutional review board-approved retrospective study. From March 14 to 24, 2020, 192 patients in the emergency department with symptoms suggestive of COVID-19 infection were studied by using low-dose chest CT and real-time reverse transcription polymerase chain reaction (RT-PCR). Image analysis included the likelihood of COVID-19 infection and the semiquantitative extent of lung involvement. CT images were analyzed by two radiologists blinded to the RT-PCR results. Reproducibility was assessed using the McNemar test and intraclass correlation coefficient. Time between CT acquisition and report was measured.

RESULTS:

When compared with RT-PCR, low-dose submillisievert chest CT demonstrated excellent sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for diagnosis of COVID-19 (86.7%, 93.6%, 91.1%, 90.3%, and 90.2%, respectively), in particular in patients with clinical symptoms for more than 48 hours (95.6%, 93.2%, 91.5%, 96.5%, and 94.4%, respectively). In patients with a positive CT result, the likelihood of disease increased from 43.2% (pretest probability) to 91.1% or 91.4% (posttest probability), while in patients with a negative CT result, the likelihood of disease decreased to 9.6% or 3.7% for all patients or those with clinical symptoms for >48 hours. The prevalence of alternative diagnoses based on chest CT in patients without COVID-19 infection was 17.6%. The mean effective radiation dose was 0.56 mSv ± 0.25 (standard deviation). Median time between CT acquisition and report was 25 minutes (interquartile range 13-49 minutes). Intra- and interreader reproducibility of CT was excellent (all intraclass correlation coefficients ≥ 0.95) without significant bias in the Bland-Altman analysis.

CONCLUSION:

Low-dose submillisievert chest CT allows for rapid, accurate, and reproducible assessment of COVID-19 infection in patients in the emergency department, in particular in patients with symptoms lasting longer than 48 hours. Chest CT has the additional advantage of offering alternative diagnoses in a significant subset of patients.© RSNA, 2020.

Full text: Available Collection: International databases Database: MEDLINE Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Language: English Journal: Radiol Cardiothorac Imaging Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Language: English Journal: Radiol Cardiothorac Imaging Year: 2020 Document Type: Article