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Diagnostic accuracy and interobserver variability of CO-RADS in patients with suspected coronavirus disease-2019: a multireader validation study.
Bellini, Davide; Panvini, Nicola; Rengo, Marco; Vicini, Simone; Lichtner, Miriam; Tieghi, Tiziana; Ippoliti, Dea; Giulio, Federica; Orlando, Elena; Iozzino, Mario; Ciolfi, Maria Grazia; Montechiarello, Sarah; d'Ambrosio, Ugo; d'Adamo, Emanuele; Gambaretto, Chiara; Panno, Stefano; Caldon, Vanessa; Ambrogi, Cesare; Carbone, Iacopo.
  • Bellini D; Department of Radiological Sciences, Oncology and Pathology, "Sapienza" University of Rome, I.C.O.T. Hospital, Via Franco Faggiana, 1668, 04100, Latina, Italy. bellinidavide29@gmail.com.
  • Panvini N; Department of Diagnostic Imaging and Interventional Radiology, Santa Maria Goretti Hospital, 04100, Latina, Italy. bellinidavide29@gmail.com.
  • Rengo M; Department of Radiological Sciences, Oncology and Pathology, "Sapienza" University of Rome, I.C.O.T. Hospital, Via Franco Faggiana, 1668, 04100, Latina, Italy.
  • Vicini S; Department of Radiological Sciences, Oncology and Pathology, "Sapienza" University of Rome, I.C.O.T. Hospital, Via Franco Faggiana, 1668, 04100, Latina, Italy.
  • Lichtner M; Department of Radiological Sciences, Oncology and Pathology, "Sapienza" University of Rome, I.C.O.T. Hospital, Via Franco Faggiana, 1668, 04100, Latina, Italy.
  • Tieghi T; Infectious Diseases Unit, "Sapienza" University of Rome, Santa Maria Goretti Hospital, 04100, Latina, Italy.
  • Ippoliti D; Infectious Diseases Unit, "Sapienza" University of Rome, Santa Maria Goretti Hospital, 04100, Latina, Italy.
  • Giulio F; Department of Radiological Sciences, Oncology and Pathology, "Sapienza" University of Rome, I.C.O.T. Hospital, Via Franco Faggiana, 1668, 04100, Latina, Italy.
  • Orlando E; Department of Radiological Sciences, Oncology and Pathology, "Sapienza" University of Rome, I.C.O.T. Hospital, Via Franco Faggiana, 1668, 04100, Latina, Italy.
  • Iozzino M; Department of Radiological Sciences, Oncology and Pathology, "Sapienza" University of Rome, I.C.O.T. Hospital, Via Franco Faggiana, 1668, 04100, Latina, Italy.
  • Ciolfi MG; Department of Diagnostic Imaging and Interventional Radiology, Santa Maria Goretti Hospital, 04100, Latina, Italy.
  • Montechiarello S; Department of Diagnostic Imaging and Interventional Radiology, Santa Maria Goretti Hospital, 04100, Latina, Italy.
  • d'Ambrosio U; Department of Diagnostic Imaging and Interventional Radiology, Santa Maria Goretti Hospital, 04100, Latina, Italy.
  • d'Adamo E; Department of Diagnostic Imaging and Interventional Radiology, Santa Maria Goretti Hospital, 04100, Latina, Italy.
  • Gambaretto C; Department of Diagnostic Imaging and Interventional Radiology, Santa Maria Goretti Hospital, 04100, Latina, Italy.
  • Panno S; Department of Diagnostic Imaging and Interventional Radiology, Santa Maria Goretti Hospital, 04100, Latina, Italy.
  • Caldon V; Department of Diagnostic Imaging and Interventional Radiology, Santa Maria Goretti Hospital, 04100, Latina, Italy.
  • Ambrogi C; Department of Diagnostic Imaging and Interventional Radiology, Santa Maria Goretti Hospital, 04100, Latina, Italy.
  • Carbone I; Department of Diagnostic Imaging and Interventional Radiology, Santa Maria Goretti Hospital, 04100, Latina, Italy.
Eur Radiol ; 31(4): 1932-1940, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-784507
ABSTRACT

OBJECTIVE:

To conduct a multireader validation study to evaluate the interobserver variability and the diagnostic accuracy for the lung involvement by COVID-19 of COVID-19 Reporting and Data System (CO-RADS) score.

METHODS:

This retrospective study included consecutive symptomatic patients who underwent chest CT and reverse transcriptase-polymerase chain reaction (RT-PCR) from March 2020 to May 2020 for suspected COVID-19. Twelve readers with different levels of expertise independently scored each CT using the CO-RADS scheme for detecting pulmonary involvement by COVID-19. Receiver operating characteristic (ROC) curves were computed to investigate diagnostic yield. Fleiss' kappa statistics was used to evaluate interreader agreement.

RESULTS:

A total of 572 patients (mean age, 63 ± 20 [standard deviation]; 329 men; 142 patients with COVID-19 and 430 patients without COVID-19) were evaluated. There was a moderate agreement for CO-RADS rating among all readers (Fleiss' K = 0.43 [95% CI 0.42-0.44]) with a substantial agreement for CO-RADS 1 category (Fleiss' K = 0.61 [95% CI 0.60-0.62]) and moderate agreement for CO-RADS 5 category (Fleiss' K = 0.60 [95% CI 0.58-0.61]). ROC analysis showed the CO-RADS score ≥ 4 as the optimal threshold, with a cumulative area under the curve of 0.72 (95% CI 66-78%), sensitivity 61% (95% CI 52-69%), and specificity 81% (95% CI 77-84%).

CONCLUSION:

CO-RADS showed high diagnostic accuracy and moderate interrater agreement across readers with different levels of expertise. Specificity is higher than previously thought and that could lead to reconsider the role of CT in this clinical setting. KEY POINTS • COVID-19 Reporting and Data System (CO-RADS) demonstrated a good diagnostic accuracy for lung involvement by COVID-19 with an average AUC of 0.72 (95% CI 67-75%). • When a threshold of ≥ 4 was used, sensitivity and specificity were 61% (95% CI 52-69%) and 81% (95% CI 76-84%), respectively. • There was an overall moderate agreement for CO-RADS rating across readers with different levels of expertise (Fleiss' K = 0.43 [95% CI 0.42-0.44]).
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Coronavirus Infections / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Adult / Aged / Humans / Male / Middle aged Language: English Journal: Eur Radiol Journal subject: Radiology Year: 2021 Document Type: Article Affiliation country: S00330-020-07273-y

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Coronavirus Infections / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Adult / Aged / Humans / Male / Middle aged Language: English Journal: Eur Radiol Journal subject: Radiology Year: 2021 Document Type: Article Affiliation country: S00330-020-07273-y