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Observer agreement and clinical significance of chest CT reporting in patients suspected of COVID-19
OBJECTIVES: To assess interobserver agreement and clinical significance of chest CT reporting in patients suspected of COVID-19. METHODS: From 16 to 24 March 2020, 241 consecutive patients addressed to hospital for COVID-19 suspicion had both chest CT and SARS-CoV-2 RT-PCR. Eight observers (2 thorac...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7456359/ https://www.ncbi.nlm.nih.gov/pubmed/32862289 http://dx.doi.org/10.1007/s00330-020-07126-8 |
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author | Debray, Marie-Pierre Tarabay, Helena Males, Lisa Chalhoub, Nisrine Mahdjoub, Elyas Pavlovsky, Thomas Visseaux, Benoît Bouzid, Donia Borie, Raphael Wackenheim, Catherine Crestani, Bruno Rioux, Christophe Saker, Loukbi Choquet, Christophe Mullaert, Jimmy Khalil, Antoine |
author_facet | Debray, Marie-Pierre Tarabay, Helena Males, Lisa Chalhoub, Nisrine Mahdjoub, Elyas Pavlovsky, Thomas Visseaux, Benoît Bouzid, Donia Borie, Raphael Wackenheim, Catherine Crestani, Bruno Rioux, Christophe Saker, Loukbi Choquet, Christophe Mullaert, Jimmy Khalil, Antoine |
author_sort | Debray, Marie-Pierre |
collection | PubMed |
description | OBJECTIVES: To assess interobserver agreement and clinical significance of chest CT reporting in patients suspected of COVID-19. METHODS: From 16 to 24 March 2020, 241 consecutive patients addressed to hospital for COVID-19 suspicion had both chest CT and SARS-CoV-2 RT-PCR. Eight observers (2 thoracic and 2 general senior radiologists, 2 junior radiologists, and 2 emergency physicians) retrospectively categorized each CT into one out of 4 categories (evocative, compatible for COVID-19 pneumonia, not evocative, and normal). Observer agreement for categorization between all readers and pairs of readers with similar experience was evaluated with the Kappa coefficient. The results of a consensus categorization were correlated to RT-PCR. RESULTS: Observer agreement across the 4 categories was good between all readers (κ value 0.61 95% CI 0.60–0.63) and moderate to good between pairs of readers (0.54–0.75). It was very good (κ 0.81 95% CI 0.79–0.83), fair (κ 0.32 95% CI 0.29–0.34), moderate (κ 0.56 95% CI 0.54–0.58), and moderate (0.58 95% CI 0.56–0.61) for the categories evocative, compatible, not evocative, and normal, respectively. RT-PCR was positive in 97%, 50%, 31%, and 11% of cases in the respective categories. Observer agreement was lower (p < 0.001) and RT-PCR positive cases less frequently categorized evocative in the presence of an underlying pulmonary disease (p < 0.001). CONCLUSION: Interobserver agreement for chest CT reporting using categorization of findings is good in patients suspected of COVID-19. Among patients considered for hospitalization in an epidemic context, CT categorized evocative is highly predictive of COVID-19, whereas the predictive value of CT decreases between the categories compatible and not evocative. KEY POINTS: • In patients suspected of COVID-19, interobserver agreement for chest CT reporting into categories is good, and very good to categorize CT “evocative.” • Chest CT can participate in estimating the likelihood of COVID-19 in patients presenting to hospital during the outbreak, CT categorized “evocative” being highly predictive of the disease whereas almost a third of patients with CT “not evocative” had a positive RT-PCR in our study. • Observer agreement is lower and CTs of positive RT-PCR cases less frequently “evocative” in presence of an underlying pulmonary disease. |
format | Online Article Text |
id | pubmed-7456359 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-74563592020-08-31 Observer agreement and clinical significance of chest CT reporting in patients suspected of COVID-19 Debray, Marie-Pierre Tarabay, Helena Males, Lisa Chalhoub, Nisrine Mahdjoub, Elyas Pavlovsky, Thomas Visseaux, Benoît Bouzid, Donia Borie, Raphael Wackenheim, Catherine Crestani, Bruno Rioux, Christophe Saker, Loukbi Choquet, Christophe Mullaert, Jimmy Khalil, Antoine Eur Radiol Chest OBJECTIVES: To assess interobserver agreement and clinical significance of chest CT reporting in patients suspected of COVID-19. METHODS: From 16 to 24 March 2020, 241 consecutive patients addressed to hospital for COVID-19 suspicion had both chest CT and SARS-CoV-2 RT-PCR. Eight observers (2 thoracic and 2 general senior radiologists, 2 junior radiologists, and 2 emergency physicians) retrospectively categorized each CT into one out of 4 categories (evocative, compatible for COVID-19 pneumonia, not evocative, and normal). Observer agreement for categorization between all readers and pairs of readers with similar experience was evaluated with the Kappa coefficient. The results of a consensus categorization were correlated to RT-PCR. RESULTS: Observer agreement across the 4 categories was good between all readers (κ value 0.61 95% CI 0.60–0.63) and moderate to good between pairs of readers (0.54–0.75). It was very good (κ 0.81 95% CI 0.79–0.83), fair (κ 0.32 95% CI 0.29–0.34), moderate (κ 0.56 95% CI 0.54–0.58), and moderate (0.58 95% CI 0.56–0.61) for the categories evocative, compatible, not evocative, and normal, respectively. RT-PCR was positive in 97%, 50%, 31%, and 11% of cases in the respective categories. Observer agreement was lower (p < 0.001) and RT-PCR positive cases less frequently categorized evocative in the presence of an underlying pulmonary disease (p < 0.001). CONCLUSION: Interobserver agreement for chest CT reporting using categorization of findings is good in patients suspected of COVID-19. Among patients considered for hospitalization in an epidemic context, CT categorized evocative is highly predictive of COVID-19, whereas the predictive value of CT decreases between the categories compatible and not evocative. KEY POINTS: • In patients suspected of COVID-19, interobserver agreement for chest CT reporting into categories is good, and very good to categorize CT “evocative.” • Chest CT can participate in estimating the likelihood of COVID-19 in patients presenting to hospital during the outbreak, CT categorized “evocative” being highly predictive of the disease whereas almost a third of patients with CT “not evocative” had a positive RT-PCR in our study. • Observer agreement is lower and CTs of positive RT-PCR cases less frequently “evocative” in presence of an underlying pulmonary disease. Springer Berlin Heidelberg 2020-08-29 2021 /pmc/articles/PMC7456359/ /pubmed/32862289 http://dx.doi.org/10.1007/s00330-020-07126-8 Text en © European Society of Radiology 2020 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Chest Debray, Marie-Pierre Tarabay, Helena Males, Lisa Chalhoub, Nisrine Mahdjoub, Elyas Pavlovsky, Thomas Visseaux, Benoît Bouzid, Donia Borie, Raphael Wackenheim, Catherine Crestani, Bruno Rioux, Christophe Saker, Loukbi Choquet, Christophe Mullaert, Jimmy Khalil, Antoine Observer agreement and clinical significance of chest CT reporting in patients suspected of COVID-19 |
title | Observer agreement and clinical significance of chest CT reporting in patients suspected of COVID-19 |
title_full | Observer agreement and clinical significance of chest CT reporting in patients suspected of COVID-19 |
title_fullStr | Observer agreement and clinical significance of chest CT reporting in patients suspected of COVID-19 |
title_full_unstemmed | Observer agreement and clinical significance of chest CT reporting in patients suspected of COVID-19 |
title_short | Observer agreement and clinical significance of chest CT reporting in patients suspected of COVID-19 |
title_sort | observer agreement and clinical significance of chest ct reporting in patients suspected of covid-19 |
topic | Chest |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7456359/ https://www.ncbi.nlm.nih.gov/pubmed/32862289 http://dx.doi.org/10.1007/s00330-020-07126-8 |
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