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Diagnostic performance of chest CT in screening patients with suspected COVID-19 infection in a Western population
OBJECTIVE: To investigate the diagnostic performance of chest CT in screening patients suspected of Coronavirus disease 2019 (COVID-19) in a Western population. METHODS: Consecutive patients who underwent chest CT because of clinical suspicion of COVID-19 were included. CT scans were prospectively e...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The British Institute of Radiology.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7465869/ https://www.ncbi.nlm.nih.gov/pubmed/32808545 http://dx.doi.org/10.1259/bjr.20200643 |
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author | Krdzalic, Jasenko de Jaegere, Tom M.H. Kwee, Robert M. |
author_facet | Krdzalic, Jasenko de Jaegere, Tom M.H. Kwee, Robert M. |
author_sort | Krdzalic, Jasenko |
collection | PubMed |
description | OBJECTIVE: To investigate the diagnostic performance of chest CT in screening patients suspected of Coronavirus disease 2019 (COVID-19) in a Western population. METHODS: Consecutive patients who underwent chest CT because of clinical suspicion of COVID-19 were included. CT scans were prospectively evaluated by frontline general radiologists who were on duty at the time when the CT scan was performed and retrospectively assessed by a chest radiologist in an independent and blinded manner. Real-time reverse transcriptase–polymerase chain reaction was used as reference standard. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Sensitivity and specificity of the frontline general radiologists were compared to those of the chest radiologist using the McNemar test. RESULTS: 56 patients were included. Sensitivity, specificity, PPV, and NPV for the frontline general radiologists were 89.3% [95% confidence interval (CI): 71.8%, 97.7%], 32.1% (95% CI: 15.9%, 52.4%), 56.8% (95% CI: 41.0%, 71.7%), and 75.0% (95% CI: 42.8%, 94.5%), respectively. Sensitivity, specificity, PPV, and NPV for the chest radiologist were 89.3% (95% CI: 71.8%, 97.7%), 75.0% (95% CI: 55.1%, 89.3%), 78.1% (95% CI: 60.0%, 90.7%), and 87.5% (95% CI: 67.6%, 97.3%), respectively. Sensitivity was not significantly different (p = 1.000), but specificity was significantly higher for the chest radiologist (p = 0.001). CONCLUSION: Chest CT interpreted by frontline general radiologists achieves insufficient screening performance. Although specificity of a chest radiologist appears to be significantly higher, sensitivity did not improve. A negative chest CT result does not exclude COVID-19. ADVANCES IN KNOWLEDGE: Our study shows that chest CT interpreted by frontline general radiologists achieves insufficient diagnostic performance to use it as an independent screening tool for COVID-19. Although specificity of a chest radiologist appears to be significantly higher, sensitivity is still insufficiently high. |
format | Online Article Text |
id | pubmed-7465869 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | The British Institute of Radiology. |
record_format | MEDLINE/PubMed |
spelling | pubmed-74658692021-09-01 Diagnostic performance of chest CT in screening patients with suspected COVID-19 infection in a Western population Krdzalic, Jasenko de Jaegere, Tom M.H. Kwee, Robert M. Br J Radiol Full Paper OBJECTIVE: To investigate the diagnostic performance of chest CT in screening patients suspected of Coronavirus disease 2019 (COVID-19) in a Western population. METHODS: Consecutive patients who underwent chest CT because of clinical suspicion of COVID-19 were included. CT scans were prospectively evaluated by frontline general radiologists who were on duty at the time when the CT scan was performed and retrospectively assessed by a chest radiologist in an independent and blinded manner. Real-time reverse transcriptase–polymerase chain reaction was used as reference standard. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Sensitivity and specificity of the frontline general radiologists were compared to those of the chest radiologist using the McNemar test. RESULTS: 56 patients were included. Sensitivity, specificity, PPV, and NPV for the frontline general radiologists were 89.3% [95% confidence interval (CI): 71.8%, 97.7%], 32.1% (95% CI: 15.9%, 52.4%), 56.8% (95% CI: 41.0%, 71.7%), and 75.0% (95% CI: 42.8%, 94.5%), respectively. Sensitivity, specificity, PPV, and NPV for the chest radiologist were 89.3% (95% CI: 71.8%, 97.7%), 75.0% (95% CI: 55.1%, 89.3%), 78.1% (95% CI: 60.0%, 90.7%), and 87.5% (95% CI: 67.6%, 97.3%), respectively. Sensitivity was not significantly different (p = 1.000), but specificity was significantly higher for the chest radiologist (p = 0.001). CONCLUSION: Chest CT interpreted by frontline general radiologists achieves insufficient screening performance. Although specificity of a chest radiologist appears to be significantly higher, sensitivity did not improve. A negative chest CT result does not exclude COVID-19. ADVANCES IN KNOWLEDGE: Our study shows that chest CT interpreted by frontline general radiologists achieves insufficient diagnostic performance to use it as an independent screening tool for COVID-19. Although specificity of a chest radiologist appears to be significantly higher, sensitivity is still insufficiently high. The British Institute of Radiology. 2020-09-01 2020-07-29 /pmc/articles/PMC7465869/ /pubmed/32808545 http://dx.doi.org/10.1259/bjr.20200643 Text en © 2020 The Authors. Published by the British Institute of Radiology https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Full Paper Krdzalic, Jasenko de Jaegere, Tom M.H. Kwee, Robert M. Diagnostic performance of chest CT in screening patients with suspected COVID-19 infection in a Western population |
title | Diagnostic performance of chest CT in screening patients with suspected COVID-19 infection in a Western population |
title_full | Diagnostic performance of chest CT in screening patients with suspected COVID-19 infection in a Western population |
title_fullStr | Diagnostic performance of chest CT in screening patients with suspected COVID-19 infection in a Western population |
title_full_unstemmed | Diagnostic performance of chest CT in screening patients with suspected COVID-19 infection in a Western population |
title_short | Diagnostic performance of chest CT in screening patients with suspected COVID-19 infection in a Western population |
title_sort | diagnostic performance of chest ct in screening patients with suspected covid-19 infection in a western population |
topic | Full Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7465869/ https://www.ncbi.nlm.nih.gov/pubmed/32808545 http://dx.doi.org/10.1259/bjr.20200643 |
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