1. Radiographers and COVID-19 pneumonia: Diagnostic performance using CO-RADS
- Author
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Davide Bellini, Marco Rengo, Simone Vicini, V. Caldon, C. Gambaretto, Iacopo Carbone, Nicola Panvini, M. De Vivo, C. Del Borgo, S. Panno, and M. Ciotola
- Subjects
Male ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Diagnostic accuracy ,95% CI, 95% Confidence Interval ,Article ,030218 nuclear medicine & medical imaging ,computed tomography ,COVID-19 ,diagnostic accuracy ,ROC curve ,sensitivity and specificity ,severe acute respiratory syndrome coronavirus 2 ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Severe acute respiratory syndrome coronavirus 2 ,RT-PCR, Reverse Transcriptase-Polymerase Chain Reaction ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,Computed tomography ,Retrospective Studies ,Receiver operating characteristic ,Health professionals ,business.industry ,SARS-CoV-2 ,STARD, Standards for Reporting Diagnostic Accuracy Initiative ,CO-RADS, COVID-19 Reporting and Data System ,Middle Aged ,Thorax ,medicine.disease ,Confidence interval ,Pneumonia ,Sensitivity and specificity ,SARS-CoV-2, Severe Acute Respiratory Syndrome Coronavirus 2 ,ROC Curve ,030220 oncology & carcinogenesis ,COVID-19, Coronavirus Disease-2019 ,Female ,Radiology ,business ,Tomography, X-Ray Computed - Abstract
Introduction A more structured role of radiographers is advisable to speed up the management of patients with suspected COVID-19. The purpose of our study was to evaluate the diagnostic performance of radiographers in the detection of COVID-19 pneumonia on chest CT using CO-RADS descriptors. Methods CT images of patients who underwent RT-PCR and chest CT due to COVID-19 suspicion between March and July 2020 were analysed retrospectively. Six readers, including two radiologists, two highly experienced radiographers and two less experienced radiographers, independently scored each CT using the CO-RADS lexicon. ROC curves were used to investigate diagnostic accuracy, and Fleiss’κ statistics to evaluate inter-rater agreement. Results 714 patients (419 men; 295 women; mean age: 64 years ±19SD) were evaluated. CO-RADS> 3 was identified as optimal diagnostic threshold. Highly experienced radiographers achieved an average sensitivity of 58.7% (95%CI: 52.5–64.7), an average specificity of 81.8% (95%CI: 77.9–85.2), and a mean AUC of 0.72 (95%CI: 0.68–0.75). Among less experienced radiographers, an average sensitivity of 56.3% (95%CI: 50.1–62.2) and an average specificity of 81.5% (95%CI: 77.6–84.9) were observed, with a mean AUC of 0.71 (95%CI: 0.68–0.74). Consultant radiologists achieved an average sensitivity of 60.0% (95%CI: 53.7–65.8), an average specificity of 81.7% (95%CI: 77.8–85.1), and a mean AUC of 0.73 (95%CI: 0.70–0.77). Conclusion Radiographers can adequately recognise the classic appearances of COVID-19 on CT, as described by the CO-RADS assessment scheme, in a way comparable to expert radiologists. Implications for practice Radiographers, as the first healthcare professionals to evaluate CT images in patients with suspected SARS-CoV-2 infection, could diagnose COVID-19 pneumonia by means of a categorical reporting scheme at CT in a reliable way, hence playing a primary role in the early management of these patients.
- Published
- 2021