Radiographers and COVID-19 pneumonia: Diagnostic performance using CO-RADS. Issue 4 (November 2021)

• Record Type: Journal Article
• Authors: Vicini, S.; Panvini, N.; Bellini, D.; Rengo, M.; Ciotola, M.; De Vivo, M.; Gambaretto, C.; Caldon, V.; Panno, S.; Del Borgo, C.; Carbone, I.
• Is Part Of: Radiography. Volume 27:Issue 4(2021)
• Page Start: 1078
• Page End: 1084
• Publication Date: 2021-11
• Subjects: COVID-19 -- Severe acute respiratory syndrome coronavirus 2 -- Computed tomography -- Diagnostic accuracy -- ROC Curve -- Sensitivity and specificity; 95% CI 95% Confidence Interval -- COVID-19 Coronavirus Disease-2019 -- CO-RADS COVID-19 Reporting and Data System -- RT-PCR Reverse Transcriptase-Polymerase Chain Reaction -- SARS-CoV-2 Severe Acute Respiratory Syndrome Coronavirus 2 -- STARD Standards for Reporting Diagnostic Accuracy Initiative; Diagnostic imaging -- Periodicals; Radiotherapy -- Periodicals; Cancer -- Radiotherapy -- Periodicals; Diagnostic Imaging -- Periodicals; Neoplasms -- Periodicals; Radiotherapy -- Periodicals; Imagerie pour le diagnostic -- Périodiques; Radiothérapie -- Périodiques; Cancer -- Radiothérapie -- Périodiques; Electronic journals; 616.0757
• DOI: 10.1016/j.radi.2021.04.010
• Languages: English
• ISSNs: 1078-8174

Abstract

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.