Diagnostic performance of the RSNA-proposed classification for COVID-19 pneumonia versus pre-pandemic controls

Brazilian Journal of Infectious Diseases

Carlo S. Faccin¹  Rogério B. Borges²  Tássia A.D. Prioste²  Natalia B. Mainardi³  Luciano Folador³  Pedro G. Knijnik³  Mateus S. Tonetto³  Cauã O. Rocha³  Tiago S. Garcia⁴ 

[1] Corresponding author.;Postgraduate Program in Pneumological Sciences, Universidade Federal do Rio Grande do Sul, RS, Brazil;Radiology Department, Hospital de Clínicas de Porto Alegre (HCPA), RS, Brazil;School of Medicine, Universidade Federal do Rio Grande do Sul, RS, Brazil;

关键词: Chest CT;    COVID-19 pneumonia;    RSNA classification;    Pre-pandemic controls;   

DOI  :  

来源: DOAJ

【 摘 要 】

Objective: To evaluate the diagnostic accuracy of the Radiological Society of North America (RSNA) classification system for coronavirus disease 2019 (COVID-19) pneumonia compared to pre-pandemic chest computed tomography (CT) scan images to mitigate the risk of bias regarding the reference standard. Materials and methods: This was a retrospective, cross-sectional, diagnostic test accuracy study. Chest CT scans, carried out from May 1 to June 30, 2020, and from May 1 to July 17, 2017, were consecutively selected for the COVID-19 (positive reverse transcription-polymerase chain reaction [RT-PCR] for severe acute respiratory syndrome coronavirus 2 result) and control (pre-pandemic) groups, respectively. Four expert thoracic radiologists blindly interpreted each CT scan image. Sensitivity and specificity were calculated. Results: A total of 160 chest CT scan images were included: 79 in the COVID-19 group (56 [43.5–67] years old, 41 men) and 81 in the control group (62 [52–72] years old, 44 men). Typically, an estimated specificity of 98.5% (95% confidence interval [CI] 98.1%–98.4%) was obtained. For the indeterminate classification as a diagnostic threshold, an estimated sensitivity of 88.3% (95% CI 84.7%–91.7%) and a specificity of 79.0% (95% CI 74.5%–83.4%), with an area under the curve of 0.865 (95% CI 0.838–0.895), were obtained. Conclusion: The RSNA classification system shows strong diagnostic accuracy for COVID-19 pneumonia, even against pre-pandemic controls. It can be an important aid in clinical decision-making, especially when a typical or indeterminate pattern is found, possibly advising retesting following an initial negative RT-PCR result and streamlining early management and isolation.

【 授权许可】

Unknown