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Diagnostic accuracy and interobserver variability of CO-RADS in patients with suspected coronavirus disease-2019: a multireader validation study

European radiology, 2021-04, Vol.31 (4), p.1932-1940 [Peer Reviewed Journal]

European Society of Radiology 2020 ;COPYRIGHT 2021 Springer ;European Society of Radiology 2020. ;ISSN: 0938-7994 ;EISSN: 1432-1084 ;DOI: 10.1007/s00330-020-07273-y ;PMID: 32968883

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Title:
Diagnostic accuracy and interobserver variability of CO-RADS in patients with suspected coronavirus disease-2019: a multireader validation study
Author: Bellini, Davide ; Panvini, Nicola ; Rengo, Marco ; Vicini, Simone ; Lichtner, Miriam ; Tieghi, Tiziana ; Ippoliti, Dea ; Giulio, Federica ; Orlando, Elena ; Iozzino, Mario ; Ciolfi, Maria Grazia ; Montechiarello, Sarah ; d’Ambrosio, Ugo ; d’Adamo, Emanuele ; Gambaretto, Chiara ; Panno, Stefano ; Caldon, Vanessa ; Ambrogi, Cesare ; Carbone, Iacopo
Subjects: Accuracy ; Adult ; Aged ; Aged, 80 and over ; Analysis ; Carbon monoxide ; Care and treatment ; Chest ; Coronavirus Infections ; Coronaviruses ; COVID-19 ; Diagnosis ; Diagnostic Radiology ; Diagnostic systems ; DNA polymerases ; Humans ; Imaging ; Internal Medicine ; Interventional Radiology ; Lungs ; Male ; Medical research ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Middle Aged ; Neuroradiology ; Observer Variation ; Polymerase chain reaction ; Radiology ; Retrospective Studies ; RNA-directed DNA polymerase ; SARS-CoV-2 ; Sensitivity ; Severe acute respiratory syndrome ; Statistical analysis ; Ultrasound ; Validation studies ; Viral diseases
Is Part Of: European radiology, 2021-04, Vol.31 (4), p.1932-1940
Description: Objective To conduct a multireader validation study to evaluate the interobserver variability and the diagnostic accuracy for the lung involvement by COVID-19 of COVID-19 Reporting and Data System (CO-RADS) score. Methods This retrospective study included consecutive symptomatic patients who underwent chest CT and reverse transcriptase-polymerase chain reaction (RT-PCR) from March 2020 to May 2020 for suspected COVID-19. Twelve readers with different levels of expertise independently scored each CT using the CO-RADS scheme for detecting pulmonary involvement by COVID-19. Receiver operating characteristic (ROC) curves were computed to investigate diagnostic yield. Fleiss’ kappa statistics was used to evaluate interreader agreement. Results A total of 572 patients (mean age, 63 ± 20 [standard deviation]; 329 men; 142 patients with COVID-19 and 430 patients without COVID-19) were evaluated. There was a moderate agreement for CO-RADS rating among all readers (Fleiss’ K = 0.43 [95% CI 0.42–0.44]) with a substantial agreement for CO-RADS 1 category (Fleiss’ K = 0.61 [95% CI 0.60–0.62]) and moderate agreement for CO-RADS 5 category (Fleiss’ K = 0.60 [95% CI 0.58–0.61]). ROC analysis showed the CO-RADS score ≥ 4 as the optimal threshold, with a cumulative area under the curve of 0.72 (95% CI 66–78%), sensitivity 61% (95% CI 52–69%), and specificity 81% (95% CI 77–84%). Conclusion CO-RADS showed high diagnostic accuracy and moderate interrater agreement across readers with different levels of expertise. Specificity is higher than previously thought and that could lead to reconsider the role of CT in this clinical setting. Key Points • COVID-19 Reporting and Data System (CO-RADS) demonstrated a good diagnostic accuracy for lung involvement by COVID-19 with an average AUC of 0.72 (95% CI 67 – 75%). • When a threshold of ≥ 4 was used, sensitivity and specificity were 61% (95% CI 52 – 69%) and 81% (95% CI 76 – 84%), respectively. • There was an overall moderate agreement for CO-RADS rating across readers with different levels of expertise (Fleiss’ K = 0.43 [95% CI 0.42 – 0.44]).
Publisher: Berlin/Heidelberg: Springer Berlin Heidelberg
Language: English
Identifier: ISSN: 0938-7994
EISSN: 1432-1084
DOI: 10.1007/s00330-020-07273-y
PMID: 32968883
Source: AUTh Library subscriptions: ProQuest Central
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Diagnostic accuracy and interobserver variability of CO-RADS in patients with suspected coronavirus disease-2019: a multireader validation study

European Society of Radiology 2020 ;COPYRIGHT 2021 Springer ;European Society of Radiology 2020. ;ISSN: 0938-7994 ;EISSN: 1432-1084 ;DOI: 10.1007/s00330-020-07273-y ;PMID: 32968883

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