Radiological Society of North America Chest CT Classification System for Reporting COVID-19 Pneumonia: Interobserver Variability and Correlation with Reverse-Transcription Polymerase Chain Reaction
Radiological Society of North America Chest CT Classification System for Reporting COVID-19 Pneumonia: Interobserver Variability and Correlation with Reverse-Transcription Polymerase Chain Reaction
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DOI：
10.1148/ryct.2020200213
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发表时间：
2020-06-01
期刊：
影响因子：
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通讯作者：
Kwee, Robert M.
中科院分区：
文献类型：
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作者：
de Jaegere, Tom M. H.;Krdzalic, Jasenko;Kwee, Robert M.
目的：评估北美放射学会（RSNA）胸部CT分类系统报告2019冠状病毒病（COVID-19）肺炎的情况。材料和方法：由两名胸部放射科医生和一名5年放射科住院医师使用RSNA胸部CT分类系统报告COVID-19肺炎，对疑似COVID-19的连续患者的胸部CT扫描进行回顾性和独立评估。通过计算加权kappa系数评价观察者间一致性。计算了四种胸部CT分类（典型、不确定、非典型和COVID-19阴性特征）中实时逆转录聚合酶链反应（RT-PCR）证实COVID-19的患者比例。结果：共纳入96例患者（61例男性;中位年龄70岁[范围，2994]），其中45例RT-PCR证实COVID-19。三位阅片师将患者分为典型、不确定、非典型和阴性胸部CT类别，范围分别为18 - 29、26 - 43、19 - 31和5 - 8。胸部放射科医师之间的Kappa系数为0.663（95%置信区间[CI]：0.565，0.761）。胸部放射科医师和5年放射科住院医师的Kappa系数分别为0.570（95%CI：0.443，0.696）和0.564（95%CI：0.451，0.678）。三位阅片师的胸部CT分类中，RT-PCR证实的COVID-19患者的比例分别为76.9%至96.6%、51.2%至64.1%、2.8%至5.3%和20%至25%。报告COVID-19肺炎的RSNA胸部CT分类系统具有中度至实质性的观察者间一致性。然而，RT-PCR证实的COVID-19病例在非典型外观和肺炎阴性类别中的比例不可忽略。(c)RSNA，2020年
Purpose: To evaluate the Radiological Society of North America (RSNA) chest CT classification system for reporting coronavirus disease 2019 (COVID-19) pneumonia.Materials and Methods: Chest CT scans of consecutive patients suspected of having COVID-19 were retrospectively and independently evaluated by two chest radiologists and a 5th-year radiology resident using the RSNA chest CT classification system for reporting COVID-19 pneumonia. Interobserver agreement was evaluated by calculating weighted kappa coefficients. The proportion of patients with real-time reverse-transcription polymerase chain reaction (RT-PCR)confirmed COVID-19 in each of the four chest CT categories (typical, indeterminate, atypical, and negative features for COVID-19) was calculated.Results: In total, 96 patients (61 men; median age, 70 years [range, 2994]) were included, of whom 45 had RT-PCRconfirmed COVID-19. The number of patients assigned to chest CT categories typical, indeterminate, atypical, and negative by the three readers ranged from 18 to 29, 26 to 43, 19 to 31, and 5 to 8, respectively. The kappa coefficient among the chest radiologists was 0.663 (95% confidence interval [CI]: 0.565, 0.761). kappa coefficients among the chest radiologists and the 5th-year radiology resident were 0.570 (95% CI: 0.443, 0.696) and 0.564 (95% CI: 0.451, 0.678), respectively. The proportion of patients with RT-PCRconfirmed COVID-19 in the chest CT categories typical, indeterminate, atypical, and negative for the three readers ranged from 76.9% to 96.6%, 51.2% to 64.1%, 2.8% to 5.3%, and 20% to 25%, respectively.Conclusion: The RSNA chest CT classification system for reporting COVID-19 pneumonia has moderate-to-substantial interobserver agreement. However, the proportion of RT-PCRconfirmed COVID-19 cases in the categories atypical appearance and negative for pneumonia is nonnegligible. (c) RSNA, 2020