Implementation of the Radiological Society of North America Expert Consensus Guidelines on Reporting Chest CT Findings Related to COVID-19: A Multireader Performance Study
Implementation of the Radiological Society of North America Expert Consensus Guidelines on Reporting Chest CT Findings Related to COVID-19: A Multireader Performance Study
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DOI：
10.1148/ryct.2020200276
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发表时间：
2020-10-01
期刊：
影响因子：
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通讯作者：
Little, Brent P.
中科院分区：
文献类型：
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作者：
Som, Avik;Lang, Min;Little, Brent P.
目的：评估北美放射学会（RSNA）指南的性能，并量化指南在疑似冠状病毒病2019 （COVID-19）肺炎胸部CT患者中应用的观察者间变异性。材料与方法：回顾性检索2020年1月15日至2020年3月30日的89例连续CT扫描，其放射逻辑报告涉及COVID-19。1次逆转录聚合酶链反应阳性或2次阴性作为诊断的参考标准。每个胸部CT扫描由9名阅读者（6名接受过奖学金培训的胸科放射科医生和3名住院实习放射科医生）根据RSNA指南进行评估。从电子病历中获得临床信息。结果：放射学培训水平之间的发现有很强的一致性，主治医生和受训人员之间的一致性范围为60%至86% （K值为0.43至0.86）。RSNA指南对COVID-19典型CT表现的敏感性和特异性平均分别为86%（范围72%-94%）和80.2%（范围75%-93%）。结合典型和不确定的发现，敏感性为97.5%（范围，94%-100%），特异性为54.7%（范围，37%-62%）。801份意见中有163份意见不一致（79.6%的意见一致）。分类的不确定性主要源于难以确定周围分布、多重显性疾病过程或最小疾病。结论：COVID-19 CT报告的典型外观分类平均敏感性为86%，特异性为80%。在不同层次的经验中，有合理的解读者一致性和良好的再现性。本文有补充材料。(c) RSNA， 2020年
Purpose: To assess the performance of the Radiological Society of North America (RSNA) guidelines and quantify interobserver variability in application of the guidelines in patients undergoing chest CT for suspected coronavirus disease 2019 (COVID-19) pneumonia.Materials and Methods: A retrospective search from January 15, 2020 to March 30, 2020 identified 89 consecutive CT scans whose radio -logic report mentioned COVID-19. One positive or two negative reverse-transcription polymerase chain reaction tests for COVID-19 were considered the reference standard for diagnosis. Each chest CT scan was evaluated using RSNA guidelines by nine readers (six fellowship-trained thoracic radiologists and three radiology resident trainees). Clinical information was obtained from the electronic medical record.Results: There was strong concordance of findings between radiology training levels with agreement ranging from 60% to 86% among attending physicians and trainees (K, 0.43 to 0.86). Sensitivity and specificity of typical CT findings for COVID-19 per the RSNA guidelines were on average 86% (range, 72%-94%) and 80.2% (range, 75%-93%), respectively. Combined typical and indeterminate findings had a sensitivity of 97.5% (range, 94%-100%) and specificity of 54.7% (range, 37%-62%). A total of 163 disagreements were seen out of 801 observations (79.6% total agreement). Uncertainty in classification primarily derived from difficulty in ascertain-ing peripheral distribution, multiple dominant disease processes, or minimal disease.Conclusion: The typical appearance category for COVID-19 CT reporting has an average sensitivity of 86% and specificity rate of 80%. There is reasonable interreader agreement and good reproducibility across various levels of experience.Supplemental material is available for this article.(c) RSNA, 2020