Journal article
Diagnostic accuracy and inter-observer agreement with the CO-RADS lexicon for CT chest reporting in COVID-19
Emergency radiology, Vol.28(6), pp.1045-1054
12/01/2021
DOI: 10.1007/s10140-021-01967-6
PMCID: PMC8308071
PMID: 34302561
Abstract
Purpose To measure the diagnostic accuracy and inter-observer agreement with the use of COVID-19 Reporting and Data System (CO-RADS) for detection of COVID-19 on CT chest imaging. Methods This retrospective study included 164 consecutive patients with clinical suspicion of COVID-19 in whom a CT chest examination was performed at a single institution between April 2020 and July 2020. Of them, 101 patients was RT-PCR positive for COVID-19. Six readers with varying radiological experience (two each of chest radiologists, general radiologists, and radiologists in training) independently assigned a CO-RADS assessment category for each CT chest study. The Fleiss' K was used to quantify inter-observer agreement. The inter-observer agreement was also assessed based on the duration of onset of symptoms to CT scan. ROC curve analysis was used to determine the diagnostic accuracy of CO-RADS. The area under curve was calculated to determine the reader accuracy for detection of COVID-19 lung involvement with RT-PCR as reference standards. The data sets were plotted in ROC space, and Youden's J statistic was calculated to determine the threshold cut-off CO-RADS category for COVID-19 positivity. Results There was overall moderate inter-observer agreement between all readers (Fleiss' K 0.54 [95% CI 0.54, 0.54]), with substantial agreement among chest radiologists (Fleiss' K 0.68 [95% CI 0.67, 0.68]), general radiologists (Fleiss' K 0.61 [95% CI 0.61, 0.61]), and moderate agreement among radiologists-in-training (Fleiss' K 0.56 [95% CI 0.56, 0.56]). There was overall moderate inter-observer agreement in early disease (stages 1 and 2), with cumulative Fleiss' K 0.45 [95% CI 0.45, 0.45]). The overall AUC for CO-RADS lexicon scheme to accurately diagnose COVID-19 yielded 0.92 (95% CI 0.91, 0.94) with strong concordance within and between groups, of chests radiologists with AUC of 0.91 (95% CI 0.88, 0.94), general radiologists with AUC 0.96 (95% CI 0.94, 0.98), and radiologists in training with AUC of 0.90 (95% CI 0.87, 0.94). For detecting COVID-19, ROC curve analysis yielded CO-RADS > 3 as the cut-off threshold with sensitivity 90% (95% CI 0.88, 0.93), and specificity of 87% (95% CI 0.83, 0.91). Conclusion Readers across different levels of experience could accurately identify COVID-19 positive patients using the CO-RADS lexicon with moderate inter-observer agreement and high diagnostic accuracy.
Details
- Title: Subtitle
- Diagnostic accuracy and inter-observer agreement with the CO-RADS lexicon for CT chest reporting in COVID-19
- Creators
- Anirudh Venugopalan Nair - Hamad Medical CorporationMatthew McInnes - University of OttawaBamil Jacob - Hamad Medical CorporationDevendra Kumar - Hamad Medical CorporationDeepak Kuttikatt Soman - Government Medical CollegeHanee Subair Valiyakath Subair - Hamad Medical CorporationParag Suresh Mahajan - Hamad Medical CorporationMohammed Ameer Hamza Shah - Hamad Med Corp, Dept Clin Imaging, Doha, QatarMohammed Ali Saleh Sabawi - Hamad Med Corp, Dept Clin Imaging, Doha, QatarMahmoud Al-Heidous - Hamad Medical Corporation
- Resource Type
- Journal article
- Publication Details
- Emergency radiology, Vol.28(6), pp.1045-1054
- DOI
- 10.1007/s10140-021-01967-6
- PMID
- 34302561
- PMCID
- PMC8308071
- NLM abbreviation
- Emerg Radiol
- ISSN
- 1070-3004
- eISSN
- 1438-1435
- Publisher
- Springer Nature
- Number of pages
- 10
- Language
- English
- Date published
- 12/01/2021
- Academic Unit
- Radiology
- Record Identifier
- 9984948041602771
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