Dataset Information

Diagnostic accuracy of CT and radiographic findings for novel coronavirus 2019 pneumonia: Systematic review and meta-analysis.

ABSTRACT:

Purpose

To evaluate pooled prevalence, sensitivity, and specificity of chest computed tomography (CT) and radiographic findings for novel coronavirus-2019 (COVID-19) pneumonia.

Methods

We performed systematic literature search in PubMed and Embase to identify articles reporting baseline imaging findings of COVID-19 pneumonia. The quality of the articles was assessed using NIH quality assessment tool for case series studies. The pooled prevalence, sensitivity, specificity, and diagnostic odds ratio of imaging findings were calculated.

Results

Fifty-six studies (6007 patients, age, 2.1-70 years, 2887 females, 5762 CT, 396 radiographs,) were included. The mean interval between onset of symptoms and CT acquisition was 1-8 days. On CT, the pooled prevalence of ground glass opacities (GGO), GGO plus consolidation, and consolidation only was 66.9% (95% CI 60.8-72.4%), 44.9% (38.7-51.3%), and 32.1 (23.6-41.9%) respectively. Pooled sensitivity and specificity of GGO on CT was 73% (71%-80%) and 61% (41%-78%), respectively. For GGO plus consolidation and consolidation only, the pooled sensitivities/ specificities were 58% (48%-68%)/ 58% (41%-73%) and 49% (20%-78%)/ 56% (30%-78%), respectively. The pooled prevalence of GGO and consolidation on chest radiograph was 38.7% (22.2%-58.3%) and 46.9% (29.7%-64.9%), respectively. The diagnostic accuracy of radiographic findings could not be assessed due to small number of studies.

Conclusion

GGO on CT has the highest diagnostic performance for COVID-19 pneumonia, followed by GGO plus consolidation and consolidation only. However, the moderate to low sensitivity and specificity suggest that CT should not be used as the primary tool for diagnosis. Chest radiographic abnormalities are seen in half of the patients.

SUBMITTER: Garg M

PROVIDER: S-EPMC7657023 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Publications

Diagnostic accuracy of CT and radiographic findings for novel coronavirus 2019 pneumonia: Systematic review and meta-analysis.

Garg Mandeep M Gupta Pankaj P Maralakunte Muniraju M Kumar-M Praveen P Sinha Anindita A Kang Mandeep M Agarwal Ritesh R Sandhu Manavjit Singh MS

Clinical imaging 20201111

<h4>Purpose</h4>To evaluate pooled prevalence, sensitivity, and specificity of chest computed tomography (CT) and radiographic findings for novel coronavirus-2019 (COVID-19) pneumonia.<h4>Methods</h4>We performed systematic literature search in PubMed and Embase to identify articles reporting baseline imaging findings of COVID-19 pneumonia. The quality of the articles was assessed using NIH quality assessment tool for case series studies. The pooled prevalence, sensitivity, specificity, and diag ...[more]

PMID: 33217674

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Project description:OBJECTIVE:The objective of this systematic review was to evaluate the key imaging manifestations of COVID-19 on chest CT in adult patients by providing a comprehensive review of the published literature. METHODS:We performed a systematic literature search from the PubMed, Google Scholar, Embase, and WHO databases for studies mentioning the chest CT imaging findings of adult COVID-19 patients. RESULTS:A total of 45 studies comprising 4410 patients were included. Ground glass opacities (GGO), in isolation (50.2%) or coexisting with consolidations (44.2%), were the most common lesions. Distribution of GGOs was most commonly bilateral, peripheral/subpleural, and posterior with predilection for lower lobes. Common ancillary findings included pulmonary vascular enlargement (64%), intralobular septal thickening (60%), adjacent pleural thickening (41.7%), air bronchograms (41.2%), subpleural lines, crazy paving, bronchus distortion, bronchiectasis, and interlobular septal thickening. CT in early follow-up period generally showed an increase in size, number, and density of GGOs, with progression into mixed areas of GGOs plus consolidations and crazy paving, peaking at 10-11 days, before gradually resolving or persisting as patchy fibrosis. While younger adults more commonly had GGOs, extensive/multilobar involvement with consolidations was prevalent in the older population and those with severe disease. CONCLUSION:This review describes the imaging features for diagnosis, stratification, and follow-up of COVID-19 patients. The most common CT manifestations are bilateral, peripheral/subpleural, posterior GGOs with or without consolidations with a lower lobe predominance. It is pertinent to be familiar with the various imaging findings to positively impact the management of these patients. KEY POINTS:• Ground glass opacities (GGOs), whether isolated or coexisting with consolidations, in bilateral and subpleural distribution, are the most prevalent chest CT findings in adult COVID-19 patients. • Follow-up CT shows a progression of GGOs into a mixed pattern, reaching a peak at 10-11 days, before gradually resolving or persisting as patchy fibrosis. • Younger people tend to have more GGOs. Older or sicker people tend to have more extensive involvement with consolidations.

Project description:PurposeTo study the extent of pulmonary involvement in coronavirus 19 (COVID-19) with quantitative CT and to assess the impact of disease burden on opacity visibility on chest radiographs.Materials and methodsThis retrospective study included 20 pairs of CT scans and same-day chest radiographs from 17 patients with COVID-19, along with 20 chest radiographs of controls. All pulmonary opacities were semiautomatically segmented on CT images, producing an anteroposterior projection image to match the corresponding frontal chest radiograph. The quantitative CT lung opacification mass (QCTmass) was defined as (opacity attenuation value + 1000 HU)/1000 × 1.065 (g/mL) × combined volume (cm3) of the individual opacities. Eight thoracic radiologists reviewed the 40 radiographs, and a receiver operating characteristic curve analysis was performed for the detection of lung opacities. Logistic regression analysis was performed to identify factors affecting opacity visibility on chest radiographs.ResultsThe mean QCTmass per patient was 72.4 g ± 120.8 (range, 0.7-420.7 g), and opacities occupied 3.2% ± 5.8 (range, 0.1%-19.8%) and 13.9% ± 18.0 (range, 0.5%-57.8%) of the lung area on the CT images and projected images, respectively. The radiographs had a median sensitivity of 25% and specificity of 90% among radiologists. Nineteen of 186 opacities were visible on chest radiographs, and a median area of 55.8% of the projected images was identifiable on radiographs. Logistic regression analysis showed that QCTmass (P < .001) and combined opacity volume (P < .001) significantly affected opacity visibility on radiographs.ConclusionQCTmass varied among patients with COVID-19. Chest radiographs had high specificity for detecting lung opacities in COVID-19 but a low sensitivity. QCTmass and combined opacity volume were significant determinants of opacity visibility on radiographs.Earlier incorrect version appeared online. This article was corrected on April 6, 2020 and December 14, 2020.Supplemental material is available for this article.© RSNA, 2020.

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Dataset Information

Diagnostic accuracy of CT and radiographic findings for novel coronavirus 2019 pneumonia: Systematic review and meta-analysis.

Purpose

Methods

Results

Conclusion

Publications

Diagnostic accuracy of CT and radiographic findings for novel coronavirus 2019 pneumonia: Systematic review and meta-analysis.

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