Chest radiography or computed tomography for COVID-19 pneumonia? Comparative study in a simulated triage setting
| Autor: | Gianluca Milanese, Carmelinda Manna, Mário J. Silva, Elisabetta A. Renzoni, Carlotta Sartorio, Nicola Sverzellati, Francesco Bonella, Davide Colombi, Licia Veronesi, Ivan Comelli, Andrea Ciuni, Athol U. Wells, Christopher J. Ryerson, Emanuele Michieletti, Paola Affanni, Giulia Tringali, Annalisa Volpi, Paolo Spagnolo |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Coronavirus disease 2019 (COVID-19) Radiography Medizin Computed tomography 030204 cardiovascular system & hematology 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine medicine Humans Lung medicine.diagnostic_test business.industry SARS-CoV-2 COVID-19 medicine.disease Triage Pneumonia medicine.anatomical_structure Radiological weapon Radiography Thoracic Original Article Radiology Tomography business Tomography X-Ray Computed |
| Zdroj: | The European Respiratory Journal article-version (AM) Accepted Manuscript |
| ISSN: | 1399-3003 |
| Popis: | IntroductionFor the management of patients referred to respiratory triage during the early stages of the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) pandemic, either chest radiography or computed tomography (CT) were used as first-line diagnostic tools. The aim of this study was to compare the impact on the triage, diagnosis and prognosis of patients with suspected COVID-19 when clinical decisions are derived from reconstructed chest radiography or from CT.MethodsWe reconstructed chest radiographs from high-resolution CT (HRCT) scans. Five clinical observers independently reviewed clinical charts of 300 subjects with suspected COVID-19 pneumonia, integrated with either a reconstructed chest radiography or HRCT report in two consecutive blinded and randomised sessions: clinical decisions were recorded for each session. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and prognostic value were compared between reconstructed chest radiography and HRCT. The best radiological integration was also examined to develop an optimised respiratory triage algorithm.ResultsInterobserver agreement was fair (Kendall's W=0.365, pW=0.654, pConclusionsThe present findings suggest that clinical triage is safely assisted by chest radiography. An integrated algorithm using first-line chest radiography and contingent use of HRCT can help optimise management and prognostication of COVID-19. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|