Radiology
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Background The standard for diagnosis of severe acute respiratory syndrome coronavirus 2 is a reverse transcription polymerase chain reaction (RT-PCR) test, but chest CT may play a complimentary role in the early detection of Coronavirus Disease 2019 (COVID-19) pneumonia. Purpose To investigate CT features of patients with COVID-19 in Rome, Italy, and to compare the accuracy of CT with that of RT-PCR. Materials and Methods In this prospective study from March 4, 2020, until March 19, 2020, consecutive patients suspected of having COVID-19 infection and respiratory symptoms were enrolled. ⋯ In the subgroup of 58 participants with positive RT-PCR and CT findings, ground-glass opacities were present in all 58 (100%), both multilobe and posterior involvement were present in 54 (93%), bilateral pneumonia was present in 53 (91%), and subsegmental vessel enlargement (>3 mm) was present in 52 (89%). Conclusion The typical pattern of COVID-19 pneumonia in Rome, Italy, was peripheral ground-glass opacities with multilobe and posterior involvement, bilateral distribution, and subsegmental vessel enlargement (>3 mm). Chest CT had high sensitivity (97%) but lower specificity (56%). © RSNA, 2020.
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Multicenter Study
Using Artificial Intelligence to Detect COVID-19 and Community-acquired Pneumonia Based on Pulmonary CT: Evaluation of the Diagnostic Accuracy.
Background Coronavirus disease 2019 (COVID-19) has widely spread all over the world since the beginning of 2020. It is desirable to develop automatic and accurate detection of COVID-19 using chest CT. Purpose To develop a fully automatic framework to detect COVID-19 using chest CT and evaluate its performance. ⋯ The per-scan sensitivity and specificity for detecting COVID-19 in the independent test set was 90% (95% confidence interval [CI]: 83%, 94%; 114 of 127 scans) and 96% (95% CI: 93%, 98%; 294 of 307 scans), respectively, with an area under the receiver operating characteristic curve of 0.96 (P < .001). The per-scan sensitivity and specificity for detecting CAP in the independent test set was 87% (152 of 175 scans) and 92% (239 of 259 scans), respectively, with an area under the receiver operating characteristic curve of 0.95 (95% CI: 0.93, 0.97). Conclusion A deep learning model can accurately detect coronavirus 2019 and differentiate it from community-acquired pneumonia and other lung conditions. © RSNA, 2020 Online supplemental material is available for this article.
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Observational Study
Temporal Changes of CT Findings in 90 Patients with COVID-19 Pneumonia: A Longitudinal Study.
Background CT may play a central role in the diagnosis and management of coronavirus disease 2019 (COVID-19) pneumonia. Purpose To perform a longitudinal study to analyze the serial CT findings over time in patients with COVID-19 pneumonia. Materials and Methods During January 16 to February 17, 2020, 90 patients (33 men, 57 women; mean age, 45 years) with COVID-19 pneumonia were prospectively enrolled and followed up until being discharged, death, or the end of the study. ⋯ Sixty-six of the 70 patients discharged (94%) had residual disease on final CT scans (median CT score, 4; median number of zones involved, four), with ground-glass opacity (42 of 70 patients [60%]) and pure ground-glass opacity (31 of 42 patients [74%]) the most common pattern and subtype. Conclusion The extent of lung abnormalities at CT peaked during illness days 6-11. The temporal changes of the diverse CT manifestations followed a specific pattern, which might indicate the progression and recovery of the illness. © RSNA, 2020 Online supplemental material is available for this article.
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Case Reports
Chest CT for Typical Coronavirus Disease 2019 (COVID-19) Pneumonia: Relationship to Negative RT-PCR Testing.
Some patients with positive chest CT findings may present with negative results of real-time reverse-transcription polymerase chain reaction (RT-PCR) tests for coronavirus disease 2019 (COVID-19). In this study, the authors present chest CT findings from five patients with COVID-19 infection who had initial negative RT-PCR results. ⋯ After isolation for presumed COVID-19 pneumonia, all patients were eventually confirmed to have COVID-19 infection by means of repeated swab tests. A combination of repeated swab tests and CT scanning may be helpful for individuals with a high clinical suspicion of COVID-19 infection but negative findings at RT-PCR screening.