Based on the limitations of the low quality studies conducted so far, with biased cohorts, confounding variables with lack of body of evidence, in terms of overestimated sensitivity in a predefined clinical setting of variably ill hospitalized patients with no data from mildly ill / asymptomatic patients, with inherent lack of specificity of CT findings, use of CT chest as a diagnostic screening tool for COVID-19 vis a vis RT-PCR cannot be advocated, as is the consensus of many national / international organizations like Society of thoracic radiology5, American college of radiology6, Chest subspecialty group of Indian college of radiology and imaging7.
References
- Ai T, Yang Z, Hou H, et al. Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. Radiology 2020 Feb 13
- Fang Y, Zhang H, Xie J, et al. Sensitivity of chest CT for COVID-19: comparison to RT-PCR. Radiology 2020 Feb 19.
- Yan Li and Liming Xia. Coronavirus disease 2019 (COVID-19): Role of Chest CT in Diagnosis and management. American Journal of Roentgenology: 1-7. 10.2214/AJR.20.22954.
- Dandan Chen, Xinqing Jiang. Can chest CT features distinguish patients with negative from those with positive initial RT-PCR results for corona virus disease (COVID-19). American Journal of Roentgenology: 1-5. 10.2214/AJR.20.23012.
- Society of Thoracic Radiology/American Society of Emergency Radiology COVID-19 Position Statement, March 11, 2020. https://thoracicrad.org
- American College of Radiology (ACR). ACR recommendations for the use of chest radiography and computed tomography (CT) for suspected COVID-19 infection. ACR website. www.acr.org/ Advocacy-and-Economics/ACR-Position-Statements/Recommendations-for-Chest-Radiography-and-CTfor-Suspected-COVID19-Infection. Updated March 2020.
- Under aegis of ICRI Chest Radiology Sub-Specialty Group. Imaging Recommendations for COVID-19 Patients. Ashu Seith Bhalla, Priyanka Naranje, Gh Mohammad Wani, Anant Mohan. AIIMS, New Delhi.
Indications and tests for diagnosis-CT Chest Summary tables