Summary tables: Role of CT Chest in diagnosis of COVID-19 pneumonia

May 22, 2020COVID Literature Appraisal, Indications and tests for diagnosis

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

  1. 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
  2. Fang Y, Zhang H, Xie J, et al. Sensitivity of chest CT for COVID-19: comparison to RT-PCR. Radiology 2020 Feb 19.
  3. 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.
  4. 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.
  5. Society of Thoracic Radiology/American Society of Emergency Radiology COVID-19 Position Statement, March 11, 2020. https://thoracicrad.org
  6. 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.
  7. 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