Diagnostic performance of radiologists in distinguishing post-COVID-19 residual abnormalities from interstitial lung abnormalities
Year: 2024
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: Distinguishing post-COVID-19 residual abnormalities from interstitial lung abnormalities (ILA) on CT can be challenging if clinical information is limited. This study aimed to evaluate the diagnostic performance of radiologists in distinguishing post-COVID-19 residual abnormalities from ILA. METHODS: This multi-reader, multi-case study included 60 age- and sex-matched subjects with chest CT scans. There were 40 cases of ILA (20 fibrotic and 20 non-fibrotic) and 20 cases of post-COVID-19 residual abnormalities. Fifteen radiologists from multiple nations with varying levels of experience independently rated suspicion scores on a 5-point scale to distinguish post-COVID-19 residual abnormalities from fibrotic ILA or non-fibrotic ILA. Interobserver agreement was assessed using the weighted κ value, and the scores of individual readers were compared with the consensus of all readers. Receiver operating characteristic curve analysis was conducted to evaluate the diagnostic performance of suspicion scores for distinguishing post-COVID-19 residual abnormalities from ILA and for differentiating post-COVID-19 residual abnormalities from both fibrotic and non-fibrotic ILA. RESULTS: Radiologists' diagnostic performance for distinguishing post-COVID-19 residual abnormalities from ILA was good (area under the receiver operating characteristic curve (AUC) range, 0.67-0.92; median AUC, 0.85) with moderate agreement (κ = 0.56). The diagnostic performance for distinguishing post-COVID-19 residual abnormalities from non-fibrotic ILA was lower than that from fibrotic ILA (median AUC = 0.89 vs. AUC = 0.80, p = 0.003). CONCLUSION: Radiologists demonstrated good diagnostic performance and moderate agreement in distinguishing post-COVID-19 residual abnormalities from ILA, but careful attention is needed to avoid misdiagnosing them as non-fibrotic ILA. KEY POINTS: Question How good are radiologists at differentiating interstitial lung abnormalities (ILA) from changes related to COVID-19 infection? Findings Radiologists had a median AUC of 0.85 in distinguishing post-COVID-19 abnormalities from ILA with moderate agreement (κ = 0.56). Clinical relevance Radiologists showed good diagnostic performance and moderate agreement in distinguishing post-COVID-19 residual abnormalities from ILA; nonetheless, caution is needed in distinguishing residual abnormalities from non-fibrotic ILA.
Source: European Radiology
Institutions: Asan Medical Center, Chonnam National University Hospital, Jeonbuk National University Hospital, Jeonbuk National University, Seoul National University, Seoul Metropolitan Government, SNUH SMG-SNU Boramae Medical Center, Universitat Autònoma de Barcelona, Corporació Sanitària Parc Taulí, Institute of Research and Innovation Parc Tauli, Cliniques Universitaires Saint-Luc, UCLouvain, NYU Langone Health, New York University, Vienna General Hospital, Medical University of Vienna, Hospital of the University of Pennsylvania, Università Cattolica del Sacro Cuore, Agostino Gemelli University Polyclinic, University of Wisconsin–Madison, University of Zurich, University Hospital Zurich, Pusan National University Yangsan Hospital, Seoul National University Hospital
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,190
OpenAlex ID: W4402731683