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?:abstract
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OBJECTIVES: Although chest CT has been widely used in patients with COVID-19, its role for early diagnosis of COVID-19 is unclear We report the diagnostic performance of chest CT using structured reporting in a routine clinical setting during the early phase of the epidemic in Germany METHODS: Patients with clinical suspicion of COVID-19 and moderate-to-severe symptoms were included in this retrospective study CTs were performed and reported before RT-PCR results (reference standard) became available A structured reporting system was used that concluded in a recently described five-grade score (\'CO-RADS\'), indicating the level of suspicion for pulmonary involvement of COVID-19 from 1 = very low to 5 = very high Structured reporting was performed by three Radiologists in consensus RESULTS: In 96 consecutive patients (50 male, mean age 64), RT-PCR was positive in 20 (21%) cases CT features significantly more common in RT-PCR-positive patients were ground-glass opacities as dominant feature, crazy paving, hazy margins of opacities, and multifocal bilateral distribution (p < 0 05) Using a cut-off point between CO-RADS 3 and 4, sensitivity was 90%, specificity 91%, positive predictive value 72%, negative predictive value 97%, and accuracy 91% ROC analysis showed an AUC of 0 938 CONCLUSIONS: Structured reporting of chest CT with a five-grade scale provided accurate diagnosis of COVID-19 Its use was feasible and helpful in clinical routine ADVANCES IN KNOWLEDGE: Chest CT with structured reporting may be a provisional diagnostic alternative to RT-PCR testing for early diagnosis of COVID-19, especially when RT-PCR results are delayed or test capacities are limited
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