Even novice radiologists benefit from RSNA's new COVID-19 reporting guidance
Radiologists with varying levels of experience found success using the Radiological Society of North America’s guidelines for reporting CT findings of COVID-19, according to a study published Thursday.
RSNA’s recently released guidance focuses on four major categories of COVID-19 pneumonia imaging features, with a goal of limiting reporting variability and uncertainty while helping referring providers understand such findings.
And after imaging experts used the society’s guidelines to reevaluate scans performed at the height of the pandemic, researchers found strong agreement between them and high reproducibility across all experience levels.
“Our results indicate a relatively high concordance among radiologists of varying level of training and experience, ranging from first-year radiology residents to fellowship-trained academic radiologists with >10 years of experience, which suggests that the RSNA guidelines are clear and feasible to implement,” Avik Som, and colleagues with Massachusetts General Hospital’s Department of Radiology, wrote in Radiology: Cardiothoracic Imaging.
CT features of the novel virus are often nonspecific, with findings such as ground-glass opacities often seen in various lung injuries. The modality remains an important tool for managing more difficult cases, the authors noted, but reporting has not been widely standardized.
Som and colleagues set out to test whether RSNA’s tool is making a difference. They identified 89 consecutive CTs mentioning COVID-19, performed between Jan. 15 and March 30. Nine readers, including six thoracic rads and three radiology residents, evaluated the scans using the RSNA guidelines.
Overall, rad attendings and trainees strongly agreed on findings, ranging from 60% to 86%. For “typical” COVID findings, sensitivity and specificity averaged 86% and 80.2%, respectively. Those deemed typical and indeterminate had a combined sensitivity of 97.5% and specificity of 54.7%.
The authors did note 163 disagreements out of 801 observations, with most uncertainties stemming from peripheral distribution, multiple dominant disease processes, or minimal disease, they wrote.
“In the setting of a pandemic, the rapid implementation of standardized CT reporting has been very helpful for communicating clearly and effectively to providers about the potential of COVID-19 infection,” Some et al. concluded. “The RSNA consensus statement serves as an important guideline for both detection of features typical for COVID-19 pneumonia and identification of features that might be seen in other infections or that might suggest alternative diagnoses.”
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.