Efficacy of Chest CT for COVID-19 Pneumonia Diagnosis in France
Guillaume Herpe1, Mathieu Lederlin1, Mathieu Naudin1
1From the University Hospital Centre Poitiers, Radiology, 2 rue de la Milétrie, 86000 Poitiers, Vienne, France (G. Herpe.); Laboratoire de Mathématiques et Applications Université de Poitiers, DACTIM-MIS TEAM, Chasseneuil, Nouvelle Aquitaine, France (G. Herpe.); University Hospital of Rennes, Radiology, Rennes, Ille-et-Vilaine, France (M. Lederlin.); University of Rennes, Rennes, Ille-et-Vilaine, France (M. Lederlin.); Université de Poitiers Laboratoire de Mathématiques et Applications, DACTIM-MIS, Chasseneuil, Nouvelle Aquitaine, France (M.N.); University Hospital Centre Poitiers, DACTIM-MIS, Poitiers, France (M.N.); Nouvel Hôpital Civil, Radiology, Strasbourg, Alsace, France (M.O.); APHM, Radiology, Marseille, PACA, France (K.C.); AMU, Marseille, PACA, France (K.C.); Beaujon Hospital Department of Medical Imaging, Radiology, Clichy, France (J.G.); Beaujon University Hospitals Paris Nord Val de Seine, Radiology, Clichy, Hauts-de-Seine, France (V.V.); CHU Nîmes, Nîmes, Gard, France (C.A.F.); Hôpital Saint-Louis, Radiology, Paris, Île-de-France, France (C.D.M.M.); Université de Paris, INSERM U1149-Center for Research on Inflammation, Paris, Île-de-France, France (C.D.M.M.); Centre Hospitalier Universitaire de Nice Hôpital Pasteur, Radiology, Nice, Alpes Maritimes, France (V.F.); Centre Hospitalier Annecy Genevois, Radiology, Epagny Metz-Tessy, Auvergne-Rhône-Alpes, France (M. Ludwig.); CHU Nice, Radiology, Nice, PACA, France (L.M.); European Hospital Group Georges-Pompidou, Radiology, Paris, Île-de-France, France (I.F.); Université de la Méditérranée, Faculté de Médecine de Marseille, Centre de Résonance Magnétique Biologique et Médicale (CRMBM), UMR CNRS no. 6612, Marseille, BdR, France (A.R.R.J.); Centre Hospitalo Universitaire la Timone, Service de Radiologie Cardiovasculaire, Marseille, France (A.R.R.J.); Centre Hospitalier de la Côte Basque, Bayonne, Nouvelle Aquitaine, France (P.A.); CHRU de Nancy, Radiology, Nancy, Grand Est, France (I.P.); HIA Legouest, Service d'Imagerie Médicale, Metz, France (A.G.); CHU Nancy, Service D'imagerie Guilloz, Nancy, France (A.G.); Hôpital Saint-Joseph, Radiology, Marseille, PACA, France (O.B.); Clinique Emilie de Vialar, IMEV, Radiologie, Rhône, France (A.C.); CH Douai, NORD, Loffre, France (M.M.S.); University Hospital Centre Poitiers, Poitiers, Vienne, France (C.T.); CHRDS, Neuilly-sur-Seine, Neuilly-sur-Seine, France (G. Henry.);, Île de France, France (V.B.); Hôpital d'Instruction des Armées Begin, Radiology, Saint Mande, Île-de-France, France (T.L.T.); Hôpital d'Instruction des Armées Percy, Radiology, Clamart, Île-de-France, France (T.L.T.); CHU Limoges, Radiology, Limoges, Nouvelle Aquitaine, France (M.S.G.); CHU Dupuytren, Radiologie, Limoges, Haute-Vienne, France (P.G.); Military Teaching Hospital Clermont-Tonnerre, Radiology, Brest, Bretagne, France (M.G.); Hôpital Argenteuil, Argenteuil, Île-de-France, France (E.B.); Centre Hospitalier Pierre-le-Damany Lannion Trestel, Kergomar, Lannion, Bretagne, France (C.M.); Institut Bergonie, Bordeaux, Nouvelle Aquitaine, France (B.L.); CH Douai, Radiology, Douai, Nord, France (A.K.); Centre Hospitalier de Vienne Lucien Hussel, Medical Imaging, Vienne, Aura, France (H.K.); Hôpital d'Instruction des Armées Laveran, Radiology, Marseille, Bouches-du-Rhône, France (F.D.); CHU Tivoli, La Louvière, Wallonie, Belgium (B.D.); CHU Poitiers, Clinical Investigation Center CIC1402, Poitiers, Vienne, France (P.J.S.); CHU Poitiers, Radiology, Poitiers, Poitou-Charentes, France (R.G.); La Timone Hospital, Radiology, Marseille, BdR, France (J.M.B.); University Hospital Center of Nîmes, Radiology, Nîmes, Gard, France (J.P.B.); Université de Poitiers, Faculté de Médecine et de Pharmacie, Poitiers, France, France (J.P.T.); and CHU de Poitiers, Service de Radiologie, Poitiers, France, France (J.P.T.) .
Abstract:
Background The role and performance of chest CT in the diagnosis of the coronavirus disease 2019 (COVID-19) pandemic remains under active investigation. Purpose To evaluate the French national experience using chest CT for COVID-19, results of chest CT and reverse transcription polymerase chain reaction (RT-PCR) assays were compared together and with the final discharge diagnosis used as the reference standard. Materials and Methods A structured CT scan survey (NCT04339686) was sent to 26 hospital radiology departments in France between March 2, 2020, and April 24, 2020. These dates correspond to the peak of the national COVID-19 epidemic. Radiology departments were selected to reflect the estimated geographic prevalence heterogeneities of the epidemic. All symptomatic patients suspected of having COVID-19 pneumonia who underwent both initial chest CT and at least one RT-PCR test within 48 hours were included. The final discharge diagnosis, based on multiparametric items, was recorded. Data for each center were prospectively collected and gathered each week. Test efficacy was determined by using the Mann-Whitney test, Student t test, χ2 test, and Pearson correlation coefficient. P < .05 indicated a significant difference. Results Twenty-six of 26 hospital radiology departments responded to the survey, with 7500 patients entered; 2652 did not have RT-PCR test results or had unknown or excess delay between the RT-PCR test and CT. After exclusions, 4824 patients (mean age, 64 years ± 19 [standard deviation], 2669 male) were included. With final diagnosis as the reference, 2564 of the 4824 patients had COVID-19 (53%). Sensitivity, specificity, negative predictive value, and positive predictive value of chest CT in the diagnosis of COVID-19 were 2319 of 2564 (90%; 95% CI: 89, 91), 2056 of 2260 (91%; 95% CI: 91, 92), 2056 of 2300 (89%; 95% CI: 87, 90), and 2319 of 2524 (92%; 95% CI: 91, 93), respectively. There was no significant difference for chest CT efficacy among the 26 geographically separate sites, each with varying amounts of disease prevalence. Conclusion Use of chest CT for the initial diagnosis and triage of patients suspected of having coronavirus disease 2019 was successful. © RSNA, 2021 Online supplemental material is available for this article.
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