30 Apr 2021
Introduction A more structured role of radiographers is advisable to speed up the management of patients with suspected COVID-19. The purpose of our study was to evaluate the diagnostic performance of radiographers in the detection of COVID-19 pneumonia on chest CT using CO-RADS descriptors. Methods CT images of patients who underwent RT-PCR and chest CT scan at our institution due to COVID-19 suspicion between March and July 2020 were analysed retrospectively. Six readers, including two radiologists, two highly experienced radiographers and two less experienced radiographers, independently scored each CT using the CO-RADS lexicon to evaluate lung involvement by COVID-19. ROC curves were computed to investigate diagnostic accuracy. Fleiss’ κ statistics was used to evaluate inter-rater agreement. Results 714 patients, including 419 men and 295 women (mean age: 64 years ± 19 SD; range: 8-96) were evaluated. CO-RADS > 3 was identified as the optimal threshold to discern between COVID-19 (+) and COVID-19 (-) patients for all readers. Highly experienced radiographers achieved an average sensitivity of 58.7% (95% CI: 52.5-64.7) and an average specificity of 81.8% (95% CI: 77.9-85.2), with a mean AUC of 0.72 (95% CI: 0.68-0.75). As for less experienced radiographers, an average sensitivity of 56.3% (95% CI: 50.1-62.2) and an average specificity of 81.5% (95% CI: 77.6-84.9) were observed, with a mean AUC of 0.71 (95% CI: 0.68-0.74). Consultant radiologists achieved an average sensitivity of 60.0% (95% CI: 53.7-65.8) and an average specificity of 81.7% (95% CI: 77.8-85.1), with a mean AUC of 0.73 (95% CI: 0.70-0.77). Conclusion Radiographers can adequately recognise the classic appearances of COVID-19 on CT, as described by the CO-RADS assessment scheme, in a way comparable to expert radiologists. Implications for Practice Radiographers are the first healthcare professionals to evaluate CT images in patients with suspected SARS-CoV-2 infection, and they could diagnose COVID-19 pneumonia by means of a categorical reporting scheme at CT in a reliable way, hence playing a primary role in the early management and care of these patients.