scholarly journals Performance of Radiologists in the Evaluation of the Chest Radiography with the Use of a “new software score” in Coronavirus Disease 2019 Pneumonia Suspected Patients

2020 ◽  
Vol 10 ◽  
pp. 40
Author(s):  
Silvia Bagnera ◽  
Francesca Bisanti ◽  
Claudia Tibaldi ◽  
Massimo Pasquino ◽  
Giulia Berrino ◽  
...  
Keyword(s):  
Chest Radiography ◽  
Work Experience ◽  
Imaging Analysis ◽  
Rater Agreement ◽  
X Ray ◽  
Cumulative Score ◽  
Kappa Value ◽  
Automatic Software ◽  
Chest X Ray ◽  
Group Agreement

Objectives: The purpose of this study is to assess the performance of radiologists using a new software called “COVID-19 score” when performing chest radiography on patients potentially infected by coronavirus disease 2019 (COVID-19) pneumonia. Chest radiography (or chest X-ray, CXR) and CT are important for the imaging diagnosis of the coronavirus pneumonia (COVID-19). CXR mobile devices are efficient during epidemies, because allow to reduce the risk of contagion and are easy to sanitize. Material and Methods: From February–April 2020, 14 radiologists retrospectively evaluated a pool of 312 chest X-ray exams to test a new software function for lung imaging analysis based on radiological features and graded on a three-point scale. This tool automatically generates a cumulative score (0–18). The intra- rater agreement (evaluated with Fleiss’s method) and the average time for the compilation of the banner were calculated. Results: Fourteen radiologists evaluated 312 chest radiographs of COVID-19 pneumonia suspected patients (80 males and 38 females) with an average age of 64, 47 years. The inter-rater agreement showed a Fleiss’ kappa value of 0.53 and the intra-group agreement varied from Fleiss’ Kappa value between 0.49 and 0.59, indicating a moderate agreement (considering as “moderate” ranges 0.4–0.6). The years of work experience were irrelevant. The average time for obtaining the result with the automatic software was between 7 s (e.g., zero COVID-19 score) and 21 s (e.g., with COVID-19 score from 6 to 12). Conclusion: The use of automatic software for the generation of a CXR “COVID-19 score” has proven to be simple, fast, and replicable. Implementing this tool with scores weighed on the number of lung pathological areas, a useful parameter for clinical monitoring could be available.

scholarly journals Ventilator-associated pneumonia in neonates: the role of point of care lung ultrasound

2020 ◽  
Vol 180 (1) ◽  
pp. 137-146
Author(s):  
Nora Tusor ◽  
Angela De Cunto ◽  
Yousef Basma ◽  
John L. Klein ◽  
Virginie Meau-Petit
Keyword(s):  
Lung Disease ◽  
Chronic Lung Disease ◽  
Lung Ultrasound ◽  
Clinical Laboratory ◽  
Control Group ◽  
Ventilator Associated Pneumonia ◽  
Lung Pathology ◽  
Rater Agreement ◽  
X Ray ◽  
Chest X Ray

AbstractNo consensus exists regarding the definition of ventilator-associated pneumonia (VAP) in neonates and reliability of chest X-ray (CXR) is low. Lung ultrasound (LU) is a potential alternative diagnostic tool. The aim was to define characteristics of VAP in our patient population and propose a multiparameter score, incorporating LU, for VAP diagnosis. Between March 25, 2018, and May 25, 2019, infants with VAP were identified. Clinical, laboratory and microbiology data were collected. CXRs and LU scans were reviewed. A multiparameter VAP score, including LU, was calculated on Day 1 and Day 3 for infants with VAP and for a control group and compared with CXR. VAP incidence was 10.47 episodes/1000 ventilator days. LU and CXR were available for 31 episodes in 21 infants with VAP, and for six episodes in five patients without VAP. On Day 1, a VAP score of > 4, and on Day 3 a score of > 5 showed sensitivity of 0.94, and area under the curve of 0.91 and 0.97, respectively. AUC for clinical information only was 0.88 and for clinical and CXR 0.85.Conclusion: The multiparameter VAP score including LU could be useful in diagnosing VAP in neonates with underlying lung pathology. What is Known:• Ventilator associated pneumonia (VAP) is common in infants on the neonatal unit and is associated with increased use of antibiotics, prolonged ventilation and higher incidence of chronic lung disease.• Commonly used definitions of VAP are difficult to apply in neonates and interpretation of chest X-ray is challenging with poor inter-rater agreement in patients with underlying chronic lung disease. What is New:• The multiparameter VAP score combining clinical, microbiology and lung ultrasound (LU) data is predictive for VAP diagnosis in preterm infants with chronic lung disease.• LU findings of VAP in neonates showed high inter-rater agreement and included consolidated lung areas, dynamic bronchograms and pleural effusion.

scholarly journals Chest X-ray for predicting mortality and the need for ventilatory support in COVID-19 patients presenting to the emergency department

2020 ◽  
Author(s):  
Maurizio Balbi ◽  
Anna Caroli ◽  
Andrea Corsi ◽  
Gianluca Milanese ◽  
Alessandra Surace ◽  
...  
Keyword(s):  
Emergency Department ◽  
Intraclass Correlation ◽  
Laboratory Data ◽  
Ventilatory Support ◽  
Scoring Systems ◽  
Lung Involvement ◽  
Rater Agreement ◽  
Patient History ◽  
X Ray ◽  
Chest X Ray

Abstract Objectives To evaluate the inter-rater agreement of chest X-ray (CXR) findings in coronavirus disease 2019 (COVID-19) and to determine the value of initial CXR along with demographic, clinical, and laboratory data at emergency department (ED) presentation for predicting mortality and the need for ventilatory support. Methods A total of 340 COVID-19 patients who underwent CXR in the ED setting (March 1–13, 2020) were retrospectively included. Two reviewers independently assessed CXR abnormalities, including ground-glass opacities (GGOs) and consolidation. Two scoring systems (Brixia score and percentage of lung involvement) were applied. Inter-rater agreement was assessed by weighted Cohen’s kappa (κ) or intraclass correlation coefficient (ICC). Predictors of death and respiratory support were identified by logistic or Poisson regression. Results GGO admixed with consolidation (n = 235, 69%) was the most common CXR finding. The inter-rater agreement was almost perfect for type of parenchymal opacity (κ = 0.90), Brixia score (ICC = 0.91), and percentage of lung involvement (ICC = 0.95). The Brixia score (OR: 1.19; 95% CI: 1.06, 1.34; p = 0.003), age (OR: 1.16; 95% CI: 1.11, 1.22; p < 0.001), PaO2/FiO2 ratio (OR: 0.99; 95% CI: 0.98, 1; p = 0.002), and cardiovascular diseases (OR: 3.21; 95% CI: 1.28, 8.39; p = 0.014) predicted death. Percentage of lung involvement (OR: 1.02; 95% CI: 1.01, 1.03; p = 0.001) and PaO2/FiO2 ratio (OR: 0.99; 95% CI: 0.99, 1.00; p < 0.001) were significant predictors of the need for ventilatory support. Conclusions CXR is a reproducible tool for assessing COVID-19 and integrates with patient history, PaO2/FiO2 ratio, and SpO2 values to early predict mortality and the need for ventilatory support. Key Points • Chest X-ray is a reproducible tool for assessing COVID-19 pneumonia. • The Brixia score and percentage of lung involvement on chest X-ray integrate with patient history, PaO2/FIO2ratio, and SpO2values to early predict mortality and the need for ventilatory support in COVID-19 patients presenting to the emergency department.

scholarly journals Agreement between chest ultrasonography and chest X-ray in patients who have undergone thoracic surgery: preliminary results

2019 ◽  
Vol 14 ◽  
Author(s):  
Andrea Smargiassi ◽  
Riccardo Inchingolo ◽  
Marco Chiappetta ◽  
Leonardo Petracca Ciavarella ◽  
Stefania Lopatriello ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Rater Agreement ◽  
Pleural Effusions ◽  
Cohen’S Kappa ◽  
Chest Ultrasonography ◽  
X Ray ◽  
Cohen's Kappa ◽  
Diaphragm Position ◽  
Chest X Ray ◽  
Ionizing Radiations

Background: Chest Ultrasonography (chest US) has shown good sensibility in detecting pneumothorax, pleural effusions and peripheral consolidations and it can be performed bedside. Objectives: The aim of the study was to analyze agreement between chest US and chest X-ray in patients who have undergone thoracic surgery and discuss cases of discordance. Methods: Patients undergoing thoracic surgery were retrospectively selected. Patients underwent routinely Chest X-ray (CXR) during the first 48 h after surgery. Chest US have been routinely performed in all selected patients in the same date of CXR. Chest US operators were blind to both reports and images of CXR. Ultrasonographic findings regarding pneumothorax (PNX), subcutaneous emphysema (SCE), lung consolidations (LC), pleural effusions (PE) and hemi-diaphragm position were collected and compared to corresponding CXR findings. Inter-rater agreement between two techniques was determined by Cohen’s kappa-coefficient. Results: Twenty-four patients were selected. Inter-rater agreement showed a moderate magnitude for PNX (Cohen’s Kappa 0.5), a slight/fair magnitude for SCE (Cohen’s Kappa 0.21), a fair magnitude for PE (Cohen’s Kappa 0.39), no agreement for LCs (Cohen’s Kappa 0.06), high levels of agreement for position of hemi-diaphragm (Cohen’s Kappa 0.7). Conclusion: Analysis of agreement between chest X-ray and chest US showed that ultrasonography is able to detect important findings for surgeons. Limitations and advantages have been found for both chest X-ray and chest US. Knowing the limits of each one is important to really justify and optimize the use of ionizing radiations.

scholarly journals Screening TB in asylum seekers in Switzerland: comparing chest X-ray and interview-based system

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Y Jackson ◽  
J P Zellweger
Keyword(s):  
Chest Radiography ◽  
Asylum Seekers ◽  
Geographic Origin ◽  
Initial Screening ◽  
Cross Sectional ◽  
X Ray ◽  
Individual Assessment ◽  
Retrospective Comparison ◽  
Chest X Ray ◽  
Higher Sensitivity

Abstract Setting Mandatory initial screening of asylum seekers for tuberculosis (TB) in Switzerland, 2004-2005 and 2007-2008. Objective To compare the yield of screening by chest radiography with an individual assessment based on geographic origin, personal history and symptoms. Design Cross-sectional retrospective comparison of two 2-year periods. Results The prevalence of detected TB cases was defined as the proportion of screenees starting antit tuberculosis treatment for culture-confi rmed pulmonary TB within 90 days. TB prevalence was 14.3 per 10 000 asylum seekers screened (31/21 727) using chest radiography and 12.4 (29/23 402) using individual assessment. The sensitivity of radiography was 100% vs. 55% for individual assessment, but its specifi city was lower (89.9% vs. 96.0%, respectively). The higher sensitivity of radiography meant shorter delays between screening and start of treatment (median 6 vs. 25 days). Its lower specifi city led to a larger proportion of screenees needing further investigations for suspicion of TB (12% vs. 4%). Conclusions The interview-based system initially missed more cases, but the ultimate 90-day yield was comparable for the two periods. The main difference is the delay until start of treatment, which potentially increases transmission and secondary cases. The radiograph system was more burdensome to both the health care system and the screenees, as more suspects required further investigations.

scholarly journals Inter-rater agreement in the assessment of abnormal chest X-ray findings for tuberculosis between two Asian countries

2012 ◽  
Vol 12 (1) ◽  
Author(s):  
Shinsaku Sakurada ◽  
Nguyen TL Hang ◽  
Naoki Ishizuka ◽  
Emiko Toyota ◽  
Le D Hung ◽  
...  
Keyword(s):  
Rater Agreement ◽  
Asian Countries ◽  
X Ray ◽  
Abnormal Chest ◽  
Chest X Ray

scholarly journals Diagnostic Value of Spiral CT Chest Enhanced Scan in Adult with Active Pulmonary Tuberculosis

2020 ◽  
Vol 4 (3) ◽  
Author(s):  
Ruishu Wang
Keyword(s):  
Pulmonary Tuberculosis ◽  
Chest Radiography ◽  
Detection Rate ◽  
Spiral Ct ◽  
Diagnostic Value ◽  
X Ray ◽  
Active Pulmonary Tuberculosis ◽  
Chest X Ray ◽  
Tuberculosis Diagnosis ◽  
The Difference

Aim: To explore the diagnostic value of spiral CT chest enhanced scan for adults with active pulmonary tuberculosis. Methods: The clinical data of 60 adult patients with active pulmonary tuberculosis who were treated in our hospital from January 2018 to November 2019 were retrospectively analyzed. All patients underwent conventional chest radiography and spiral CT chest enhanced scan. The number of tuberculosis diagnosis, the detection rate of special site lesions, and the detection rate of active pulmonary tuberculosis signs by the two methods were compared. Results: In 60 patients, the pathological results confirmed the existence of 75 tuberculosis lesions. The detection rate of spiral CT was 98.67%, which was not statistically significant compared with the detection rate of 92.00% (P>0.05) in the conventional chest X-ray. The detection rate of spiral CT enhanced scans for tuberculosis lesions in special sites was 100.00%, which was significantly higher than that of conventional chest X-ray of 7.69%, and the accuracy rate of active pulmonary tuberculosis signs was 98.85% higher than that of conventional chest X-ray of 79.31%. P<0.05). The difference was statistically significant (P<0.05). Conclusion: Spiral CT chest enhanced scan can not only find special tuberculosis lesions that cannot be detected by conventional chest radiography, but also accurately determine active pulmonary tuberculosis in adults, which is of high diagnostic value.

scholarly journals Elevated Hemidiaphragm and Shortness of Breath: Challenges in Clinicoradiologic Integration

2018 ◽  
Vol 4 (3-4) ◽  
pp. 223-229
Author(s):  
Vivek Podder ◽  
Rakesh Biswas ◽  
Nidhi Sehgal
Keyword(s):  
Chest Radiography ◽  
Systolic Function ◽  
High Sensitivity ◽  
Diaphragmatic Paralysis ◽  
Peak Exercise ◽  
X Ray ◽  
St Segment ◽  
History Of ◽  
Chest X Ray ◽  
Rule Out

Unilateral diaphragmatic paralysis is often suspected when a hemidiaphragm is found abnormally elevated on chest radiography. Chest radiography has a high sensitivity for diaphragmatic palsy. A 67-year-old male presented to the hospital with a history of 4 months of exertional breathlessness that improved after taking a rest. The patient had normal cardiac and respiratory physical function. He also had a normal electrocardiogram and good systolic function on echocardiography. A treadmill test revealed ST-segment changes during peak exercise and recovery phases. On chest X-ray, his right hemidiaphragm was shown to be significantly elevated. Further investigation was conducted to rule out diaphragmatic paralysis, and the findings took a surprising turn to an entirely different diagnosis.

Dual-Ray Net: Automatic Diagnosis of Thoracic Diseases Using Frontal and Lateral Chest X-rays

2020 ◽  
Vol 10 (2) ◽  
pp. 348-355
Author(s):  
Xin Huang ◽  
Yu Fang ◽  
Mingming Lu ◽  
Fengqi Yan ◽  
Jun Yang ◽  
...  
Keyword(s):  
Chest Radiography ◽  
Feature Fusion ◽  
Small Data ◽  
Data Sets ◽  
X Rays ◽  
X Ray ◽  
Comparison Results ◽  
Chest Disease ◽  
Chest X Ray ◽  
Lateral Chest

Computer-aided diagnosis (CAD) is an important work which can improve the working efficiency of physicians. With the availability of large-scale data sets, several methods have been proposed to classify pathology on chest X-ray images. However, most methods report performance based on a frontal chest radiograph, ignoring the effect of the lateral chest radiography on the diagnosis. This paper puts forward a kind of model, Dual-Ray Net, of a deep convolutional neural network which can deal with the front and lateral chest radiography at the same time by referring the method of using lateral chest radiography to assist diagnose during the diagnosis used by radiologists. Firstly, we evaluated the performance of parameter migration to small data after pre-training for large datasets. The data sets for pre-training are chest X-ray 14 and ImageNet respectively. The results showed that pre-training with chest X-ray 14 performed better than with the generic dataset ImageNet. Secondly, We evaluated the performance of the Frontal and lateral chest radiographs in different modes of input model for the diagnosis of assisted chest disease. Finally, by comparing different feature fusion methods of addition and concatenation, we found that the fusion effect of concatenation is better, which average AUC reached 0.778. The comparison results show that whether it is a public or a non-public dataset, our Dual-Ray Net (concatenation) architecture shows improved performance in recognizing findings in CXR images when compared to applying separate baseline frontal and lateral classes.

scholarly journals Kerosene Oil Pneumonitis

2021 ◽  
Vol 12 (6) ◽  
pp. 116-117
Author(s):  
Ranjan Kumar Singh
Keyword(s):  
Human Immunodeficiency Virus ◽  
Negative Pressure ◽  
Chest Radiography ◽  
Clinical History ◽  
X Ray ◽  
Negative Pressure Pulmonary Oedema ◽  
Immunodeficiency Virus ◽  
Hiv Antibodies ◽  
History Of ◽  
Chest X Ray

Radiographic abnormalities in the lungs are very common in an individual positive for HIV antibodies. Majority of lesions are of infective or neoplastic in origin. We present a case of chemical pneumonitis following regurgitation of kerosene oil in a patient positive for human immunodeficiency virus (HIV) antibodies. Chemical pneumonitis is diagnosed with a characteristic clinical history of regurgitation of fluid and gravity-dependent infiltration in the lung on chest x-ray. Another condition arising from the aspiration of the fluid/chemical is negative-pressure pulmonary oedema which results from laryngeal spasm following regurgitation of fluid. Chest radiography, however, distinguishes it from chemical pneumonitis. Bilateral infiltration is seen in the former, while lesion at dependent portion of right lung is seen in the latter condition.

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