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Performance of Radiologists in Differentiating COVID-19 from Non-COVID-19 Viral Pneumonia at Chest CT.
Radiology. 2020 08; 296(2):E46-E54.R

Abstract

Background Despite its high sensitivity in diagnosing coronavirus disease 2019 (COVID-19) in a screening population, the chest CT appearance of COVID-19 pneumonia is thought to be nonspecific. Purpose To assess the performance of radiologists in the United States and China in differentiating COVID-19 from viral pneumonia at chest CT. Materials and Methods In this study, 219 patients with positive COVID-19, as determined with reverse-transcription polymerase chain reaction (RT-PCR) and abnormal chest CT findings, were retrospectively identified from seven Chinese hospitals in Hunan Province, China, from January 6 to February 20, 2020. Two hundred five patients with positive respiratory pathogen panel results for viral pneumonia and CT findings consistent with or highly suspicious for pneumonia, according to original radiologic interpretation within 7 days of each other, were identified from Rhode Island Hospital in Providence, RI. Three radiologists from China reviewed all chest CT scans (n = 424) blinded to RT-PCR findings to differentiate COVID-19 from viral pneumonia. A sample of 58 age-matched patients was randomly selected and evaluated by four radiologists from the United States in a similar fashion. Different CT features were recorded and compared between the two groups. Results For all chest CT scans (n = 424), the accuracy of the three radiologists from China in differentiating COVID-19 from non-COVID-19 viral pneumonia was 83% (350 of 424), 80% (338 of 424), and 60% (255 of 424). In the randomly selected sample (n = 58), the sensitivities of three radiologists from China and four radiologists from the United States were 80%, 67%, 97%, 93%, 83%, 73%, and 70%, respectively. The corresponding specificities of the same readers were 100%, 93%, 7%, 100%, 93%, 93%, and 100%, respectively. Compared with non-COVID-19 pneumonia, COVID-19 pneumonia was more likely to have a peripheral distribution (80% vs 57%, P < .001), ground-glass opacity (91% vs 68%, P < .001), fine reticular opacity (56% vs 22%, P < .001), and vascular thickening (59% vs 22%, P < .001), but it was less likely to have a central and peripheral distribution (14% vs 35%, P < .001), pleural effusion (4% vs 39%, P < .001), or lymphadenopathy (3% vs 10%, P = .002). Conclusion Radiologists in China and in the United States distinguished coronavirus disease 2019 from viral pneumonia at chest CT with moderate to high accuracy. © RSNA, 2020 Online supplemental material is available for this article. A translation of this abstract in Farsi is available in the supplement. ترجمه چکیده این مقاله به فارسی، در ضمیمه موجود است.

Authors+Show Affiliations

From the Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI (H.X.B., B.H., K.H., I.P., T.K.E., S.A., T.H., M.K.A.); Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China 410008 (Z.X., D.C.W., F.F.X., S.L., W.H.L.); Brown University Warren Alpert Medical School, Providence, RI (K.H., J.W.C., T.M.L.T., I.P., T.K.E.); Department of Radiology, Yongzhou Central Hospital, Yongzhou, Hunan, China 425006 (L.B.S.); Department of Radiology, Changde Second People's Hospital, Changde, Hunan, China (J.M.); Department of Radiology, Affiliated Nan Hua Hospital, University of South China, Hengyang, Hunan, China (X.L.J.); Department of Radiology, Loudi Central Hospital, Loudi, Hunan, China (Q.H.Z.); and Department of Radiology, Chenzhou Second People's Hospital, Chenzhou, Hunan, China (P.F.H.).From the Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI (H.X.B., B.H., K.H., I.P., T.K.E., S.A., T.H., M.K.A.); Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China 410008 (Z.X., D.C.W., F.F.X., S.L., W.H.L.); Brown University Warren Alpert Medical School, Providence, RI (K.H., J.W.C., T.M.L.T., I.P., T.K.E.); Department of Radiology, Yongzhou Central Hospital, Yongzhou, Hunan, China 425006 (L.B.S.); Department of Radiology, Changde Second People's Hospital, Changde, Hunan, China (J.M.); Department of Radiology, Affiliated Nan Hua Hospital, University of South China, Hengyang, Hunan, China (X.L.J.); Department of Radiology, Loudi Central Hospital, Loudi, Hunan, China (Q.H.Z.); and Department of Radiology, Chenzhou Second People's Hospital, Chenzhou, Hunan, China (P.F.H.).From the Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI (H.X.B., B.H., K.H., I.P., T.K.E., S.A., T.H., M.K.A.); Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China 410008 (Z.X., D.C.W., F.F.X., S.L., W.H.L.); Brown University Warren Alpert Medical School, Providence, RI (K.H., J.W.C., T.M.L.T., I.P., T.K.E.); Department of Radiology, Yongzhou Central Hospital, Yongzhou, Hunan, China 425006 (L.B.S.); Department of Radiology, Changde Second People's Hospital, Changde, Hunan, China (J.M.); Department of Radiology, Affiliated Nan Hua Hospital, University of South China, Hengyang, Hunan, China (X.L.J.); Department of Radiology, Loudi Central Hospital, Loudi, Hunan, China (Q.H.Z.); and Department of Radiology, Chenzhou Second People's Hospital, Chenzhou, Hunan, China (P.F.H.).From the Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI (H.X.B., B.H., K.H., I.P., T.K.E., S.A., T.H., M.K.A.); Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China 410008 (Z.X., D.C.W., F.F.X., S.L., W.H.L.); Brown University Warren Alpert Medical School, Providence, RI (K.H., J.W.C., T.M.L.T., I.P., T.K.E.); Department of Radiology, Yongzhou Central Hospital, Yongzhou, Hunan, China 425006 (L.B.S.); Department of Radiology, Changde Second People's Hospital, Changde, Hunan, China (J.M.); Department of Radiology, Affiliated Nan Hua Hospital, University of South China, Hengyang, Hunan, China (X.L.J.); Department of Radiology, Loudi Central Hospital, Loudi, Hunan, China (Q.H.Z.); and Department of Radiology, Chenzhou Second People's Hospital, Chenzhou, Hunan, China (P.F.H.).From the Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI (H.X.B., B.H., K.H., I.P., T.K.E., S.A., T.H., M.K.A.); Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China 410008 (Z.X., D.C.W., F.F.X., S.L., W.H.L.); Brown University Warren Alpert Medical School, Providence, RI (K.H., J.W.C., T.M.L.T., I.P., T.K.E.); Department of Radiology, Yongzhou Central Hospital, Yongzhou, Hunan, China 425006 (L.B.S.); Department of Radiology, Changde Second People's Hospital, Changde, Hunan, China (J.M.); Department of Radiology, Affiliated Nan Hua Hospital, University of South China, Hengyang, Hunan, China (X.L.J.); Department of Radiology, Loudi Central Hospital, Loudi, Hunan, China (Q.H.Z.); and Department of Radiology, Chenzhou Second People's Hospital, Chenzhou, Hunan, China (P.F.H.).From the Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI (H.X.B., B.H., K.H., I.P., T.K.E., S.A., T.H., M.K.A.); Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China 410008 (Z.X., D.C.W., F.F.X., S.L., W.H.L.); Brown University Warren Alpert Medical School, Providence, RI (K.H., J.W.C., T.M.L.T., I.P., T.K.E.); Department of Radiology, Yongzhou Central Hospital, Yongzhou, Hunan, China 425006 (L.B.S.); Department of Radiology, Changde Second People's Hospital, Changde, Hunan, China (J.M.); Department of Radiology, Affiliated Nan Hua Hospital, University of South China, Hengyang, Hunan, China (X.L.J.); Department of Radiology, Loudi Central Hospital, Loudi, Hunan, China (Q.H.Z.); and Department of Radiology, Chenzhou Second People's Hospital, Chenzhou, Hunan, China (P.F.H.).From the Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI (H.X.B., B.H., K.H., I.P., T.K.E., S.A., T.H., M.K.A.); Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China 410008 (Z.X., D.C.W., F.F.X., S.L., W.H.L.); Brown University Warren Alpert Medical School, Providence, RI (K.H., J.W.C., T.M.L.T., I.P., T.K.E.); Department of Radiology, Yongzhou Central Hospital, Yongzhou, Hunan, China 425006 (L.B.S.); Department of Radiology, Changde Second People's Hospital, Changde, Hunan, China (J.M.); Department of Radiology, Affiliated Nan Hua Hospital, University of South China, Hengyang, Hunan, China (X.L.J.); Department of Radiology, Loudi Central Hospital, Loudi, Hunan, China (Q.H.Z.); and Department of Radiology, Chenzhou Second People's Hospital, Chenzhou, Hunan, China (P.F.H.).From the Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI (H.X.B., B.H., K.H., I.P., T.K.E., S.A., T.H., M.K.A.); Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China 410008 (Z.X., D.C.W., F.F.X., S.L., W.H.L.); Brown University Warren Alpert Medical School, Providence, RI (K.H., J.W.C., T.M.L.T., I.P., T.K.E.); Department of Radiology, Yongzhou Central Hospital, Yongzhou, Hunan, China 425006 (L.B.S.); Department of Radiology, Changde Second People's Hospital, Changde, Hunan, China (J.M.); Department of Radiology, Affiliated Nan Hua Hospital, University of South China, Hengyang, Hunan, China (X.L.J.); Department of Radiology, Loudi Central Hospital, Loudi, Hunan, China (Q.H.Z.); and Department of Radiology, Chenzhou Second People's Hospital, Chenzhou, Hunan, China (P.F.H.).From the Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI (H.X.B., B.H., K.H., I.P., T.K.E., S.A., T.H., M.K.A.); Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China 410008 (Z.X., D.C.W., F.F.X., S.L., W.H.L.); Brown University Warren Alpert Medical School, Providence, RI (K.H., J.W.C., T.M.L.T., I.P., T.K.E.); Department of Radiology, Yongzhou Central Hospital, Yongzhou, Hunan, China 425006 (L.B.S.); Department of Radiology, Changde Second People's Hospital, Changde, Hunan, China (J.M.); Department of Radiology, Affiliated Nan Hua Hospital, University of South China, Hengyang, Hunan, China (X.L.J.); Department of Radiology, Loudi Central Hospital, Loudi, Hunan, China (Q.H.Z.); and Department of Radiology, Chenzhou Second People's Hospital, Chenzhou, Hunan, China (P.F.H.).From the Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI (H.X.B., B.H., K.H., I.P., T.K.E., S.A., T.H., M.K.A.); Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China 410008 (Z.X., D.C.W., F.F.X., S.L., W.H.L.); Brown University Warren Alpert Medical School, Providence, RI (K.H., J.W.C., T.M.L.T., I.P., T.K.E.); Department of Radiology, Yongzhou Central Hospital, Yongzhou, Hunan, China 425006 (L.B.S.); Department of Radiology, Changde Second People's Hospital, Changde, Hunan, China (J.M.); Department of Radiology, Affiliated Nan Hua Hospital, University of South China, Hengyang, Hunan, China (X.L.J.); Department of Radiology, Loudi Central Hospital, Loudi, Hunan, China (Q.H.Z.); and Department of Radiology, Chenzhou Second People's Hospital, Chenzhou, Hunan, China (P.F.H.).From the Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI (H.X.B., B.H., K.H., I.P., T.K.E., S.A., T.H., M.K.A.); Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China 410008 (Z.X., D.C.W., F.F.X., S.L., W.H.L.); Brown University Warren Alpert Medical School, Providence, RI (K.H., J.W.C., T.M.L.T., I.P., T.K.E.); Department of Radiology, Yongzhou Central Hospital, Yongzhou, Hunan, China 425006 (L.B.S.); Department of Radiology, Changde Second People's Hospital, Changde, Hunan, China (J.M.); Department of Radiology, Affiliated Nan Hua Hospital, University of South China, Hengyang, Hunan, China (X.L.J.); Department of Radiology, Loudi Central Hospital, Loudi, Hunan, China (Q.H.Z.); and Department of Radiology, Chenzhou Second People's Hospital, Chenzhou, Hunan, China (P.F.H.).From the Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI (H.X.B., B.H., K.H., I.P., T.K.E., S.A., T.H., M.K.A.); Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China 410008 (Z.X., D.C.W., F.F.X., S.L., W.H.L.); Brown University Warren Alpert Medical School, Providence, RI (K.H., J.W.C., T.M.L.T., I.P., T.K.E.); Department of Radiology, Yongzhou Central Hospital, Yongzhou, Hunan, China 425006 (L.B.S.); Department of Radiology, Changde Second People's Hospital, Changde, Hunan, China (J.M.); Department of Radiology, Affiliated Nan Hua Hospital, University of South China, Hengyang, Hunan, China (X.L.J.); Department of Radiology, Loudi Central Hospital, Loudi, Hunan, China (Q.H.Z.); and Department of Radiology, Chenzhou Second People's Hospital, Chenzhou, Hunan, China (P.F.H.).From the Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI (H.X.B., B.H., K.H., I.P., T.K.E., S.A., T.H., M.K.A.); Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China 410008 (Z.X., D.C.W., F.F.X., S.L., W.H.L.); Brown University Warren Alpert Medical School, Providence, RI (K.H., J.W.C., T.M.L.T., I.P., T.K.E.); Department of Radiology, Yongzhou Central Hospital, Yongzhou, Hunan, China 425006 (L.B.S.); Department of Radiology, Changde Second People's Hospital, Changde, Hunan, China (J.M.); Department of Radiology, Affiliated Nan Hua Hospital, University of South China, Hengyang, Hunan, China (X.L.J.); Department of Radiology, Loudi Central Hospital, Loudi, Hunan, China (Q.H.Z.); and Department of Radiology, Chenzhou Second People's Hospital, Chenzhou, Hunan, China (P.F.H.).From the Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI (H.X.B., B.H., K.H., I.P., T.K.E., S.A., T.H., M.K.A.); Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China 410008 (Z.X., D.C.W., F.F.X., S.L., W.H.L.); Brown University Warren Alpert Medical School, Providence, RI (K.H., J.W.C., T.M.L.T., I.P., T.K.E.); Department of Radiology, Yongzhou Central Hospital, Yongzhou, Hunan, China 425006 (L.B.S.); Department of Radiology, Changde Second People's Hospital, Changde, Hunan, China (J.M.); Department of Radiology, Affiliated Nan Hua Hospital, University of South China, Hengyang, Hunan, China (X.L.J.); Department of Radiology, Loudi Central Hospital, Loudi, Hunan, China (Q.H.Z.); and Department of Radiology, Chenzhou Second People's Hospital, Chenzhou, Hunan, China (P.F.H.).From the Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI (H.X.B., B.H., K.H., I.P., T.K.E., S.A., T.H., M.K.A.); Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China 410008 (Z.X., D.C.W., F.F.X., S.L., W.H.L.); Brown University Warren Alpert Medical School, Providence, RI (K.H., J.W.C., T.M.L.T., I.P., T.K.E.); Department of Radiology, Yongzhou Central Hospital, Yongzhou, Hunan, China 425006 (L.B.S.); Department of Radiology, Changde Second People's Hospital, Changde, Hunan, China (J.M.); Department of Radiology, Affiliated Nan Hua Hospital, University of South China, Hengyang, Hunan, China (X.L.J.); Department of Radiology, Loudi Central Hospital, Loudi, Hunan, China (Q.H.Z.); and Department of Radiology, Chenzhou Second People's Hospital, Chenzhou, Hunan, China (P.F.H.).From the Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI (H.X.B., B.H., K.H., I.P., T.K.E., S.A., T.H., M.K.A.); Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China 410008 (Z.X., D.C.W., F.F.X., S.L., W.H.L.); Brown University Warren Alpert Medical School, Providence, RI (K.H., J.W.C., T.M.L.T., I.P., T.K.E.); Department of Radiology, Yongzhou Central Hospital, Yongzhou, Hunan, China 425006 (L.B.S.); Department of Radiology, Changde Second People's Hospital, Changde, Hunan, China (J.M.); Department of Radiology, Affiliated Nan Hua Hospital, University of South China, Hengyang, Hunan, China (X.L.J.); Department of Radiology, Loudi Central Hospital, Loudi, Hunan, China (Q.H.Z.); and Department of Radiology, Chenzhou Second People's Hospital, Chenzhou, Hunan, China (P.F.H.).From the Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI (H.X.B., B.H., K.H., I.P., T.K.E., S.A., T.H., M.K.A.); Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China 410008 (Z.X., D.C.W., F.F.X., S.L., W.H.L.); Brown University Warren Alpert Medical School, Providence, RI (K.H., J.W.C., T.M.L.T., I.P., T.K.E.); Department of Radiology, Yongzhou Central Hospital, Yongzhou, Hunan, China 425006 (L.B.S.); Department of Radiology, Changde Second People's Hospital, Changde, Hunan, China (J.M.); Department of Radiology, Affiliated Nan Hua Hospital, University of South China, Hengyang, Hunan, China (X.L.J.); Department of Radiology, Loudi Central Hospital, Loudi, Hunan, China (Q.H.Z.); and Department of Radiology, Chenzhou Second People's Hospital, Chenzhou, Hunan, China (P.F.H.).From the Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI (H.X.B., B.H., K.H., I.P., T.K.E., S.A., T.H., M.K.A.); Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China 410008 (Z.X., D.C.W., F.F.X., S.L., W.H.L.); Brown University Warren Alpert Medical School, Providence, RI (K.H., J.W.C., T.M.L.T., I.P., T.K.E.); Department of Radiology, Yongzhou Central Hospital, Yongzhou, Hunan, China 425006 (L.B.S.); Department of Radiology, Changde Second People's Hospital, Changde, Hunan, China (J.M.); Department of Radiology, Affiliated Nan Hua Hospital, University of South China, Hengyang, Hunan, China (X.L.J.); Department of Radiology, Loudi Central Hospital, Loudi, Hunan, China (Q.H.Z.); and Department of Radiology, Chenzhou Second People's Hospital, Chenzhou, Hunan, China (P.F.H.).From the Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI (H.X.B., B.H., K.H., I.P., T.K.E., S.A., T.H., M.K.A.); Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China 410008 (Z.X., D.C.W., F.F.X., S.L., W.H.L.); Brown University Warren Alpert Medical School, Providence, RI (K.H., J.W.C., T.M.L.T., I.P., T.K.E.); Department of Radiology, Yongzhou Central Hospital, Yongzhou, Hunan, China 425006 (L.B.S.); Department of Radiology, Changde Second People's Hospital, Changde, Hunan, China (J.M.); Department of Radiology, Affiliated Nan Hua Hospital, University of South China, Hengyang, Hunan, China (X.L.J.); Department of Radiology, Loudi Central Hospital, Loudi, Hunan, China (Q.H.Z.); and Department of Radiology, Chenzhou Second People's Hospital, Chenzhou, Hunan, China (P.F.H.).From the Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI (H.X.B., B.H., K.H., I.P., T.K.E., S.A., T.H., M.K.A.); Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China 410008 (Z.X., D.C.W., F.F.X., S.L., W.H.L.); Brown University Warren Alpert Medical School, Providence, RI (K.H., J.W.C., T.M.L.T., I.P., T.K.E.); Department of Radiology, Yongzhou Central Hospital, Yongzhou, Hunan, China 425006 (L.B.S.); Department of Radiology, Changde Second People's Hospital, Changde, Hunan, China (J.M.); Department of Radiology, Affiliated Nan Hua Hospital, University of South China, Hengyang, Hunan, China (X.L.J.); Department of Radiology, Loudi Central Hospital, Loudi, Hunan, China (Q.H.Z.); and Department of Radiology, Chenzhou Second People's Hospital, Chenzhou, Hunan, China (P.F.H.).

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32155105

Citation

Bai, Harrison X., et al. "Performance of Radiologists in Differentiating COVID-19 From Non-COVID-19 Viral Pneumonia at Chest CT." Radiology, vol. 296, no. 2, 2020, pp. E46-E54.
Bai HX, Hsieh B, Xiong Z, et al. Performance of Radiologists in Differentiating COVID-19 from Non-COVID-19 Viral Pneumonia at Chest CT. Radiology. 2020;296(2):E46-E54.
Bai, H. X., Hsieh, B., Xiong, Z., Halsey, K., Choi, J. W., Tran, T. M. L., Pan, I., Shi, L. B., Wang, D. C., Mei, J., Jiang, X. L., Zeng, Q. H., Egglin, T. K., Hu, P. F., Agarwal, S., Xie, F. F., Li, S., Healey, T., Atalay, M. K., & Liao, W. H. (2020). Performance of Radiologists in Differentiating COVID-19 from Non-COVID-19 Viral Pneumonia at Chest CT. Radiology, 296(2), E46-E54. https://doi.org/10.1148/radiol.2020200823
Bai HX, et al. Performance of Radiologists in Differentiating COVID-19 From Non-COVID-19 Viral Pneumonia at Chest CT. Radiology. 2020;296(2):E46-E54. PubMed PMID: 32155105.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Performance of Radiologists in Differentiating COVID-19 from Non-COVID-19 Viral Pneumonia at Chest CT. AU - Bai,Harrison X, AU - Hsieh,Ben, AU - Xiong,Zeng, AU - Halsey,Kasey, AU - Choi,Ji Whae, AU - Tran,Thi My Linh, AU - Pan,Ian, AU - Shi,Lin-Bo, AU - Wang,Dong-Cui, AU - Mei,Ji, AU - Jiang,Xiao-Long, AU - Zeng,Qiu-Hua, AU - Egglin,Thomas K, AU - Hu,Ping-Feng, AU - Agarwal,Saurabh, AU - Xie,Fang-Fang, AU - Li,Sha, AU - Healey,Terrance, AU - Atalay,Michael K, AU - Liao,Wei-Hua, Y1 - 2020/03/10/ PY - 2020/3/11/pubmed PY - 2020/8/1/medline PY - 2020/3/11/entrez SP - E46 EP - E54 JF - Radiology JO - Radiology VL - 296 IS - 2 N2 - Background Despite its high sensitivity in diagnosing coronavirus disease 2019 (COVID-19) in a screening population, the chest CT appearance of COVID-19 pneumonia is thought to be nonspecific. Purpose To assess the performance of radiologists in the United States and China in differentiating COVID-19 from viral pneumonia at chest CT. Materials and Methods In this study, 219 patients with positive COVID-19, as determined with reverse-transcription polymerase chain reaction (RT-PCR) and abnormal chest CT findings, were retrospectively identified from seven Chinese hospitals in Hunan Province, China, from January 6 to February 20, 2020. Two hundred five patients with positive respiratory pathogen panel results for viral pneumonia and CT findings consistent with or highly suspicious for pneumonia, according to original radiologic interpretation within 7 days of each other, were identified from Rhode Island Hospital in Providence, RI. Three radiologists from China reviewed all chest CT scans (n = 424) blinded to RT-PCR findings to differentiate COVID-19 from viral pneumonia. A sample of 58 age-matched patients was randomly selected and evaluated by four radiologists from the United States in a similar fashion. Different CT features were recorded and compared between the two groups. Results For all chest CT scans (n = 424), the accuracy of the three radiologists from China in differentiating COVID-19 from non-COVID-19 viral pneumonia was 83% (350 of 424), 80% (338 of 424), and 60% (255 of 424). In the randomly selected sample (n = 58), the sensitivities of three radiologists from China and four radiologists from the United States were 80%, 67%, 97%, 93%, 83%, 73%, and 70%, respectively. The corresponding specificities of the same readers were 100%, 93%, 7%, 100%, 93%, 93%, and 100%, respectively. Compared with non-COVID-19 pneumonia, COVID-19 pneumonia was more likely to have a peripheral distribution (80% vs 57%, P < .001), ground-glass opacity (91% vs 68%, P < .001), fine reticular opacity (56% vs 22%, P < .001), and vascular thickening (59% vs 22%, P < .001), but it was less likely to have a central and peripheral distribution (14% vs 35%, P < .001), pleural effusion (4% vs 39%, P < .001), or lymphadenopathy (3% vs 10%, P = .002). Conclusion Radiologists in China and in the United States distinguished coronavirus disease 2019 from viral pneumonia at chest CT with moderate to high accuracy. © RSNA, 2020 Online supplemental material is available for this article. A translation of this abstract in Farsi is available in the supplement. ترجمه چکیده این مقاله به فارسی، در ضمیمه موجود است. SN - 1527-1315 UR - https://www.unboundmedicine.com/medline/citation/32155105/full_citation L2 - https://pubs.rsna.org/doi/10.1148/radiol.2020200823?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -