ArticleLa Radiologia medica2023
Immune checkpoint inhibitor-related pneumonitis and COVID-19: a case-matched comparison of CT findings.
Article in La Radiologia medica, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- COVID-19 and Lung Cancer Interactions: A Literature Review.Medical sciences (Basel, Switzerland) · 2025Review
- Beyond Tumor Immunity: The Disruption of Endocrine and Infectious Homeostasis by Immune Checkpoint Inhibitors.International journal of molecular sciences · 2025Review
- Comprehensive review of pulmonary embolism imaging: past, present and future innovations in computed tomography (CT) and other diagnostic techniques.Japanese journal of radiology · 2025Review
- Acute respiratory distress syndrome (ARDS): from mechanistic insights to therapeutic strategies.MedComm · 2025Review
- Exploring kappa statistics considerations between two raters.La Radiologia medica · 2024Article
- Fundamental misunderstandings and methodological flaws in "exploring kappa statistics considerations between two raters" by Yu et al.La Radiologia medica · 2024Article
- The Clinical Analysis of Checkpoint Inhibitor Pneumonitis with Different Severities in Lung Cancer Patients: A Retrospective Study.Journal of clinical medicine · 2024Article
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Authors and funding
7 authors.
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Abstract
objectivesTo compare the radiological findings of immune checkpoint inhibitor-related pneumonitis (IRP) and COVID-19 pneumonia, evaluating the potential of the CO-RADS score to differentiate between them.
methodsTwo readers blindly reviewed chest CTs from age- and sex-matched groups of 33 patients with IRP and 33 patients with COVID-19 pneumonia. Each examiner evaluated the presence of 13 CT features, semiquantitatively scored lung involvement, and assigned a CO-RADS score. Inter-reader reliability in the assessment of CT features and CO-RADS categories was evaluated with Cohen's κ. Distribution differences between groups were evaluated with the χ
resultsSubstantial or higher inter-reader reliability was found in CO-RADS assignments (κ = 0.664) and in the evaluation of CT features (κ ≥ 0.638), among which the sole feature found to significantly differentiate IRP from COVID-19 pneumonia was unilateral presentation (p < 0.001). Lung involvement semiquantitative scores and CO-RADS scores were significantly higher (p < 0.001) in COVID patients (median involvement score 4, IQR 4-6; median CO-RADS score 5, IQR 4-5) than in IRP patients (median involvement score 2.5, IQR 2-4; median CO-RADS score 3, IQR 3-4) but exploratory analysis of CO-RADS specificity revealed comparatively low values, ranging between 51.5% (Reader 1) and 54.6% (Reader 2).
conclusionsCT features of IRP and COVID-19 pneumonia frequently overlap, save for the extent of lung involvement and bilaterality. In the current SARS-CoV-2 pandemic, the low specificity of the CO-RADS score for the differential diagnosis of COVID-19 pneumonia and IRP may prompt to reconsider the role of imaging in IRP work-up.
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