Persigehl Thorsten, Fervers Philipp, Bucher Andreas, Isfort Peter, Maintz David, Penzkofer Tobias, Sähn Marwin, Vogl Thomas, Kottlors Jonathan, Doellinger Felix
Institute for Diagnostic and Interventional Radiology, University Hospital Cologne, University of Cologne, Cologne, Germany.
Department of Diagnostic and Interventional Radiology, Goethe University Frankfurt, Frankfurt am Main, Germany.
Front Med (Lausanne). 2025 Jul 23;12:1578282. doi: 10.3389/fmed.2025.1578282. eCollection 2025.
The multi-dimensional RACOON Viral Pneumonia Score (RVPS) was developed to compensate for the main weaknesses of the established one-dimensional chest computed tomography (CT) scores. It aimed to quantify the severity of pneumonia and qualitatively monitor infectious lung disease from the acute stage to post-pneumonic sequelae.
This research focuses on the original development and evaluation of applicability and inter-reader reliability of the RVPS.
Within the Radiological Cooperative Network (RACOON), the scoring system was developed after several expert meetings and tested in this proof-of-concept study with 8,525 observations. In the subset of inter-reader validation (7,800 observations), eight blinded radiologists applied the RVPS and evaluated the following CT findings for each lung lobe individually: (I) pure ground glass opacities (GGO), (II) GGO and interstitial thickening, (III) consolidations, (IV) linear opacities and reticulations, and (V) fibrotic-like changes. The extent of each pathology was scored on a scale of 0-5 points, and the total involvement was calculated. Inter-reader variability was assessed using Kendall's W.
Overall inter-reader reliability of the RVPS was excellent (Kendalls' W 0.95). CT findings associated with acute pneumonia were scored with good agreement (W 0.81-0.87). Moderate uncertainty was introduced when separating category IV vs. category V findings (W 0.55-0.69). The overall extent of post-infectious findings was assessed with good agreement (W 0.79). The longitudinal distribution of subscores allowed for differentiation between acute pneumonia and post-pneumonic sequelae.
This study presents the RVPS as a comprehensive tool for inter-reader reliable evaluation, longitudinal monitoring, and structured documentation of the extent as well as quality of chest CT findings in infectious lung disease.
多维浣熊病毒性肺炎评分（RVPS）旨在弥补已有的一维胸部计算机断层扫描（CT）评分的主要缺陷。它旨在量化肺炎的严重程度，并从急性期到肺炎后后遗症对感染性肺部疾病进行定性监测。
本研究聚焦于RVPS的原始开发以及对其适用性和阅片者间可靠性的评估。
在放射学合作网络（RACOON）内，经过多次专家会议开发了该评分系统，并在这项概念验证研究中对8525例观察病例进行了测试。在阅片者间验证的子集中（7800例观察病例），8名 blinded 放射科医生应用RVPS，分别对每个肺叶的以下CT表现进行评估：（I）单纯磨玻璃影（GGO），（II）GGO和间质增厚，（III）实变，（IV）线状影和网状影，以及（V）纤维化样改变。每种病变的范围按0 - 5分进行评分，并计算总累及范围。使用肯德尔W系数评估阅片者间的变异性。
RVPS的总体阅片者间可靠性极佳（肯德尔W系数为0.95）。与急性肺炎相关的CT表现评分一致性良好（W系数为0.81 - 0.87）。在区分IV类与V类表现时引入了中度不确定性（W系数为0.55 - 0.69）。感染后表现的总体范围评估一致性良好（W系数为0.79）。子评分的纵向分布有助于区分急性肺炎和肺炎后后遗症。
本研究表明RVPS是一种用于阅片者间可靠评估、纵向监测以及对感染性肺部疾病胸部CT表现的范围和质量进行结构化记录的综合工具。
