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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">R.M. Kwee</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">November 2020,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">41 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(11) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">E88; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A6787 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-80800--6199455628" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">R.M. Kwee </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>Department of RadiologyZuyderland Medical CenterHeerlen/Sittard/Geleen, the Netherlands</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=R.M.%2BKwee%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Kwee%20R&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AR.M.%2BKwee%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-7760-867X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for R.M. Kwee</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article fulltext-view "><span class="highwire-journal-article-marker-start"></span><p id="p-2">I thank Li and colleagues for their interest in our article “CT Scanning in Suspected Stroke or Head Trauma: Is it Worth Going the Extra Mile and Including the Chest to Screen for COVID-19 Infection?”<sup><a id="xref-ref-1-1" class="xref-bibr" href="#ref-1">1</a></sup> Our article title is a question, which does not imply that using chest CT to screen for coronavirus disease 2019 (COVID-19) in this patient population may add value. The Fleischner Society’s position article on the use of chest imaging during the COVID-19 pandemic<sup><a id="xref-ref-2-1" class="xref-bibr" href="#ref-2">2</a></sup> did not specifically address whether additional chest CT should be performed to detect COVID-19 in patients who undergo extrathoracic CT in regions of high COVID-19 prevalence. Our study<sup><a id="xref-ref-1-2" class="xref-bibr" href="#ref-1">1</a></sup> provides new scientific information, and we address the possible pros and cons of performing additional chest CT for COVID-19 detection in patients who undergo head CT for suspected stroke or head trauma in a COVID-19–endemic region. We clearly stated that the data from our study may be used to weigh the potential advantages and disadvantages of performing additional chest CT. This is up to the readers of our article. However, I certainly appreciate that Li and colleagues are sharing their valuable thoughts. They relied on reverse transcription polymerase chain reaction (RT-PCR) testing for diagnosing COVID-19 infection. Unfortunately, RT-PCR is an imperfect test, with a reported pooled sensitivity of 89% (95% CI, 81%–94%).<sup><a id="xref-ref-3-1" class="xref-bibr" href="#ref-3">3</a></sup> Even repeat RT-PCR testing may yield a false-negative result in patients with COVID-19.<sup><a id="xref-ref-4-1" class="xref-bibr" href="#ref-4">4</a></sup> Li and colleagues did not perform chest CT. Therefore, from a scientific point of view, it remains speculative whether chest CT would truly have had a low diagnostic yield in their stroke population during the rise and peak of the COVID-19 pandemic.</p><div class="license" id="license-1"><p id="p-1">Indicates open access to non-subscribers at <a href="http://www.ajnr.org" rel="license">www.ajnr.org</a></p></div><div class="section ref-list" id="ref-list-1"><h2 class="">References</h2><ol class="cit-list ref-use-labels"><li><span class="ref-label">1.</span><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1. in text" id="ref-1">↵</a><div class="cit ref-cit ref-journal" id="cit-41.11.E88.1" data-doi="10.3174/ajnr.A6607"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Kwee</span>  <span class="cit-name-given-names">RM</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Krdzalic</span>  <span class="cit-name-given-names">J</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Fasen</span>  <span class="cit-name-given-names">BA</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">CT scanning in suspected stroke or head trauma: is it worth going the extra mile and including the chest to screen for COVID-19 infection?</span> <abbr class="cit-jnl-abbrev">AJNR Am J Neuroradiol</abbr> <span class="cit-pub-date">2020</span>;<span class="cit-vol">41</span>:<span class="cit-fpage">1165</span>–<span class="cit-lpage">69</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.3174/ajnr.A6607</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>32439651</span></cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiYWpuciI7czo1OiJyZXNpZCI7czo5OiI0MS83LzExNjUiO3M6NDoiYXRvbSI7czoyMDoiL2FqbnIvNDEvMTEvRTg4LmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div></li><li><span class="ref-label">2.</span><a class="rev-xref-ref" href="#xref-ref-2-1" title="View reference 2. in text" id="ref-2">↵</a><div class="cit ref-cit ref-journal" id="cit-41.11.E88.2" data-doi="10.1016/j.chest.2020.04.003"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Rubin</span>  <span class="cit-name-given-names">GD</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Ryerson</span>  <span class="cit-name-given-names">CJ</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Haramati</span>  <span class="cit-name-given-names">LB</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">The role of chest imaging in patient management during the COVID-19 pandemic: a multinational consensus statement from the Fleischner Society</span>. <abbr class="cit-jnl-abbrev">Chest</abbr> <span class="cit-pub-date">2020</span>;<span class="cit-vol">158</span>:<span class="cit-fpage">106</span>–<span class="cit-lpage">16</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1016/j.chest.2020.04.003</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>32275978</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/j.chest.2020.04.003&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=32275978&amp;link_type=MED&amp;atom=%2Fajnr%2F41%2F11%2FE88.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">3.</span><a class="rev-xref-ref" href="#xref-ref-3-1" title="View reference 3. in text" id="ref-3">↵</a><div class="cit ref-cit ref-journal" id="cit-41.11.E88.3" data-doi="10.3348/kjr.2020.0146"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Li</span>  <span class="cit-name-given-names">D</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Wang</span>  <span class="cit-name-given-names">D</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Dong</span>  <span class="cit-name-given-names">J</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">False-negative results of real-time reverse-transcriptase polymerase chain reaction for severe acute respiratory syndrome coronavirus, 2: role of deep-learning-based CT diagnosis and insights from two cases</span>. <abbr class="cit-jnl-abbrev">Korean J Radiol</abbr> <span class="cit-pub-date">2020</span>;<span class="cit-vol">21</span>:<span class="cit-fpage">505</span>–<span class="cit-lpage">08</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.3348/kjr.2020.0146</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>32174053</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.3348/kjr.2020.0146&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=http://www.n&amp;link_type=MED&amp;atom=%2Fajnr%2F41%2F11%2FE88.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">4.</span><a class="rev-xref-ref" href="#xref-ref-4-1" title="View reference 4. in text" id="ref-4">↵</a><div class="cit ref-cit ref-journal" id="cit-41.11.E88.4" data-doi="10.1148/radiol.2020201343"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Kim</span>  <span class="cit-name-given-names">H</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Hong</span>  <span class="cit-name-given-names">H</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Yoon</span>  <span class="cit-name-given-names">SH</span></span></li></ol><cite>. <span class="cit-article-title">Diagnostic performance of CT and reverse transcriptase-polymerase chain reaction for coronavirus disease 2019: a meta-analysis</span>. <abbr class="cit-jnl-abbrev">Radiology</abbr> <span class="cit-pub-date">2020</span> <span class="cit-month">Apr</span> <span class="cit-day">17</span>. [<span class="cit-comment">Epub ahead of print</span>]<span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1148/radiol.2020201343</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>32301646</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1148/radiol.2020201343&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=32301646&amp;link_type=MED&amp;atom=%2Fajnr%2F41%2F11%2FE88.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li></ol></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2020 by American Journal of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 41</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 11 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Nov 2020 </div></div>
      
      
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