Quantitative Chest CT analysis in discriminating COVID-19 from non-COVID-19 patients.
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ABSTRACT:
SUBMITTER: Caruso D
PROVIDER: S-EPMC7548413 | biostudies-literature | 2020 Oct
REPOSITORIES: biostudies-literature
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Quantitative Chest CT analysis in discriminating COVID-19 from non-COVID-19 patients.
Caruso Damiano D Polici Michela M Zerunian Marta M Pucciarelli Francesco F Polidori Tiziano T Guido Gisella G Rucci Carlotta C Bracci Benedetta B Muscogiuri Emanuele E De Dominicis Chiara C Laghi Andrea A
La Radiologia medica 20201012 2
<h4>Introduction</h4>COVID-19 pneumonia is characterized by ground-glass opacities (GGOs) and consolidations on Chest CT, although these CT features cannot be considered specific, at least on a qualitative analysis. The aim is to evaluate if Quantitative Chest CT could provide reliable information in discriminating COVID-19 from non-COVID-19 patients.<h4>Materials and methods</h4>From March 31, 2020 until April 18, 2020, patients with Chest CT suggestive for interstitial pneumonia were retrospec ...[more]
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Project description:PurposeTo test the association between death and both qualitative and quantitative CT parameters obtained visually and by software in coronavirus disease (COVID-19) early outbreak.MethodsThe study analyzed retrospectively patients underwent chest CT at hospital admission for COVID-19 pneumonia suspicion, between February 21 and March 6, 2020. CT was performed in case of hypoxemia or moderate-to-severe dyspnea. CT scans were analyzed for quantitative and qualitative features obtained visually and by software. Cox proportional hazards regression analysis examined the association between variables and overall survival (OS). Three models were built for stratification of mortality risk: clinical, clinical/visual CT evaluation, and clinical/software-based CT assessment. AUC for each model was used to assess performance in predicting death.ResultsThe study included 248 patients (70% males, median age 68 years). Death occurred in 78/248 (32%) patients. Visual pneumonia extent > 40% (HR 2.15, 95% CI 1.2-3.85, P = 0.01), %high attenuation area - 700 HU > 35% (HR 2.17, 95% CI 1.2-3.94, P = 0.01), exudative consolidations (HR 2.85-2.93, 95% CI 1.61-5.05/1.66-5.16, P < 0.001), visual CAC score > 1 (HR 2.76-3.32, 95% CI 1.4-5.45/1.71-6.46, P < 0.01/P < 0.001), and CT classified as COVID-19 and other disease (HR 1.92-2.03, 95% CI 1.01-3.67/1.06-3.9, P = 0.04/P = 0.03) were significantly associated with shorter OS. Models including CT parameters (AUC 0.911-0.913, 95% CI 0.873-0.95/0.875-0.952) were better predictors of death as compared to clinical model (AUC 0.869, 95% CI 0.816-0.922; P = 0.04 for both models).ConclusionsIn COVID-19 patients, qualitative and quantitative chest CT parameters obtained visually or by software are predictors of mortality. Predictive models including CT metrics were better predictors of death in comparison to clinical model.
| S-EPMC7594966 | biostudies-literature
Project description:PurposeTo quantitatively evaluate lung burden changes in patients with coronavirus disease 2019 (COVID-19) by using serial CT scan by an automated deep learning method.Materials and methodsPatients with COVID-19, who underwent chest CT between January 1 and February 3, 2020, were retrospectively evaluated. The patients were divided into mild, moderate, severe, and critical types, according to their baseline clinical, laboratory, and CT findings. CT lung opacification percentages of the whole lung and five lobes were automatically quantified by a commercial deep learning software and compared with those at follow-up CT scans. Longitudinal changes of the CT quantitative parameter were also compared among the four clinical types.ResultsA total of 126 patients with COVID-19 (mean age, 52 years ± 15 [standard deviation]; 53.2% males) were evaluated, including six mild, 94 moderate, 20 severe, and six critical cases. CT-derived opacification percentage was significantly different among clinical groups at baseline, gradually progressing from mild to critical type (all P < .01). Overall, the whole-lung opacification percentage significantly increased from baseline CT to first follow-up CT (median [interquartile range]: 3.6% [0.5%, 12.1%] vs 8.7% [2.7%, 21.2%]; P < .01). No significant progression of the opacification percentages was noted from the first follow-up to second follow-up CT (8.7% [2.7%, 21.2%] vs 6.0% [1.9%, 24.3%]; P = .655).ConclusionThe quantification of lung opacification in COVID-19 measured at chest CT by using a commercially available deep learning-based tool was significantly different among groups with different clinical severity. This approach could potentially eliminate the subjectivity in the initial assessment and follow-up of pulmonary findings in COVID-19.Supplemental material is available for this article.© RSNA, 2020.
| S-EPMC7233442 | biostudies-literature
Project description:BackgroundMany studies have described lung lesion computed tomography (CT) features of coronavirus disease 2019 (COVID-19) patients at the early and progressive stages. In this study, we aim to evaluate lung lesion CT radiological features along with quantitative analysis for the COVID-19 patients ready for discharge.MethodsFrom February 10 to March 10, 2020, 125 COVID-19 patients (age: 16–67 years, 63 males) ready for discharge, with two consecutive negative reverse transcription-polymerase chain reaction (RT-PCR) and no clinical symptoms for more than 3 days, were included. The pre-discharge CT was performed on all patients 1–3 days after the second negative RT-PCR test, and the follow-up CTs were performed on 44 patients 2–13 days later. The imaging features and quantitative analysis were evaluated on both the pre-discharge and the follow-up CTs, by both radiologists and an artificial intelligence (AI) software.ResultsOn the pre-discharge CT, the most common CT findings included ground-glass opacity (GGO) (99/125, 79.2%) with bilateral mixed distribution, and fibrosis (56/125, 44.8%) with bilateral subpleural distribution. Enlarged mediastinal lymph nodes were also commonly observed (45/125, 36.0%). AI enabled quantitative analysis showed the right lower lobe was mostly involved, and lesions most commonly had CT value of –570 to –470 HU consistent with GGO. Follow-up CT showed GGO decrease in size and density (40/40, 100%) and fibrosis reduction (17/26, 65.4%). Compared with the pre-discharge CT results, quantitative analysis shows the lung lesion volume regressed significantly at follow-up.ConclusionsFor COVID-19 patients ready for discharge, GGO and fibrosis are the main CT features and they further regress at follow-up.
| S-EPMC7276361 | biostudies-literature
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| S-EPMC7850864 | biostudies-literature
Project description: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. ????? ????? ??? ????? ?? ?????? ?? ????? ????? ???.
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| S-EPMC8081746 | biostudies-literature
Project description:The present study was done to evaluate chest computed tomography (CT) images of patients with 2019 novel coronavirus disease (COVID-19) by multifractal technique as a new method to find a way for comparing lung infection quantitatively and identifying progression pattern of the disease. The multifractal spectra extracted from analysis of CT images showed that these spectra were correlated with lung infection amount and disease progression so that, multifractal parameters (αmin, αmax, ∆α, f(αmin), f(αmax), ∆f(α), α(q = 0), and f(α) max) were strongly dependent on amount of lung infection. The results demonstrated that multifractality of chest CT images was increased with the increase in lung infection in patients. The interesting and promising result was that capacity dimension (D0) as a new diagnostic parameter varied linearly with progression and reduction of lung infection. A critical value was found for D0, according to which patients with D0 lower than 1.4 can be healed by treatment. Therefore, herein, a way was found for quantitative assessment of lung infection of patients with COVID-19 by analyzing chest CT images using the multifractal method. This method can be very effective for physicians in diagnosis and treatment of pneumonia caused by COVID-19 and timely identification of therapeutic effects.
| S-EPMC8784535 | biostudies-literature
Project description:Background COVID-19 was discovered in February in China. Due to the high prevalence of the disease, early detection and rapid isolation of patients are the vital points for controlling the outbreak. The purpose of this study was to determine the correct location of chest CT scan in the diagnosis of COVID-19. Main text The current study is a systematic review and meta-analysis. 2959 papers were found in all national and international databases. The study has been reported based on the PRISMA checklist. All analyses were done by CMA Ver. 2 software. The statistical analysis results show that the GGO observation level in the available shape was 46% in CT scan results, and the consolidation observation level in the general form was 33% in CT scan results. Pleural effusion was 7%, and linear opacity observation level was 24% in CT scan results in the general form. The CT scan test sensitivity level was gained 94.7%, and PCR test sensitivity level was achieved as 94.8%. This level was 89% in the early stage. Conclusion The chest CT has about 24% higher diagnostic sensitivity than the PCR test, in the early stage. GGO revealed a declining process and also indicates that GGO is an early symptom of the disease in CT scan. Linear opacity is the reason behind the initial dyspnea in coronavirus suffering patients referring to the medical centers. The extra-pulmonary lesions increase in the last stage of the disease that makes the patient’s worse. Supplementary Information The online version contains supplementary material available at 10.1186/s43055-021-00457-6.
| S-EPMC7992511 | biostudies-literature
Project description:ObjectiveTo develop prognostic models for survival (alive or deceased status) prediction of COVID-19 patients using clinical data (demographics and history, laboratory tests, visual scoring by radiologists) and lung/lesion radiomic features extracted from chest CT images.MethodsOverall, 152 patients were enrolled in this study protocol. These were divided into 106 training/validation and 46 test datasets (untouched during training), respectively. Radiomic features were extracted from the segmented lungs and infectious lesions separately from chest CT images. Clinical data, including patients' history and demographics, laboratory tests and radiological scores were also collected. Univariate analysis was first performed (q-value reported after false discovery rate (FDR) correction) to determine the most predictive features among all imaging and clinical data. Prognostic modeling of survival was performed using radiomic features and clinical data, separately or in combination. Maximum relevance minimum redundancy (MRMR) and XGBoost were used for feature selection and classification. The receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC), sensitivity, specificity, and accuracy were used to assess the prognostic performance of the models on the test datasets.ResultsFor clinical data, cancer comorbidity (q-value < 0.01), consciousness level (q-value < 0.05) and radiological score involved zone (q-value < 0.02) were found to have high correlated features with outcome. Oxygen saturation (AUC = 0.73, q-value < 0.01) and Blood Urea Nitrogen (AUC = 0.72, q-value = 0.72) were identified as high clinical features. For lung radiomic features, SAHGLE (AUC = 0.70) and HGLZE (AUC = 0.67) from GLSZM were identified as most prognostic features. Amongst lesion radiomic features, RLNU from GLRLM (AUC = 0.73), HGLZE from GLSZM (AUC = 0.73) had the highest performance. In multivariate analysis, combining lung, lesion and clinical features was determined to provide the most accurate prognostic model (AUC = 0.95 ± 0.029 (95%CI: 0.95-0.96), accuracy = 0.88 ± 0.046 (95% CI: 0.88-0.89), sensitivity = 0.88 ± 0.066 (95% CI = 0.87-0.9) and specificity = 0.89 ± 0.07 (95% CI = 0.87-0.9)).ConclusionCombination of radiomic features and clinical data can effectively predict outcome in COVID-19 patients. The developed model has significant potential for improved management of COVID-19 patients.
| S-EPMC7925235 | biostudies-literature