Computed tomography semi-automated lung volume quantification in SARS-CoV-2-related pneumonia
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IMAGING INFORMATICS AND ARTIFICIAL INTELLIGENCE
Computed tomography semi-automated lung volume quantification in SARS-CoV-2-related pneumonia Davide Ippolito 1,2 & Maria Ragusi 1,2 & Davide Gandola 1,2 & Cesare Maino 1,2 & Anna Pecorelli 1,2 & Simone Terrani 3 & Marta Peroni 3 & Teresa Giandola 1,2 & Marco Porta 1,2 & Cammillo Talei Franzesi 1,2 & Sandro Sironi 1,4 Received: 22 July 2020 / Revised: 20 August 2020 / Accepted: 8 September 2020 # The Author(s) 2020
Abstract Objectives To evaluate a semi-automated segmentation and ventilated lung quantification on chest computed tomography (CT) to assess lung involvement in patients affected by SARS-CoV-2. Results were compared with clinical and functional parameters and outcomes. Methods All images underwent quantitative analyses with a dedicated workstation using a semi-automatic lung segmentation software to compute ventilated lung volume (VLV), Ground-glass opacity (GGO) volume (GGO-V), and consolidation volume (CONS-V) as absolute volume and as a percentage of total lung volume (TLV). The ratio between CONS-V, GGO-V, and VLV (CONS-V/VLV and GGO-V/VLV, respectively), TLV (CONS-V/TLV, GGO-V/TLV, and GGO-V + CONS-V/TLV respectively), and the ratio between VLV and TLV (VLV/TLV) were calculated. Results A total of 108 patients were enrolled. GGO-V/TLV significantly correlated with WBC (r = 0.369), neutrophils (r = 0.446), platelets (r = 0.182), CRP (r = 0.190), PaCO2 (r = 0.176), HCO3− (r = 0.284), and PaO2/FiO2 (P/F) values (r = − 0.344). CONS-V/TLV significantly correlated with WBC (r = 0.294), neutrophils (r = 0.300), lymphocytes (r = −0.225), CRP (r = 0.306), PaCO2 (r = 0.227), pH (r = 0.162), HCO3− (r = 0.394), and P/F (r = − 0.419) values. Statistically significant differences between CONS-V, GGO-V, GGO-V/TLV, CONS-V/TLV, GGO-V/VLV, CONS-V/VLV, GGO-V + CONS-V/TLV, VLV/ TLV, CT score, and invasive ventilation by ET were found (all p < 0.05). Conclusion The use of quantitative semi-automated algorithm for lung CT elaboration effectively correlates the severity of SARS-CoV-2-related pneumonia with laboratory parameters and the need for invasive ventilation. Key Points • Pathological lung volumes, expressed both as GGO-V and as CONS-V, can be considered a useful tool in SARS-CoV-2-related pneumonia. • All lung volumes, expressed themselves and as ratio with TLV and VLV, correlate with laboratory data, in particular C-reactive protein and white blood cell count. • All lung volumes correlate with patient’s outcome, in particular concerning invasive ventilation. Keywords Artificial intelligence . Computed tomography, X-ray . Lung volume measurements . Infection, coronavirus . Pneumonia
* Davide Ippolito [email protected] 1
Department of Diagnostic Radiology, San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, Monza, MB 20900, Italy
2
School of Medicine, University of Milano-Bicocca, Via Cadore 48, Monza, MB 20900, Italy
3
Philips Healthcare, Viale Sacra 235, Milan, MI 20126, Italy
4
Department of Diagnostic Radiology, H Papa Giovanni
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