Nicolò Cardobi1,2, Giulio Benetti3, Giuseppe Cardano1, Cinzia Arena4, Claudio Micheletto4, Carlo Cavedon5,6, Stefania Montemezzi1,2. 1. Department of Pathology and Diagnostics, Radiology Unit, Azienda Ospedaliera Universitaria Integrata, P.le Stefani 1, 37126, Verona, Italy. 2. Università di Verona, Verona, Italy. 3. Department of Pathology and Diagnostics, Medical Physics Unit, Azienda Ospedaliera Universitaria Integrata, P.le Stefani 1, 37126, Verona, Italy. 4. Cardiovascular and Thoracic Department, Pneumology Unit, Azienda Ospedaliera Universitaria Integrata, P.le Stefani 1, 37126, Verona, Italy. 5. Department of Pathology and Diagnostics, Medical Physics Unit, Azienda Ospedaliera Universitaria Integrata, P.le Stefani 1, 37126, Verona, Italy. carlo.cavedon@aovr.veneto.it. 6. Università di Verona, Verona, Italy. carlo.cavedon@aovr.veneto.it.
Abstract
PURPOSE: To classify COVID-19, COVID-19-like and non-COVID-19 interstitial pneumonia using lung CT radiomic features. MATERIAL AND METHODS: CT data of 115 patients with respiratory symptoms suspected for COVID-19 disease were retrospectively analyzed. Based on the results of nasopharyngeal swab, patients were divided into two main groups, COVID-19 positive (C +) and COVID-19 negative (C-), respectively. C- patients, however, presented with interstitial lung involvement. A subgroup of C-, COVID-19-like (CL), were considered as highly suggestive of COVID pneumonia at CT. Radiomic features were extracted from the whole lungs. A dual machine learning (ML) model approach was used. The first one excluded CL patients from the training set, eventually included on the test set. The second model included the CL patients also in the training set. RESULTS: The first model classified C + and C- pneumonias with AUC of 0.83. CL median response (0.80) was more similar to C + (0.92) compared to C- (0.17). Radiomic footprints of CL were similar to the C + ones (possibly false negative swab test). The second model, however, merging C + with CL patients in the training set, showed a slight decrease in classification performance (AUC = 0.81). CONCLUSION: Whole lung ML models based on radiomics can classify C + and C- interstitial pneumonia. This may help in the correct management of patients with clinical and radiological stigmata of COVID-19, however presenting with a negative swab test. CL pneumonia was similar to C + pneumonia, albeit with slightly different radiomic footprints.
PURPOSE: To classify COVID-19, COVID-19-like and non-COVID-19 interstitial pneumonia using lung CT radiomic features. MATERIAL AND METHODS: CT data of 115 patients with respiratory symptoms suspected for COVID-19 disease were retrospectively analyzed. Based on the results of nasopharyngeal swab, patients were divided into two main groups, COVID-19 positive (C +) and COVID-19 negative (C-), respectively. C- patients, however, presented with interstitial lung involvement. A subgroup of C-, COVID-19-like (CL), were considered as highly suggestive of COVID pneumonia at CT. Radiomic features were extracted from the whole lungs. A dual machine learning (ML) model approach was used. The first one excluded CL patients from the training set, eventually included on the test set. The second model included the CL patients also in the training set. RESULTS: The first model classified C + and C- pneumonias with AUC of 0.83. CL median response (0.80) was more similar to C + (0.92) compared to C- (0.17). Radiomic footprints of CL were similar to the C + ones (possibly false negative swab test). The second model, however, merging C + with CL patients in the training set, showed a slight decrease in classification performance (AUC = 0.81). CONCLUSION: Whole lung ML models based on radiomics can classify C + and C- interstitial pneumonia. This may help in the correct management of patients with clinical and radiological stigmata of COVID-19, however presenting with a negative swab test. CL pneumonia was similar to C + pneumonia, albeit with slightly different radiomic footprints.
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