A multicenter evaluation of a deep learning software (LungQuant) for lung parenchyma characterization in COVID-19 pneumonia.

COVID-19 Deep Learning Lung Software validation Tomography (x-ray computed)

Journal

European radiology experimental
ISSN: 2509-9280
Titre abrégé: Eur Radiol Exp
Pays: England
ID NLM: 101721752

Informations de publication

Date de publication:
10 04 2023
Historique:
received: 01 11 2022
accepted: 27 02 2023
medline: 11 4 2023
entrez: 9 4 2023
pubmed: 10 4 2023
Statut: epublish

Résumé

The role of computed tomography (CT) in the diagnosis and characterization of coronavirus disease 2019 (COVID-19) pneumonia has been widely recognized. We evaluated the performance of a software for quantitative analysis of chest CT, the LungQuant system, by comparing its results with independent visual evaluations by a group of 14 clinical experts. The aim of this work is to evaluate the ability of the automated tool to extract quantitative information from lung CT, relevant for the design of a diagnosis support model. LungQuant segments both the lungs and lesions associated with COVID-19 pneumonia (ground-glass opacities and consolidations) and computes derived quantities corresponding to qualitative characteristics used to clinically assess COVID-19 lesions. The comparison was carried out on 120 publicly available CT scans of patients affected by COVID-19 pneumonia. Scans were scored for four qualitative metrics: percentage of lung involvement, type of lesion, and two disease distribution scores. We evaluated the agreement between the LungQuant output and the visual assessments through receiver operating characteristics area under the curve (AUC) analysis and by fitting a nonlinear regression model. Despite the rather large heterogeneity in the qualitative labels assigned by the clinical experts for each metric, we found good agreement on the metrics compared to the LungQuant output. The AUC values obtained for the four qualitative metrics were 0.98, 0.85, 0.90, and 0.81. Visual clinical evaluation could be complemented and supported by computer-aided quantification, whose values match the average evaluation of several independent clinical experts. We conducted a multicenter evaluation of the deep learning-based LungQuant automated software. We translated qualitative assessments into quantifiable metrics to characterize coronavirus disease 2019 (COVID-19) pneumonia lesions. Comparing the software output to the clinical evaluations, results were satisfactory despite heterogeneity of the clinical evaluations. An automatic quantification tool may contribute to improve the clinical workflow of COVID-19 pneumonia.

Sections du résumé

BACKGROUND
The role of computed tomography (CT) in the diagnosis and characterization of coronavirus disease 2019 (COVID-19) pneumonia has been widely recognized. We evaluated the performance of a software for quantitative analysis of chest CT, the LungQuant system, by comparing its results with independent visual evaluations by a group of 14 clinical experts. The aim of this work is to evaluate the ability of the automated tool to extract quantitative information from lung CT, relevant for the design of a diagnosis support model.
METHODS
LungQuant segments both the lungs and lesions associated with COVID-19 pneumonia (ground-glass opacities and consolidations) and computes derived quantities corresponding to qualitative characteristics used to clinically assess COVID-19 lesions. The comparison was carried out on 120 publicly available CT scans of patients affected by COVID-19 pneumonia. Scans were scored for four qualitative metrics: percentage of lung involvement, type of lesion, and two disease distribution scores. We evaluated the agreement between the LungQuant output and the visual assessments through receiver operating characteristics area under the curve (AUC) analysis and by fitting a nonlinear regression model.
RESULTS
Despite the rather large heterogeneity in the qualitative labels assigned by the clinical experts for each metric, we found good agreement on the metrics compared to the LungQuant output. The AUC values obtained for the four qualitative metrics were 0.98, 0.85, 0.90, and 0.81.
CONCLUSIONS
Visual clinical evaluation could be complemented and supported by computer-aided quantification, whose values match the average evaluation of several independent clinical experts.
KEY POINTS
We conducted a multicenter evaluation of the deep learning-based LungQuant automated software. We translated qualitative assessments into quantifiable metrics to characterize coronavirus disease 2019 (COVID-19) pneumonia lesions. Comparing the software output to the clinical evaluations, results were satisfactory despite heterogeneity of the clinical evaluations. An automatic quantification tool may contribute to improve the clinical workflow of COVID-19 pneumonia.

Identifiants

pubmed: 37032383
doi: 10.1186/s41747-023-00334-z
pii: 10.1186/s41747-023-00334-z
pmc: PMC10083148
doi:

Types de publication

Multicenter Study Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

18

Informations de copyright

© 2023. The Author(s).

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Auteurs

Camilla Scapicchio (C)

Physics Department, University of Pisa, Pisa, Italy. camilla.scapicchio@phd.unipi.it.
Pisa Division, National Institute for Nuclear Physics, Pisa, Italy. camilla.scapicchio@phd.unipi.it.

Andrea Chincarini (A)

Genova Division, National Institute for Nuclear Physics, Genova, Italy.

Elena Ballante (E)

Department of Political and Social Sciences, University of Pavia, Pavia, Italy.
Pavia Division, National Institute for Nuclear Physics, Pavia, Italy.

Luca Berta (L)

Department of Medical Physics, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
Milano Division, National Institute for Nuclear Physics, Milan, Italy.

Eleonora Bicci (E)

Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence-Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.

Chandra Bortolotto (C)

Unit of Imaging and Radiotherapy, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
Institute of Radiology, Department of Diagnostic and Imaging Services, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

Francesca Brero (F)

Pavia Division, National Institute for Nuclear Physics, Pavia, Italy.

Raffaella Fiamma Cabini (RF)

Pavia Division, National Institute for Nuclear Physics, Pavia, Italy.
Department of Mathematics, University of Pavia, Pavia, Italy.

Giuseppe Cristofalo (G)

Department of Biomedicine, Neuroscience and Advanced Diagnostic (BiND), University of Palermo, Palermo, Italy.

Salvatore Claudio Fanni (SC)

Department of Translational Research, Academic Radiology, University of Pisa, Pisa, Italy.

Maria Evelina Fantacci (ME)

Physics Department, University of Pisa, Pisa, Italy.
Pisa Division, National Institute for Nuclear Physics, Pisa, Italy.

Silvia Figini (S)

Department of Political and Social Sciences, University of Pavia, Pavia, Italy.
Pavia Division, National Institute for Nuclear Physics, Pavia, Italy.

Massimo Galia (M)

Department of Biomedicine, Neuroscience and Advanced Diagnostic (BiND), University of Palermo, Palermo, Italy.

Pietro Gemma (P)

Post-graduate School in Radiodiagnostics, University of Milan, Milan, Italy.

Emanuele Grassedonio (E)

Department of Biomedicine, Neuroscience and Advanced Diagnostic (BiND), University of Palermo, Palermo, Italy.

Alessandro Lascialfari (A)

Pavia Division, National Institute for Nuclear Physics, Pavia, Italy.

Cristina Lenardi (C)

Milano Division, National Institute for Nuclear Physics, Milan, Italy.
Department of Physics "Aldo Pontremoli", University of Milan, Milan, Italy.

Alice Lionetti (A)

Unit of Imaging and Radiotherapy, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.

Francesca Lizzi (F)

Physics Department, University of Pisa, Pisa, Italy.
Pisa Division, National Institute for Nuclear Physics, Pisa, Italy.

Maurizio Marrale (M)

Department of Physics and Chemistry "Emilio Segrè", University of Palermo, Palermo, Italy.
Catania Division, National Institute for Nuclear Physics, Catania, Italy.

Massimo Midiri (M)

Department of Biomedicine, Neuroscience and Advanced Diagnostic (BiND), University of Palermo, Palermo, Italy.

Cosimo Nardi (C)

Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence-Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.

Piernicola Oliva (P)

Cagliari Division, National Institute for Nuclear Physics, Monserrato, Cagliari, Italy.
Department of Chemical, Physical, Mathematical and Natural Sciences, University of Sassari, Sassari, Italy.

Noemi Perillo (N)

Post-graduate School in Radiodiagnostics, University of Milan, Milan, Italy.

Ian Postuma (I)

Pavia Division, National Institute for Nuclear Physics, Pavia, Italy.

Lorenzo Preda (L)

Unit of Imaging and Radiotherapy, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
Institute of Radiology, Department of Diagnostic and Imaging Services, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

Vieri Rastrelli (V)

Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence-Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.

Francesco Rizzetto (F)

Department of Radiology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
Postgraduate School of Diagnostic and Interventional Radiology, University of Milan, Milan, Italy.

Nicola Spina (N)

Department of Translational Research, Academic Radiology, University of Pisa, Pisa, Italy.

Cinzia Talamonti (C)

Department Biomedical Experimental and Clinical Science "Mario Serio", University of Florence, Florence, Italy.
Florence Division, National Institute for Nuclear Physics, Sesto Fiorentino, Firenze, Italy.

Alberto Torresin (A)

Department of Medical Physics, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
Milano Division, National Institute for Nuclear Physics, Milan, Italy.
Department of Physics "Aldo Pontremoli", University of Milan, Milan, Italy.

Angelo Vanzulli (A)

Department of Medical Physics, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.

Federica Volpi (F)

Department of Translational Research, Academic Radiology, University of Pisa, Pisa, Italy.

Emanuele Neri (E)

Department of Translational Research, Academic Radiology, University of Pisa, Pisa, Italy.
Italian Society of Medical and Interventional Radiology, SIRM Foundation, Milan, Italy.

Alessandra Retico (A)

Pisa Division, National Institute for Nuclear Physics, Pisa, Italy.

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