Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China.
Beijing Youan Hospital, Capital Medical University, Beijing, China.
Eur J Radiol. 2021 Apr;137:109602. doi: 10.1016/j.ejrad.2021.109602. Epub 2021 Feb 15.
Differentiating COVID-19 from other acute infectious pneumonias rapidly is challenging at present. This study aims to improve the diagnosis of COVID-19 using computed tomography (CT).
COVID-19 was confirmed mainly by virus nucleic acid testing and epidemiological history according to WHO interim guidance, while other infectious pneumonias were diagnosed by antigen testing. The texture features were extracted from CT images by two radiologists with 5 years of work experience using modified wavelet transform and matrix computation analyses. The random forest (RF) classifier was applied to identify COVID-19 patients and images.
We retrospectively analysed the data of 95 individuals (291 images) with COVID-19 and 96 individuals (279 images) with other acute infectious pneumonias, including 50 individuals (160 images) with influenza A/B. In total, 6 texture features showed a positive association with COVID-19, while 4 features were negatively associated. The mean AUROC, accuracy, sensitivity, and specificity values of the 5-fold test sets were 0.800, 0.722, 0.770, and 0.680 for image classification and 0.858, 0.826, 0.809, and 0.842 for individual classification, respectively. The feature 'Correlation' contributed most both at the image level and individual level, even compared with the clinical factors. In addition, the texture features could discriminate COVID-19 from influenza A/B, with an AUROC of 0.883 for images and 0.957 for individuals.
The developed texture feature-based RF classifier could assist in the diagnosis of COVID-19, which could be a rapid screening tool in the era of pandemic.
目前,快速区分 COVID-19 和其他急性传染性肺炎具有挑战性。本研究旨在通过计算机断层扫描(CT)提高 COVID-19 的诊断率。
根据世界卫生组织的临时指南,COVID-19 主要通过病毒核酸检测和流行病学史进行确认,而其他传染性肺炎则通过抗原检测进行诊断。两位具有 5 年工作经验的放射科医生使用改进的小波变换和矩阵计算分析从 CT 图像中提取纹理特征。随机森林(RF)分类器用于识别 COVID-19 患者和图像。
我们回顾性分析了 95 名 COVID-19 患者(291 张图像)和 96 名其他急性传染性肺炎患者(279 张图像)的数据,其中包括 50 名流感 A/B 患者(160 张图像)。共有 6 个纹理特征与 COVID-19 呈正相关,而 4 个特征与 COVID-19 呈负相关。五重交叉验证集的平均 AUC、准确率、敏感度和特异度值分别为 0.800、0.722、0.770 和 0.680 用于图像分类,0.858、0.826、0.809 和 0.842 用于个体分类。在图像和个体水平上,特征“相关性”的贡献最大,甚至比临床因素的贡献还要大。此外,纹理特征可将 COVID-19 与流感 A/B 区分开来,图像的 AUC 为 0.883,个体的 AUC 为 0.957。
基于开发的纹理特征的 RF 分类器可辅助 COVID-19 的诊断,有望成为大流行时代的快速筛查工具。