Radiomics-based machine learning differentiates “ground-glass” opacities due to COVID-19 from acute non-COVID-19 lung disease

Abstract Ground-glass opacities (GGOs) are a non-specific high-resolution computed tomography (HRCT) finding tipically observed in early Coronavirus disesase 19 (COVID-19) pneumonia. However, GGOs are also seen in other acute lung diseases, thus making challenging the differential diagnosis. To this...

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Main Authors: Andrea Delli Pizzi, Antonio Maria Chiarelli, Piero Chiacchiaretta, Cristina Valdesi, Pierpaolo Croce, Domenico Mastrodicasa, Michela Villani, Stefano Trebeschi, Francesco Lorenzo Serafini, Consuelo Rosa, Giulio Cocco, Riccardo Luberti, Sabrina Conte, Lucia Mazzamurro, Manuela Mereu, Rosa Lucia Patea, Valentina Panara, Stefano Marinari, Jacopo Vecchiet, Massimo Caulo
Format: Article
Language:English
Published: Nature Portfolio 2021-08-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-021-96755-0
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author Andrea Delli Pizzi
Antonio Maria Chiarelli
Piero Chiacchiaretta
Cristina Valdesi
Pierpaolo Croce
Domenico Mastrodicasa
Michela Villani
Stefano Trebeschi
Francesco Lorenzo Serafini
Consuelo Rosa
Giulio Cocco
Riccardo Luberti
Sabrina Conte
Lucia Mazzamurro
Manuela Mereu
Rosa Lucia Patea
Valentina Panara
Stefano Marinari
Jacopo Vecchiet
Massimo Caulo
author_facet Andrea Delli Pizzi
Antonio Maria Chiarelli
Piero Chiacchiaretta
Cristina Valdesi
Pierpaolo Croce
Domenico Mastrodicasa
Michela Villani
Stefano Trebeschi
Francesco Lorenzo Serafini
Consuelo Rosa
Giulio Cocco
Riccardo Luberti
Sabrina Conte
Lucia Mazzamurro
Manuela Mereu
Rosa Lucia Patea
Valentina Panara
Stefano Marinari
Jacopo Vecchiet
Massimo Caulo
author_sort Andrea Delli Pizzi
collection DOAJ
description Abstract Ground-glass opacities (GGOs) are a non-specific high-resolution computed tomography (HRCT) finding tipically observed in early Coronavirus disesase 19 (COVID-19) pneumonia. However, GGOs are also seen in other acute lung diseases, thus making challenging the differential diagnosis. To this aim, we investigated the performance of a radiomics-based machine learning method to discriminate GGOs due to COVID-19 from those due to other acute lung diseases. Two sets of patients were included: a first set of 28 patients (COVID) diagnosed with COVID-19 infection confirmed by real-time polymerase chain reaction (RT-PCR) between March and April 2020 having (a) baseline HRCT at hospital admission and (b) predominant GGOs pattern on HRCT; a second set of 30 patients (nCOVID) showing (a) predominant GGOs pattern on HRCT performed between August 2019 and April 2020 and (b) availability of final diagnosis. Two readers independently segmented GGOs on HRCTs using a semi-automated approach, and radiomics features were extracted using a standard open source software (PyRadiomics). Partial least square (PLS) regression was used as the multivariate machine-learning algorithm. A leave-one-out nested cross-validation was implemented. PLS β-weights of radiomics features, including the 5% features with the largest β-weights in magnitude (top 5%), were obtained. The diagnostic performance of the radiomics model was assessed through receiver operating characteristic (ROC) analysis. The Youden’s test assessed sensitivity and specificity of the classification. A null hypothesis probability threshold of 5% was chosen (p < 0.05). The predictive model delivered an AUC of 0.868 (Youden’s index = 0.68, sensitivity = 93%, specificity 75%, p = 4.2 × 10–7). Of the seven features included in the top 5% features, five were texture-related. A radiomics-based machine learning signature showed the potential to accurately differentiate GGOs due to COVID-19 pneumonia from those due to other acute lung diseases. Most of the discriminant radiomics features were texture-related. This approach may assist clinician to adopt the appropriate management early, while improving the triage of patients.
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spelling doaj.art-ca0ccf9204d9467b9413f9ffef0d77892022-12-21T23:00:17ZengNature PortfolioScientific Reports2045-23222021-08-011111910.1038/s41598-021-96755-0Radiomics-based machine learning differentiates “ground-glass” opacities due to COVID-19 from acute non-COVID-19 lung diseaseAndrea Delli Pizzi0Antonio Maria Chiarelli1Piero Chiacchiaretta2Cristina Valdesi3Pierpaolo Croce4Domenico Mastrodicasa5Michela Villani6Stefano Trebeschi7Francesco Lorenzo Serafini8Consuelo Rosa9Giulio Cocco10Riccardo Luberti11Sabrina Conte12Lucia Mazzamurro13Manuela Mereu14Rosa Lucia Patea15Valentina Panara16Stefano Marinari17Jacopo Vecchiet18Massimo Caulo19Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” UniversityDepartment of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” UniversityCenter of Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-PescaraDepartment of Radiology, “Santissima Annunziata” Hospital, “G. d’Annunzio” University of ChietiDepartment of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” UniversityDepartment of Radiology, Stanford University School of MedicineDepartment of Radiology, “Santissima Annunziata” Hospital, “G. d’Annunzio” University of ChietiDepartment of Radiology, Netherlands Cancer InstituteDepartment of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” UniversityDepartment of Radiation Oncology, “Santissima Annunziata” Hospital, “G. d’Annunzio” University of ChietiUnit of Ultrasound in Internal Medicine, Department of Medicine and Science of Aging, “G. D’Annunzio” UniversityDepartment of Radiology, “Santissima Annunziata” Hospital, “G. d’Annunzio” University of ChietiDepartment of Radiology, “Santissima Annunziata” Hospital, “G. d’Annunzio” University of ChietiDepartment of Radiology, “Santissima Annunziata” Hospital, “G. d’Annunzio” University of ChietiDepartment of Radiology, “Santissima Annunziata” Hospital, “G. d’Annunzio” University of ChietiDepartment of Radiology, “Santissima Annunziata” Hospital, “G. d’Annunzio” University of ChietiDepartment of Radiology, “Santissima Annunziata” Hospital, “G. d’Annunzio” University of ChietiDepartment of Pneumology, “Santissima Annunziata” Hospital, “G. d’Annunzio” University of ChietiClinic of Infectious Diseases, Department of Medicine and Science of Aging, University ‘G. d’Annunzio’ Chieti-PescaraDepartment of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” UniversityAbstract Ground-glass opacities (GGOs) are a non-specific high-resolution computed tomography (HRCT) finding tipically observed in early Coronavirus disesase 19 (COVID-19) pneumonia. However, GGOs are also seen in other acute lung diseases, thus making challenging the differential diagnosis. To this aim, we investigated the performance of a radiomics-based machine learning method to discriminate GGOs due to COVID-19 from those due to other acute lung diseases. Two sets of patients were included: a first set of 28 patients (COVID) diagnosed with COVID-19 infection confirmed by real-time polymerase chain reaction (RT-PCR) between March and April 2020 having (a) baseline HRCT at hospital admission and (b) predominant GGOs pattern on HRCT; a second set of 30 patients (nCOVID) showing (a) predominant GGOs pattern on HRCT performed between August 2019 and April 2020 and (b) availability of final diagnosis. Two readers independently segmented GGOs on HRCTs using a semi-automated approach, and radiomics features were extracted using a standard open source software (PyRadiomics). Partial least square (PLS) regression was used as the multivariate machine-learning algorithm. A leave-one-out nested cross-validation was implemented. PLS β-weights of radiomics features, including the 5% features with the largest β-weights in magnitude (top 5%), were obtained. The diagnostic performance of the radiomics model was assessed through receiver operating characteristic (ROC) analysis. The Youden’s test assessed sensitivity and specificity of the classification. A null hypothesis probability threshold of 5% was chosen (p < 0.05). The predictive model delivered an AUC of 0.868 (Youden’s index = 0.68, sensitivity = 93%, specificity 75%, p = 4.2 × 10–7). Of the seven features included in the top 5% features, five were texture-related. A radiomics-based machine learning signature showed the potential to accurately differentiate GGOs due to COVID-19 pneumonia from those due to other acute lung diseases. Most of the discriminant radiomics features were texture-related. This approach may assist clinician to adopt the appropriate management early, while improving the triage of patients.https://doi.org/10.1038/s41598-021-96755-0
spellingShingle Andrea Delli Pizzi
Antonio Maria Chiarelli
Piero Chiacchiaretta
Cristina Valdesi
Pierpaolo Croce
Domenico Mastrodicasa
Michela Villani
Stefano Trebeschi
Francesco Lorenzo Serafini
Consuelo Rosa
Giulio Cocco
Riccardo Luberti
Sabrina Conte
Lucia Mazzamurro
Manuela Mereu
Rosa Lucia Patea
Valentina Panara
Stefano Marinari
Jacopo Vecchiet
Massimo Caulo
Radiomics-based machine learning differentiates “ground-glass” opacities due to COVID-19 from acute non-COVID-19 lung disease
Scientific Reports
title Radiomics-based machine learning differentiates “ground-glass” opacities due to COVID-19 from acute non-COVID-19 lung disease
title_full Radiomics-based machine learning differentiates “ground-glass” opacities due to COVID-19 from acute non-COVID-19 lung disease
title_fullStr Radiomics-based machine learning differentiates “ground-glass” opacities due to COVID-19 from acute non-COVID-19 lung disease
title_full_unstemmed Radiomics-based machine learning differentiates “ground-glass” opacities due to COVID-19 from acute non-COVID-19 lung disease
title_short Radiomics-based machine learning differentiates “ground-glass” opacities due to COVID-19 from acute non-COVID-19 lung disease
title_sort radiomics based machine learning differentiates ground glass opacities due to covid 19 from acute non covid 19 lung disease
url https://doi.org/10.1038/s41598-021-96755-0
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