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Eur Radiol . Computed tomography semi-automated lung volume quantification in SARS-CoV-2-related pneumonia

tetano

Editor, Senior Moderator
Eur Radiol


. 2020 Oct 30.
doi: 10.1007/s00330-020-07271-0. Online ahead of print.
Computed tomography semi-automated lung volume quantification in SARS-CoV-2-related pneumonia


Davide Ippolito[SUP] 1 2 [/SUP], Maria Ragusi[SUP] 3 4 [/SUP], Davide Gandola[SUP] 3 4 [/SUP], Cesare Maino[SUP] 3 4 [/SUP], Anna Pecorelli[SUP] 3 4 [/SUP], Simone Terrani[SUP] 5 [/SUP], Marta Peroni[SUP] 5 [/SUP], Teresa Giandola[SUP] 3 4 [/SUP], Marco Porta[SUP] 3 4 [/SUP], Cammillo Talei Franzesi[SUP] 3 4 [/SUP], Sandro Sironi[SUP] 3 6 [/SUP]



Affiliations

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), PaCO[SUB]2[/SUB] (r = 0.176), HCO[SUB]3[/SUB][SUP]-[/SUP] (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), PaCO[SUB]2[/SUB] (r = 0.227), pH (r = 0.162), HCO[SUB]3[/SUB][SUP]-[/SUP] (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; Infection, coronavirus; Lung volume measurements; Pneumonia.
 
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