Generic placeholder image

Current Medical Imaging


ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Research Article

Heterogeneity Analysis of Chest CT Predict Individual Prognosis of COVID-19 Patients

Author(s): Bo Yang, Bei Zhang, Lichen Gao, Jian Zhang, Huaiming Qiu* and Wencai Huang*

Volume 18, Issue 3, 2022

Published on: 12 January, 2022

Page: [312 - 321] Pages: 10

DOI: 10.2174/1573405617666210916120355

Price: $65


Background: Ground-glass Opacity (GGO) and Consolidation Opacity (CLO) are the common CT lung opacities, and their heterogeneity may have potential for prognosis ofcoronavirus disease-19 (COVID-19) patients.

Objective: This study aimed to estimate clinical outcomes in individual COVID-19 patients using histogram heterogeneity analysis based on CT opacities.

Methods: 71 COVID-19 cases’ medical records were retrospectively reviewed from a designated hospital in Wuhan, China, from January 24th to February 28th at the early stage of the pandemic. Two characteristic lung abnormity opacities, GGO and CLO, were drawn on CT images to identify the heterogeneity using quantitative histogram analysis. The parameters (mean, mode, kurtosis, and skewness) were derived from histograms to evaluate the accuracy of clinical classification and outcome prediction. Nomograms were built to predict the risk of death and median length of hospital stays (LOS), respectively.

Results: A total of 57 COVID-19 cases were eligible for the study cohort after excluding 14 cases. The highest lung abnormalities were GGO mixed with CLO in both the survival populations (26 in 42, 61.9%) and died population (10 in 15, 66.7%). The best performance heterogeneity parameters to discriminate severe type from mild/moderate counterparts were as follows: GGO_skewness: specificity= 66.67%, sensitivity=78.12%, AUC=0.706; CLO_mean: specificity=70.00%, sensitivity= 76.92%, and AUC=0.746. Nomogram based on histogram parameters can predict the individual risk of death and the prolonged median LOS of COVID-19 patients. C-indexes were 0.763 and 0.888 for risk of death and prolonged median LOS, respectively.

Conclusion: Histogram analysis method based on GGO and CLO has the ability for individual risk prediction in COVID-19 patients.

Keywords: COVID-19, nomograms, prognosis, spiral computed tomography, ground- glass opacity, tomography.

Graphical Abstract
Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020; 382(8): 727-33.
[] [PMID: 31978945]
Coronavirus COVID-19 global cases by the center for systems science and engineering (CSSE) at Johns Hopkins University (JHU). 2021. Retrieved from Johns Hopkins CSSE
Inui S, Fujikawa A, Jitsu M, et al. Chest CT findings in cases from the cruise ship diamond princess with Coronavirus disease (COVID-19). Radiol Cardiothorac Imaging 2020; 2(2): e200110.
[] [PMID: 33778566]
Park J, Jung J, Yoon SH, Goo JM, Hong H, Yoon JH. Inspiratory lung expansion in patients with interstitial lung disease: CT histogram analyses. Sci Rep 2018; 8(1): 15265.
[] [PMID: 30323215]
Hansell DM, Bankier AA, MacMahon H, McLoud TC, Müller NL, Remy J. Fleischner Society: Glossary of terms for thoracic imaging. Radiology 2008; 246(3): 697-722.
[] [PMID: 18195376]
Ó Hartaigh B, Gransar H, Callister T, et al. Development and validation of a simple-to-use nomogram for predicting 5-, 10-, and 15-year survival in asymptomatic adults undergoing coronary artery calcium scoring. JACC Cardiovasc Imag 2018; 11(3): 450-8.
[] [PMID: 28624402]
Simpson S, Kay FU, Abbara S, et al. Radiological society of north America expert consensus document on reporting chest CT findings related to COVID-19: endorsed by the society of thoracic Radiology, the American college of Radiology, and RSNA. Radiology. Radiol Cardiothorac Imaging 2020; 2(2): e200152.
[] [PMID: 33778571]
ACR. Recommendations for the use of chest radiography and computed tomography (CT) for suspected COVID-19 infection. Am Coll Radiol 2020; 14. Available in: https://www. acr. org/Advocacy-and-Economics/ACR-Position-Statements/Recommendations-for-Chest-Radiography-and-CT-for-Suspected- COVID19-Infection [Access in, 2020, 14]
Eng J, Bluemke DA. Imaging publications in the COVID-19 pandemic: Applying new research results to clinical practice. Radiology 2020; 297(1): E228-31.
[] [PMID: 32324100]
Li H, Liu L, Zhang D, et al. SARS-CoV-2 and viral sepsis: Observations and hypotheses. Lancet 2020; 395(10235): 1517-20.
[] [PMID: 32311318]
Xu Z, Shi L, Wang Y, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med 2020; 8(4): 420-2.
[] [PMID: 32085846]
Xu Z, Shi L, Wang Y. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med 2020; 8(4): 420-2.
[] [PMID: 32085846]
Fu L, Wang B, Yuan T, et al. Clinical characteristics of coronavirus disease 2019 (COVID-19) in China: A systematic review and meta-analysis. J Infect Dis 2020; 80(6): 656-65.
[PMID: 32283155]
Mao R, Qiu Y, He JS, et al. Manifestations and prognosis of gastrointestinal and liver involvement in patients with COVID-19: A systematic review and meta-analysis. Lancet Gastroenterol Hepatol 2020; 5(7): 667-78.
[] [PMID: 32405603]
Balachandran VP, Gonen M, Smith JJ, DeMatteo RP. Nomograms in oncology: more than meets the eye. Lancet Oncol 2015; 16(4): e173-80.
[] [PMID: 25846097]
Zaki AM, van Boheemen S, Bestebroer TM, Osterhaus AD, Fouchier RA. Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia. N Engl J Med 2012; 367(19): 1814-20.
[] [PMID: 23075143]
Li Q, Guan X, Wu P, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med 2020; 382(13): 1199-207.
[] [PMID: 31995857]
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395(10223): 497-506.
[] [PMID: 31986264]
Jin JM, Bai P, He W, et al. Gender differences in patients with COVID-19: Focus on severity and mortality. Front Public Health 2020; 8: 152.
[] [PMID: 32411652]
Choi WI, Rho BH, Lee MY. Male predominance of pneumonia and hospitalization in pandemic influenza A (H1N1) 2009 infection. BMC Res Notes 2011; 4(1): 351.
[] [PMID: 21906395]
Bernheim A, Mei X, Huang M, et al. Chest CT findings in coronavirus disease-19 (COVID-19): Relationship to duration of infection. Radiology 2020; 295(3): 200463.
[] [PMID: 32077789]
Fang L, Karakiulakis G, Roth M. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? Lancet Respir Med 2020; 8(4): e21.
[] [PMID: 32171062]

Rights & Permissions Print Export Cite as
© 2023 Bentham Science Publishers | Privacy Policy