Development and validation of an automated radiomic CT signature for detecting COVID-19

Guiot, J.; Vaidyanathan, A.; Deprez, L.; Zerka, F.; Danthine, D.; Frix, A.-N.; Thys, M.; Henket, M.; Canivet, G.; Mathieu, S.; Eftaxia, E.; Lambin, P.; Tsoutzidis, N.; Miraglio, B.; Walsh, S.; Moutschen, M.; Louis, R.; Meunier, P.; Vos, W.; Leijenaar, R.; Lovinfosse, P.

Background : The coronavirus disease 2019 (COVID-19) outbreak has reached pandemic status. Drastic measures of social distancing are enforced in society and healthcare systems are being pushed to and over their limits. Objectives : To develop a fully automatic framework to detect COVID-19 by applying AI to chest CT and evaluate validation performance. Methods : In this retrospective multi-site study, a fully automated AI framework was developed to extract radiomics features from volumetric chest CT exams to learn the detection pattern of COVID-19 patients. We analysed the data from 181 RT-PCR confirmed COVID-19 patients as well as 1200 other non-COVID-19 control patients to build and assess the performance of the model. The datasets were collected from 2 different hospital sites of the CHU Liege, Belgium. Diagnostic performance was assessed by the area under the receiver operating characteristic curve (AUC), sensitivity and specificity. Results : 1381 patients were included in this study. The average age was 64.4 and 63.8 years with a gender balance of 56% and 52% male in the COVID-19 and control group, respectively. The final curated dataset used for model construction and validation consisted of chest CT scans of 892 patients. The model sensitivity and specificity for detecting COVID-19 in the test set (training 80% and test 20% of patients) were 78.94% and 91.09%, respectively, with an AUC of 0.9398 (95% CI: 0.875-1). The negative predictive value of the algorithm was found to be larger than 97%. Conclusions : Benchmarked against RT-PCR confirmed cases of COVID-19, our AI framework can accurately differentiate COVID-19 from routine clinical conditions in a fully automated fashion. Thus, providing rapid accurate diagnosis in patients suspected of COVID-19 infection, facilitating the timely implementation of isolation procedures and early intervention.