An AI-based radiomics nomogram for disease prognosis in patients with COVID-19 pneumonia using initial CT images and clinical indicators

Zhang, Mudan; Zeng, Xianchun; Huang, Chencui; Liu, Jun; Liu, Xinfeng; Xie, Xingzhi; Wang, Rongpin

This study utilized a comprehensive nomogram to evaluate the prognosis of patients with COVID-19 pneumonia. Methods: COVID-19 pneumonia data was divided into training set (256 of 321, 80%), internal validation set (65 of 321, 20%) and independent external validation set (n =188). After image processing, lesion segmentation, feature extraction and feature selection, radiomics signatures and clinical indicators were used to develop a radiomics model and a clinical model respectively. Combining radiomics signatures and clinical indicators, a radiomics nomogram was built. The performance of proposed models was evaluated by the receiver operating characteristic curve (AUC). Calibration curves and decision curve analysis were used to assess the performance of the radiomics nomogram. Results: Two clinical indicators that were age and chronic lung disease or asthma and 21 radiomics features were selected to build the radiomics nomogram. The radiomics nomogram yielded an Area Under The Curve (AUC) of 0.88 and accuracy of 0.80 in the training set, an AUC of 0.85 and accuracy of 0.77 in internal testing validation set and an AUC of 0.84 and accuracy of 0.75 in independent external validation set. The performance of radiomics nomogram was better than clinical model (AUC = 0.77, p <0.001) and radiomics model (AUC = 0.72, p = 0.025) in independent external validation set. Conclusions: The radiomics nomogram may be used to assess the deterioration of COVID-19 pneumonia.