Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Assessment of the Severity of Coronavirus Disease: Quantitative Computed Tomography Parameters versus Semiquantitative Visual Score

  • Xi Yin (Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology) ;
  • Xiangde Min (Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology) ;
  • Yan Nan (Department of CT & MRI, The First Affiliated Hospital, College of Medicine, Shihezi University) ;
  • Zhaoyan Feng (Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology) ;
  • Basen Li (Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology) ;
  • Wei Cai (Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology) ;
  • Xiaoqing Xi (Department of Geriatrics, The First Affiliated Hospital, College of Medicine, Shihezi University) ;
  • Liang Wang (Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology)
  • Received : 2020.04.09
  • Accepted : 2020.05.02
  • Published : 2020.08.01
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Abstract

Objective: To compare the accuracies of quantitative computed tomography (CT) parameters and semiquantitative visual score in evaluating clinical classification of severity of coronavirus disease (COVID-19). Materials and Methods: We retrospectively enrolled 187 patients with COVID-19 treated at Tongji Hospital of Tongji Medical College from February 15, 2020, to February 29, 2020. Demographic data, imaging characteristics, and clinical data were collected, and based on the clinical classification of severity, patients were divided into groups 1 (mild) and 2 (severe/critical). A semiquantitative visual score was used to estimate the lesion extent. A three-dimensional slicer was used to precisely quantify the volume and CT value of the lung and lesions. Correlation coefficients of the quantitative CT parameters, semiquantitative visual score, and clinical classification were calculated using Spearman's correlation. A receiver operating characteristic curve was used to compare the accuracies of quantitative and semi-quantitative methods. Results: There were 59 patients in group 1 and 128 patients in group 2. The mean age and sex distribution of the two groups were not significantly different. The lesions were primarily located in the subpleural area. Compared to group 1, group 2 had larger values for all volume-dependent parameters (p < 0.001). The percentage of lesions had the strongest correlation with disease severity with a correlation coefficient of 0.495. In comparison, the correlation coefficient of semiquantitative score was 0.349. To classify the severity of COVID-19, area under the curve of the percentage of lesions was the highest (0.807; 95% confidence interval, 0.744-0.861: p < 0.001) and that of the quantitative CT parameters was significantly higher than that of the semiquantitative visual score (p = 0.001). Conclusion: The classification accuracy of quantitative CT parameters was significantly superior to that of semiquantitative visual score in terms of evaluating the severity of COVID-19.

Keywords

Acknowledgement

The authors would like to acknowledge Yao Jing for his assistance in improving the English in this manuscript.

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