COVLIAS 1.0 vs. MedSeg: Artificial Intelligence-Based Comparative Study for Automated COVID-19 Computed Tomography Lung Segmentation in Italian and Croatian Cohorts
Jasjit S. Suri, Sushant Agarwal, Alessandro Carriero, Alessio Paschè, Pietro Danna, Marta Columbu, Luca Saba, Klaudija Višković, Armin Mehmedović, Samriddhi Agarwal, Lakshya Gupta, Gavino Faa, Inder M. Singh, Monika Turk, Paramjit S. Chadha, Amer M. Johri, Narendra N. Khanna, Sophie Mavrogeni, John R. Laird, Gyan Pareek, Martin Miner, David Sobel, Antonella Balestrieri, Petros P. Sfikakis, George Tsoulfas, Athanase D. Protogerou, Durga Prasanna Misra, Vikas Agarwal, George D. Kitas, Jagjit S. Teji, Mustafa Al-Maini, Surinder Dhanjil, Andrew Nicolaides, Aditya Sharma, Vijay Rathore, Mostafa Fatemi, Azra Alizad, Pudukode R. Krishnan, F. Nagy, Zoltán Ruzsa, Archna Gupta, Subbaram Naidu, Kosmas I. Paraskevas, Mannudeep K. Kalra
Abstract
, Roseville, CA, USA, referred to as COVLIAS), against MedSeg, a web-based Artificial Intelligence (AI) segmentation tool, where COVLIAS uses hybrid deep learning (HDL) models for CT lung segmentation. (2) Materials and Methods: The proposed study used 5000 ITALIAN COVID-19 positive CT lung images collected from 72 patients (experimental data) that confirmed the reverse transcription-polymerase chain reaction (RT-PCR) test. Two hybrid AI models from the COVLIAS system, namely, VGG-SegNet (HDL 1) and ResNet-SegNet (HDL 2), were used to segment the CT lungs. As part of the results, we compared both COVLIAS and MedSeg against two manual delineations (MD 1 and MD 2) using (i) Bland-Altman plots, (ii) Correlation coefficient (CC) plots, (iii) Receiver operating characteristic curve, and (iv) Figure of Merit and (v) visual overlays. A cohort of 500 CROATIA COVID-19 positive CT lung images (validation data) was used. A previously trained COVLIAS model was directly applied to the validation data (as part of Unseen-AI) to segment the CT lungs and compare them against MedSeg. (3) Result: For the experimental data, the four CCs between COVLIAS (HDL 1) vs. MD 1, COVLIAS (HDL 1) vs. MD 2, COVLIAS (HDL 2) vs. MD 1, and COVLIAS (HDL 2) vs. MD 2 were 0.96, 0.96, 0.96, and 0.96, respectively. The mean value of the COVLIAS system for the above four readings was 0.96. CC between MedSeg vs. MD 1 and MedSeg vs. MD 2 was 0.98 and 0.98, respectively. Both had a mean value of 0.98. On the validation data, the CC between COVLIAS (HDL 1) vs. MedSeg and COVLIAS (HDL 2) vs. MedSeg was 0.98 and 0.99, respectively. For the experimental data, the difference between the mean values for COVLIAS and MedSeg showed a difference of <2.5%, meeting the standard of equivalence. The average running times for COVLIAS and MedSeg on a single lung CT slice were ~4 s and ~10 s, respectively. (4) Conclusions: The performances of COVLIAS and MedSeg were similar. However, COVLIAS showed improved computing time over MedSeg.