Computed tomography semi-automated lung volume quantification in SARS-CoV-2-related pneumonia
Davide Ippolito, Maria Ragusi, Davide Gandola, Cesare Maino, Anna Pecorelli, Simone Terrani, M. Peroni, Teresa Giandola, Marco Porta, Cammillo Talei Franzesi, Sandro Sironi
Abstract
Abstract Objectives To evaluate a semi-automated segmentation and ventilated lung quantification on chest computed tomography (CT) to assess lung involvement in patients affected by SARS-CoV-2. Results were compared with clinical and functional parameters and outcomes. Methods All images underwent quantitative analyses with a dedicated workstation using a semi-automatic lung segmentation software to compute ventilated lung volume (VLV), Ground-glass opacity (GGO) volume (GGO-V), and consolidation volume (CONS-V) as absolute volume and as a percentage of total lung volume (TLV). The ratio between CONS-V, GGO-V, and VLV (CONS-V/VLV and GGO-V/VLV, respectively), TLV (CONS-V/TLV, GGO-V/TLV, and GGO-V + CONS-V/TLV respectively), and the ratio between VLV and TLV (VLV/TLV) were calculated. Results A total of 108 patients were enrolled. GGO-V/TLV significantly correlated with WBC ( r = 0.369), neutrophils ( r = 0.446), platelets ( r = 0.182), CRP ( r = 0.190), PaCO 2 ( r = 0.176), HCO 3 − ( r = 0.284), and PaO2/FiO2 (P / F ) values ( r = − 0.344). CONS-V/TLV significantly correlated with WBC ( r = 0.294), neutrophils ( r = 0.300), lymphocytes ( r = −0.225), CRP ( r = 0.306), PaCO 2 ( r = 0.227), pH (r = 0.162), HCO 3 − ( r = 0.394), and P / F ( r = − 0.419) values. Statistically significant differences between CONS-V, GGO-V, GGO-V/TLV, CONS-V/TLV, GGO-V/VLV, CONS-V/VLV, GGO-V + CONS-V/TLV, VLV/TLV, CT score, and invasive ventilation by ET were found (all p < 0.05). Conclusion The use of quantitative semi-automated algorithm for lung CT elaboration effectively correlates the severity of SARS-CoV-2-related pneumonia with laboratory parameters and the need for invasive ventilation. Key Points • Pathological lung volumes, expressed both as GGO-V and as CONS-V, can be considered a useful tool in SARS-CoV-2-related pneumonia. • All lung volumes, expressed themselves and as ratio with TLV and VLV, correlate with laboratory data, in particular C-reactive protein and white blood cell count. • All lung volumes correlate with patient’s outcome, in particular concerning invasive ventilation.