ABSTRACT
PURPOSE: To evaluate the discrimination of parenchymal lesions between COVID-19 and other atypical pneumonia (AP) by using only radiomics features. METHODS: In this retrospective study, 301 pneumonic lesions (150 ground-glass opacity [GGO], 52 crazy paving [CP], 99 consolidation) obtained from nonenhanced thorax CT scans of 74 AP (46 male and 28 female; 48.25±13.67 years) and 60 COVID-19 (39 male and 21 female; 48.01±20.38 years) patients were segmented manually by two independent radiologists, and Location, Size, Shape, and First- and Second-order radiomics features were calculated. RESULTS: Multiple parameters showed significant differences between AP and COVID-19-related GGOs and consolidations, although only the Range parameter was significantly different for CPs. Models developed by using the Bayesian information criterion (BIC) for the whole group of GGO and consolidation lesions predicted COVID-19 consolidation and AP GGO lesions with low accuracy (46.1% and 60.8%, respectively). Thus, instead of subjective classification, lesions were reclassified according to their skewness into positive skewness group (PSG, 78 AP and 71 COVID-19 lesions) and negative skewness group (NSG, 56 AP and 44 COVID-19 lesions), and group-specific models were created. The best AUC, accuracy, sensitivity, and specificity were respectively 0.774, 75.8%, 74.6%, and 76.9% among the PSG models and 0.907, 83%, 79.5%, and 85.7% for the NSG models. The best PSG model was also better at predicting NSG lesions smaller than 3 mL. Using an algorithm, 80% of COVID-19 and 81.1% of AP patients were correctly predicted. CONCLUSION: During periods of increasing AP, radiomics parameters may provide valuable data for the differential diagnosis of COVID-19.
Subject(s)
COVID-19/diagnostic imaging , Pneumonia, Mycoplasma/diagnostic imaging , Tomography, X-Ray Computed/methods , Adult , Aged , Aged, 80 and over , Bayes Theorem , COVID-19/pathology , Cross-Sectional Studies , Diagnosis, Differential , Disease Progression , Female , Humans , Lung/pathology , Lung Diseases, Interstitial/pathology , Male , Middle Aged , Mycoses/pathology , Parenchymal Tissue/diagnostic imaging , Pneumonia, Mycoplasma/pathology , Retrospective Studies , SARS-CoV-2/pathogenicity , Thorax , Tomography, Emission-Computed/methodsSubject(s)
Antibodies, Bacterial/blood , COVID-19/complications , Mucocutaneous Lymph Node Syndrome/complications , Mycoplasma pneumoniae/pathogenicity , Pneumonia, Mycoplasma/complications , SARS-CoV-2/pathogenicity , Severe Acute Respiratory Syndrome/complications , Adolescent , Blotting, Western , COVID-19/diagnosis , COVID-19/pathology , COVID-19/virology , COVID-19 Testing , Child , Child, Preschool , Coinfection , Conjunctivitis/diagnosis , Conjunctivitis/physiopathology , Edema/diagnosis , Edema/physiopathology , Exanthema/diagnosis , Exanthema/physiopathology , Female , Fever/diagnosis , Fever/physiopathology , Humans , Infant , Male , Mucocutaneous Lymph Node Syndrome/diagnosis , Mucocutaneous Lymph Node Syndrome/pathology , Mucocutaneous Lymph Node Syndrome/virology , Mycoplasma pneumoniae/growth & development , Pneumonia, Mycoplasma/diagnosis , Pneumonia, Mycoplasma/microbiology , Pneumonia, Mycoplasma/pathology , SARS-CoV-2/growth & development , Severe Acute Respiratory Syndrome/diagnosis , Severe Acute Respiratory Syndrome/pathology , Severe Acute Respiratory Syndrome/virology , Stomatitis/diagnosis , Stomatitis/physiopathologyABSTRACT
We report a case of childhood coronavirus disease 2019 infection with pleural effusion complicated by possible secondary Mycoplasma pneumoniae infection. Fever and pulmonary lesions on computed tomography were the early clinical manifestations, and the patient developed nonproductive cough later. The hydrothorax in this coronavirus disease 2019 case was exudative, showing predominantly mature lymphocytes.