A novel method using machine learning to integrate features from lung and epicardial adipose tissue for detecting the severity of COVID-19 infection

Objectives: To investigate the value of radiomics features of epicardial adipose tissue (EAT) combined with lung for detecting the severity of Coronavirus Disease 2019 (COVID-19) infection. Methods: The retrospective study included data from 515 COVID-19 patients (Cohort1: 415, cohort2: 100) from the two centers between January 2020 and July 2020. A deep learning method was developed to extract the myocardium and visceral pericardium from chest CTs, and then a threshold was applied for automatic EAT extraction. Lung segmentation was achieved according to a published method. Radiomics features of both EAT and lung were extracted for the severity prediction. In a derivation cohort (290, cohort1), univariate analysis and Pearson correlation analysis were used to identify predictors of the severity of COVID-19. A generalized linear regression model for detecting the severity of COVID-19 was built in a derivation cohort and evaluated in internal (125, cohort1) and external (100, cohort2) validation cohorts. Results: For EAT extraction, the Dice similarity coefficients (DSC) of the two centers were 0.972 (0.011) and 0.968 (0.005), respectively. For severity detection, the AUC, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) of the model with radiomics features of both lung and EAT increased by 0.09 (p<0.001), 22.4%, and 17.0%, respectively, compared with the model with lung radiomics features, in the internal validation cohort. The AUC, NRI, and IDI increased by 0.04 (p<0.001), 11.1%, and 8.0%, respectively, in the external validation cohort. Conclusion: Radiomics features of EAT combined with lung have incremental value in detecting the severity of COVID-19.

A Deep Learning-based Method to Extract Lumen and Media-Adventitia in Intravascular Ultrasound Images

Intravascular ultrasound (IVUS) imaging allows direct visualization of the coronary vessel wall and is suitable for the assessment of atherosclerosis and the degree of stenosis. Accurate segmentation and measurements of lumen and median-adventitia (MA) from IVUS are essential for such a successful clinical evaluation. However, current segmentation relies on manual operations, which is time-consuming and user-dependent. In this paper, we aim to develop a deep learning-based method using an encoder-decoder deep architecture to automatically extract both lumen and MA border. Our method named IVUS-U-Net++ is an extension of the well-known U-Net++ model. More specifically, a feature pyramid network was added to the U-Net++ model, enabling the utilization of feature maps at different scales. As a result, the accuracy of the probability map and subsequent segmentation have been improved We collected 1746 IVUS images from 18 patients in this study. The whole dataset was split into a training dataset (1572 images) for the 10-fold cross-validation and a test dataset (174 images) for evaluating the performance of models. Our IVUS-U-Net++ segmentation model achieved a Jaccard measure (JM) of 0.9412, a Hausdorff distance (HD) of 0.0639 mm for the lumen border, and a JM of 0.9509, an HD of 0.0867 mm for the MA border, respectively. Moreover, the Pearson correlation and Bland-Altman analyses were performed to evaluate the correlations of 12 clinical parameters measured from our segmentation results and the ground truth, and automatic measurements agreed well with those from the ground truth (all Ps<0.01). In conclusion, our preliminary results demonstrate that the proposed IVUS-U-Net++ model has great promise for clinical use.