Value of radiomics features from adrenal gland and periadrenal fat CT images predicting COVID-19 progression

BackgroundValue of radiomics features from the adrenal gland and periadrenal fat CT images for predicting disease progression in patients with COVID-19 has not been studied. MethodsA total of 1,245 patients (685 moderate and 560 severe patients) were enrolled in a retrospective study. We proposed 3D V-Net to segment adrenal glands in onset CT images automatically, and periadrenal fat was obtained using inflation operation around the adrenal gland. Next, we built a clinical model (CM), three radiomics models (adrenal gland model [AM], periadrenal fat model [PM], and fusion of adrenal gland and periadrenal fat model [FM]), and radiomics nomogram (RN) after radiomics features extracted to predict disease progression in patients with COVID-19. ResultsThe auto-segmentation framework yielded a dice value of 0.79 in the training set. CM, AM, PM, FM, and RN obtained AUCs of 0.712, 0.692, 0.763, 0.791, and 0.806, respectively in the training set. FM and RN had better predictive efficacy than CM (P < 0.0001) in the training set. RN showed that there was no significant difference in the validation set (mean absolute error [MAE] = 0.04) and test set (MAE = 0.075) between predictive and actual results. Decision curve analysis showed that if the threshold probability was more than 0.3 in the validation set or between 0.4 and 0.8 in the test set, it could gain more net benefits using RN than FM and CM. ConclusionRadiomics features extracted from the adrenal gland and periadrenal fat CT images may predict progression in patients with COVID-19. FundingThis study was funded by Science and Technology Foundation of Guizhou Province (QKHZC [2020]4Y002, QKHPTRC [2019]5803), the Guiyang Science and Technology Project (ZKXM [2020]4), Guizhou Science and Technology Department Key Lab. Project (QKF [2017]25), Beijing Medical and Health Foundation (YWJKJJHKYJJ-B20261CS) and the special fund for basic Research Operating Expenses of public welfare research institutes at the central level from Chinese Academy of Medical Sciences (2019PT320003).