Automated Quantification of Pneumonia Infected Volume in Lung CT Images: A Comparison with Subjective Assessment of Radiologists

Seyedehnafiseh Mirniaharikandehei, Alireza Abdihamzehkolaei, Angel Choquehuanca, Marco Aedo, Wilmer Pacheco, Laura Estacio, Victor Cahui, Luis Huallpa, Kevin Quiñonez, Valeria Calderón, Ana Maria Gutierrez, Ana Vargas, Dery Gamero, Eveling Castro-Gutierrez, Yuchen Qiu, Bin Zheng, Javier A. Jo

Research output: Contribution to journalArticlepeer-review


Objective: To help improve radiologists’ efficacy of disease diagnosis in reading computed tomography (CT) images, this study aims to investigate the feasibility of applying a modified deep learning (DL) method as a new strategy to automatically segment disease-infected regions and predict disease severity. Methods: We employed a public dataset acquired from 20 COVID-19 patients, which includes manually annotated lung and infections masks, to train a new ensembled DL model that combines five customized residual attention U-Net models to segment disease infected regions followed by a Feature Pyramid Network model to predict disease severity stage. To test the potential clinical utility of the new DL model, we conducted an observer comparison study. First, we collected another set of CT images acquired from 80 COVID-19 patients and process images using the new DL model. Second, we asked two chest radiologists to read images of each CT scan and report the estimated percentage of the disease-infected lung volume and disease severity level. Third, we also asked radiologists to rate acceptance of DL model-generated segmentation results using a 5-scale rating method. Results: Data analysis results show that agreement of disease severity classification between the DL model and radiologists is >90% in 45 testing cases. Furthermore, >73% of cases received a high rating score (≥4) from two radiologists. Conclusion: This study demonstrates the feasibility of developing a new DL model to automatically segment disease-infected regions and quantitatively predict disease severity, which may help avoid tedious effort and inter-reader variability in subjective assessment of disease severity in future clinical practice.

Original languageEnglish
Article number321
Issue number3
StatePublished - Mar 2023

Bibliographical note

Publisher Copyright:
© 2023 by the authors.


  • COVID-19 detection
  • COVID-19 severity assessment
  • comparison between manual and automated image segmentation
  • deep neural network
  • infected lung segmentation
  • quantification of lung disease severity


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