Chest CT Computerized Aided Quantification of PNEUMONIA Lesions in COVID-19 Infection: A Comparison among Three Commercial Software

Roberto Grassi, Salvatore Cappabianca, Fabrizio Urraro, Beatrice Feragalli, Alessandro Montanelli, Gianluigi Patelli, Vincenza Granata, Giuliana Giacobbe, Gaetano Maria Russo, Assunta Grillo, Angela De Lisio, Cesare Paura, Alfredo Clemente, Giuliano Gagliardi, Simona Magliocchetti, Diletta Cozzi, Roberta Fusco, Maria Paola Belfiore, Roberta Grassi, Vittorio Miele

Research output: Contribution to journalArticlepeer-review


PURPOSE: To compare different commercial software in the quantification of Pneumonia Lesions in COVID-19 infection and to stratify the patients based on the disease severity using on chest computed tomography (CT) images.

MATERIALS AND METHODS: We retrospectively examined 162 patients with confirmed COVID-19 infection by reverse transcriptase-polymerase chain reaction (RT-PCR) test. All cases were evaluated separately by radiologists (visually) and by using three computer software programs: (1) Thoracic VCAR software, GE Healthcare, United States; (2) Myrian, Intrasense, France; (3) InferRead, InferVision Europe, Wiesbaden, Germany. The degree of lesions was visually scored by the radiologist using a score on 5 levels (none, mild, moderate, severe, and critic). The parameters obtained using the computer tools included healthy residual lung parenchyma, ground-glass opacity area, and consolidation volume. Intraclass coefficient (ICC), Spearman correlation analysis, and non-parametric tests were performed.

RESULTS: Thoracic VCAR software was not able to perform volumes segmentation in 26/162 (16.0%) cases, Myrian software in 12/162 (7.4%) patients while InferRead software in 61/162 (37.7%) patients. A great variability (ICC ranged for 0.17 to 0.51) was detected among the quantitative measurements of the residual healthy lung parenchyma volume, GGO, and consolidations volumes calculated by different computer tools. The overall radiological severity score was moderately correlated with the residual healthy lung parenchyma volume obtained by ThoracicVCAR or Myrian software, with the GGO area obtained by the ThoracicVCAR tool and with consolidation volume obtained by Myrian software. Quantified volumes by InferRead software had a low correlation with the overall radiological severity score.

CONCLUSIONS: Computer-aided pneumonia quantification could be an easy and feasible way to stratify COVID-19 cases according to severity; however, a great variability among quantitative measurements provided by computer tools should be considered.

Original languageEnglish
JournalInternational Journal of Environmental Research and Public Health
Issue number18
Publication statusPublished - Sep 22 2020


  • Coronavirus Infections/diagnostic imaging
  • Diagnosis, Computer-Assisted/methods
  • Feasibility Studies
  • Humans
  • Pandemics
  • Pneumonia, Viral/diagnostic imaging
  • Retrospective Studies
  • Severity of Illness Index
  • Software
  • Tomography, X-Ray Computed/methods


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