Large-scale screening to distinguish between COVID-19 and community-acquired pneumonia using infection size-aware classification

The worldwide spread of coronavirus disease (COVID-19) has become a threat to global public health. It is of great importance to rapidly and accurately screen and distinguish patients with COVID-19 from those with community-acquired pneumonia (CAP). In this study, a total of 1,658 patients with COVID-19 and 1,027 CAP patients underwent thin-section CT and were enrolled. All images were preprocessed to obtain the segmentations of infections and lung fields. A set of handcrafted location-specific features was proposed to best capture the COVID-19 distribution pattern, in comparison to the conventional CT severity score (CT-SS) and radiomics features. An infection size-aware random forest method (iSARF) was proposed for discriminating COVID-19 from CAP. Experimental results show that the proposed method yielded its best performance when using the handcrafted features, with a sensitivity of 90.7%, a specificity of 87.2%, and an accuracy of 89.4% over state-of-the-art classifiers. Additional tests on 734 subjects, with thick slice images, demonstrates great generalizability. It is anticipated that our proposed framework could assist clinical decision making.

Automated summary

The study proposed an infection size-aware random forest method for discriminating between COVID-19 and CAP patients, showing promising performance in experimental results and potential in assisting clinical decision-making.