AI-Based Chest CT Analysis for Rapid COVID-19 Diagnosis and Prognosis: A Practical Tool to Flag High-Risk Patients and Lower Healthcare Costs

Abstract

Early diagnosis of COVID-19 is required to provide the best treatment to our patients, to prevent the epidemic from spreading in the community, and to reduce costs associated with the aggravation of the disease. We developed a decision tree model to evaluate the impact of using an artificial intelligence-based chest computed tomography (CT) analysis software (icolung, icometrix) to analyze CT scans for the detection and prognosis of COVID-19 cases. The model compared routine practice where patients receiving a chest CT scan were not screened for COVID-19, with a scenario where icolung was introduced to enable COVID-19 diagnosis. The primary outcome was to evaluate the impact of icolung on the transmission of COVID-19 infection, and the secondary outcome was the in-hospital length of stay. Using EUR 20000 as a willingness-to-pay threshold, icolung is cost-effective in reducing the risk of transmission, with a low prevalence of COVID-19 infections. Concerning the hospitalization cost, icolung is cost-effective at a higher value of COVID-19 prevalence and risk of hospitalization. This model provides a framework for the evaluation of AI-based tools for the early detection of COVID-19 cases. It allows for making decisions regarding their implementation in routine practice, considering both costs and effects.

Comparing Visual and Software-Based Quantitative Assessment Scores of Lungs’ Parenchymal Involvement Quantification in COVID-19 Patients

“…The quantitative scoring was performed with a dedicated semi-automatic tool, and the selection of a well-aerated lung was assessed in a range between −950 and −700 HU density. Additionally, Esposito G. et al [16] proposed the Icolung tool (Icometrix, Leuven, Belgium) as a practical tool to flag high-risk patients and lower healthcare costs. The authors created a decision tree analytical model, in which they compared a routine pathway with the one using Icolung as screening tool.…”

“…The first one, "Icolung" (Icometrix, Leuven, Belgium), is a cloud-based software that automatically contours the lungs. Moreover, it returns a report with the percentage of the lung parenchyma involved [16]. This software is based on deep learning (DL) models that sequentially carry out fully automated lung segmentation and lung abnormalities, such as ground-glass opacity (GGO), crazy-paving pattern (CPP) and consolidation.…”

Quantitative Evaluation of COVID-19 Pneumonia CT Using AI Analysis—Feasibility and Differentiation from Other Common Pneumonia Forms

“…The first approaches deal with the identification and successively the severity quantification of COVID-19 in lung CT [ 13 ]. Currently, numerous applications of AI, in different forms, are proposed to facilitate several clinical tasks in the management of COVID-19 [ 23 ].…”

“…A fast-to-site clinically oriented approach is also required to reduce the additional costs in the healthcare system [ 23 ].…”