• PET/CT image radiomics is a quantitative approach assessing different aspects of tumour uptake. • Radiomic features robustness is an important issue over different image reconstruction settings. • Variability and robustness of PET/CT image radiomics in advanced reconstruction settings is feature-dependent. • Robust radiomic features can be considered as good candidates for tumour quantification.

Objective We demonstrate the feasibility of direct generation of attenuation and scatter-corrected images from uncorrected images (PET-nonASC) using deep residual networks in whole-body 18 F-FDG PET imaging. Methods Two-and three-dimensional deep residual networks using 2D successive slices (DL-2DS), 3D slices (DL-3DS) and 3D patches (DL-3DP) as input were constructed to perform joint attenuation and scatter correction on uncorrected whole-body images in an end-to-end fashion. We included 1150 clinical whole-body 18 F-FDG PET/CT studies, among which 900, 100 and 150 patients were randomly partitioned into training, validation and independent validation sets, respectively. The images generated by the proposed approach were assessed using various evaluation metrics, including the root-mean-squared-error (RMSE) and absolute relative error (ARE %) using CT-based attenuation and scatter-corrected (CTAC) PET images as reference. PET image quantification variability was also assessed through voxel-wise standardized uptake value (SUV) bias calculation in different regions of the body (head, neck, chest, liver-lung, abdomen and pelvis). Results Our proposed attenuation and scatter correction (Deep-JASC) algorithm provided good image quality, comparable with those produced by CTAC. Across the 150 patients of the independent external validation set, the voxel-wise REs (%) were − 1.72 ± 4.22%, 3.75 ± 6.91% and − 3.08 ± 5.64 for DL-2DS, DL-3DS and DL-3DP, respectively. Overall, the DL-2DS approach led to superior performance compared with the other two 3D approaches. The brain and neck regions had the highest and lowest RMSE values between Deep-JASC and CTAC images, respectively. However, the largest ARE was observed in the chest (15.16 This article is part of the Topical Collection on Advanced Image Analyses (Radiomics and Artificial Intelligence)

Objective To develop prognostic models for survival (alive or deceased status) prediction of COVID-19 patients using clinical data (demographics and history, laboratory tests, visual scoring by radiologists) and lung/lesion radiomic features extracted from chest CT images. Methods Overall, 152 patients were enrolled in this study protocol. These were divided into 106 training/validation and 46 test datasets (untouched during training), respectively. Radiomic features were extracted from the segmented lungs and infectious lesions separately from chest CT images. Clinical data, including patients’ history and demographics, laboratory tests and radiological scores were also collected. Univariate analysis was first performed (q-value reported after false discovery rate (FDR) correction) to determine the most predictive features among all imaging and clinical data. Prognostic modeling of survival was performed using radiomic features and clinical data, separately or in combination. Maximum relevance minimum redundancy (MRMR) and XGBoost were used for feature selection and classification. The receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC), sensitivity, specificity, and accuracy were used to assess the prognostic performance of the models on the test datasets. Results For clinical data, cancer comorbidity (q-value < 0.01), consciousness level (q-value < 0.05) and radiological score involved zone (q-value < 0.02) were found to have high correlated features with outcome. Oxygen saturation (AUC = 0.73, q-value < 0.01) and Blood Urea Nitrogen (AUC = 0.72, q-value = 0.72) were identified as high clinical features. For lung radiomic features, SAHGLE (AUC = 0.70) and HGLZE (AUC = 0.67) from GLSZM were identified as most prognostic features. Amongst lesion radiomic features, RLNU from GLRLM (AUC = 0.73), HGLZE from GLSZM (AUC = 0.73) had the highest performance. In multivariate analysis, combining lung, lesion and clinical features was determined to provide the most accurate prognostic model (AUC = 0.95 ± 0.029 (95%CI: 0.95-0.96), accuracy = 0.88 ± 0.046 (95% CI: 0.88-0.89), sensitivity = 0.88 ± 0.066 (95% CI = 0.87-0.9) and specificity = 0.89 ± 0.07 (95% CI = 0.87-0.9)). Conclusion Combination of radiomic features and clinical data can effectively predict outcome in COVID-19 patients. The developed model has significant potential for improved management of COVID-19 patients.

Conflicts of Interest:The authors declare no potential conflicts of interest. Abstract PurposeConsiderable progress has been made in assessment and management of NSCLC patients based on mutation status in the EGFR and KRAS. At the same time, NSCLC management through KRAS and EGFR mutation profiling faces some challenges. In the present work, we aimed to evaluate a comprehensive radiomics framework that enabled prediction of EGFR and KRAS mutation status in NSCLC cancer patients based on low dose CT, diagnostic CT, PET modalities radiomic features and machine learning (ML) algorithms. MethodsOur study involved NSCLC cancer patient with 186 PET, and 175 low dose CT and CTD images. More than twenty thousand radiomic features from different image-feature sets were extracted. Conventional clinically used standard uptake value (SUV) parameters were also obtained for PET images. Feature value was normalized to obtain Z-scores, followed by student t-test students for comparison, high correlated features were eliminated and the False discovery rate (FDR) correction were performed and q-value were reported for univariate analysis. Six feature selection methods and twelve classifiers were used to predict gene status in patient. We performed 10-fold cross-validation for model tuning to improve robustness and all model evaluation was reported on independent validation sets (68 patients). The mean area under the receiver operator characteristic (ROC) curve (AUC) was obtained for performance evaluation. ResultsThe best predictive power of conventional PET parameters was achieved by SUVpeak (AUC: 0.69, P-value = 0.0002) and MTV (AUC: 0.55, P-value = 0.0011) for EGFR and KRAS, respectively. Univariate analysis of extracted radiomics features improved prediction power up to AUC: 75 (q-value: 0.003, Short Run Emphasis feature of GLRLM from LOG preprocessed image of PET with sigma value 1.5) and AUC: 0.71 (q-value 0.00005, The Large Dependence Low Gray Level Emphasis from GLDM in LOG preprocessed image of CTD sigma value 5) for EGFR and KRAS, respectively. Furthermore, the machine learning algorithm improved the perdition power up to AUC: 0.82 for EGFR (LOG preprocessed of PET image set with sigma 3 with VT feature selector and SGD classifier) and AUC: 0.83 for KRAS (CT image set with sigma 3.5 with SM feature selector and SGD classifier). ConclusionOur findings demonstrated that non-invasive and reliable radiomics analysis can be successfully used to predict EGFR and KRAS mutation status in NSCLC patients. We demonstrated that radiomic features extracted from different image-feature sets could be used for EGFR and KRAS mutation status prediction in NSCLC patients, and showed that they have more predictive power than conventional imaging parameters.This study was conducted on 211 NSCLC cancer patients with available imaging and genomic data. Imaging modalities, including diagnostic CT (CTD) and PET/CT (i.e., low-dose CT (CT) used for PET attenuation correction and the PET image) for all patients were obtained (29-32) . All images we...

Objectives The current study aimed to design an ultra-low-dose CT examination protocol using a deep learning approach suitable for clinical diagnosis of COVID-19 patients. Methods In this study, 800, 170, and 171 pairs of ultra-low-dose and full-dose CT images were used as input/output as training, test, and external validation set, respectively, to implement the full-dose prediction technique. A residual convolutional neural network was applied to generate full-dose from ultra-low-dose CT images. The quality of predicted CT images was assessed using root mean square error (RMSE), structural similarity index (SSIM), and peak signal-to-noise ratio (PSNR). Scores ranging from 1 to 5 were assigned reflecting subjective assessment of image quality and related COVID-19 features, including ground glass opacities (GGO), crazy paving (CP), consolidation (CS), nodular infiltrates (NI), bronchovascular thickening (BVT), and pleural effusion (PE). Results The radiation dose in terms of CT dose index (CTDI vol ) was reduced by up to 89%. The RMSE decreased from 0.16 ± 0.05 to 0.09 ± 0.02 and from 0.16 ± 0.06 to 0.08 ± 0.02 for the predicted compared with ultra-low-dose CT images in the test and external validation set, respectively. The overall scoring assigned by radiologists showed an acceptance rate of 4.72 ± 0.57 out of 5 for reference full-dose CT images, while ultra-low-dose CT images rated 2.78 ± 0.9. The predicted CT images using the deep learning algorithm achieved a score of 4.42 ± 0.8. Conclusions The results demonstrated that the deep learning algorithm is capable of predicting standard full-dose CT images with acceptable quality for the clinical diagnosis of COVID-19 positive patients with substantial radiation dose reduction. Key Points • Ultra-low-dose CT imaging of COVID-19 patients would result in the loss of critical information about lesion types, which could potentially affect clinical diagnosis. • Deep learning–based prediction of full-dose from ultra-low-dose CT images for the diagnosis of COVID-19 could reduce the radiation dose by up to 89%. • Deep learning algorithms failed to recover the correct lesion structure/density for a number of patients considered outliers, and as such, further research and development is warranted to address these limitations. Electronic supplementary material The online version of this article (10.1007/s00330-020-07225-6) contains supplementary material, which is available to authorized users.