Chest x-ray imaging score is associated with severity of COVID-19 pneumonia: the MBrixia score

Jensen, Christian M; Costa, Junia; Nørgaard, Jens Christian; Zucco, Adrian G.; Neesgaard, Bastian; Niemann, Carsten Utoft; Ostrowski, Sisse Rye; Reekie, Joanne; Holten, Birgit; Kalhauge, Anna; Matthay, Michael A.; Lundgren, Jens D.; Helleberg, Marie; Moestrup, Kasper Sommerlund

doi:10.1038/s41598-022-25397-7

Cited by 4 publications

(1 citation statement)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Newer, highly portable digital CXR devices have been deployed in many high burden TB settings, improving access to medical imaging outside of regional hospitals, and CXRs may aid in the identification of individuals with communicable respiratory diseases including those at greater risk for worsening. (5), (6,7) Such interventions may also be beneficial when future respiratory pandemics arise. Yet, the interpretation of CXR findings, especially in a setting where the caseload of patients with respiratory symptoms is high, requires novel strategies given variation in access to radiologists and expert readers.…”

Section: Introductionmentioning

confidence: 99%

A Comparison of CXR-CAD Software to Radiologists in Identifying COVID-19 in Individuals Evaluated for Sars CoV 2 Infection in Malawi and Zambia

Linsen,

Kamoun,

Gunda

et al. 2024

Preprint

View full text Add to dashboard Cite

Introduction: AI based software, including computer aided detection software for chest radiographs (CXR-CAD), was developed during the pandemic to improve COVID-19 case finding and triage. In high burden TB countries, the use of highly portable CXR and computer aided detection software has been adopted more broadly to improve the screening and triage of individuals for TB, but there is little evidence in these settings regarding COVID-19 CAD performance.Methods: We performed a multicenter, retrospective cross-over study evaluating CXRs from individuals at risk for COVID-19. We evaluated performance of CAD software and radiologists in comparison to COVID-19 laboratory results in 671 individuals evaluated for COVID-19 at sites in Zambia and Malawi between January 2021 and June 2022. All CXRs were interpreted by an expert radiologist and two commercially available COVID-19 CXR-CAD software.Results: Radiologists interpreted CXRs for COVID-19 with a sensitivity of 73% (95% CI: 69%- 76%) and specificity of 49% (95% CI: 40%-58%). One CAD software (CAD2) showed performance in diagnosing COVID-19 that was comparable to that of radiologists, (AUC-ROC of 0.70 (95% CI: 0.65-0.75)), while a second (CAD1) showed inferior performance ( AUC-ROC of 0.57 (95% CI: 0.52-0.63)). Agreement between CAD software and radiologists was moderate for diagnosing COVID-19, and very good agreement in differentiating normal and abnormal CXRs in this high prevalent population.Conclusions: The study highlights the potential of CXR-CAD as a tool to support effective triage of individuals in Malawi and Zambia during the pandemic, particularly for distinguishing normal from abnormal CXRs. These findings suggest that while current AI-based diagnostics like CXR- CAD show promise, their effectiveness varies significantly. In order to better prepare for future pandemics, there is a need for representative training data to optimize performance in key populations, and ongoing data collection to maintain diagnostic accuracy, especially as new disease strains emerge.

show abstract

Section: Introductionmentioning

confidence: 99%

A Comparison of CXR-CAD Software to Radiologists in Identifying COVID-19 in Individuals Evaluated for Sars CoV 2 Infection in Malawi and Zambia

Linsen,

Kamoun,

Gunda

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

Radiographic scores as a predictor of oxygenation index in very low‐birthweight infants

Zuiki,

Asuka,

Hasegawa

et al. 2024

Pediatrics International

View full text Add to dashboard Cite

BackgroundVery low birthweight infants (VLBWIs) often undergo chest radiographic examinations without standardization or objectivity. This study aimed to assess the association of two radiographic scores, the Brixia and radiographic assessment of lung edema (RALE), with oxygenation index (OI) in ventilated VLBWIs and to determine the optimal cutoff values to predict hypoxic respiratory severity.MethodsVLBWIs who received invasive respiratory support with arterial lines between January 2010 and October 2023 were enrolled in this study (n = 144). The correlation between the Brixia or RALE scores and OI was investigated. Receiver operating characteristic curve analysis was performed to determine the optimal cutoff points of the two radiographic scores for predicting OI values (OI ≥5, ≥10, and ≥15).ResultsThe enrolled infants had a median gestational age of 27 weeks (interquartile range [IQR], 25–28 weeks) and a median birthweight of 855 g (IQR, 684–1003 g). Radiographic scoring methods correlated with the OI (Brixia score: r = 0.79, p < 0.001; RALE score: r = 0.72, p < 0.001). The optimal cutoff points for predicting OI values were as follows: Brixia score: OI ≥5, 10; OI ≥10, 13; OI ≥15, 15; RALE score: OI ≥5, 22; OI ≥10, 31; and OI ≥15, 40.ConclusionsBrixia and RALE scores are useful predictive markers of the oxygenation status in intubated VLBWIs with stable hemodynamics. These scores are easy to use and promising tools for clinicians to identify patients with a higher risk of hypoxic respiratory failure.

show abstract

The Impact of Pentraxin 3 Serum Levels and Angiotensin-Converting Enzyme Polymorphism on Pulmonary Infiltrates and Mortality in COVID-19 Patients

Krivdić Dupan,

Periša,

Suver Stević

et al. 2024

Biomedicines

View full text Add to dashboard Cite

Objectives: The aim of this study was to examine the impact of the pentraxin 3 (PTX3) serum level and angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism on the severity of radiographic pulmonary infiltrates and the clinical outcomes of COVID-19. Methods: The severity of COVID-19 pulmonary infiltrates was evaluated within a week of admission by analyzing chest X-rays (CXR) using the modified Brixia (MBrixa) scoring system. The insertion (I)/deletion (D) polymorphism of the ACE gene and the serum levels of PTX3 were determined for all patients included in the study. Results: This study included 80 patients. Using a cut-off serum level of PTX3 ≥ 2.765 ng/mL, the ROC analysis (AUC 0.871, 95% CI 0.787–0.954, p < 0.001) showed a sensitivity of 85.7% and specificity of 78.8% in predicting severe MBrixa scores. Compared to ACE I/I polymorphism, D/D polymorphism significantly increased the risk of severe CXR infiltrates, OR 7.7 (95% CI: 1.9–30.1), and p = 0.002. Significant independent predictors of severe CXR infiltrates include hypertension (OR 7.71), PTX3 (OR 1.20), and ACE D/D polymorphism (OR 18.72). Hypertension (OR 6.91), PTX3 (OR 1.47), and ACE I/I polymorphism (OR 0.09) are significant predictors of poor outcomes. Conclusion: PTX3 and ACE D/D polymorphism are significant predictors of the severity of COVID-19 pneumonia. PTX3 is a significant predictor of death.

show abstract

Chest x-ray imaging score is associated with severity of COVID-19 pneumonia: the MBrixia score

Cited by 4 publications

References 34 publications

A Comparison of CXR-CAD Software to Radiologists in Identifying COVID-19 in Individuals Evaluated for Sars CoV 2 Infection in Malawi and Zambia

A Comparison of CXR-CAD Software to Radiologists in Identifying COVID-19 in Individuals Evaluated for Sars CoV 2 Infection in Malawi and Zambia

Radiographic scores as a predictor of oxygenation index in very low‐birthweight infants

The Impact of Pentraxin 3 Serum Levels and Angiotensin-Converting Enzyme Polymorphism on Pulmonary Infiltrates and Mortality in COVID-19 Patients

Contact Info

Product

Resources

About