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Updated: Sep 29, 2025

Lung CT Segmentation to Identify Consolidations and Ground Glass Areas for Quantitative Assesment of SARS-CoV Pneumonia
Published on: December 19, 2020
The Role of 3D CT Imaging in the Accurate Diagnosis of Lung Function in Coronavirus Patients
Ibrahim Shawky Farahat1, Ahmed Sharafeldeen1, Mohamed Elsharkawy1
1BioImaging Laboratory, Department of Bioengineering, University of Louisville, Louisville, KY 40292, USA.
Insights
An automated system grades coronavirus disease 2019 (COVID-19) severity using CT scans. This computer-aided diagnostic tool accurately identifies and quantifies disease, aiding physicians and reducing mortality rates.
Area of Science:
- Medical Imaging
- Artificial Intelligence
- Radiology
Background:
- Coronavirus disease 2019 (COVID-19) poses a global health challenge, necessitating efficient diagnostic tools.
- Accurate grading of COVID-19 severity is crucial for patient management and reducing mortality.
- Physician workload can be reduced through automated diagnostic systems.
Purpose of the Study:
- To develop an automatic Computer-Aided Diagnostic (CAD) system for grading COVID-19 severity from CT images.
- To segment lung regions and extract analytical imaging markers for disease assessment.
- To compare the performance of the developed system against other machine learning classifiers.
Main Methods:
- Unsupervised lung segmentation using an appearance model and 3D rotation invariant Markov-Gibbs Random Field (MGRF).
- Estimation of MGRF-based analytical potentials to generate imaging markers.
- Extraction of statistical markers from Cumulative Distribution Functions (CDF) and classification using a backpropagation neural network.
Main Results:
- The system achieved 100% accuracy and 100% Kappa when trained and tested on lesions.
- Training and testing on lungs yielded 95.83% accuracy and 93.39% Kappa.
- The system demonstrated superior performance compared to k-Nearest Neighbor, decision tree, naïve Bayes, and random forest classifiers.
Conclusions:
- The developed CAD system accurately grades COVID-19 lesions from CT scans.
- The system offers a reliable and efficient tool for assisting physicians in COVID-19 diagnosis and management.
- Automated grading systems show significant potential in improving healthcare outcomes for infectious diseases.
Abstract:
Early grading of coronavirus disease 2019 (COVID-19), as well as ventilator support machines, are prime ways to help the world fight this virus and reduce the mortality rate. To reduce the burden on physicians, we developed an automatic Computer-Aided Diagnostic (CAD) system to grade COVID-19 from Computed Tomography (CT) images. This system segments the lung region from chest CT scans using an unsupervised approach based on an appearance model, followed by 3D rotation invariant Markov-Gibbs Random Field (MGRF)-based morphological constraints. This system analyzes the segmented lung and generates precise, analytical imaging markers by estimating the MGRF-based analytical potentials. Three Gibbs energy markers were extracted from each CT scan by tuning the MGRF parameters on each lesion separately. The latter were healthy/mild, moderate, and severe lesions. To represent these markers more reliably, a Cumulative Distribution Function (CDF) was generated, then statistical markers were extracted from it, namely, 10th through 90th CDF percentiles with 10% increments. Subsequently, the three extracted markers were combined together and fed into a backpropagation neural network to make the diagnosis. The developed system was assessed on 76 COVID-19-infected patients using two metrics, namely, accuracy and Kappa. In this paper, the proposed system was trained and tested by three approaches. In the first approach, the MGRF model was trained and tested on the lungs. This approach achieved 95.83% accuracy and 93.39% kappa. In the second approach, we trained the MGRF model on the lesions and tested it on the lungs. This approach achieved 91.67% accuracy and 86.67% kappa. Finally, we trained and tested the MGRF model on lesions. It achieved 100% accuracy and 100% kappa. The results reported in this paper show the ability of the developed system to accurately grade COVID-19 lesions compared to other machine learning classifiers, such as k-Nearest Neighbor (KNN), decision tree, naïve Bayes, and random forest.
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