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Background The coronavirus disease 2019 (COVID-19) pandemic has spread across the globe with alarming speed, morbidity, and mortality. Immediate triage of patients with chest infections suspected to be caused by COVID-19 using chest CT may be of assistance when results from definitive viral testing are delayed. Purpose To develop and validate an artificial intelligence (AI) system to score the likelihood and extent of pulmonary COVID-19 on chest CT scans using the COVID-19 Reporting and Data System (CO-RADS) and CT severity scoring systems. Materials and Methods The CO-RADS AI system consists of three deep-learning algorithms that automatically segment the five pulmonary lobes, assign a CO-RADS score for the suspicion of COVID-19, and assign a CT severity score for the degree of parenchymal involvement per lobe. This study retrospectively included patients who underwent a nonenhanced chest CT examination because of clinical suspicion of COVID-19 at two medical centers. The system was trained, validated, and tested with data from one of the centers. Data from the second center served as an external test set. Diagnostic performance and agreement with scores assigned by eight independent observers were measured using receiver operating characteristic analysis, linearly weighted κ values, and classification accuracy. Results A total of 105 patients (mean age, 62 years ± 16 [standard deviation]; 61 men) and 262 patients (mean age, 64 years ± 16; 154 men) were evaluated in the internal and external test sets, respectively. The system discriminated between patients with COVID-19 and those without COVID-19, with areas under the receiver operating characteristic curve of 0.95 (95% CI: 0.91, 0.98) and 0.88 (95% CI: 0.84, 0.93), for the internal and external test sets, respectively. Agreement with the eight human observers was moderate to substantial, with mean linearly weighted κ values of 0.60 ± 0.01 for CO-RADS scores and 0.54 ± 0.01 for CT severity scores. Conclusion With high diagnostic performance, the CO-RADS AI system correctly identified patients with COVID-19 using chest CT scans and assigned standardized CO-RADS and CT severity scores that demonstrated good agreement with findings from eight independent observers and generalized well to external data. © RSNA, 2020

Deep learning is a powerful tool to solve problems in the area of image analysis. The dominant compute platform for deep learning is Nvidia’s proprietary CUDA, which can only be used together with Nvidia graphics cards. The nivida-docker project allows exposing Nvidia graphics cards to docker containers and thus makes it possible to run deep learning experiments in docker containers.In our department, we use deep learning to solve problems in the area of medical image analysis and use docker containers to offer researchers a unified way to set up experiments on machines with inhomogeneous hardware configurations. By running experiments in docker containers, researches can set up their own custom software environments which often depend on the medical image modality that is being analyzed. Experiments can be archived in a docker registry and easily be moved between computers. Differences in hardware configurations can be hidden through the system configuration of the base system. This way, container environments remain largely the same even across different computers.Using graphics hardware from docker containers, however, also introduces extra complications: CUDA uses C-like code that is compiled to binaries that are not necessarily compatible between graphics cards. It is also possible, due to the lack of proper hardware virtualization, to crash the Nvidia driver on the base system which will affect all other containers running on the system.Allowing researchers to define their own runtime environments for their experiments using containers made archiving of experiments more viable. Experiments do not depend on local system configurations anymore and therefore can be moved between systems and expected run. Using graphics hardware from docker containers introduces more complexity, but generally works and should make deep learning experiments more repeatable in the long run.