Background

The COVID-19 pandemic is a global healthcare emergency. Prediction models for COVID-19 imaging are rapidly being developed to support medical decision making in imaging. However, inadequate availability of a diverse annotated dataset has limited the performance and generalizability of existing models.

Purpose

To create the first multi-institutional, multi-national expert annotated COVID-19 imaging dataset made freely available to the machine learning community as a research and educational resource for COVID-19 chest imaging.

Materials and Methods

This dataset was created through a collaboration between the RSNA and Society of Thoracic Radiology (STR). Pixel-level volumetric segmentation with clinical annotations by thoracic radiology subspecialists was performed for all COVID positive thoracic computed tomography (CT) imaging studies in a labeling schema coordinated with other international consensus panels and COVID data annotation efforts, European Society of Medical Imaging Informatics (EUSOMII), the American College of Radiology (ACR) and the American Association of Physicists in Medicine (AAPM).

Results

The RSNA International COVID-19 Open Annotated Radiology Database (RICORD) consists of 120 thoracic computed tomography (CT) scans from four international sites annotated with detailed segmentation and diagnostic labels.

Patient Selection: Patients at least 18 years in age receiving positive diagnosis for COVID-19.

Data Abstract

1. 120 Chest CT examinations (axial series only, any protocol).
2. Annotations with detailed segmentation; image-level labels (Infectious opacity, Infectious TIB/micronodules, Infectious cavity, Noninfectious nodule/mass, Atalectasis, Other noninfectious opacity) and exam-level labels (Typical, Indeterminate, Atypical, Negative for pneumonia, Halo sign, Reversed halo sign, Reticular pattern w/o parenchymal opacity, Perilesional vessel enlargement, Bronchial wall thickening, Bronchiectasis, Subpleural curvilinear line, Effusion, Pleural thickening, Pneumothorax, Pericardial effusion, Lymphadenopathy, Pulmonary embolism, Normal lung, Infectious lung disease, Emphysema, Oncologic lung disease, Non-infectious inflammatory lung disease, Non-infectious interstitial, Fibrotic lung disease, Other lung disease, With IV contrast, Without IV contrast, QA- inadequate motion/breathing, QA- inadequate insufficient inspiration, QA- inadequate low resolution, QA- inadequate incomplete lungs, QA- inadequate wrong body part/modality, Endotracheal tube, Central venous/arterial line, Nasogastric tube, Sternotomy wires, Pacemaker, Other support apparatus).
3. Supporting clinical variables: MRN*, Age, Exam Date/Time*, Exam Description, Sex, Study UID*, Image Count, Modality, Symptomatic, Testing Result, Specimen Source (* pseudonymous values).

Research Benefits

As this is a public dataset, RICORD is available for non-commercial use (and further enrichment) by the research and education communities which may include development of educational resources for COVID-19, use of RICORD to create AI systems for diagnosis and quantification, benchmarking performance for existing solutions, exploration of distributed/federated learning, further annotation or data augmentation efforts, and evaluation of the examinations for disease entities beyond COVID-19 pneumonia. Deliberate consideration of the detailed annotation schema, demographics, and other included meta-data will be critical when generating cohorts with RICORD, particularly as more public COVID-19 imaging datasets are made available via complementary and parallel efforts. It is important to emphasize that there are limitations to the clinical “ground truth” as the SARS-CoV-2 RT-PCR tests have widely documented limitations and are subject to both false-negative and false-positive results1,4 which impact the distribution of the included imaging data, and may have led to an unknown epidemiologic distortion of patients based on the inclusion criteria. These limitations notwithstanding, RICORD has achieved the stated objectives for data complexity, heterogeneity, and high-quality expert annotations as a comprehensive COVID-19 thoracic imaging data resource.