Dataset Information

Does non-COVID-19 lung lesion help? investigating transferability in COVID-19 CT image segmentation.

ABSTRACT:

Background and objective

Coronavirus disease 2019 (COVID-19) is a highly contagious virus spreading all around the world. Deep learning has been adopted as an effective technique to aid COVID-19 detection and segmentation from computed tomography (CT) images. The major challenge lies in the inadequate public COVID-19 datasets. Recently, transfer learning has become a widely used technique that leverages the knowledge gained while solving one problem and applying it to a different but related problem. However, it remains unclear whether various non-COVID19 lung lesions could contribute to segmenting COVID-19 infection areas and how to better conduct this transfer procedure. This paper provides a way to understand the transferability of non-COVID19 lung lesions and a better strategy to train a robust deep learning model for COVID-19 infection segmentation.

Methods

Based on a publicly available COVID-19 CT dataset and three public non-COVID19 datasets, we evaluate four transfer learning methods using 3D U-Net as a standard encoder-decoder method. i) We introduce the multi-task learning method to get a multi-lesion pre-trained model for COVID-19 infection. ii) We propose and compare four transfer learning strategies with various performance gains and training time costs. Our proposed Hybrid-encoder Learning strategy introduces a Dedicated-encoder and an Adapted-encoder to extract COVID-19 infection features and general lung lesion features, respectively. An attention-based Selective Fusion unit is designed for dynamic feature selection and aggregation.

Results

Experiments show that trained with limited data, proposed Hybrid-encoder strategy based on multi-lesion pre-trained model achieves a mean DSC, NSD, Sensitivity, F1-score, Accuracy and MCC of 0.704, 0.735, 0.682, 0.707, 0.994 and 0.716, respectively, with better genetalization and lower over-fitting risks for segmenting COVID-19 infection.

Conclusions

The results reveal the benefits of transferring knowledge from non-COVID19 lung lesions, and learning from multiple lung lesion datasets can extract more general features, leading to accurate and robust pre-trained models. We further show the capability of the encoder to learn feature representations of lung lesions, which improves segmentation accuracy and facilitates training convergence. In addition, our proposed Hybrid-encoder learning method incorporates transferred lung lesion features from non-COVID19 datasets effectively and achieves significant improvement. These findings promote new insights into transfer learning for COVID-19 CT image segmentation, which can also be further generalized to other medical tasks.

SUBMITTER: Wang Y

PROVIDER: S-EPMC7899930 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundCoronavirus disease 2019 (COVID-19) is very contagious. Cases appear faster than the available Polymerase Chain Reaction test kits in many countries. Recently, lung computerized tomography (CT) has been used as an auxiliary COVID-19 testing approach. Automatic analysis of the lung CT images is needed to increase the diagnostic efficiency and release the human participant. Deep learning is successful in automatically solving computer vision problems. Thus, it can be introduced to the automatic and rapid COVID-19 CT diagnosis. Many advanced deep learning-based computer vison techniques were developed to increase the model performance but have not been introduced to medical image analysis.MethodsIn this study, we propose a self-supervised two-stage deep learning model to segment COVID-19 lesions (ground-glass opacity and consolidation) from chest CT images to support rapid COVID-19 diagnosis. The proposed deep learning model integrates several advanced computer vision techniques such as generative adversarial image inpainting, focal loss, and lookahead optimizer. Two real-life datasets were used to evaluate the model's performance compared to the previous related works. To explore the clinical and biological mechanism of the predicted lesion segments, we extract some engineered features from the predicted lung lesions. We evaluate their mediation effects on the relationship of age with COVID-19 severity, as well as the relationship of underlying diseases with COVID-19 severity using statistic mediation analysis.ResultsThe best overall F1 score is observed in the proposed self-supervised two-stage segmentation model (0.63) compared to the two related baseline models (0.55, 0.49). We also identified several CT image phenotypes that mediate the potential causal relationship between underlying diseases with COVID-19 severity as well as the potential causal relationship between age with COVID-19 severity.ConclusionsThis work contributes a promising COVID-19 lung CT image segmentation model and provides predicted lesion segments with potential clinical interpretability. The model could automatically segment the COVID-19 lesions from the raw CT images with higher accuracy than related works. The features of these lesions are associated with COVID-19 severity through mediating the known causal of the COVID-19 severity (age and underlying diseases).

Project description:Automatic lung lesion segmentation of chest computer tomography (CT) scans is considered a pivotal stage toward accurate diagnosis and severity measurement of COVID-19. Traditional U-shaped encoder-decoder architecture and its variants suffer from diminutions of contextual information in pooling/upsampling operations with increased semantic gaps among encoded and decoded feature maps as well as instigate vanishing gradient problems for its sequential gradient propagation that result in suboptimal performance. Moreover, operating with 3-D CT volume poses further limitations due to the exponential increase of computational complexity making the optimization difficult. In this article, an automated COVID-19 lesion segmentation scheme is proposed utilizing a highly efficient neural network architecture, namely CovSegNet, to overcome these limitations. Additionally, a two-phase training scheme is introduced where a deeper 2-D network is employed for generating region-of-interest (ROI)-enhanced CT volume followed by a shallower 3-D network for further enhancement with more contextual information without increasing computational burden. Along with the traditional vertical expansion of Unet, we have introduced horizontal expansion with multistage encoder-decoder modules for achieving optimum performance. Additionally, multiscale feature maps are integrated into the scale transition process to overcome the loss of contextual information. Moreover, a multiscale fusion module is introduced with a pyramid fusion scheme to reduce the semantic gaps between subsequent encoder/decoder modules while facilitating the parallel optimization for efficient gradient propagation. Outstanding performances have been achieved in three publicly available datasets that largely outperform other state-of-the-art approaches. The proposed scheme can be easily extended for achieving optimum segmentation performances in a wide variety of applications. Impact Statement-With lower sensitivity (60-70%), elongated testing time, and a dire shortage of testing kits, traditional RTPCR based COVID-19 diagnostic scheme heavily relies on postCT based manual inspection for further investigation. Hence, automating the process of infected lesions extraction from chestCT volumes will be major progress for faster accurate diagnosis of COVID-19. However, in challenging conditions with diffused, blurred, and varying shaped edges of COVID-19 lesions, conventional approaches fail to provide precise segmentation of lesions that can be deleterious for false estimation and loss of information. The proposed scheme incorporating an efficient neural network architecture (CovSegNet) overcomes the limitations of traditional approaches that provide significant improvement of performance (8.4% in averaged dice measurement scale) over two datasets. Therefore, this scheme can be an effective, economical tool for the physicians for faster infection analysis to greatly reduce the spread and massive death toll of this deadly virus through mass-screening.

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Project description:The recent global outbreak and spread of coronavirus disease (COVID-19) makes it an imperative to develop accurate and efficient diagnostic tools for the disease as medical resources are getting increasingly constrained. Artificial intelligence (AI)-aided tools have exhibited desirable potential; for example, chest computed tomography (CT) has been demonstrated to play a major role in the diagnosis and evaluation of COVID-19. However, developing a CT-based AI diagnostic system for the disease detection has faced considerable challenges, which is mainly due to the lack of adequate manually-delineated samples for training, as well as the requirement of sufficient sensitivity to subtle lesions in the early infection stages. In this study, we developed a dual-branch combination network (DCN) for COVID-19 diagnosis that can simultaneously achieve individual-level classification and lesion segmentation. To focus the classification branch more intensively on the lesion areas, a novel lesion attention module was developed to integrate the intermediate segmentation results. Furthermore, to manage the potential influence of different imaging parameters from individual facilities, a slice probability mapping method was proposed to learn the transformation from slice-level to individual-level classification. We conducted experiments on a large dataset of 1202 subjects from ten institutes in China. The results demonstrated that 1) the proposed DCN attained a classification accuracy of 96.74% on the internal dataset and 92.87% on the external validation dataset, thereby outperforming other models; 2) DCN obtained comparable performance with fewer samples and exhibited higher sensitivity, especially in subtle lesion detection; and 3) DCN provided good interpretability on the loci of infection compared to other deep models due to its classification guided by high-level semantic information. An online CT-based diagnostic platform for COVID-19 derived from our proposed framework is now available.