On the Use of Deep Learning for Imaging-Based COVID-19 Detection Using Chest X-rays.
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ABSTRACT:
SUBMITTER: Okolo GI
PROVIDER: S-EPMC8434119 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Chest X-rays (CXRs) can help triage for Coronavirus disease (COVID-19) patients in resource-constrained environments, and a computer-aided detection system (CAD) that can identify pneumonia on CXR may help the triage of patients in those environment where expert radiologists are not available. However, the performance of existing CAD for identifying COVID-19 and associated pneumonia on CXRs has been scarcely investigated. In this study, CXRs of patients with and without COVID-19 confirmed by reverse transcriptase polymerase chain reaction (RT-PCR) were retrospectively collected from four and one institution, respectively, and a commercialized, regulatory-approved CAD that can identify various abnormalities including pneumonia was used to analyze each CXR. Performance of the CAD was evaluated using area under the receiver operating characteristic curves (AUCs), with reference standards of the RT-PCR results and the presence of findings of pneumonia on chest CTs obtained within 24 hours from the CXR. For comparison, 5 thoracic radiologists and 5 non-radiologist physicians independently interpreted the CXRs. Afterward, they re-interpreted the CXRs with corresponding CAD results. The performance of CAD (AUCs, 0.714 and 0.790 against RT-PCR and chest CT, respectively hereinafter) were similar with those of thoracic radiologists (AUCs, 0.701 and 0.784), and higher than those of non-radiologist physicians (AUCs, 0.584 and 0.650). Non-radiologist physicians showed significantly improved performance when assisted with the CAD (AUCs, 0.584 to 0.664 and 0.650 to 0.738). In addition, inter-reader agreement among physicians was also improved in the CAD-assisted interpretation (Fleiss' kappa coefficient, 0.209 to 0.322). In conclusion, radiologist-level performance of the CAD in identifying COVID-19 and associated pneumonia on CXR and enhanced performance of non-radiologist physicians with the CAD assistance suggest that the CAD can support physicians in interpreting CXRs and helping image-based triage of COVID-19 patients in resource-constrained environment.
| S-EPMC8184006 | biostudies-literature
Project description:BackgroundAirspace disease as seen on chest X-rays is an important point in triage for patients initially presenting to the emergency department with suspected COVID-19 infection. The purpose of this study is to evaluate a previously trained interpretable deep learning algorithm for the diagnosis and prognosis of COVID-19 pneumonia from chest X-rays obtained in the ED.MethodsThis retrospective study included 2456 (50% RT-PCR positive for COVID-19) adult patients who received both a chest X-ray and SARS-CoV-2 RT-PCR test from January 2020 to March of 2021 in the emergency department at a single U.S.InstitutionA total of 2000 patients were included as an additional training cohort and 456 patients in the randomized internal holdout testing cohort for a previously trained Siemens AI-Radiology Companion deep learning convolutional neural network algorithm. Three cardiothoracic fellowship-trained radiologists systematically evaluated each chest X-ray and generated an airspace disease area-based severity score which was compared against the same score produced by artificial intelligence. The interobserver agreement, diagnostic accuracy, and predictive capability for inpatient outcomes were assessed. Principal statistical tests used in this study include both univariate and multivariate logistic regression.ResultsOverall ICC was 0.820 (95% CI 0.790-0.840). The diagnostic AUC for SARS-CoV-2 RT-PCR positivity was 0.890 (95% CI 0.861-0.920) for the neural network and 0.936 (95% CI 0.918-0.960) for radiologists. Airspace opacities score by AI alone predicted ICU admission (AUC = 0.870) and mortality (0.829) in all patients. Addition of age and BMI into a multivariate log model improved mortality prediction (AUC = 0.906).ConclusionThe deep learning algorithm provides an accurate and interpretable assessment of the disease burden in COVID-19 pneumonia on chest radiographs. The reported severity scores correlate with expert assessment and accurately predicts important clinical outcomes. The algorithm contributes additional prognostic information not currently incorporated into patient management.
| S-EPMC9301895 | biostudies-literature
Project description:IntroductionThe objective of this study was to assess seven configurations of six convolutional deep neural network architectures for classification of chest X-rays (CXRs) as COVID-19 positive or negative.MethodsThe primary dataset consisted of 294 COVID-19 positive and 294 COVID-19 negative CXRs, the latter comprising roughly equally many pneumonia, emphysema, fibrosis, and healthy images. We used six common convolutional neural network architectures, VGG16, DenseNet121, DenseNet201, MobileNet, NasNetMobile and InceptionV3. We studied six models (one for each architecture) which were pre-trained on a vast repository of generic (non-CXR) images, as well as a seventh DenseNet121 model, which was pre-trained on a repository of CXR images. For each model, we replaced the output layers with custom fully connected layers for the task of binary classification of images as COVID-19 positive or negative. Performance metrics were calculated on a hold-out test set with CXRs from patients who were not included in the training/validation set.ResultsWhen pre-trained on generic images, the VGG16, DenseNet121, DenseNet201, MobileNet, NasNetMobile, and InceptionV3 architectures respectively produced hold-out test set areas under the receiver operating characteristic (AUROCs) of 0.98, 0.95, 0.97, 0.95, 0.99, and 0.96 for the COVID-19 classification of CXRs. The X-ray pre-trained DenseNet121 model, in comparison, had a test set AUROC of 0.87.DiscussionCommon convolutional neural network architectures with parameters pre-trained on generic images yield high-performance and well-calibrated COVID-19 CXR classification.
| S-EPMC8302887 | biostudies-literature
Project description:Presently, COVID-19 has posed a serious threat to researchers, scientists, health professionals, and administrations around the globe from its detection to its treatment. The whole world is witnessing a lockdown like situation because of COVID-19 pandemic. Persistent efforts are being made by the researchers to obtain the possible solutions to control this pandemic in their respective areas. One of the most common and effective methods applied by the researchers is the use of CT-Scans and X-rays to analyze the images of lungs for COVID-19. However, it requires several radiology specialists and time to manually inspect each report which is one of the challenging tasks in a pandemic. In this paper, we have proposed a deep learning neural network-based method nCOVnet, an alternative fast screening method that can be used for detecting the COVID-19 by analyzing the X-rays of patients which will look for visual indicators found in the chest radiography imaging of COVID-19 patients.
| S-EPMC7254021 | biostudies-literature
Project description:The COVID-19 pandemic is causing a major outbreak in more than 150 countries around the world, having a severe impact on the health and life of many people globally. One of the crucial step in fighting COVID-19 is the ability to detect the infected patients early enough, and put them under special care. Detecting this disease from radiography and radiology images is perhaps one of the fastest ways to diagnose the patients. Some of the early studies showed specific abnormalities in the chest radiograms of patients infected with COVID-19. Inspired by earlier works, we study the application of deep learning models to detect COVID-19 patients from their chest radiography images. We first prepare a dataset of 5000 Chest X-rays from the publicly available datasets. Images exhibiting COVID-19 disease presence were identified by board-certified radiologist. Transfer learning on a subset of 2000 radiograms was used to train four popular convolutional neural networks, including ResNet18, ResNet50, SqueezeNet, and DenseNet-121, to identify COVID-19 disease in the analyzed chest X-ray images. We evaluated these models on the remaining 3000 images, and most of these networks achieved a sensitivity rate of 98% ( ± 3%), while having a specificity rate of around 90%. Besides sensitivity and specificity rates, we also present the receiver operating characteristic (ROC) curve, precision-recall curve, average prediction, and confusion matrix of each model. We also used a technique to generate heatmaps of lung regions potentially infected by COVID-19 and show that the generated heatmaps contain most of the infected areas annotated by our board certified radiologist. While the achieved performance is very encouraging, further analysis is required on a larger set of COVID-19 images, to have a more reliable estimation of accuracy rates. The dataset, model implementations (in PyTorch), and evaluations, are all made publicly available for research community at https://github.com/shervinmin/DeepCovid.git.
| S-EPMC7372265 | biostudies-literature
Project description:Acute respiratory distress syndrome (ARDS) is a life-threatening lung injury with global prevalence and high mortality. Chest x-rays (CXR) are critical in the early diagnosis and treatment of ARDS. However, imaging findings may not result in proper identification of ARDS due to a number of reasons, including nonspecific appearance of radiological features, ambiguity in a patient's case due to the pathological stage of the disease, and poor inter-rater reliability from interpretations of CXRs by multiple clinical experts. This study demonstrates the potential capability of methodologies in artificial intelligence, machine learning, and image processing to overcome these challenges and quantitatively assess CXRs for presence of ARDS. We propose and describe Directionality Measure, a novel feature engineering technique used to capture the "cloud-like" appearance of diffuse alveolar damage as a mathematical concept. This study also examines the effectiveness of using an off-the-shelf, pretrained deep learning model as a feature extractor in addition to standard features extracted from the histogram and gray-level co-occurrence matrix (GLCM). Data was collected from hospitalized patients at Michigan Medicine's intensive care unit and the cohort's inclusion criteria was specifically designed to be representative of patients at risk of developing ARDS. Multiple machine learning models were used to evaluate these features with 5-fold cross-validation and the final performance was reported on a hold-out, temporally distinct test set. With AdaBoost, Directionality Measure achieved an accuracy of 78% and AUC of 74% - outperforming classification results using features from the histogram (75% accuracy and 73% AUC), GLCM (76% accuracy and 73% AUC), and ResNet-50 (77% accuracy and 73% AUC). Further experimental results demonstrated that using all feature sets in combination achieved the best overall performance, yielding an accuracy of 83% and AUC of 79% with AdaBoost. These results demonstrate the potential capability of using the proposed methodologies to complement current clinical analysis for detection of ARDS from CXRs.
| S-EPMC9169678 | biostudies-literature
Project description:In today's world, we find ourselves struggling to fight one of the worst pandemics in the history of humanity known as COVID-2019 caused by a coronavirus. When the virus reaches the lungs, we observe ground-glass opacity in the chest X-ray due to fibrosis in the lungs. Due to the significant differences between X-ray images of an infected and non-infected person, artificial intelligence techniques can be used to identify the presence and severity of the infection. We propose a classification model that can analyze the chest X-rays and help in the accurate diagnosis of COVID-19. Our methodology classifies the chest X-rays into four classes viz. normal, pneumonia, tuberculosis (TB), and COVID-19. Further, the X-rays indicating COVID-19 are classified on a severity-basis into mild, medium, and severe. The deep learning model used for the classification of pneumonia, TB, and normal is VGG-16 with a test accuracy of 95.9 %. For the segregation of normal pneumonia and COVID-19, the DenseNet-161 was used with a test accuracy of 98.9 %, whereas the ResNet-18 worked best for severity classification achieving a test accuracy up to 76 %. Our approach allows mass screening of the people using X-rays as a primary validation for COVID-19.Supplementary informationThe online version contains supplementary material available at 10.1007/s42979-021-00695-5.
| S-EPMC8152712 | biostudies-literature
Project description:The Coronavirus (COVID-19) pandemic has created havoc on humanity by causing millions of deaths and adverse physical and mental health effects. To prepare humankind for the fast and efficient detection of the virus and its variants shortly, COVID-19 detection using Artificial Intelligence and Computer-Aided Diagnosis has been the subject of several studies. To detect COVID-19, there are numerous publicly accessible datasets of Chest X-rays that the researchers have combined to solve the problem of inadequate data. The cause for concern here is that in combining two or more datasets, some of the images might be duplicates, so a curated dataset has been used in this study, taken from an author's paper. This dataset consists of 1281 COVID-19, 3270 Normal X-rays, and 1656 viral-pneumonia infected Chest X-ray images. Dataset has been pre-processed and divided carefully to ensure that there are no duplicate images. A comparative study on many traditional pre-trained models was performed, analyzing top-performing models. Fine-tuned InceptionV3, Modified EfficientNet B0&B1 produced an accuracy of 99.78% on binary classification, i.e., covid-19 infected and normal Chest X-ray image. ResNetV2 had a classification accuracy of 97.90% for 3-class classification i.e., covid-19 infected, normal, and pneumonia. Furthermore, a trailblazing custom CNN-based model, CoviXNet, has been proposed consisting of 15 layers that take efficiency into account. The proposed model CoviXNet exhibited a 10-fold accuracy of 99.47% on binary classification and 96.61% on 3-class. CoviXNet has shown phenomenal performance with exceptional accuracy and minimum computational cost. We anticipate that this comparative study, along with the proposed model CoviXNet, can assist medical centers with the efficient real-life detection of Coronavirus.
| S-EPMC9174225 | biostudies-literature
Project description:The rapid spread of COVID-19 across the globe since its emergence has pushed many countries' healthcare systems to the verge of collapse. To restrict the spread of the disease and lessen the ongoing cost on the healthcare system, it is critical to appropriately identify COVID-19-positive individuals and isolate them as soon as possible. The primary COVID-19 screening test, RT-PCR, although accurate and reliable, has a long turn-around time. More recently, various researchers have demonstrated the use of deep learning approaches on chest X-ray (CXR) for COVID-19 detection. However, existing Deep Convolutional Neural Network (CNN) methods fail to capture the global context due to their inherent image-specific inductive bias. In this article, we investigated the use of vision transformers (ViT) for detecting COVID-19 in Chest X-ray (CXR) images. Several ViT models were fine-tuned for the multiclass classification problem (COVID-19, Pneumonia and Normal cases). A dataset consisting of 7598 COVID-19 CXR images, 8552 CXR for healthy patients and 5674 for Pneumonia CXR were used. The obtained results achieved high performance with an Area Under Curve (AUC) of 0.99 for multi-class classification (COVID-19 vs. Other Pneumonia vs. normal). The sensitivity of the COVID-19 class achieved 0.99. We demonstrated that the obtained results outperformed comparable state-of-the-art models for detecting COVID-19 on CXR images using CNN architectures. The attention map for the proposed model showed that our model is able to efficiently identify the signs of COVID-19.
| S-EPMC9181325 | biostudies-literature
Project description:COVID-19 is an infectious and contagious virus. As of this writing, more than 160 million people have been infected since its emergence, including more than 125,000 in Algeria. In this work, We first collected a dataset of 4986 COVID and non-COVID images confirmed by RT-PCR tests at Tlemcen hospital in Algeria. Then we performed a transfer learning on deep learning models that got the best results on the ImageNet dataset, such as DenseNet121, DenseNet201, VGG16, VGG19, Inception Resnet-V2, and Xception, in order to conduct a comparative study. Therefore, We have proposed an explainable model based on the DenseNet201 architecture and the GradCam explanation algorithm to detect COVID-19 in chest CT images and explain the output decision. Experiments have shown promising results and proven that the introduced model can be beneficial for diagnosing and following up patients with COVID-19.
| S-EPMC8455169 | biostudies-literature