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Register a new userWas there COVID-19 back in 2012? Challenge for AI in Diagnosis with Similar Indications
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Purpose: Since the recent COVID-19 outbreak, there has been an avalanche of research papers applying deep learning based image processing to chest radiographs for detection of the disease. To test the performance of the two top models for CXR COVID-19 diagnosis on external datasets to assess model generalizability. Methods: In this paper, we present our argument regarding the efficiency and applicability of existing deep learning models for COVID-19 diagnosis. We provide results from two popular models - COVID-Net and CoroNet evaluated on three publicly available datasets and an additional institutional dataset collected from EMORY Hospital between January and May 2020, containing patients tested for COVID-19 infection using RT-PCR. Results: There is a large false positive rate (FPR) for COVID-Net on both ChexPert (55.3%) and MIMIC-CXR (23.4%) dataset. On the EMORY Dataset, COVID-Net has 61.4% sensitivity, 0.54 F1-score and 0.49 precision value. The FPR of the CoroNet model is significantly lower across all the datasets as compared to COVID-Net - EMORY(9.1%), ChexPert (1.3%), ChestX-ray14 (0.02%), MIMIC-CXR (0.06%). Conclusion: The models reported good to excellent performance on their internal datasets, however we observed from our testing that their performance dramatically worsened on external data. This is likely from several causes including overfitting models due to lack of appropriate control patients and ground truth labels. The fourth institutional dataset was labeled using RT-PCR, which could be positive without radiographic findings and vice versa. Therefore, a fusion model of both clinical and radiographic data may have better performance and generalization.
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Early detection of the coronavirus disease 2019 (COVID-19) helps to treat patients timely and increase the cure rate, thus further suppressing the spread of the disease. In this study, we propose a novel deep learning based detection and similar case recommendation network to help control the epidemic. Our proposed network contains two stages: the first one is a lung region segmentation step and is used to exclude irrelevant factors, and the second is a detection and recommendation stage. Under this framework, in the second stage, we develop a dual-children network (DuCN) based on a pre-trained ResNet-18 to simultaneously realize the disease diagnosis and similar case recommendation. Besides, we employ triplet loss and intrapulmonary distance maps to assist the detection, which helps incorporate tiny differences between two images and is conducive to improving the diagnostic accuracy. For each confirmed COVID-19 case, we give similar cases to provide radiologists with diagnosis and treatment references. We conduct experiments on a large publicly available dataset (CC-CCII) and compare the proposed model with state-of-the-art COVID-19 detection methods. The results show that our proposed model achieves a promising clinical performance.
The outbreak of novel coronavirus disease (COVID- 19) has claimed millions of lives and has affected all aspects of human life. This paper focuses on the application of deep learning (DL) models to medical imaging and drug discovery for managing COVID-19 disease. In this article, we detail various medical imaging-based studies such as X-rays and computed tomography (CT) images along with DL methods for classifying COVID-19 affected versus pneumonia. The applications of DL techniques to medical images are further described in terms of image localization, segmentation, registration, and classification leading to COVID-19 detection. The reviews of recent papers indicate that the highest classification accuracy of 99.80% is obtained when InstaCovNet-19 DL method is applied to an X-ray dataset of 361 COVID-19 patients, 362 pneumonia patients and 365 normal people. Furthermore, it can be seen that the best classification accuracy of 99.054% can be achieved when EDL_COVID DL method is applied to a CT image dataset of 7500 samples where COVID-19 patients, lung tumor patients and normal people are equal in number. Moreover, we illustrate the potential DL techniques in drug or vaccine discovery in combating the coronavirus. Finally, we address a number of problems, concerns and future research directions relevant to DL applications for COVID-19.
Purpose. Imaging plays an important role in assessing severity of COVID 19 pneumonia. However, semantic interpretation of chest radiography (CXR) findings does not include quantitative description of radiographic opacities. Most current AI assisted CXR image analysis framework do not quantify for regional variations of disease. To address these, we proposed a four region lung segmentation method to assist accurate quantification of COVID 19 pneumonia. Methods. A segmentation model to separate left and right lung is firstly applied, and then a carina and left hilum detection network is used, which are the clinical landmarks to separate the upper and lower lungs. To improve the segmentation performance of COVID 19 images, ensemble strategy incorporating five models is exploited. Using each region, we evaluated the clinical relevance of the proposed method with the Radiographic Assessment of the Quality of Lung Edema (RALE). Results. The proposed ensemble strategy showed dice score of 0.900, which is significantly higher than conventional methods (0.854 0.889). Mean intensities of segmented four regions indicate positive correlation to the extent and density scores of pulmonary opacities under the RALE framework. Conclusion. A deep learning based model in CXR can accurately segment and quantify regional distribution of pulmonary opacities in patients with COVID 19 pneumonia.
The infection of respiratory coronavirus disease 2019 (COVID-19) starts with the upper respiratory tract and as the virus grows, the infection can progress to lungs and develop pneumonia. The conventional way of COVID-19 diagnosis is reverse transcription polymerase chain reaction (RT-PCR), which is less sensitive during early stages; especially if the patient is asymptomatic, which may further cause more severe pneumonia. In this context, several deep learning models have been proposed to identify pulmonary infections using publicly available chest X-ray (CXR) image datasets for early diagnosis, better treatment and quick cure. In these datasets, presence of less number of COVID-19 positive samples compared to other classes (normal, pneumonia and Tuberculosis) raises the challenge for unbiased learning of deep learning models. All deep learning models opted class balancing techniques to solve this issue; which however should be avoided in any medical diagnosis process. Moreover, the deep learning models are also data hungry and need massive computation resources. Therefore for quicker diagnosis, this research proposes a novel pinball loss function based one-class support vector machine (PB-OCSVM), that can work in presence of limited COVID-19 positive CXR samples with objectives to maximize the learning efficiency and to minimize the false predictions. The performance of the proposed model is compared with conventional OCSVM and existing deep learning models, and the experimental results prove that the proposed model outperformed over state-of-the-art methods. To validate the robustness of the proposed model, experiments are also performed with noisy CXR images and UCI benchmark datasets.
Radiological image is currently adopted as the visual evidence for COVID-19 diagnosis in clinical. Using deep models to realize automated infection measurement and COVID-19 diagnosis is important for faster examination based on radiological imaging. Unfortunately, collecting large training data systematically in the early stage is difficult. To address this problem, we explore the feasibility of learning deep models for COVID-19 diagnosis from a single radiological image by resorting to synthesizing diverse radiological images. Specifically, we propose a novel conditional generative model, called CoSinGAN, which can be learned from a single radiological image with a given condition, i.e., the annotations of the lung and COVID-19 infection. Our CoSinGAN is able to capture the conditional distribution of visual finds of COVID-19 infection, and further synthesize diverse and high-resolution radiological images that match the input conditions precisely. Both deep classification and segmentation networks trained on synthesized samples from CoSinGAN achieve notable detection accuracy of COVID-19 infection. Such results are significantly better than the counterparts trained on the same extremely small number of real samples (1 or 2 real samples) by using strong data augmentation, and approximate to the counterparts trained on large dataset (2846 real images). It confirms our method can significantly reduce the performance gap between deep models trained on extremely small dataset and on large dataset, and thus has the potential to realize learning COVID-19 diagnosis from few radiological images in the early stage of COVID-19 pandemic. Our codes are made publicly available at https://github.com/PengyiZhang/CoSinGAN.
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