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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.
Convolutional neural networks are showing promise in the automatic diagnosis of thoracic pathologies on chest x-rays. Their black-box nature has sparked many recent works to explain the prediction via input feature attribution methods (aka saliency methods). However, input feature attribution methods merely identify the importance of input regions for the prediction and lack semantic interpretation of model behavior. In this work, we first identify the semantics associated with internal units (feature maps) of the network. We proceed to investigate the following questions; Does a regression model that is only trained with COVID-19 severity scores implicitly learn visual patterns associated with thoracic pathologies? Does a network that is trained on weakly labeled data (e.g. healthy, unhealthy) implicitly learn pathologies? Moreover, we investigate the effect of pretraining and data imbalance on the interpretability of learned features. In addition to the analysis, we propose semantic attribution to semantically explain each prediction. We present our findings using publicly available chest pathologies (CheXpert, NIH ChestX-ray8) and COVID-19 datasets (BrixIA, and COVID-19 chest X-ray segmentation dataset). The Code is publicly available.
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.
The ongoing global pandemic of Coronavirus Disease 2019 (COVID-19) poses a serious threat to public health and the economy. Rapid and accurate diagnosis of COVID-19 is crucial to prevent the further spread of the disease and reduce its mortality. Chest Computed tomography (CT) is an effective tool for the early diagnosis of lung diseases including pneumonia. However, detecting COVID-19 from CT is demanding and prone to human errors as some early-stage patients may have negative findings on images. Recently, many deep learning methods have achieved impressive performance in this regard. Despite their effectiveness, most of these methods underestimate the rich spatial information preserved in the 3D structure or suffer from the propagation of errors. To address this problem, we propose a Dual-Attention Residual Network (DARNet) to automatically identify COVID-19 from other common pneumonia (CP) and healthy people using 3D chest CT images. Specifically, we design a dual-attention module consisting of channel-wise attention and depth-wise attention mechanisms. The former is utilized to enhance channel independence, while the latter is developed to recalibrate the depth-level features. Then, we integrate them in a unified manner to extract and refine the features at different levels to further improve the diagnostic performance. We evaluate DARNet on a large public CT dataset and obtain superior performance. Besides, the ablation study and visualization analysis prove the effectiveness and interpretability of the proposed method.
Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus. The disease presents with symptoms such as shortness of breath, fever, dry cough, and chronic fatigue, amongst others. Sometimes the symptoms of the disease increase so much they lead to the death of the patients. The disease may be asymptomatic in some patients in the early stages, which can lead to increased transmission of the disease to others. Many studies have tried to use medical imaging for early diagnosis of COVID-19. This study attempts to review papers on automatic methods for medical image analysis and diagnosis of COVID-19. For this purpose, PubMed, Google Scholar, arXiv and medRxiv were searched to find related studies by the end of April 2020, and the essential points of the collected studies were summarised. The contribution of this study is four-fold: 1) to use as a tutorial of the field for both clinicians and technologists, 2) to comprehensively review the characteristics of COVID-19 as presented in medical images, 3) to examine automated artificial intelligence-based approaches for COVID-19 diagnosis based on the accuracy and the method used, 4) to express the research limitations in this field and the methods used to overcome them. COVID-19 reveals signs in medical images can be used for early diagnosis of the disease even in asymptomatic patients. Using automated machine learning-based methods can diagnose the disease with high accuracy from medical images and reduce time, cost and error of diagnostic procedure. It is recommended to collect bulk imaging data from patients in the shortest possible time to improve the performance of COVID-19 automated diagnostic methods.