scholarly journals COVIDScreen: Explainable deep learning framework for differential diagnosis of COVID-19 using chest X-Rays

Author(s):  
Rajeev Kumar Singh ◽  
Rohan Pandey ◽  
Rishie Nandhan Babu

Abstract COVID-19 has emerged as a global crisis with unprecedented socio-economic challenges, jeopardizing our lives and livelihoods for years to come. The unavailability of vaccines for COVID-19 has rendered rapid testing of the population instrumental in order to contain the exponential rise in cases of infection. Shortage of RT-PCR test kits and delay in obtaining test results calls for alternative methods of rapid and reliable diagnosis. In this article, we propose a novel Deep Learning based solution to rapidly classify COVID -19 patient using chest X-Ray. The proposed solution uses image enhancement, image segmentation and employs a modified stacked ensemble model consisting of four CNN base-learners along with Naive Bayes as meta-learner to classify Chest X-Ray into three classes viz. COVID-19, Pneumonia and Normal. An effective pruning strategy as introduced in the proposed framework results in increased model performance, generalisability, and decreased model complexity. We incorporate explainability in our article by using Grad-CAM visualisation in order to establish trust in the medical AI system. Furthermore, we evaluate multiple state of the art GAN architectures and their ability to generate realistic synthetic samples of COVID-19 chest X-Rays to deal with limited numbers of training samples. The proposed solution significantly outperforms existing methods, with 98.67\% accuracy, 0.98 Kappa score, and F-1 scores of 100, 98, and 98 for COVID-19, Normal, and Pneumonia classes respectively on standard datasets. The proposed solution can be used as one element of patient evaluation along with gold standard clinical and laboratory testing.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Makoto Nishimori ◽  
Kunihiko Kiuchi ◽  
Kunihiro Nishimura ◽  
Kengo Kusano ◽  
Akihiro Yoshida ◽  
...  

AbstractCardiac accessory pathways (APs) in Wolff–Parkinson–White (WPW) syndrome are conventionally diagnosed with decision tree algorithms; however, there are problems with clinical usage. We assessed the efficacy of the artificial intelligence model using electrocardiography (ECG) and chest X-rays to identify the location of APs. We retrospectively used ECG and chest X-rays to analyse 206 patients with WPW syndrome. Each AP location was defined by an electrophysiological study and divided into four classifications. We developed a deep learning model to classify AP locations and compared the accuracy with that of conventional algorithms. Moreover, 1519 chest X-ray samples from other datasets were used for prior learning, and the combined chest X-ray image and ECG data were put into the previous model to evaluate whether the accuracy improved. The convolutional neural network (CNN) model using ECG data was significantly more accurate than the conventional tree algorithm. In the multimodal model, which implemented input from the combined ECG and chest X-ray data, the accuracy was significantly improved. Deep learning with a combination of ECG and chest X-ray data could effectively identify the AP location, which may be a novel deep learning model for a multimodal model.


COVID ◽  
2021 ◽  
Vol 1 (1) ◽  
pp. 403-415
Author(s):  
Abeer Badawi ◽  
Khalid Elgazzar

Coronavirus disease (COVID-19) is an illness caused by a novel coronavirus family. One of the practical examinations for COVID-19 is chest radiography. COVID-19 infected patients show abnormalities in chest X-ray images. However, examining the chest X-rays requires a specialist with high experience. Hence, using deep learning techniques in detecting abnormalities in the X-ray images is presented commonly as a potential solution to help diagnose the disease. Numerous research has been reported on COVID-19 chest X-ray classification, but most of the previous studies have been conducted on a small set of COVID-19 X-ray images, which created an imbalanced dataset and affected the performance of the deep learning models. In this paper, we propose several image processing techniques to augment COVID-19 X-ray images to generate a large and diverse dataset to boost the performance of deep learning algorithms in detecting the virus from chest X-rays. We also propose innovative and robust deep learning models, based on DenseNet201, VGG16, and VGG19, to detect COVID-19 from a large set of chest X-ray images. A performance evaluation shows that the proposed models outperform all existing techniques to date. Our models achieved 99.62% on the binary classification and 95.48% on the multi-class classification. Based on these findings, we provide a pathway for researchers to develop enhanced models with a balanced dataset that includes the highest available COVID-19 chest X-ray images. This work is of high interest to healthcare providers, as it helps to better diagnose COVID-19 from chest X-rays in less time with higher accuracy.


2021 ◽  
Vol 11 (21) ◽  
pp. 10301
Author(s):  
Muhammad Shoaib Farooq ◽  
Attique Ur Rehman ◽  
Muhammad Idrees ◽  
Muhammad Ahsan Raza ◽  
Jehad Ali ◽  
...  

COVID-19 has been difficult to diagnose and treat at an early stage all over the world. The numbers of patients showing symptoms for COVID-19 have caused medical facilities at hospitals to become unavailable or overcrowded, which is a major challenge. Studies have recently allowed us to determine that COVID-19 can be diagnosed with the aid of chest X-ray images. To combat the COVID-19 outbreak, developing a deep learning (DL) based model for automated COVID-19 diagnosis on chest X-ray is beneficial. In this research, we have proposed a customized convolutional neural network (CNN) model to detect COVID-19 from chest X-ray images. The model is based on nine layers which uses a binary classification method to differentiate between COVID-19 and normal chest X-rays. It provides COVID-19 detection early so the patients can be admitted in a timely fashion. The proposed model was trained and tested on two publicly available datasets. Cross-dataset studies are used to assess the robustness in a real-world context. Six hundred X-ray images were used for training and two hundred X-rays were used for validation of the model. The X-ray images of the dataset were preprocessed to improve the results and visualized for better analysis. The developed algorithm reached 98% precision, recall and f1-score. The cross-dataset studies also demonstrate the resilience of deep learning algorithms in a real-world context with 98.5 percent accuracy. Furthermore, a comparison table was created which shows that our proposed model outperforms other relative models in terms of accuracy. The quick and high-performance of our proposed DL-based customized model identifies COVID-19 patients quickly, which is helpful in controlling the COVID-19 outbreak.


Author(s):  
Sanhita Basu ◽  
Sushmita Mitra ◽  
Nilanjan Saha

AbstractWith the ever increasing demand for screening millions of prospective “novel coronavirus” or COVID-19 cases, and due to the emergence of high false negatives in the commonly used PCR tests, the necessity for probing an alternative simple screening mechanism of COVID-19 using radiological images (like chest X-Rays) assumes importance. In this scenario, machine learning (ML) and deep learning (DL) offer fast, automated, effective strategies to detect abnormalities and extract key features of the altered lung parenchyma, which may be related to specific signatures of the COVID-19 virus. However, the available COVID-19 datasets are inadequate to train deep neural networks. Therefore, we propose a new concept called domain extension transfer learning (DETL). We employ DETL, with pre-trained deep convolutional neural network, on a related large chest X-Ray dataset that is tuned for classifying between four classes viz. normal, other_disease, pneumonia and Covid — 19. A 5-fold cross validation is performed to estimate the feasibility of using chest X-Rays to diagnose COVID-19. The initial results show promise, with the possibility of replication on bigger and more diverse data sets. The overall accuracy was measured as 95.3% ± 0.02. In order to get an idea about the COVID-19 detection transparency, we employed the concept of Gradient Class Activation Map (Grad-CAM) for detecting the regions where the model paid more attention during the classification. This was found to strongly correlate with clinical findings, as validated by experts.


AI ◽  
2020 ◽  
Vol 1 (3) ◽  
pp. 418-435
Author(s):  
Khandaker Haque ◽  
Ahmed Abdelgawad

Deep Learning has improved multi-fold in recent years and it has been playing a great role in image classification which also includes medical imaging. Convolutional Neural Networks (CNNs) have been performing well in detecting many diseases including coronary artery disease, malaria, Alzheimer’s disease, different dental diseases, and Parkinson’s disease. Like other cases, CNN has a substantial prospect in detecting COVID-19 patients with medical images like chest X-rays and CTs. Coronavirus or COVID-19 has been declared a global pandemic by the World Health Organization (WHO). As of 8 August 2020, the total COVID-19 confirmed cases are 19.18 M and deaths are 0.716 M worldwide. Detecting Coronavirus positive patients is very important in preventing the spread of this virus. On this conquest, a CNN model is proposed to detect COVID-19 patients from chest X-ray images. Two more CNN models with different number of convolution layers and three other models based on pretrained ResNet50, VGG-16 and VGG-19 are evaluated with comparative analytical analysis. All six models are trained and validated with Dataset 1 and Dataset 2. Dataset 1 has 201 normal and 201 COVID-19 chest X-rays whereas Dataset 2 is comparatively larger with 659 normal and 295 COVID-19 chest X-ray images. The proposed model performs with an accuracy of 98.3% and a precision of 96.72% with Dataset 2. This model gives the Receiver Operating Characteristic (ROC) curve area of 0.983 and F1-score of 98.3 with Dataset 2. Moreover, this work shows a comparative analysis of how change in convolutional layers and increase in dataset affect classifying performances.


Sensors ◽  
2021 ◽  
Vol 21 (19) ◽  
pp. 6655
Author(s):  
Michael Horry ◽  
Subrata Chakraborty ◽  
Biswajeet Pradhan ◽  
Manoranjan Paul ◽  
Douglas Gomes ◽  
...  

Lung cancer is the leading cause of cancer death and morbidity worldwide. Many studies have shown machine learning models to be effective in detecting lung nodules from chest X-ray images. However, these techniques have yet to be embraced by the medical community due to several practical, ethical, and regulatory constraints stemming from the “black-box” nature of deep learning models. Additionally, most lung nodules visible on chest X-rays are benign; therefore, the narrow task of computer vision-based lung nodule detection cannot be equated to automated lung cancer detection. Addressing both concerns, this study introduces a novel hybrid deep learning and decision tree-based computer vision model, which presents lung cancer malignancy predictions as interpretable decision trees. The deep learning component of this process is trained using a large publicly available dataset on pathological biomarkers associated with lung cancer. These models are then used to inference biomarker scores for chest X-ray images from two independent data sets, for which malignancy metadata is available. Next, multi-variate predictive models were mined by fitting shallow decision trees to the malignancy stratified datasets and interrogating a range of metrics to determine the best model. The best decision tree model achieved sensitivity and specificity of 86.7% and 80.0%, respectively, with a positive predictive value of 92.9%. Decision trees mined using this method may be considered as a starting point for refinement into clinically useful multi-variate lung cancer malignancy models for implementation as a workflow augmentation tool to improve the efficiency of human radiologists.


2021 ◽  
Vol 11 (22) ◽  
pp. 10528
Author(s):  
Khin Yadanar Win ◽  
Noppadol Maneerat ◽  
Syna Sreng ◽  
Kazuhiko Hamamoto

The ongoing COVID-19 pandemic has caused devastating effects on humanity worldwide. With practical advantages and wide accessibility, chest X-rays (CXRs) play vital roles in the diagnosis of COVID-19 and the evaluation of the extent of lung damages incurred by the virus. This study aimed to leverage deep-learning-based methods toward the automated classification of COVID-19 from normal and viral pneumonia on CXRs, and the identification of indicative regions of COVID-19 biomarkers. Initially, we preprocessed and segmented the lung regions usingDeepLabV3+ method, and subsequently cropped the lung regions. The cropped lung regions were used as inputs to several deep convolutional neural networks (CNNs) for the prediction of COVID-19. The dataset was highly unbalanced; the vast majority were normal images, with a small number of COVID-19 and pneumonia images. To remedy the unbalanced distribution and to avoid biased classification results, we applied five different approaches: (i) balancing the class using weighted loss; (ii) image augmentation to add more images to minority cases; (iii) the undersampling of majority classes; (iv) the oversampling of minority classes; and (v) a hybrid resampling approach of oversampling and undersampling. The best-performing methods from each approach were combined as the ensemble classifier using two voting strategies. Finally, we used the saliency map of CNNs to identify the indicative regions of COVID-19 biomarkers which are deemed useful for interpretability. The algorithms were evaluated using the largest publicly available COVID-19 dataset. An ensemble of the top five CNNs with image augmentation achieved the highest accuracy of 99.23% and area under curve (AUC) of 99.97%, surpassing the results of previous studies.


Author(s):  
Ankita Shelke ◽  
Madhura Inamdar ◽  
Vruddhi Shah ◽  
Amanshu Tiwari ◽  
Aafiya Hussain ◽  
...  

AbstractIn 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. If we detect the virus at an early stage (before it enters the lower respiratory tract), the patient can be treated quickly. Once 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 4 classes viz. normal, pneumonia, tuberculosis (TB), and COVID-19. Further, the X-rays indicating COVID-19 are classified on severity-basis into mild, medium, and severe. The deep learning model used for the classification of pneumonia, TB, and normal is VGG16 with an accuracy of 95.9 %. For the segregation of normal pneumonia and COVID-19, the DenseNet-161 was used with an accuracy of 98.9 %. ResNet-18 worked best for severity classification achieving accuracy up to 76 %. Our approach allows mass screening of the people using X-rays as a primary validation for COVID-19.


Author(s):  
Lawrence Hall ◽  
Dmitry Goldgof ◽  
Rahul Paul ◽  
Gregory M. Goldgof

<p>Testing for COVID-19 has been unable to keep up with the demand. Further, the false negative rate is projected to be as high as 30% and test results can take some time to obtain. X-ray machines are widely available and provide images for diagnosis quickly. This paper explores how useful chest X-ray images can be in diagnosing COVID-19 disease. We have obtained 122 chest X-rays of COVID-19 and over 4,000 chest X-rays of viral and bacterial pneumonia. Unfortunately, we missed the fact that the chest X-rays of viral and bacterial pneumonia came from children under 5 years old. So, this work shows that you can tell kids with pneumonia from COVID-19 adult cases which is not anyone's goal. However, data from adult chest X-rays of other causes of lung disease is needed to see if you can tell adult diseases apart.<br></p>


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Matsumoto ◽  
S Kodera ◽  
H Shinohara ◽  
A Kiyosue ◽  
Y Higashikuni ◽  
...  

Abstract   The development of deep learning technology has enabled machines to achieve high-level accuracy in interpreting medical images. While many previous studies have examined the detection of pulmonary nodules and cardiomegaly in chest X-rays using deep learning, the application of this technology to heart failure remains rare. In this study, we investigated the performance of a deep learning algorithm in terms of diagnosing heart failure using images obtained from chest X-rays. We used 952 chest X-ray images from a labeled database published by the National Institutes of Health. Two cardiologists respectively verified and relabeled these images, for a total of 260 “normal” and 378 “heart failure” images, and the remainder were discarded because they had been incorrectly labeled. In this study “heart failure” was defined as “cardiomegaly or congestion”, in a chest X-ray with cardiothoracic ratio (CTR) over 50% or radiographic presence of pulmonary edema. To enable the machine to extract a sufficient number of features from the images, we used the general machine learning approach called data augmentation and transfer learning. Owing mostly to this technique and the adequate relabeling process, we established a model to detect heart failure in chest X-ray by applying deep learning, and obtained an accuracy of 82%. Sensitivity and specificity to heart failure were 75% and 94.4%, respectively. Furthermore, heatmap imaging allowed us to visualize decisions made by the machine. The figure shows randomly selected examples of the prediction probabilities and heatmaps of the chest X-rays from the dataset. The original image is on the left and its heatmap is on the right, with its prediction probability written below. The red areas on the heatmaps show important regions, according to which the machine determined the classification. While some images with ambiguous radiolucency such as (e) and (f) were prone to be misdiagnosed by this model, most of the images like (a)–(d) were diagnosed correctly. Deep learning can thus help support the diagnosis of heart failure using chest X-ray images. Heatmaps and probabilities of prediction Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): JSPS KAKENHI


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