Thorax computed tomography (CTX) guided ground truth annotation of CHEST radiographs (CXR) for improved classification and detection of COVID-19.

Several data sets have been collected and various artificial intelligence models have been developed for COVID-19 classification and detection from both chest radiography (CXR) and thorax computed tomography (CTX) images. However, the pitfalls and shortcomings of these systems significantly limit their clinical use. In this respect, improving the weaknesses of advanced models can be very effective besides developing new ones. The inability to diagnose ground-glass opacities by conventional CXR has limited the use of this modality in the diagnostic work-up of COVID-19. In our study, we investigated whether we could increase the diagnostic efficiency by collecting a novel CXR data set, which contains pneumonic regions that are not visible to the experts and can only be annotated under CTX guidance. We develop an ensemble methodology of well-established deep CXR models for this new data set and develop a machine learning-based non-maximum suppression strategy to boost the performance for challenging CXR images. CTX and CXR images of 379 patients who applied to our hospital with suspected COVID-19 were evaluated with consensus by seven radiologists. Among these, CXR images of 161 patients who also have had a CTX examination on the same day or until the day before or after and whose CTX findings are compatible with COVID-19 pneumonia, are selected for annotating. CTX images are arranged in the main section passing through the anterior, middle, and posterior according to the sagittal plane with the reformed maximum intensity projection (MIP) method in the coronal plane. Based on the analysis of coronal MIP reconstructed CTX images, the regions corresponding to the pneumonia foci are annotated manually in CXR images. Radiologically classified posterior to anterior (PA) CXR of 218 patients with negative thorax CTX imaging were classified as COVID-19 pneumonia negative group. Accordingly, we have collected a new data set using anonymized CXR (JPEG) and CT (DICOM) images, where the PA CXRs contain pneumonic regions that are hidden or not easily recognized and annotated under CTX guidance. The reference finding was the presence of pneumonic infiltration consistent with COVID-19 on chest CTX examination. COVID-Net, a specially designed convolutional neural network, was used to detect cases of COVID-19 among CXRs. Diagnostic performances were evaluated by ROC analysis by applying six COVID-Net variants (COVIDNet-CXR3-A, -B, -C/COVIDNet-CXR4-A, -B, -C) to the defined data set and combining these models in various ways via ensemble strategies. Finally, a convex optimization strategy is carried out to find the outperforming weighted ensemble of individual models. The mean age of 161 patients with pneumonia was 49.31 ± 15.12, and the median age was 48 years. The mean age of 218 patients without signs of pneumonia in thorax CTX examination was 40.04 ± 14.46, and the median was 38. When working with different combinations of COVID-Net's six variants, the area under the curve (AUC) using the ensemble COVID-Net CXR 4A-4B-3C was .78, sensitivity 67%, specificity 95%; COVID-Net CXR 4a-3b-3c was .79, sensitivity 69% and specificity 94%. When diverse and complementary COVID-Net models are used together through an ensemble, it has been determined that the AUC values are close to other studies, and the specificity is significantly higher than other studies in the literature.

Ertürk ŞM ，Toprak T ，Cömert RG ，Candemir C ，Cingöz E ，Akyol Sari ZN ，Ercan CC ，Düvek E ，Ersoy B ，Karapinar E ，Tunaci A ，Selver MA ... -  《-》

Diagnostic performance of artificial intelligence model for pneumonia from chest radiography.

Kwon T ，Lee SP ，Kim D ，Jang J ，Lee M ，Kang SU ，Kim H ，Oh K ，On J ，Kim YJ ，Yun SJ ，Jin KN ，Kim EY ，Kim KG ... -  《PLoS One》

Implementation of a Deep Learning-Based Computer-Aided Detection System for the Interpretation of Chest Radiographs in Patients Suspected for COVID-19.

To describe the experience of implementing a deep learning-based computer-aided detection (CAD) system for the interpretation of chest X-ray radiographs (CXR) of suspected coronavirus disease (COVID-19) patients and investigate the diagnostic performance of CXR interpretation with CAD assistance. In this single-center retrospective study, initial CXR of patients with suspected or confirmed COVID-19 were investigated. A commercialized deep learning-based CAD system that can identify various abnormalities on CXR was implemented for the interpretation of CXR in daily practice. The diagnostic performance of radiologists with CAD assistance were evaluated based on two different reference standards: 1) real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) results for COVID-19 and 2) pulmonary abnormality suggesting pneumonia on chest CT. The turnaround times (TATs) of radiology reports for CXR and rRT-PCR results were also evaluated. Among 332 patients (male:female, 173:159; mean age, 57 years) with available rRT-PCR results, 16 patients (4.8%) were diagnosed with COVID-19. Using CXR, radiologists with CAD assistance identified rRT-PCR positive COVID-19 patients with sensitivity and specificity of 68.8% and 66.7%, respectively. Among 119 patients (male:female, 75:44; mean age, 69 years) with available chest CTs, radiologists assisted by CAD reported pneumonia on CXR with a sensitivity of 81.5% and a specificity of 72.3%. The TATs of CXR reports were significantly shorter than those of rRT-PCR results (median 51 vs. 507 minutes; p < 0.001). Radiologists with CAD assistance could identify patients with rRT-PCR-positive COVID-19 or pneumonia on CXR with a reasonably acceptable performance. In patients suspected with COVID-19, CXR had much faster TATs than rRT-PCRs.

Hwang EJ ，Kim H ，Yoon SH ，Goo JM ，Park CM ... -  《-》

COVID-DSNet: A novel deep convolutional neural network for detection of coronavirus (SARS-CoV-2) cases from CT and Chest X-Ray images.

COVID-19 (SARS-CoV-2), which causes acute respiratory syndrome, is a contagious and deadly disease that has devastating effects on society and human life. COVID-19 can cause serious complications, especially in patients with pre-existing chronic health problems such as diabetes, hypertension, lung cancer, weakened immune systems, and the elderly. The most critical step in the fight against COVID-19 is the rapid diagnosis of infected patients. Computed Tomography (CT), chest X-ray (CXR), and RT-PCR diagnostic kits are frequently used to diagnose the disease. However, due to difficulties such as the inadequacy of RT-PCR test kits and false negative (FN) results in the early stages of the disease, the time-consuming examination of medical images obtained from CT and CXR imaging techniques by specialists/doctors, and the increasing workload on specialists, it is challenging to detect COVID-19. Therefore, researchers have suggested searching for new methods in COVID- 19 detection. In analysis studies with CT and CXR radiography images, it was determined that COVID-19-infected patients experienced abnormalities related to COVID-19. The anomalies observed here are the primary motivation for artificial intelligence researchers to develop COVID-19 detection applications with deep convolutional neural networks. Here, convolutional neural network-based deep learning algorithms from artificial intelligence technologies with high discrimination capabilities can be considered as an alternative approach in the disease detection process. This study proposes a deep convolutional neural network, COVID-DSNet, to diagnose typical pneumonia (bacterial, viral) and COVID-19 diseases from CT, CXR, hybrid CT + CXR images. In the multi-classification study with the CT dataset, 97.60 % accuracy and 97.60 % sensitivity values were obtained from the COVID-DSNet model, and 100 %, 96.30 %, and 96.58 % sensitivity values were obtained in the detection of typical, common pneumonia and COVID-19, respectively. The proposed model is an economical, practical deep learning network that data scientists can benefit from and develop. Although it is not a definitive solution in disease diagnosis, it may help experts as it produces successful results in detecting pneumonia and COVID-19.

Reis HC ，Turk V 《-》

Chest X-ray image phase features for improved diagnosis of COVID-19 using convolutional neural network.

Qi X ，Brown LG ，Foran DJ ，Nosher J ，Hacihaliloglu I ... -  《-》