Using X-ray images and deep learning for automated detection of coronavirus disease

Digital imaging, technologies and artificial intelligence applications during COVID-19 pandemic

The advancement of technology remained an immersive interest for humankind throughout the past decades. Tech enterprises offered a stream of innovation to address the universal healthcare concerns. The novel coronavirus holds a substantial foothold of planet earth which is combatted by digital interventions across afflicted geographical boundaries and territories. This study aims to explore the trends of modern healthcare technologies and Artificial Intelligence (AI) during COVID-19 crisis, define the concepts and clinical role of AI in the mitigation of COVID-19, investigate and correlate the efficacy of AI-enabled technology in medical imaging during COVID-19 and determine advantages, drawbacks, and challenges of artificial intelligence during COVID-19 pandemic. The paper applied systematic review approach using a deliberated research protocol and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow chart. Digital technologies can coordinate COVID-19 responses in a cascade fashion that extends from the clinical care facility to the exterior of the pending viral epicenter. With cases of healthcare robotics, aerial drones, and the internet of things as evidentiary examples. PCR tests and medical imaging are the frontier diagnostics of COVID-19. Computed tomography helped to correct the accuracy variation of PCR tests at a clinical sensitivity of 98 %. Artificial intelligence can enable autonomous COVID-19 responses using techniques like machine learning. Technology could be an endless system of innovation and opportunities when sourced effectively. Scientists can utilize technology to resolve global concerns challenging the history of tangible possibility. Digital interventions have enhanced the responses to COVID-19, magnified the role of medical imaging amid the COVID-19 crisis and have exposed healthcare professionals to the opportunity of contactless care.

Transfer Learning to Detect COVID-19 Automatically from X-Ray Images Using Convolutional Neural Networks

The novel coronavirus disease 2019 (COVID-19) is a contagious disease that has caused thousands of deaths and infected millions worldwide. Thus, various technologies that allow for the fast detection of COVID-19 infections with high accuracy can offer healthcare professionals much-needed help. This study is aimed at evaluating the effectiveness of the state-of-the-art pretrained Convolutional Neural Networks (CNNs) on the automatic diagnosis of COVID-19 from chest X-rays (CXRs). The dataset used in the experiments consists of 1200 CXR images from individuals with COVID-19, 1345 CXR images from individuals with viral pneumonia, and 1341 CXR images from healthy individuals. In this paper, the effectiveness of artificial intelligence (AI) in the rapid and precise identification of COVID-19 from CXR images has been explored based on different pretrained deep learning algorithms and fine-tuned to maximise detection accuracy to identify the best algorithms. The results showed that deep learning with X-ray imaging is useful in collecting critical biological markers associated with COVID-19 infections. VGG16 and MobileNet obtained the highest accuracy of 98.28%. However, VGG16 outperformed all other models in COVID-19 detection with an accuracy, F1 score, precision, specificity, and sensitivity of 98.72%, 97.59%, 96.43%, 98.70%, and 98.78%, respectively. The outstanding performance of these pretrained models can significantly improve the speed and accuracy of COVID-19 diagnosis. However, a larger dataset of COVID-19 X-ray images is required for a more accurate and reliable identification of COVID-19 infections when using deep transfer learning. This would be extremely beneficial in this pandemic when the disease burden and the need for preventive measures are in conflict with the currently available resources.

Discovery of a Generalization Gap of Convolutional Neural Networks on COVID-19 X-Rays Classification

A number of recent papers have shown experimental evidence that suggests it is possible to build highly accurate deep neural network models to detect COVID-19 from chest X-ray images. In this paper, we show that good generalization to unseen sources has not been achieved. Experiments with richer data sets than have previously been used show models have high accuracy on seen sources, but poor accuracy on unseen sources. The reason for the disparity is that the convolutional neural network model, which learns features, can focus on differences in X-ray machines or in positioning within the machines, for example. Any feature that a person would clearly rule out is called a confounding feature. Some of the models were trained on COVID-19 image data taken from publications, which may be different than raw images. Some data sets were of pediatric cases with pneumonia where COVID-19 chest X-rays are almost exclusively from adults, so lung size becomes a spurious feature that can be exploited. In this work, we have eliminated many confounding features by working with as close to raw data as possible. Still, deep learned models may leverage source specific confounders to differentiate COVID-19 from pneumonia preventing generalizing to new data sources (i.e. external sites). Our models have achieved an AUC of 1.00 on seen data sources but in the worst case only scored an AUC of 0.38 on unseen ones. This indicates that such models need further assessment/development before they can be broadly clinically deployed. An example of fine-tuning to improve performance at a new site is given.

FocusCovid: automated COVID-19 detection using deep learning with chest X-ray images

COVID-19 is an acronym for coronavirus disease 2019. Initially, it was called 2019-nCoV, and later International Committee on Taxonomy of Viruses (ICTV) termed it SARS-CoV-2. On 30th January 2020, the World Health Organization (WHO) declared it a pandemic. With an increasing number of COVID-19 cases, the available medical infrastructure is essential to detect the suspected cases. Medical imaging techniques such as Computed Tomography (CT), chest radiography can play an important role in the early screening and detection of COVID-19 cases. It is important to identify and separate the cases to stop the further spread of the virus. Artificial Intelligence can play an important role in COVID-19 detection and decreases the workload on collapsing medical infrastructure. In this paper, a deep convolutional neural network-based architecture is proposed for the COVID-19 detection using chest radiographs. The dataset used to train and test the model is available on different public repositories. Despite having the high accuracy of the model, the decision on COVID-19 should be made in consultation with the trained medical clinician.

ai-corona: Radiologist-assistant deep learning framework for COVID-19 diagnosis in chest CT scans

The development of medical assisting tools based on artificial intelligence advances is essential in the global fight against COVID-19 outbreak and the future of medical systems. In this study, we introduce ai-corona, a radiologist-assistant deep learning framework for COVID-19 infection diagnosis using chest CT scans. Our framework incorporates an EfficientNetB3-based feature extractor. We employed three datasets; the CC-CCII set, the MasihDaneshvari Hospital (MDH) cohort, and the MosMedData cohort. Overall, these datasets constitute 7184 scans from 5693 subjects and include the COVID-19, non-COVID abnormal (NCA), common pneumonia (CP), non-pneumonia, and Normal classes. We evaluate ai-corona on test sets from the CC-CCII set, MDH cohort, and the entirety of the MosMedData cohort, for which it gained AUC scores of 0.997, 0.989, and 0.954, respectively. Our results indicates ai-corona outperforms all the alternative models. Lastly, our framework's diagnosis capabilities were evaluated as assistant to several experts. Accordingly, We observed an increase in both speed and accuracy of expert diagnosis when incorporating ai-corona's assistance.

Convolutional Sparse Support Estimator-Based COVID-19 Recognition From X-Ray Images

Coronavirus disease (COVID-19) has been the main agenda of the whole world ever since it came into sight. X-ray imaging is a common and easily accessible tool that has great potential for COVID-19 diagnosis and prognosis. Deep learning techniques can generally provide state-of-the-art performance in many classification tasks when trained properly over large data sets. However, data scarcity can be a crucial obstacle when using them for COVID-19 detection. Alternative approaches such as representation-based classification [collaborative or sparse representation (SR)] might provide satisfactory performance with limited size data sets, but they generally fall short in performance or speed compared to the neural network (NN)-based methods. To address this deficiency, convolution support estimation network (CSEN) has recently been proposed as a bridge between representation-based and NN approaches by providing a noniterative real-time mapping from query sample to ideally SR coefficient support, which is critical information for class decision in representation-based techniques. The main premises of this study can be summarized as follows: 1) A benchmark X-ray data set, namely QaTa-Cov19, containing over 6200 X-ray images is created. The data set covering 462 X-ray images from COVID-19 patients along with three other classes; bacterial pneumonia, viral pneumonia, and normal. 2) The proposed CSEN-based classification scheme equipped with feature extraction from state-of-the-art deep NN solution for X-ray images, CheXNet, achieves over 98% sensitivity and over 95% specificity for COVID-19 recognition directly from raw X-ray images when the average performance of 5-fold cross validation over QaTa-Cov19 data set is calculated. 3) Having such an elegant COVID-19 assistive diagnosis performance, this study further provides evidence that COVID-19 induces a unique pattern in X-rays that can be discriminated with high accuracy.

Machine learning research towards combating COVID-19: Virus detection, spread prevention, and medical assistance

COVID-19 was first discovered in December 2019 and has continued to rapidly spread across countries worldwide infecting thousands and millions of people. The virus is deadly, and people who are suffering from prior illnesses or are older than the age of 60 are at a higher risk of mortality. Medicine and Healthcare industries have surged towards finding a cure, and different policies have been amended to mitigate the spread of the virus. While Machine Learning (ML) methods have been widely used in other domains, there is now a high demand for ML-aided diagnosis systems for screening, tracking, predicting the spread of COVID-19 and finding a cure against it. In this paper, we present a journey of what role ML has played so far in combating the virus, mainly looking at it from a screening, forecasting, and vaccine perspective. We present a comprehensive survey of the ML algorithms and models that can be used on this expedition and aid with battling the virus.

Exploring the effect of image enhancement techniques on COVID-19 detection using chest X-ray images

Computer-aided diagnosis for the reliable and fast detection of coronavirus disease (COVID-19) has become a necessity to prevent the spread of the virus during the pandemic to ease the burden on the healthcare system. Chest X-ray (CXR) imaging has several advantages over other imaging and detection techniques. Numerous works have been reported on COVID-19 detection from a smaller set of original X-ray images. However, the effect of image enhancement and lung segmentation of a large dataset in COVID-19 detection was not reported in the literature. We have compiled a large X-ray dataset (COVQU) consisting of 18,479 CXR images with 8851 normal, 6012 non-COVID lung infections, and 3616 COVID-19 CXR images and their corresponding ground truth lung masks. To the best of our knowledge, this is the largest public COVID positive database and the lung masks. Five different image enhancement techniques: histogram equalization (HE), contrast limited adaptive histogram equalization (CLAHE), image complement, gamma correction, and balance contrast enhancement technique (BCET) were used to investigate the effect of image enhancement techniques on COVID-19 detection. A novel U-Net model was proposed and compared with the standard U-Net model for lung segmentation. Six different pre-trained Convolutional Neural Networks (CNNs) (ResNet18, ResNet50, ResNet101, InceptionV3, DenseNet201, and ChexNet) and a shallow CNN model were investigated on the plain and segmented lung CXR images. The novel U-Net model showed an accuracy, Intersection over Union (IoU), and Dice coefficient of 98.63%, 94.3%, and 96.94%, respectively for lung segmentation. The gamma correction-based enhancement technique outperforms other techniques in detecting COVID-19 from the plain and the segmented lung CXR images. Classification performance from plain CXR images is slightly better than the segmented lung CXR images; however, the reliability of network performance is significantly improved for the segmented lung images, which was observed using the visualization technique. The accuracy, precision, sensitivity, F1-score, and specificity were 95.11%, 94.55%, 94.56%, 94.53%, and 95.59% respectively for the segmented lung images. The proposed approach with very reliable and comparable performance will boost the fast and robust COVID-19 detection using chest X-ray images.

A Novel Method for COVID-19 Diagnosis Using Artificial Intelligence in Chest X-ray Images

The Coronavirus disease 2019 (COVID-19) is an infectious disease spreading rapidly and uncontrollably throughout the world. The critical challenge is the rapid detection of Coronavirus infected people. The available techniques being utilized are body-temperature measurement, along with anterior nasal swab analysis. However, taking nasal swabs and lab testing are complex, intrusive, and require many resources. Furthermore, the lack of test kits to meet the exceeding cases is also a major limitation. The current challenge is to develop some technology to non-intrusively detect the suspected Coronavirus patients through Artificial Intelligence (AI) techniques such as deep learning (DL). Another challenge to conduct the research on this area is the difficulty of obtaining the dataset due to a limited number of patients giving their consent to participate in the research study. Looking at the efficacy of AI in healthcare systems, it is a great challenge for the researchers to develop an AI algorithm that can help health professionals and government officials automatically identify and isolate people with Coronavirus symptoms. Hence, this paper proposes a novel method CoVIRNet (COVID Inception-ResNet model), which utilizes the chest X-rays to diagnose the COVID-19 patients automatically. The proposed algorithm has different inception residual blocks that cater to information by using different depths feature maps at different scales, with the various layers. The features are concatenated at each proposed classification block, using the average-pooling layer, and concatenated features are passed to the fully connected layer. The efficient proposed deep-learning blocks used different regularization techniques to minimize the overfitting due to the small COVID-19 dataset. The multiscale features are extracted at different levels of the proposed deep-learning model and then embedded into various machine-learning models to validate the combination of deep-learning and machine-learning models. The proposed CoVIR-Net model achieved 95.7% accuracy, and the CoVIR-Net feature extractor with random-forest classifier produced 97.29% accuracy, which is the highest, as compared to existing state-of-the-art deep-learning methods. The proposed model would be an automatic solution for the assessment and classification of COVID-19. We predict that the proposed method will demonstrate an outstanding performance as compared to the state-of-the-art techniques being used currently.

Performance Analysis of Conventional Machine Learning Algorithms for Diabetic Sensorimotor Polyneuropathy Severity Classification

Background: Diabetic peripheral neuropathy (DSPN), a major form of diabetic neuropathy, is a complication that arises in long-term diabetic patients. Even though the application of machine learning (ML) in disease diagnosis is a very common and well-established field of research, its application in diabetic peripheral neuropathy (DSPN) diagnosis using composite scoring techniques like Michigan Neuropathy Screening Instrumentation (MNSI), is very limited in the existing literature. Method: In this study, the MNSI data were collected from the Epidemiology of Diabetes Interventions and Complications (EDIC) clinical trials. Two different datasets with different MNSI variable combinations based on the results from the eXtreme Gradient Boosting feature ranking technique were used to analyze the performance of eight different conventional ML algorithms. Results: The random forest (RF) classifier outperformed other ML models for both datasets. However, all ML models showed almost perfect reliability based on Kappa statistics and a high correlation between the predicted output and actual class of the EDIC patients when all six MNSI variables were considered as inputs. Conclusions: This study suggests that the RF algorithm-based classifier using all MNSI variables can help to predict the DSPN severity which will help to enhance the medical facilities for diabetic patients.

Medical image-based detection of COVID-19 using Deep Convolution Neural Networks

The demand for automatic detection of Novel Coronavirus or COVID-19 is increasing across the globe. The exponential rise in cases burdens healthcare facilities, and a vast amount of multimedia healthcare data is being explored to find a solution. This study presents a practical solution to detect COVID-19 from chest X-rays while distinguishing those from normal and impacted by Viral Pneumonia via Deep Convolution Neural Networks (CNN). In this study, three pre-trained CNN models (EfficientNetB0, VGG16, and InceptionV3) are evaluated through transfer learning. The rationale for selecting these specific models is their balance of accuracy and efficiency with fewer parameters suitable for mobile applications. The dataset used for the study is publicly available and compiled from different sources. This study uses deep learning techniques and performance metrics (accuracy, recall, specificity, precision, and F1 scores). The results show that the proposed approach produced a high-quality model, with an overall accuracy of 92.93%, COVID-19, a sensitivity of 94.79%. The work indicates a definite possibility to implement computer vision design to enable effective detection and screening measures.

Convolutional neural network for diagnosis of viral pneumonia and COVID-19 alike diseases

Reverse-Transcription Polymerase Chain Reaction (RT-PCR) method is currently the gold standard method for detection of viral strains in human samples, but this technique is very expensive, take time and often leads to misdiagnosis. The recent outbreak of COVID-19 has led scientists to explore other options such as the use of artificial intelligence driven tools as an alternative or a confirmatory approach for detection of viral pneumonia. In this paper, we utilized a Convolutional Neural Network (CNN) approach to detect viral pneumonia in x-ray images using a pretrained AlexNet model thereby adopting a transfer learning approach. The dataset used for the study was obtained in the form of optical Coherence Tomography and chest X-ray images made available by Kermany et al. (2018, https://doi.org/10.17632/rscbjbr9sj.3) with a total number of 5853 pneumonia (positive) and normal (negative) images. To evaluate the average efficiency of the model, the dataset was split into on 50:50, 60:40, 70:30, 80:20 and 90:10 for training and testing respectively. To evaluate the performance of the model, 10 K Cross-validation was carried out. The performance of the model using overall dataset was compared with the means of cross-validation and the currents state of arts. The classification model has shown high performance in terms of accuracy, sensitivity and specificity. 70:30 split performed better compare to other splits with accuracy of 98.73%, sensitivity of 98.59% and specificity of 99.84%.

DenseCapsNet: Detection of COVID-19 from X-ray images using a capsule neural network

At present, the global pandemic as it relates to novel coronavirus pneumonia is still a very difficult situation. Due to the recent outbreak of novel coronavirus pneumonia, novel chest X-ray (CXR) images that can be used for deep learning analysis are very rare. To solve this problem, we propose a deep learning framework that integrates a convolutional neural network and a capsule network. DenseCapsNet, a new deep learning framework, is formed by the fusion of a dense convolutional network (DenseNet) and the capsule neural network (CapsNet), leveraging their respective advantages and reducing the dependence of convolutional neural networks on a large amount of data. Using 750 CXR images of lungs of healthy patients as well as those of patients with other pneumonia and novel coronavirus pneumonia, the method can obtain an accuracy of 90.7% and an F1 score of 90.9%, and the sensitivity for detecting COVID-19 can reach 96%. These results show that the deep fusion neural network DenseCapsNet has good performance in novel coronavirus pneumonia CXR radiography detection.

Artificial intelligence (AI) for medical imaging to combat coronavirus disease (COVID-19): a detailed review with direction for future research

Since early 2020, the whole world has been facing the deadly and highly contagious disease named coronavirus disease (COVID-19) and the World Health Organization declared the pandemic on 11 March 2020. Over 23 million positive cases of COVID-19 have been reported till late August 2020. Medical images such as chest X-rays and Computed Tomography scans are becoming one of the main leading clinical diagnosis tools in fighting against COVID-19, underpinned by Artificial Intelligence based techniques, resulting in rapid decision-making in saving lives. This article provides an extensive review of AI-based methods to assist medical practitioners with comprehensive knowledge of the efficient AI-based methods for efficient COVID-19 diagnosis. Nearly all the reported methods so far along with their pros and cons as well as recommendations for improvements are discussed, including image acquisition, segmentation, classification, and follow-up diagnosis phases developed between 2019 and 2020. AI and machine learning technologies have boosted the accuracy of Covid-19 diagnosis, and most of the widely used deep learning methods have been implemented and worked well with a small amount of data for COVID-19 diagnosis. This review presents a detailed mythological analysis for the evaluation of AI-based methods used in the process of detecting COVID-19 from medical images. However, due to the quick outbreak of Covid-19, there are not many ground-truth datasets available for the communities. It is necessary to combine clinical experts' observations and information from images to have a reliable and efficient COVID-19 diagnosis. This paper suggests that future research may focus on multi-modality based models as well as how to select the best model architecture where AI can introduce more intelligence to medical systems to capture the characteristics of diseases by learning from multi-modality data to obtain reliable results for COVID-19 diagnosis for timely treatment .

GraphCovidNet: A graph neural network based model for detecting COVID-19 from CT scans and X-rays of chest

COVID-19, a viral infection originated from Wuhan, China has spread across the world and it has currently affected over 115 million people. Although vaccination process has already started, reaching sufficient availability will take time. Considering the impact of this widespread disease, many research attempts have been made by the computer scientists to screen the COVID-19 from Chest X-Rays (CXRs) or Computed Tomography (CT) scans. To this end, we have proposed GraphCovidNet, a Graph Isomorphic Network (GIN) based model which is used to detect COVID-19 from CT-scans and CXRs of the affected patients. Our proposed model only accepts input data in the form of graph as we follow a GIN based architecture. Initially, pre-processing is performed to convert an image data into an undirected graph to consider only the edges instead of the whole image. Our proposed GraphCovidNet model is evaluated on four standard datasets: SARS-COV-2 Ct-Scan dataset, COVID-CT dataset, combination of covid-chestxray-dataset, Chest X-Ray Images (Pneumonia) dataset and CMSC-678-ML-Project dataset. The model shows an impressive accuracy of 99% for all the datasets and its prediction capability becomes 100% accurate for the binary classification problem of detecting COVID-19 scans. Source code of this work can be found at GitHub-link .

COVID-19 Detection Empowered with Machine Learning and Deep Learning Techniques: A Systematic Review

COVID-19 has infected 223 countries and caused 2.8 million deaths worldwide (at the time of writing this article), and the death rate is increasing continuously. Early diagnosis of COVID patients is a critical challenge for medical practitioners, governments, organizations, and countries to overcome the rapid spread of the deadly virus in any geographical area. In this situation, the previous epidemic evidence on Machine Learning (ML) and Deep Learning (DL) techniques encouraged the researchers to play a significant role in detecting COVID-19. Similarly, the rising scope of ML/DL methodologies in the medical domain also advocates its significant role in COVID-19 detection. This systematic review presents ML and DL techniques practiced in this era to predict, diagnose, classify, and detect the coronavirus. In this study, the data was retrieved from three prevalent full-text archives, i.e., Science Direct, Web of Science, and PubMed, using the search code strategy on 16 March 2021. Using professional assessment, among 961 articles retrieved by an initial query, only 40 articles focusing on ML/DL-based COVID-19 detection schemes were selected. Findings have been presented as a country-wise distribution of publications, article frequency, various data collection, analyzed datasets, sample sizes, and applied ML/DL techniques. Precisely, this study reveals that ML/DL technique accuracy lay between 80% to 100% when detecting COVID-19. The RT-PCR-based model with Support Vector Machine (SVM) exhibited the lowest accuracy (80%), whereas the X-ray-based model achieved the highest accuracy (99.7%) using a deep convolutional neural network. However, current studies have shown that an anal swab test is super accurate to detect the virus. Moreover, this review addresses the limitations of COVID-19 detection along with the detailed discussion of the prevailing challenges and future research directions, which eventually highlight outstanding issues.

COVID-19 infection map generation and detection from chest X-ray images

Computer-aided diagnosis has become a necessity for accurate and immediate coronavirus disease 2019 (COVID-19) detection to aid treatment and prevent the spread of the virus. Numerous studies have proposed to use Deep Learning techniques for COVID-19 diagnosis. However, they have used very limited chest X-ray (CXR) image repositories for evaluation with a small number, a few hundreds, of COVID-19 samples. Moreover, these methods can neither localize nor grade the severity of COVID-19 infection. For this purpose, recent studies proposed to explore the activation maps of deep networks. However, they remain inaccurate for localizing the actual infestation making them unreliable for clinical use. This study proposes a novel method for the joint localization, severity grading, and detection of COVID-19 from CXR images by generating the so-called infection maps. To accomplish this, we have compiled the largest dataset with 119,316 CXR images including 2951 COVID-19 samples, where the annotation of the ground-truth segmentation masks is performed on CXRs by a novel collaborative human–machine approach. Furthermore, we publicly release the first CXR dataset with the ground-truth segmentation masks of the COVID-19 infected regions. A detailed set of experiments show that state-of-the-art segmentation networks can learn to localize COVID-19 infection with an F1-score of 83.20%, which is significantly superior to the activation maps created by the previous methods. Finally, the proposed approach achieved a COVID-19 detection performance with 94.96% sensitivity and 99.88% specificity.

Application of Machine Learning in Diagnosis of COVID-19 Through X-Ray and CT Images: A Scoping Review

Coronavirus disease, first detected in late 2019 (COVID-19), has spread fast throughout the world, leading to high mortality. This condition can be diagnosed using RT-PCR technique on nasopharyngeal and throat swabs with sensitivity values ranging from 30 to 70%. However, chest CT scans and X-ray images have been reported to have sensitivity values of 98 and 69%, respectively. The application of machine learning methods on CT and X-ray images has facilitated the accurate diagnosis of COVID-19. In this study, we reviewed studies which used machine and deep learning methods on chest X-ray images and CT scans for COVID-19 diagnosis and compared their performance. The accuracy of these methods ranged from 76% to more than 99%, indicating the applicability of machine and deep learning methods in the clinical diagnosis of COVID-19.

Deep learning-based improved snapshot ensemble technique for COVID-19 chest X-ray classification

COVID-19 has proven to be a deadly virus, and unfortunately, it triggered a worldwide pandemic. Its detection for further treatment poses a severe threat to researchers, scientists, health professionals, and administrators worldwide. One of the daunting tasks during the pandemic for doctors in radiology is the use of chest X-ray or CT images for COVID-19 diagnosis. Time is required to inspect each report manually. While a CT scan is the better standard, an X-ray is still useful because it is cheaper, faster, and more widely used. To diagnose COVID-19, this paper proposes to use a deep learning-based improved Snapshot Ensemble technique for efficient COVID-19 chest X-ray classification. In addition, the proposed method takes advantage of the transfer learning technique using the ResNet-50 model, which is a pre-trained model. The proposed model uses the publicly accessible COVID-19 chest X-ray dataset consisting of 2905 images, which include COVID-19, viral pneumonia, and normal chest X-ray images. For performance evaluation, the model applied the metrics such as AU-ROC, AU-PR, and Jaccard Index. Furthermore, it also obtained a multi-class micro-average of 97% specificity, 95% f 1-score, and 95% classification accuracy. The obtained results demonstrate that the performance of the proposed method outperformed those of several existing methods. This method appears to be a suitable and efficient approach for COVID-19 chest X-ray classification.

Federated learning for COVID-19 screening from Chest X-ray images

Today, the whole world is facing a great medical disaster that affects the health and lives of the people: the COVID-19 disease, colloquially known as the Corona virus. Deep learning is an effective means to assist radiologists to analyze the vast amount of chest X-ray images, which can potentially have a substantial role in streamlining and accelerating the diagnosis of COVID-19. Such techniques involve large datasets for training and all such data must be centralized in order to be processed. Due to medical data privacy regulations, it is often not possible to collect and share patient data in a centralized data server. In this work, we present a collaborative federated learning framework allowing multiple medical institutions screening COVID-19 from Chest X-ray images using deep learning without sharing patient data. We investigate several key properties and specificities of federated learning setting including the not independent and identically distributed (non-IID) and unbalanced data distributions that naturally arise. We experimentally demonstrate that the proposed federated learning framework provides competitive results to that of models trained by sharing data, considering two different model architectures. These findings would encourage medical institutions to adopt collaborative process and reap benefits of the rich private data in order to rapidly build a powerful model for COVID-19 screening.

Transfer learning-based ensemble support vector machine model for automated COVID-19 detection using lung computerized tomography scan data

The novel discovered disease coronavirus popularly known as COVID-19 is caused due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and declared a pandemic by the World Health Organization (WHO). An early-stage detection of COVID-19 is crucial for the containment of the pandemic it has caused. In this study, a transfer learning–based COVID-19 screening technique is proposed. The motivation of this study is to design an automated system that can assist medical staff especially in areas where trained staff are outnumbered. The study investigates the potential of transfer learning–based models for automatically diagnosing diseases like COVID-19 to assist the medical force, especially in times of an outbreak. In the proposed work, a deep learning model, i.e., truncated VGG16 (Visual Geometry Group from Oxford) is implemented to screen COVID-19 CT scans. The VGG16 architecture is fine-tuned and used to extract features from CT scan images. Further principal component analysis (PCA) is used for feature selection. For the final classification, four different classifiers, namely deep convolutional neural network (DCNN), extreme learning machine (ELM), online sequential ELM, and bagging ensemble with support vector machine (SVM) are compared. The best performing classifier bagging ensemble with SVM within 385 ms achieved an accuracy of 95.7%, the precision of 95.8%, area under curve (AUC) of 0.958, and an F1 score of 95.3% on 208 test images. The results obtained on diverse datasets prove the superiority and robustness of the proposed work. A pre-processing technique has also been proposed for radiological data. The study further compares pre-trained CNN architectures and classification models against the proposed technique.

COVID_SCREENET: COVID-19 Screening in Chest Radiography Images Using Deep Transfer Stacking

Infectious diseases are highly contagious due to rapid transmission and very challenging to diagnose in the early stage. Artificial Intelligence and Machine Learning now become a strategic weapon in assisting infectious disease prevention, rapid-response in diagnosis, surveillance, and management. In this paper, a bifold COVID_SCREENET architecture is introduced for providing COVID-19 screening solutions using Chest Radiography (CR) images. Transfer learning using nine pre-trained ImageNet models to extract the features of Normal, Pneumonia, and COVID-19 images is adapted in the first fold and classified using baseline Convolutional Neural Network (CNN). A Modified Stacked Ensemble Learning (MSEL) is proposed in the second fold by stacking the top five pre-trained models, and then the predictions resulted. Experimentation is carried out in two folds: In first fold, open-source samples are considered and in second fold 2216 real-time samples collected from Tamilnadu Government Hospitals, India, and the screening results for COVID data is 100% accurate in both the cases. The proposed approach is also validated and blind reviewed with the help of two radiologists at Thanjavur Medical College & Hospitals by collecting 2216 chest X-ray images between the month of April and May. Based on the reports, the measures are calculated for COVID_SCREENET and it showed 100% accuracy in performing multi-class classification.

Identification of Images of COVID-19 from Chest X-rays Using Deep Learning: Comparing COGNEX VisionPro Deep Learning 1.0™ Software with Open Source Convolutional Neural Networks

The novel Coronavirus, COVID-19, pandemic is being considered the most crucial health calamity of the century. Many organizations have come together during this crisis and created various Deep Learning models for the effective diagnosis of COVID-19 from chest radiography images. For example, The University of Waterloo, along with Darwin AI—a start-up spin-off of this department, has designed the Deep Learning model ‘COVID-Net’ and created a dataset called ‘COVIDx’ consisting of 13,975 images across 13,870 patient cases. In this study, COGNEX’s Deep Learning Software, VisionPro Deep Learning™,  is used to classify these Chest X-rays from the COVIDx dataset. The results are compared with the results of COVID-Net and various other state-of-the-art Deep Learning models from the open-source community. Deep Learning tools are often referred to as black boxes because humans cannot interpret how or why a model is classifying an image into a particular class. This problem is addressed by testing VisionPro Deep Learning with two settings, first, by selecting the entire image as the Region of Interest (ROI), and second, by segmenting the lungs in the first step, and then doing the classification step on the segmented lungs only, instead of using the entire image. VisionPro Deep Learning results: on the entire image as the ROI it achieves an overall F score of 94.0%, and on the segmented lungs, it gets an F score of 95.3%, which is better than COVID-Net and other state-of-the-art open-source Deep Learning models.

Advance Warning Methodologies for COVID-19 Using Chest X-Ray Images

Coronavirus disease 2019 (COVID-19) has rapidly become a global health concern after its first known detection in December 2019. As a result, accurate and reliable advance warning system for the early diagnosis of COVID-19 has now become a priority. The detection of COVID-19 in early stages is not a straightforward task from chest X-ray images according to expert medical doctors because the traces of the infection are visible only when the disease has progressed to a moderate or severe stage. In this study, our first aim is to evaluate the ability of recent state-of-the-art Machine Learning techniques for the early detection of COVID-19 from chest X-ray images. Both compact classifiers and deep learning approaches are considered in this study. Furthermore, we propose a recent compact classifier, Convolutional Support Estimator Network (CSEN) approach for this purpose since it is well-suited for a scarce-data classification task. Finally, this study introduces a new benchmark dataset called Early-QaTa-COV19, which consists of 1065 early-stage COVID-19 pneumonia samples (very limited or no infection signs) labeled by the medical doctors and 12544 samples for control (normal) class. A detailed set of experiments shows that the CSEN achieves the top (over 97%) sensitivity with over 95.5% specificity. Moreover, DenseNet-121 network produces the leading performance among other deep networks with 95% sensitivity and 99.74% specificity.

Deep Learning-Driven Automated Detection of COVID-19 from Radiography Images: a Comparative Analysis

The COVID-19 pandemic has wreaked havoc on the whole world, taking over half a million lives and capsizing the world economy in unprecedented magnitudes. With the world scampering for a possible vaccine, early detection and containment are the only redress. Existing diagnostic technologies with high accuracy like RT-PCRs are expensive and sophisticated, requiring skilled individuals for specimen collection and screening, resulting in lower outreach. So, methods excluding direct human intervention are much sought after, and artificial intelligence-driven automated diagnosis, especially with radiography images, captured the researchers' interest. This survey marks a detailed inspection of the deep learning-based automated detection of COVID-19 works done to date, a comparison of the available datasets, methodical challenges like imbalanced datasets and others, along with probable solutions with different preprocessing methods, and scopes of future exploration in this arena. We also benchmarked the performance of 315 deep models in diagnosing COVID-19, normal, and pneumonia from X-ray images of a custom dataset created from four others. The dataset is publicly available at https://github.com/rgbnihal2/COVID-19-X-ray-Dataset. Our results show that DenseNet201 model with Quadratic SVM classifier performs the best (accuracy: 98.16%, sensitivity: 98.93%, specificity: 98.77%) and maintains high accuracies in other similar architectures as well. This proves that even though radiography images might not be conclusive for radiologists, but it is so for deep learning algorithms for detecting COVID-19. We hope this extensive review will provide a comprehensive guideline for researchers in this field.

COVIDC: An expert system to diagnose COVID-19 and predict its severity using chest CT scans: Application in radiology

Early diagnosis of Coronavirus disease 2019 (COVID-19) is significantly important, especially in the absence or inadequate provision of a specific vaccine, to stop the surge of this lethal infection by advising quarantine. This diagnosis is challenging as most of the patients having COVID-19 infection stay asymptomatic while others showing symptoms are hard to distinguish from patients having different respiratory infections such as severe flu and Pneumonia. Due to cost and time-consuming wet-lab diagnostic tests for COVID-19, there is an utmost requirement for some alternate, non-invasive, rapid, and discounted automatic screening system. A chest CT scan can effectively be used as an alternative modality to detect and diagnose the COVID-19 infection. In this study, we present an automatic COVID-19 diagnostic and severity prediction system called COVIDC (COVID-19 detection using CT scans) that uses deep feature maps from the chest CT scans for this purpose. Our newly proposed system not only detects COVID-19 but also predicts its severity by using a two-phase classification approach (COVID vs non-COVID, and COVID-19 severity) with deep feature maps and different shallow supervised classification algorithms such as SVMs and random forest to handle data scarcity. We performed a stringent COVIDC performance evaluation not only through 10-fold cross-validation and an external validation dataset but also in a real setting under the supervision of an experienced radiologist. In all the evaluation settings, COVIDC outperformed all the existing state-of-the-art methods designed to detect COVID-19 with an F1 score of 0.94 on the validation dataset and justified its use to diagnose COVID-19 effectively in the real setting by classifying correctly 9 out of 10 COVID-19 CT scans. We made COVIDC openly accessible through a cloud-based webserver and python code available at https://sites.google.com/view/wajidarshad/software and https://github.com/wajidarshad/covidc.

Convolutional neural network model based on radiological images to support COVID-19 diagnosis: Evaluating database biases

As SARS-CoV-2 has spread quickly throughout the world, the scientific community has spent major efforts on better understanding the characteristics of the virus and possible means to prevent, diagnose, and treat COVID-19. A valid approach presented in the literature is to develop an image-based method to support COVID-19 diagnosis using convolutional neural networks (CNN). Because the availability of radiological data is rather limited due to the novelty of COVID-19, several methodologies consider reduced datasets, which may be inadequate, biasing the model. Here, we performed an analysis combining six different databases using chest X-ray images from open datasets to distinguish images of infected patients while differentiating COVID-19 and pneumonia from 'no-findings' images. In addition, the performance of models created from fewer databases, which may imperceptibly overestimate their results, is discussed. Two CNN-based architectures were created to process images of different sizes (512 × 512, 768 × 768, 1024 × 1024, and 1536 × 1536). Our best model achieved a balanced accuracy (BA) of 87.7% in predicting one of the three classes ('no-findings', 'COVID-19', and 'pneumonia') and a specific balanced precision of 97.0% for 'COVID-19' class. We also provided binary classification with a precision of 91.0% for detection of sick patients (i.e., with COVID-19 or pneumonia) and 98.4% for COVID-19 detection (i.e., differentiating from 'no-findings' or 'pneumonia'). Indeed, despite we achieved an unrealistic 97.2% BA performance for one specific case, the proposed methodology of using multiple databases achieved better and less inflated results than from models with specific image datasets for training. Thus, this framework is promising for a low-cost, fast, and noninvasive means to support the diagnosis of COVID-19.

A Radiomics Signature to Quantitatively Analyze COVID-19-Infected Pulmonary Lesions

Assessing pulmonary lesions using computed tomography (CT) images is of great significance to the severity diagnosis and treatment of coronavirus disease 2019 (COVID-19)-infected patients. Such assessment mainly depends on radiologists' subjective judgment, which is inefficient and presents difficulty for those with low levels of experience, especially in rural areas. This work focuses on developing a radiomics signature to quantitatively analyze whether COVID-19-infected pulmonary lesions are mild (Grade I) or moderate/severe (Grade II). We retrospectively analyzed 1160 COVID-19-infected pulmonary lesions from 16 hospitals. First, texture features were extracted from the pulmonary lesion regions of CT images. Then, feature preselection was performed and a radiomics signature was built using a stepwise logistic regression. The stepwise logistic regression also calculated the correlation between the radiomics signature and the grade of a pulmonary lesion. Finally, a logistic regression model was trained to classify the grades of pulmonary lesions. Given a significance level of α = 0.001, the stepwise logistic regression achieved an R (multiple correlation coefficient) of 0.70, which is much larger than Rα = 0.18 (the critical value of R). In the classification, the logistic regression model achieved an AUC of 0.87 on an independent test set. Overall, the radiomics signature is significantly correlated with the grade of a pulmonary lesion in COVID-19 infection. The classification model is interpretable and can assist radiologists in quickly and efficiently diagnosing pulmonary lesions. This work aims to develop a CT-based radiomics signature to quantitatively analyze whether COVID-19-infected pulmonary lesions are mild (Grade I) or moderate/severe (Grade II). The logistic regression model established based on this radiomics signature can assist radiologists to quickly and efficiently diagnose the grades of pulmonary lesions. The model calculates a radiomics score for a lesion and is interpretable and appropriate for clinical use.

COVID-19 Chest CT Image Segmentation Network by Multi-Scale Fusion and Enhancement Operations

A novel coronavirus disease 2019 (COVID-19) was detected and has spread rapidly across various countries around the world since the end of the year 2019. Computed Tomography (CT) images have been used as a crucial alternative to the time-consuming RT-PCR test. However, pure manual segmentation of CT images faces a serious challenge with the increase of suspected cases, resulting in urgent requirements for accurate and automatic segmentation of COVID-19 infections. Unfortunately, since the imaging characteristics of the COVID-19 infection are diverse and similar to the backgrounds, existing medical image segmentation methods cannot achieve satisfactory performance. In this article, we try to establish a new deep convolutional neural network tailored for segmenting the chest CT images with COVID-19 infections. We first maintain a large and new chest CT image dataset consisting of 165,667 annotated chest CT images from 861 patients with confirmed COVID-19. Inspired by the observation that the boundary of the infected lung can be enhanced by adjusting the global intensity, in the proposed deep CNN, we introduce a feature variation block which adaptively adjusts the global properties of the features for segmenting COVID-19 infection. The proposed FV block can enhance the capability of feature representation effectively and adaptively for diverse cases. We fuse features at different scales by proposing Progressive Atrous Spatial Pyramid Pooling to handle the sophisticated infection areas with diverse appearance and shapes. The proposed method achieves state-of-the-art performance. Dice similarity coefficients are 0.987 and 0.726 for lung and COVID-19 segmentation, respectively. We conducted experiments on the data collected in China and Germany and show that the proposed deep CNN can produce impressive performance effectively. The proposed network enhances the segmentation ability of the COVID-19 infection, makes the connection with other techniques and contributes to the development of remedying COVID-19 infection.

A robust blind medical image watermarking approach for telemedicine applications

In order to enhance the security of exchanged medical images in telemedicine, we propose in this paper a blind and robust approach for medical image protection. This approach consists in embedding patient information and image acquisition data in the image. This imperceptible integration must generate the least possible distortion. The watermarked image must present the same clinical reading as the original image. The proposed approach is applied in the frequency domain. For this purpose, four transforms were used: discrete wavelets transform, non-subsampled contourlet transform, non-subsampled shearlet transform and discreet cosine transform. All these transforms was combined with Schur decomposition and the watermark bits were integrated in the upper triangular matrix. To obtain a satisfactory compromise between robustness and imperceptibility, the integration was performed in the medium frequencies of the image. Imperceptibility and robustness experimental results shows that the proposed methods maintain a high quality of watermarked images and are remarkably robust against several conventional attacks.

Current limitations to identify COVID-19 using artificial intelligence with chest X-ray imaging

The scientific community has joined forces to mitigate the scope of the current COVID-19 pandemic. The early identification of the disease, as well as the evaluation of its evolution is a primary task for the timely application of medical protocols. The use of medical images of the chest provides valuable information to specialists. Specifically, chest X-ray images have been the focus of many investigations that apply artificial intelligence techniques for the automatic classification of this disease. The results achieved to date on the subject are promising. However, some results of these investigations contain errors that must be corrected to obtain appropriate models for clinical use. This research discusses some of the problems found in the current scientific literature on the application of artificial intelligence techniques in the automatic classification of COVID-19. It is evident that in most of the reviewed works an incorrect evaluation protocol is applied, which leads to overestimating the results.

Run length encoding based wavelet features for COVID-19 detection in X-rays

OBJECTIVES

Introduced in his paper is a novel approach for the recognition of COVID-19 cases in chest X-rays.

METHODS

The discrete Wavelet transform (DWT) is employed in the proposed system to obtain highly discriminative features from the input chest X-ray image. The selected features are then classified by a support vector machine (SVM) classifier as either normal or COVID-19 cases. The DWT is well-known for its energy compression power. The proposed system uses the DWT to decompose the chest X-ray image into a group of approximation coefficients that contain a small number of high-energy (high-magnitude) coefficients. The proposed system introduces a novel coefficient selection scheme that employs hard thresholding combined with run-length encoding to extract only high-magnitude Wavelet approximation coefficients. These coefficients are utilized as features symbolizing the chest X-ray input image. After applying zero-padding to unify their lengths, the feature vectors are introduced to a SVM which classifies them as either normal or COVID-19 cases.

RESULTS

The proposed system yields promising results in terms of classification accuracy, which justifies further work in this direction.

CONCLUSION

The DWT can produce a few features that are highly discriminative. By reducing the dimensionality of the feature space, the proposed system is able to reduce the number of required training images and diminish the space and time complexities of the system.

ADVANCES IN KNOWLEDGE

Exploiting and reshaping the approximation coefficients can produce discriminative features representing the input image.

InstaCovNet-19: A deep learning classification model for the detection of COVID-19 patients using Chest X-ray

Recently, the whole world became infected by the newly discovered coronavirus (COVID-19). SARS-CoV-2, or widely known as COVID-19, has proved to be a hazardous virus severely affecting the health of people. It causes respiratory illness, especially in people who already suffer from other diseases. Limited availability of test kits as well as symptoms similar to other diseases such as pneumonia has made this disease deadly, claiming the lives of millions of people. Artificial intelligence models are found to be very successful in the diagnosis of various diseases in the biomedical field In this paper, an integrated stacked deep convolution network InstaCovNet-19 is proposed. The proposed model makes use of various pre-trained models such as ResNet101, Xception, InceptionV3, MobileNet, and NASNet to compensate for a relatively small amount of training data. The proposed model detects COVID-19 and pneumonia by identifying the abnormalities caused by such diseases in Chest X-ray images of the person infected. The proposed model achieves an accuracy of 99.08% on 3 class (COVID-19, Pneumonia, Normal) classification while achieving an accuracy of 99.53% on 2 class (COVID, NON-COVID) classification. The proposed model achieves an average recall, F1 score, and precision of 99%, 99%, and 99%, respectively on ternary classification, while achieving a 100% precision and a recall of 99% on the binary class., while achieving a 100% precision and a recall of 99% on the COVID class. InstaCovNet-19's ability to detect COVID-19 without any human intervention at an economical cost with high accuracy can benefit humankind greatly in this age of Quarantine.

Deep Learning Approaches for Detecting COVID-19 From Chest X-Ray Images: A Survey

Chest X-ray (CXR) imaging is a standard and crucial examination method used for suspected cases of coronavirus disease (COVID-19). In profoundly affected or limited resource areas, CXR imaging is preferable owing to its availability, low cost, and rapid results. However, given the rapidly spreading nature of COVID-19, such tests could limit the efficiency of pandemic control and prevention. In response to this issue, artificial intelligence methods such as deep learning are promising options for automatic diagnosis because they have achieved state-of-the-art performance in the analysis of visual information and a wide range of medical images. This paper reviews and critically assesses the preprint and published reports between March and May 2020 for the diagnosis of COVID-19 via CXR images using convolutional neural networks and other deep learning architectures. Despite the encouraging results, there is an urgent need for public, comprehensive, and diverse datasets. Further investigations in terms of explainable and justifiable decisions are also required for more robust, transparent, and accurate predictions.

Texture Analysis in the Evaluation of Covid-19 Pneumonia in Chest X-Ray Images: a Proof of Concept Study

BACKGROUND

One of the most challenging aspects related to Covid-19 is to establish the presence of infection in early phase of the disease. Texture analysis might be an additional tool for the evaluation of Chest X-ray in patients with clinical suspicion of Covid-19 related pneumonia.

OBJECTIVE

To evaluate the diagnostic performance of texture analysis and machine learning models for the diagnosis of Covid-19 interstitial pneumonia in Chest X-ray images.

METHODS

Chest X-ray images were accessed from a publicly available repository (https://www.kaggle.com/tawsifurrahman/covid19-radiography-database). Lung areas were manually segmented using a polygonal regions of interest covering both lung areas, using MaZda, a freely available software for texture analysis. A total of 308 features per ROI was extracted. One hundred-ten Covid-19 Chest X-ray images were selected for the final analysis.

RESULTS

Six models, namely NB, GLM, DL, GBT, ANN and PLS-DA were selected and ensembled. According to Youden's index, the Covid-19 Ensemble Machine Learning Score showing the highest Area Under the Curve (0.971±0.015) was 132.57. Assuming this cut-off the Ensemble model performance was estimated evaluating both true and false positive/negative, resulting in 91.8% accuracy with 93% sensitivity and 90% specificity. Moving the cut-off value to -100, although the accuracy resulted lower (90.6%), the Ensemble Machine Learning showed 100% sensitivity, with 80% specificity.

CONCLUSION

Texture analysis of Chest X-ray images and machine learning algorithms may help in differentiating patients with Covid-19 pneumonia. Despite several limitations, this study can lay ground for future researches in this field and help developing more rapid and accurate screening tools for these patients.

An Ensemble of Global and Local-Attention Based Convolutional Neural Networks for COVID-19 Diagnosis on Chest X-ray Images

The recent Coronavirus Disease 2019 (COVID-19) pandemic has put a tremendous burden on global health systems. Medical practitioners are under great pressure for reliable screening of suspected cases employing adjunct diagnostic tools to standard point-of-care testing methodology. Chest X-rays (CXRs) are appearing as a prospective diagnostic tool with easy-to-acquire, low-cost and less cross-contamination risk features. Artificial intelligence (AI)-attributed CXR evaluation has shown great potential for distinguishing COVID-19-induced pneumonia from other associated clinical instances. However, one of the associated challenges with diagnostic imaging-based modeling is incorrect feature attribution, which leads the model to learn misguiding disease patterns, causing wrong predictions. Here, we demonstrate an effective deep learning-based methodology to mitigate the problem, thereby allowing the classification algorithm to learn from relevant features. The proposed deep-learning framework consists of an ensemble of convolutional neural network (CNN) models focusing on both global and local pathological features from CXR lung images, while the latter is extracted using a multi-instance learning scheme and a local attention mechanism. An inspection of a series of backbone CNN models using global and local features, and an ensemble of both features, trained from high-quality CXR images of 1311 patients, further augmented for achieving the symmetry in class distribution, to localize lung pathological features followed by the classification of COVID-19 and other related pneumonia, shows that a DenseNet161 architecture outperforms all other models, as evaluated on an independent test set of 159 patients with confirmed cases. Specifically, an ensemble of DenseNet161 models with global and local attention-based features achieve an average balanced accuracy of 91.2%, average precision of 92.4%, and F1-score of 91.9% in a multi-label classification framework comprising COVID-19, pneumonia, and control classes. The DenseNet161 ensembles were also found to be statistically significant from all other models in a comprehensive statistical analysis. The current study demonstrated that the proposed deep learning-based algorithm can accurately identify the COVID-19-related pneumonia in CXR images, along with differentiating non-COVID-19-associated pneumonia with high specificity, by effectively alleviating the incorrect feature attribution problem, and exploiting an enhanced feature descriptor.

COVIDScreen: explainable deep learning framework for differential diagnosis of COVID-19 using chest X-rays

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 delays in obtaining test results calls for alternative methods of rapid and reliable diagnosis. In this article, we propose a novel deep learning-based solution using chest X-rays which can help in rapid triaging of COVID-19 patients. 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-rays into three classes viz. COVID-19, pneumonia, and normal. An effective pruning strategy as introduced in the proposed framework results in increased model performance, generalizability, and decreased model complexity. We incorporate explainability in our article by using Grad-CAM visualization 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.

Deep Ensemble Model for Classification of Novel Coronavirus in Chest X-Ray Images

The novel coronavirus, SARS-CoV-2, can be deadly to people, causing COVID-19. The ease of its propagation, coupled with its high capacity for illness and death in infected individuals, makes it a hazard to the community. Chest X-rays are one of the most common but most difficult to interpret radiographic examination for early diagnosis of coronavirus-related infections. They carry a considerable amount of anatomical and physiological information, but it is sometimes difficult even for the expert radiologist to derive the related information they contain. Automatic classification using deep learning models can help in better assessing these infections swiftly. Deep CNN models, namely, MobileNet, ResNet50, and InceptionV3, were applied with different variations, including training the model from the start, fine-tuning along with adjusting learned weights of all layers, and fine-tuning with learned weights along with augmentation. Fine-tuning with augmentation produced the best results in pretrained models. Out of these, two best-performing models (MobileNet and InceptionV3) selected for ensemble learning produced accuracy and FScore of 95.18% and 90.34%, and 95.75% and 91.47%, respectively. The proposed hybrid ensemble model generated with the merger of these deep models produced a classification accuracy and FScore of 96.49% and 92.97%. For test dataset, which was separately kept, the model generated accuracy and FScore of 94.19% and 88.64%. Automatic classification using deep ensemble learning can help radiologists in the correct identification of coronavirus-related infections in chest X-rays. Consequently, this swift and computer-aided diagnosis can help in saving precious human lives and minimizing the social and economic impact on society.

Pneumonia Classification Using Deep Learning from Chest X-ray Images During COVID-19

The outbreak of the novel corona virus disease (COVID-19) in December 2019 has led to global crisis around the world. The disease was declared pandemic by World Health Organization (WHO) on 11th of March 2020. Currently, the outbreak has affected more than 200 countries with more than 37 million confirmed cases and more than 1 million death tolls as of 10 October 2020. Reverse-transcription polymerase chain reaction (RT-PCR) is the standard method for detection of COVID-19 disease, but it has many challenges such as false positives, low sensitivity, expensive, and requires experts to conduct the test. As the number of cases continue to grow, there is a high need for developing a rapid screening method that is accurate, fast, and cheap. Chest X-ray (CXR) scan images can be considered as an alternative or a confirmatory approach as they are fast to obtain and easily accessible. Though the literature reports a number of approaches to classify CXR images and detect the COVID-19 infections, the majority of these approaches can only recognize two classes (e.g., COVID-19 vs. normal). However, there is a need for well-developed models that can classify a wider range of CXR images belonging to the COVID-19 class itself such as the bacterial pneumonia, the non-COVID-19 viral pneumonia, and the normal CXR scans. The current work proposes the use of a deep learning approach based on pretrained AlexNet model for the classification of COVID-19, non-COVID-19 viral pneumonia, bacterial pneumonia, and normal CXR scans obtained from different public databases. The model was trained to perform two-way classification (i.e., COVID-19 vs. normal, bacterial pneumonia vs. normal, non-COVID-19 viral pneumonia vs. normal, and COVID-19 vs. bacterial pneumonia), three-way classification (i.e., COVID-19 vs. bacterial pneumonia vs. normal), and four-way classification (i.e., COVID-19 vs. bacterial pneumonia vs. non-COVID-19 viral pneumonia vs. normal). For non-COVID-19 viral pneumonia and normal (healthy) CXR images, the proposed model achieved 94.43% accuracy, 98.19% sensitivity, and 95.78% specificity. For bacterial pneumonia and normal CXR images, the model achieved 91.43% accuracy, 91.94% sensitivity, and 100% specificity. For COVID-19 pneumonia and normal CXR images, the model achieved 99.16% accuracy, 97.44% sensitivity, and 100% specificity. For classification CXR images of COVID-19 pneumonia and non-COVID-19 viral pneumonia, the model achieved 99.62% accuracy, 90.63% sensitivity, and 99.89% specificity. For the three-way classification, the model achieved 94.00% accuracy, 91.30% sensitivity, and 84.78%. Finally, for the four-way classification, the model achieved an accuracy of 93.42%, sensitivity of 89.18%, and specificity of 98.92%.

Applications of artificial intelligence in battling against covid-19: A literature review

Colloquially known as coronavirus, the Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2), that causes CoronaVirus Disease 2019 (COVID-19), has become a matter of grave concern for every country around the world. The rapid growth of the pandemic has wreaked havoc and prompted the need for immediate reactions to curb the effects. To manage the problems, many research in a variety of area of science have started studying the issue. Artificial Intelligence is among the area of science that has found great applications in tackling the problem in many aspects. Here, we perform an overview on the applications of AI in a variety of fields including diagnosis of the disease via different types of tests and symptoms, monitoring patients, identifying severity of a patient, processing covid-19 related imaging tests, epidemiology, pharmaceutical studies, etc. The aim of this paper is to perform a comprehensive survey on the applications of AI in battling against the difficulties the outbreak has caused. Thus we cover every way that AI approaches have been employed and to cover all the research until the writing of this paper. We try organize the works in a way that overall picture is comprehensible. Such a picture, although full of details, is very helpful in understand where AI sits in current pandemonium. We also tried to conclude the paper with ideas on how the problems can be tackled in a better way and provide some suggestions for future works.

ECOVNet: a highly effective ensemble based deep learning model for detecting COVID-19

The goal of this research is to develop and implement a highly effective deep learning model for detecting COVID-19. To achieve this goal, in this paper, we propose an ensemble of Convolutional Neural Network (CNN) based on EfficientNet, named ECOVNet, to detect COVID-19 from chest X-rays. To make the proposed model more robust, we have used one of the largest open-access chest X-ray data sets named COVIDx containing three classes-COVID-19, normal, and pneumonia. For feature extraction, we have applied an effective CNN structure, namely EfficientNet, with ImageNet pre-training weights. The generated features are transferred into custom fine-tuned top layers followed by a set of model snapshots. The predictions of the model snapshots (which are created during a single training) are consolidated through two ensemble strategies, i.e., hard ensemble and soft ensemble, to enhance classification performance. In addition, a visualization technique is incorporated to highlight areas that distinguish classes, thereby enhancing the understanding of primal components related to COVID-19. The results of our empirical evaluations show that the proposed ECOVNet model outperforms the state-of-the-art approaches and significantly improves detection performance with 100% recall for COVID-19 and overall accuracy of 96.07%. We believe that ECOVNet can enhance the detection of COVID-19 disease, and thus, underpin a fully automated and efficacious COVID-19 detection system.

Deep learning based detection of COVID-19 from chest X-ray images

The whole world is facing a health crisis, that is unique in its kind, due to the COVID-19 pandemic. As the coronavirus continues spreading, researchers are concerned by providing or help provide solutions to save lives and to stop the pandemic outbreak. Among others, artificial intelligence (AI) has been adapted to address the challenges caused by pandemic. In this article, we design a deep learning system to extract features and detect COVID-19 from chest X-ray images. Three powerful networks, namely ResNet50, InceptionV3, and VGG16, have been fine-tuned on an enhanced dataset, which was constructed by collecting COVID-19 and normal chest X-ray images from different public databases. We applied data augmentation techniques to artificially generate a large number of chest X-ray images: Random Rotation with an angle between - 10 and 10 degrees, random noise, and horizontal flips. Experimental results are encouraging: the proposed models reached an accuracy of 97.20 % for Resnet50, 98.10 % for InceptionV3, and 98.30 % for VGG16 in classifying chest X-ray images as Normal or COVID-19. The results show that transfer learning is proven to be effective, showing strong performance and easy-to-deploy COVID-19 detection methods. This enables automatizing the process of analyzing X-ray images with high accuracy and it can also be used in cases where the materials and RT-PCR tests are limited.

Chest X-Ray image and pathological data based artificial intelligence enabled dual diagnostic method for multi-stage classification of COVID-19 patients

<abstract> <p>The use of Artificial Intelligence (AI) in combination with Internet of Things (IoT) drastically reduces the need to test the COVID samples manually, saving not only time but money and ultimately lives. In this paper, the authors have proposed a novel methodology to identify the COVID-19 patients with an annotated stage to enable the medical staff to manually activate a geo-fence around the subject thus ensuring early detection and isolation. The use of radiography images with pathology data used for COVID-19 identification forms the first-ever contribution by any research group globally. The novelty lies in the correct stage classification of COVID-19 subjects as well. The present analysis would bring this AI Model on the edge to make the facility an IoT-enabled unit. The developed system has been compared and extensively verified thoroughly with those of clinical observations. The significance of radiography imaging for detecting and identification of COVID-19 subjects with severity score tag for stage classification is mathematically established. In a Nutshell, this entire algorithmic workflow can be used not only for predictive analytics but also for prescriptive analytics to complete the entire pipeline from the diagnostic viewpoint of a doctor. As a matter of fact, the authors have used a supervised based learning approach aided by a multiple hypothesis based decision fusion based technique to increase the overall system's accuracy and prediction. The end to end value chain has been put under an IoT based ecosystem to leverage the combined power of AI and IoT to not only detect but also to isolate the coronavirus affected individuals. To emphasize further, the developed AI model predicts the respective categories of a coronavirus affected patients and the IoT system helps the point of care facilities to isolate and prescribe the need of hospitalization for the COVID patients.</p> </abstract>

Diagnosis of COVID-19 Using Machine Learning and Deep Learning: A Review

BACKGROUND

This paper provides a systematic review of the application of Artificial Intelligence (AI) in the form of Machine Learning (ML) and Deep Learning (DL) techniques in fighting against the effects of novel coronavirus disease (COVID-19).

OBJECTIVE & METHODS

The objective is to perform a scoping review on AI for COVID-19 using preferred reporting items of systematic reviews and meta-analysis (PRISMA) guidelines. A literature search was performed for relevant studies published from 1 January 2020 till 27 March 2021. Out of 4050 research papers available in reputed publishers, a full-text review of 440 articles was done based on the keywords of AI, COVID-19, ML, forecasting, DL, X-ray, and Computed Tomography (CT). Finally, 52 articles were included in the result synthesis of this paper. As part of the review, different ML regression methods were reviewed first in predicting the number of confirmed and death cases. Secondly, a comprehensive survey was carried out on the use of ML in classifying COVID-19 patients. Thirdly, different datasets on medical imaging were compared in terms of the number of images, number of positive samples and number of classes in the datasets. The different stages of the diagnosis, including preprocessing, segmentation and feature extraction were also reviewed. Fourthly, the performance results of different research papers were compared to evaluate the effectiveness of DL methods on different datasets.

RESULTS

Results show that residual neural network (ResNet-18) and densely connected convolutional network (DenseNet 169) exhibit excellent classification accuracy for X-ray images, while DenseNet-201 has the maximum accuracy in classifying CT scan images. This indicates that ML and DL are useful tools in assisting researchers and medical professionals in predicting, screening and detecting COVID-19.

CONCLUSION

Finally, this review highlights the existing challenges, including regulations, noisy data, data privacy, and the lack of reliable large datasets, then provides future research directions in applying AI in managing COVID-19.

Transfer Learning to Detect COVID-19 Automatically from X-Ray Images Using Convolutional Neural Networks

The novel coronavirus disease 2019 (COVID-19) is a contagious disease that has caused thousands of deaths and infected millions worldwide. Thus, various technologies that allow for the fast detection of COVID-19 infections with high accuracy can offer healthcare professionals much-needed help. This study is aimed at evaluating the effectiveness of the state-of-the-art pretrained Convolutional Neural Networks (CNNs) on the automatic diagnosis of COVID-19 from chest X-rays (CXRs). The dataset used in the experiments consists of 1200 CXR images from individuals with COVID-19, 1345 CXR images from individuals with viral pneumonia, and 1341 CXR images from healthy individuals. In this paper, the effectiveness of artificial intelligence (AI) in the rapid and precise identification of COVID-19 from CXR images has been explored based on different pretrained deep learning algorithms and fine-tuned to maximise detection accuracy to identify the best algorithms. The results showed that deep learning with X-ray imaging is useful in collecting critical biological markers associated with COVID-19 infections. VGG16 and MobileNet obtained the highest accuracy of 98.28%. However, VGG16 outperformed all other models in COVID-19 detection with an accuracy, F1 score, precision, specificity, and sensitivity of 98.72%, 97.59%, 96.43%, 98.70%, and 98.78%, respectively. The outstanding performance of these pretrained models can significantly improve the speed and accuracy of COVID-19 diagnosis. However, a larger dataset of COVID-19 X-ray images is required for a more accurate and reliable identification of COVID-19 infections when using deep transfer learning. This would be extremely beneficial in this pandemic when the disease burden and the need for preventive measures are in conflict with the currently available resources.

Novel coronavirus (COVID-19) diagnosis using computer vision and artificial intelligence techniques: a review

The universal transmission of pandemic COVID-19 (Coronavirus) causes an immediate need to commit in the fight across the whole human population. The emergencies for human health care are limited for this abrupt outbreak and abandoned environment. In this situation, inventive automation like computer vision (machine learning, deep learning, artificial intelligence), medical imaging (computed tomography, X-Ray) has developed an encouraging solution against COVID-19. In recent months, different techniques using image processing are done by various researchers. In this paper, a major review on image acquisition, segmentation, diagnosis, avoidance, and management are presented. An analytical comparison of the various proposed algorithm by researchers for coronavirus has been carried out. Also, challenges and motivation for research in the future to deal with coronavirus are indicated. The clinical impact and use of computer vision and deep learning were discussed and we hope that dermatologists may have better understanding of these areas from the study.

CGNet: A graph-knowledge embedded convolutional neural network for detection of pneumonia

Pneumonia is a global disease that causes high children mortality. The situation has even been worsening by the outbreak of the new coronavirus named COVID-19, which has killed more than 983,907 so far. People infected by the virus would show symptoms like fever and coughing as well as pneumonia as the infection progresses. Timely detection is a public consensus achieved that would benefit possible treatments and therefore contain the spread of COVID-19. X-ray, an expedient imaging technique, has been widely used for the detection of pneumonia caused by COVID-19 and some other virus. To facilitate the process of diagnosis of pneumonia, we developed a deep learning framework for a binary classification task that classifies chest X-ray images into normal and pneumonia based on our proposed CGNet. In our CGNet, there are three components including feature extraction, graph-based feature reconstruction and classification. We first use the transfer learning technique to train the state-of-the-art convolutional neural networks (CNNs) for binary classification while the trained CNNs are used to produce features for the following two components. Then, by deploying graph-based feature reconstruction, we, therefore, combine features through the graph to reconstruct features. Finally, a shallow neural network named GNet, a one layer graph neural network, which takes the combined features as the input, classifies chest X-ray images into normal and pneumonia. Our model achieved the best accuracy at 0.9872, sensitivity at 1 and specificity at 0.9795 on a public pneumonia dataset that includes 5,856 chest X-ray images. To evaluate the performance of our proposed method on detection of pneumonia caused by COVID-19, we also tested the proposed method on a public COVID-19 CT dataset, where we achieved the highest performance at the accuracy of 0.99, specificity at 1 and sensitivity at 0.98, respectively.

COVIDScreen: explainable deep learning framework for differential diagnosis of COVID-19 using chest X-rays

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 delays in obtaining test results calls for alternative methods of rapid and reliable diagnosis. In this article, we propose a novel deep learning-based solution using chest X-rays which can help in rapid triaging of COVID-19 patients. 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-rays into three classes viz. COVID-19, pneumonia, and normal. An effective pruning strategy as introduced in the proposed framework results in increased model performance, generalizability, and decreased model complexity. We incorporate explainability in our article by using Grad-CAM visualization 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.