Inf-Net: Automatic COVID-19 Lung Infection Segmentation From CT Images

Remora Namib Beetle Optimization Enabled Deep Learning for Severity of COVID-19 Lung Infection Identification and Classification Using CT Images

Coronavirus disease 2019 (COVID-19) has seen a crucial outburst for both females and males worldwide. Automatic lung infection detection from medical imaging modalities provides high potential for increasing the treatment for patients to tackle COVID-19 disease. COVID-19 detection from lung CT images is a rapid way of diagnosing patients. However, identifying the occurrence of infectious tissues and segmenting this from CT images implies several challenges. Therefore, efficient techniques termed as Remora Namib Beetle Optimization_ Deep Quantum Neural Network (RNBO_DQNN) and RNBO_Deep Neuro Fuzzy Network (RNBO_DNFN) are introduced for the identification as well as classification of COVID-19 lung infection. Here, the pre-processing of lung CT images is performed utilizing an adaptive Wiener filter, whereas lung lobe segmentation is performed employing the Pyramid Scene Parsing Network (PSP-Net). Afterwards, feature extraction is carried out wherein features are extracted for the classification phase. In the first level of classification, DQNN is utilized, tuned by RNBO. Furthermore, RNBO is designed by merging the Remora Optimization Algorithm (ROA) and Namib Beetle Optimization (NBO). If a classified output is COVID-19, then the second-level classification is executed using DNFN for further classification. Additionally, DNFN is also trained by employing the newly proposed RNBO. Furthermore, the devised RNBO_DNFN achieved maximum testing accuracy, with TNR and TPR obtaining values of 89.4%, 89.5% and 87.5%.

CRV-NET: Robust Intensity Recognition of Coronavirus in Lung Computerized Tomography Scan Images

The early diagnosis of infectious diseases is demanded by digital healthcare systems. Currently, the detection of the new coronavirus disease (COVID-19) is a major clinical requirement. For COVID-19 detection, deep learning models are used in various studies, but the robustness is still compromised. In recent years, deep learning models have increased in popularity in almost every area, particularly in medical image processing and analysis. The visualization of the human body's internal structure is critical in medical analysis; many imaging techniques are in use to perform this job. A computerized tomography (CT) scan is one of them, and it has been generally used for the non-invasive observation of the human body. The development of an automatic segmentation method for lung CT scans showing COVID-19 can save experts time and can reduce human error. In this article, the CRV-NET is proposed for the robust detection of COVID-19 in lung CT scan images. A public dataset (SARS-CoV-2 CT Scan dataset), is used for the experimental work and customized according to the scenario of the proposed model. The proposed modified deep-learning-based U-Net model is trained on a custom dataset with 221 training images and their ground truth, which was labeled by an expert. The proposed model is tested on 100 test images, and the results show that the model segments COVID-19 with a satisfactory level of accuracy. Moreover, the comparison of the proposed CRV-NET with different state-of-the-art convolutional neural network models (CNNs), including the U-Net Model, shows better results in terms of accuracy (96.67%) and robustness (low epoch value in detection and the smallest training data size).

ADSeg: A flap-attention-based deep learning approach for aortic dissection segmentation

Accurate and rapid segmentation of the lumen in an aortic dissection (AD) is an important prerequisite for risk evaluation and medical planning for patients with this serious condition. Although some recent studies have pioneered technical advances for the challenging AD segmentation task, they generally neglect the intimal flap structure that separates the true and false lumens. Identification and segmentation of the intimal flap may simplify AD segmentation, and the incorporation of long-distance z axis information interaction along the curved aorta may improve segmentation accuracy. This study proposes a flap attention module that focuses on key flap voxels and performs operations with long-distance attention. In addition, a pragmatic cascaded network structure with feature reuse and a two-step training strategy are presented to fully exploit network representation power. The proposed ADSeg method was evaluated on a multicenter dataset of 108 cases, with or without thrombus; ADSeg outperformed previous state-of-the-art methods by a significant margin and was robust against center variation.

Dense regression activation maps for lesion segmentation in CT scans of COVID-19 patients

Automatic lesion segmentation on thoracic CT enables rapid quantitative analysis of lung involvement in COVID-19 infections. However, obtaining a large amount of voxel-level annotations for training segmentation networks is prohibitively expensive. Therefore, we propose a weakly-supervised segmentation method based on dense regression activation maps (dRAMs). Most weakly-supervised segmentation approaches exploit class activation maps (CAMs) to localize objects. However, because CAMs were trained for classification, they do not align precisely with the object segmentations. Instead, we produce high-resolution activation maps using dense features from a segmentation network that was trained to estimate a per-lobe lesion percentage. In this way, the network can exploit knowledge regarding the required lesion volume. In addition, we propose an attention neural network module to refine dRAMs, optimized together with the main regression task. We evaluated our algorithm on 90 subjects. Results show our method achieved 70.2% Dice coefficient, substantially outperforming the CAM-based baseline at 48.6%. We published our source code at https://github.com/DIAGNijmegen/bodyct-dram.

Semi-Supervised CT Lesion Segmentation Using Uncertainty-Based Data Pairing and SwapMix

Semi-supervised learning (SSL) methods show their powerful performance to deal with the issue of data shortage in the field of medical image segmentation. However, existing SSL methods still suffer from the problem of unreliable predictions on unannotated data due to the lack of manual annotations for them. In this paper, we propose an unreliability-diluted consistency training (UDiCT) mechanism to dilute the unreliability in SSL by assembling reliable annotated data into unreliable unannotated data. Specifically, we first propose an uncertainty-based data pairing module to pair annotated data with unannotated data based on a complementary uncertainty pairing rule, which avoids two hard samples being paired off. Secondly, we develop SwapMix, a mixed sample data augmentation method, to integrate annotated data into unannotated data for training our model in a low-unreliability manner. Finally, UDiCT is trained by minimizing a supervised loss and an unreliability-diluted consistency loss, which makes our model robust to diverse backgrounds. Extensive experiments on three chest CT datasets show the effectiveness of our method for semi-supervised CT lesion segmentation.

Broad learning solution for rapid diagnosis of COVID-19

COVID-19 has put all of humanity in a health dilemma as it spreads rapidly. For many infectious diseases, the delay of detection results leads to the spread of infection and an increase in healthcare costs. COVID-19 diagnostic methods rely on a large number of redundant labeled data and time-consuming data training processes to obtain satisfactory results. However, as a new epidemic, obtaining large clinical datasets is still challenging, which will inhibit the training of deep models. And a model that can really rapidly diagnose COVID-19 at all stages of the model has still not been proposed. To address these limitations, we combine feature attention and broad learning to propose a diagnostic system (FA-BLS) for COVID-19 pulmonary infection, which introduces a broad learning structure to address the slow diagnosis speed of existing deep learning methods. In our network, transfer learning is performed with ResNet50 convolutional modules with fixed weights to extract image features, and the attention mechanism is used to enhance feature representation. After that, feature nodes and enhancement nodes are generated by broad learning with random weights to adaptly select features for diagnosis. Finally, three publicly accessible datasets were used to evaluate our optimization model. It was determined that the FA-BLS model had a 26-130 times faster training speed than deep learning with a similar level of accuracy, which can achieve a fast and accurate diagnosis, achieve effective isolation from COVID-19 and the proposed method also opens up a new method for other types of chest CT image recognition problems.

MESTrans: Multi-scale embedding spatial transformer for medical image segmentation

BACKGROUND AND OBJECTIVE

Transformers profiting from global information modeling derived from the self-attention mechanism have recently achieved remarkable performance in computer vision. In this study, a novel transformer-based medical image segmentation network called the multi-scale embedding spatial transformer (MESTrans) was proposed for medical image segmentation.

METHODS

First, a dataset called COVID-DS36 was created from 4369 computed tomography (CT) images of 36 patients from a partner hospital, of which 18 had COVID-19 and 18 did not. Subsequently, a novel medical image segmentation network was proposed, which introduced a self-attention mechanism to improve the inherent limitation of convolutional neural networks (CNNs) and was capable of adaptively extracting discriminative information in both global and local content. Specifically, based on U-Net, a multi-scale embedding block (MEB) and multi-layer spatial attention transformer (SATrans) structure were designed, which can dynamically adjust the receptive field in accordance with the input content. The spatial relationship between multi-level and multi-scale image patches was modeled, and the global context information was captured effectively. To make the network concentrate on the salient feature region, a feature fusion module (FFM) was established, which performed global learning and soft selection between shallow and deep features, adaptively combining the encoder and decoder features. Four datasets comprising CT images, magnetic resonance (MR) images, and H&E-stained slide images were used to assess the performance of the proposed network.

RESULTS

Experiments were performed using four different types of medical image datasets. For the COVID-DS36 dataset, our method achieved a Dice similarity coefficient (DSC) of 81.23%. For the GlaS dataset, 89.95% DSC and 82.39% intersection over union (IoU) were obtained. On the Synapse dataset, the average DSC was 77.48% and the average Hausdorff distance (HD) was 31.69 mm. For the I2CVB dataset, 92.3% DSC and 85.8% IoU were obtained.

CONCLUSIONS

The experimental results demonstrate that the proposed model has an excellent generalization ability and outperforms other state-of-the-art methods. It is expected to be a potent tool to assist clinicians in auxiliary diagnosis and to promote the development of medical intelligence technology.

FSNet: Focus Scanning Network for Camouflaged Object Detection

Camouflaged object detection (COD) aims to discover objects that blend in with the background due to similar colors or textures, etc. Existing deep learning methods do not systematically illustrate the key tasks in COD, which seriously hinders the improvement of its performance. In this paper, we introduce the concept of focus areas that represent some regions containing discernable colors or textures, and develop a two-stage focus scanning network for camouflaged object detection. Specifically, a novel encoder-decoder module is first designed to determine a region where the focus areas may appear. In this process, a multi-layer Swin transformer is deployed to encode global context information between the object and the background, and a novel cross-connection decoder is proposed to fuse cross-layer textures or semantics. Then, we utilize the multi-scale dilated convolution to obtain discriminative features with different scales in focus areas. Meanwhile, the dynamic difficulty aware loss is designed to guide the network paying more attention to structural details. Extensive experimental results on the benchmarks, including CAMO, CHAMELEON, COD10K, and NC4K, illustrate that the proposed method performs favorably against other state-of-the-art methods.

Dual attention fusion UNet for COVID-19 lesion segmentation from CT images

BACKGROUND

Chest CT scan is an effective way to detect and diagnose COVID-19 infection. However, features of COVID-19 infection in chest CT images are very complex and heterogeneous, which make segmentation of COVID-19 lesions from CT images quite challenging.

OBJECTIVE

To overcome this challenge, this study proposes and test an end-to-end deep learning method called dual attention fusion UNet (DAF-UNet).

METHODS

The proposed DAF-UNet improves the typical UNet into an advanced architecture. The dense-connected convolution is adopted to replace the convolution operation. The mixture of average-pooling and max-pooling acts as the down-sampling in the encoder. Bridge-connected layers, including convolution, batch normalization, and leaky rectified linear unit (leaky ReLU) activation, serve as the skip connections between the encoder and decoder to bridge the semantic gap differences. A multiscale pyramid pooling module acts as the bottleneck to fit the features of COVID-19 lesion with complexity. Furthermore, dual attention feature (DAF) fusion containing channel and position attentions followed the improved UNet to learn the long-dependency contextual features of COVID-19 and further enhance the capacity of the proposed DAF-UNet. The proposed model is first pre-trained on the pseudo label dataset (generated by Inf-Net) containing many samples, then fine-tuned on the standard annotation dataset (provided by the Italian Society of Medical and Interventional Radiology) with high-quality but limited samples to improve performance of COVID-19 lesion segmentation on chest CT images.

RESULTS

The Dice coefficient and Sensitivity are 0.778 and 0.798 respectively. The proposed DAF-UNet has higher scores than the popular models (Att-UNet, Dense-UNet, Inf-Net, COPLE-Net) tested using the same dataset as our model.

CONCLUSION

The study demonstrates that the proposed DAF-UNet achieves superior performance for precisely segmenting COVID-19 lesions from chest CT scans compared with the state-of-the-art approaches. Thus, the DAF-UNet has promising potential for assisting COVID-19 disease screening and detection.

LIVE-Net: Comprehensive 3D vessel extraction framework in CT angiography

The extraction of vessels from computed tomography angiography (CTA) is significant in diagnosing and evaluating vascular diseases. However, due to the anatomical complexity, wide intensity distribution, and small volume proportion of vessels, vessel extraction is laborious and time-consuming, and it is easy to lead to error-prone diagnostic results in clinical practice. This study proposes a novel comprehensive vessel extraction framework, called the Local Iterative-based Vessel Extraction Network (LIVE-Net), to achieve 3D vessel segmentation while tracking vessel centerlines. LIVE-Net contains dual dataflow pathways that work alternately: an iterative tracking network and a local segmentation network. The former can generate the fine-grain direction and radius prediction of a vascular patch by using the attention-embedded atrous pyramid network (aAPN), and the latter can achieve 3D vascular lumen segmentation by constructing the multi-order self-attention U-shape network (MOSA-UNet). LIVE-Net is trained and evaluated on two datasets: the MICCAI 2008 Coronary Artery Tracking Challenge (CAT08) dataset and head and neck CTA dataset from the clinic. Experimental results of both tracking and segmentation show that our proposed LIVE-Net exhibits superior performance compared with other state-of-the-art (SOTA) networks. In the CAT08 dataset, the tracked centerlines have an average overlap of 95.2%, overlap until first error of 91.2%, overlap with the clinically relevant vessels of 98.3%, and error distance inside of 0.21 mm. The corresponding tracking overlap metrics in the head and neck CTA dataset are 96.7%, 91.0%, and 99.8%, respectively. In addition, the results of the consistent experiment also show strong clinical correspondence. For the segmentation of bilateral carotid and vertebral arteries, our method can not only achieve better accuracy with an average dice similarity coefficient (DSC) of 90.03%, Intersection over Union (IoU) of 81.97%, and 95% Hausdorff distance (95%HD) of 3.42 mm , but higher efficiency with an average time of 67.25 s , even three times faster compared to some methods applied in full field view. Both the tracking and segmentation results prove the potential clinical utility of our network.

Automated semantic lung segmentation in chest CT images using deep neural network

Lung segmentation algorithms play a significant role in segmenting theinfected regions in the lungs. This work aims to develop a computationally efficient and robust deep learning model for lung segmentation using chest computed tomography (CT) images with DeepLabV3 + networks for two-class (background and lung field) and four-class (ground-glass opacities, background, consolidation, and lung field). In this work, we investigate the performance of the DeepLabV3 + network with five pretrained networks: Xception, ResNet-18, Inception-ResNet-v2, MobileNet-v2 and ResNet-50. A publicly available database for COVID-19 that contains 750 chest CT images and corresponding pixel-labeled images are used to develop the deep learning model. The segmentation performance has been assessed using five performance measures: Intersection of Union (IoU), Weighted IoU, Balance F1 score, pixel accu-racy, and global accuracy. The experimental results of this work confirm that the DeepLabV3 + network with ResNet-18 and a batch size of 8 have a higher performance for two-class segmentation. DeepLabV3 + network coupled with ResNet-50 and a batch size of 16 yielded better results for four-class segmentation compared to other pretrained networks. Besides, the ResNet with a fewer number of layers is highly adequate for developing a more robust lung segmentation network with lesser computational complexity compared to the conventional DeepLabV3 + network with Xception. This present work proposes a unified DeepLabV3 + network to delineate the two and four different regions automatically using CT images for CoVID-19 patients. Our developed automated segmented model can be further developed to be used as a clinical diagnosis system for CoVID-19 as well as assist clinicians in providing an accurate second opinion CoVID-19 diagnosis.

Semantic Decomposition Network With Contrastive and Structural Constraints for Dental Plaque Segmentation

Segmenting dental plaque from images of medical reagent staining provides valuable information for diagnosis and the determination of follow-up treatment plan. However, accurate dental plaque segmentation is a challenging task that requires identifying teeth and dental plaque subjected to semantic-blur regions (i.e., confused boundaries in border regions between teeth and dental plaque) and complex variations of instance shapes, which are not fully addressed by existing methods. Therefore, we propose a semantic decomposition network (SDNet) that introduces two single-task branches to separately address the segmentation of teeth and dental plaque and designs additional constraints to learn category-specific features for each branch, thus facilitating the semantic decomposition and improving the performance of dental plaque segmentation. Specifically, SDNet learns two separate segmentation branches for teeth and dental plaque in a divide-and-conquer manner to decouple the entangled relation between them. Each branch that specifies a category tends to yield accurate segmentation. To help these two branches better focus on category-specific features, two constraint modules are further proposed: 1) contrastive constraint module (CCM) to learn discriminative feature representations by maximizing the distance between different category representations, so as to reduce the negative impact of semantic-blur regions on feature extraction; 2) structural constraint module (SCM) to provide complete structural information for dental plaque of various shapes by the supervision of an boundary-aware geometric constraint. Besides, we construct a large-scale open-source Stained Dental Plaque Segmentation dataset (SDPSeg), which provides high-quality annotations for teeth and dental plaque. Experimental results on SDPSeg datasets show SDNet achieves state-of-the-art performance.

SELDNet: Sequenced encoder and lightweight decoder network for COVID-19 infection region segmentation

Segmenting regions of lung infection from computed tomography (CT) images shows excellent potential for rapid and accurate quantifying of Coronavirus disease 2019 (COVID-19) infection and determining disease development and treatment approaches. However, a number of challenges remain, including the complexity of imaging features and their variability with disease progression, as well as the high similarity to other lung diseases, which makes feature extraction difficult. To answer the above challenges, we propose a new sequence encoder and lightweight decoder network for medical image segmentation model (SELDNet). (i) Construct sequence encoders and lightweight decoders based on Transformer and deep separable convolution, respectively, to achieve different fine-grained feature extraction. (ii) Design a semantic association module based on cross-attention mechanism between encoder and decoder to enhance the fusion of different levels of semantics. The experimental results showed that the network can effectively achieve segmentation of COVID-19 infected regions. The dice of the segmentation result was 79.1%, the sensitivity was 76.3%, and the specificity was 96.7%. Compared with several state-of-the-art image segmentation models, our proposed SELDNet model achieves better results in the segmentation task of COVID-19 infected regions.

MIC-Net: A deep network for cross-site segmentation of COVID-19 infection in the fog-assisted IoMT

The automatic segmentation of COVID-19 pneumonia from a computerized tomography (CT) scan has become a major interest for scholars in developing a powerful diagnostic framework in the Internet of Medical Things (IoMT). Federated deep learning (FDL) is considered a promising approach for efficient and cooperative training from multi-institutional image data. However, the nonindependent and identically distributed (Non-IID) data from health care remain a remarkable challenge, limiting the applicability of FDL in the real world. The variability in features incurred by different scanning protocols, scanners, or acquisition parameters produces the learning drift phenomena during the training, which impairs both the training speed and segmentation performance of the model. This paper proposes a novel FDL approach for reliable and efficient multi-institutional COVID-19 segmentation, called MIC-Net. MIC-Net consists of three main building modules: the down-sampler, context enrichment (CE) module, and up-sampler. The down-sampler was designed to effectively learn both local and global representations from input CT scans by combining the advantages of lightweight convolutional and attention modules. The contextual enrichment (CE) module is introduced to enable the network to capture the contextual representation that can be later exploited to enrich the semantic knowledge of the up-sampler through skip connections. To further tackle the inter-site heterogeneity within the model, the approach uses an adaptive and switchable normalization (ASN) to adaptively choose the best normalization strategy according to the underlying data. A novel federated periodic selection protocol (FED-PCS) is proposed to fairly select the training participants according to their resource state, data quality, and loss of a local model. The results of an experimental evaluation of MIC-Net on three publicly available data sets show its robust performance, with an average dice score of 88.90% and an average surface dice of 87.53%.

Challenges, opportunities, and advances related to COVID-19 classification based on deep learning

The novel coronavirus disease, or COVID-19, is a hazardous disease. It is endangering the lives of many people living in more than two hundred countries. It directly affects the lungs. In general, two main imaging modalities: - computed tomography (CT) and chest x-ray (CXR) are used to achieve a speedy and reliable medical diagnosis. Identifying the coronavirus in medical images is exceedingly difficult for diagnosis, assessment, and treatment. It is demanding, time-consuming, and subject to human mistakes. In biological disciplines, excellent performance can be achieved by employing artificial intelligence (AI) models. As a subfield of AI, deep learning (DL) networks have drawn considerable attention than standard machine learning (ML) methods. DL models automatically carry out all the steps of feature extraction, feature selection, and classification. This study has performed comprehensive analysis of coronavirus classification using CXR and CT imaging modalities using DL architectures. Additionally, we have discussed how transfer learning is helpful in this regard. Finally, the problem of designing and implementing a system using computer-aided diagnostic (CAD) to find COVID-19 using DL approaches is highlighted a future research possibility.

PDAtt-Unet: Pyramid Dual-Decoder Attention Unet for Covid-19 infection segmentation from CT-scans

Since the emergence of the Covid-19 pandemic in late 2019, medical imaging has been widely used to analyse this disease. Indeed, CT-scans of the lungs can help diagnose, detect, and quantify Covid-19 infection. In this paper, we address the segmentation of Covid-19 infection from CT-scans. To improve the performance of the Att-Unet architecture and maximize the use of the Attention Gate, we propose the PAtt-Unet and DAtt-Unet architectures. PAtt-Unet aims to exploit the input pyramids to preserve the spatial awareness in all of the encoder layers. On the other hand, DAtt-Unet is designed to guide the segmentation of Covid-19 infection inside the lung lobes. We also propose to combine these two architectures into a single one, which we refer to as PDAtt-Unet. To overcome the blurry boundary pixels segmentation of Covid-19 infection, we propose a hybrid loss function. The proposed architectures were tested on four datasets with two evaluation scenarios (intra and cross datasets). Experimental results showed that both PAtt-Unet and DAtt-Unet improve the performance of Att-Unet in segmenting Covid-19 infections. Moreover, the combination architecture PDAtt-Unet led to further improvement. To Compare with other methods, three baseline segmentation architectures (Unet, Unet++, and Att-Unet) and three state-of-the-art architectures (InfNet, SCOATNet, and nCoVSegNet) were tested. The comparison showed the superiority of the proposed PDAtt-Unet trained with the proposed hybrid loss (PDEAtt-Unet) over all other methods. Moreover, PDEAtt-Unet is able to overcome various challenges in segmenting Covid-19 infections in four datasets and two evaluation scenarios.

MGL: Mutual Graph Learning for Camouflaged Object Detection

Camouflaged object detection, which aims to detect/segment the object(s) that blend in with their surrounding, remains challenging for deep models due to the intrinsic similarities between foreground objects and background surroundings. Ideally, an effective model should be capable of finding valuable clues from the given scene and integrating them into a joint learning framework to co-enhance the representation. Inspired by this observation, we propose a novel Mutual Graph Learning (MGL) model by shifting the conventional perspective of mutual learning from regular grids to graph domain. Specifically, an image is decoupled by MGL into two task-specific feature maps - one for finding the rough location of the target and the other for capturing its accurate boundary details. Then, the mutual benefits can be fully exploited by reasoning their high-order relations through graphs recurrently. It should be noted that our method is different from most mutual learning models that model all between-task interactions with the use of a shared function. To increase information interactions, MGL is built with typed functions for dealing with different complementary relations. To overcome the accuracy loss caused by interpolation to higher resolution and the computational redundancy resulting from recurrent learning, the S-MGL is equipped with a multi-source attention contextual recovery module, called R-MGL_v2, which uses the pixel feature information iteratively. Experiments on challenging datasets, including CHAMELEON, CAMO, COD10K, and NC4K demonstrate the effectiveness of our MGL with superior performance to existing state-of-the-art methods. The code can be found at https://github.com/fanyang587/MGL.

COVID-19 disease identification network based on weakly supervised feature selection

The coronavirus disease 2019 (COVID-19) outbreak has resulted in countless infections and deaths worldwide, posing increasing challenges for the health care system. The use of artificial intelligence to assist in diagnosis not only had a high accuracy rate but also saved time and effort in the sudden outbreak phase with the lack of doctors and medical equipment. This study aimed to propose a weakly supervised COVID-19 classification network (W-COVNet). This network was divided into three main modules: weakly supervised feature selection module (W-FS), deep learning bilinear feature fusion module (DBFF) and Grad-CAM++ based network visualization module (Grad-Ⅴ). The first module, W-FS, mainly removed redundant background features from computed tomography (CT) images, performed feature selection and retained core feature regions. The second module, DBFF, mainly used two symmetric networks to extract different features and thus obtain rich complementary features. The third module, Grad-Ⅴ, allowed the visualization of lesions in unlabeled images. A fivefold cross-validation experiment showed an average classification accuracy of 85.3%, and a comparison with seven advanced classification models showed that our proposed network had a better performance.

Computer-Aided Diagnosis of COVID-19 from Chest X-ray Images Using Hybrid-Features and Random Forest Classifier

In recent years, a lot of attention has been paid to using radiology imaging to automatically find COVID-19. (1) Background: There are now a number of computer-aided diagnostic schemes that help radiologists and doctors perform diagnostic COVID-19 tests quickly, accurately, and consistently. (2) Methods: Using chest X-ray images, this study proposed a cutting-edge scheme for the automatic recognition of COVID-19 and pneumonia. First, a pre-processing method based on a Gaussian filter and logarithmic operator is applied to input chest X-ray (CXR) images to improve the poor-quality images by enhancing the contrast, reducing the noise, and smoothing the image. Second, robust features are extracted from each enhanced chest X-ray image using a Convolutional Neural Network (CNNs) transformer and an optimal collection of grey-level co-occurrence matrices (GLCM) that contain features such as contrast, correlation, entropy, and energy. Finally, based on extracted features from input images, a random forest machine learning classifier is used to classify images into three classes, such as COVID-19, pneumonia, or normal. The predicted output from the model is combined with Gradient-weighted Class Activation Mapping (Grad-CAM) visualisation for diagnosis. (3) Results: Our work is evaluated using public datasets with three different train–test splits (70–30%, 80–20%, and 90–10%) and achieved an average accuracy, F1 score, recall, and precision of 97%, 96%, 96%, and 96%, respectively. A comparative study shows that our proposed method outperforms existing and similar work. The proposed approach can be utilised to screen COVID-19-infected patients effectively. (4) Conclusions: A comparative study with the existing methods is also performed. For performance evaluation, metrics such as accuracy, sensitivity, and F1-measure are calculated. The performance of the proposed method is better than that of the existing methodologies, and it can thus be used for the effective diagnosis of the disease.

Automated Quantification of Pneumonia Infected Volume in Lung CT Images: A Comparison with Subjective Assessment of Radiologists

OBJECTIVE

To help improve radiologists' efficacy of disease diagnosis in reading computed tomography (CT) images, this study aims to investigate the feasibility of applying a modified deep learning (DL) method as a new strategy to automatically segment disease-infected regions and predict disease severity.

METHODS

We employed a public dataset acquired from 20 COVID-19 patients, which includes manually annotated lung and infections masks, to train a new ensembled DL model that combines five customized residual attention U-Net models to segment disease infected regions followed by a Feature Pyramid Network model to predict disease severity stage. To test the potential clinical utility of the new DL model, we conducted an observer comparison study. First, we collected another set of CT images acquired from 80 COVID-19 patients and process images using the new DL model. Second, we asked two chest radiologists to read images of each CT scan and report the estimated percentage of the disease-infected lung volume and disease severity level. Third, we also asked radiologists to rate acceptance of DL model-generated segmentation results using a 5-scale rating method.

RESULTS

Data analysis results show that agreement of disease severity classification between the DL model and radiologists is >90% in 45 testing cases. Furthermore, >73% of cases received a high rating score (≥4) from two radiologists.

CONCLUSION

This study demonstrates the feasibility of developing a new DL model to automatically segment disease-infected regions and quantitatively predict disease severity, which may help avoid tedious effort and inter-reader variability in subjective assessment of disease severity in future clinical practice.

Pseudo-Label Guided Image Synthesis for Semi-Supervised COVID-19 Pneumonia Infection Segmentation

Coronavirus disease 2019 (COVID-19) has become a severe global pandemic. Accurate pneumonia infection segmentation is important for assisting doctors in diagnosing COVID-19. Deep learning-based methods can be developed for automatic segmentation, but the lack of large-scale well-annotated COVID-19 training datasets may hinder their performance. Semi-supervised segmentation is a promising solution which explores large amounts of unlabelled data, while most existing methods focus on pseudo-label refinement. In this paper, we propose a new perspective on semi-supervised learning for COVID-19 pneumonia infection segmentation, namely pseudo-label guided image synthesis. The main idea is to keep the pseudo-labels and synthesize new images to match them. The synthetic image has the same COVID-19 infected regions as indicated in the pseudo-label, and the reference style extracted from the style code pool is added to make it more realistic. We introduce two representative methods by incorporating the synthetic images into model training, including single-stage Synthesis-Assisted Cross Pseudo Supervision (SA-CPS) and multi-stage Synthesis-Assisted Self-Training (SA-ST), which can work individually as well as cooperatively. Synthesis-assisted methods expand the training data with high-quality synthetic data, thus improving the segmentation performance. Extensive experiments on two COVID-19 CT datasets for segmenting the infections demonstrate our method is superior to existing schemes for semi-supervised segmentation, and achieves the state-of-the-art performance on both datasets. Code is available at: https://github.com/FeiLyu/SASSL.

EffViT-COVID: A dual-path network for COVID-19 percentage estimation

The first case of novel Coronavirus (COVID-19) was reported in December 2019 in Wuhan City, China and led to an international outbreak. This virus causes serious respiratory illness and affects several other organs of the body differently for different patient. Worldwide, several waves of this infection have been reported, and researchers/doctors are working hard to develop novel solutions for the COVID diagnosis. Imaging and vision-based techniques are widely explored for the prediction of COVID-19; however, COVID infection percentage estimation is under explored. In this work, we propose a novel framework for the estimation of COVID-19 infection percentage based on deep learning techniques. The proposed network utilizes the features from vision transformers and CNN (Convolutional Neural Networks), specifically EfficientNet-B7. The features of both are fused together for preparing an information-rich feature vector that contributes to a more precise estimation of infection percentage. We evaluate our model on the Per-COVID-19 dataset (Bougourzi et al., 2021b) which comprises labeled CT data of COVID-19 patients. For the evaluation of the model on this dataset, we employ the most widely-used slice-level metrics, i.e., Pearson correlation coefficient (PC), Mean absolute error (MAE), and Root mean square error (RMSE). The network outperforms the other state-of-the-art methods and achieves 0 . 9886 ± 0 . 009 , 1 . 23 ± 0 . 378 , and 3 . 12 ± 1 . 56 , PC, MAE, and RMSE, respectively, using a 5-fold cross-validation technique. In addition, the overall average difference in the actual and predicted infection percentage is observed to be < 2 % . In conclusion, the detailed experimental results reveal the robustness and efficiency of the proposed network.

LDANet: Automatic lung parenchyma segmentation from CT images

Automatic segmentation of the lung parenchyma from computed tomography (CT) images is helpful for the subsequent diagnosis and treatment of patients. In this paper, based on a deep learning algorithm, a lung dense attention network (LDANet) is proposed with two mechanisms: residual spatial attention (RSA) and gated channel attention (GCA). RSA is utilized to weight the spatial information of the lung parenchyma and suppress feature activation in irrelevant regions, while the weights of each channel are adaptively calibrated using GCA to implicitly predict potential key features. Then, a dual attention guidance module (DAGM) is designed to maximize the integration of the advantages of both mechanisms. In addition, LDANet introduces a lightweight dense block (LDB) that reuses feature information and a positioned transpose block (PTB) that realizes accurate positioning and gradually restores the image resolution until the predicted segmentation map is generated. Experiments are conducted on two public datasets, LIDC-IDRI and COVID-19 CT Segmentation, on which LDANet achieves Dice similarity coefficient values of 0.98430 and 0.98319, respectively, outperforming a state-of-the-art lung segmentation model. Additionally, the effectiveness of the main components of LDANet is demonstrated through ablation experiments.

A convolutional neural network with pixel-wise sparse graph reasoning for COVID-19 lesion segmentation in CT images

The COVID-19 pandemic has extremely threatened human health, and automated algorithms are needed to segment infected regions in the lung using computed tomography (CT). Although several deep convolutional neural networks (DCNNs) have proposed for this purpose, their performance on this task is suppressed due to the limited local receptive field and deficient global reasoning ability. To address these issues, we propose a segmentation network with a novel pixel-wise sparse graph reasoning (PSGR) module for the segmentation of COVID-19 infected regions in CT images. The PSGR module, which is inserted between the encoder and decoder of the network, can improve the modeling of global contextual information. In the PSGR module, a graph is first constructed by projecting each pixel on a node based on the features produced by the encoder. Then, we convert the graph into a sparsely-connected one by keeping K strongest connections to each uncertainly segmented pixel. Finally, the global reasoning is performed on the sparsely-connected graph. Our segmentation network was evaluated on three publicly available datasets and compared with a variety of widely-used segmentation models. Our results demonstrate that (1) the proposed PSGR module can capture the long-range dependencies effectively and (2) the segmentation model equipped with this PSGR module can accurately segment COVID-19 infected regions in CT images and outperform all other competing models.

A novel adaptive cubic quasi-Newton optimizer for deep learning based medical image analysis tasks, validated on detection of COVID-19 and segmentation for COVID-19 lung infection, liver tumor, and optic disc/cup

BACKGROUND

Most of existing deep learning research in medical image analysis is focused on networks with stronger performance. These networks have achieved success, while their architectures are complex and even contain massive parameters ranging from thousands to millions in numbers. The nature of high dimension and nonconvex makes it easy to train a suboptimal model through the popular stochastic first-order optimizers, which only use gradient information.

PURPOSE

Our purpose is to design an adaptive cubic quasi-Newton optimizer, which could help to escape from suboptimal solution and improve the performance of deep neural networks on four medical image analysis tasks including: detection of COVID-19, COVID-19 lung infection segmentation, liver tumor segmentation, optic disc/cup segmentation.

METHODS

In this work, we introduce a novel adaptive cubic quasi-Newton optimizer with high-order moment (termed ACQN-H) for medical image analysis. The optimizer dynamically captures the curvature of the loss function by diagonally approximated Hessian and the norm of difference between previous two estimates, which helps to escape from saddle points more efficiently. In addition, to reduce the variance introduced by the stochastic nature of the problem, ACQN-H hires high-order moment through exponential moving average on iteratively calculated approximated Hessian matrix. Extensive experiments are performed to access the performance of ACQN-H. These include detection of COVID-19 using COVID-Net on dataset COVID-chestxray, which contains 16 565 training samples and 1841 test samples; COVID-19 lung infection segmentation using Inf-Net on COVID-CT, which contains 45, 5, and 5 computer tomography (CT) images for training, validation, and testing, respectively; liver tumor segmentation using ResUNet on LiTS2017, which consists of 50 622 abdominal scan images for training and 26 608 images for testing; optic disc/cup segmentation using MRNet on RIGA, which has 655 color fundus images for training and 95 for testing. The results are compared with commonly used stochastic first-order optimizers such as Adam, SGD, and AdaBound, and recently proposed stochastic quasi-Newton optimizer Apollo. In task detection of COVID-19, we use classification accuracy as the evaluation metric. For the other three medical image segmentation tasks, seven commonly used evaluation metrics are utilized, that is, Dice, structure measure, enhanced-alignment measure (EM), mean absolute error (MAE), intersection over union (IoU), true positive rate (TPR), and true negative rate.

RESULTS

Experiments on four tasks show that ACQN-H achieves improvements over other stochastic optimizers: (1) comparing with AdaBound, ACQN-H achieves 0.49%, 0.11%, and 0.70% higher accuracy on the COVID-chestxray dataset using network COVID-Net with VGG16, ResNet50 and DenseNet121 as backbones, respectively; (2) ACQN-H has the best scores in terms of evaluation metrics Dice, TPR, EM, and MAE on COVID-CT dataset using network Inf-Net. Particularly, ACQN-H achieves 1.0% better Dice as compared to Apollo; (3) ACQN-H achieves the best results on LiTS2017 dataset using network ResUNet, and outperforms Adam in terms of Dice by 2.3%; (4) ACQN-H improves the performance of network MRNet on RIGA dataset, and achieves 0.5% and 1.0% better scores on cup segmentation for Dice and IoU, respectively, compared with SGD. We also present fivefold validation results of four tasks. It can be found that the results on detection of COVID-19, liver tumor segmentation and optic disc/cup segmentation can achieve high performance with low variance. For COVID-19 lung infection segmentation, the variance on test set is much larger than on validation set, which may due to small size of dataset.

CONCLUSIONS

The proposed optimizer ACQN-H has been validated on four medical image analysis tasks including: detection of COVID-19 using COVID-Net on COVID-chestxray, COVID-19 lung infection segmentation using Inf-Net on COVID-CT, liver tumor segmentation using ResUNet on LiTS2017, optic disc/cup segmentation using MRNet on RIGA. Experiments show that ACQN-H can achieve some performance improvement. Moreover, the work is expected to boost the performance of existing deep learning networks in medical image analysis.

MMViT-Seg: A lightweight transformer and CNN fusion network for COVID-19 segmentation

BACKGROUND AND OBJECTIVE

COVID-19 is a serious threat to human health. Traditional convolutional neural networks (CNNs) can realize medical image segmentation, whilst transformers can be used to perform machine vision tasks, because they have a better ability to capture long-range relationships than CNNs. The combination of CNN and transformers to complete the task of semantic segmentation has attracted intense research. Currently, it is challenging to segment medical images on limited data sets like that on COVID-19.

METHODS

This study proposes a lightweight transformer+CNN model, in which the encoder sub-network is a two-path design that enables both the global dependence of image features and the low layer spatial details to be effectively captured. Using CNN and MobileViT to jointly extract image features reduces the amount of computation and complexity of the model as well as improves the segmentation performance. So this model is titled Mini-MobileViT-Seg (MMViT-Seg). In addition, a multi query attention (MQA) module is proposed to fuse the multi-scale features from different levels of decoder sub-network, further improving the performance of the model. MQA can simultaneously fuse multi-input, multi-scale low-level feature maps and high-level feature maps as well as conduct end-to-end supervised learning guided by ground truth.

RESULTS

The two-class infection labeling experiments were conducted based on three datasets. The final results show that the proposed model has the best performance and the minimum number of parameters among five popular semantic segmentation algorithms. In multi-class infection labeling results, the proposed model also achieved competitive performance.

CONCLUSIONS

The proposed MMViT-Seg is tested on three COVID-19 segmentation datasets, with results showing that this model has better performance than other models. In addition, the proposed MQA module, which can effectively fuse multi-scale features of different levels further improves the segmentation accuracy.

RA-DENet: Reverse Attention and Distractions Elimination Network for polyp segmentation

To address the problems of polyps of different shapes, sizes, and colors, low-contrast polyps, various noise distractions, and blurred edges on colonoscopy, we propose the Reverse Attention and Distraction Elimination Network, which includes Improved Reverse Attention, Distraction Elimination, and Feature Enhancement. First, we input the images in the polyp image set, and use the five levels polyp features and the global polyp feature extracted from the Res2Net-based backbone as the input of the Improved Reverse Attention to obtain augmented representations of salient and non-salient regions to capture the different shapes of polyp and distinguish low-contrast polyps from background. Then, the augmented representations of salient and non-salient areas are fed into the Distraction Elimination to obtain the refined polyp feature without false positive and false negative distractions for eliminating noises. Finally, the extracted low-level polyp feature is used as the input of the Feature Enhancement to obtain the edge feature for supplementing missing edge information of polyp. The polyp segmentation result is output by connecting the edge feature with the refined polyp feature. The proposed method is evaluated on five polyp datasets and compared with the current polyp segmentation models. Our model improves the mDice to 0.760 on the most challenge dataset (ETIS).

COVID-19 CT ground-glass opacity segmentation based on attention mechanism threshold

The ground glass opacity (GGO) of the lung is one of the essential features of COVID-19. The GGO in computed tomography (CT) images has various features and low-intensity contrast between the GGO and edge structures. These problems pose significant challenges for segmenting the GGO. To tackle these problems, we propose a new threshold method for accurate segmentation of GGO. Specifically, we offer a framework for adjusting the threshold parameters according to the image contrast. Three functions include Attention mechanism threshold, Contour equalization, and Lung segmentation (ACL). The lung is divided into three areas using the attention mechanism threshold. Further, the segmentation parameters of the attention mechanism thresholds of the three parts are adaptively adjusted according to the image contrast. Only the segmentation regions restricted by the lung segmentation results are retained. Extensive experiments on four COVID datasets show that ACL can segment GGO images at low contrast well. Compared with the state-of-the-art methods, the similarity Dice of the ACL segmentation results is improved by 8.9%, the average symmetry surface distance ASD is reduced by 23%, and the required computational power F L O P s are only 0.09% of those of deep learning models. For GGO segmentation, ACL is more lightweight, and the accuracy is higher. Code will be released at https://github.com/Lqs-github/ACL.

Local contrastive loss with pseudo-label based self-training for semi-supervised medical image segmentation

Supervised deep learning-based methods yield accurate results for medical image segmentation. However, they require large labeled datasets for this, and obtaining them is a laborious task that requires clinical expertise. Semi/self-supervised learning-based approaches address this limitation by exploiting unlabeled data along with limited annotated data. Recent self-supervised learning methods use contrastive loss to learn good global level representations from unlabeled images and achieve high performance in classification tasks on popular natural image datasets like ImageNet. In pixel-level prediction tasks such as segmentation, it is crucial to also learn good local level representations along with global representations to achieve better accuracy. However, the impact of the existing local contrastive loss-based methods remains limited for learning good local representations because similar and dissimilar local regions are defined based on random augmentations and spatial proximity; not based on the semantic label of local regions due to lack of large-scale expert annotations in the semi/self-supervised setting. In this paper, we propose a local contrastive loss to learn good pixel level features useful for segmentation by exploiting semantic label information obtained from pseudo-labels of unlabeled images alongside limited annotated images with ground truth (GT) labels. In particular, we define the proposed contrastive loss to encourage similar representations for the pixels that have the same pseudo-label/GT label while being dissimilar to the representation of pixels with different pseudo-label/GT label in the dataset. We perform pseudo-label based self-training and train the network by jointly optimizing the proposed contrastive loss on both labeled and unlabeled sets and segmentation loss on only the limited labeled set. We evaluated the proposed approach on three public medical datasets of cardiac and prostate anatomies, and obtain high segmentation performance with a limited labeled set of one or two 3D volumes. Extensive comparisons with the state-of-the-art semi-supervised and data augmentation methods and concurrent contrastive learning methods demonstrate the substantial improvement achieved by the proposed method. The code is made publicly available at https://github.com/krishnabits001/pseudo_label_contrastive_training.

Multi-Attention Segmentation Networks Combined with the Sobel Operator for Medical Images

Medical images are used as an important basis for diagnosing diseases, among which CT images are seen as an important tool for diagnosing lung lesions. However, manual segmentation of infected areas in CT images is time-consuming and laborious. With its excellent feature extraction capabilities, a deep learning-based method has been widely used for automatic lesion segmentation of COVID-19 CT images. However, the segmentation accuracy of these methods is still limited. To effectively quantify the severity of lung infections, we propose a Sobel operator combined with multi-attention networks for COVID-19 lesion segmentation (SMA-Net). In our SMA-Net method, an edge feature fusion module uses the Sobel operator to add edge detail information to the input image. To guide the network to focus on key regions, SMA-Net introduces a self-attentive channel attention mechanism and a spatial linear attention mechanism. In addition, the Tversky loss function is adopted for the segmentation network for small lesions. Comparative experiments on COVID-19 public datasets show that the average Dice similarity coefficient (DSC) and joint intersection over union (IOU) of the proposed SMA-Net model are 86.1% and 77.8%, respectively, which are better than those in most existing segmentation networks.

Deep Learning Applied to Intracranial Hemorrhage Detection

Intracranial hemorrhage is a serious medical problem that requires rapid and often intensive medical care. Identifying the location and type of any hemorrhage present is a critical step in the treatment of the patient. Detection of, and diagnosis of, a hemorrhage that requires an urgent procedure is a difficult and time-consuming process for human experts. In this paper, we propose methods based on EfficientDet's deep-learning technology that can be applied to the diagnosis of hemorrhages at a patient level and which could, thus, become a decision-support system. Our proposal is two-fold. On the one hand, the proposed technique classifies slices of computed tomography scans for the presence of hemorrhage or its lack of, and evaluates whether the patient is positive in terms of hemorrhage, and achieving, in this regard, 92.7% accuracy and 0.978 ROC AUC. On the other hand, our methodology provides visual explanations of the chosen classification using the Grad-CAM methodology.

Improving Data-Efficiency and Robustness of Medical Imaging Segmentation Using Inpainting-Based Self-Supervised Learning

We systematically evaluate the training methodology and efficacy of two inpainting-based pretext tasks of context prediction and context restoration for medical image segmentation using self-supervised learning (SSL). Multiple versions of self-supervised U-Net models were trained to segment MRI and CT datasets, each using a different combination of design choices and pretext tasks to determine the effect of these design choices on segmentation performance. The optimal design choices were used to train SSL models that were then compared with baseline supervised models for computing clinically-relevant metrics in label-limited scenarios. We observed that SSL pretraining with context restoration using 32 × 32 patches and Poission-disc sampling, transferring only the pretrained encoder weights, and fine-tuning immediately with an initial learning rate of 1 × 10-3 provided the most benefit over supervised learning for MRI and CT tissue segmentation accuracy (p < 0.001). For both datasets and most label-limited scenarios, scaling the size of unlabeled pretraining data resulted in improved segmentation performance. SSL models pretrained with this amount of data outperformed baseline supervised models in the computation of clinically-relevant metrics, especially when the performance of supervised learning was low. Our results demonstrate that SSL pretraining using inpainting-based pretext tasks can help increase the robustness of models in label-limited scenarios and reduce worst-case errors that occur with supervised learning.

Utilisation of deep learning for COVID-19 diagnosis

The COVID-19 pandemic that began in 2019 has resulted in millions of deaths worldwide. Over this period, the economic and healthcare consequences of COVID-19 infection in survivors of acute COVID-19 infection have become apparent. During the course of the pandemic, computer analysis of medical images and data have been widely used by the medical research community. In particular, deep-learning methods, which are artificial intelligence (AI)-based approaches, have been frequently employed. This paper provides a review of deep-learning-based AI techniques for COVID-19 diagnosis using chest radiography and computed tomography. Thirty papers published from February 2020 to March 2022 that used two-dimensional (2D)/three-dimensional (3D) deep convolutional neural networks combined with transfer learning for COVID-19 detection were reviewed. The review describes how deep-learning methods detect COVID-19, and several limitations of the proposed methods are highlighted.

MT-nCov-Net: A Multitask Deep-Learning Framework for Efficient Diagnosis of COVID-19 Using Tomography Scans

The localization and segmentation of the novel coronavirus disease of 2019 (COVID-19) lesions from computerized tomography (CT) scans are of great significance for developing an efficient computer-aided diagnosis system. Deep learning (DL) has emerged as one of the best choices for developing such a system. However, several challenges limit the efficiency of DL approaches, including data heterogeneity, considerable variety in the shape and size of the lesions, lesion imbalance, and scarce annotation. In this article, a novel multitask regression network for segmenting COVID-19 lesions is proposed to address these challenges. We name the framework MT-nCov-Net. We formulate lesion segmentation as a multitask shape regression problem that enables partaking the poor-, intermediate-, and high-quality features between various tasks. A multiscale feature learning (MFL) module is presented to capture the multiscale semantic information, which helps to efficiently learn small and large lesion features while reducing the semantic gap between different scale representations. In addition, a fine-grained lesion localization (FLL) module is introduced to detect infection lesions using an adaptive dual-attention mechanism. The generated location map and the fused multiscale representations are subsequently passed to the lesion regression (LR) module to segment the infection lesions. MT-nCov-Net enables learning complete lesion properties to accurately segment the COVID-19 lesion by regressing its shape. MT-nCov-Net is experimentally evaluated on two public multisource datasets, and the overall performance validates its superiority over the current cutting-edge approaches and demonstrates its effectiveness in tackling the problems facing the diagnosis of COVID-19.

Boundary-Sensitive Loss Function With Location Constraint for Hard Region Segmentation

In computer-aided diagnosis and treatment planning, accurate segmentation of medical images plays an essential role, especially for some hard regions including boundaries, small objects and background interference. However, existing segmentation loss functions including distribution-, region- and boundary-based losses cannot achieve satisfactory performances on these hard regions. In this paper, a boundary-sensitive loss function with location constraint is proposed for hard region segmentation in medical images, which provides three advantages: i) our Boundary-Sensitive loss (BS-loss) can automatically pay more attention to the hard-to-segment boundaries (e.g., thin structures and blurred boundaries), thus obtaining finer object boundaries; ii) BS-loss also can adjust its attention to small objects during training to segment them more accurately; and iii) our location constraint can alleviate the negative impact of the background interference, through the distribution matching of pixels between prediction and Ground Truth (GT) along each axis. By resorting to the proposed BS-loss and location constraint, the hard regions in both foreground and background are considered. Experimental results on three public datasets demonstrate the superiority of our method. Specifically, compared to the second-best method tested in this study, our method improves performance on hard regions in terms of Dice similarity coefficient (DSC) and 95% Hausdorff distance (95%HD) of up to 4.17% and 73% respectively. In addition, it also achieves the best overall segmentation performance. Hence, we can conclude that our method can accurately segment these hard regions and improve the overall segmentation performance in medical images.

Bilateral adaptive graph convolutional network on CT based Covid-19 diagnosis with uncertainty-aware consensus-assisted multiple instance learning

Coronavirus disease (COVID-19) has caused a worldwide pandemic, putting millions of people's health and lives in jeopardy. Detecting infected patients early on chest computed tomography (CT) is critical in combating COVID-19. Harnessing uncertainty-aware consensus-assisted multiple instance learning (UC-MIL), we propose to diagnose COVID-19 using a new bilateral adaptive graph-based (BA-GCN) model that can use both 2D and 3D discriminative information in 3D CT volumes with arbitrary number of slices. Given the importance of lung segmentation for this task, we have created the largest manual annotation dataset so far with 7,768 slices from COVID-19 patients, and have used it to train a 2D segmentation model to segment the lungs from individual slices and mask the lungs as the regions of interest for the subsequent analyses. We then used the UC-MIL model to estimate the uncertainty of each prediction and the consensus between multiple predictions on each CT slice to automatically select a fixed number of CT slices with reliable predictions for the subsequent model reasoning. Finally, we adaptively constructed a BA-GCN with vertices from different granularity levels (2D and 3D) to aggregate multi-level features for the final diagnosis with the benefits of the graph convolution network's superiority to tackle cross-granularity relationships. Experimental results on three largest COVID-19 CT datasets demonstrated that our model can produce reliable and accurate COVID-19 predictions using CT volumes with any number of slices, which outperforms existing approaches in terms of learning and generalisation ability. To promote reproducible research, we have made the datasets, including the manual annotations and cleaned CT dataset, as well as the implementation code, available at https://doi.org/10.5281/zenodo.6361963.

Deep Gradient Learning for Efficient Camouflaged Object Detection

This paper introduces deep gradient network (DGNet), a novel deep framework that exploits object gradient supervision for camouflaged object detection (COD). It decouples the task into two connected branches, i.e., a context and a texture encoder. The essential connection is the gradient-induced transition, representing a soft grouping between context and texture features. Benefiting from the simple but efficient framework, DGNet outperforms existing state-of-the-art COD models by a large margin. Notably, our efficient version, DGNet-S, runs in real-time (80 fps) and achieves comparable results to the cutting-edge model JCSOD-CVPR21 with only 6.82% parameters. The application results also show that the proposed DGNet performs well in the polyp segmentation, defect detection, and transparent object segmentation tasks. The code will be made available at https://github.com/GewelsJI/DGNet.

An attention residual u-net with differential preprocessing and geometric postprocessing: Learning how to segment vasculature including intracranial aneurysms

OBJECTIVE

Intracranial aneurysms (IA) are lethal, with high morbidity and mortality rates. Reliable, rapid, and accurate segmentation of IAs and their adjacent vasculature from medical imaging data is important to improve the clinical management of patients with IAs. However, due to the blurred boundaries and complex structure of IAs and overlapping with brain tissue or other cerebral arteries, image segmentation of IAs remains challenging. This study aimed to develop an attention residual U-Net (ARU-Net) architecture with differential preprocessing and geometric postprocessing for automatic segmentation of IAs and their adjacent arteries in conjunction with 3D rotational angiography (3DRA) images.

METHODS

The proposed ARU-Net followed the classic U-Net framework with the following key enhancements. First, we preprocessed the 3DRA images based on boundary enhancement to capture more contour information and enhance the presence of small vessels. Second, we introduced the long skip connections of the attention gate at each layer of the fully convolutional decoder-encoder structure to emphasize the field of view (FOV) for IAs. Third, residual-based short skip connections were also embedded in each layer to implement in-depth supervision to help the network converge. Fourth, we devised a multiscale supervision strategy for independent prediction at different levels of the decoding path, integrating multiscale semantic information to facilitate the segmentation of small vessels. Fifth, the 3D conditional random field (3DCRF) and 3D connected component optimization (3DCCO) were exploited as postprocessing to optimize the segmentation results.

RESULTS

Comprehensive experimental assessments validated the effectiveness of our ARU-Net. The proposed ARU-Net model achieved comparable or superior performance to the state-of-the-art methods through quantitative and qualitative evaluations. Notably, we found that ARU-Net improved the identification of arteries connecting to an IA, including small arteries that were hard to recognize by other methods. Consequently, IA geometries segmented by the proposed ARU-Net model yielded superior performance during subsequent computational hemodynamic studies (also known as "patient-specific" computational fluid dynamics [CFD] simulations). Furthermore, in an ablation study, the five key enhancements mentioned above were confirmed.

CONCLUSIONS

The proposed ARU-Net model can automatically segment the IAs in 3DRA images with relatively high accuracy and potentially has significant value for clinical computational hemodynamic analysis.

Structural Attention Graph Neural Network for Diagnosis and Prediction of COVID-19 Severity

With rapid worldwide spread of Coronavirus Disease 2019 (COVID-19), jointly identifying severe COVID-19 cases from mild ones and predicting the conversion time (from mild to severe) is essential to optimize the workflow and reduce the clinician's workload. In this study, we propose a novel framework for COVID-19 diagnosis, termed as Structural Attention Graph Neural Network (SAGNN), which can combine the multi-source information including features extracted from chest CT, latent lung structural distribution, and non-imaging patient information to conduct diagnosis of COVID-19 severity and predict the conversion time from mild to severe. Specifically, we first construct a graph to incorporate structural information of the lung and adopt graph attention network to iteratively update representations of lung segments. To distinguish different infection degrees of left and right lungs, we further introduce a structural attention mechanism. Finally, we introduce demographic information and develop a multi-task learning framework to jointly perform both tasks of classification and regression. Experiments are conducted on a real dataset with 1687 chest CT scans, which includes 1328 mild cases and 359 severe cases. Experimental results show that our method achieves the best classification (e.g., 86.86% in terms of Area Under Curve) and regression (e.g., 0.58 in terms of Correlation Coefficient) performance, compared with other comparison methods.

BPCN: bilateral progressive compensation network for lung infection image segmentation

Lung infection image segmentation is a key technology for autonomous understanding of the potential illness. However, current approaches usually lose the low-level details, which leads to a considerable accuracy decrease for lung infection areas with varied shapes and sizes. In this paper, we propose bilateral progressive compensation network (BPCN), a bilateral progressive compensation network to improve the accuracy of lung lesion segmentation through complementary learning of spatial and semantic features. The proposed BPCN are mainly composed of two deep branches. One branch is the multi-scale progressive fusion for main region features. The other branch is a flow-field based adaptive body-edge aggregation operations to explicitly learn detail features of lung infection areas which is supplement to region features. In addition, we propose a bilateral spatial-channel down-sampling to generate a hierarchical complementary feature which avoids losing discriminative features caused by pooling operations. Experimental results show that our proposed network outperforms state-of-the-art segmentation methods in lung infection segmentation on two public image datasets with or without a pseudo-label training strategy.

Research on the Application of Artificial Intelligence in Public Health Management: Leveraging Artificial Intelligence to Improve COVID-19 CT Image Diagnosis

Since the start of 2020, the outbreak of the Coronavirus disease (COVID-19) has been a global public health emergency, and it has caused unprecedented economic and social disaster. In order to improve the diagnosis efficiency of COVID-19 patients, a number of researchers have conducted extensive studies on applying artificial intelligence techniques to the analysis of COVID-19-related medical images. The automatic segmentation of lesions from computed tomography (CT) images using deep learning provides an important basis for the quantification and diagnosis of COVID-19 cases. For a deep learning-based CT diagnostic method, a few of accurate pixel-level labels are essential for the training process of a model. However, the translucent ground-glass area of the lesion usually leads to mislabeling while performing the manual labeling operation, which weakens the accuracy of the model. In this work, we propose a method for correcting rough labels; that is, to hierarchize these rough labels into precise ones by performing an analysis on the pixel distribution of the infected and normal areas in the lung. The proposed method corrects the incorrectly labeled pixels and enables the deep learning model to learn the infected degree of each infected pixel, with which an aiding system (named DLShelper) for COVID-19 CT image diagnosis using the hierarchical labels is also proposed. The DLShelper targets lesion segmentation from CT images, as well as the severity grading. The DLShelper assists medical staff in efficient diagnosis by providing rich auxiliary diagnostic information (including the severity grade, the proportions of the lesion and the visualization of the lesion area). A comprehensive experiment based on a public COVID-19 CT image dataset is also conducted, and the experimental results show that the DLShelper significantly improves the accuracy of segmentation for the lesion areas and also achieves a promising accuracy for the severity grading task.

RNN-combined graph convolutional network with multi-feature fusion for tuberculosis cavity segmentation

Tuberculosis is a common infectious disease in the world. Tuberculosis cavities are common and an important imaging signs in tuberculosis. Accurate segmentation of tuberculosis cavities has practical significance for indicating the activity of lesions and guiding clinical treatment. However, this task faces challenges such as blurred boundaries, irregular shapes, different location and size of lesions and similar structures on computed tomography (CT) to other lung diseases or tissues. To overcome these problems, we propose a novel RNN-combined graph convolutional network (R2GCN) method, which integrates the bidirectional recurrent network (BRN) and graph convolution network (GCN) modules. First, feature extraction is performed on the input image by VGG-16 or ResNet-50 to obtain the feature map. The feature map is then used as the input of the two modules. On the one hand, we adopt the BRN to retrieve contextual information from the feature map. On the other hand, we take the vector for each location in the feature map as input nodes and utilize GCN to extract node topology information. Finally, two types of features obtained fuse together. Our strategy can not only make full use of node correlations and differences, but also obtain more precise segmentation boundaries. Extensive experiments on CT images of cavitary patients with tuberculosis show that our proposed method achieves the best segmentation accuracy than compared segmentation methods. Our method can be used for the diagnosis of tuberculosis cavity and the evaluation of tuberculosis cavity treatment.

Fusing clinical and image data for detecting the severity level of hospitalized symptomatic COVID-19 patients using hierarchical model

Purpose

Based on medical reports, it is hard to find levels of different hospitalized symptomatic COVID-19 patients according to their features in a short time. Besides, there are common and special features for COVID-19 patients at different levels based on physicians’ knowledge that make diagnosis difficult. For this purpose, a hierarchical model is proposed in this paper based on experts’ knowledge, fuzzy C-mean (FCM) clustering, and adaptive neuro-fuzzy inference system (ANFIS) classifier.

Methods

Experts considered a special set of features for different groups of COVID-19 patients to find their treatment plans. Accordingly, the structure of the proposed hierarchical model is designed based on experts’ knowledge. In the proposed model, we applied clustering methods to patients’ data to determine some clusters. Then, we learn classifiers for each cluster in a hierarchical model. Regarding different common and special features of patients, FCM is considered for the clustering method. Besides, ANFIS had better performances than other classification methods. Therefore, FCM and ANFIS were considered to design the proposed hierarchical model. FCM finds the membership degree of each patient’s data based on common and special features of different clusters to reinforce the ANFIS classifier. Next, ANFIS identifies the need of hospitalized symptomatic COVID-19 patients to ICU and to find whether or not they are in the end-stage (mortality target class). Two real datasets about COVID-19 patients are analyzed in this paper using the proposed model. One of these datasets had only clinical features and another dataset had both clinical and image features. Therefore, some appropriate features are extracted using some image processing and deep learning methods.

Results

According to the results and statistical test, the proposed model has the best performance among other utilized classifiers. Its accuracies based on clinical features of the first and second datasets are 92% and 90% to find the ICU target class. Extracted features of image data increase the accuracy by 94%.

Conclusion

The accuracy of this model is even better for detecting the mortality target class among different classifiers in this paper and the literature review. Besides, this model is compatible with utilized datasets about COVID-19 patients based on clinical data and both clinical and image data, as well.

Highlights

• A new hierarchical model is proposed using ANFIS classifiers and FCM clustering method in this paper. Its structure is designed based on experts’ knowledge and real medical process. FCM reinforces the ANFIS classification learning phase based on the features of COVID-19 patients.

• Two real datasets about COVID-19 patients are studied in this paper. One of these datasets has both clinical and image data. Therefore, appropriate features are extracted based on its image data and considered with available meaningful clinical data. Different levels of hospitalized symptomatic COVID-19 patients are considered in this paper including the need of patients to ICU and whether or not they are in end-stage.

• Well-known classification methods including case-based reasoning (CBR), decision tree, convolutional neural networks (CNN), K-nearest neighbors (KNN), learning vector quantization (LVQ), multi-layer perceptron (MLP), Naive Bayes (NB), radial basis function network (RBF), support vector machine (SVM), recurrent neural networks (RNN), fuzzy type-I inference system (FIS), and adaptive neuro-fuzzy inference system (ANFIS) are designed for these datasets and their results are analyzed for different random groups of the train and test data;

• According to unbalanced utilized datasets, different performances of classifiers including accuracy, sensitivity, specificity, precision, F-score, and G-mean are compared to find the best classifier. ANFIS classifiers have the best results for both datasets.

• To reduce the computational time, the effects of the Principal Component Analysis (PCA) feature reduction method are studied on the performances of the proposed model and classifiers. According to the results and statistical test, the proposed hierarchical model has the best performances among other utilized classifiers.

Graphical Abstract

Supplementary Information

The online version contains supplementary material available at 10.1007/s42600-023-00268-w.

Multi-center Integrating Radiomics, Structured Reports, and Machine Learning Algorithms for Assisted Classification of COVID-19 in Lung Computed Tomography

Purpose

To evaluate the classification performance of structured report features, radiomics, and machine learning (ML) models to differentiate between Coronavirus Disease 2019 (COVID-19) and other types of pneumonia using chest computed tomography (CT) scans.

Methods

Sixty-four COVID-19 subjects and 64 subjects with non-COVID-19 pneumonia were selected. The data was split into two independent cohorts: one for the structured report, radiomic feature selection and model building (n = 73), and another for model validation (n = 55). Physicians performed readings with and without machine learning support. The model's sensitivity and specificity were calculated, and inter-rater reliability was assessed using Cohen's Kappa agreement coefficient.

Results

Physicians performed with mean sensitivity and specificity of 83.4 and 64.3%, respectively. When assisted with machine learning, the mean sensitivity and specificity increased to 87.1 and 91.1%, respectively. In addition, machine learning improved the inter-rater reliability from moderate to substantial.

Conclusion

Integrating structured reports and radiomics promises assisted classification of COVID-19 in CT chest scans.

Contrastive Semi-Supervised Learning for Domain Adaptive Segmentation Across Similar Anatomical Structures

Convolutional Neural Networks (CNNs) have achieved state-of-the-art performance for medical image segmentation, yet need plenty of manual annotations for training. Semi-Supervised Learning (SSL) methods are promising to reduce the requirement of annotations, but their performance is still limited when the dataset size and the number of annotated images are small. Leveraging existing annotated datasets with similar anatomical structures to assist training has a potential for improving the model's performance. However, it is further challenged by the cross-anatomy domain shift due to the image modalities and even different organs in the target domain. To solve this problem, we propose Contrastive Semi-supervised learning for Cross Anatomy Domain Adaptation (CS-CADA) that adapts a model to segment similar structures in a target domain, which requires only limited annotations in the target domain by leveraging a set of existing annotated images of similar structures in a source domain. We use Domain-Specific Batch Normalization (DSBN) to individually normalize feature maps for the two anatomical domains, and propose a cross-domain contrastive learning strategy to encourage extracting domain invariant features. They are integrated into a Self-Ensembling Mean-Teacher (SE-MT) framework to exploit unlabeled target domain images with a prediction consistency constraint. Extensive experiments show that our CS-CADA is able to solve the challenging cross-anatomy domain shift problem, achieving accurate segmentation of coronary arteries in X-ray images with the help of retinal vessel images and cardiac MR images with the help of fundus images, respectively, given only a small number of annotations in the target domain. Our code is available at https://github.com/HiLab-git/DAG4MIA.

An Explainable AI driven Decision Support System for COVID-19 Diagnosis using Fused Classification and Segmentation

The coronavirus has caused havoc on billions of people worldwide. The Reverse Transcription Polymerase Chain Reaction(RT-PCR) test is widely accepted as a standard diagnostic tool for detecting infection, however, the severity of infection can't be measured accurately with RT-PCR results. Chest CT Scans of infected patients can manifest the presence of lesions with high sensitivity. During the pandemic, there is a dearth of competent doctors to examine chest CT images. Therefore, a Guided Gradcam based Explainable Classification and Segmentation system (GGECS) which is a real-time explainable classification and lesion identification decision support system is proposed in this work. The classification model used in the proposed GGECS system is inspired by Res2Net. Explainable AI techniques like GradCam and Guided GradCam are used to demystify Convolutional Neural Networks (CNNs). These explainable systems can assist in localizing the regions in the CT scan that contribute significantly to the system's prediction. The segmentation model can further reliably localize infected regions. The segmentation model is a fusion between the VGG-16 and the classification network. The proposed classification model in GGECS obtains an overall accuracy of 98.51 % and the segmentation model achieves an IoU score of 0.595.

A teacher-student framework with Fourier Transform augmentation for COVID-19 infection segmentation in CT images

Automatic segmentation of infected regions in computed tomography (CT) images is necessary for the initial diagnosis of COVID-19. Deep-learning-based methods have the potential to automate this task but require a large amount of data with pixel-level annotations. Training a deep network with annotated lung cancer CT images, which are easier to obtain, can alleviate this problem to some extent. However, this approach may suffer from a reduction in performance when applied to unseen COVID-19 images during the testing phase, caused by the difference in the image intensity and object region distribution between the training set and test set. In this paper, we proposed a novel unsupervised method for COVID-19 infection segmentation that aims to learn the domain-invariant features from lung cancer and COVID-19 images to improve the generalization ability of the segmentation network for use with COVID-19 CT images. First, to address the intensity difference, we proposed a novel data augmentation module based on Fourier Transform, which transfers the annotated lung cancer data into the style of COVID-19 image. Secondly, to reduce the distribution difference, we designed a teacher-student network to learn rotation-invariant features for segmentation. The experiments demonstrated that even without getting access to the annotations of the COVID-19 CT images during the training phase, the proposed network can achieve a state-of-the-art segmentation performance on COVID-19 infection.