Covid-MANet: Multi-task attention network for explainable diagnosis and severity assessment of COVID-19 from CXR images

Unlocking the Power of 3D Convolutional Neural Networks for COVID-19 Detection: A Comprehensive Review

The advent of three-dimensional convolutional neural networks (3D CNNs) has revolutionized the detection and analysis of COVID-19 cases. As imaging technologies have advanced, 3D CNNs have emerged as a powerful tool for segmenting and classifying COVID-19 in medical images. These networks have demonstrated both high accuracy and rapid detection capabilities, making them crucial for effective COVID-19 diagnostics. This study offers a thorough review of various 3D CNN algorithms, evaluating their efficacy in segmenting and classifying COVID-19 across a range of medical imaging modalities. This review systematically examines recent advancements in 3D CNN methodologies. The process involved a comprehensive screening of abstracts and titles to ensure relevance, followed by a meticulous selection and analysis of research papers from academic repositories. The study evaluates these papers based on specific criteria and provides detailed insights into the network architectures and algorithms used for COVID-19 detection. The review reveals significant trends in the use of 3D CNNs for COVID-19 segmentation and classification. It highlights key findings, including the diverse range of networks employed for COVID-19 detection compared to other diseases, which predominantly utilize encoder/decoder frameworks. The study provides an in-depth analysis of these methods, discussing their strengths, limitations, and potential areas for future research. The study reviewed a total of 60 papers published across various repositories, including Springer and Elsevier. The insights from this study have implications for clinical diagnosis and treatment strategies. Despite some limitations, the accuracy and efficiency of 3D CNN algorithms underscore their potential for advancing medical image segmentation and classification. The findings suggest that 3D CNNs could significantly enhance the detection and management of COVID-19, contributing to improved healthcare outcomes.

EF-net: Accurate edge segmentation for segmenting COVID-19 lung infections from CT images

Despite advances in modern medicine including the use of computed tomography for detecting COVID-19, precise identification and segmentation of lesions remain a significant challenge owing to indistinct boundaries and low degrees of contrast between infected and healthy lung tissues. This study introduces a novel model called the edge-based dual-parallel attention (EDA)-guided feature-filtering network (EF-Net), specifically designed to accurately segment the edges of COVID-19 lesions. The proposed model comprises two modules: an EDA module and a feature-filtering module (FFM). EDA efficiently extracts structural and textural features from low-level features, enabling the precise identification of lesion boundaries. FFM receives semantically rich features from a deep-level encoder and integrates features with abundant texture and contour information obtained from the EDA module. After filtering through a gating mechanism of the FFM, the EDA features are fused with deep-level features, yielding features rich in both semantic and textural information. Experiments demonstrate that our model outperforms existing models including Inf_Net, GFNet, and BSNet considering various metrics, offering better and clearer segmentation results, particularly for segmenting lesion edges. Moreover, superior performance on the three datasets is achieved, with dice coefficients of 98.1, 97.3, and 72.1 %.

Automated Pulmonary Tuberculosis Severity Assessment on Chest X-rays

According to the 2022 World Health Organization's Global Tuberculosis (TB) report, an estimated 10.6 million people fell ill with TB, and 1.6 million died from the disease in 2021. In addition, 2021 saw a reversal of a decades-long trend of declining TB infections and deaths, with an estimated increase of 4.5% in the number of people who fell ill with TB compared to 2020, and an estimated yearly increase of 450,000 cases of drug resistant TB. Estimating the severity of pulmonary TB using frontal chest X-rays (CXR) can enable better resource allocation in resource constrained settings and monitoring of treatment response, enabling prompt treatment modifications if disease severity does not decrease over time. The Timika score is a clinically used TB severity score based on a CXR reading. This work proposes and evaluates three deep learning-based approaches for predicting the Timika score with varying levels of explainability. The first approach uses two deep learning-based models, one to explicitly detect lesion regions using YOLOV5n and another to predict the presence of cavitation using DenseNet121, which are then utilized in score calculation. The second approach uses a DenseNet121-based regression model to directly predict the affected lung percentage and another to predict cavitation presence using a DenseNet121-based classification model. Finally, the third approach directly predicts the Timika score using a DenseNet121-based regression model. The best performance is achieved by the second approach with a mean absolute error of 13-14% and a Pearson correlation of 0.7-0.84 using three held-out datasets for evaluating generalization.

A multistage framework for respiratory disease detection and assessing severity in chest X-ray images

Chest Radiography is a non-invasive imaging modality for diagnosing and managing chronic lung disorders, encompassing conditions such as pneumonia, tuberculosis, and COVID-19. While it is crucial for disease localization and severity assessment, existing computer-aided diagnosis (CAD) systems primarily focus on classification tasks, often overlooking these aspects. Additionally, prevalent approaches rely on class activation or saliency maps, providing only a rough localization. This research endeavors to address these limitations by proposing a comprehensive multi-stage framework. Initially, the framework identifies relevant lung areas by filtering out extraneous regions. Subsequently, an advanced fuzzy-based ensemble approach is employed to categorize images into specific classes. In the final stage, the framework identifies infected areas and quantifies the extent of infection in COVID-19 cases, assigning severity scores ranging from 0 to 3 based on the infection's severity. Specifically, COVID-19 images are classified into distinct severity levels, such as mild, moderate, severe, and critical, determined by the modified RALE scoring system. The study utilizes publicly available datasets, surpassing previous state-of-the-art works. Incorporating lung segmentation into the proposed ensemble-based classification approach enhances the overall classification process. This solution can be a valuable alternative for clinicians and radiologists, serving as a secondary reader for chest X-rays, reducing reporting turnaround times, aiding clinical decision-making, and alleviating the workload on hospital staff.

Analysis of vaccine responses after anti-CD20 maintenance in B-cell lymphoma in the Balearic Islands. A single reference center experience

Introduction

The use of maintenance approaches with anti-CD20 monoclonal antibodies has improved the outcomes of B-cell indolent lymphomas but may lead to significant peripheral B-cell depletion. This depletion can potentially hinder the serological response to neoantigens.

Methods

Our objective was to analyze the effect of anti-CD20 maintenance therapy in a reliable model of response to neoantigens: SARS-CoV-2 vaccine responses and the incidence/severity ofCOVID-19 in a reference hospital.

Results

In our series (n=118), the rate of vaccination failures was 31%. Through ROC curve analysis, we determined a cutoff for SARS-CoV-2 vaccine serologic response at 24 months from the last anti-CD20 dose. The risk of severe COVID-19 was notably higher within the first 24months following the last anti-CD20 dose (52%) compared to after this period (just 18%) (p=0.007). In our survival analysis, neither vaccine response nor hypogammaglobulinemia significantly affected OS. While COVID-19 led to a modest mortality rate of 2.5%, this figure was comparable to the OS reported in the general immunocompetent population. However, most patients with hypogammaglobulinemia received intravenous immunoglobulin therapy and all were vaccinated. In conclusion, anti-CD20 maintenance therapy impairs serological responses to SARS-CoV-2 vaccines.

Discussion

We report for the first time that patients during maintenance therapy and up to 24 months after the last anti-CD20 dose are at a higher risk of vaccine failure and more severe cases of COVID-19. Nevertheless, with close monitoring, intravenous immunoglobulin supplementation or proper vaccination, the impact on survival due to the lack of serological response in this high-risk population can be mitigated, allowing for the benefits of anti-CD20 maintenance therapy, even in the presence of hypogammaglobulinemia.

MTMC-AUR2CNet: Multi-textural multi-class attention recurrent residual convolutional neural network for COVID-19 classification using chest X-ray images

Coronavirus disease (COVID-19) has infected over 603 million confirmed cases as of September 2022, and its rapid spread has raised concerns worldwide. More than 6.4 million fatalities in confirmed patients have been reported. According to reports, the COVID-19 virus causes lung damage and rapidly mutates before the patient receives any diagnosis-specific medicine. Daily increasing COVID-19 cases and the limited number of diagnosis tool kits encourage the use of deep learning (DL) models to assist health care practitioners using chest X-ray (CXR) images. The CXR is a low radiation radiography tool available in hospitals to diagnose COVID-19 and combat this spread. We propose a Multi-Textural Multi-Class (MTMC) UNet-based Recurrent Residual Convolutional Neural Network (MTMC-UR2CNet) and MTMC-UR2CNet with attention mechanism (MTMC-AUR2CNet) for multi-class lung lobe segmentation of CXR images. The lung lobe segmentation output of MTMC-UR2CNet and MTMC-AUR2CNet are mapped individually with their input CXRs to generate the region of interest (ROI). The multi-textural features are extracted from the ROI of each proposed MTMC network. The extracted multi-textural features from ROI are fused and are trained to the Whale optimization algorithm (WOA) based DeepCNN classifier on classifying the CXR images into normal (healthy), COVID-19, viral pneumonia, and lung opacity. The experimental result shows that the MTMC-AUR2CNet has superior performance in multi-class lung lobe segmentation of CXR images with an accuracy of 99.47%, followed by MTMC-UR2CNet with an accuracy of 98.39%. Also, MTMC-AUR2CNet improves the multi-textural multi-class classification accuracy of the WOA-based DeepCNN classifier to 97.60% compared to MTMC-UR2CNet.

E pluribus unum interpretable convolutional neural networks

The adoption of convolutional neural network (CNN) models in high-stake domains is hindered by their inability to meet society's demand for transparency in decision-making. So far, a growing number of methodologies have emerged for developing CNN models that are interpretable by design. However, such models are not capable of providing interpretations in accordance with human perception, while maintaining competent performance. In this paper, we tackle these challenges with a novel, general framework for instantiating inherently interpretable CNN models, named E pluribus unum interpretable CNN (EPU-CNN). An EPU-CNN model consists of CNN sub-networks, each of which receives a different representation of an input image expressing a perceptual feature, such as color or texture. The output of an EPU-CNN model consists of the classification prediction and its interpretation, in terms of relative contributions of perceptual features in different regions of the input image. EPU-CNN models have been extensively evaluated on various publicly available datasets, as well as a contributed benchmark dataset. Medical datasets are used to demonstrate the applicability of EPU-CNN for risk-sensitive decisions in medicine. The experimental results indicate that EPU-CNN models can achieve a comparable or better classification performance than other CNN architectures while providing humanly perceivable interpretations.

Image enhancement techniques on deep learning approaches for automated diagnosis of COVID-19 features using CXR images

The outbreak of novel coronavirus (COVID-19) disease has infected more than 135.6 million people globally. For its early diagnosis, researchers consider chest X-ray examinations as a standard screening technique in addition to RT-PCR test. Majority of research work till date focused only on application of deep learning approaches that is relevant but lacking in better pre-processing of CXR images. Towards this direction, this study aims to explore cumulative effects of image denoising and enhancement approaches on the performance of deep learning approaches. Regarding pre-processing, suitable methods for X-ray images, Histogram equalization, CLAHE and gamma correction have been tested individually and along with adaptive median filter, median filter, total variation filter and gaussian denoising filters. Proposed study compared eleven combinations in exploration of most coherent approach in greedy manner. For more robust analysis, we compared ten CNN architectures for performance evaluation with and without enhancement approaches. These models are InceptionV3, InceptionResNetV2, MobileNet, MobileNetV2, Vgg19, NASNetMobile, ResNet101, DenseNet121, DenseNet169, DenseNet201. These models are trained in 4-way (COVID-19 pneumonia vs Viral vs Bacterial pneumonia vs Normal) and 3-way classification scenario (COVID-19 vs Pneumonia vs Normal) on two benchmark datasets. The proposed methodology determines with TVF + Gamma, models achieve higher classification accuracy and sensitivity. In 4-way classification MobileNet with TVF + Gamma achieves top accuracy of 93.25% with 1.91% improvement in accuracy score, COVID-19 sensitivity of 98.72% and F1-score of 92.14%. In 3-way classification our DenseNet201 with TVF + Gamma gains accuracy of 91.10% with improvement of 1.47%, COVID-19 sensitivity of 100% and F1-score of 91.09%. Proposed study concludes that deep learning modes with gamma correction and TVF + Gamma has superior performance compared to state-of-the-art models. This not only minimizes overlapping between COVID-19 and virus pneumonia but advantageous in time required to converge best possible results.