Towards Unbiased COVID-19 Lesion Localisation and Segmentation via Weakly Supervised Learning

Despite tremendous efforts, it is very challenging to generate a robust model to assist in the accurate quantification assessment of COVID-19 on chest CT images. Due to the nature of blurred boundaries, the supervised segmentation methods usually suffer from annotation biases. To support unbiased lesion localisation and to minimise the labeling costs, we propose a data-driven framework supervised by only image-level labels. The framework can explicitly separate potential lesions from original images, with the help of a generative adversarial network and a lesion-specific decoder. Experiments on two COVID-19 datasets demonstrate the effectiveness of the proposed framework and its superior performance to several existing methods.Comment: accepted by ISBI 202

Label-Free Segmentation of COVID-19 Lesions in Lung CT

Scarcity of annotated images hampers the building of automated solution for reliable COVID-19 diagnosis and evaluation from CT. To alleviate the burden of data annotation, we herein present a label-free approach for segmenting COVID-19 lesions in CT via pixel-level anomaly modeling that mines out the relevant knowledge from normal CT lung scans. Our modeling is inspired by the observation that the parts of tracheae and vessels, which lay in the high-intensity range where lesions belong to, exhibit strong patterns. To facilitate the learning of such patterns at a pixel level, we synthesize `lesions' using a set of surprisingly simple operations and insert the synthesized `lesions' into normal CT lung scans to form training pairs, from which we learn a normalcy-converting network (NormNet) that turns an 'abnormal' image back to normal. Our experiments on three different datasets validate the effectiveness of NormNet, which conspicuously outperforms a variety of unsupervised anomaly detection (UAD) methods.Comment: Accepted by Transaction on Medical Imaging 202

Dual-Consistency Semi-Supervised Learning with Uncertainty Quantification for COVID-19 Lesion Segmentation from CT Images

The novel coronavirus disease 2019 (COVID-19) characterized by atypical pneumonia has caused millions of deaths worldwide. Automatically segmenting lesions from chest Computed Tomography (CT) is a promising way to assist doctors in COVID-19 screening, treatment planning, and follow-up monitoring. However, voxel-wise annotations are extremely expert-demanding and scarce, especially when it comes to novel diseases, while an abundance of unlabeled data could be available. To tackle the challenge of limited annotations, in this paper, we propose an uncertainty-guided dual-consistency learning network (UDC-Net) for semi-supervised COVID-19 lesion segmentation from CT images. Specifically, we present a dual-consistency learning scheme that simultaneously imposes image transformation equivalence and feature perturbation invariance to effectively harness the knowledge from unlabeled data. We then quantify the segmentation uncertainty in two forms and employ them together to guide the consistency regularization for more reliable unsupervised learning. Extensive experiments showed that our proposed UDC-Net improves the fully supervised method by 6.3% in Dice and outperforms other competitive semi-supervised approaches by significant margins, demonstrating high potential in real-world clinical practice.Comment: Accepted to MICCAI2021. The first two authors contributed equally. Code is available at https://github.com/poiuohke/UDC-Ne

COVID-Rate: An Automated Framework for Segmentation of COVID-19 Lesions from Chest CT Scans

Novel Coronavirus disease (COVID-19) is a highly contagious respiratory infection that has had devastating effects on the world. Recently, new COVID-19 variants are emerging making the situation more challenging and threatening. Evaluation and quantification of COVID-19 lung abnormalities based on chest Computed Tomography (CT) scans can help determining the disease stage, efficiently allocating limited healthcare resources, and making informed treatment decisions. During pandemic era, however, visual assessment and quantification of COVID-19 lung lesions by expert radiologists become expensive and prone to error, which raises an urgent quest to develop practical autonomous solutions. In this context, first, the paper introduces an open access COVID-19 CT segmentation dataset containing 433 CT images from 82 patients that have been annotated by an expert radiologist. Second, a Deep Neural Network (DNN)-based framework is proposed, referred to as the COVID-Rate, that autonomously segments lung abnormalities associated with COVID-19 from chest CT scans. Performance of the proposed COVID-Rate framework is evaluated through several experiments based on the introduced and external datasets. The results show a dice score of 0:802 and specificity and sensitivity of 0:997 and 0:832, respectively. Furthermore, the results indicate that the COVID-Rate model can efficiently segment COVID-19 lesions in both 2D CT images and whole lung volumes. Results on the external dataset illustrate generalization capabilities of the COVID-Rate model to CT images obtained from a different scanner

Deep Learning and Medical Imaging for COVID-19 Diagnosis: A Comprehensive Survey

COVID-19 (Coronavirus disease 2019) has been quickly spreading since its outbreak, impacting financial markets and healthcare systems globally. Countries all around the world have adopted a number of extraordinary steps to restrict the spreading virus, where early COVID-19 diagnosis is essential. Medical images such as X-ray images and Computed Tomography scans are becoming one of the main diagnostic tools to combat COVID-19 with the aid of deep learning-based systems. In this survey, we investigate the main contributions of deep learning applications using medical images in fighting against COVID-19 from the aspects of image classification, lesion localization, and severity quantification, and review different deep learning architectures and some image preprocessing techniques for achieving a preciser diagnosis. We also provide a summary of the X-ray and CT image datasets used in various studies for COVID-19 detection. The key difficulties and potential applications of deep learning in fighting against COVID-19 are finally discussed. This work summarizes the latest methods of deep learning using medical images to diagnose COVID-19, highlighting the challenges and inspiring more studies to keep utilizing the advantages of deep learning to combat COVID-19

Interactive Segmentation for COVID-19 Infection Quantification on Longitudinal CT scans

Consistent segmentation of COVID-19 patient's CT scans across multiple time points is essential to assess disease progression and response to therapy accurately. Existing automatic and interactive segmentation models for medical images only use data from a single time point (static). However, valuable segmentation information from previous time points is often not used to aid the segmentation of a patient's follow-up scans. Also, fully automatic segmentation techniques frequently produce results that would need further editing for clinical use. In this work, we propose a new single network model for interactive segmentation that fully utilizes all available past information to refine the segmentation of follow-up scans. In the first segmentation round, our model takes 3D volumes of medical images from two-time points (target and reference) as concatenated slices with the additional reference time point segmentation as a guide to segment the target scan. In subsequent segmentation refinement rounds, user feedback in the form of scribbles that correct the segmentation and the target's previous segmentation results are additionally fed into the model. This ensures that the segmentation information from previous refinement rounds is retained. Experimental results on our in-house multiclass longitudinal COVID-19 dataset show that the proposed model outperforms its static version and can assist in localizing COVID-19 infections in patient's follow-up scans.Comment: 10 pages, 11 figures, 4 table

A Review of Automated Diagnosis of COVID-19 Based on Scanning Images

The pandemic of COVID-19 has caused millions of infections, which has led to a great loss all over the world, socially and economically. Due to the false-negative rate and the time-consuming of the conventional Reverse Transcription Polymerase Chain Reaction (RT-PCR) tests, diagnosing based on X-ray images and Computed Tomography (CT) images has been widely adopted. Therefore, researchers of the computer vision area have developed many automatic diagnosing models based on machine learning or deep learning to assist the radiologists and improve the diagnosing accuracy. In this paper, we present a review of these recently emerging automatic diagnosing models. 70 models proposed from February 14, 2020, to July 21, 2020, are involved. We analyzed the models from the perspective of preprocessing, feature extraction, classification, and evaluation. Based on the limitation of existing models, we pointed out that domain adaption in transfer learning and interpretability promotion would be the possible future directions.Comment: In ICRAI 2020: 2020 6th International Conference on Robotics and Artificial Intelligenc

Detection and severity classification of COVID-19 in CT images using deep learning

Since the breakout of coronavirus disease (COVID-19), the computer-aided diagnosis has become a necessity to prevent the spread of the virus. Detecting COVID-19 at an early stage is essential to reduce the mortality risk of the patients. In this study, a cascaded system is proposed to segment the lung, detect, localize, and quantify COVID-19 infections from computed tomography (CT) images Furthermore, the system classifies the severity of COVID-19 as mild, moderate, severe, or critical based on the percentage of infected lungs. An extensive set of experiments were performed using state-of-the-art deep Encoder-Decoder Convolutional Neural Networks (ED-CNNs), UNet, and Feature Pyramid Network (FPN), with different backbone (encoder) structures using the variants of DenseNet and ResNet. The conducted experiments showed the best performance for lung region segmentation with Dice Similarity Coefficient (DSC) of 97.19% and Intersection over Union (IoU) of 95.10% using U-Net model with the DenseNet 161 encoder. Furthermore, the proposed system achieved an elegant performance for COVID-19 infection segmentation with a DSC of 94.13% and IoU of 91.85% using the FPN model with the DenseNet201 encoder. The achieved performance is significantly superior to previous methods for COVID-19 lesion localization. Besides, the proposed system can reliably localize infection of various shapes and sizes, especially small infection regions, which are rarely considered in recent studies. Moreover, the proposed system achieved high COVID-19 detection performance with 99.64% sensitivity and 98.72% specificity. Finally, the system was able to discriminate between different severity levels of COVID-19 infection over a dataset of 1,110 subjects with sensitivity values of 98.3%, 71.2%, 77.8%, and 100% for mild, moderate, severe, and critical infections, respectively.Comment: 9 Figures, 8 Table

Do not repeat these mistakes -- a critical appraisal of applications of explainable artificial intelligence for image based COVID-19 detection

The sudden outbreak and uncontrolled spread of COVID-19 disease is one of the most important global problems today. In a short period of time, it has led to the development of many deep neural network models for COVID-19 detection with modules for explainability. In this work, we carry out a systematic analysis of various aspects of proposed models. Our analysis revealed numerous mistakes made at different stages of data acquisition, model development, and explanation construction. In this work, we overview the approaches proposed in the surveyed ML articles and indicate typical errors emerging from the lack of deep understanding of the radiography domain. We present the perspective of both: experts in the field - radiologists, and deep learning engineers dealing with model explanations. The final result is a proposed a checklist with the minimum conditions to be met by a reliable COVID-19 diagnostic model

Comparative study of deep learning methods for the automatic segmentation of lung, lesion and lesion type in CT scans of COVID-19 patients

Recent research on COVID-19 suggests that CT imaging provides useful information to assess disease progression and assist diagnosis, in addition to help understanding the disease. There is an increasing number of studies that propose to use deep learning to provide fast and accurate quantification of COVID-19 using chest CT scans. The main tasks of interest are the automatic segmentation of lung and lung lesions in chest CT scans of confirmed or suspected COVID-19 patients. In this study, we compare twelve deep learning algorithms using a multi-center dataset, including both open-source and in-house developed algorithms. Results show that ensembling different methods can boost the overall test set performance for lung segmentation, binary lesion segmentation and multiclass lesion segmentation, resulting in mean Dice scores of 0.982, 0.724 and 0.469, respectively. The resulting binary lesions were segmented with a mean absolute volume error of 91.3 ml. In general, the task of distinguishing different lesion types was more difficult, with a mean absolute volume difference of 152 ml and mean Dice scores of 0.369 and 0.523 for consolidation and ground glass opacity, respectively. All methods perform binary lesion segmentation with an average volume error that is better than visual assessment by human raters, suggesting these methods are mature enough for a large-scale evaluation for use in clinical practice.Comment: Updated acknowledgment