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      Truncated inception net: COVID-19 outbreak screening using chest X-rays.

      Physical and Engineering Sciences in Medicine
      Springer Science and Business Media LLC
      Tuberculosis, Inception net, CNN, Chest X-rays, Pneumonia, COVID-19, Deep learning

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          Abstract

          Since December 2019, the Coronavirus Disease (COVID-19) pandemic has caused world-wide turmoil in a short period of time, and the infection, caused by SARS-CoV-2, is spreading rapidly. AI-driven tools are used to identify Coronavirus outbreaks as well as forecast their nature of spread, where imaging techniques are widely used, such as CT scans and chest X-rays (CXRs). In this paper, motivated by the fact that X-ray imaging systems are more prevalent and cheaper than CT scan systems, a deep learning-based Convolutional Neural Network (CNN) model, which we call Truncated Inception Net, is proposed to screen COVID-19 positive CXRs from other non-COVID and/or healthy cases. To validate our proposal, six different types of datasets were employed by taking the following CXRs: COVID-19 positive, Pneumonia positive, Tuberculosis positive, and healthy cases into account. The proposed model achieved an accuracy of 99.96% (AUC of 1.0) in classifying COVID-19 positive cases from combined Pneumonia and healthy cases. Similarly, it achieved an accuracy of 99.92% (AUC of 0.99) in classifying COVID-19 positive cases from combined Pneumonia, Tuberculosis, and healthy CXRs. To the best of our knowledge, as of now, the achieved results outperform the existing AI-driven tools for screening COVID-19 using the acquired CXRs, and proves the viability of using the proposed Truncated Inception Net as a screening tool.

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          Most cited references13

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          Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

          Summary Background A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.
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            Artificial Intelligence Distinguishes COVID-19 from Community Acquired Pneumonia on Chest CT

            Background Coronavirus disease has widely spread all over the world since the beginning of 2020. It is desirable to develop automatic and accurate detection of COVID-19 using chest CT. Purpose To develop a fully automatic framework to detect COVID-19 using chest CT and evaluate its performances. Materials and Methods In this retrospective and multi-center study, a deep learning model, COVID-19 detection neural network (COVNet), was developed to extract visual features from volumetric chest CT exams for the detection of COVID-19. Community acquired pneumonia (CAP) and other non-pneumonia CT exams were included to test the robustness of the model. The datasets were collected from 6 hospitals between August 2016 and February 2020. Diagnostic performance was assessed by the area under the receiver operating characteristic curve (AUC), sensitivity and specificity. Results The collected dataset consisted of 4356 chest CT exams from 3,322 patients. The average age is 49±15 years and there were slightly more male patients than female (1838 vs 1484; p-value=0.29). The per-exam sensitivity and specificity for detecting COVID-19 in the independent test set was 114 of 127 (90% [95% CI: 83%, 94%]) and 294 of 307 (96% [95% CI: 93%, 98%]), respectively, with an AUC of 0.96 (p-value<0.001). The per-exam sensitivity and specificity for detecting CAP in the independent test set was 87% (152 of 175) and 92% (239 of 259), respectively, with an AUC of 0.95 (95% CI: 0.93, 0.97). Conclusions A deep learning model can accurately detect COVID-19 and differentiate it from community acquired pneumonia and other lung diseases.
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              Covid-19: automatic detection from X-ray images utilizing transfer learning with convolutional neural networks

              In this study, a dataset of X-ray images from patients with common bacterial pneumonia, confirmed Covid-19 disease, and normal incidents, was utilized for the automatic detection of the Coronavirus disease. The aim of the study is to evaluate the performance of state-of-the-art convolutional neural network architectures proposed over the recent years for medical image classification. Specifically, the procedure called Transfer Learning was adopted. With transfer learning, the detection of various abnormalities in small medical image datasets is an achievable target, often yielding remarkable results. The datasets utilized in this experiment are two. Firstly, a collection of 1427 X-ray images including 224 images with confirmed Covid-19 disease, 700 images with confirmed common bacterial pneumonia, and 504 images of normal conditions. Secondly, a dataset including 224 images with confirmed Covid-19 disease, 714 images with confirmed bacterial and viral pneumonia, and 504 images of normal conditions. The data was collected from the available X-ray images on public medical repositories. The results suggest that Deep Learning with X-ray imaging may extract significant biomarkers related to the Covid-19 disease, while the best accuracy, sensitivity, and specificity obtained is 96.78%, 98.66%, and 96.46% respectively. Since by now, all diagnostic tests show failure rates such as to raise concerns, the probability of incorporating X-rays into the diagnosis of the disease could be assessed by the medical community, based on the findings, while more research to evaluate the X-ray approach from different aspects may be conducted.
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                Author and article information

                Journal
                32588200
                7315909
                10.1007/s13246-020-00888-x

                Tuberculosis,Inception net,CNN,Chest X-rays,Pneumonia,COVID-19,Deep learning

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