Exploring the Effect of Image Enhancement Techniques on COVID-19 Detection using Chest X-rays Images

The use of computer-aided diagnosis in the reliable and fast detection of coronavirus disease (COVID-19) has become a necessity to prevent the spread of the virus during the pandemic to ease the burden on the medical infrastructure. Chest X-ray (CXR) imaging has several advantages over other imaging techniques as it is cheap, easily accessible, fast and portable. This paper explores the effect of various popular image enhancement techniques and states the effect of each of them on the detection performance. We have compiled the largest X-ray dataset called COVQU-20, consisting of 18,479 normal, non-COVID lung opacity and COVID-19 CXR images. To the best of our knowledge, this is the largest public COVID positive database. Ground glass opacity is the common symptom reported in COVID-19 pneumonia patients and so a mixture of 3616 COVID-19, 6012 non-COVID lung opacity, and 8851 normal chest X-ray images were used to create this dataset. Five different image enhancement techniques: histogram equalization, contrast limited adaptive histogram equalization, image complement, gamma correction, and Balance Contrast Enhancement Technique were used to improve COVID-19 detection accuracy. Six different Convolutional Neural Networks (CNNs) were investigated in this study. Gamma correction technique outperforms other enhancement techniques in detecting COVID-19 from standard and segmented lung CXR images. The accuracy, precision, sensitivity, f1-score, and specificity in the detection of COVID-19 with gamma correction on CXR images were 96.29%, 96.28%, 96.29%, 96.28% and 96.27% respectively. The accuracy, precision, sensitivity, F1-score, and specificity were 95.11 %, 94.55 %, 94.56 %, 94.53 % and 95.59 % respectively for segmented lung images. The proposed approach with very high and comparable performance will boost the fast and robust COVID-19 detection using chest X-ray images.

COVID-19 Infection Map Generation and Detection from Chest X-Ray Images

Computer-aided diagnosis has become a necessity for accurate and immediate coronavirus disease 2019 (COVID-19) detection to aid treatment and prevent the spread of the virus. Compared to other diagnosis methodologies, chest X-ray (CXR) imaging is an advantageous tool since it is fast, low-cost, and easily accessible. Thus, CXR has a great potential not only to help diagnose COVID-19 but also to track the progression of the disease. Numerous studies have proposed to use Deep Learning techniques for COVID-19 diagnosis. However, they have used very limited CXR image repositories for evaluation with a small number, a few hundreds, of COVID-19 samples. Moreover, these methods can neither localize nor grade the severity of COVID-19 infection. For this purpose, recent studies proposed to explore the activation maps of deep networks. However, they remain inaccurate for localizing the actual infestation making them unreliable for clinical use. This study proposes a novel method for the joint localization, severity grading, and detection of COVID-19 from CXR images by generating the so-called infection maps that can accurately localize and grade the severity of COVID-19 infection. To accomplish this, we have compiled the largest COVID-19 dataset up to date with 2951 COVID-19 CXR images, where the annotation of the ground-truth segmentation masks is performed on CXRs by a novel collaborative expert human-machine approach. Furthermore, we publicly release the first CXR dataset with the ground-truth segmentation masks of the COVID-19 infected regions. A detailed set of experiments show that state-of-the-art segmentation networks can learn to localize COVID-19 infection with an F1-score of 85.81%, that is significantly superior to the activation maps created by the previous methods. Finally, the proposed approach achieved a COVID-19 detection performance with 98.37% sensitivity and 99.16% specificity.

An early warning tool for predicting mortality risk of COVID-19 patients using machine learning

COVID-19 pandemic has created an extreme pressure on the global healthcare services. Fast, reliable and early clinical assessment of the severity of the disease can help in allocating and prioritizing resources to reduce mortality. In order to study the important blood biomarkers for predicting disease mortality, a retrospective study was conducted on 375 COVID-19 positive patients admitted to Tongji Hospital (China) from January 10 to February 18, 2020. Demographic and clinical characteristics, and patient outcomes were investigated using machine learning tools to identify key biomarkers to predict the mortality of individual patient. A nomogram was developed for predicting the mortality risk among COVID-19 patients. Lactate dehydrogenase, neutrophils (%), lymphocyte (%), high sensitive C-reactive protein, and age - acquired at hospital admission were identified as key predictors of death by multi-tree XGBoost model. The area under curve (AUC) of the nomogram for the derivation and validation cohort were 0.961 and 0.991, respectively. An integrated score (LNLCA) was calculated with the corresponding death probability. COVID-19 patients were divided into three subgroups: low-, moderate- and high-risk groups using LNLCA cut-off values of 10.4 and 12.65 with the death probability less than 5%, 5% to 50%, and above 50%, respectively. The prognostic model, nomogram and LNLCA score can help in early detection of high mortality risk of COVID-19 patients, which will help doctors to improve the management of patient stratification.

Reliable Tuberculosis Detection using Chest X-ray with Deep Learning, Segmentation and Visualization

Tuberculosis (TB) is a chronic lung disease that occurs due to bacterial infection and is one of the top 10 leading causes of death. Accurate and early detection of TB is very important, otherwise, it could be life-threatening. In this work, we have detected TB reliably from the chest X-ray images using image pre-processing, data augmentation, image segmentation, and deep-learning classification techniques. Several public databases were used to create a database of 700 TB infected and 3500 normal chest X-ray images for this study. Nine different deep CNNs (ResNet18, ResNet50, ResNet101, ChexNet, InceptionV3, Vgg19, DenseNet201, SqueezeNet, and MobileNet), which were used for transfer learning from their pre-trained initial weights and trained, validated and tested for classifying TB and non-TB normal cases. Three different experiments were carried out in this work: segmentation of X-ray images using two different U-net models, classification using X-ray images, and segmented lung images. The accuracy, precision, sensitivity, F1-score, specificity in the detection of tuberculosis using X-ray images were 97.07 %, 97.34 %, 97.07 %, 97.14 % and 97.36 % respectively. However, segmented lungs for the classification outperformed than whole X-ray image-based classification and accuracy, precision, sensitivity, F1-score, specificity were 99.9 %, 99.91 %, 99.9 %, 99.9 %, and 99.52 % respectively. The paper also used a visualization technique to confirm that CNN learns dominantly from the segmented lung regions results in higher detection accuracy. The proposed method with state-of-the-art performance can be useful in the computer-aided faster diagnosis of tuberculosis.

Coronavirus: Comparing COVID-19, SARS and MERS in the eyes of AI

Novel Coronavirus disease (COVID-19) is an extremely contagious and quickly spreading Coronavirus disease. Severe Acute Respiratory Syndrome (SARS)-CoV, Middle East Respiratory Syndrome (MERS)-CoV outbreak in 2002 and 2011 and current COVID-19 pandemic all from the same family of Coronavirus. The fatality rate due to SARS and MERS were higher than COVID-19 however, the spread of those were limited to few countries while COVID-19 affected more than two-hundred countries of the world. In this work, authors used deep machine learning algorithms along with innovative image pre-processing techniques to distinguish COVID-19 images from SARS and MERS images. Several deep learning algorithms were trained, and tested and four outperforming algorithms were reported: SqueezeNet, ResNet18, Inceptionv3 and DenseNet201. Original, Contrast limited adaptive histogram equalized and complemented image were used individually and in concatenation as the inputs to the networks. It was observed that inceptionv3 outperforms all networks for 3-channel concatenation technique and provide an excellent sensitivity of 99.5%, 93.1% and 97% for classifying COVID-19, MERS and SARS images respectively. Investigating deep layer activation mapping of the correctly classified images and miss-classified images, it was observed that some overlapping features between COVID-19 and MERS images were identified by the deep layer network. Interestingly these features were present in MERS images and 10 out of 144 images were miss-classified as COVID while only one out of 423 COVID-19 images was miss-classified as MERS. None of the MERS images was miss-classified to SARS and only one COVID-19 image was miss-classified as SARS. Therefore, it can be summarized that SARS images are significantly different from MERS and COVID-19 in the eyes of AI while there are some overlapping feature available between MERS and COVID-19.

A Comparative Study on Early Detection of COVID-19 from Chest X-Ray Images

In this study, our first aim is to evaluate the ability of recent state-of-the-art Machine Learning techniques to early detect COVID-19 from plain chest X-ray images. Both compact classifiers and deep learning approaches are considered in this study. Furthermore, we propose a recent compact classifier, Convolutional Support Estimator Network (CSEN) approach for this purpose since it is well-suited for a scarce-data classification task. Finally, this study introduces a new benchmark dataset called Early-QaTa-COV19, which consists of 175 early-stage COVID-19 Pneumonia samples (very limited or no infection signs) labelled by the medical doctors and 1579 samples for control (normal) class. A detailed set of experiments show that the CSEN achieves the top (over 98.5%) sensitivity with over 96% specificity. Moreover, transfer learning over the deep CheXNet fine-tuned with the augmented data produces the leading performance among other deep networks with 97.14% sensitivity and 99.49% specificity.

Convolutional Sparse Support Estimator Based Covid-19 Recognition from X-ray Images

Coronavirus disease (Covid-19) has been the main agenda of the whole world since it came in sight in December 2019. It has already caused thousands of causalities and infected several millions worldwide. Any technological tool that can be provided to healthcare practitioners to save time, effort, and possibly lives has crucial importance. The main tools practitioners currently use to diagnose Covid-19 are Reverse Transcription-Polymerase Chain reaction (RT-PCR) and Computed Tomography (CT), which require significant time, resources and acknowledged experts. X-ray imaging is a common and easily accessible tool that has great potential for Covid-19 diagnosis. In this study, we propose a novel approach for Covid-19 recognition from chest X-ray images. Despite the importance of the problem, recent studies in this domain produced not so satisfactory results due to the limited datasets available for training. Recall that Deep Learning techniques can generally provide state-of-the-art performance in many classification tasks when trained properly over large datasets, such data scarcity can be a crucial obstacle when using them for Covid-19 detection. Alternative approaches such as representation-based classification (collaborative or sparse representation) might provide satisfactory performance with limited size datasets, but they generally fall short in performance or speed compared to Machine Learning methods. To address this deficiency, Convolution Support Estimation Network (CSEN) has recently been proposed as a bridge between model-based and Deep Learning approaches by providing a non-iterative real-time mapping from query sample to ideally sparse representation coefficient' support, which is critical information for class decision in representation based techniques.

Estimating Blood Pressure from Photoplethysmogram Signal and Demographic Features using Machine Learning Techniques

Hypertension is a potentially unsafe health ailment, which can be indicated directly from the Blood pressure (BP). Hypertension always leads to other health complications. Continuous monitoring of BP is very important; however, cuff-based BP measurements are discrete and uncomfortable to the user. To address this need, a cuff-less, continuous and a non-invasive BP measurement system is proposed using Photoplethysmogram (PPG) signal and demographic features using machine learning (ML) algorithms. PPG signals were acquired from 219 subjects, which undergo pre-processing and feature extraction steps. Time, frequency and time-frequency domain features were extracted from the PPG and their derivative signals. Feature selection techniques were used to reduce the computational complexity and to decrease the chance of over-fitting the ML algorithms. The features were then used to train and evaluate ML algorithms. The best regression models were selected for Systolic BP (SBP) and Diastolic BP (DBP) estimation individually. Gaussian Process Regression (GPR) along with ReliefF feature selection algorithm outperforms other algorithms in estimating SBP and DBP with a root-mean-square error (RMSE) of 6.74 and 3.59 respectively. This ML model can be implemented in hardware systems to continuously monitor BP and avoid any critical health conditions due to sudden changes.

An Intelligent and Low-cost Eye-tracking System for Motorized Wheelchair Control

In the 34 developed and 156 developing countries, there are about 132 million disabled people who need a wheelchair constituting 1.86% of the world population. Moreover, there are millions of people suffering from diseases related to motor disabilities, which cause inability to produce controlled movement in any of the limbs or even head.The paper proposes a system to aid people with motor disabilities by restoring their ability to move effectively and effortlessly without having to rely on others utilizing an eye-controlled electric wheelchair. The system input was images of the users eye that were processed to estimate the gaze direction and the wheelchair was moved accordingly. To accomplish such a feat, four user-specific methods were developed, implemented and tested; all of which were based on a benchmark database created by the authors.The first three techniques were automatic, employ correlation and were variants of template matching, while the last one uses convolutional neural networks (CNNs). Different metrics to quantitatively evaluate the performance of each algorithm in terms of accuracy and latency were computed and overall comparison is presented. CNN exhibited the best performance (i.e. 99.3% classification accuracy), and thus it was the model of choice for the gaze estimator, which commands the wheelchair motion. The system was evaluated carefully on 8 subjects achieving 99% accuracy in changing illumination conditions outdoor and indoor. This required modifying a motorized wheelchair to adapt it to the predictions output by the gaze estimation algorithm. The wheelchair control can bypass any decision made by the gaze estimator and immediately halt its motion with the help of an array of proximity sensors, if the measured distance goes below a well-defined safety margin.

Can AI help in screening Viral and COVID-19 pneumonia?

Coronavirus disease (COVID-19) is a pandemic disease, which has already infected around 3 million people and caused fatalities of above 200 thousand. The aim of this paper is to automatically detect COVID-19 pneumonia patients using digital x-ray images while maximizing the accuracy in detection using image pre-processing and deep-learning techniques. A public database was created by the authors using three public databases and by collecting images from recently published articles. The database contains a mixture of 190 COVID-19, 1345 viral pneumonia, and 1341 normal chest x-ray images. An image augmented training set was created with around 2600 images of each category for training and validating four different pre-trained deep Convolutional Neural Networks (CNNs). These networks were tested for the classification of two different schemes (normal and COVID-19 pneumonia; normal, viral and COVID-19 pneumonia). The classification accuracy, sensitivity, specificity and precision for both the schemes were 98.3%, 96.7%, 100%, 100% and 98.3%, 96.7%, 99%, 100%, respectively. The high accuracy of this computer-aided diagnostic tool can significantly improve the speed and accuracy of diagnosing cases with COVID-19. This would be highly useful in this pandemic where disease burden and need for preventive measures are at odds with available resources.