COVID-19 infection localization and severity grading from chest X-ray images

• Published in: Computers in biology and medicine 2021-12, Vol.139, p.105002-105002, Article 105002
• Main Authors: Tahir, Anas M., Chowdhury, Muhammad E.H., Khandakar, Amith, Rahman, Tawsifur, Qiblawey, Yazan, Khurshid, Uzair, Kiranyaz, Serkan, Ibtehaz, Nabil, Rahman, M. Sohel, Al-Maadeed, Somaya, Mahmud, Sakib, Ezeddin, Maymouna, Hameed, Khaled, Hamid, Tahir
• Format: Article
• Language: English
• Subjects: Annotations; Chest; Chest X-ray; Classification; Convolutional Neural Networks; Coronaviruses; COVID-19; Datasets; Deep Learning; Disease transmission; Humans; Image segmentation; Infection Segmentation; Infections; Iterative methods; Localization; Lung - diagnostic imaging; Lung Segmentation; Lungs; Medical imaging; Neural networks; Pandemics; Pipelines; Pneumonia; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Thorax; Tuberculosis; Viral diseases; Viral infections; X-Rays
• ISSN: 0010-4825; 1879-0534; 1879-0534
• DOI: 10.1016/j.compbiomed.2021.105002

The immense spread of coronavirus disease 2019 (COVID-19) has left healthcare systems incapable to diagnose and test patients at the required rate. Given the effects of COVID-19 on pulmonary tissues, chest radiographic imaging has become a necessity for screening and monitoring the disease. Numerous studies have proposed Deep Learning approaches for the automatic diagnosis of COVID-19. Although these methods achieved outstanding performance in detection, they have used limited chest X-ray (CXR) repositories for evaluation, usually with a few hundred COVID-19 CXR images only. Thus, such data scarcity prevents reliable evaluation of Deep Learning models with the potential of overfitting. In addition, most studies showed no or limited capability in infection localization and severity grading of COVID-19 pneumonia. In this study, we address this urgent need by proposing a systematic and unified approach for lung segmentation and COVID-19 localization with infection quantification from CXR images. To accomplish this, we have constructed the largest benchmark dataset with 33,920 CXR images, including 11,956 COVID-19 samples, where the annotation of ground-truth lung segmentation masks is performed on CXRs by an elegant human-machine collaborative approach. An extensive set of experiments was performed using the state-of-the-art segmentation networks, U-Net, U-Net++, and Feature Pyramid Networks (FPN). The developed network, after an iterative process, reached a superior performance for lung region segmentation with Intersection over Union (IoU) of 96.11% and Dice Similarity Coefficient (DSC) of 97.99%. Furthermore, COVID-19 infections of various shapes and types were reliably localized with 83.05% IoU and 88.21% DSC. Finally, the proposed approach has achieved an outstanding COVID-19 detection performance with both sensitivity and specificity values above 99%. •Localization, Quantification, and Severity Grading of COVID-19 from Chest X-rays.•Superior lung region segmentation performance with 98% Dice-score (F1-score).•Reliable localization of COVID-19 infections of various shapes and types.•The largest Chest X-ray dataset with ground-truth lung segmentation masks.•An elegant collaborative human-machine segmentation approach.