Beyond COVID-19 Diagnosis: Prognosis with Hierarchical Graph Representation Learning

Liu, C.; Cui, J.; Gan, D.; Yin, G.

Coronavirus disease 2019 (COVID-19), the pandemic that is spreading fast globally, has caused over 181 million confirmed cases. Apart from the reverse transcription polymerase chain reaction (RT-PCR), the chest computed tomography (CT) is viewed as a standard and effective tool for disease diagnosis and progression monitoring. We propose a diagnosis and prognosis model based on graph convolutional networks (GCNs). The chest CT scan of a patient, typically involving hundreds of sectional images in a sequential order, is formulated as a densely connected weighted graph. A novel distance aware pooling is proposed to abstract the node information hierarchically, which is robust and efficient for such densely connected graphs. Our method, combining GCNs and distance aware pooling, can integrate the information from all slices in the chest CT scans for optimal decision making, which leads to the state-of-the-art accuracy in the COVID-19 diagnosis and prognosis. With less than 1% of the total number of parameters in the baseline 3D ResNet model, our method achieves 94.8% accuracy for diagnosis, which represents a 2.4% improvement over the baseline on the same dataset. In addition, we can localize the most informative slices with disease lesions for COVID-19 within a large sequence of chest CT images. The proposed model can produce visual explanations for the diagnosis and prognosis, making the decision more transparent and explainable, while RT-PCR only leads to the test result with no prognosis information. The prognosis analysis can help hospitals or clinical centers designate medical resources more efficiently and better support clinicians to determine the proper clinical treatment. © 2021, Springer Nature Switzerland AG.