COVID-19 Classification of X-ray Images Using Deep Neural Networks

Goldstein, Elisha; Keidar, Daphna; Yaron, Daniel; Shachar, Yair; Blass, Ayelet; Charbinsky, Leonid; Aharony, Israel; Lifshitz, Liza; Lumelsky, Dimitri; Neeman, Ziv; Mizrachi, Matti; Hajouj, Majd; Eizenbach, Nethanel; Sela, Eyal; Weiss, Chedva S; Levin, Philip; Benjaminov, Ofer; Bachar, Gil N; Tamir, Shlomit; Rapson, Yael; Suhami, Dror; Dror, Amiel A; Bogot, Naama R; Grubstein, Ahuva; Shabshin, Nogah; Elyada, Yishai M; Eldar, Yonina C

In the midst of the coronavirus disease 2019 (COVID-19) outbreak, chest X-ray (CXR) imaging is playing an important role in the diagnosis and monitoring of patients with COVID-19. Machine learning solutions have been shown to be useful for X-ray analysis and classification in a range of medical contexts. The purpose of this study is to create and evaluate a machine learning model for diagnosis of COVID-19, and to provide a tool for searching for similar patients according to their X-ray scans. In this retrospective study, a classifier was built using a pre-trained deep learning model (ReNet50) and enhanced by data augmentation and lung segmentation to detect COVID-19 in frontal CXR images collected between January 2018 and July 2020 in four hospitals in Israel. A nearest-neighbors algorithm was implemented based on the network results that identifies the images most similar to a given image. The model was evaluated using accuracy, sensitivity, area under the curve (AUC) of receiver operating characteristic (ROC) curve and of the precision-recall (P-R) curve. The dataset sourced for this study includes 2362 CXRs, balanced for positive and negative COVID-19, from 1384 patients (63 +/- 18 years, 552 men). Our model achieved 89.7% (314/350) accuracy and 87.1% (156/179) sensitivity in classification of COVID-19 on a test dataset comprising 15% (350 of 2326) of the original data, with AUC of ROC 0.95 and AUC of the P-R curve 0.94. For each image we retrieve images with the most similar DNN-based image embeddings; these can be used to compare with previous cases.