Six artificial intelligence paradigms for tissue characterisation and classification of non-COVID-19 pneumonia against COVID-19 pneumonia in computed tomography lungs

Saba, Luca; Agarwal, Mohit; Patrick, Anubhav; Puvvula, Anudeep; Gupta, Suneet K.; Carriero, Alessandro; Laird, John R.; Kitas, George D.; Johri, Amer M.; Balestrieri, Antonella; Falaschi, Zeno; Paschè, Alessio; Viswanathan, Vijay; El-Baz, Ayman; Alam, Iqbal; Jain, Abhinav; Naidu, Subbaram; Oberleitner, Ronald; Khanna, Narendra N.; Bit, Arindam; Fatemi, Mostafa; Alizad, Azra; Suri, Jasjit S.

BACKGROUND: COVID-19 pandemic has currently no vaccines. Thus, the only feasible solution for prevention relies on the detection of COVID-19-positive cases through quick and accurate testing. Since artificial intelligence (AI) offers the powerful mechanism to automatically extract the tissue features and characterise the disease, we therefore hypothesise that AI-based strategies can provide quick detection and classification, especially for radiological computed tomography (CT) lung scans. METHODOLOGY: Six models, two traditional machine learning (ML)-based (k-NN and RF), two transfer learning (TL)-based (VGG19 and InceptionV3), and the last two were our custom-designed deep learning (DL) models (CNN and iCNN), were developed for classification between COVID pneumonia (CoP) and non-COVID pneumonia (NCoP). K10 cross-validation (90% training: 10% testing) protocol on an Italian cohort of 100 CoP and 30 NCoP patients was used for performance evaluation and bispectrum analysis for CT lung characterisation. RESULTS: Using K10 protocol, our results showed the accuracy in the order of DL > TL > ML, ranging the six accuracies for k-NN, RF, VGG19, IV3, CNN, iCNN as 74.58 ± 2.44%, 96.84 ± 2.6, 94.84 ± 2.85%, 99.53 ± 0.75%, 99.53 ± 1.05%, and 99.69 ± 0.66%, respectively. The corresponding AUCs were 0.74, 0.94, 0.96, 0.99, 0.99, and 0.99 (p-values < 0.0001), respectively. Our Bispectrum-based characterisation system suggested CoP can be separated against NCoP using AI models. COVID risk severity stratification also showed a high correlation of 0.7270 (p < 0.0001) with clinical scores such as ground-glass opacities (GGO), further validating our AI models. CONCLUSIONS: We prove our hypothesis by demonstrating that all the six AI models successfully classified CoP against NCoP due to the strong presence of contrasting features such as ground-glass opacities (GGO), consolidations, and pleural effusion in CoP patients. Further, our online system takes < 2 s for inference. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11548-021-02317-0.