COVID-19 classification of X-ray images using deep neural networks

Keidar, Daphna; Yaron, Daniel; Goldstein, Elisha; 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; Atar, Eli; Dror, Amiel A.; Bogot, Naama R.; Grubstein, Ahuva; Shabshin, Nogah; Elyada, Yishai M.; Eldar, Yonina C.

OBJECTIVES: In the midst of the coronavirus disease 2019 (COVID-19) outbreak, chest X-ray (CXR) imaging is playing an important role in diagnosis and monitoring of patients with COVID-19. We propose a deep learning model for detection of COVID-19 from CXRs, as well as a tool for retrieving similar patients according to the model’s results on their CXRs. For training and evaluating our model, we collected CXRs from inpatients hospitalized in four different hospitals. METHODS: In this retrospective study, 1384 frontal CXRs, of COVID-19 confirmed patients imaged between March and August 2020, and 1024 matching CXRs of non-COVID patients imaged before the pandemic, were collected and used to build a deep learning classifier for detecting patients positive for COVID-19. The classifier consists of an ensemble of pre-trained deep neural networks (DNNS), specifically, ReNet34, ReNet50¸ ReNet152, and vgg16, and is enhanced by data augmentation and lung segmentation. We further implemented a nearest-neighbors algorithm that uses DNN-based image embeddings to retrieve the images most similar to a given image. RESULTS: Our model achieved accuracy of 90.3%, (95% CI: 86.3–93.7%) specificity of 90% (95% CI: 84.3–94%), and sensitivity of 90.5% (95% CI: 85–94%) on a test dataset comprising 15% (350/2326) of the original images. The AUC of the ROC curve is 0.96 (95% CI: 0.93–0.97). CONCLUSION: We provide deep learning models, trained and evaluated on CXRs that can assist medical efforts and reduce medical staff workload in handling COVID-19. KEY POINTS: • A machine learning model was able to detect chest X-ray (CXR) images of patients tested positive for COVID-19 with accuracy and detection rate above 90%. • A tool was created for finding existing CXR images with imaging characteristics most similar to a given CXR, according to the model’s image embeddings. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00330-021-08050-1.