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PLoS One . Deep transfer learning artificial intelligence accurately stages COVID-19 lung disease severity on portable chest radiographs

tetano

Editor, Senior Moderator
PLoS One


. 2020 Jul 28;15(7):e0236621.
doi: 10.1371/journal.pone.0236621. eCollection 2020.
Deep transfer learning artificial intelligence accurately stages COVID-19 lung disease severity on portable chest radiographs


Jocelyn Zhu[SUP] 1 [/SUP], Beiyi Shen[SUP] 1 [/SUP], Almas Abbasi[SUP] 1 [/SUP], Mahsa Hoshmand-Kochi[SUP] 1 [/SUP], Haifang Li[SUP] 1 [/SUP], Tim Q Duong[SUP] 1 [/SUP]



Affiliations

Abstract

This study employed deep-learning convolutional neural networks to stage lung disease severity of Coronavirus Disease 2019 (COVID-19) infection on portable chest x-ray (CXR) with radiologist score of disease severity as ground truth. This study consisted of 131 portable CXR from 84 COVID-19 patients (51M 55.1?14.9yo; 29F 60.1?14.3yo; 4 missing information). Three expert chest radiologists scored the left and right lung separately based on the degree of opacity (0-3) and geographic extent (0-4). Deep-learning convolutional neural network (CNN) was used to predict lung disease severity scores. Data were split into 80% training and 20% testing datasets. Correlation analysis between AI-predicted versus radiologist scores were analyzed. Comparison was made with traditional and transfer learning. The average opacity score was 2.52 (range: 0-6) with a standard deviation of 0.25 (9.9%) across three readers. The average geographic extent score was 3.42 (range: 0-8) with a standard deviation of 0.57 (16.7%) across three readers. The inter-rater agreement yielded a Fleiss' Kappa of 0.45 for opacity score and 0.71 for extent score. AI-predicted scores strongly correlated with radiologist scores, with the top model yielding a correlation coefficient (R2) of 0.90 (range: 0.73-0.90 for traditional learning and 0.83-0.90 for transfer learning) and a mean absolute error of 8.5% (ranges: 17.2-21.0% and 8.5%-15.5, respectively). Transfer learning generally performed better. In conclusion, deep-learning CNN accurately stages disease severity on portable chest x-ray of COVID-19 lung infection. This approach may prove useful to stage lung disease severity, prognosticate, and predict treatment response and survival, thereby informing risk management and resource allocation.
 
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