MAVIDH Score: A COVID-19 Severity Scoring using Chest X-Ray Pathology Features.

The application of computer vision for COVID-19 diagnosis is complex and challenging, given the risks associated with patient misclassifications. Arguably, the primary value of medical imaging for COVID-19 lies rather on patient prognosis. Radiological images can guide physicians assessing the severity of the disease, and a series of images from the same patient at different stages can help to gauge disease progression. Based on these premises, a simple method based on lung-pathology features for scoring disease severity from Chest X-rays is proposed here. As the primary contribution, this method shows to be correlated to patient severity in different stages of disease progression comparatively well when contrasted with other existing methods. An original approach for data selection is also proposed, allowing the simple model to learn the severity-related features. It is hypothesized that the resulting competitive performance presented here is related to the method being feature-based rather than reliant on lung involvement or compromise as others in the literature. The fact that it is simpler and interpretable than other end-to-end, more complex models, also sets aside this work. As the data set is small, bias-inducing artifacts that could lead to overfitting are minimized through an image normalization and lung segmentation step at the learning phase. A second contribution comes from the validation of the results, conceptualized as the scoring of patients groups from different stages of the disease. Besides performing such validation on an independent data set, the results were also compared with other proposed scoring methods in the literature. The expressive results show that although imaging alone is not sufficient for assessing severity as a whole, there is a strong correlation with the scoring system, termed as MAVIDH score, with patient outcome.

[1]  Roberto Maroldi,et al.  COVID-19 outbreak in Italy: experimental chest X-ray scoring system for quantifying and monitoring disease progression , 2020, La radiologia medica.

[2]  Yoshua Bengio,et al.  Predicting COVID-19 Pneumonia Severity on Chest X-ray With Deep Learning , 2020, Cureus.

[3]  Patrice Cacoub,et al.  Multivariable prediction model of intensive care unit transfer and death: a French prospective cohort study of COVID-19 patients , 2020 .

[4]  Jiyuan Zhang,et al.  Pathological findings of COVID-19 associated with acute respiratory distress syndrome , 2020, The Lancet Respiratory Medicine.

[5]  Marco Grangetto,et al.  Unveiling COVID-19 from CHEST X-Ray with Deep Learning: A Hurdles Race with Small Data , 2020, International journal of environmental research and public health.

[6]  Nicholas S Peters,et al.  Machine learning for COVID-19—asking the right questions , 2020, The Lancet Digital Health.

[7]  Manoranjan Paul,et al.  COVID-19 Detection Through Transfer Learning Using Multimodal Imaging Data , 2020, IEEE Access.

[8]  Ziyue Xu,et al.  Determination of disease severity in COVID-19 patients using deep learning in chest X-ray images. , 2020, Diagnostic and interventional radiology.

[9]  M. Kuo,et al.  Frequency and Distribution of Chest Radiographic Findings in COVID-19 Positive Patients , 2019, Radiology.

[10]  K. Doi,et al.  Development of a digital image database for chest radiographs with and without a lung nodule: receiver operating characteristic analysis of radiologists' detection of pulmonary nodules. , 2000, AJR. American journal of roentgenology.

[11]  G. Cacciapaglia,et al.  Second wave COVID-19 pandemics in Europe: a temporal playbook , 2020, Scientific Reports.

[12]  Rula Amer,et al.  COVID-19 in CXR: From Detection and Severity Scoring to Patient Disease Monitoring , 2020, IEEE Journal of Biomedical and Health Informatics.

[13]  Ran Yang,et al.  Chest CT Severity Score: An Imaging Tool for Assessing Severe COVID-19 , 2020, Radiology. Cardiothoracic imaging.

[14]  K. Yuen,et al.  Clinical Characteristics of Coronavirus Disease 2019 in China , 2020, The New England journal of medicine.

[15]  Serge J. Belongie,et al.  Does Image Segmentation Improve Object Categorization ? , 2007 .

[16]  Jian Sun,et al.  Deep Residual Learning for Image Recognition , 2015, 2016 IEEE Conference on Computer Vision and Pattern Recognition (CVPR).

[17]  Manoranjan Paul,et al.  Potential Features of ICU Admission in X-ray Images of COVID-19 Patients , 2020, ArXiv.

[18]  Joseph D. Janizek,et al.  AI for radiographic COVID-19 detection selects shortcuts over signal , 2020, Nature Machine Intelligence.

[19]  Stefan Jaeger,et al.  Two public chest X-ray datasets for computer-aided screening of pulmonary diseases. , 2014, Quantitative imaging in medicine and surgery.

[20]  Manoranjan Paul,et al.  COVID-19 Control by Computer Vision Approaches: A Survey , 2020, IEEE Access.

[21]  Manoranjan Paul,et al.  Enhanced Transfer Learning with ImageNet Trained Classification Layer , 2019, PSIVT.

[22]  Y. Hu,et al.  Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China , 2020, The Lancet.

[23]  F. Jacobson,et al.  Determinants of Chest X-Ray Sensitivity for COVID- 19: A Multi-Institutional Study in the United States , 2020, Radiology. Cardiothoracic imaging.

[24]  Andrea Borghesi,et al.  BS-Net: Learning COVID-19 pneumonia severity on a large chest X-ray dataset , 2021, Medical Image Analysis.

[25]  H. Kauczor,et al.  The Role of Chest Imaging in Patient Management during the COVID-19 Pandemic: A Multinational Consensus Statement from the Fleischner Society , 2020, Radiology.

[26]  K. Sklinda,et al.  COVID-19 severity scoring systems in radiological imaging – a review , 2020, Polish journal of radiology.

[27]  N. Voutsinas,et al.  COVID-19: A Multimodality Review of Radiologic Techniques, Clinical Utility, and Imaging Features , 2020, Radiology. Cardiothoracic imaging.

[28]  H. Neo,et al.  COVID 19: Prioritise Autonomy, Beneficence and Conversations Before Score-based Triage , 2020, Age and ageing.

[29]  Hong Jiang,et al.  Coronavirus disease 2019 in elderly patients: Characteristics and prognostic factors based on 4-week follow-up , 2020, Journal of Infection.

[30]  Severity of lung involvement on chest X-rays in SARS-coronavirus-2 infected patients as a possible tool to predict clinical progression: an observational retrospective analysis of the relationship between radiological, clinical, and laboratory data , 2020, Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia.

[31]  Andrew Zisserman,et al.  Very Deep Convolutional Networks for Large-Scale Image Recognition , 2014, ICLR.

[32]  Gaël Varoquaux,et al.  Scikit-learn: Machine Learning in Python , 2011, J. Mach. Learn. Res..

[33]  N. Arun,et al.  Assessing the (Un)Trustworthiness of Saliency Maps for Localizing Abnormalities in Medical Imaging , 2020, medRxiv.

[34]  G. Heinze,et al.  Prediction models for diagnosis and prognosis of covid-19: systematic review and critical appraisal , 2020, BMJ.

[35]  F. Zhou,et al.  Comparison of severity scores for COVID-19 patients with pneumonia: a retrospective study , 2020, European Respiratory Journal.

[36]  Sangheum Hwang,et al.  Accurate Lung Segmentation via Network-Wise Training of Convolutional Networks , 2017, DLMIA/ML-CDS@MICCAI.

[37]  Joseph Paul Cohen,et al.  COVID-19 Image Data Collection: Prospective Predictions Are the Future , 2020, The Journal of Machine Learning for Biomedical Imaging.

[38]  Been Kim,et al.  Sanity Checks for Saliency Maps , 2018, NeurIPS.

[39]  Thomas Brox,et al.  U-Net: Convolutional Networks for Biomedical Image Segmentation , 2015, MICCAI.

[40]  Sema Candemir,et al.  A review on lung boundary detection in chest X-rays , 2019, International Journal of Computer Assisted Radiology and Surgery.

[41]  J. Vincent,et al.  Understanding pathways to death in patients with COVID-19 , 2020, The Lancet Respiratory Medicine.