Automatic Pleural Line Extraction and COVID-19 Scoring From Lung Ultrasound Data

Recent works highlighted the significant potential of lung ultrasound (LUS) imaging in the management of subjects affected by COVID-19. In general, the development of objective, fast, and accurate automatic methods for LUS data evaluation is still at an early stage. This is particularly true for COVID-19 diagnostic. In this article, we propose an automatic and unsupervised method for the detection and localization of the pleural line in LUS data based on the hidden Markov model and Viterbi Algorithm. The pleural line localization step is followed by a supervised classification procedure based on the support vector machine (SVM). The classifier evaluates the healthiness level of a patient and, if present, the severity of the pathology, i.e., the score value for each image of a given LUS acquisition. The experiments performed on a variety of LUS data acquired in Italian hospitals with both linear and convex probes highlight the effectiveness of the proposed method. The average overall accuracy in detecting the pleura is 84% and 94% for convex and linear probes, respectively. The accuracy of the SVM classification in correctly evaluating the severity of COVID-19 related pleural line alterations is about 88% and 94% for convex and linear probes, respectively. The results as well as the visualization of the detected pleural line and the predicted score chart, provide a significant support to medical staff for further evaluating the patient condition.

[1]  Linda S. Gottfredson Appendix B , 1977, Annals of the ICRP.

[2]  G. Soldati,et al.  Chest sonography: a useful tool to differentiate acute cardiogenic pulmonary edema from acute respiratory distress syndrome , 2008, Cardiovascular ultrasound.

[3]  James F. Greenleaf,et al.  Lung Ultrasound Surface Wave Elastography: A Pilot Clinical Study , 2017, IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control.

[4]  Jason Weston,et al.  A user's guide to support vector machines. , 2010, Methods in molecular biology.

[5]  Mirko Zimic,et al.  Automatic classification of pediatric pneumonia based on lung ultrasound pattern recognition , 2018, PloS one.

[6]  J. Jensen,et al.  Automatic Detection of B-Lines in $In Vivo$ Lung Ultrasound , 2019, IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control.

[7]  J Sijbers,et al.  Estimation of the noise in magnitude MR images. , 1998, Magnetic resonance imaging.

[8]  Lorenzo Bruzzone,et al.  Classification of hyperspectral remote sensing images with support vector machines , 2004, IEEE Transactions on Geoscience and Remote Sensing.

[9]  Lorenzo Bruzzone,et al.  Automatic Enhancement and Detection of Layering in Radar Sounder Data Based on a Local Scale Hidden Markov Model and the Viterbi Algorithm , 2017, IEEE Transactions on Geoscience and Remote Sensing.

[10]  D. Lichtenstein,et al.  The comet-tail artifact. An ultrasound sign of alveolar-interstitial syndrome. , 1997, American journal of respiratory and critical care medicine.

[11]  Ranjan Maitra,et al.  Noise Estimation in Magnitude MR Datasets , 2009, IEEE Transactions on Medical Imaging.

[12]  V. Brusasco,et al.  Computer-Aided Quantitative Ultrasonography for Detection of Pulmonary Edema in Mechanically Ventilated Cardiac Surgery Patients. , 2016, Chest.

[13]  O. Karlsen,et al.  Parameter estimation from Rician‐distributed data sets using a maximum likelihood estimator: Application to t1 and perfusion measurements , 1999, Magnetic resonance in medicine.

[14]  D. Thickman,et al.  The comet tail artifact. , 1982, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[15]  Lorenzo Bruzzone,et al.  A System for the Automatic Classification of Ice Sheet Subsurface Targets in Radar Sounder Data , 2015, IEEE Transactions on Geoscience and Remote Sensing.

[16]  M. Demi,et al.  The role of ultrasound lung artifacts in the diagnosis of respiratory diseases , 2019, Expert review of respiratory medicine.

[17]  Libertario Demi,et al.  Localizing B-Lines in Lung Ultrasonography by Weakly Supervised Deep Learning, In-Vivo Results , 2020, IEEE Journal of Biomedical and Health Informatics.

[18]  David Bull,et al.  Line Detection as an Inverse Problem: Application to Lung Ultrasound Imaging , 2017, IEEE Transactions on Medical Imaging.

[19]  P. Pellikka,et al.  Ultrasound of extravascular lung water: a new standard for pulmonary congestion , 2016, European heart journal.

[20]  Q. Peng,et al.  Findings of lung ultrasonography of novel corona virus pneumonia during the 2019–2020 epidemic , 2020, Intensive Care Medicine.

[21]  L. Demi,et al.  Is There a Role for Lung Ultrasound During the COVID‐19 Pandemic? , 2020, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[22]  M. Demi,et al.  Physical Mechanisms Providing Clinical Information From Ultrasound Lung Images: Hypotheses and Early Confirmations , 2020, IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control.

[23]  Alistair Black,et al.  Introduction , 2004, Libr. Trends.

[24]  G. Lyu,et al.  Modified Scoring Method for COVID‐19 Pneumonia , 2020, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[25]  Francesca Bovolo,et al.  Rayleigh-Rice Mixture Parameter Estimation via EM Algorithm for Change Detection in Multispectral Images , 2015, IEEE Transactions on Image Processing.

[26]  L. Gargani Ultrasound of the Lungs: More than a Room with a View. , 2019, Heart failure clinics.

[27]  Lawrence R. Rabiner,et al.  A tutorial on hidden Markov models and selected applications in speech recognition , 1989, Proc. IEEE.

[28]  D. Caramella,et al.  Ultrasound lung comets in systemic sclerosis: a chest sonography hallmark of pulmonary interstitial fibrosis. , 2009, Rheumatology.

[29]  Hua Xie,et al.  Ultrasound-Based Detection of Lung Abnormalities Using Single Shot Detection Convolutional Neural Networks , 2018, POCUS/BIVPCS/CuRIOUS/CPM@MICCAI.

[30]  M. Demi,et al.  On the Physical Basis of Pulmonary Sonographic Interstitial Syndrome , 2016, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[31]  Cristiano Saltori,et al.  Deep Learning for Classification and Localization of COVID-19 Markers in Point-of-Care Lung Ultrasound , 2020, IEEE Transactions on Medical Imaging.

[32]  M. Muller,et al.  Lung Ultrasound Imaging, a Technical Review , 2020, Applied Sciences.

[33]  L. Gargani Lung ultrasound: a new tool for the cardiologist , 2011, Cardiovascular ultrasound.

[34]  F. Mojoli,et al.  Lung Ultrasound for Critically Ill Patients , 2019, American journal of respiratory and critical care medicine.