Volume 31, Issue 3 p. 1087-1104
RESEARCH ARTICLE

Deep convolution neural networks to differentiate between COVID-19 and other pulmonary abnormalities on chest radiographs: Evaluation using internal and external datasets

Yongwon Cho

Yongwon Cho

Department of Radiology, Korea University Anam Hospital, Seoul, Republic of Korea

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Sung Ho Hwang

Sung Ho Hwang

Department of Radiology, Korea University Anam Hospital, Seoul, Republic of Korea

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Yu-Whan Oh

Yu-Whan Oh

Department of Radiology, Korea University Anam Hospital, Seoul, Republic of Korea

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Byung-Joo Ham

Byung-Joo Ham

Department of Psychiatry, Korea University Anam Hospital, Seoul, Republic of Korea

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Min Ju Kim

Min Ju Kim

Department of Radiology, Korea University Anam Hospital, Seoul, Republic of Korea

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Beom Jin Park

Corresponding Author

Beom Jin Park

Department of Radiology, Korea University Anam Hospital, Seoul, Republic of Korea

Correspondence

Beom Jin Park, Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea.

Email: [email protected]

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First published: 13 May 2021
Citations: 3

Cho Yongwon and Sung Ho Hwang contributed equally to this work as co-first authors.

Funding information: Korea University Anam Hospital, Grant/Award Numbers: K1809771, O2000221; National Research Foundation of Korea, The Ministry of Education, Grant/Award Numbers: 2018R1D1A1A02085358, 2020R1I1A1A01071600

Abstract

We aimed to evaluate the performance of convolutional neural networks (CNNs) in the classification of coronavirus disease 2019 (COVID-19) disease using normal, pneumonia, and COVID-19 chest radiographs (CXRs). First, we collected 9194 CXRs from open datasets and 58 from the Korea University Anam Hospital (KUAH). The number of normal, pneumonia, and COVID-19 CXRs were 4580, 3884, and 730, respectively. The CXRs obtained from the open dataset were randomly assigned to the training, tuning, and test sets in a 70:10:20 ratio. For external validation, the KUAH (20 normal, 20 pneumonia, and 18 COVID-19) dataset, verified by radiologists using computed tomography, was used. Subsequently, transfer learning was conducted using DenseNet169, InceptionResNetV2, and Xception to identify COVID-19 using open datasets (internal) and the KUAH dataset (external) with histogram matching. Gradient-weighted class activation mapping was used for the visualization of abnormal patterns in CXRs. The average AUC and accuracy of the multiscale and mixed-COVID-19Net using three CNNs over five folds were (0.99 ± 0.01 and 92.94% ± 0.45%), (0.99 ± 0.01 and 93.12% ± 0.23%), and (0.99 ± 0.01 and 93.57% ± 0.29%), respectively, using the open datasets (internal). Furthermore, these values were (0.75 and 74.14%), (0.72 and 68.97%), and (0.77 and 68.97%), respectively, for the best model among the fivefold cross-validation with the KUAH dataset (external) using domain adaptation. The various state-of-the-art models trained on open datasets show satisfactory performance for clinical interpretation. Furthermore, the domain adaptation for external datasets was found to be important for detecting COVID-19 as well as other diseases.

CONFLICT OF INTEREST

The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as potential conflicts of interest.

DATA AVAILABILITY STATEMENT

Even though the limitations of our dataset (KUAH) for public use are regulated by the Personal Information Protection Act in South Korea, we expect to share our datasets and source code as requests.

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