Abstract

The pandemic of Coronavirus Disease 2019 (COVID-19) is causing enormous loss of life globally. Prompt case identification is critical. The reference method is the real-time reverse transcription PCR (RT-PCR) assay, whose limitations may curb its prompt large-scale application. COVID-19 manifests with chest computed tomography (CT) abnormalities, some even before the onset of symptoms. We tested the hypothesis that the application of deep learning (DL) to 3D CT images could help identify COVID-19 infections. Using data from 920 COVID-19 and 1,073 non-COVID-19 pneumonia patients, we developed a modified DenseNet-264 model, COVIDNet, to classify CT images to either class. When tested on an independent set of 233 COVID-19 and 289 non-COVID-19 pneumonia patients, COVIDNet achieved an accuracy rate of 94.3% and an area under the curve of 0.98. As of March 23, 2020, the COVIDNet system had been used 11,966 times with a sensitivity of 91.12% and a specificity of 88.50% in six hospitals with PCR confirmation. Application of DL to CT images may improve both efficiency and capacity of case detection and long-term surveillance.

Details

Title
Assisting scalable diagnosis automatically via CT images in the combat against COVID-19
Author
Liu Bohan 1 ; Liu, Pan 1 ; Dai Lutao 2 ; Yang, Yanlin 3 ; Xie, Peng 4 ; Tan, Yiqing 5 ; Du Jicheng 6 ; Wei, Shan 7 ; Zhao Chenghui 1 ; Zhong Qin 1 ; Lin Xixiang 1 ; Guan Xizhou 8 ; Xing Ning 9 ; Sun, Yuhui 1 ; Wang, Wenjun 1 ; Zhang, Zhibing 10 ; Fu Xia 11 ; Fan Yanqing 12 ; Li, Meifang 13 ; Zhang, Na 14 ; Li, Lin 15 ; Liu Yaou 16 ; Xu, Lin 17 ; Du Jingbo 18 ; Zhao, Zhenhua 19 ; Hu Xuelong 20 ; Fan Weipeng 21 ; Wang Rongpin 22 ; Wu Chongchong 9 ; Nie Yongkang 9 ; Cheng Liuquan 9 ; Lin, Ma 9 ; Li Zongren 1 ; Jia Qian 1 ; Liu Minchao 23 ; Guo Huayuan 23 ; Huang, Gao 24 ; Shen Haipeng 25 ; Zhang, Liang 26 ; Zhang Peifang 26 ; Guo, Gang 26 ; Li, Hao 27 ; An, Weimin 28 ; Zhou, Jianxin 3 ; He Kunlun 1 

1  Chinese PLA General Hospital, Key Laboratory of Ministry of Industry and Information, Technology of Biomedical Engineering and Translational Medicine, Beijing, People’s Republic of China (GRID:grid.414252.4) (ISNI:0000 0004 1761 8894); Chinese PLA General Hospital, Translational Medical Research Center, Beijing, People’s Republic of China (GRID:grid.414252.4) (ISNI:0000 0004 1761 8894) 
2  The University of Hong Kong, HKU Business School, Hong Kong, People’s Republic of China (GRID:grid.194645.b) (ISNI:0000000121742757) 
3  Capital Medical University, Department of Critical Care Medicine, Beijing Tiantan Hospital, Beijing, People’s Republic of China (GRID:grid.24696.3f) (ISNI:0000 0004 0369 153X) 
4  Hubei University of Medicine (Suizhou Central Hospital), Department of Medical Imaging, Suizhou Hospital, Suizhou, People’s Republic of China (GRID:grid.440226.6) 
5  Tongren Hospital of Wuhan University, Department of Radiology, Wuhan Third Hospital, Wuhan, People’s Republic of China (GRID:grid.49470.3e) (ISNI:0000 0001 2331 6153) 
6  WenZhou Central Hospital, Department of Radiology, WenZhou, People’s Republic of China (GRID:grid.507993.1) (ISNI:0000 0004 1776 6707) 
7  Capital Medical University, Department of Neurology, Beijing Tiantan Hospital, Beijing, People’s Republic of China (GRID:grid.24696.3f) (ISNI:0000 0004 0369 153X) 
8  Chinese PLA General Hospital, Pulmonary and Critical Care Medicine, Beijing, People’s Republic of China (GRID:grid.414252.4) (ISNI:0000 0004 1761 8894) 
9  Chinese PLA General Hospital, Department of Radiology, Beijing, People’s Republic of China (GRID:grid.414252.4) (ISNI:0000 0004 1761 8894) 
10  Affiliated to Yangtze University, Department of Radiology, Xiantao First People’s Hospital, Xiantao, People’s Republic of China (GRID:grid.410654.2) (ISNI:0000 0000 8880 6009) 
11  The First People’s Hospital of Jiangxia District, Department of Radiology, Wuhan, People’s Republic of China (GRID:grid.410654.2) 
12  Wuhan Jinyintan Hospital, Department of Radiology, Wuhan, People’s Republic of China (GRID:grid.507952.c) (ISNI:0000 0004 1764 577X) 
13  Affiliated Hospital of Putian University, Department of Medical Imaging, Putian, People’s Republic of China (GRID:grid.440618.f) (ISNI:0000 0004 1757 7156) 
14  Chengdu Public Health Clinical Medical Center, Department of Radiology, Chengdu, People’s Republic of China (GRID:grid.508318.7) 
15  Wuhan Huangpi People’s Hospital, Department of Radiology, Wuhan, People’s Republic of China (GRID:grid.508318.7); Jianghan University Affiliated Huangpi People’s Hospital, Wuhan, People’s Republic of China (GRID:grid.411854.d) (ISNI:0000 0001 0709 0000) 
16  Capital Medical University, Department of Radiology, Beijing Tiantan Hospital, Beijing, People’s Republic of China (GRID:grid.24696.3f) (ISNI:0000 0004 0369 153X) 
17  Dazhou Central Hospital, Department of Medical Imaging Center, Dazhou, People’s Republic of China (GRID:grid.507934.c) 
18  Beijing Daxing District People’s Hospital (Capital Medical University Daxing Teaching Hospital), Department of Radiology, Beijing, People’s Republic of China (GRID:grid.411634.5) (ISNI:0000 0004 0632 4559) 
19  Shaoxing People’s Hospital (The First Affiliated Hospital of Shaoxing University), Department of Radiology, Shaoxing, People’s Republic of China (GRID:grid.415644.6) (ISNI:0000 0004 1798 6662) 
20  The People’s Hospital of Zigui, Department of Radiology, Zigui, People’s Republic of China (GRID:grid.415644.6) 
21  Anshan Central Hospital, Department of Medical Imaging, Anshan, People’s Republic of China (GRID:grid.415644.6) 
22  Guizhou Provincial People’s Hospital, Department of Medical Imaging, Guiyang, People’s Republic of China (GRID:grid.459540.9) (ISNI:0000 0004 1791 4503) 
23  Chinese PLA General Hospital, Department of Computer Application and Management, Beijing, People’s Republic of China (GRID:grid.414252.4) (ISNI:0000 0004 1761 8894) 
24  Tsinghua University, Department of Automation, Beijing, People’s Republic of China (GRID:grid.12527.33) (ISNI:0000 0001 0662 3178) 
25  The University of Hong Kong, HKU Business School, Hong Kong, People’s Republic of China (GRID:grid.194645.b) (ISNI:0000000121742757); Center for Bigdata Analytics and Artificial Intelligence, China National Clinical Research Center for Neurological Diseases, Beijing, People’s Republic of China (GRID:grid.411617.4) (ISNI:0000 0004 0642 1244) 
26  Biomind Technology Co. Ltd, Beijing, People’s Republic of China (GRID:grid.411617.4) 
27  Center for Bigdata Analytics and Artificial Intelligence, China National Clinical Research Center for Neurological Diseases, Beijing, People’s Republic of China (GRID:grid.411617.4) (ISNI:0000 0004 0642 1244) 
28  Chinese PLA General Hospital, Department of Radiology, 5th Medical Center, Beijing, People’s Republic of China (GRID:grid.414252.4) (ISNI:0000 0004 1761 8894) 
Publication year
2021
Publication date
2021
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1038/s41598-021-83424-5
ProQuest document ID
2490848447
Copyright
© The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.