Open AccessDeep transfer learning artificial intelligence accurately stages COVID-19 lung disease severity on portable chest radiographs
Author(s) -
Jocelyn Zhu,
Beiyi Shen,
Almas Abbasi,
Mahsa Hoshmand-Kochi,
Haifang Li,
Timothy Q. Duong
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0236621
Subject(s) - radiography , medicine , transfer of learning , convolutional neural network , covid-19 , ground glass opacity , deep learning , artificial intelligence , kappa , standard deviation , lung , cohen's kappa , radiology , nuclear medicine , disease , machine learning , statistics , computer science , mathematics , infectious disease (medical specialty) , adenocarcinoma , geometry , cancer
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 (R 2 ) 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.