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      A Rapid, Accurate and Machine-Agnostic Segmentation and Quantification Method for CT-Based COVID-19 Diagnosis

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          Abstract

          COVID-19 has caused a global pandemic and become the most urgent threat to the entire world. Tremendous efforts and resources have been invested in developing diagnosis, prognosis and treatment strategies to combat the disease. Although nucleic acid detection has been mainly used as the gold standard to confirm this RNA virus-based disease, it has been shown that such a strategy has a high false negative rate, especially for patients in the early stage, and thus CT imaging has been applied as a major diagnostic modality in confirming positive COVID-19. Despite the various, urgent advances in developing artificial intelligence (AI)-based computer-aided systems for CT-based COVID-19 diagnosis, most of the existing methods can only perform classification, whereas the state-of-the-art segmentation method requires a high level of human intervention. In this paper, we propose a fully-automatic, rapid, accurate, and machine-agnostic method that can segment and quantify the infection regions on CT scans from different sources. Our method is founded upon two innovations: 1) the first CT scan simulator for COVID-19, by fitting the dynamic change of real patients’ data measured at different time points, which greatly alleviates the data scarcity issue; and 2) a novel deep learning algorithm to solve the large-scene-small-object problem, which decomposes the 3D segmentation problem into three 2D ones, and thus reduces the model complexity by an order of magnitude and, at the same time, significantly improves the segmentation accuracy. Comprehensive experimental results over multi-country, multi-hospital, and multi-machine datasets demonstrate the superior performance of our method over the existing ones and suggest its important application value in combating the disease.

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          Most cited references37

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          Correlation of Chest CT and RT-PCR Testing in Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases

          Background Chest CT is used for diagnosis of 2019 novel coronavirus disease (COVID-19), as an important complement to the reverse-transcription polymerase chain reaction (RT-PCR) tests. Purpose To investigate the diagnostic value and consistency of chest CT as compared with comparison to RT-PCR assay in COVID-19. Methods From January 6 to February 6, 2020, 1014 patients in Wuhan, China who underwent both chest CT and RT-PCR tests were included. With RT-PCR as reference standard, the performance of chest CT in diagnosing COVID-19 was assessed. Besides, for patients with multiple RT-PCR assays, the dynamic conversion of RT-PCR results (negative to positive, positive to negative, respectively) was analyzed as compared with serial chest CT scans for those with time-interval of 4 days or more. Results Of 1014 patients, 59% (601/1014) had positive RT-PCR results, and 88% (888/1014) had positive chest CT scans. The sensitivity of chest CT in suggesting COVID-19 was 97% (95%CI, 95-98%, 580/601 patients) based on positive RT-PCR results. In patients with negative RT-PCR results, 75% (308/413) had positive chest CT findings; of 308, 48% were considered as highly likely cases, with 33% as probable cases. By analysis of serial RT-PCR assays and CT scans, the mean interval time between the initial negative to positive RT-PCR results was 5.1 ± 1.5 days; the initial positive to subsequent negative RT-PCR result was 6.9 ± 2.3 days). 60% to 93% of cases had initial positive CT consistent with COVID-19 prior (or parallel) to the initial positive RT-PCR results. 42% (24/57) cases showed improvement in follow-up chest CT scans before the RT-PCR results turning negative. Conclusion Chest CT has a high sensitivity for diagnosis of COVID-19. Chest CT may be considered as a primary tool for the current COVID-19 detection in epidemic areas. A translation of this abstract in Farsi is available in the supplement. - ترجمه چکیده این مقاله به فارسی، در ضمیمه موجود است.
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            Identifying Medical Diagnoses and Treatable Diseases by Image-Based Deep Learning

            The implementation of clinical-decision support algorithms for medical imaging faces challenges with reliability and interpretability. Here, we establish a diagnostic tool based on a deep-learning framework for the screening of patients with common treatable blinding retinal diseases. Our framework utilizes transfer learning, which trains a neural network with a fraction of the data of conventional approaches. Applying this approach to a dataset of optical coherence tomography images, we demonstrate performance comparable to that of human experts in classifying age-related macular degeneration and diabetic macular edema. We also provide a more transparent and interpretable diagnosis by highlighting the regions recognized by the neural network. We further demonstrate the general applicability of our AI system for diagnosis of pediatric pneumonia using chest X-ray images. This tool may ultimately aid in expediting the diagnosis and referral of these treatable conditions, thereby facilitating earlier treatment, resulting in improved clinical outcomes. VIDEO ABSTRACT.
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              Mastering the game of Go without human knowledge

              A long-standing goal of artificial intelligence is an algorithm that learns, tabula rasa, superhuman proficiency in challenging domains. Recently, AlphaGo became the first program to defeat a world champion in the game of Go. The tree search in AlphaGo evaluated positions and selected moves
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                Author and article information

                Contributors
                Journal
                IEEE Trans Med Imaging
                IEEE Trans Med Imaging
                0048700
                TMI
                ITMID4
                Ieee Transactions on Medical Imaging
                IEEE
                0278-0062
                1558-254X
                August 2020
                11 June 2020
                : 39
                : 8
                : 2638-2652
                Affiliations
                [1] divisionComputer, Electrical, and Mathematical Sciences and Engineering (CEMSE) Division, Computational Bioscience Research Center (CBRC), institutionKing Abdullah University of Science and Technology (KAUST); Thuwal 23955 Saudi Arabia
                [2] departmentDepartment of Biology, institutionSouthern University of Science and Technology; Shenzhen 518055 China
                [3] divisionCancer Systems Biology Center, China–Japan Union Hospital, institutionJilin University, institutionringgold 12510; Changchun 130031 China
                [4] institutionPeng Cheng Laboratory; Shenzhen 518066 China
                [5] institutionHeilongjiang Tuomeng Technology Company Ltd.; Harbin 150040 China
                [6] departmentDepartment of Computer Tomography, institutionThe First Affiliated Hospital of Harbin Medical University, institutionringgold 74559; Harbin 150001 China
                [7] departmentDepartment of Computer Tomography, institutionThe First Hospital of Harbin Medical University; Harbin 150010 China
                [8] institutionInstitute of Biomedical Engineering and Instrumentation, Hangzhou Dianzi University, institutionringgold 12626; Hangzhou 310018 China
                [9] divisionOncology Center, institutionKing Faisal Specialist Hospital and Research Center, institutionringgold 37852; Riyadh 11211 Saudi Arabia
                [10] departmentDepartment Medical Imaging, institutionKing Faisal Specialist Hospital and Research Center, institutionringgold 37852; Riyadh 11211 Saudi Arabia
                [11] institutionInstitute of Information and Computer Engineering, Northeast Forestry University, institutionringgold 47820; Harbin 150040 China
                Article
                10.1109/TMI.2020.3001810
                8769013
                32730214
                304f13d7-dd5e-4702-bdc6-b154aab98496
                This work is licensed under a Creative Commons Attribution 4.0 License. For more information, see https://creativecommons.org/licenses/by/4.0/

                This work is licensed under a Creative Commons Attribution 4.0 License. For more information, see https://creativecommons.org/licenses/by/4.0/

                History
                : 24 May 2020
                : 06 June 2020
                : 07 June 2020
                : 30 July 2020
                Page count
                Figures: 6, Tables: 7, Equations: 188, References: 37, Pages: 15
                Funding
                Funded by: Office of Sponsored Research (OSR), King Abdullah University of Science and Technology (KAUST), fundref 10.13039/501100004052;
                Award ID: FCC/1/1976-04
                Award ID: FCC/1/1976-06
                Award ID: FCC/1/1976-17
                Award ID: FCC/1/1976-18
                Award ID: FCC/1/1976-23
                Award ID: FCC/1/1976-25
                Award ID: FCC/1/1976-26
                Award ID: URF/1/3450-01
                Award ID: URF/1/4098-01-01
                Award ID: REI/1/0018-01-01
                Funded by: National Natural Science Foundation of China, fundref 10.13039/501100001809;
                Award ID: 61731008
                Award ID: 61871428
                Award ID: U1809205
                Funded by: Natural Science Foundation of Zhejiang Province of China, fundref 10.13039/501100004731;
                Award ID: LJ19H180001
                Funded by: Ministry of Science and Technology Central Guiding Local Science and Technology Development Project;
                Award ID: ZY18C01
                This work was supported in part by the Office of Sponsored Research (OSR), King Abdullah University of Science and Technology (KAUST), under Grant FCC/1/1976-04, Grant FCC/1/1976-06, Grant FCC/1/1976-17, Grant FCC/1/1976-18, Grant FCC/1/1976-23, Grant FCC/1/1976-25, Grant FCC/1/1976-26, Grant URF/1/3450-01, Grant URF/1/4098-01-01, and Grant REI/1/0018-01-01, in part by the National Natural Science Foundation of China under Grant 61731008, Grant 61871428, and Grant U1809205, in part by the Natural Science Foundation of Zhejiang Province of China under Grant LJ19H180001, and in part by the Ministry of Science and Technology Central Guiding Local Science and Technology Development Project under Grant ZY18C01.
                Categories
                Article

                covid-19,deep learning,segmentation,computerized tomography

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