The Key Lab of RF Circuits and Systems of Ministry of Education, Microelectronics CAD Center, Hangzhou Dianzi University, Hangzhou, 310018, China.
College of Media Engineering, Communication University of Zhejiang, Hangzhou, 310018, China.
Med Phys. 2021 May;48(5):2337-2353. doi: 10.1002/mp.14711. Epub 2021 Mar 29.
PURPOSE: The worldwide spread of the SARS-CoV-2 virus poses unprecedented challenges to medical resources and infection prevention and control measures around the world. In this case, a rapid and effective detection method for COVID-19 can not only relieve the pressure of the medical system but find and isolate patients in time, to a certain extent, slow down the development of the epidemic. In this paper, we propose a method that can quickly and accurately diagnose whether pneumonia is viral pneumonia, and classify viral pneumonia in a fine-grained way to diagnose COVID-19. METHODS: We proposed a Cascade Squeeze-Excitation and Moment Exchange (Cascade-SEME) framework that can effectively detect COVID-19 cases by evaluating the chest x-ray images, where SE is the structure we designed in the network which has attention mechanism, and ME is a method for image enhancement from feature dimension. The framework integrates a model for a coarse level detection of virus cases among other forms of lung infection, and a model for fine-grained categorisation of pneumonia types identifying COVID-19 cases. In addition, a Regional Learning approach is proposed to mitigate the impact of non-lesion features on network training. The network output is also visualised, highlighting the likely areas of lesion, to assist experts' assessment and diagnosis of COVID-19. RESULTS: Three datasets were used: a set of Chest x-ray Images for Classification with bacterial pneumonia, viral pneumonia and normal chest x-rays, a COVID chest x-ray dataset with COVID-19, and a Lung Segmentation dataset containing 1000 chest x-rays with masks in the lung region. We evaluated all the models on the test set. The results shows the proposed SEME structure significantly improves the performance of the models: in the task of pneumonia infection type diagnosis, the sensitivity, specificity, accuracy and F1 score of ResNet50 with SEME structure are significantly improved in each category, and the accuracy and AUC of the whole test set are also enhanced; in the detection task of COVID-19, the evaluation results shows that when SEME structure was added to the task, the sensitivities, specificities, accuracy and F1 scores of ResNet50 and DenseNet169 are improved. Although the sensitivities and specificities are not significantly promoted, SEME well balanced these two significant indicators. Regional learning also plays an important role. Experiments show that Regional Learning can effectively correct the impact of non-lesion features on the network, which can be seen in the Grad-CAM method. CONCLUSIONS: Experiments show that after the application of SEME structure in the network, the performance of SEME-ResNet50 and SEME-DenseNet169 in both two datasets show a clear enhancement. And the proposed regional learning method effectively directs the network's attention to focus on relevant pathological regions in the lung radiograph, ensuring the performance of the proposed framework even when a small training set is used. The visual interpretation step using Grad-CAM finds that the region of attention on radiographs of different types of pneumonia are located in different regions of the lungs.
目的:SARS-CoV-2 病毒在全球范围内的传播给世界各国的医疗资源和感染防控措施带来了前所未有的挑战。在这种情况下,一种快速有效的 COVID-19 检测方法不仅可以缓解医疗系统的压力,还可以及时发现和隔离患者,在一定程度上减缓疫情的发展。在本文中,我们提出了一种可以快速准确地诊断肺炎是否为病毒性肺炎,并对病毒性肺炎进行细粒度分类以诊断 COVID-19 的方法。
方法:我们提出了一个级联压缩激励和矩交换(Cascade-SEME)框架,通过评估胸部 X 光图像,该框架可以有效地检测 COVID-19 病例,其中 SE 是我们在网络中设计的具有注意力机制的结构,ME 是一种从特征维度增强图像的方法。该框架集成了一种用于病毒病例粗级别的检测模型以及一种用于细粒度分类肺炎类型以识别 COVID-19 病例的模型。此外,还提出了一种区域学习方法来减轻非病变特征对网络训练的影响。网络输出也进行了可视化,突出了可能的病变区域,以协助专家对 COVID-19 的评估和诊断。
结果:使用了三个数据集:一组带有细菌性肺炎、病毒性肺炎和正常胸部 X 光的胸部 X 光图像分类集、一个包含 COVID-19 的 COVID 胸部 X 光数据集以及一个包含 1000 张胸部 X 光的肺部分割数据集,其中肺部区域带有掩模。我们在测试集上评估了所有模型。结果表明,所提出的 SEME 结构显著提高了模型的性能:在肺炎感染类型诊断任务中,带有 SEME 结构的 ResNet50 在每个类别中的灵敏度、特异性、准确性和 F1 得分都有显著提高,整个测试集的准确性和 AUC 也得到了提高;在 COVID-19 的检测任务中,评估结果表明,当在任务中添加 SEME 结构时,ResNet50 和 DenseNet169 的灵敏度、特异性、准确性和 F1 得分都得到了提高。虽然灵敏度和特异性没有得到显著提高,但 SEME 很好地平衡了这两个重要指标。区域学习也发挥了重要作用。实验表明,区域学习可以有效地纠正非病变特征对网络的影响,这可以从 Grad-CAM 方法中看出。
结论:实验表明,在网络中应用 SEME 结构后,SEME-ResNet50 和 SEME-DenseNet169 在两个数据集上的性能都有明显提高。所提出的区域学习方法有效地指导网络将注意力集中在肺部 X 光片上的相关病理区域,确保即使使用较小的训练集,所提出框架的性能也能得到保证。使用 Grad-CAM 的可视化解释步骤发现,不同类型肺炎的 X 光片的注意力区域位于肺部的不同区域。
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