Dual-branch combination network (DCN): Towards accurate diagnosis and lesion segmentation of COVID-19 using CT images

• Published in: Medical image analysis Vol. 67; p. 101836
• Main Authors: Gao, Kai, Su, Jianpo, Jiang, Zhongbiao, Zeng, Ling-Li, Feng, Zhichao, Shen, Hui, Rong, Pengfei, Xu, Xin, Qin, Jian, Yang, Yuexiang, Wang, Wei, Hu, Dewen
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.01.2021; Elsevier BV
• Subjects: Artificial intelligence; Attention; Classification; Combined segmentation and classification; Computed tomography; Coronaviruses; COVID-19; COVID-19 - classification; COVID-19 - diagnostic imaging; CT image; Datasets; Diagnosis; Diagnostic software; Diagnostic systems; Disease detection; Humans; Image processing; Image segmentation; Infections; Lesions; Medical diagnosis; Neural Networks, Computer; Pneumonia, Viral - classification; Pneumonia, Viral - diagnostic imaging; Radiography, Thoracic; SARS-CoV-2; Sensitivity; Sensitivity and Specificity; Tomography, X-Ray Computed; Viral diseases; COVID-19; Combined segmentation and classification; CT image; Attention
• ISSN: 1361-8415; 1361-8423; 1361-8423
• DOI: 10.1016/j.media.2020.101836

•We develop a dual-branch combination network (DCN) for combined segmentation and classification of COVID-19 using CT images.•Inspired by the attention mechanism, we propose a lesion attention (LA) module to improve the sensitivity to CT images with small lesions and facilitate early screening of COVID-19.•The LA module provide accurate attention maps to improve the interpretability of the network and contribute to further assessment of the classification result. The recent global outbreak and spread of coronavirus disease (COVID-19) makes it an imperative to develop accurate and efficient diagnostic tools for the disease as medical resources are getting increasingly constrained. Artificial intelligence (AI)-aided tools have exhibited desirable potential; for example, chest computed tomography (CT) has been demonstrated to play a major role in the diagnosis and evaluation of COVID-19. However, developing a CT-based AI diagnostic system for the disease detection has faced considerable challenges, which is mainly due to the lack of adequate manually-delineated samples for training, as well as the requirement of sufficient sensitivity to subtle lesions in the early infection stages. In this study, we developed a dual-branch combination network (DCN) for COVID-19 diagnosis that can simultaneously achieve individual-level classification and lesion segmentation. To focus the classification branch more intensively on the lesion areas, a novel lesion attention module was developed to integrate the intermediate segmentation results. Furthermore, to manage the potential influence of different imaging parameters from individual facilities, a slice probability mapping method was proposed to learn the transformation from slice-level to individual-level classification. We conducted experiments on a large dataset of 1202 subjects from ten institutes in China. The results demonstrated that 1) the proposed DCN attained a classification accuracy of 96.74% on the internal dataset and 92.87% on the external validation dataset, thereby outperforming other models; 2) DCN obtained comparable performance with fewer samples and exhibited higher sensitivity, especially in subtle lesion detection; and 3) DCN provided good interpretability on the loci of infection compared to other deep models due to its classification guided by high-level semantic information. An online CT-based diagnostic platform for COVID-19 derived from our proposed framework is now available. [Display omitted]