ABSTRACT
Computed tomography (CT) images are currently being adopted as the visual evidence for COVID-19 diagnosis in clinical practice. Automated detection of COVID-19 infection from CT images based on deep models is important for faster examination. Unfortunately, collecting large-scale training data systematically in the early stage is difficult. To address this problem, we explore the feasibility of learning deep models for lung and COVID-19 infection segmentation from a single radiological image by resorting to synthesizing diverse radiological images. Specifically, we propose a novel conditional generative model, called CoSinGAN, which can be learned from a single radiological image with a given condition, i.e., the annotation mask of the lungs and infected regions. Our CoSinGAN is able to capture the conditional distribution of the single radiological image, and further synthesize high-resolution (512 × 512) and diverse radiological images that match the input conditions precisely. We evaluate the efficacy of CoSinGAN in learning lung and infection segmentation from very few radiological images by performing 5-fold cross validation on COVID-19-CT-Seg dataset (20 CT cases) and an independent testing on the MosMed dataset (50 CT cases). Both 2D U-Net and 3D U-Net, learned from four CT slices by using our CoSinGAN, have achieved notable infection segmentation performance, surpassing the COVID-19-CT-Seg-Benchmark, i.e., the counterparts trained on an average of 704 CT slices, by a large margin. Such results strongly confirm that our method has the potential to learn COVID-19 infection segmentation from few radiological images in the early stage of COVID-19 pandemic.
ABSTRACT
Automated infection measurement and COVID-19 diagnosis based on Chest X-ray (CXR) imaging is important for faster examination, where infection segmentation is an essential step for assessment and quantification. However, due to the heterogeneity of X-ray imaging and the difficulty of annotating infected regions precisely, learning automated infection segmentation on CXRs remains a challenging task. We propose a novel approach, called DRR4Covid, to learn COVID-19 infection segmentation on CXRs from digitally reconstructed radiographs (DRRs). DRR4Covid consists of an infection-aware DRR generator, a segmentation network, and a domain adaptation module. Given a labeled Computed Tomography scan, the infection-aware DRR generator can produce infection-aware DRRs with pixel-level annotations of infected regions for training the segmentation network. The domain adaptation module is designed to enable the segmentation network trained on DRRs to generalize to CXRs. The statistical analyses made on experiment results have indicated that our infection-aware DRRs are significantly better than standard DRRs in learning COVID-19 infection segmentation (p < 0.05) and the domain adaptation module can improve the infection segmentation performance on CXRs significantly (p < 0.05). Without using any annotations of CXRs, our network has achieved a classification score of (Accuracy: 0.949, AUC: 0.987, F1-score: 0.947) and a segmentation score of (Accuracy: 0.956, AUC: 0.980, F1-score: 0.955) on a test set with 558 normal cases and 558 positive cases. Besides, by adjusting the strength of radiological signs of COVID-19 infection in infection-aware DRRs, we estimate the detection limit of X-ray imaging in detecting COVID-19 infection. The estimated detection limit, measured by the percent volume of the lung that is infected by COVID-19, is 19.43% ± 16.29%, and the estimated lower bound of infected voxel contribution rate for significant radiological signs of COVID-19 infection is 20.0%. Our codes are made publicly available at https://github.com/PengyiZhang/DRR4Covid.