Abstract

The COVID-19 pandemic continues to rage on, with multiple waves causing substantial harm to health and economies around the world. Motivated by the use of computed tomography (CT) imaging at clinical institutes around the world as an effective complementary screening method to RT-PCR testing, we introduced COVID-Net CT, a deep neural network tailored for detection of COVID-19 cases from chest CT images, along with a large curated benchmark dataset comprising 1,489 patient cases as part of the open-source COVID-Net initiative. However, one potential limiting factor is restricted data quantity and diversity given the single nation patient cohort used in the study. To address this limitation, in this study we introduce enhanced deep neural networks for COVID-19 detection from chest CT images which are trained using a large, diverse, multinational patient cohort. We accomplish this through the introduction of two new CT benchmark datasets, the largest of which comprises a multinational cohort of 4,501 patients from at least 16 countries. To the best of our knowledge, this represents the largest, most diverse multinational cohort for COVID-19 CT images in open-access form. Additionally, we introduce a novel lightweight neural network architecture called COVID-Net CT S, which is significantly smaller and faster than the previously introduced COVID-Net CT architecture. We leverage explainability to investigate the decision-making behavior of the trained models and ensure that decisions are based on relevant indicators, with the results for select cases reviewed and reported on by two board-certified radiologists with over 10 and 30 years of experience, respectively. The best-performing deep neural network in this study achieved accuracy, COVID-19 sensitivity, positive predictive value, specificity, and negative predictive value of 99.0%/99.1%/98.0%/99.4%/99.7%, respectively. Moreover, explainability-driven performance validation shows consistency with radiologist interpretation by leveraging correct, clinically relevant critical factors. The results are promising and suggest the strong potential of deep neural networks as an effective tool for computer-aided COVID-19 assessment. While not a production-ready solution, we hope the open-source, open-access release of COVID-Net CT-2 and the associated benchmark datasets will continue to enable researchers, clinicians, and citizen data scientists alike to build upon them.

Highlights

  • The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), continues to rage on, with multiple waves causing substantial harm to health and economies around the world

  • To explore the efficacy of the COVID-Net computed tomography (CT)-2 networks for COVID-19 detection from CT images, we conducted a quantitative evaluation of the trained networks using the COVIDx CT-2 test dataset

  • We introduced COVID-Net CT-2, enhanced convolutional neural network (CNN) tailored for the purpose of COVID-19 detection from chest CT images

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Summary

Introduction

The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), continues to rage on, with multiple waves causing substantial harm to health and economies around the world. Real-time reverse transcription polymerase chain reaction (RTPCR) testing remains the primary screening tool for COVID-19, where SARS-CoV-2 ribonucleic acid (RNA) is detected within an upper respiratory tract sputum sample [1]. Clinical institutes around the world have explored the use of computed tomography (CT) imaging as an effective, complementary screening tool alongside RT-PCR [2, 5, 6]. Studies have shown that a number of potential indicators for COVID-19 infections may be present in chest CT images [2, 5, 6, 9–12], but may be present in non-COVID-19 infections. This can lead to challenges for radiologists in distinguishing COVID-19 infections from non-COVID-19 infections using chest CT [13, 14]

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