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Title: Deep learning attention-guided radiomics for COVID-19 chest radiograph classification
Authors: Yang, D 
Ren, G 
Ni, R 
Huang, YH 
Lam, NFD 
Sun, H 
Wan, SBN
Wong, MFE
Chan, KK
Tsang, HCH
Xu, L
Wu, TC
Kong, FM
Wáng, YXJ
Qin, J 
Chan, WCL 
Ying, M 
Cai, J 
Issue Date: 1-Feb-2023
Source: Quantitative imaging in medicine and surgery, 1 Feb. 2023, v. 13, no. 2, p. 572-584
Abstract: Background: Accurate assessment of coronavirus disease 2019 (COVID-19) lung involvement through chest radiograph plays an important role in effective management of the infection. This study aims to develop a two-step feature merging method to integrate image features from deep learning and radiomics to differentiate COVID-19, non-COVID-19 pneumonia and normal chest radiographs (CXR).
Methods: In this study, a deformable convolutional neural network (deformable CNN) was developed and used as a feature extractor to obtain 1,024-dimensional deep learning latent representation (DLR) features. Then 1,069-dimensional radiomics features were extracted from the region of interest (ROI) guided by deformable CNN’s attention. The two feature sets were concatenated to generate a merged feature set for classification. For comparative experiments, the same process has been applied to the DLR-only feature set for verifying the effectiveness of feature concatenation.
Results: Using the merged feature set resulted in an overall average accuracy of 91.0% for three-class classification, representing a statistically significant improvement of 0.6% compared to the DLR-only classification. The recall and precision of classification into the COVID-19 class were 0.926 and 0.976, respectively. The feature merging method was shown to significantly improve the classification performance as compared to using only deep learning features, regardless of choice of classifier (P value <0.0001). Three classes’ F1-score were 0.892, 0.890, and 0.950 correspondingly (i.e., normal, non-COVID-19 pneumonia, COVID-19).
Conclusions: A two-step COVID-19 classification framework integrating information from both DLR and radiomics fe+atures (guided by deep learning attention mechanism) has been developed. The proposed feature merging method has been shown to improve the performance of chest radiograph classification as compared to the case of using only deep learning features.
Keywords: Chest radiograph
Classification
Coronavirus disease 2019 (COVID-19)
Deep learning
Radiomics
Publisher: AME Publishing Company
Journal: Quantitative imaging in medicine and surgery 
ISSN: 2223-4292
EISSN: 2223-4306
DOI: 10.21037/qims-22-531
Rights: © Quantitative Imaging in Medicine and Surgery. All rights reserved.
This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.
The following publication Yang D, Ren G, Ni R, Huang YH, Lam NFD, Sun H, Wan SBN, Wong MFE, Chan KK, Tsang HCH, Xu L, Wu TC, Kong FM(, Wáng YXJ, Qin J, Chan LWC, Ying M, Cai J. Deep learning attention-guided radiomics for COVID-19 chest radiograph classification. Quant Imaging Med Surg 2023;13(2):572-584 is available at https://doi.org/10.21037/qims-22-531.
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