Automatic segmentation of lung findings in CT and application to Long COVID
Abstract: Automated segmentation of lung abnormalities in computed tomography is an important step for diagnosing and characterizing lung disease. In this work, we improve upon a previous method and propose S-MEDSeg, a deep learning based approach for accurate segmentation of lung lesions in chest CT images. S-MEDSeg combines a pre-trained EfficientNet backbone, bidirectional feature pyramid network, and modern network advancements to achieve improved segmentation performance. A comprehensive ablation study was performed to evaluate the contribution of the proposed network modifications. The results demonstrate modifications introduced in S-MEDSeg significantly improves segmentation performance compared to the baseline approach. The proposed method is applied to an independent dataset of long COVID inpatients to study the effect of post-acute infection vaccination on extent of lung findings. Open-source code, graphical user interface and pip package are available at https://github.com/MICLab-Unicamp/medseg.
- C. Chen, S. R. Haupert, L. Zimmermann, X. Shi, L. G. Fritsche, and B. Mukherjee, “Global prevalence of post COVID-19 condition or long COVID: A meta-analysis and systematic review,” The Journal of Infectious Diseases, 2022.
- E. Beghi, R. Helbok, S. Ozturk, O. Karadas, V. Lisnic, O. Grosu, T. Kovács, L. Dobronyi, D. Bereczki, M. S. Cotelli, et al., “Short-and long-term outcome and predictors in an international cohort of patients with neuro-covid-19,” European journal of neurology, vol. 29, no. 6, pp. 1663–1684, 2022.
- J. L. Cho, R. Villacreses, P. Nagpal, J. Guo, A. A. Pezzulo, A. L. Thurman, N. Y. Hamzeh, R. J. Blount, S. Fortis, E. A. Hoffman, et al., “Quantitative chest ct assessment of small airways disease in post-acute sars-cov-2 infection,” Radiology, p. 212170, 2022.
- K. I. Notarte, J. A. Catahay, J. V. Velasco, A. Pastrana, A. T. Ver, F. C. Pangilinan, P. J. Peligro, M. Casimiro, J. J. Guerrero, M. M. L. Gellaco, et al., “Impact of covid-19 vaccination on the risk of developing long-covid and on existing long-covid symptoms: A systematic review,” EClinicalMedicine, vol. 53, p. 101624, 2022.
- P. Wasilewski, B. Mruk, S. Mazur, G. Półtorak-Szymczak, K. Sklinda, and J. Walecki, “Covid-19 severity scoring systems in radiological imaging–a review,” Polish journal of radiology, vol. 85, no. 1, pp. 361–368, 2020.
- F. Shi, J. Wang, J. Shi, Z. Wu, Q. Wang, Z. Tang, K. He, Y. Shi, and D. Shen, “Review of artificial intelligence techniques in imaging data acquisition, segmentation, and diagnosis for covid-19,” IEEE reviews in biomedical engineering, vol. 14, pp. 4–15, 2020.
- C. Fan, Z. Zeng, L. Xiao, and X. Qu, “Gfnet: Automatic segmentation of covid-19 lung infection regions using ct images based on boundary features,” Pattern Recognition, vol. 132, p. 108963, 2022.
- C. H. Sudre, W. Li, T. Vercauteren, S. Ourselin, and M. J. Cardoso, “Generalised dice overlap as a deep learning loss function for highly unbalanced segmentations,” in Deep learning in medical image analysis and multimodal learning for clinical decision support, pp. 240–248, Springer, 2017.
- D. Carmo, I. Campiotti, L. Rodrigues, I. Fantini, G. Pinheiro, D. Moraes, R. Nogueira, L. Rittner, and R. Lotufo, “Rapidly deploying a covid-19 decision support system in one of the largest brazilian hospitals,” Health Informatics Journal, vol. 27, no. 3, p. 14604582211033017, 2021.
- X. Zhang, D. Wang, J. Shao, S. Tian, W. Tan, Y. Ma, Q. Xu, X. Ma, D. Li, J. Chai, et al., “A deep learning integrated radiomics model for identification of coronavirus disease 2019 using computed tomography,” Scientific reports, vol. 11, no. 1, pp. 1–12, 2021.
- Q. Ni, Z. Y. Sun, L. Qi, W. Chen, Y. Yang, L. Wang, X. Zhang, L. Yang, Y. Fang, Z. Xing, et al., “A deep learning approach to characterize 2019 coronavirus disease (covid-19) pneumonia in chest ct images,” European radiology, vol. 30, no. 12, pp. 6517–6527, 2020.
- Y. Xudong, L. Weihong, X. Feng, L. Yanli, L. Weishun, Z. Fengjun, G. Jiao, L. Jiawei, H. Xiaolu, H. Huailiang, et al., “Artificial intelligence–based ct metrics used in predicting clinical outcome of covid-19 in young and middle-aged adults,” Medical Physics, vol. 49, no. 8, pp. 5604–5615, 2022.
- D. Carmo, I. Campiotti, I. Fantini, L. Rodrigues, L. Rittner, and R. Lotufo, “Multitasking segmentation of lung and covid-19 findings in ct scans using modified efficientdet, unet and mobilenetv3 models,” in 17th International Symposium on Medical Information Processing and Analysis, vol. 12088, pp. 65–74, SPIE, 2021.
- S. E. Gerard and J. M. Reinhardt, “Pulmonary lobe segmentation using a sequence of convolutional neural networks for marginal learning,” in 2019 IEEE 16th International Symposium on Biomedical Imaging (ISBI 2019), pp. 1207–1211, IEEE, 2019.
- M. Tan and Q. V. Le, “Efficientnet: Rethinking model scaling for convolutional neural networks,” arXiv preprint arXiv:1905.11946, 2019.
- M. Tan, R. Pang, and Q. V. Le, “Efficientdet: Scalable and efficient object detection,” in Proceedings of the IEEE/CVF Conference on Computer Vision and Pattern Recognition, pp. 10781–10790, 2020.
- D. Carmo, L. Rittner, and R. Lotufo, “Open-source tool for airway segmentation in computed tomography using 2.5 d modified efficientdet: Contribution to the atm22 challenge,” arXiv preprint arXiv:2209.15094, 2022.
- Z. Liu, H. Mao, C.-Y. Wu, C. Feichtenhofer, T. Darrell, and S. Xie, “A convnet for the 2020s,” in Proceedings of the IEEE/CVF Conference on Computer Vision and Pattern Recognition, pp. 11976–11986, 2022.
- I. Loshchilov and F. Hutter, “Decoupled weight decay regularization,” in International Conference on Learning Representations, 2019.
- D. Carmo, G. Pinheiro, L. Rodrigues, T. Abreu, R. Lotufo, and L. Rittner, “Automated computed tomography and magnetic resonance imaging segmentation using deep learning: a beginner’s guide,” arXiv preprint arXiv:2304.05901, 2023.
- J. Hofmanninger, F. Prayer, J. Pan, S. Röhrich, H. Prosch, and G. Langs, “Automatic lung segmentation in routine imaging is primarily a data diversity problem, not a methodology problem,” European Radiology Experimental, vol. 4, no. 1, pp. 1–13, 2020.
- S. E. Gerard, J. Herrmann, Y. Xin, K. T. Martin, E. Rezoagli, D. Ippolito, G. Bellani, M. Cereda, J. Guo, E. A. Hoffman, D. W. Kaczka, and J. M. Reinhardt, “CT image segmentation for inflamed and fibrotic lungs using a multi-resolution convolutional neural network,” Scientific reports, vol. 11, no. 1, pp. 1–12, 2021.
- F. Isensee, P. F. Jaeger, S. A. Kohl, J. Petersen, and K. H. Maier-Hein, “nnu-net: a self-configuring method for deep learning-based biomedical image segmentation,” Nature methods, vol. 18, no. 2, pp. 203–211, 2021.
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