An integrated framework with machine learning and radiomics for accurate and rapid early diagnosis of COVID-19 from Chest X-ray

The objective of the research article is to propose and validate a combination of machine learning and radiomics features to detect COVID-19 early and rapidly from chest X-ray (CXR) in presence of other viral/bacterial pneumonia and at different severity levels of diseases. It is vital to assess the performance of any diagnosis method on an independent data set and at very early stage of the disease when the disease severity of is very low. In such cases, most of the diagnosis methods fail. A total of 378 CXR images containing both normal lung and pneumonia (both COVID-19 and others lung conditions) were collected from publically available data set. 71 radiomics features for each lung segment were chosen from 100 extracted features based on Z-score heatmap and one way ANOVA test that can detect COVID-19. Three best performing classical machine learning algorithms during the training phase - 1) fine Gaussian support vector machine (SVM), 2) fine k-nearest neighbor (KNN) and 3) ensemble bagged model (EBM) trees were chosen for further evaluation on an independent test data set. The independent test data set consists of 115 COVID-19 CXR images collected from a local hospital and 100 CXR images collected from publically available data set containing normal lung and viral/bacterial pneumonia. Severity was scored between 0 to 4 by two experienced radiologists for each lung with pneumonia (both COVID-19 and non COVID-19) for the test data set. Ensemble Bagging Model Trees (EBM) with the selected radiomics features is the most suitable to distinguish between COVID-19 and other lung infections with an overall sensitivity of 87.8% and specificity of 97% (95.2% accuracy and 0.9228 area under curve) and is robust across severity levels. The method also can detect COVID-19 from CXR when two experienced radiologists were unable to detect any abnormality in the lung CXR (represented by severity score of 0). Once the CXR is acquired and lung is segmented, it takes less than two minutes for extracting radiomics features and providing diagnosis result. Since the proposed method does not require any manual intervention (e.g., sample collection etc.), it can be straightway integrated with standard X-ray reporting system to be used as an efficient, cost-effective and rapid early diagnosis device.