Artificial intelligence and radiology: Combating the COVID-19 conundrum

Abstract

The COVID-19 pandemic has necessitated rapid testing and diagnosis to manage its spread. While reverse transcriptase polymerase chain reaction (RT-PCR) is being used as the gold standard method to diagnose COVID-19, many scientists and doctors have pointed out some challenges related to the variability, accuracy, and affordability of this technique. At the same time, radiological methods, which were being used to diagnose COVID-19 in the early phase of the pandemic in China, were sidelined by many primarily due to their low specificity and the difficulty in conducting a differential diagnosis. However, the utility of radiological methods cannot be neglected. Indeed, over the past few months, healthcare consultants and radiologists in India have been using or advising the use of high-resolution computed tomography (HRCT) of the chest for early diagnosis and tracking of COVID-19, particularly in preoperative and asymptomatic patients. At the same time, scientists have been trying to improve upon the radiological method of COVID-19 diagnosis and monitoring by using artificial intelligence (AI)-based interpretation models. This review is an effort to compile and compare such efforts. To this end, the latest scientific literature on the use of radiology and AI-assisted radiology for the diagnosis and monitoring of COVID-19 has been reviewed and presented, highlighting the strengths and limitations of such techniques.

Radiologist’s Role in Artificial Intelligence Era

“…5 Regarding chest radiology, both radiographs and CT are interesting in the market because chest radiographs are the most common imaging in the hospitals, especially in the coronavirus disease-2019 (COVID-19) infection era. [21][22][23] Additionally, the amount of lung involvement in patients with COVID-19 for treatment planning and prognosis prediction is important for AI to have higher and faster accuracy in calculation. 21 Much AI research has launched recently; however, a few researchers have tested AI systems in real-world clinical settings, 16,24 and research about AI's true benefits to patients has not been exactly explored.…”

A review of emerging innovations in COVID-19

“…It was found that early stages of COVID-19 pneumonia in the lungs of COVID affected patients showed differences in imaging from those suffering from other types of pneumonia/viral disease. 5,6 The study concluded that HRCT of the chest was rapidly replacing pathological tests in the early diagnosis of COVID-19 but though AI based radiology models offer many advantages, they warranted larger, well-annotated training datasets for diagnostic utility yet. 5,6 Born et al conducting a meta-analysis of 463 manuscripts established that AI had greater diagnostic accuracy for CT scans than X-ray and concluded that as many as 72% research papers focused predominantly on the use of AI for chest X-ray and for diagnosis purposes more than for severity and prognosis.…”

“…5,6 The study concluded that HRCT of the chest was rapidly replacing pathological tests in the early diagnosis of COVID-19 but though AI based radiology models offer many advantages, they warranted larger, well-annotated training datasets for diagnostic utility yet. 5,6 Born et al conducting a meta-analysis of 463 manuscripts established that AI had greater diagnostic accuracy for CT scans than X-ray and concluded that as many as 72% research papers focused predominantly on the use of AI for chest X-ray and for diagnosis purposes more than for severity and prognosis. 7 Google's DeepMind released AI structure predictions for proteins with high biological significance for the SARS-CoV-2.…”

COVID-19: The Second Wave—Are There Lessons from the First Wave to Prepare Us for the Second Wave?

“…Numerous articles have evaluated the performance of AI systems especially in India where the cohort of patients has been very high, all concluding the experienced radiologists performed better than the AI system in the detection of COVID-19 pneumonia. [19][20][21] Where AI is making a significant impact is on the quantification of extent of lung involvement. In a pandemic, the main concern is as large volumes of patients present at the same time, medical facilities will get overwhelmed triggering panic and societal problems.…”

“…Numerous articles have evaluated the performance of AI systems especially in India where the cohort of patients has been very high, all concluding the experienced radiologists performed better than the AI system in the detection of COVID-19 pneumonia. 19 20 21 …”