PAM-DenseNet: A Deep Convolutional Neural Network for Computer-Aided COVID-19 Diagnosis

Currently, several convolutional neural network (CNN)-based methods have been proposed for computer-aided COVID-19 diagnosis based on lung computed tomography (CT) scans. However, the lesions of pneumonia in CT scans have wide variations in appearances, sizes, and locations in the lung regions, and the manifestations of COVID-19 in CT scans are also similar to other types of viral pneumonia, which hinders the further improvement of CNN-based methods. Delineating infection regions manually is a solution to this issue, while excessive workload of physicians during the epidemic makes it difficult for manual delineation. In this article, we propose a CNN called dense connectivity network with parallel attention module (PAM-DenseNet), which can perform well on coarse labels without manually delineated infection regions. The parallel attention module automatically learns to strengthen informative features from both channelwise and spatialwise simultaneously, which can make the network pay more attention to the infection regions without any manual delineation. The dense connectivity structure performs feature maps reuse by introducing direct connections from previous layers to all subsequent layers, which can extract representative features from fewer CT slices. The proposed network is first trained on 3530 lung CT slices selected from 382 COVID-19 lung CT scans, 372 lung CT scans infected by other pneumonia, and 200 normal lung CT scans to obtain a pretrained model for slicewise prediction. We then apply this pretrained model to a CT scans dataset containing 94 COVID-19 CT scans, 93 other pneumonia CT scans, and 93 normal lung scans, and achieve patientwise prediction through a voting mechanism. The experimental results show that the proposed network achieves promising results with an accuracy of 94.29%, a precision of 93.75%, a sensitivity of 95.74%, and a specificity of 96.77%, which is comparable to the methods that are based on manually delineated infection regions.