• Shuyi Yang, Longquan Jiang, Zhuoqun Cao, Liya Wang, Jiawang Cao, Rui Feng, Zhiyong Zhang, Xiangyang Xue, Yuxin Shi, and Fei Shan.
• Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
• Ann Transl Med. 2020 Apr 1; 8 (7): 450.

BackgroundTo evaluate the diagnostic efficacy of Densely Connected Convolutional Networks (DenseNet) for detection of COVID-19 features on high resolution computed tomography (HRCT).MethodsThe Ethic Committee of our institution approved the protocol of this study and waived the requirement for patient informed consent. Two hundreds and ninety-five patients were enrolled in this study (healthy person: 149; COVID-19 patients: 146), which were divided into three separate non-overlapping cohorts (training set, n=135, healthy person, n=69, patients, n=66; validation set, n=20, healthy person, n=10, patients, n=10; test set, n=140, healthy person, n=70, patients, n=70). The DenseNet was trained and tested to classify the images as having manifestation of COVID-19 or as healthy. A radiologist also blindly evaluated all the test images and rechecked the misdiagnosed cases by DenseNet. Receiver operating characteristic curves (ROC) and areas under the curve (AUCs) were used to assess the model performance. The sensitivity, specificity and accuracy of DenseNet model and radiologist were also calculated.ResultsThe DenseNet algorithm model yielded an AUC of 0.99 (95% CI: 0.958-1.0) in the validation set and 0.98 (95% CI: 0.972-0.995) in the test set. The threshold value was selected as 0.8, while for validation and test sets, the accuracies were 95% and 92%, the sensitivities were 100% and 97%, the specificities were 90% and 87%, and the F1 values were 95% and 93%, respectively. The sensitivity of radiologist was 94%, the specificity was 96%, while the accuracy was 95%.ConclusionsDeep learning (DL) with DenseNet can accurately classify COVID-19 on HRCT with an AUC of 0.98, which can reduce the miss diagnosis rate (combined with radiologists' evaluation) and radiologists' workload.2020 Annals of Translational Medicine. All rights reserved.

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