An interpretable multi-task system for clinically applicable COVID-19 diagnosis using CXR

Yan Zhuang, Md Fashiar Rahman, Yuxin Wen, Michael Pokojovy, Peter Mccaffrey, Alexander Vo, Eric Walser, Scott Moen, Honglun Xu, Tzu Liang Tseng

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: With the emergence of continuously mutating variants of coronavirus, it is urgent to develop a deep learning model for automatic COVID-19 diagnosis at early stages from chest X-ray images. Since laboratory testing is time-consuming and requires trained laboratory personal, diagnosis using chest X-ray (CXR) is a befitting option. Objective: In this study, we proposed an interpretable multi-task system for automatic lung detection and COVID-19 screening in chest X-rays to find an alternate method of testing which are reliable, fast and easily accessible, and able to generate interpretable predictions that are strongly correlated with radiological findings. Methods: The proposed system consists of image preprocessing and an unsupervised machine learning (UML) algorithm for lung region detection, as well as a truncated CNN model based on deep transfer learning (DTL) to classify chest X-rays into three classes of COVID-19, pneumonia, and normal. The Grad-CAM technique was applied to create class-specific heatmap images in order to establish trust in the medical AI system. Results: Experiments were performed with 15,884 frontal CXR images to show that the proposed system achieves an accuracy of 91.94% in a test dataset with 2,680 images including a sensitivity of 94.48% on COVID-19 cases, a specificity of 88.46% on normal cases, and a precision of 88.01% on pneumonia cases. Our system also produced state-of-the-art outcomes with a sensitivity of 97.40% on public test data and 88.23% on a previously unseen clinical data (1,000 cases) for binary classification of COVID-19-positive and COVID-19-negative films. Conclusion: Our automatic computerized evaluation for grading lung infections exhibited sensitivity comparable to that of radiologist interpretation in clinical applicability. Therefore, the proposed solution can be used as one element of patient evaluation along with gold-standard clinical and laboratory testing.

Original languageEnglish (US)
Pages (from-to)847-862
Number of pages16
JournalJournal of X-Ray Science and Technology
Issue number5
StatePublished - May 26 2022


  • COVID-19
  • chest X-ray
  • clinical applicability
  • lung detection
  • multi-task system
  • transfer learning

ASJC Scopus subject areas

  • Radiation
  • Instrumentation
  • Radiology Nuclear Medicine and imaging
  • Condensed Matter Physics
  • Electrical and Electronic Engineering


Dive into the research topics of 'An interpretable multi-task system for clinically applicable COVID-19 diagnosis using CXR'. Together they form a unique fingerprint.

Cite this