COVID-19 identification in chest X-ray images on flat and hierarchical classification scenarios

The COVID-19 can cause severe pneumonia and is estimated to have a high impact on the healthcare system. The standard image diagnosis tests for pneumonia are chest X-ray (CXR) and computed tomography (CT) scan. CXR are useful in because it is cheaper, faster and more widespread than CT. This study aims to identify pneumonia caused by COVID-19 from other types and also healthy lungs using only CXR images. In order to achieve the objectives, we have proposed a classification schema considering the multi-class and hierarchical perspectives, since pneumonia can be structured as a hierarchy. Given the natural data imbalance in this domain, we also proposed the use of resampling algorithms in order to re-balance the classes distribution. Our classification schema extract features using some well-known texture descriptors and also using a pre-trained CNN model. We also explored early and late fusion techniques in order to leverage the strength of multiple texture descriptors and base classifiers at once. To evaluate the approach, we composed a database, named RYDLS-20, containing CXR images of pneumonia caused by different pathogens as well as CXR images of healthy lungs. The classes distribution follows a real-world scenario in which some pathogens are more common than others. The proposed approach achieved a macro-avg F1-Score of 0.65 using a multi-class approach and a F1-Score of 0.89 for the COVID-19 identification in the hierarchical classification scenario. As far as we know, we achieved the best nominal rate obtained for COVID-19 identification in an unbalanced environment with more than three classes. We must also highlight the novel proposed hierarchical classification approach for this task, which considers the types of pneumonia caused by the different pathogens and lead us to the best COVID-19 recognition rate obtained here.