As the Coronavirus Disease 2019 (COVID-19) continues to impact many aspects of life and the global healthcare systems, the adoption of rapid and effective screening methods to prevent the further spread of the virus and lessen the burden on healthcare providers is a necessity. As a cheap and widely accessible medical image modality, point-of-care ultrasound (POCUS) imaging allows radiologists to identify symptoms and assess severity through visual inspection of the chest ultrasound images. Combined with the recent advancements in computer science, applications of deep learning techniques in medical image analysis have shown promising results, demonstrating that artificial intelligence-based solutions can accelerate the diagnosis of COVID-19 and lower the burden on healthcare professionals. However, the lack of large, well annotated datasets poses a challenge in developing effective deep neural networks, especially in the case of rare diseases and new pandemics. To address this issue, we present COVID-Net USPro, an explainable few-shot deep prototypical network that is designed to detect COVID-19 cases from very few ultrasound images. Through intensive quantitative and qualitative assessments, the network not only demonstrates high performance in identifying COVID-19 positive cases, using an explainability component, but it is also shown that the network makes decisions based on the actual representative patterns of the disease. Specifically, COVID-Net USPro achieves 99.55% overall accuracy, 99.93% recall, and 99.83% precision for COVID-19-positive cases when trained with only five shots. In addition to the quantitative performance assessment, our contributing clinician with extensive experience in POCUS interpretation verified the analytic pipeline and results, ensuring that the network's decisions are based on clinically relevant image patterns integral to COVID-19 diagnosis. We believe that network explainability and clinical validation are integral components for the successful adoption of deep learning in the medical field. As part of the COVID-Net initiative, and to promote reproducibility and foster further innovation, the network is open-sourced and available to the public.
Keywords: COVID-19; deep explainable architecture; few-shot learning; lung; ultrasonic imaging.