DETECTION OF COVID-19 FROM CHEST X-RAYS
AND CT IMAGES USING RESNET-50
Abstract— The 2019 novel coronavirus disease (COVID-
19), with a starting point in China, has spread rapidly
among people living in other countries, and is
approaching approximately 34,986,502 cases worldwide
according to the statistics of European Centre for Disease
Prevention and Control. There are a limited number of
COVID-19 test kits available in hospitals due to the
increasing cases daily. Therefore, it is necessary to
implement an automatic detection system as a quick
alternative diagnosis option to prevent COVID-19
spreading among people. The aim of the study is to
evaluate performance of state-of-the-art pre-trained
model ResNet-50 using mixed precision and fine tuning.
1000 Chest X-ray and 750 CT images were used as dataset
for training and testing purposes. 95% and 82%
accuracies were obtained for Chest X-ray and CT
datasets individually.
Keywords— CNN, Deep Learning, Chest X-ray,
Transfer Learning, CT.
I. IINTRODUCTION
The coronavirus disease (COVID-19) pandemic emerged in
Wuhan, China in December 2019 and became a serious
public health problem worldwide [1,2]. Until now, no specific
drug or vaccine has been found against COVID-19 [2]. The
virus that causes COVID-19 epidemic disease is called severe
acute respiratory syndrome coronavirus-2 (SARS-CoV-2)
[3]. Coronaviruses (CoV) is a large family of viruses that
cause diseases such as Middle East Respiratory Syndrome
(MERS-CoV) and Severe Acute Respiratory Syndrome
(SARS-CoV). COVID-19 is a new species discovered in
2019 and has not been previously identified in humans [4].
COVID-19 causes lighter symptoms in about 99% of cases,
according to early data, while the rest is severe or critical [5].
As of 4th October 2020, the total number of worldwide cases
of Coronavirus is 35,248,330. Of these, 1,039,541 (4%)
people were deaths and 26,225,235 (96%) were recovered.
The number of active patients is 7,983,554. Of these,
7,917,287 (99%) had mild disease while 66,267 (1%) had
more severe disease [6]. Nowadays the world is struggling
with the COVID-19 epidemic. Deaths from pneumonia
developing due to the SARS-CoV-2 virus are increasing day
by day.
Chest radiography (X-ray) is one of the most important
methods used for the diagnosis of pneumonia worldwide [7].
Chest X-ray is a fast, cheap [8] and common clinical method
[9-11]. The chest X-ray gives the patient a lower radiation
dose compared to computed tomography (CT) and magnetic
resonance imaging (MRI) [11]. However, making the correct
diagnosis from X-ray images requires expert knowledge and
experience [7]. It is much more difficult to diagnose using a
chest X-ray than other imaging modalities such as CT or MRI
[8]. By looking at the chest X-ray, COVID-19 can only be
diagnosed by specialist physicians. The number of specialists
who can make this diagnosis is less than the number of
normal doctors. Even in normal times, the number of doctors
per person is insufficient in countries around the world.
According to data from 2017, Greece ranks first with 607
doctors per 100,000 people. In other countries, this number is
much lower [12].
In case of disasters such as COVID-19 pandemic, demanding
health services at the same time, collapse of the health system
is inevitable due to the insufficient number of hospital beds
and health personnel. Also, COVID-19 is a highly contagious
disease, and doctors, nurses, and caregivers are most at risk.
Early diagnosis of pneumonia has a vital importance both in
terms of slowing the speed of the spread of the epidemic by
quarantining the patient and in the recovery process of the
patient [13]. Doctors can diagnose pneumonia from the chest
X-ray more quickly and accurately thanks to computer-aided
diagnosis (CAD) [8]. Use of artificial intelligence methods
are increasing due to its ability to cope with enormous
datasets exceeding human potential in the field of medical
services [14]. Integrating CAD methods into radiologist
diagnostic systems greatly reduces the workload of doctors
and increases reliability and quantitative analysis [11]. CAD
systems based on deep learning and medical imaging are
becoming more and more research fields [14,15].
II. RELATED WORKS
Studies diagnosed with COVID-19 using chest X-rays have
binary or multiple classifications. Some studies use raw data
while others have feature extraction process. The number of
data used in studies also varies. Among the studies, the most
preferred method is convolutional neural network (CNN).
Apostolopoulos and Bessiana used a common pneumonia,
COVID-19-induced pneumonia, and an evolutionary neural
network for healthy differentiation on automatic detection of
COVID-19. In particular, the procedure called transfer
learning has been adopted. With transfer learning, the
detection of various abnormalities in small medical image
datasets is an achievable goal, often with remarkable results
[16].
Based on chest X-ray images, Zhang et al. aimed to develop
a deep learning-based model that can detect COVID-19 with
high sensitivity, providing fast and reliable scanning [17].
Singh et al. classified the chest computed tomography (CT)
images from infected people with and without COVID-19
using multi-objective differential evolution (MODE) based
CNN [18]. In the study of Chen et al, they proposed Residual
Attention U-Net for automated multi class segmentation
technique to prepare the ground for the quantitative diagnosis
of lung infection on COVID-19 related pneumonia using CT
images [19].
Adhikari's study suggested a network called “Auto
Diagnostic Medical Analysis” trying to find infectious areas
to help the doctor better identify the diseased part, if any.
Both X-ray and CT images were used in the study. It has been
recommended DenseNet network to remove and mark
infected areas of the lung [20]. In the study by Alqudah et al.,
two different methods were used to diagnose COVID-19
using chest X-ray images. The first one used AOCTNet,
MobileNet and ShuffleNet CNNs. Secondly, the features of
their images have been removed and they have been classified
using softmaxclassifier, K nearest neighbor (kNN), Support
vector machine (SVM) and Random forest (RF) algorithms
[21]. Khan et al. classified the chest X-ray images from
normal, bacterial and viral pneumonia cases using the
Xception architecture to detect COVID-19 infection [22].
Ghoshal and Tucker used the dropweights based Bayesian
CNN model using chest X-ray images for the diagnosis of
COVID-19 [23]. Hemdan et al. used VGG19 and DenseNet
models to diagnose COVID-19 from X-ray images [24]. Uçar
and Korkmaz worked on X-ray images for COVID-19
diagnosis and supported the SqueezeNet model with
Bayesian optimization [25]. In the study conducted by
Apostopolus et al., they performed automatic detection from
X-ray images using CNNs with transfer learning [26].
Sahinbas and Catak used X-ray images for the diagnosis of
COVID-19 and worked on VGG16, VGG19, ResNet,
DenseNet and InceptionV3 models [27]. Medhi et al. used X-
ray images as feature extraction and segmentation in their
study, then COVID-19 was positively and normally classified
using CNN [28]. Barstugan et al. classified X-ray images for
the diagnosis of COVID-19 using five different feature
extraction methods that are Grey Level Cooccurrence Matrix
(GLCM), Local Directional Patterns (LDP), Grey Level Run
Length Matrix (GLRLM), Grey Level Size Zone Matrix
(GLSZM), and Discrete Wavelet Transform (DWT). The
obtained features were classified by SVM. During the
classification process, 2-fold, 5-fold, and 10-fold cross-
validation methods were used [29]. Punn and Agarwal
worked on X-ray images and used ResNet, InceptionV3,
InceptionResNet models to diagnose COVID-19 [30]. Afshar
et al. developed deep neural network (DNN) based diagnostic
solutions and offered an alternative modeling framework
based on Capsule Networks that can process on small data
sets [31].
This study focuses on automatic prediction of COVID-19
using a deep convolution neural network based pre-trained
transfer model ResNet50 and chest X-ray and CT images.
The contribution of this study includes:-
a. Analysing the model on multimodal images including
Chest X-ray and CT-scan having both positive and negative
cases.
b. Using Pre-trained model ResNet-50, this study uses
methods like mixed precision and fine tuning using Fast AI
v2 Library of PyTorch to achieve the best accuracy with very
less execution time.

III. DESIGN AND METHODOLOGY
A. DATASET AND PRE-PROCESSING
The dataset for the project was gathered from two sources:
A. Chest X-ray images (1000 images) were obtained from:
https://github.com/ieee8023/covid-chestxray-dataset.
B. CT Scan images (750 images) were obtained from:
https://github.com/UCSD-AI4H/COVID-
CT/tree/master/Data-split 80% of the images were used for
training the models and the remaining 20% for testing.
System Specifications: 2GB NVIDIA GPU, 8GB RAM with
Intel Core i7 8th Gen Processor. Python and all the necessary
packages like tensorflow, keras, Pytorch were used.
Fig 1. Chest X-ray (L) and CT scan(R) image
B. PROPOSED METHODOLOGY
PRE- RESNET -
DATASET
PROCESSING 50
C
TRAINING MIXED FINE
AND
PRECISION TUNING
TESTING
. less memory, enabling the training and deployment of larger
C. FINE TUNING
Fine tuning consists of the following four steps:
• Pre-train a neural network model, i.e., the source model, on
a source dataset (e.g., the ImageNet dataset).
• Create a new neural network model, i.e., the target model.
This replicates all model designs and their parameters on the
source model, except the output layer. We assume that these
model parameters contain the knowledge learned from the
source dataset and this knowledge will be equally applicable
to the target dataset. We also assume that the output layer of
the source model is closely related to the labels of the source
dataset and is therefore not used in the target model.
• Add an output layer whose output size is the number of
target dataset categories to the target model, and randomly
initialize the model parameters of this layer.
• Train the target model on a target dataset, such as a chair
dataset. We will train the output layer from scratch, while the
parameters of all remaining layers are fine-tuned based on the
parameters of the source model.
So, Fine-tuning is a concept of transfer learning. Transfer
learning is a machine learning technique, where knowledge
gain during training in one type of problem is used to train in
other related task or domain [32]. In deep learning, the first
few layers are trained to identify features of the task. During
transfer learning, you can remove last few layers of the
trained network and retrain with fresh layers for target job.
Fine-tuned learning experiments require a bit of learning, but
they are still much faster than learning from scratch [33].
Additionally, they are more accurate compared to models
trained from scratch.
Fig 2. Fine Tuning
D. MIXED PRECISION
There are numerous benefits to using numerical formats with
lower precision than 32-bit floating point. First, they require
neural networks. Second, they require less memory
bandwidth, thereby speeding up data transfer operations.
Third, math operations run much faster in reduced precision,
especially on GPUs with Tensor Core support for that
precision. Mixed precision training achieves all these benefits
while ensuring that no task-specific accuracy is lost compared
to full precision training. It does so by identifying the steps
that require full precision and using 32-bit floating point for
only those steps while using 16-bit floating point everywhere
else.
Mixed precision is the use of both 16-bit and 32-bit floating-
point types in a model during training to make it run faster
and use less memory. By keeping certain parts of the model
in the 32-bit types for numeric stability, the model will have
a lower step time and train equally as well in terms of the
evaluation metrics such as accuracy. This guide describes
how to use the experimental Keras mixed precision API to
speed up your models. Using this API can improve
performance by more than 3 times on modern GPUs and 60%
on TPUs [34].
IV. RESULTS AND DISCUSSION
Performance were evaluated for both Chest X-ray and CT
scan images individually by using Pre-Trained model
ResNet-50. Data Augmentation was used for increasing
image complexity so that the model can learn more features.

20% was of the dataset was used for training.

E. FAST AI V2

Fastai is a deep learning library which provides practitioners
with high-level components that can quickly and easily
provide state-of-the-art results in standard deep learning
domains, and provides researchers with low-level
components that can be mixed and matched to build new
approaches. It aims to do both things without substantial
compromises in ease of use, flexibility, or performance. This
is possible thanks to a carefully layered architecture, which
expresses common underlying patterns of many deep
learning and data processing techniques in terms of
decoupled abstractions. These abstractions can be expressed
concisely and clearly by leveraging the dynamism of the
underlying Python language and the flexibility of the
PyTorch library [35]. Fastai includes:
 A new type dispatch system for Python along with a
semantic type hierarchy for tensors
 A GPU-optimized computer vision library which
can be extended in pure Python
 An optimizer which refactors out the common
functionality of modern optimizers into two basic
pieces, allowing optimization algorithms to be
implemented in 4–5 lines of code
Parameter Type/ Value
Name
Epochs 10
Batch Size 32
Num_workers 0
Input Size 100*100*3
Table 1: Hyper parameters details
By using cnn_learner and learn.fine_tune the mixed precision
and fine tuning were done. In learner command we mentioned
the training to be carried out in 16-bit floating point half
precision format so that training time is reduced without any
loss of information. By using half precision format lowers the
required memory enabling training of larger models or
training with larger mini-batches.
By using fine tuning models training time is greatly reduced.
Since using pre-trained weights, the model's first few layers
are already very effective. We just need to train the final
layers of your model and hence the model is free of problems
like overfitting and activation exploding.

 A novel 2-way callback system that can access any

part of the data, model, or optimizer and change it at
any point during training

 A new data block API

F. RESNET-50

ResNet-50 is a convolutional neural network that is 50

layers deep. You can load a pretrained version of the
network trained on more than a million images from the
ImageNet database. The pretrained network can classify
images into 1000 object categories, such as keyboard,
mouse, pencil, and many animals. As a result, the Fig 4: Data Block Visualization (Chest X-ray)
network has learned rich feature representations for a
wide range of images. The network has an image input
size of 224-by-224 [36].

Fig 3. RESNET-50 Architecture Fig 5. Training of ResNet-50(Chest X-ray)


Fig 6. Confusion Matrix for Chest X-ray
DATASET Accuracy Sensitivity Specificity
Chest X-ray 0.95 0.92 0.99
CT-scan 0.82 0.86 0.80
Table 2: Performance for Chest-Xray and CT scan
All the above results were achieved within 5 min of execution
time. This study achieved best results for Chest X-ray
datasets, although the results were satisfactory for CT-scan
images but it can be improved if we have more images to train
the model.
V. CONCLUSION
Early prediction of COVID-19 patients is vital to prevent the
spread of the disease to other people. In this study a deep
transfer learning based approach was used for multimodal
images of X-ray and CT using pre-trained model ResNet-50.
By using methods like mixed precision and fine tuning this
study achieved best results for Chest X-ray dataset(acc: 0.95,
sensitivity: 0.92, specificity: 0.99) and satisfactory results for
CT-scan dataset(acc: 0.82, sensitivity: 0.86, specificity: 0.80)
with very less execution time .
This study focused on concepts of transfer learning used for
medical image processing using pre-trained models and it is
believed that it will help in diagnosing for making quick
decisions in clinical practice due to the higher performance
and less execution time with extreme accuracy.
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