Fusing fine-tuned deep features for recognizing different tympanic membranes

Optimized fine-tuned ensemble classifier using Bayesian optimization for the detection of ear diseases

External and middle ear diseases are common disorders, especially in children, and can be examined using a digital otoscope. Hearing loss can result from delayed diagnosis and treatment which is subjective and error-prone depending on the expertise of the otolaryngologist. For these reasons, deep learning-based automated diagnostic systems are highly needed. In this study, a novel weighted average voting ensemble classifier between MobileNet and DenseNet169 has been developed to diagnose and detect different ear conditions. Bayesian optimization was used to select hyperparameters that gave the best results during the training process. MobileNet and DenseNet169 were fine-tuned by updating the weights of all layers in addition to the newly added layers before fusing them into one ensemble classifier to improve the classification ability of the model and be more specific to our task. This study was performed on a public dataset consisting of 282 otoscopic images. All classes were considered except the Tympanostomy Tubes class for having only two samples. Consequently, the proposed model demonstrated promising results of 99.54 % accuracy and an AUC of 1. Grad-CAM++ saliency maps were employed to highlight the affected area and pertinent features of the otoscopic image. The proposed approach contributes to improving accuracy, decreasing the misdiagnosis rate, and developing an automatic ear disease classification tool.

Artificial intelligence in pediatric otolaryngology: A state-of-the-art review of opportunities and pitfalls

BACKGROUND

Artificial Intelligence (AI) and machine learning (ML) have transformative potential in enhancing diagnostics, treatment planning, and patient management. However, their application in pediatric otolaryngology remains limited as the unique physiological and developmental characteristics of children require tailored AI applications, highlighting a gap in knowledge.

PURPOSE

To provide a narrative review of current literature on the application of AI in pediatric otolaryngology, highlighting knowledge gaps, associated challenges and future directions.

RESULTS

ML models have demonstrated efficacy in diagnosing conditions such as otitis media, adenoid hypertrophy, and pediatric obstructive sleep apnea through deep learning-based image analysis and predictive modeling. AI systems also show potential in surgical settings such as landmark identification during otologic surgery and prediction of middle ear effusion during tympanostomy tube placement. Telemedicine solutions and large language models have shown potential to improve accessibility to care and patient education. The principal challenges include flawed generalization of adult training data and the relative lack of pediatric data.

CONCLUSIONS

AI holds significant promise in pediatric otolaryngology. However, its widespread clinical integration requires addressing algorithmic bias, enhancing model interpretability, and ensuring robust validation across pediatric population. Future research should prioritize federated learning, developmental trajectory modeling, and psychosocial integration to create patient-centered solutions.

Application of Artificial Intelligence in Otology: Past, Present, and Future

Artificial Intelligence (AI) is a concept whose goal is to imitate human intellectual activity in computers. It emerged in the 1950s and has gone through three booms. We are in the third boom, and it will continue. Medical applications of AI include diagnosing otitis media from images of the eardrum, often outperforming human doctors. Temporal bone CT and MRI analyses also benefit from AI, with segmentation accuracy improved in anatomically significant structures or diagnostic accuracy improved in conditions such as otosclerosis and vestibular schwannoma. In treatment, AI predicts hearing outcomes for sudden sensorineural hearing loss and post-operative hearing outcomes for patients who have undergone tympanoplasty. AI helps patients with hearing aids hear in challenging situations, such as in noisy environments or when multiple people are speaking. It also provides fitting information to help improve hearing with hearing aids. AI also improves cochlear implant mapping and outcome prediction, even in cases of cochlear malformation. Future trends include generative AI, such as ChatGPT, which can provide medical advice and information, although its reliability and application in clinical settings requires further investigation.

Development and Validation of an Automated Classifier to Diagnose Acute Otitis Media in Children

Importance

Acute otitis media (AOM) is a frequently diagnosed illness in children, yet the accuracy of diagnosis has been consistently low. Multiple neural networks have been developed to recognize the presence of AOM with limited clinical application.

Objective

To develop and internally validate an artificial intelligence decision-support tool to interpret videos of the tympanic membrane and enhance accuracy in the diagnosis of AOM.

Design, Setting, and Participants

This diagnostic study analyzed otoscopic videos of the tympanic membrane captured using a smartphone during outpatient clinic visits at 2 sites in Pennsylvania between 2018 and 2023. Eligible participants included children who presented for sick visits or wellness visits.

Exposure

Otoscopic examination.

Main Outcomes and Measures

Using the otoscopic videos that were annotated by validated otoscopists, a deep residual-recurrent neural network was trained to predict both features of the tympanic membrane and the diagnosis of AOM vs no AOM. The accuracy of this network was compared with a second network trained using a decision tree approach. A noise quality filter was also trained to prompt users that the video segment acquired may not be adequate for diagnostic purposes.

Results

Using 1151 videos from 635 children (majority younger than 3 years of age), the deep residual-recurrent neural network had almost identical diagnostic accuracy as the decision tree network. The finalized deep residual-recurrent neural network algorithm classified tympanic membrane videos into AOM vs no AOM categories with a sensitivity of 93.8% (95% CI, 92.6%-95.0%) and specificity of 93.5% (95% CI, 92.8%-94.3%) and the decision tree model had a sensitivity of 93.7% (95% CI, 92.4%-94.9%) and specificity of 93.3% (92.5%-94.1%). Of the tympanic membrane features outputted, bulging of the TM most closely aligned with the predicted diagnosis; bulging was present in 230 of 230 cases (100%) in which the diagnosis was predicted to be AOM in the test set.

Conclusions and Relevance

These findings suggest that given its high accuracy, the algorithm and medical-grade application that facilitates image acquisition and quality filtering could reasonably be used in primary care or acute care settings to aid with automated diagnosis of AOM and decisions regarding treatment.

Insight into Automatic Image Diagnosis of Ear Conditions Based on Optimized Deep Learning Approach

Examining otoscopic images for ear diseases is necessary when the clinical diagnosis of ear diseases extracted from the knowledge of otolaryngologists is limited. Improved diagnosis approaches based on otoscopic image processing are urgently needed. Recently, convolutional neural networks (CNNs) have been carried out for medical diagnosis to obtain higher accuracy than standard machine learning algorithms and specialists' expertise. Therefore, the proposed approach involves using the Bayesian hyperparameter optimization with the CNN architecture for automatic diagnosis of ear imagery database including four classes: normal, myringosclerosis, earwax plug, and chronic otitis media (COM). The suggested approach was trained using 616 otoscopic images, and the performance of this approach was assessed using 264 testing images. In this paper, the performance of ear disease classification was compared in terms of accuracy, sensitivity, specificity, and positive predictive value (PPV). The results produced a classification accuracy of 98.10%, a sensitivity of 98.11%, a specificity of 99.36%, and a PPV of 98.10%. Finally, the suggested approach demonstrates how to locate optimal CNN hyperparameters for accurate diagnosis of ear diseases while taking time into account. As a result, the usefulness and dependability of the suggested approach will lead to the establishment of an automated tool for better categorization and prediction of different ear diseases.

Structure-constrained deep feature fusion for chronic otitis media and cholesteatoma identification

Chronic suppurative otitis media (CSOM) and middle ear cholesteatoma (MEC) were two most common chronic middle ear disease(MED) clinically. Accurate differential diagnosis between these two diseases is of high clinical importance given the difference in etiologies, lesion manifestations and treatments. The high-resolution computed tomography (CT) scanning of the temporal bone presents a better view of auditory structures, which is currently regarded as the first-line diagnostic imaging modality in the case of MED. In this paper, we first used a region-of-interest (ROI) network to find the area of the middle ear in the entire temporal bone CT image and segment it to a size of 100*100 pixels. Then, we used a structure-constrained deep feature fusion algorithm to convert different characteristic features of the middle ear in three groups as suppurative otitis media (CSOM), middle ear cholesteatoma (MEC) and normal patches. To fuse structure information, we introduced a graph isomorphism network that implements a feature vector from neighbourhoods and the coordinate distance between vertices. Finally, we construct a classifier named the "otitis media, cholesteatoma and normal identification classifier" (OMCNIC). The experimental results achieved by the graph isomorphism network revealed a 96.36% accuracy in all CSOM and MEC classifications. The experimental results indicate that our structure-constrained deep feature fusion algorithm can quickly and effectively classify CSOM and MEC. It will help otologist in the selection of the most appropriate treatment, and the complications can also be reduced.

Advances in Artificial Intelligence to Diagnose Otitis Media: State of the Art Review

OBJECTIVE

Otitis media (OM) is a model disease for developing, validating, and implementing artificial intelligence (AI) techniques. We aim to review the state of the art applications of AI used to diagnose OM in pediatric and adult populations.

DATA SOURCES

Several comprehensive databases were searched to identify all articles that applied AI technologies to diagnose OM.

REVIEW METHODS

Relevant articles from January 2010 through May 2021 were identified by title and abstract. Articles were excluded if they did not discuss AI in conjunction with diagnosing OM. References of included studies and relevant review articles were cross-referenced to identify any additional studies.

CONCLUSION

Title and abstract screening resulted in full-text retrieval of 40 articles that met initial screening parameters. Of this total, secondary review articles (n = 7) and commentary-based articles (n = 2) were removed, as were articles that did not specifically discuss AI and OM diagnosis (n = 5), leaving 25 articles for review. Applications of AI technologies specific to diagnosing OM included machine learning and natural language processing (n = 23) and prototype approaches (n = 2).

IMPLICATIONS FOR PRACTICE

This review emphasizes the utility of AI techniques to automate and aid in diagnosing OM. Although these techniques are still in the development and testing stages, AI has the potential to improve the practice of otolaryngologists and primary care clinicians by increasing the efficiency and accuracy of diagnoses.

Evaluating the generalizability of deep learning image classification algorithms to detect middle ear disease using otoscopy

To evaluate the generalizability of artificial intelligence (AI) algorithms that use deep learning methods to identify middle ear disease from otoscopic images, between internal to external performance. 1842 otoscopic images were collected from three independent sources: (a) Van, Turkey, (b) Santiago, Chile, and (c) Ohio, USA. Diagnostic categories consisted of (i) normal or (ii) abnormal. Deep learning methods were used to develop models to evaluate internal and external performance, using area under the curve (AUC) estimates. A pooled assessment was performed by combining all cohorts together with fivefold cross validation. AI-otoscopy algorithms achieved high internal performance (mean AUC: 0.95, 95%CI: 0.80-1.00). However, performance was reduced when tested on external otoscopic images not used for training (mean AUC: 0.76, 95%CI: 0.61-0.91). Overall, external performance was significantly lower than internal performance (mean difference in AUC: -0.19, p ≤ 0.04). Combining cohorts achieved a substantial pooled performance (AUC: 0.96, standard error: 0.01). Internally applied algorithms for otoscopy performed well to identify middle ear disease from otoscopy images. However, external performance was reduced when applied to new test cohorts. Further efforts are required to explore data augmentation and pre-processing techniques that might improve external performance and develop a robust, generalizable algorithm for real-world clinical applications.

Automated multi-class classification for prediction of tympanic membrane changes with deep learning models

BACKGROUNDS AND OBJECTIVE

Evaluating the tympanic membrane (TM) using an otoendoscope is the first and most important step in various clinical fields. Unfortunately, most lesions of TM have more than one diagnostic name. Therefore, we built a database of otoendoscopic images with multiple diseases and investigated the impact of concurrent diseases on the classification performance of deep learning networks.

STUDY DESIGN

This retrospective study investigated the impact of concurrent diseases in the tympanic membrane on diagnostic performance using multi-class classification. A customized architecture of EfficientNet-B4 was introduced to predict the primary class (otitis media with effusion (OME), chronic otitis media (COM), and 'None' without OME and COM) and secondary classes (attic cholesteatoma, myringitis, otomycosis, and ventilating tube).

RESULTS

Deep-learning classifications accurately predicted the primary class with dice similarity coefficient (DSC) of 95.19%, while misidentification between COM and OME rarely occurred. Among the secondary classes, the diagnosis of attic cholesteatoma and myringitis achieved a DSC of 88.37% and 88.28%, respectively. Although concurrent diseases hampered the prediction performance, there was only a 0.44% probability of inaccurately predicting two or more secondary classes (29/6,630). The inference time per image was 2.594 ms on average.

CONCLUSION

Deep-learning classification can be used to support clinical decision-making by accurately and reproducibly predicting tympanic membrane changes in real time, even in the presence of multiple concurrent diseases.

Intelligent Control Techniques for the Detection of Biomedical Ear Infections

The capacity to carry out one's regular tasks is affected to varying degrees by hearing difficulties. Poorer understanding, slower learning, and an overall reduction in efficiency in academic endeavours are just a few of the negative impacts of hearing impairments on children's performance, which may range from mild to severe. A significant factor in determining whether or not there will be a decrease in performance is the kind and source of impairment. Research has shown that the Artificial Neural Network technique is capable of modelling both linear and nonlinear solution surfaces in a trustworthy way, as demonstrated in previous studies. To improve the precision with which hearing impairment challenges are diagnosed, a neural network backpropagation approach has been developed with the purpose of fine-tuning the diagnostic process. In particular, it highlights the vital role performed by medical informatics in supporting doctors in the identification of diseases as well as the formulation of suitable choices via the use of data management and knowledge discovery. As part of the intelligent control method, it is proposed in this research to construct a Histogram Equalization (HE)-based Adaptive Center-Weighted Median (ACWM) filter, which is then used to segment/detect the OM in tympanic membrane images using different segmentation methods in order to minimise noise and improve the image quality. A tympanic membrane dataset, which is freely accessible, was used in all experiments.

Smartphone-based artificial intelligence using a transfer learning algorithm for the detection and diagnosis of middle ear diseases: A retrospective deep learning study

BACKGROUND

Middle ear diseases such as otitis media and middle ear effusion, for which diagnoses are often delayed or misdiagnosed, are among the most common issues faced by clinicians providing primary care for children and adolescents. Artificial intelligence (AI) has the potential to assist clinicians in the detection and diagnosis of middle ear diseases through imaging.

METHODS

Otoendoscopic images obtained by otolaryngologists from Taipei Veterans General Hospital in Taiwan between Jany 1, 2011 to Dec 31, 2019 were collected retrospectively and de-identified. The images were entered into convolutional neural network (CNN) training models after data pre-processing, augmentation and splitting. To differentiate sophisticated middle ear diseases, nine CNN-based models were constructed to recognize middle ear diseases. The best-performing models were chosen and ensembled in a small CNN for mobile device use. The pretrained model was converted into the smartphone-based program, and the utility was evaluated in terms of detecting and classifying ten middle ear diseases based on otoendoscopic images. A class activation map (CAM) was also used to identify key features for CNN classification. The performance of each classifier was determined by its accuracy, precision, recall, and F1-score.

FINDINGS

A total of 2820 clinical eardrum images were collected for model training. The programme achieved a high detection accuracy for binary outcomes (pass/refer) of otoendoscopic images and ten different disease categories, with an accuracy reaching 98.0% after model optimisation. Furthermore, the application presented a smooth recognition process and a user-friendly interface and demonstrated excellent performance, with an accuracy of 97.6%. A fifty-question questionnaire related to middle ear diseases was designed for practitioners with different levels of clinical experience. The AI-empowered mobile algorithm's detection accuracy was generally superior to that of general physicians, resident doctors, and otolaryngology specialists (36.0%, 80.0% and 90.0%, respectively). Our results show that the proposed method provides sufficient treatment recommendations that are comparable to those of specialists.

INTERPRETATION

We developed a deep learning model that can detect and classify middle ear diseases. The use of smartphone-based point-of-care diagnostic devices with AI-empowered automated classification can provide real-world smart medical solutions for the diagnosis of middle ear diseases and telemedicine.

FUNDING

This study was supported by grants from the Ministry of Science and Technology (MOST110-2622-8-075-001, MOST110-2320-B-075-004-MY3, MOST-110-2634-F-A49 -005, MOST110-2745-B-075A-001A and MOST110-2221-E-075-005), Veterans General Hospitals and University System of Taiwan Joint Research Program (VGHUST111-G6-11-2, VGHUST111c-140), and Taipei Veterans General Hospital (V111E-002-3).

A Machine Learning Approach to Screen for Otitis Media Using Digital Otoscope Images Labelled by an Expert Panel

Background: Otitis media includes several common inflammatory conditions of the middle ear that can have severe complications if left untreated. Correctly identifying otitis media can be difficult and a screening system supported by machine learning would be valuable for this prevalent disease. This study investigated the performance of a convolutional neural network in screening for otitis media using digital otoscopic images labelled by an expert panel. Methods: Five experienced otologists diagnosed 347 tympanic membrane images captured with a digital otoscope. Images with a majority expert diagnosis (n = 273) were categorized into three screening groups Normal, Pathological and Wax, and the same images were used for training and testing of the convolutional neural network. Expert panel diagnoses were compared to the convolutional neural network classification. Different approaches to the convolutional neural network were tested to identify the best performing model. Results: Overall accuracy of the convolutional neural network was above 0.9 in all except one approach. Sensitivity to finding ears with wax or pathology was above 93% in all cases and specificity was 100%. Adding more images to train the convolutional neural network had no positive impact on the results. Modifications such as normalization of datasets and image augmentation enhanced the performance in some instances. Conclusions: A machine learning approach could be used on digital otoscopic images to accurately screen for otitis media.

Classification of Ear Imagery Database using Bayesian Optimization based on CNN-LSTM Architecture

The external and middle ear conditions are diagnosed using a digital otoscope. The clinical diagnosis of ear conditions is suffered from restricted accuracy due to the increased dependency on otolaryngologist expertise, patient complaint, blurring of the otoscopic images, and complexity of lesions definition. There is a high requirement for improved diagnosis algorithms based on otoscopic image processing. This paper presented an ear diagnosis approach based on a convolutional neural network (CNN) as feature extraction and long short-term memory (LSTM) as a classifier algorithm. However, the suggested LSTM model accuracy may be decreased by the omission of a hyperparameter tuning process. Therefore, Bayesian optimization is used for selecting the hyperparameters to improve the results of the LSTM network to obtain a good classification. This study is based on an ear imagery database that consists of four categories: normal, myringosclerosis, earwax plug, and chronic otitis media (COM). This study used 880 otoscopic images divided into 792 training images and 88 testing images to evaluate the approach performance. In this paper, the evaluation metrics of ear condition classification are based on a percentage of accuracy, sensitivity, specificity, and positive predictive value (PPV). The findings yielded a classification accuracy of 100%, a sensitivity of 100%, a specificity of 100%, and a PPV of 100% for the testing database. Finally, the proposed approach shows how to find the best hyperparameters concerning the Bayesian optimization for reliable diagnosis of ear conditions under the consideration of LSTM architecture. This approach demonstrates that CNN-LSTM has higher performance and lower training time than CNN, which has not been used in previous studies for classifying ear diseases. Consequently, the usefulness and reliability of the proposed approach will create an automatic tool for improving the classification and prediction of various ear pathologies.

Pediatric Otoscopy Video Screening With Shift Contrastive Anomaly Detection

Ear related concerns and symptoms represent the leading indication for seeking pediatric healthcare attention. Despite the high incidence of such encounters, the diagnostic process of commonly encountered diseases of the middle and external presents a significant challenge. Much of this challenge stems from the lack of cost effective diagnostic testing, which necessitates the presence or absence of ear pathology to be determined clinically. Research has, however, demonstrated considerable variation among clinicians in their ability to accurately diagnose and consequently manage ear pathology. With recent advances in computer vision and machine learning, there is an increasing interest in helping clinicians to accurately diagnose middle and external ear pathology with computer-aided systems. It has been shown that AI has the capacity to analyze a single clinical image captured during the examination of the ear canal and eardrum from which it can determine the likelihood of a pathognomonic pattern for a specific diagnosis being present. The capture of such an image can, however, be challenging especially to inexperienced clinicians. To help mitigate this technical challenge, we have developed and tested a method using video sequences. The videos were collected using a commercially available otoscope smartphone attachment in an urban, tertiary-care pediatric emergency department. We present a two stage method that first, identifies valid frames by detecting and extracting ear drum patches from the video sequence, and second, performs the proposed shift contrastive anomaly detection (SCAD) to flag the otoscopy video sequences as normal or abnormal. Our method achieves an AUROC of 88.0% on the patient level and also outperforms the average of a group of 25 clinicians in a comparative study, which is the largest of such published to date. We conclude that the presented method achieves a promising first step toward the automated analysis of otoscopy video.

Detection of retinopathy disease using morphological gradient and segmentation approaches in fundus images

BACKGROUND AND OBJECTIVE

Diabetes-related cases can cause glaucoma, cataracts, optic neuritis, paralysis of the eye muscles, or various retinal damages over time. Diabetic retinopathy is the most common form of blindness that occurs with diabetes. Diabetic retinopathy is a disease that occurs when the blood vessels in the retina of the eye become damaged, leading to loss of vision in advanced stages. This disease can occur in any diabetic patient, and the most important factor in treating the disease is early diagnosis. Nowadays, deep learning models and machine learning methods, which are open to technological developments, are already used in early diagnosis systems. In this study, two publicly available datasets were used. The datasets consist of five types according to the severity of diabetic retinopathy. The objectives of the proposed approach in diabetic retinopathy detection are to positively contribute to the performance of CNN models by processing fundus images through preprocessing steps (morphological gradient and segmentation approaches). The other goal is to detect efficient sets from type-based activation sets obtained from CNN models using Atom Search Optimization method and increase the classification success.

METHODS

The proposed approach consists of three steps. In the first step, the Morphological Gradient method is used to prevent parasitism in each image, and the ocular vessels in fundus images are extracted using the segmentation method. In the second step, the datasets are trained with transfer learning models and the activations for each class type in the last fully connected layers of these models are extracted. In the last step, the Atom Search optimization method is used, and the most dominant activation class is selected from the extracted activations on a class basis.

RESULTS

When classified by the severity of diabetic retinopathy, an overall accuracy of 99.59% was achieved for dataset #1 and 99.81% for dataset #2.

CONCLUSIONS

In this study, it was found that the overall accuracy achieved with the proposed approach increased. To achieve this increase, the application of preprocessing steps and the selection of the dominant activation sets from the deep learning models were implemented using the Atom Search optimization method.

A new composite approach for COVID-19 detection in X-ray images using deep features

The new type of coronavirus, COVID 19, appeared in China at the end of 2019. It has become a pandemic that is spreading all over the world in a very short time. The detection of this disease, which has serious health and socio-economic damages, is of vital importance. COVID-19 detection is performed by applying PCR and serological tests. Additionally, COVID detection is possible using X-ray and computed tomography images. Disease detection has an important position in scientific researches that includes artificial intelligence methods.

The combined models, which consist of different phases, are frequently used for classification problems. In this paper, a new combined approach is proposed to detect COVID-19 cases using deep features obtained from X-ray images. Two main variances of the approach can be presented as single layer-based (SLB) and feature fusion-based (FFB). SLB model consists of pre-processing, deep feature extraction, post-processing, and classification phases. On the other side, the FFB model consists of pre-processing, deep feature extraction, feature fusion, post-processing, and classification phases. Four different SLB and six different FFB models were developed according to the number and binary combination of layers used in the feature extraction phase. Each model is employed for binary and multi-class classification experiments.

According to experimental results, the accuracy performance for COVID-19 and no-findings classification of the proposed FFB3 model is 99.52%, which is better than the best performance accuracy (of 98.08%) in the literature. Concurrently, for multi-class classification, the proposed FFB3 model has an accuracy performance of 87.64% outperforming the best existing work (which reported an 87.02% classification performance). Various metrics, including sensitivity, specificity, precision, and F1-score metrics are used for performance analysis. For all performance metrics, the FFB3 model recorded a higher success rate than existing work in the literature. To the best of our knowledge, these accuracy rates are the best in the literature for the dataset and data split type (five-fold cross-validation).

Composite models (SLBs and FFBs), which are generated in this paper, are successful ways to detect COVID-19. Experimental results show that feature extraction, pre-processing, post-processing, and hyperparameter tuning are the steps are necessary to obtain a higher success. For prospective works, different types of pre-trained models and other hyperparameter tuning methods can be implemented.

Machine Learning Approach Equipped with Neighbourhood Component Analysis for DDoS Attack Detection in Software-Defined Networking

The Software-Defined Network (SDN) is a new network paradigm that promises more dynamic and efficiently manageable network architecture for new-generation networks. With its programmable central controller approach, network operators can easily manage and control the whole network. However, at the same time, due to its centralized structure, it is the target of many attack vectors. Distributed Denial of Service (DDoS) attacks are the most effective attack vector to the SDN. The purpose of this study is to classify the SDN traffic as normal or attack traffic using machine learning algorithms equipped with Neighbourhood Component Analysis (NCA). We handle a public “DDoS attack SDN Dataset” including a total of 23 features. The dataset consists of Transmission Control Protocol (TCP), User Datagram Protocol (UDP), and Internet Control Message Protocol (ICMP) normal and attack traffics. The dataset, including more than 100 thousand recordings, has statistical features such as byte_count, duration_sec, packet rate, and packet per flow, except for features that define source and target machines. We use the NCA algorithm to reveal the most relevant features by feature selection and perform an effective classification. After preprocessing and feature selection stages, the obtained dataset was classified by k-Nearest Neighbor (kNN), Decision Tree (DT), Artificial Neural Network (ANN), and Support Vector Machine (SVM) algorithms. The experimental results show that DT has a better accuracy rate than the other algorithms with 100% classification achievement.

Tumor type detection in brain MR images of the deep model developed using hypercolumn technique, attention modules, and residual blocks

Brain cancer is a disease caused by the growth of abnormal aggressive cells in the brain outside of normal cells. Symptoms and diagnosis of brain cancer cases are producing more accurate results day by day in parallel with the development of technological opportunities. In this study, a deep learning model called BrainMRNet which is developed for mass detection in open-source brain magnetic resonance images was used. The BrainMRNet model includes three processing steps: attention modules, the hypercolumn technique, and residual blocks. To demonstrate the accuracy of the proposed model, three types of tumor data leading to brain cancer were examined in this study: glioma, meningioma, and pituitary. In addition, a segmentation method was proposed, which additionally determines in which lobe area of the brain the two classes of tumors that cause brain cancer are more concentrated. The classification accuracy rates were performed in the study; it was 98.18% in glioma tumor, 96.73% in meningioma tumor, and 98.18% in pituitary tumor. At the end of the experiment, using the subset of glioma and meningioma tumor images, it was determined which at brain lobe the tumor region was seen, and 100% success was achieved in the analysis of this determination. In this study, a hybrid deep learning model is presented to determine the detection of the brain tumor. In addition, open-source software was proposed, which statistically found in which lobe region of the human brain the brain tumor occurred. The methods applied and tested in the experiments have shown promising results with a high level of accuracy, precision, and specificity. These results demonstrate the availability of the proposed approach in clinical settings to support the medical decision regarding brain tumor detection.

Otitis media detection using tympanic membrane images with a novel multi-class machine learning algorithm

BACKGROUND

Otitis media (OM) is the infection and inflammation of the mucous membrane covering the Eustachian with the airy cavities of the middle ear and temporal bone. OM is also one of the most common ailments. In clinical practice, the diagnosis of OM is carried out by visual inspection of otoscope images. This vulnerable process is subjective and error-prone.

METHODS

In this study, a novel computer-aided decision support model based on the convolutional neural network (CNN) has been developed. To improve the generalized ability of the proposed model, a combination of the channel and spatial model (CBAM), residual blocks, and hypercolumn technique is embedded into the proposed model. All experiments were performed on an open-access tympanic membrane dataset that consists of 956 otoscopes images collected into five classes.

RESULTS

The proposed model yielded satisfactory classification achievement. The model ensured an overall accuracy of 98.26%, sensitivity of 97.68%, and specificity of 99.30%. The proposed model produced rather superior results compared to the pre-trained CNNs such as AlexNet, VGG-Nets, GoogLeNet, and ResNets. Consequently, this study points out that the CNN model equipped with the advanced image processing techniques is useful for OM diagnosis. The proposed model may help to field specialists in achieving objective and repeatable results, decreasing misdiagnosis rate, and supporting the decision-making processes.

Tumor type detection in brain MR images of the deep model developed using hypercolumn technique, attention modules, and residual blocks

Brain cancer is a disease caused by the growth of abnormal aggressive cells in the brain outside of normal cells. Symptoms and diagnosis of brain cancer cases are producing more accurate results day by day in parallel with the development of technological opportunities. In this study, a deep learning model called BrainMRNet which is developed for mass detection in open-source brain magnetic resonance images was used. The BrainMRNet model includes three processing steps: attention modules, the hypercolumn technique, and residual blocks. To demonstrate the accuracy of the proposed model, three types of tumor data leading to brain cancer were examined in this study: glioma, meningioma, and pituitary. In addition, a segmentation method was proposed, which additionally determines in which lobe area of the brain the two classes of tumors that cause brain cancer are more concentrated. The classification accuracy rates were performed in the study; it was 98.18% in glioma tumor, 96.73% in meningioma tumor, and 98.18% in pituitary tumor. At the end of the experiment, using the subset of glioma and meningioma tumor images, it was determined which at brain lobe the tumor region was seen, and 100% success was achieved in the analysis of this determination. In this study, a hybrid deep learning model is presented to determine the detection of the brain tumor. In addition, open-source software was proposed, which statistically found in which lobe region of the human brain the brain tumor occurred. The methods applied and tested in the experiments have shown promising results with a high level of accuracy, precision, and specificity. These results demonstrate the availability of the proposed approach in clinical settings to support the medical decision regarding brain tumor detection.

MH-COVIDNet: Diagnosis of COVID-19 using deep neural networks and meta-heuristic-based feature selection on X-ray images

COVID-19 is a disease that causes symptoms in the lungs and causes deaths around the world. Studies are ongoing for the diagnosis and treatment of this disease, which is defined as a pandemic. Early diagnosis of this disease is important for human life. This process is progressing rapidly with diagnostic studies based on deep learning. Therefore, to contribute to this field, a deep learning-based approach that can be used for early diagnosis of the disease is proposed in our study. In this approach, a data set consisting of 3 classes of COVID19, normal and pneumonia lung X-ray images was created, with each class containing 364 images. Pre-processing was performed using the image contrast enhancement algorithm on the prepared data set and a new data set was obtained. Feature extraction was completed from this data set with deep learning models such as AlexNet, VGG19, GoogleNet, and ResNet. For the selection of the best potential features, two metaheuristic algorithms of binary particle swarm optimization and binary gray wolf optimization were used. After combining the features obtained in the feature selection of the enhancement data set, they were classified using SVM. The overall accuracy of the proposed approach was obtained as 99.38%. The results obtained by verification with two different metaheuristic algorithms proved that the approach we propose can help experts during COVID-19 diagnostic studies.

COVID-19 detection using deep learning models to exploit Social Mimic Optimization and structured chest X-ray images using fuzzy color and stacking approaches

Coronavirus causes a wide variety of respiratory infections and it is an RNA-type virus that can infect both humans and animal species. It often causes pneumonia in humans. Artificial intelligence models have been helpful for successful analyses in the biomedical field. In this study, Coronavirus was detected using a deep learning model, which is a sub-branch of artificial intelligence. Our dataset consists of three classes namely: coronavirus, pneumonia, and normal X-ray imagery. In this study, the data classes were restructured using the Fuzzy Color technique as a preprocessing step and the images that were structured with the original images were stacked. In the next step, the stacked dataset was trained with deep learning models (MobileNetV2, SqueezeNet) and the feature sets obtained by the models were processed using the Social Mimic optimization method. Thereafter, efficient features were combined and classified using Support Vector Machines (SVM). The overall classification rate obtained with the proposed approach was 99.27%. With the proposed approach in this study, it is evident that the model can efficiently contribute to the detection of COVID-19 disease.

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Chest data obtained from patients infected with the new Coronavirus (COVID-19) were used.

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It was detected with deep learning models using COVID-19, normal, and pneumonia chest data.

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The original dataset was restructured with the Fuzzy Color technique and two datasets were stacked.

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Efficient features were selected by applying Social Mimic optimization to feature sets extracted from CNN models.

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The efficient features obtained were combined, and classified with a success rate of 99.27% with SVM method.

Computer-aided diagnosis of external and middle ear conditions: A machine learning approach

In medicine, a misdiagnosis or the absence of specialists can affect the patient’s health, leading to unnecessary tests and increasing the costs of healthcare. In particular, the lack of specialists in otolaryngology in third world countries forces patients to seek medical attention from general practitioners, whom might not have enough training and experience for making correct diagnosis in this field. To tackle this problem, we propose and test a computer-aided system based on machine learning models and image processing techniques for otoscopic examination, as a support for a more accurate diagnosis of ear conditions at primary care before specialist referral; in particular, for myringosclerosis, earwax plug, and chronic otitis media. To characterize the tympanic membrane and ear canal for each condition, we implemented three different feature extraction methods: color coherence vector, discrete cosine transform, and filter bank. We also considered three machine learning algorithms: support vector machine (SVM), k-nearest neighbor (k-NN) and decision trees to develop the ear condition predictor model. To conduct the research, our database included 160 images as testing set and 720 images as training and validation sets of 180 patients. We repeatedly trained the learning models using the training dataset and evaluated them using the validation dataset to thus obtain the best feature extraction method and learning model that produce the highest validation accuracy. The results showed that the SVM and k-NN presented the best performance followed by decision trees model. Finally, we performed a classification stage –i.e., diagnosis– using testing data, where the SVM model achieved an average classification accuracy of 93.9%, average sensitivity of 87.8%, average specificity of 95.9%, and average positive predictive value of 87.7%. The results show that this system might be used for general practitioners as a reference to make better decisions in the ear pathologies diagnosis.