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Liu RW, Ong W, Makmur A, Kumar N, Low XZ, Shuliang G, Liang TY, Ting DFK, Tan JH, Hallinan JTPD. Application of Artificial Intelligence Methods on Osteoporosis Classification with Radiographs-A Systematic Review. Bioengineering (Basel) 2024; 11:484. [PMID: 38790351 PMCID: PMC11117497 DOI: 10.3390/bioengineering11050484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 04/24/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
Osteoporosis is a complex endocrine disease characterized by a decline in bone mass and microstructural integrity. It constitutes a major global health problem. Recent progress in the field of artificial intelligence (AI) has opened new avenues for the effective diagnosis of osteoporosis via radiographs. This review investigates the application of AI classification of osteoporosis in radiographs. A comprehensive exploration of electronic repositories (ClinicalTrials.gov, Web of Science, PubMed, MEDLINE) was carried out in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement (PRISMA). A collection of 31 articles was extracted from these repositories and their significant outcomes were consolidated and outlined. This encompassed insights into anatomical regions, the specific machine learning methods employed, the effectiveness in predicting BMD, and categorizing osteoporosis. Through analyzing the respective studies, we evaluated the effectiveness and limitations of AI osteoporosis classification in radiographs. The pooled reported accuracy, sensitivity, and specificity of osteoporosis classification ranges from 66.1% to 97.9%, 67.4% to 100.0%, and 60.0% to 97.5% respectively. This review underscores the potential of AI osteoporosis classification and offers valuable insights for future research endeavors, which should focus on addressing the challenges in technical and clinical integration to facilitate practical implementation of this technology.
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Affiliation(s)
- Ren Wei Liu
- Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore (D.F.K.T.)
| | - Wilson Ong
- Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore (D.F.K.T.)
| | - Andrew Makmur
- Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore (D.F.K.T.)
- Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore
| | - Naresh Kumar
- University Spine Centre, Department of Orthopaedic Surgery, National University Health System, 1E, Lower Kent Ridge Road, Singapore 119228, Singapore
| | - Xi Zhen Low
- Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore (D.F.K.T.)
- Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore
| | - Ge Shuliang
- Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore (D.F.K.T.)
- Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore
| | - Tan Yi Liang
- Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore (D.F.K.T.)
- Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore
| | - Dominic Fong Kuan Ting
- Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore (D.F.K.T.)
- Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore
| | - Jiong Hao Tan
- University Spine Centre, Department of Orthopaedic Surgery, National University Health System, 1E, Lower Kent Ridge Road, Singapore 119228, Singapore
| | - James Thomas Patrick Decourcy Hallinan
- Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore (D.F.K.T.)
- Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore
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Zhang K, Liang W, Cao P, Liu X, Yang J, Zaiane O. Label correlation guided discriminative label feature learning for multi-label chest image classification. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2024; 245:108032. [PMID: 38244339 DOI: 10.1016/j.cmpb.2024.108032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 01/02/2024] [Accepted: 01/12/2024] [Indexed: 01/22/2024]
Abstract
BACKGROUND AND OBJECTIVE Multi-label Chest X-ray (CXR) images often contain rich label relationship information, which is beneficial to improve classification performance. However, because of the intricate relationships among labels, most existing works fail to effectively learn and make full use of the label correlations, resulting in limited classification performance. In this study, we propose a multi-label learning framework that learns and leverages the label correlations to improve multi-label CXR image classification. METHODS In this paper, we capture the global label correlations through the self-attention mechanism. Meanwhile, to better utilize label correlations for guiding feature learning, we decompose the image-level features into label-level features. Furthermore, we enhance label-level feature learning in an end-to-end manner by a consistency constraint between global and local label correlations, and a label correlation guided multi-label supervised contrastive loss. RESULTS To demonstrate the superior performance of our proposed approach, we conduct three times 5-fold cross-validation experiments on the CheXpert dataset. Our approach obtains an average F1 score of 44.6% and an AUC of 76.5%, achieving a 7.7% and 1.3% improvement compared to the state-of-the-art results. CONCLUSION More accurate label correlations and full utilization of the learned label correlations help learn more discriminative label-level features. Experimental results demonstrate that our approach achieves exceptionally competitive performance compared to the state-of-the-art algorithms.
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Affiliation(s)
- Kai Zhang
- Computer Science and Engineering, Northeastern University, Shenyang, China
| | - Wei Liang
- Computer Science and Engineering, Northeastern University, Shenyang, China
| | - Peng Cao
- Computer Science and Engineering, Northeastern University, Shenyang, China; Key Laboratory of Intelligent Computing in Medical Image of Ministry of Education, Northeastern University, Shenyang, China; National Frontiers Science Center for Industrial Intelligence and Systems Optimization, Shenyang, China.
| | - Xiaoli Liu
- DAMO Academy, Alibaba Group, Hangzhou, China
| | - Jinzhu Yang
- Computer Science and Engineering, Northeastern University, Shenyang, China; Key Laboratory of Intelligent Computing in Medical Image of Ministry of Education, Northeastern University, Shenyang, China; National Frontiers Science Center for Industrial Intelligence and Systems Optimization, Shenyang, China
| | - Osmar Zaiane
- Alberta Machine Intelligence Institute, University of Alberta, Edmonton, Alberta, Canada
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Arora M, Davis CM, Gowda NR, Foster DG, Mondal A, Coopersmith CM, Kamaleswaran R. Uncertainty-Aware Convolutional Neural Network for Identifying Bilateral Opacities on Chest X-rays: A Tool to Aid Diagnosis of Acute Respiratory Distress Syndrome. Bioengineering (Basel) 2023; 10:946. [PMID: 37627831 PMCID: PMC10451804 DOI: 10.3390/bioengineering10080946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/26/2023] [Accepted: 08/03/2023] [Indexed: 08/27/2023] Open
Abstract
Acute Respiratory Distress Syndrome (ARDS) is a severe lung injury with high mortality, primarily characterized by bilateral pulmonary opacities on chest radiographs and hypoxemia. In this work, we trained a convolutional neural network (CNN) model that can reliably identify bilateral opacities on routine chest X-ray images of critically ill patients. We propose this model as a tool to generate predictive alerts for possible ARDS cases, enabling early diagnosis. Our team created a unique dataset of 7800 single-view chest-X-ray images labeled for the presence of bilateral or unilateral pulmonary opacities, or 'equivocal' images, by three blinded clinicians. We used a novel training technique that enables the CNN to explicitly predict the 'equivocal' class using an uncertainty-aware label smoothing loss. We achieved an Area under the Receiver Operating Characteristic Curve (AUROC) of 0.82 (95% CI: 0.80, 0.85), a precision of 0.75 (95% CI: 0.73, 0.78), and a sensitivity of 0.76 (95% CI: 0.73, 0.78) on the internal test set while achieving an (AUROC) of 0.84 (95% CI: 0.81, 0.86), a precision of 0.73 (95% CI: 0.63, 0.69), and a sensitivity of 0.73 (95% CI: 0.70, 0.75) on an external validation set. Further, our results show that this approach improves the model calibration and diagnostic odds ratio of the hypothesized alert tool, making it ideal for clinical decision support systems.
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Affiliation(s)
- Mehak Arora
- Department of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA 30332, USA;
| | - Carolyn M. Davis
- Department of Surgery, Emory University School of Medicine, Atlanta, GA 30332, USA; (C.M.D.); (D.G.F.); (C.M.C.)
- Emory Critical Care Center, Emory University School of Medicine, Atlanta, GA 30332, USA
| | - Niraj R. Gowda
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Emory University School of Medicine, Atlanta, GA 30332, USA;
| | - Dennis G. Foster
- Department of Surgery, Emory University School of Medicine, Atlanta, GA 30332, USA; (C.M.D.); (D.G.F.); (C.M.C.)
| | - Angana Mondal
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA 30332, USA;
| | - Craig M. Coopersmith
- Department of Surgery, Emory University School of Medicine, Atlanta, GA 30332, USA; (C.M.D.); (D.G.F.); (C.M.C.)
- Emory Critical Care Center, Emory University School of Medicine, Atlanta, GA 30332, USA
| | - Rishikesan Kamaleswaran
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA 30332, USA;
- Emory Critical Care Center, Emory University School of Medicine, Atlanta, GA 30332, USA
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