A CNN-based active learning framework to identify mycobacteria in digitized Ziehl-Neelsen stained human tissues

Clinical microbiology and artificial intelligence: Different applications, challenges, and future prospects

Conventional clinical microbiological techniques are enhanced by the introduction of artificial intelligence (AI). Comprehensive data processing and analysis enabled the development of curated datasets that has been effectively used in training different AI algorithms. Recently, a number of machine learning (ML) and deep learning (DL) algorithms are developed and evaluated using diverse microbiological datasets. These datasets included spectral analysis (Raman and MALDI-TOF spectroscopy), microscopic images (Gram and acid fast stains), and genomic and protein sequences (whole genome sequencing (WGS) and protein data banks (PDBs)). The primary objective of these algorithms is to minimize the time, effort, and expenses linked to conventional analytical methods. Furthermore, AI algorithms are incorporated with quantitative structure-activity relationship (QSAR) models to predict novel antimicrobial agents that address the continuing surge of antimicrobial resistance. During the COVID-19 pandemic, AI algorithms played a crucial role in vaccine developments and the discovery of new antiviral agents, and introduced potential drug candidates via drug repurposing. However, despite their significant benefits, the implementation of AI encounters various challenges, including ethical considerations, the potential for bias, and errors related to data training. This review seeks to provide an overview of the most recent applications of artificial intelligence in clinical microbiology, with the intention of educating a wider audience of clinical practitioners regarding the current uses of machine learning algorithms and encouraging their implementation. Furthermore, it will discuss the challenges related to the incorporation of AI into clinical microbiology laboratories and examine future opportunities for AI within the realm of infectious disease epidemiology.

A 5G network based conceptual framework for real-time malaria parasite detection from thick and thin blood smear slides using modified YOLOv5 model

Objective

This paper aims to address the need for real-time malaria disease detection that integrates a faster prediction model with a robust underlying network. The study first proposes a 5G network-based healthcare system and then develops an automated malaria detection model capable of providing an accurate diagnosis, particularly in areas with limited diagnostic resources.

Methods

The proposed system leverages a deep learning-based YOLOv5x algorithm to detect malaria parasites in thick and thin blood smear samples. The YOLOv5x network architecture was modified by introducing two squeeze-and-excitation network (SENet) layers just before the Upsample layers. The system is designed to operate over 5G networks efficiently, enabling remote and smart healthcare solutions.

Results

The modified YOLOv5x model demonstrated improved accuracy and precision in detecting malaria parasites on microscopic slides. The inclusion of SENet layers optimized the network's performance, making it suitable for real-time disease detection over a 5G network.

Conclusion

Our model exemplifies how a generic one-stage object detection algorithm, such as YOLOv5x, can be repurposed to detect objects as small as malaria parasites from microscopic visuals in a cost-effective manner over the 5G network. By integrating the computational efficiency of deep learning with the connectivity of 5G networks, this system can significantly enhance remote diagnostic capabilities and contribute to smart healthcare solutions.

Utilizing active learning and attention-CNN to classify vegetation based on UAV multispectral data

This paper presents a deep learning model based on an active learning strategy. The model achieves accurate identification of vegetation types in the study area by utilizing multispectral data obtained from preprocessing of unmanned aerial vehicle (UAV) remote sensing equipment. This approach offers advantages such as high data accuracy, mobility, and easy data collection. In active learning, the minimum confidence scoring method and a sampling technique based on a data pool are employed to reduce labeling costs. The deep learning model incorporates a semantic segmentation gated full fusion module that integrates a dual attention mechanism. This module enhances the capture of detailed texture information, optimally allocates spectral weights, and improves the model's ability to distinguish between similar categories. At a labeling cost of 20%, the average accuracy of the model is 93.2%. Compared with other models, the proposed model achieved the highest classification accuracy in the case of limited training samples. At full annotation cost, the average accuracy is 95.32%, with only a difference of about 2%, but saving 80% of annotation cost. Therefore, active learning strategies can filter out high-value samples that are beneficial for model training, greatly reducing the annotation cost of samples Finally, the recognition results of surface vegetation cover types in the study area are presented, and the model's accuracy is verified through field investigation.

Computer vision applications for the detection or analysis of tuberculosis using digitised human lung tissue images - a systematic review

OBJECTIVE

To conduct a systematic review of the computer vision applications that detect, diagnose, or analyse tuberculosis (TB) pathology or bacilli using digitised human lung tissue images either through automatic or semi-automatic methods. We categorised the computer vision platform into four technologies: image processing, object/pattern recognition, computer graphics, and deep learning. In this paper, the focus is on image processing and deep learning (DL) applications for either 2D or 3D digitised human lung tissue images. This review is useful for establishing a common practice in TB analysis using human lung tissue as well as identifying opportunities for further research in this space. The review brings attention to the state-of-art techniques for detecting TB, with emphasis on the challenges and limitations of the current techniques. The ultimate goal is to promote the development of more efficient and accurate algorithms for the detection or analysis of TB, and raise awareness about the importance of early detection.

DESIGN

We searched five databases and Google Scholar for articles published between January 2017 and December 2022 that focus on Mycobacterium tuberculosis detection, or tuberculosis pathology using digitised human lung tissue images. Details regarding design, image processing and computer-aided techniques, deep learning models, and datasets were collected and summarised. Discussions, analysis, and comparisons of state-of-the-art methods are provided to help guide future research. Further, a brief update on the relevant techniques and their performance is provided.

RESULTS

Several studies have been conducted to develop automated and AI-assisted methods for diagnosing Mtb and TB pathology from digitised human lung tissue images. Some studies presented a completely automated method of diagnosis, while other studies developed AI-assisted diagnostic methods. Low-level focus areas included the development of a novel μ CT scanner for soft tissue image contract, and use of multiresolution computed tomography to analyse the 3D structure of the human lung. High-level focus areas included the investigation the effects of aging on the number and size of small airways in the lungs using CT and whole lung high-resolution μ CT, and the 3D microanatomy characterisation of human tuberculosis lung using μ CT in conjunction with histology and immunohistochemistry. Additionally, a novel method for acquiring high-resolution 3D images of human lung structure and topology is also presented.

CONCLUSION

The literature indicates that post 1950s, TB was predominantly studied using animal models even though no animal model reflects the full spectrum of human pulmonary TB disease and does not reproducibly transmit Mtb infection to other animals (Hunter, 2011). This explains why there are very few studies that used human lung tissue for detection or analysis of Mtb. Nonetheless, we found 10 studies that used human tissues (predominately lung) of which five studies proposed machine learning (ML) models for the detection of bacilli and the other five used CT on human lung tissue scanned ex-vivo.

Lung Disease Detection Using U-Net Feature Extractor Cascaded by Graph Convolutional Network

Computed tomography (CT) scans have recently emerged as a major technique for the fast diagnosis of lung diseases via image classification techniques. In this study, we propose a method for the diagnosis of COVID-19 disease with improved accuracy by utilizing graph convolutional networks (GCN) at various layer formations and kernel sizes to extract features from CT scan images. We apply a U-Net model to aid in segmentation and feature extraction. In contrast with previous research retrieving deep features from convolutional filters and pooling layers, which fail to fully consider the spatial connectivity of the nodes, we employ GCNs for classification and prediction to capture spatial connectivity patterns, which provides a significant association benefit. We handle the extracted deep features to form an adjacency matrix that contains a graph structure and pass it to a GCN along with the original image graph and the largest kernel graph. We combine these graphs to form one block of the graph input and then pass it through a GCN with an additional dropout layer to avoid overfitting. Our findings show that the suggested framework, called the feature-extracted graph convolutional network (FGCN), performs better in identifying lung diseases compared to recently proposed deep learning architectures that are not based on graph representations. The proposed model also outperforms a variety of transfer learning models commonly used for medical diagnosis tasks, highlighting the abstraction potential of the graph representation over traditional methods.

Artificial intelligence in the clinical laboratory

Laboratory medicine has become a highly automated medical discipline. Nowadays, artificial intelligence (AI) applied to laboratory medicine is also gaining more and more attention, which can optimize the entire laboratory workflow and even revolutionize laboratory medicine in the future. However, only a few commercially available AI models are currently approved for use in clinical laboratories and have drawbacks such as high cost, lack of accuracy, and the need for manual review of model results. Furthermore, there are a limited number of literature reviews that comprehensively address the research status, challenges, and future opportunities of AI applications in laboratory medicine. Our article begins with a brief introduction to AI and some of its subsets, then reviews some AI models that are currently being used in clinical laboratories or that have been described in emerging studies, and explains the existing challenges associated with their application and possible solutions, finally provides insights into the future opportunities of the field. We highlight the current status of implementation and potential applications of AI models in different stages of the clinical testing process.

The Impact of Artificial Intelligence on Microbial Diagnosis

Traditional microbial diagnostic methods face many obstacles such as sample handling, culture difficulties, misidentification, and delays in determining susceptibility. The advent of artificial intelligence (AI) has markedly transformed microbial diagnostics with rapid and precise analyses. Nonetheless, ethical considerations accompany AI adoption, necessitating measures to uphold patient privacy, mitigate biases, and ensure data integrity. This review examines conventional diagnostic hurdles, stressing the significance of standardized procedures in sample processing. It underscores AI's significant impact, particularly through machine learning (ML), in microbial diagnostics. Recent progressions in AI, particularly ML methodologies, are explored, showcasing their influence on microbial categorization, comprehension of microorganism interactions, and augmentation of microscopy capabilities. This review furnishes a comprehensive evaluation of AI's utility in microbial diagnostics, addressing both advantages and challenges. A few case studies including SARS-CoV-2, malaria, and mycobacteria serve to illustrate AI's potential for swift and precise diagnosis. Utilization of convolutional neural networks (CNNs) in digital pathology, automated bacterial classification, and colony counting further underscores AI's versatility. Additionally, AI improves antimicrobial susceptibility assessment and contributes to disease surveillance, outbreak forecasting, and real-time monitoring. Despite a few limitations, integration of AI in diagnostic microbiology presents robust solutions, user-friendly algorithms, and comprehensive training, promising paradigm-shifting advancements in healthcare.

Active learning for left ventricle segmentation in echocardiography

BACKGROUND AND OBJECTIVE

Training deep learning models for medical image segmentation require large annotated datasets, which can be expensive and time-consuming to create. Active learning is a promising approach to reduce this burden by strategically selecting the most informative samples for segmentation. This study investigates the use of active learning for efficient left ventricle segmentation in echocardiography with sparse expert annotations.

METHODS

We adapt and evaluate various sampling techniques, demonstrating their effectiveness in judiciously selecting samples for segmentation. Additionally, we introduce a novel strategy, Optimised Representativeness Sampling, which combines feature-based outliers with the most representative samples to enhance annotation efficiency.

RESULTS

Our findings demonstrate a substantial reduction in annotation costs, achieving a remarkable 99% upper bound performance while utilising only 20% of the labelled data. This equates to a reduction of 1680 images needing annotation within our dataset. When applied to a publicly available dataset, our approach yielded a remarkable 70% reduction in required annotation efforts, representing a significant advancement compared to baseline active learning strategies, which achieved only a 50% reduction. Our experiments highlight the nuanced performance of diverse sampling strategies across datasets within the same domain.

CONCLUSIONS

The study provides a cost-effective approach to tackle the challenges of limited expert annotations in echocardiography. By introducing a distinct dataset, made publicly available for research purposes, our work contributes to the field's understanding of efficient annotation strategies in medical image segmentation.

Automatic bright-field smear microscopy for diagnosis of pulmonary tuberculosis

In recent decades, many studies have been published on the use of automatic smear microscopy for diagnosing pulmonary tuberculosis (TB). Most of them deal with a preliminary step of the diagnosis, the bacilli detection, whereas sputum smear microscopy for diagnosis of pulmonary TB comprises detecting and reporting the number of bacilli found in at least 100 microscopic fields, according to the 5 grading scales (negative, scanty, 1+, 2+ and 3+) endorsed by the World Health Organization (WHO). Pulmonary TB diagnosis in bright-field smear microscopy, however, depends upon the attention of a trained and motivated technician, while the automated TB diagnosis requires little or no interpretation by a technician. As far as we know, this work proposes the first automatic method for pulmonary TB diagnosis in bright-field smear microscopy, according to the WHO recommendations. The proposed method comprises a semantic segmentation step, using a deep neural network, followed by a filtering step aiming to reduce the number of false positives (false bacilli): color and shape filtering. In semantic segmentation, different configurations of encoders are evaluated, using depth-wise separable convolution layers and channel attention mechanism. The proposed method was evaluated with a large, robust, and annotated image dataset designed for this purpose, consisting of 250 testing sets, 50 sets for each of the 5 TB diagnostic classes. The following performance metrics were obtained for automatic pulmonary TB diagnosis by smear microscopy: mean precision of 0.894, mean recall of 0.896, and mean F1-score of 0.895.

Harnessing of Artificial Intelligence for the Diagnosis and Prevention of Hospital-Acquired Infections: A Systematic Review

Healthcare-associated infections (HAIs) are the most common adverse events in healthcare and constitute a major global public health concern. Surveillance represents the foundation for the effective prevention and control of HAIs, yet conventional surveillance is costly and labor intensive. Artificial intelligence (AI) and machine learning (ML) have the potential to support the development of HAI surveillance algorithms for the understanding of HAI risk factors, the improvement of patient risk stratification as well as the prediction and timely detection and prevention of infections. AI-supported systems have so far been explored for clinical laboratory testing and imaging diagnosis, antimicrobial resistance profiling, antibiotic discovery and prediction-based clinical decision support tools in terms of HAIs. This review aims to provide a comprehensive summary of the current literature on AI applications in the field of HAIs and discuss the future potentials of this emerging technology in infection practice. Following the PRISMA guidelines, this study examined the articles in databases including PubMed and Scopus until November 2023, which were screened based on the inclusion and exclusion criteria, resulting in 162 included articles. By elucidating the advancements in the field, we aim to highlight the potential applications of AI in the field, report related issues and shortcomings and discuss the future directions.

Deep learning segmentation of endothelial cell images using an active learning paradigm with guided label corrections

Purpose

To create Guided Correction Software for informed manual editing of automatically generated corneal endothelial cell (EC) segmentations and apply it to an active learning paradigm to analyze a diverse set of post-keratoplasty EC images.

Approach

An original U-Net model trained on 130 manually labeled post-Descemet stripping automated endothelial keratoplasty (EK) images was applied to 841 post-Descemet membrane EK images generating "uncorrected" cell border segmentations. Segmentations were then manually edited using the Guided Correction Software to create corrected labels. This dataset was split into 741 training and 100 testing EC images. U-Net and DeepLabV3+ were trained on the EC images and the corresponding uncorrected and corrected labels. Model performance was evaluated in a cell-by-cell analysis. Evaluation metrics included the number of over-segmentations, under-segmentations, correctly identified new cells, and endothelial cell density (ECD).

Results

Utilizing corrected segmentations for training U-Net and DeepLabV3+ improved their performance. The average number of over- and under-segmentations per image was reduced from 23 to 11 with the corrected training set. Predicted ECD values generated by networks trained on the corrected labels were not significantly different than the ground truth counterparts (p = 0.02 , paired t -test). These models also correctly segmented a larger percentage of newly identified cells. The proposed Guided Correction Software and semi-automated approach reduced the time to accurately segment EC images from 15 to 30 to 5 min, an ∼ 80 % decrease compared to manual editing.

Conclusions

Guided Correction Software can efficiently label new training data for improved deep learning performance and generalization between EC datasets.

Multilayer outperforms single-layer slide scanning in AI-based classification of whole slide images with low-burden acid-fast mycobacteria (AFB)

Manual screening of Ziehl-Neelsen (ZN)-stained slides that are negative or contain rare acid-fast mycobacteria (AFB) is labor-intensive and requires repetitive refocusing to visualize AFB candidates under the microscope. Whole slide image (WSI) scanners have enabled implementation of AI to classify digital ZN-stained slides as AFB+ or AFB-. By default, these scanners acquire a single-layer WSI. However, some scanners can acquire a multilayer WSI with a z-stack and an extended focus image layer embedded. We developed a parameterized WSI classification pipeline to assess whether multilayer imaging improves ZN-stained slide classification accuracy. A CNN built into the pipeline classified tiles in each image layer to form an AFB probability score heatmap. Features extracted from the heatmap were then entered into a WSI classifier. 46 AFB+ and 88 AFB- single-layer WSIs were used for the classifier training. 15 AFB+ (with rare microorganisms) and 5 AFB- multilayer WSIs comprised the test set. Parameters in the pipeline included: (a) a WSI representation: z-stack of image layers, middle image layer (a single image layer equivalent) or an extended focus image layer, (b) 4 methods of aggregating AFB probability scores across the z-stack, (c) 3 classifiers, (d) 3 AFB probability thresholds, and (e) 9 feature vector types extracted from the aggregated AFB probability heatmaps. Balanced accuracy (BACC) was used to measure the pipeline performance for all parameter combinations. Analysis of Covariance (ANCOVA) was used to statistically evaluate the effect of each parameter on the BACC. After adjusting for other factors, a significant effect of the WSI representation (p-value < 1.99E-76), classifier type (p-value < 1.73E-21), and AFB threshold (p-value = 0.003) was observed on the BACC. The feature type had no significant effect (p-value = 0.459) on the BACC. WSIs represented by the middle layer, extended focus layer and the z-stack followed by the weighted averaging of AFB probability scores were classified with the average BACC of 58.80%, 68.64%, and 77.28%, respectively. The multilayer WSIs represented by the z-stack with the weighted averaging of AFB probability scores were classified by a Random Forest classifier with the average BACC of 83.32%. Low classification accuracy of WSIs represented by the middle layer suggests that they contain fewer features permitting identification of AFB than the multilayer WSIs. Our results indicate that single-layer acquisition can introduce a bias (sampling error) into the WSI. This bias can be mitigated by the multilayer or the extended focus acquisitions.

A systematic review and repeatability study on the use of deep learning for classifying and detecting tuberculosis bacilli in microscopic images

Tuberculosis (TB) is among the leading causes of death worldwide from a single infectious agent. This disease usually affects the lungs (pulmonary TB) and can be cured in most cases with a quick diagnosis and proper treatment. Microscopic sputum smear is widely used to diagnose and manage pulmonary TB. Despite being relatively fast and low cost, it can be exhausting because it depends on manually counting TB bacilli (Mycobacterium tuberculosis) in microscope images. In this context, different Deep Learning (DL) techniques are proposed in the literature to assist in performing smear microscopy. This article presents a systematic review based on the PRISMA procedure, which investigates which DL techniques can contribute to classifying TB bacilli in microscopic images of sputum smears using the Ziehl-Nielsen method. After an extensive search and a careful inclusion/exclusion procedure, 28 papers were selected from a total of 400 papers retrieved from nine databases. Based on these articles, the DL techniques are presented as possible solutions to improve smear microscopy. The main concepts necessary to understand how such techniques are proposed and used are also presented. In addition, replication work is also carried out, verifying reproducibility and comparing different works in the literature. In this review, we look at how DL techniques can be a partner to make sputum smear microscopy faster and more efficient. We also identify some gaps in the literature that can guide which issues can be addressed in other works to contribute to the practical use of these methods in laboratories.

Using transfer learning with a convolutional neural network to detect African manatee (Trichechus senegalensis) vocalizations

African manatees (Trichechus senegalensis) are vulnerable, understudied, and difficult to detect. Areas where African manatees are found were acoustically sampled and deep learning techniques were used to develop the first African manatee vocalization detector. A transfer learning approach was used to develop a convolutional neural network (CNN) using a pretrained CNN (GoogLeNet). The network was highly successful, even when applied to recordings collected from a different location. Vocal detections were more common at night and tended to occur within less than 2 min of one another.

Demonstration of Neural Networks to Reconstruct Temperatures from Simulated Fluorescent Data Toward Use in Bio-microfluidics

Biological systems often have a narrow temperature range of operation, which require highly accurate spatially resolved temperature measurements, often near ±0.1 K. However, many temperature sensors cannot meet both accuracy and spatial distribution requirements, often because their accuracy is limited by data fitting and temperature reconstruction models. Machine learning algorithms have the potential to meet this need, but their usage in generating spatial distributions of temperature is severely lacking in the literature. This work presents the first instance of using neural networks to process fluorescent images to map the spatial distribution of temperature. Three standard network architectures were investigated using non-spatially resolved fluorescent thermometry (simply-connected feed-forward network) or during image or pixel identification (U-net and convolutional neural network, CNN). Simulated fluorescent images based on experimental data were generated based on known temperature distributions where Gaussian white noise with a standard deviation of ±0.1 K was added. The poor results from these standard networks motivated the creation of what is termed a moving CNN, with an RMSE error of ±0.23 K, where the elements of the matrix represent the neighboring pixels. Finally, the performance of this MCNN is investigated when trained and applied to three distinctive temperature distributions characteristic within microfluidic devices, where the fluorescent image is simulated at either three or five different wavelengths. The results demonstrate that having a minimum of 10 ^3.5 data points per temperature and the broadest range of temperatures during training provides temperature predictions nearest to the true temperatures of the images, with a minimum RMSE of ±0.15 K. When compared to traditional curve fitting techniques, this work demonstrates that greater accuracy when spatially mapping temperature from fluorescent images can be achieved when using convolutional neural networks.

The state of the art for artificial intelligence in lung digital pathology

Lung diseases carry a significant burden of morbidity and mortality worldwide. The advent of digital pathology (DP) and an increase in computational power have led to the development of artificial intelligence (AI)-based tools that can assist pathologists and pulmonologists in improving clinical workflow and patient management. While previous works have explored the advances in computational approaches for breast, prostate, and head and neck cancers, there has been a growing interest in applying these technologies to lung diseases as well. The application of AI tools on radiology images for better characterization of indeterminate lung nodules, fibrotic lung disease, and lung cancer risk stratification has been well documented. In this article, we discuss methodologies used to build AI tools in lung DP, describing the various hand-crafted and deep learning-based unsupervised feature approaches. Next, we review AI tools across a wide spectrum of lung diseases including cancer, tuberculosis, idiopathic pulmonary fibrosis, and COVID-19. We discuss the utility of novel imaging biomarkers for different types of clinical problems including quantification of biomarkers like PD-L1, lung disease diagnosis, risk stratification, and prediction of response to treatments such as immune checkpoint inhibitors. We also look briefly at some emerging applications of AI tools in lung DP such as multimodal data analysis, 3D pathology, and transplant rejection. Lastly, we discuss the future of DP-based AI tools, describing the challenges with regulatory approval, developing reimbursement models, planning clinical deployment, and addressing AI biases. © 2022 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.

Computational techniques for the automated detection of mycobacterium tuberculosis from digitized sputum smear microscopic images: A systematic review

BACKGROUND

Tuberculosis is an infectious disease that is caused by Mycobacterium tuberculosis (MTB), which mostly affects the lungs of humans. Bright-field microscopy and fluorescence microscopy are two major testing techniques used for tuberculosis (TB) detection. TB bacilli were identified and counted manually from sputum under a microscope and were found to be tedious, laborious and error prone. To eliminate this problem, traditional image processing techniques and deep learning (DL) models were deployed here to build computer-aided diagnosis (CADx) systems for TB detection.

METHODS

In this paper, we performed a systematic review on image processing techniques used in developing computer-aided diagnosis systems for TB detection. Articles selected for this review were retrieved from publication databases such as Science Direct, ACM, IEEE Xplore, Springer Link and PubMed. After a rigorous pruning exercise, 42 articles were selected, of which 21 were journal articles and 21 were conference articles.

RESULT

Image processing techniques and deep neural networks such as CNN and DCNN proposed in the literature along with clinical applications are presented and discussed. The performance of these techniques has been evaluated on metrics such as accuracy, sensitivity, specificity, precision and F-1 score and is presented accordingly.

CONCLUSION

CADx systems built on DL models performed better in TB detection and classification due to their abstraction of low-level features, better generalization and minimal or no human intervention in their operations. Research gaps identified in the literature have been highlighted and discussed for further investigation.

A New Artificial Intelligence-Based Method for Identifying Mycobacterium Tuberculosis in Ziehl–Neelsen Stain on Tissue

Mycobacteria identification is crucial to diagnose tuberculosis. Since the bacillus is very small, finding it in Ziehl–Neelsen (ZN)-stained slides is a long task requiring significant pathologist’s effort. We developed an automated (AI-based) method of identification of mycobacteria. We prepared a training dataset of over 260,000 positive and over 700,000,000 negative patches annotated on scans of 510 whole slide images (WSI) of ZN-stained slides (110 positive and 400 negative). Several image augmentation techniques coupled with different custom computer vision architectures were used. WSIs automatic analysis was followed by a report indicating areas more likely to present mycobacteria. Our model performs AI-based diagnosis (the final decision of the diagnosis of WSI belongs to the pathologist). The results were validated internally on a dataset of 286,000 patches and tested in pathology laboratory settings on 60 ZN slides (23 positive and 37 negative). We compared the pathologists’ results obtained by separately evaluating slides and WSIs with the results given by a pathologist aided by automatic analysis of WSIs. Our architecture showed 0.977 area under the receiver operating characteristic curve. The clinical test presented 98.33% accuracy, 95.65% sensitivity, and 100% specificity for the AI-assisted method, outperforming any other AI-based proposed methods for AFB detection.

Deep-Learning-Aided Detection of Mycobacteria in Pathology Specimens Increases the Sensitivity in Early Diagnosis of Pulmonary Tuberculosis Compared with Bacteriology Tests

The histopathological diagnosis of mycobacterial infection may be improved by a comprehensive analysis using artificial intelligence. Two autopsy cases of pulmonary tuberculosis, and forty biopsy cases of undetected acid-fast bacilli (AFB) were used to train AI (convolutional neural network), and construct an AI to support AFB detection. Forty-two patients underwent bronchoscopy, and were evaluated using AI-supported pathology to detect AFB. The AI-supported pathology diagnosis was compared with bacteriology diagnosis from bronchial lavage fluid and the final definitive diagnosis of mycobacteriosis. Among the 16 patients with mycobacteriosis, bacteriology was positive in 9 patients (56%). Two patients (13%) were positive for AFB without AI assistance, whereas AI-supported pathology identified eleven positive patients (69%). When limited to tuberculosis, AI-supported pathology had significantly higher sensitivity compared with bacteriology (86% vs. 29%, p = 0.046). Seven patients diagnosed with mycobacteriosis had no consolidation or cavitary shadows in computed tomography; the sensitivity of bacteriology and AI-supported pathology was 29% and 86%, respectively (p = 0.046). The specificity of AI-supported pathology was 100% in this study. AI-supported pathology may be more sensitive than bacteriological tests for detecting AFB in samples collected via bronchoscopy.

Deep Neural Network-Aided Histopathological Analysis of Myocardial Injury

Deep neural networks have become the mainstream approach for analyzing and interpreting histology images. In this study, we established and validated an interpretable DNN model to assess endomyocardial biopsy (EMB) data of patients with myocardial injury. Deep learning models were used to extract features and classify EMB histopathological images of heart failure cases diagnosed with either ischemic cardiomyopathy or idiopathic dilated cardiomyopathy and non-failing cases (organ donors without a history of heart failure). We utilized the gradient-weighted class activation mapping (Grad-CAM) technique to emphasize injured regions, providing an entry point to assess the dominant morphology in the process of a comprehensive evaluation. To visualize clustered regions of interest (ROI), we utilized uniform manifold approximation and projection (UMAP) embedding for dimension reduction. We further implemented a multi-model ensemble mechanism to improve the quantitative metric (area under the receiver operating characteristic curve, AUC) to 0.985 and 0.992 on ROI-level and case-level, respectively, outperforming the achievement of 0.971 ± 0.017 and 0.981 ± 0.020 based on the sub-models. Collectively, this new methodology provides a robust and interpretive framework to explore local histopathological patterns, facilitating the automatic and high-throughput quantification of cardiac EMB analysis.

Interactive Deep Learning for Shelf Life Prediction of Muskmelons Based on an Active Learning Approach

A pivotal topic in agriculture and food monitoring is the assessment of the quality and ripeness of agricultural products by using non-destructive testing techniques. Acoustic testing offers a rapid in situ analysis of the state of the agricultural good, obtaining global information of its interior. While deep learning (DL) methods have outperformed state-of-the-art benchmarks in various applications, the reason for lacking adaptation of DL algorithms such as convolutional neural networks (CNNs) can be traced back to its high data inefficiency and the absence of annotated data. Active learning is a framework that has been heavily used in machine learning when the labelled instances are scarce or cumbersome to obtain. This is specifically of interest when the DL algorithm is highly uncertain about the label of an instance. By allowing the human-in-the-loop for guidance, a continuous improvement of the DL algorithm based on a sample efficient manner can be obtained. This paper seeks to study the applicability of active learning when grading 'Galia' muskmelons based on its shelf life. We propose k-Determinantal Point Processes (k-DPP), which is a purely diversity-based method that allows to take influence on the exploration within the feature space based on the chosen subset k. While getting coequal results to uncertainty-based approaches when k is large, we simultaneously obtain a better exploration of the data distribution. While the implementation based on eigendecomposition takes up a runtime of O(n3), this can further be reduced to O(n·poly(k)) based on rejection sampling. We suggest the use of diversity-based acquisition when only a few labelled samples are available, allowing for better exploration while counteracting the disadvantage of missing the training objective in uncertainty-based methods following a greedy fashion.

Artificial Intelligence and Mapping a New Direction in Laboratory Medicine: A Review

BACKGROUND

Modern artificial intelligence (AI) and machine learning (ML) methods are now capable of completing tasks with performance characteristics that are comparable to those of expert human operators. As a result, many areas throughout healthcare are incorporating these technologies, including in vitro diagnostics and, more broadly, laboratory medicine. However, there are limited literature reviews of the landscape, likely future, and challenges of the application of AI/ML in laboratory medicine.

CONTENT

In this review, we begin with a brief introduction to AI and its subfield of ML. The ensuing sections describe ML systems that are currently in clinical laboratory practice or are being proposed for such use in recent literature, ML systems that use laboratory data outside the clinical laboratory, challenges to the adoption of ML, and future opportunities for ML in laboratory medicine.

SUMMARY

AI and ML have and will continue to influence the practice and scope of laboratory medicine dramatically. This has been made possible by advancements in modern computing and the widespread digitization of health information. These technologies are being rapidly developed and described, but in comparison, their implementation thus far has been modest. To spur the implementation of reliable and sophisticated ML-based technologies, we need to establish best practices further and improve our information system and communication infrastructure. The participation of the clinical laboratory community is essential to ensure that laboratory data are sufficiently available and incorporated conscientiously into robust, safe, and clinically effective ML-supported clinical diagnostics.

MotilityJ: An open-source tool for the classification and segmentation of bacteria on motility images

BACKGROUND AND OBJECTIVES

Infectious diseases produced by antimicrobial resistant microorganisms are a major threat to human, and animal health worldwide. This problem is increased by the virulence and spread of these bacteria. Surface motility has been regarded as a pathogenicity element because it is essential for many biological functions, but also for disease spreading; hence, investigations on the motility behaviour of bacteria are crucial to understand chemotaxis, biofilm formation and virulence in general. To identify a motile strain in the laboratory, the bacterial spread area is observed on media solidified with agar. Up to now, the task of measuring bacteria spread was a manual, and, therefore, tedious and time-consuming task. The aim of this work is the development of a set of tools for bacteria segmentation in motility images.

METHODS

In this work, we address the problem of measuring bacteria spread on motility images by creating an automatic pipeline based on deep learning models. Such a pipeline consists of a classification model to determine whether the bacteria has spread to cover completely the Petri dish, and a segmentation model to determine the spread of those bacteria that do not fully cover the Petri dishes. In order to annotate enough images to train our deep learning models, a semi-automatic annotation procedure is presented.

RESULTS

The classification model of our pipeline achieved a F1-score of 99.85%, and the segmentation model achieved a Dice coefficient of 95.66%. In addition, the segmentation model produces results that are indistinguishable, and in many cases preferred, from those produced manually by experts. Finally, we facilitate the dissemination of our pipeline with the development of MotilityJ, an open-source and user-friendly application for measuring bacteria spread on motility images.

CONCLUSIONS

In this work, we have developed an algorithm and trained several models for measuring bacteria spread on motility images. Thanks to this work, the analysis of motility images will be faster and more reliable. The developed tools will help to advance our understanding of the behaviour and virulence of bacteria.