Lung Pattern Classification for Interstitial Lung Diseases Using a Deep Convolutional Neural Network

Global Research Trends, Hotspots, Impacts, and Emergence of Artificial Intelligence and Machine Learning in Health and Medicine: A 25-Year Bibliometric Analysis

Background/Objectives: The increasing application of artificial intelligence (AI) and machine learning (ML) in health and medicine has attracted a great deal of research interest in recent decades. This study aims to provide a global and historical picture of research concerning AI and ML in health and medicine. Methods: We used the Scopus database for searching and extracted articles published between 2000 and 2024. Then, we generated information about productivity, citations, collaboration, most impactful research topics, emerging research topics, and author keywords using Microsoft Excel 365 and VOSviewer software (version 1.6.20). Results: We retrieved a total of 22,113 research articles, with a notable surge in research activity in recent years. Core journals were Scientific Reports and IEEE Access, and core institutions included Harvard Medical School and the Ministry of Education of the People's Republic of China, while core countries comprised the United States, China, India, the United Kingdom, and Saudi Arabia. Citation trends indicated substantial growth and recognition of AI's and ML impact on health and medicine. Frequent author keywords identified key research hotspots, including specific diseases like Alzheimer's disease, Parkinson's diseases, COVID-19, and diabetes. The author keyword analysis identified "deep learning", "convolutional neural network", and "classification" as dominant research themes. Conclusions: AI's transformative potential in AI and ML in health and medicine holds promise for improving global health outcomes.

Improving ultrasound image classification accuracy of liver tumors using deep learning model with hepatitis virus infection information

PURPOSE

In recent years, computer-aided diagnosis (CAD) using deep learning methods for medical images has been studied. Although studies have been conducted to classify ultrasound images of tumors of the liver into four categories (liver cysts (Cyst), liver hemangiomas (Hemangioma), hepatocellular carcinoma (HCC), and metastatic liver cancer (Meta)), no studies with additional information for deep learning have been reported. Therefore, we attempted to improve the classification accuracy of ultrasound images of hepatic tumors by adding hepatitis virus infection information to deep learning.

METHODS

Four combinations of hepatitis virus infection information were assigned to each image, plus or minus HBs antigen and plus or minus HCV antibody, and the classification accuracy was compared before and after the information was input and weighted to fully connected layers.

RESULTS

With the addition of hepatitis virus infection information, accuracy changed from 0.574 to 0.643. The F1-Score for Cyst, Hemangioma, HCC, and Meta changed from 0.87 to 0.88, 0.55 to 0.57, 0.46 to 0.59, and 0.54 to 0.62, respectively, remaining the same for Hemangioma but increasing for the rest.

CONCLUSION

Learning hepatitis virus infection information showed the highest increase in the F1-Score for HCC, resulting in improved classification accuracy of ultrasound images of hepatic tumors.

Feature Separation in Diffuse Lung Disease Image Classification by Using Evolutionary Algorithm-Based NAS

In the field of diagnosing lung diseases, the application of neural networks (NNs) in image classification exhibits significant potential. However, NNs are considered "black boxes," making it difficult to discern their decision-making processes, thereby leading to skepticism and concern regarding NNs. This compromises model reliability and hampers intelligent medicine's development. To tackle this issue, we introduce the Evolutionary Neural Architecture Search (EvoNAS). In image classification tasks, EvoNAS initially utilizes an Evolutionary Algorithm to explore various Convolutional Neural Networks, ultimately yielding an optimized network that excels at separating between redundant texture features and the most discriminative ones. Retaining the most discriminative features improves classification accuracy, particularly in distinguishing similar features. This approach illuminates the intrinsic mechanics of classification, thereby enhancing the accuracy of the results. Subsequently, we incorporate a Differential Evolution algorithm based on distribution estimation, significantly enhancing search efficiency. Employing visualization techniques, we demonstrate the effectiveness of EvoNAS, endowing the model with interpretability. Finally, we conduct experiments on the diffuse lung disease texture dataset using EvoNAS. Compared to the original network, the classification accuracy increases by 0.56%. Moreover, our EvoNAS approach demonstrates significant advantages over existing methods in the same dataset.

Enhanced Superpixel-Guided ResNet Framework with Optimized Deep-Weighted Averaging-Based Feature Fusion for Lung Cancer Detection in Histopathological Images

Background/Objectives: Lung cancer is a leading cause of cancer-related mortalities, with early diagnosis crucial for survival. While biopsy is the gold standard, manual histopathological analysis is time-consuming. This research enhances lung cancer diagnosis through deep learning-based feature extraction, fusion, optimization, and classification for improved accuracy and efficiency. Methods: The study begins with image preprocessing using an adaptive fuzzy filter, followed by segmentation with a modified simple linear iterative clustering (SLIC) algorithm. The segmented images are input into deep learning architectures, specifically ResNet-50 (RN-50), ResNet-101 (RN-101), and ResNet-152 (RN-152), for feature extraction. The extracted features are fused using a deep-weighted averaging-based feature fusion (DWAFF) technique, producing ResNet-X (RN-X)-fused features. To further refine these features, particle swarm optimization (PSO) and red deer optimization (RDO) techniques are employed within the selective feature pooling layer. The optimized features are classified using various machine learning classifiers, including support vector machine (SVM), decision tree (DT), random forest (RF), K-nearest neighbor (KNN), SoftMax discriminant classifier (SDC), Bayesian linear discriminant analysis classifier (BLDC), and multilayer perceptron (MLP). A performance evaluation is performed using K-fold cross-validation with K values of 2, 4, 5, 8, and 10. Results: The proposed DWAFF technique, combined with feature selection using RDO and classification with MLP, achieved the highest classification accuracy of 98.68% when using K = 10 for cross-validation. The RN-X features demonstrated superior performance compared to individual ResNet variants, and the integration of segmentation and optimization significantly enhanced classification accuracy. Conclusions: The proposed methodology automates lung cancer classification using deep learning, feature fusion, optimization, and advanced classification techniques. Segmentation and feature selection enhance performance, improving diagnostic accuracy. Future work may explore further optimizations and hybrid models.

Fibrous Tissue Semantic Segmentation in CT Images of Diffuse Interstitial Lung Disease

Interstitial-lung-disease progression assessment and diagnosis via radiological findings on computed tomography images require significant time and effort from expert physicians. Accurate results from these analyses are critical for treatment decisions. Automatic semantic segmentation of radiological findings has been developed recently using convolutional neural networks (CNN). However, on the one hand, few works present individual performance scores for radiological findings that allow for accurately measuring fibrosis segmentation performances; on the other hand, the poorly annotated quality of available databases may mislead researcher observations. This study presents a CNN methodology employing three different architectures (U-net, LinkNet, and FPN) with transfer learning and data augmentation to enhance the performance in semantic segmentation of fibrosis-related radiological findings (FRF). In addition, considering the poor quality of manual CT tagging on available datasets, we use two alternative evaluation strategies, first using only the fibrosis region of interest. Second, re-tagging and validating the test set by an expert pulmonologist. Using DICOM images from the Interstitial Lung Diseases Database, the implemented approach achieves a Jaccard Score Index of 0.7355 with a standard deviation of 0.0699 and a Dice Similarity Coefficient of 0.8459 with a standard deviation of 0.0470 comparable to state-of-the-art performance in FRF semantic segmentation. Also, a visual evaluation of the images automatically tagged by our proposal was performed by a pulmonologist. Our proposed method successfully identifies these FRF areas, demonstrating its effectiveness. Also, the pulmonologist revealed discrepancies in the dataset tags, indicating deficiencies in FRF annotations.

CT Quantification of Interstitial Lung Abnormality and Interstitial Lung Disease: From Technical Challenges to Future Directions

ABSTRACT

Interstitial lung disease (ILD) encompasses a variety of lung disorders with varying degrees of inflammation or fibrosis, requiring a combination of clinical, imaging, and pathologic data for evaluation. Imaging is essential for the noninvasive diagnosis of the disease, as well as for assessing disease severity, monitoring its progression, and evaluating treatment response. However, traditional visual assessments of ILD with computed tomography (CT) suffer from reader variability. Automated quantitative CT offers a more objective approach by using computer-based analysis to consistently evaluate and measure ILD. Advancements in technology have significantly improved the accuracy and reliability of these measurements. Recently, interstitial lung abnormalities (ILAs), which represent potential preclinical ILD incidentally found on CT scans and are characterized by abnormalities in over 5% of any lung zone, have gained attention and clinical importance. The challenge lies in the accurate and consistent identification of ILA, given that its definition relies on a subjective threshold, making quantitative tools crucial for precise ILA evaluation. This review highlights the state of CT quantification of ILD and ILA, addressing clinical and research disparities while emphasizing how machine learning or deep learning in quantitative imaging can improve diagnosis and management by providing more accurate assessments, and finally, suggests the future directions of quantitative CT in this area.

Determination of cervical vertebral maturation using machine learning in lateral cephalograms

Background

The accurate timing of growth modification treatments is crucial for optimal results in orthodontics. However, traditional methods for assessing growth status, such as hand-wrist radiographs and subjective interpretation of lateral cephalograms, have limitations. This study aimed to develop a semi-automated approach using machine learning based on cervical vertebral dimensions (CVD) for determining skeletal maturation status.

Methods

A dataset comprising 980 lateral cephalograms was collected from the Department of Orthodontics, Shahid Beheshti Dental School in Tehran, Iran. Eight landmarks representing the corners of the third and fourth cervical vertebrae were selected. A ratio-based approach was employed to compute the values of C3 and C4, accompanied by the implementation of an auto_error_reduction (AER) function to enhance the accuracy of landmark selection. Linear distances and ratios were measured using the dedicated software. A novel data augmentation technique was applied to expand the dataset. Subsequently, a stacking model was developed, trained on the augmented dataset, and evaluated using a separate test set of 196 cephalograms.

Results

The proposed model achieved an accuracy of 99.49% and demonstrated a loss of 0.003 on the test set.

Conclusion

By employing feature engineering, simplified landmark selection, AER function, data augmentation, and eliminating gender and age features, a model was developed for accurate assessment of skeletal maturation for clinical applications.

CNN-O-ELMNet: Optimized Lightweight and Generalized Model for Lung Disease Classification and Severity Assessment

The high burden of lung diseases on healthcare necessitates effective detection methods. Current Computer-aided design (CAD) systems are limited by their focus on specific diseases and computationally demanding deep learning models. To overcome these challenges, we introduce CNN-O-ELMNet, a lightweight classification model designed to efficiently detect various lung diseases, surpassing the limitations of disease-specific CAD systems and the complexity of deep learning models. This model combines a convolutional neural network for deep feature extraction with an optimized extreme learning machine, utilizing the imperialistic competitive algorithm for enhanced predictions. We then evaluated the effectiveness of CNN-O-ELMNet using benchmark datasets for lung diseases: distinguishing pneumothorax vs. non-pneumothorax, tuberculosis vs. normal, and lung cancer vs. healthy cases. Our findings demonstrate that CNN-O-ELMNet significantly outperformed (p < 0.05) state-of-the-art methods in binary classifications for tuberculosis and cancer, achieving accuracies of 97.85% and 97.7%, respectively, while maintaining low computational complexity with only 2481 trainable parameters.We also extended themodel to categorize lung disease severity based on Brixia scores. Achieving a 96.2% accuracy in multi-class assessment for mild, moderate, and severe cases, makes it suitable for deployment in lightweight healthcare devices.

Weakly-supervised learning-based pathology detection and localization in 3D chest CT scans

BACKGROUND

Recent advancements in anomaly detection have paved the way for novel radiological reading assistance tools that support the identification of findings, aimed at saving time. The clinical adoption of such applications requires a low rate of false positives while maintaining high sensitivity.

PURPOSE

In light of recent interest and development in multi pathology identification, we present a novel method, based on a recent contrastive self-supervised approach, for multiple chest-related abnormality identification including low lung density area ("LLDA"), consolidation ("CONS"), nodules ("NOD") and interstitial pattern ("IP"). Our approach alerts radiologists about abnormal regions within a computed tomography (CT) scan by providing 3D localization.

METHODS

We introduce a new method for the classification and localization of multiple chest pathologies in 3D Chest CT scans. Our goal is to distinguish four common chest-related abnormalities: "LLDA", "CONS", "NOD", "IP" and "NORMAL". This method is based on a 3D patch-based classifier with a Resnet backbone encoder pretrained leveraging recent contrastive self supervised approach and a fine-tuned classification head. We leverage the SimCLR contrastive framework for pretraining on an unannotated dataset of randomly selected patches and we then fine-tune it on a labeled dataset. During inference, this classifier generates probability maps for each abnormality across the CT volume, which are aggregated to produce a multi-label patient-level prediction. We compare different training strategies, including random initialization, ImageNet weight initialization, frozen SimCLR pretrained weights and fine-tuned SimCLR pretrained weights. Each training strategy is evaluated on a validation set for hyperparameter selection and tested on a test set. Additionally, we explore the fine-tuned SimCLR pretrained classifier for 3D pathology localization and conduct qualitative evaluation.

RESULTS

Validated on 111 chest scans for hyperparameter selection and subsequently tested on 251 chest scans with multi-abnormalities, our method achieves an AUROC of 0.931 (95% confidence interval [CI]: [0.9034, 0.9557], p $ p$ -value < 0.001) and 0.963 (95% CI: [0.952, 0.976], p $ p$ -value < 0.001) in the multi-label and binary (i.e., normal versus abnormal) settings, respectively. Notably, our method surpasses the area under the receiver operating characteristic (AUROC) threshold of 0.9 for two abnormalities: IP (0.974) and LLDA (0.952), while achieving values of 0.853 and 0.791 for NOD and CONS, respectively. Furthermore, our results highlight the superiority of incorporating contrastive pretraining within the patch classifier, outperforming Imagenet pretraining weights and non-pretrained counterparts with uninitialized weights (F1 score = 0.943, 0.792, and 0.677 respectively). Qualitatively, the method achieved a satisfactory 88.8% completeness rate in localization and maintained an 88.3% accuracy rate against false positives.

CONCLUSIONS

The proposed method integrates self-supervised learning algorithms for pretraining, utilizes a patch-based approach for 3D pathology localization and develops an aggregation method for multi-label prediction at patient-level. It shows promise in efficiently detecting and localizing multiple anomalies within a single scan.

Multimodal deep learning radiomics model for predicting postoperative progression in solid stage I non-small cell lung cancer

PURPOSE

To explore the application value of a multimodal deep learning radiomics (MDLR) model in predicting the risk status of postoperative progression in solid stage I non-small cell lung cancer (NSCLC).

MATERIALS AND METHODS

A total of 459 patients with histologically confirmed solid stage I NSCLC who underwent surgical resection in our institution from January 2014 to September 2019 were reviewed retrospectively. At another medical center, 104 patients were reviewed as an external validation cohort according to the same criteria. A univariate analysis was conducted on the clinicopathological characteristics and subjective CT findings of the progression and non-progression groups. The clinicopathological characteristics and subjective CT findings that exhibited significant differences were used as input variables for the extreme learning machine (ELM) classifier to construct the clinical model. We used the transfer learning strategy to train the ResNet18 model, used the model to extract deep learning features from all CT images, and then used the ELM classifier to classify the deep learning features to obtain the deep learning signature (DLS). A MDLR model incorporating clinicopathological characteristics, subjective CT findings and DLS was constructed. The diagnostic efficiencies of the clinical model, DLS model and MDLR model were evaluated by the area under the curve (AUC).

RESULTS

Univariate analysis indicated that size (p = 0.004), neuron-specific enolase (NSE) (p = 0.03), carbohydrate antigen 19 - 9 (CA199) (p = 0.003), and pathological stage (p = 0.027) were significantly associated with the progression of solid stage I NSCLC after surgery. Therefore, these clinical characteristics were incorporated into the clinical model to predict the risk of progression in postoperative solid-stage NSCLC patients. A total of 294 deep learning features with nonzero coefficients were selected. The DLS in the progressive group was (0.721 ± 0.371), which was higher than that in the nonprogressive group (0.113 ± 0.350) (p < 0.001). The combination of size、NSE、CA199、pathological stage and DLS demonstrated the superior performance in differentiating postoperative progression status. The AUC of the MDLR model was 0.885 (95% confidence interval [CI]: 0.842-0.927), higher than that of the clinical model (0.675 (95% CI: 0.599-0.752)) and DLS model (0.882 (95% CI: 0.835-0.929)). The DeLong test and decision in curve analysis revealed that the MDLR model was the most predictive and clinically useful model.

CONCLUSION

MDLR model is effective in predicting the risk of postoperative progression of solid stage I NSCLC, and it is helpful for the treatment and follow-up of solid stage I NSCLC patients.

Use of artificial intelligence algorithms to analyse systemic sclerosis-interstitial lung disease imaging features

The use of artificial intelligence (AI) in high-resolution computed tomography (HRCT) for diagnosing systemic sclerosis-associated interstitial lung disease (SSc-ILD) is relatively limited. This study aimed to analyse lung HRCT images of patients with systemic sclerosis with interstitial lung disease (SSc-ILD) using artificial intelligence (AI), conduct correlation analysis with clinical manifestations and prognosis, and explore the features and prognosis of SSc-ILD. Overall, 72 lung HRCT images and clinical data of 58 patients with SSC-ILD were collected. ILD lesion type, location, and volume on HRCT images were identified and evaluated using AI. The imaging characteristics of diffuse SSC (dSSc)-ILD and limited SSc-ILD (lSSc-ILD) were statistically analysed. Furthermore, the correlations between lesion type, clinical indicators, and prognosis were investigated. dSSc and lSSc were more prevalent in patients with a disease duration of < 1 and ≥ 5 years, respectively. SSc-ILD mainly comprises non-specific interstitial pneumonia (NSIP), usual interstitial pneumonia (UIP), and unclassifiable idiopathic interstitial pneumonia. HRCT reveals various lesion types in the early stages of the disease, with an increase in the number of lesion types as the disease progresses. Lesions appearing as grid, ground-glass, and nodular shadows were dispersed throughout both lungs, while those appearing as consolidation shadows and honeycomb were distributed across the lungs. Ground-glass opacity lesion type was absent on HRCT images of patients with SSc-ILD and pulmonary hypertension. This study showed that AI can efficiently analyse imaging characteristics of SSc-ILD, demonstrating its potential to learn from complex images with high generalisation ability.

Olecranon bone age assessment in puberty using a lateral elbow radiograph and a deep-learning model

OBJECTIVES

To improve pubertal bone age (BA) evaluation by developing a precise and practical elbow BA classification using the olecranon, and a deep-learning AI model.

MATERIALS AND METHODS

Lateral elbow radiographs taken for BA evaluation in children under 18 years were collected from January 2020 to June 2022, retrospectively. A novel classification and the olecranon BA were established based on the morphological changes in the olecranon ossification process during puberty. The olecranon BA was compared with other elbow and hand BA methods, using intraclass correlation coefficients (ICCs), and a deep-learning AI model was developed.

RESULTS

A total of 3508 lateral elbow radiographs (mean age 9.8 ± 1.8 years) were collected. The olecranon BA showed the highest applicability (100%) and interobserver agreement (ICC 0.993) among elbow BA methods. It showed excellent reliability with Sauvegrain (0.967 in girls, 0.969 in boys) and Dimeglio (0.978 in girls, 0.978 in boys) elbow BA methods, as well as Korean standard (KS) hand BA in boys (0.917), and good reliability with KS in girls (0.896) and Greulich-Pyle (GP)/Tanner-Whitehouse (TW)3 (0.835 in girls, 0.895 in boys) hand BA methods. The AI model for olecranon BA showed an accuracy of 0.96 and a specificity of 0.98 with EfficientDet-b4. External validation showed an accuracy of 0.86 and a specificity of 0.91.

CONCLUSION

The olecranon BA evaluation for puberty, requiring only a lateral elbow radiograph, showed the highest applicability and interobserver agreement, and excellent reliability with other BA evaluation methods, along with a high performance of the AI model.

CLINICAL RELEVANCE STATEMENT

This AI model uses a single lateral elbow radiograph to determine bone age for puberty from the olecranon ossification center and can improve pubertal bone age assessment with the highest applicability and excellent reliability compared to previous methods.

KEY POINTS

Elbow bone age is valuable for pubertal bone age assessment, but conventional methods have limitations. Olecranon bone age and its AI model showed high performances for pubertal bone age assessment. Olecranon bone age system is practical and accurate while requiring only a single lateral elbow radiograph.

Quantitative chest computed tomography predicts mortality in systemic sclerosis: A longitudinal study

OBJECTIVE

Quantitative chest computed tomography (qCT) methods are new tools that objectively measure parenchymal abnormalities and vascular features on CT images in patients with interstitial lung disease (ILD). We aimed to investigate whether the qCT measures are predictors of 5-year mortality in patients with systemic sclerosis (SSc).

METHODS

Patients diagnosed with SSc were retrospectively selected from 2011 to 2022. Patients should have had volumetric high-resolution CTs (HRCTs) and pulmonary function tests (PFTs) performed at baseline and at 24 months of follow-up. The following parameters were evaluated in HRCTs using Computer-Aided Lung Informatics for Pathology Evaluation and Rating (CALIPER): ground glass opacities, reticular pattern, honeycombing, and pulmonary vascular volume. Factors associated with death were evaluated by Kaplan‒Meier survival curves and multivariate analysis models. Semiquantitative analysis of the HRCTs images was also performed.

RESULTS

Seventy-one patients were included (mean age, 54.2 years). Eleven patients (15.49%) died during the follow-up, and all patients had ILD. As shown by Kaplan‒Meier curves, survival was worse among patients with an ILD extent (ground glass opacities + reticular pattern + honeycombing) ≥ 6.32%, a reticular pattern ≥ 1.41% and a forced vital capacity (FVC) < 70% at baseline. The independent predictors of mortality by multivariate analysis were a higher reticular pattern (Exp 2.70, 95%CI 1.26-5.82) on qCT at baseline, younger age (Exp 0.906, 95%CI 0.826-0.995), and absolute FVC decline ≥ 5% at follow-up (Exp 15.01, 95%CI 1.90-118.5), but not baseline FVC. Patients with extensive disease (>20% extension) by semiquantitative analysis according to Goh's staging system had higher disease extension on qCT at baseline and follow-up.

CONCLUSION

This study showed that the reticular pattern assessed by baseline qCT may be a useful tool in the clinical practice for assessing lung damage and predicting mortality in SSc.

Bone metastasis prediction in non-small-cell lung cancer: primary CT-based radiomics signature and clinical feature

BACKGROUND

Radiomics provided opportunities to quantify the tumor phenotype non-invasively. This study extracted contrast-enhanced computed tomography (CECT) radiomic signatures and evaluated clinical features of bone metastasis in non-small-cell lung cancer (NSCLC). With the combination of the revealed radiomics and clinical features, the predictive modeling on bone metastasis in NSCLC was established.

METHODS

A total of 318 patients with NSCLC at the Tianjin Medical University Cancer Institute & Hospital was enrolled between January 2009 and December 2019, which included a feature-learning cohort (n = 223) and a validation cohort (n = 95). We trained a radiomics model in 318 CECT images from feature-learning cohort to extract the radiomics features of bone metastasis in NSCLC. The Kruskal-Wallis and the least absolute shrinkage and selection operator regression (LASSO) were used to select bone metastasis-related features and construct the CT radiomics score (Rad-score). Multivariate logistic regression was performed with the combination of the Rad-score and clinical data. A predictive nomogram was subsequently developed.

RESULTS

Radiomics models using CECT scans were significant on bone metastasis prediction in NSCLC. Model performance was enhanced with each information into the model. The radiomics nomogram achieved an AUC of 0.745 (95% confidence interval [CI]: 0.68,0.80) on predicting bone metastasis in the training set and an AUC of 0.808(95% confidence interval [CI]: 0.71,0.88) in the validation set.

CONCLUSION

The revealed invisible image features were of significance on guiding bone metastasis prediction in NSCLC. Based on the combination of the image features and clinical characteristics, the predictive nomogram was established. Such nomogram can be used for the auxiliary screening of bone metastasis in NSCLC.

Automatic ARDS surveillance with chest X-ray recognition using convolutional neural networks

OBJECTIVE

This study aims to design, validate and assess the accuracy a deep learning model capable of differentiation Chest X-Rays between pneumonia, acute respiratory distress syndrome (ARDS) and normal lungs.

MATERIALS AND METHODS

A diagnostic performance study was conducted using Chest X-Ray images from adult patients admitted to a medical intensive care unit between January 2003 and November 2014. X-ray images from 15,899 patients were assigned one of three prespecified categories: "ARDS", "Pneumonia", or "Normal".

RESULTS

A two-step convolutional neural network (CNN) pipeline was developed and tested to distinguish between the three patterns with sensitivity ranging from 91.8% to 97.8% and specificity ranging from 96.6% to 98.8%. The CNN model was validated with a sensitivity of 96.3% and specificity of 96.6% using a previous dataset of patients with Acute Lung Injury (ALI)/ARDS.

DISCUSSION

The results suggest that a deep learning model based on chest x-ray pattern recognition can be a useful tool in distinguishing patients with ARDS from patients with normal lungs, providing faster results than digital surveillance tools based on text reports.

CONCLUSION

A CNN-based deep learning model showed clinically significant performance, providing potential for faster ARDS identification. Future research should prospectively evaluate these tools in a clinical setting.

Clinically Relevant Biomarkers in Connective Tissue Disease-Associated Interstitial Lung Disease

Interstitial lung disease (ILD) complicates connective tissue disease (CTD) with variable incidence and is a leading cause of death in these patients. To improve CTD-ILD outcomes, early recognition and management of ILD is critical. Blood-based and radiologic biomarkers that assist in the diagnosis CTD-ILD have long been studied. Recent studies, including -omic investigations, have also begun to identify biomarkers that may help prognosticate such patients. This review provides an overview of clinically relevant biomarkers in patients with CTD-ILD, highlighting recent advances to assist in the diagnosis and prognostication of CTD-ILD.

A comprehensive review of deep learning-based variant calling methods

Genome sequencing data have become increasingly important in the field of personalized medicine and diagnosis. However, accurately detecting genomic variations remains a challenging task. Traditional variation detection methods rely on manual inspection or predefined rules, which can be time-consuming and prone to errors. Consequently, deep learning-based approaches for variation detection have gained attention due to their ability to automatically learn genomic features that distinguish between variants. In our review, we discuss the recent advancements in deep learning-based algorithms for detecting small variations and structural variations in genomic data, as well as their advantages and limitations.

DHAFormer: Dual-channel hybrid attention network with transformer for polyp segmentation

The accurate early diagnosis of colorectal cancer significantly relies on the precise segmentation of polyps in medical images. Current convolution-based and transformer-based segmentation methods show promise but still struggle with the varied sizes and shapes of polyps and the often low contrast between polyps and their background. This research introduces an innovative approach to confronting the aforementioned challenges by proposing a Dual-Channel Hybrid Attention Network with Transformer (DHAFormer). Our proposed framework features a multi-scale channel fusion module, which excels at recognizing polyps across a spectrum of sizes and shapes. Additionally, the framework's dual-channel hybrid attention mechanism is innovatively conceived to reduce background interference and improve the foreground representation of polyp features by integrating local and global information. The DHAFormer demonstrates significant improvements in the task of polyp segmentation compared to currently established methodologies.

Federated Learning Empowered Real-Time Medical Data Processing Method for Smart Healthcare

Computer-aided diagnosis (CAD) has always been an important research topic for applying artificial intelligence in smart healthcare. Sufficient medical data are one of the most critical factors in CAD research. However, medical data are usually obtained in chronological order and cannot be collected all at once, which poses difficulties for the application of deep learning technology in the medical field. The traditional batch learning method consumes considerable time and space resources for real-time medical data, and the incremental learning method often leads to catastrophic forgetting. To solve these problems, we propose a real-time medical data processing method based on federated learning. We divide the process into the model stage and the exemplar stage. In the model stage, we use the federated learning method to fuse the old and new models to mitigate the catastrophic forgetting problem of the new model. In the exemplar stage, we use the most representative exemplars selected from the old data to help the new model review the old knowledge, which further mitigates the catastrophic forgetting problem of the new model. We use this method to conduct experiments on a simulated medical real-time data stream. The experimental results show that our method can learn a disease diagnosis model from a continuous medical real-time data stream. As the amount of data increases, the performance of the disease diagnosis model continues to improve, and the catastrophic forgetting problem has been effectively mitigated. Compared with the traditional batch learning method, our method can significantly save time and space resources.

The efficacy of machine learning models in lung cancer risk prediction with explainability

Among many types of cancers, to date, lung cancer remains one of the deadliest cancers around the world. Many researchers, scientists, doctors, and people from other fields continuously contribute to this subject regarding early prediction and diagnosis. One of the significant problems in prediction is the black-box nature of machine learning models. Though the detection rate is comparatively satisfactory, people have yet to learn how a model came to that decision, causing trust issues among patients and healthcare workers. This work uses multiple machine learning models on a numerical dataset of lung cancer-relevant parameters and compares performance and accuracy. After comparison, each model has been explained using different methods. The main contribution of this research is to give logical explanations of why the model reached a particular decision to achieve trust. This research has also been compared with a previous study that worked with a similar dataset and took expert opinions regarding their proposed model. We also showed that our research achieved better results than their proposed model and specialist opinion using hyperparameter tuning, having an improved accuracy of almost 100% in all four models.

Pattern classification of interstitial lung diseases from computed tomography images using a ResNet-based network with a split-transform-merge strategy and split attention

In patients with interstitial lung disease (ILD), accurate pattern assessment from their computed tomography (CT) images could help track lung abnormalities and evaluate treatment efficacy. Based on excellent image classification performance, convolutional neural networks (CNNs) have been massively investigated for classifying and labeling pathological patterns in the CT images of ILD patients. However, previous studies rarely considered the three-dimensional (3D) structure of the pathological patterns of ILD and used two-dimensional network input. In addition, ResNet-based networks such as SE-ResNet and ResNeXt with high classification performance have not been used for pattern classification of ILD. This study proposed a SE-ResNeXt-SA-18 for classifying pathological patterns of ILD. The SE-ResNeXt-SA-18 integrated the multipath design of the ResNeXt and the feature weighting of the squeeze-and-excitation network with split attention. The classification performance of the SE-ResNeXt-SA-18 was compared with the ResNet-18 and SE-ResNeXt-18. The influence of the input patch size on classification performance was also evaluated. Results show that the classification accuracy was increased with the increase of the patch size. With a 32 × 32 × 16 input, the SE-ResNeXt-SA-18 presented the highest performance with average accuracy, sensitivity, and specificity of 0.991, 0.979, and 0.994. High-weight regions in the class activation maps of the SE-ResNeXt-SA-18 also matched the specific pattern features. In comparison, the performance of the SE-ResNeXt-SA-18 is superior to the previously reported CNNs in classifying the ILD patterns. We concluded that the SE-ResNeXt-SA-18 could help track or monitor the progress of ILD through accuracy pattern classification.

Prediction of Mismatch Repair Status in Endometrial Cancer from Histological Slide Images Using Various Deep Learning-Based Algorithms

The application of deep learning algorithms to predict the molecular profiles of various cancers from digital images of hematoxylin and eosin (H&E)-stained slides has been reported in recent years, mainly for gastric and colon cancers. In this study, we investigated the potential use of H&E-stained endometrial cancer slide images to predict the associated mismatch repair (MMR) status. H&E-stained slide images were collected from 127 cases of the primary lesion of endometrial cancer. After digitization using a Nanozoomer virtual slide scanner (Hamamatsu Photonics), we segmented the scanned images into 5397 tiles of 512 × 512 pixels. The MMR proteins (PMS2, MSH6) were immunohistochemically stained, classified into MMR proficient/deficient, and annotated for each case and tile. We trained several neural networks, including convolutional and attention-based networks, using tiles annotated with the MMR status. Among the tested networks, ResNet50 exhibited the highest area under the receiver operating characteristic curve (AUROC) of 0.91 for predicting the MMR status. The constructed prediction algorithm may be applicable to other molecular profiles and useful for pre-screening before implementing other, more costly genetic profiling tests.

Self-supervised learning for medical image data with anatomy-oriented imaging planes

Self-supervised learning has emerged as a powerful tool for pretraining deep networks on unlabeled data, prior to transfer learning of target tasks with limited annotation. The relevance between the pretraining pretext and target tasks is crucial to the success of transfer learning. Various pretext tasks have been proposed to utilize properties of medical image data (e.g., three dimensionality), which are more relevant to medical image analysis than generic ones for natural images. However, previous work rarely paid attention to data with anatomy-oriented imaging planes, e.g., standard cardiac magnetic resonance imaging views. As these imaging planes are defined according to the anatomy of the imaged organ, pretext tasks effectively exploiting this information can pretrain the networks to gain knowledge on the organ of interest. In this work, we propose two complementary pretext tasks for this group of medical image data based on the spatial relationship of the imaging planes. The first is to learn the relative orientation between the imaging planes and implemented as regressing their intersecting lines. The second exploits parallel imaging planes to regress their relative slice locations within a stack. Both pretext tasks are conceptually straightforward and easy to implement, and can be combined in multitask learning for better representation learning. Thorough experiments on two anatomical structures (heart and knee) and representative target tasks (semantic segmentation and classification) demonstrate that the proposed pretext tasks are effective in pretraining deep networks for remarkably boosted performance on the target tasks, and superior to other recent approaches.

The path from task-specific to general purpose artificial intelligence for medical diagnostics: A bibliometric analysis

Artificial intelligence (AI) has revolutionized many fields, and its potential in healthcare has been increasingly recognized. Based on diverse data sources such as imaging, laboratory tests, medical records, and electrophysiological data, diagnostic AI has witnessed rapid development in recent years. A comprehensive understanding of the development status, contributing factors, and their relationships in the application of AI to medical diagnostics is essential to further promote its use in clinical practice. In this study, we conducted a bibliometric analysis to explore the evolution of task-specific to general-purpose AI for medical diagnostics. We used the Web of Science database to search for relevant articles published between 2010 and 2023, and applied VOSviewer, the R package Bibliometrix, and CiteSpace to analyze collaborative networks and keywords. Our analysis revealed that the field of AI in medical diagnostics has experienced rapid growth in recent years, with a focus on tasks such as image analysis, disease prediction, and decision support. Collaborative networks were observed among researchers and institutions, indicating a trend of global cooperation in this field. Additionally, we identified several key factors contributing to the development of AI in medical diagnostics, including data quality, algorithm design, and computational power. Challenges to progress in the field include model explainability, robustness, and equality, which will require multi-stakeholder, interdisciplinary collaboration to tackle. Our study provides a holistic understanding of the path from task-specific, mono-modal AI toward general-purpose, multimodal AI for medical diagnostics. With the continuous improvement of AI technology and the accumulation of medical data, we believe that AI will play a greater role in medical diagnostics in the future.

Clinical validation of a deep-learning-based bone age software in healthy Korean children

PURPOSE

Bone age (BA) is needed to assess developmental status and growth disorders. We evaluated the clinical performance of a deep-learning-based BA software to estimate the chronological age (CA) of healthy Korean children.

METHODS

This retrospective study included 371 healthy children (217 boys, 154 girls), aged between 4 and 17 years, who visited the Department of Pediatrics for health check-ups between January 2017 and December 2018. A total of 553 left-hand radiographs from 371 healthy Korean children were evaluated using a commercial deep-learning-based BA software (BoneAge, Vuno, Seoul, Korea). The clinical performance of the deep learning (DL) software was determined using the concordance rate and Bland-Altman analysis via comparison with the CA.

RESULTS

A 2-sample t-test (P<0.001) and Fisher exact test (P=0.011) showed a significant difference between the normal CA and the BA estimated by the DL software. There was good correlation between the 2 variables (r=0.96, P<0.001); however, the root mean square error was 15.4 months. With a 12-month cutoff, the concordance rate was 58.8%. The Bland-Altman plot showed that the DL software tended to underestimate the BA compared with the CA, especially in children under the age of 8.3 years.

CONCLUSION

The DL-based BA software showed a low concordance rate and a tendency to underestimate the BA in healthy Korean children.

Label correlation guided discriminative label feature learning for multi-label chest image classification

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.

FD-Net: Feature Distillation Network for Oral Squamous Cell Carcinoma Lymph Node Segmentation in Hyperspectral Imagery

Oral squamous cell carcinoma (OSCC) has the characteristics of early regional lymph node metastasis. OSCC patients often have poor prognoses and low survival rates due to cervical lymph metastases. Therefore, it is necessary to rely on a reasonable screening method to quickly judge the cervical lymph metastastic condition of OSCC patients and develop appropriate treatment plans. In this study, the widely used pathological sections with hematoxylin-eosin (H&E) staining are taken as the target, and combined with the advantages of hyperspectral imaging technology, a novel diagnostic method for identifying OSCC lymph node metastases is proposed. The method consists of a learning stage and a decision-making stage, focusing on cancer and non-cancer nuclei, gradually completing the lesions' segmentation from coarse to fine, and achieving high accuracy. In the learning stage, the proposed feature distillation-Net (FD-Net) network is developed to segment the cancerous and non-cancerous nuclei. In the decision-making stage, the segmentation results are post-processed, and the lesions are effectively distinguished based on the prior. Experimental results demonstrate that the proposed FD-Net is very competitive in the OSCC hyperspectral medical image segmentation task. The proposed FD-Net method performs best on the seven segmentation evaluation indicators: MIoU, OA, AA, SE, CSI, GDR, and DICE. Among these seven evaluation indicators, the proposed FD-Net method is 1.75%, 1.27%, 0.35%, 1.9%, 0.88%, 4.45%, and 1.98% higher than the DeepLab V3 method, which ranks second in performance, respectively. In addition, the proposed diagnosis method of OSCC lymph node metastasis can effectively assist pathologists in disease screening and reduce the workload of pathologists.

Efficient and accurate microplastics identification and segmentation in urban waters using convolutional neural networks

Microplastics (MPs), measuring less than 5 mm, pose threats to ecological security and human health in urban waters. Additionally, they act as carriers, transporting pollutants from terrestrial systems into oceanic circulation, contributing to global pollution. Recognizing the significance of identifying MPs in urban waters, one potential solution to the time-consuming and labor-intensive manual identification process is the application of a convolutional neural network (CNN). Therefore, having a reliable CNN model that efficiently and accurately identifies MPs is essential for extensive research on MPs pollution in urban waters. In this work, an MPs dataset with complex background was acquired from urban waters in southern China. The dataset was used to train and validate CNN models, including UNet, UNet2plus, and UNet3plus. Subsequently, the computational and inference performance of the three models was evaluated using a newly collected MPs dataset. The results showed that UNet, UNet2plus, UNet3plus, after being trained for 120 epochs, provided efficient inferences within less than 1 s, 2 s, and 3 s for 100 MPs images, respectively. Accurate segmentation with mIoU of 91.45 ± 5.93 % and 91.08 ± 6.18 % was achieved using UNet and UNet2plus, respectively, while UNet3plus exhibited a lower performance with only 82.21 ± 10.33 % mIoU. This work demonstrated that UNet and UNet2plus deliver efficient and accurate identification of MPs in urban waters. Developing CNN models that efficiently and accurately identify MPs is crucial for reducing manual time, especially in large-scale investigations of MPs pollution in urban waters.

Developing the Lung Graph-Based Machine Learning Model for Identification of Fibrotic Interstitial Lung Diseases

Accurate detection of fibrotic interstitial lung disease (f-ILD) is conducive to early intervention. Our aim was to develop a lung graph-based machine learning model to identify f-ILD. A total of 417 HRCTs from 279 patients with confirmed ILD (156 f-ILD and 123 non-f-ILD) were included in this study. A lung graph-based machine learning model based on HRCT was developed for aiding clinician to diagnose f-ILD. In this approach, local radiomics features were extracted from an automatically generated geometric atlas of the lung and used to build a series of specific lung graph models. Encoding these lung graphs, a lung descriptor was gained and became as a characterization of global radiomics feature distribution to diagnose f-ILD. The Weighted Ensemble model showed the best predictive performance in cross-validation. The classification accuracy of the model was significantly higher than that of the three radiologists at both the CT sequence level and the patient level. At the patient level, the diagnostic accuracy of the model versus radiologists A, B, and C was 0.986 (95% CI 0.959 to 1.000), 0.918 (95% CI 0.849 to 0.973), 0.822 (95% CI 0.726 to 0.904), and 0.904 (95% CI 0.836 to 0.973), respectively. There was a statistically significant difference in AUC values between the model and 3 physicians (p < 0.05). The lung graph-based machine learning model could identify f-ILD, and the diagnostic performance exceeded radiologists which could aid clinicians to assess ILD objectively.

Towards the adoption of quantitative computed tomography in the management of interstitial lung disease

The shortcomings of qualitative visual assessment have led to the development of computer-based tools to characterise and quantify disease on high-resolution computed tomography (HRCT) in patients with interstitial lung diseases (ILDs). Quantitative CT (QCT) software enables quantification of patterns on HRCT with results that are objective, reproducible, sensitive to change and predictive of disease progression. Applications developed to provide a diagnosis or pattern classification are mainly based on artificial intelligence. Deep learning, which identifies patterns in high-dimensional data and maps them to segmentations or outcomes, can be used to identify the imaging patterns that most accurately predict disease progression. Optimisation of QCT software will require the implementation of protocol standards to generate data of sufficient quality for use in computerised applications and the identification of diagnostic, imaging and physiological features that are robustly associated with mortality for use as anchors in the development of algorithms. Consortia such as the Open Source Imaging Consortium have a key role to play in the collation of imaging and clinical data that can be used to identify digital imaging biomarkers that inform diagnosis, prognosis and response to therapy.

Lung cancer detection based on computed tomography image using convolutional neural networks

BACKGROUND

Lung cancer is the most common type of cancer, accounting for 12.8% of cancer cases worldwide. As initially non-specific symptoms occur, it is difficult to diagnose in the early stages.

OBJECTIVE

Image processing techniques developed using machine learning methods have played a crucial role in the development of decision support systems. This study aimed to classify benign and malignant lung lesions with a deep learning approach and convolutional neural networks (CNNs).

METHODS

The image dataset includes 4459 Computed tomography (CT) scans (benign, 2242; malignant, 2217). The research type was retrospective; the case-control analysis. A method based on GoogLeNet architecture, which is one of the deep learning approaches, was used to make maximum inference on images and minimize manual control.

RESULTS

The dataset used to develop the CNNs model is included in the training (3567) and testing (892) datasets. The model's highest accuracy rate in the training phase was estimated as 0.98. According to accuracy, sensitivity, specificity, positive predictive value, and negative predictive values of testing data, the highest classification performance ratio was positive predictive value with 0.984.

CONCLUSION

The deep learning methods are beneficial in the diagnosis and classification of lung cancer through computed tomography images.

Severity-stratification of interstitial lung disease by deep learning enabled assessment and quantification of lesion indicators from HRCT images

BACKGROUND

Interstitial lung disease (ILD) represents a group of chronic heterogeneous diseases, and current clinical practice in assessment of ILD severity and progression mainly rely on the radiologist-based visual screening, which greatly restricts the accuracy of disease assessment due to the high inter- and intra-subjective observer variability.

OBJECTIVE

To solve these problems, in this work, we propose a deep learning driven framework that can assess and quantify lesion indicators and outcome the prediction of severity of ILD.

METHODS

In detail, we first present a convolutional neural network that can segment and quantify five types of lesions including HC, RO, GGO, CONS, and EMPH from HRCT of ILD patients, and then we conduct quantitative analysis to select the features related to ILD based on the segmented lesions and clinical data. Finally, a multivariate prediction model based on nomogram to predict the severity of ILD is established by combining multiple typical lesions.

RESULTS

Experimental results showed that three lesions of HC, RO, and GGO could accurately predict ILD staging independently or combined with other HRCT features. Based on the HRCT, the used multivariate model can achieve the highest AUC value of 0.755 for HC, and the lowest AUC value of 0.701 for RO in stage I, and obtain the highest AUC value of 0.803 for HC, and the lowest AUC value of 0.733 for RO in stage II. Additionally, our ILD scoring model could achieve an average accuracy of 0.812 (0.736 - 0.888) in predicting the severity of ILD via cross-validation.

CONCLUSIONS

In summary, our proposed method provides effective segmentation of ILD lesions by a comprehensive deep-learning approach and confirms its potential effectiveness in improving diagnostic accuracy for clinicians.

CLAHE-CapsNet: Efficient retina optical coherence tomography classification using capsule networks with contrast limited adaptive histogram equalization

Manual detection of eye diseases using retina Optical Coherence Tomography (OCT) images by Ophthalmologists is time consuming, prone to errors and tedious. Previous researchers have developed a computer aided system using deep learning-based convolutional neural networks (CNNs) to aid in faster detection of the retina diseases. However, these methods find it difficult to achieve better classification performance due to noise in the OCT image. Moreover, the pooling operations in CNN reduce resolution of the image that limits the performance of the model. The contributions of the paper are in two folds. Firstly, this paper makes a comprehensive literature review to establish current-state-of-act methods successfully implemented in retina OCT image classifications. Additionally, this paper proposes a capsule network coupled with contrast limited adaptive histogram equalization (CLAHE-CapsNet) for retina OCT image classification. The CLAHE was implemented as layers to minimize the noise in the retina image for better performance of the model. A three-layer convolutional capsule network was designed with carefully chosen hyperparameters. The dataset used for this study was presented by University of California San Diego (UCSD). The dataset consists of 84,495 X-Ray images (JPEG) and 4 categories (NORMAL, CNV, DME, and DRUSEN). The images went through a grading system consisting of multiple layers of trained graders of expertise for verification and correction of image labels. Evaluation experiments were conducted and comparison of results was done with state-of-the-art models to find out the best performing model. The evaluation metrics; accuracy, sensitivity, precision, specificity, and AUC are used to determine the performance of the models. The evaluation results show that the proposed model achieves the best performing model of accuracies of 97.7%, 99.5%, and 99.3% on overall accuracy (OA), overall sensitivity (OS), and overall precision (OP), respectively. The results obtained indicate that the proposed model can be adopted and implemented to help ophthalmologists in detecting retina OCT diseases.

Trends and hotspots in research on medical images with deep learning: a bibliometric analysis from 2013 to 2023

Background

With the rapid development of the internet, the improvement of computer capabilities, and the continuous advancement of algorithms, deep learning has developed rapidly in recent years and has been widely applied in many fields. Previous studies have shown that deep learning has an excellent performance in image processing, and deep learning-based medical image processing may help solve the difficulties faced by traditional medical image processing. This technology has attracted the attention of many scholars in the fields of computer science and medicine. This study mainly summarizes the knowledge structure of deep learning-based medical image processing research through bibliometric analysis and explores the research hotspots and possible development trends in this field.

Methods

Retrieve the Web of Science Core Collection database using the search terms "deep learning," "medical image processing," and their synonyms. Use CiteSpace for visual analysis of authors, institutions, countries, keywords, co-cited references, co-cited authors, and co-cited journals.

Results

The analysis was conducted on 562 highly cited papers retrieved from the database. The trend chart of the annual publication volume shows an upward trend. Pheng-Ann Heng, Hao Chen, and Klaus Hermann Maier-Hein are among the active authors in this field. Chinese Academy of Sciences has the highest number of publications, while the institution with the highest centrality is Stanford University. The United States has the highest number of publications, followed by China. The most frequent keyword is "Deep Learning," and the highest centrality keyword is "Algorithm." The most cited author is Kaiming He, and the author with the highest centrality is Yoshua Bengio.

Conclusion

The application of deep learning in medical image processing is becoming increasingly common, and there are many active authors, institutions, and countries in this field. Current research in medical image processing mainly focuses on deep learning, convolutional neural networks, classification, diagnosis, segmentation, image, algorithm, and artificial intelligence. The research focus and trends are gradually shifting toward more complex and systematic directions, and deep learning technology will continue to play an important role.

FibroVit-Vision transformer-based framework for detection and classification of pulmonary fibrosis from chest CT images

Pulmonary Fibrosis (PF) is an immedicable respiratory condition distinguished by permanent fibrotic alterations in the pulmonary tissue for which there is no cure. Hence, it is crucial to diagnose PF swiftly and precisely. The existing research on deep learning-based pulmonary fibrosis detection methods has limitations, including dataset sample sizes and a lack of standardization in data preprocessing and evaluation metrics. This study presents a comparative analysis of four vision transformers regarding their efficacy in accurately detecting and classifying patients with Pulmonary Fibrosis and their ability to localize abnormalities within Images obtained from Computerized Tomography (CT) scans. The dataset consisted of 13,486 samples selected out of 24647 from the Pulmonary Fibrosis dataset, which included both PF-positive CT and normal images that underwent preprocessing. The preprocessed images were divided into three sets: the training set, which accounted for 80% of the total pictures; the validation set, which comprised 10%; and the test set, which also consisted of 10%. The vision transformer models, including ViT, MobileViT2, ViTMSN, and BEiT were subjected to training and validation procedures, during which hyperparameters like the learning rate and batch size were fine-tuned. The overall performance of the optimized architectures has been assessed using various performance metrics to showcase the consistent performance of the fine-tuned model. Regarding performance, ViT has shown superior performance in validation and testing accuracy and loss minimization, specifically for CT images when trained at a single epoch with a tuned learning rate of 0.0001. The results were as follows: validation accuracy of 99.85%, testing accuracy of 100%, training loss of 0.0075, and validation loss of 0.0047. The experimental evaluation of the independently collected data gives empirical evidence that the optimized Vision Transformer (ViT) architecture exhibited superior performance compared to all other optimized architectures. It achieved a flawless score of 1.0 in various standard performance metrics, including Sensitivity, Specificity, Accuracy, F1-score, Precision, Recall, Mathew Correlation Coefficient (MCC), Precision-Recall Area under the Curve (AUC PR), Receiver Operating Characteristic and Area Under the Curve (ROC-AUC). Therefore, the optimized Vision Transformer (ViT) functions as a reliable diagnostic tool for the automated categorization of individuals with pulmonary fibrosis (PF) using chest computed tomography (CT) scans.

Hybrid bio-inspired algorithm and convolutional neural network for automatic lung tumor detection

In this paper, we have proposed a hybrid bio-inspired algorithm which takes the merits of whale optimization algorithm (WOA) and adaptive particle swarm optimization (APSO). The proposed algorithm is referred as the hybrid WOA_APSO algorithm. We utilize a convolutional neural network (CNN) for classification purposes. Extensive experiments are performed to evaluate the performance of the proposed model. Here, pre-processing and segmentation are performed on 120 lung CT images for obtaining the segmented tumored and non-tumored region nodule. The statistical, texture, geometrical and structural features are extracted from the processed image using different techniques. The optimized feature selection plays a crucial role in determining the accuracy of the classification algorithm. The novel variant of whale optimization algorithm and adaptive particle swarm optimization, hybrid bio-inspired WOA_APSO, is proposed for selecting optimized features. The feature selection grouping is applied by embedding linear discriminant analysis which helps in determining the reduced dimensions of subsets. Twofold performance comparisons are done. First, we compare the performance against the different classification techniques such as support vector machine, artificial neural network (ANN) and CNN. Second, the computational cost of the hybrid WOA_APSO is compared with the standard WOA and APSO algorithms. The experimental result reveals that the proposed algorithm is capable of automatic lung tumor detection and it outperforms the other state-of-the-art methods on standard quality measures such as accuracy (97.18%), sensitivity (97%) and specificity (98.66%). The results reported in this paper are encouraging; hence, these results will motivate other researchers to explore more in this direction.

Development and external validation of the multichannel deep learning model based on unenhanced CT for differentiating fat-poor angiomyolipoma from renal cell carcinoma: a two-center retrospective study

PURPOSE

There are undetectable levels of fat in fat-poor angiomyolipoma. Thus, it is often misdiagnosed as renal cell carcinoma. We aimed to develop and evaluate a multichannel deep learning model for differentiating fat-poor angiomyolipoma (fp-AML) from renal cell carcinoma (RCC).

METHODS

This two-center retrospective study included 320 patients from the First Affiliated Hospital of Sun Yat-Sen University (FAHSYSU) and 132 patients from the Sun Yat-Sen University Cancer Center (SYSUCC). Data from patients at FAHSYSU were divided into a development dataset (n = 267) and a hold-out dataset (n = 53). The development dataset was used to obtain the optimal combination of CT modality and input channel. The hold-out dataset and SYSUCC dataset were used for independent internal and external validation, respectively.

RESULTS

In the development phase, models trained on unenhanced CT images performed significantly better than those trained on enhanced CT images based on the fivefold cross-validation. The best patient-level performance, with an average area under the receiver operating characteristic curve (AUC) of 0.951 ± 0.026 (mean ± SD), was achieved using the "unenhanced CT and 7-channel" model, which was finally selected as the optimal model. In the independent internal and external validation, AUCs of 0.966 (95% CI 0.919-1.000) and 0.898 (95% CI 0.824-0.972), respectively, were obtained using the optimal model. In addition, the performance of this model was better on large tumors (≥ 40 mm) in both internal and external validation.

CONCLUSION

The promising results suggest that our multichannel deep learning classifier based on unenhanced whole-tumor CT images is a highly useful tool for differentiating fp-AML from RCC.

EAMNet: an Alzheimer's disease prediction model based on representation learning

Objective. Brain18F-FDG PET images indicate brain lesions' metabolic status and offer the predictive potential for Alzheimer's disease (AD). However, the complexity of extracting relevant lesion features and dealing with extraneous information in PET images poses challenges for accurate prediction.Approach. To address these issues, we propose an innovative solution called the efficient adaptive multiscale network (EAMNet) for predicting potential patient populations using positron emission tomography (PET) image slices, enabling effective intervention and treatment. Firstly, we introduce an efficient convolutional strategy to enhance the receptive field of PET images during the feature learning process, avoiding excessive extraction of fine tissue features by deep-level networks while reducing the model's computational complexity. Secondly, we construct a channel attention module that enables the prediction model to adaptively allocate weights between different channels, compensating for the spatial noise in PET images' impact on classification. Finally, we use skip connections to merge features from different-scale lesion information. Through visual analysis, the network constructed in this article aligns with the regions of interest of clinical doctors.Main results. Through visualization analysis, our network aligns with regions of interest identified by clinical doctors. Experimental evaluations conducted on the ADNI (Alzheimer's Disease Neuroimaging Initiative) dataset demonstrate the outstanding classification performance of our proposed method. The accuracy rates for AD versus NC (Normal Controls), AD versus MCI (Mild Cognitive Impairment), MCI versus NC, and AD versus MCI versus NC classifications achieve 97.66%, 96.32%, 95.23%, and 95.68%, respectively.Significance. The proposed method surpasses advanced algorithms in the field, providing a hopeful advancement in accurately predicting and classifying Alzheimer's Disease using18F-FDG PET images. The source code has been uploaded tohttps://github.com/Haoliang-D-AHU/EAMNet/tree/master.

Lung Cancer Classification in Histopathology Images Using Multiresolution Efficient Nets

Histopathological images are very effective for investigating the status of various biological structures and diagnosing diseases like cancer. In addition, digital histopathology increases diagnosis precision and provides better image quality and more detail for the pathologist with multiple viewing options and team annotations. As a result of the benefits above, faster treatment is available, increasing therapy success rates and patient recovery and survival chances. However, the present manual examination of these images is tedious and time-consuming for pathologists. Therefore, reliable automated techniques are needed to effectively classify normal and malignant cancer images. This paper applied a deep learning approach, namely, EfficientNet and its variants from B0 to B7. We used different image resolutions for each model, from 224 × 224 pixels to 600 × 600 pixels. We also applied transfer learning and parameter tuning techniques to improve the results and overcome the overfitting problem. We collected the dataset from the Lung and Colon Cancer Histopathological Image LC25000 image dataset. The dataset acquisition consists of 25,000 histopathology images of five classes (lung adenocarcinoma, lung squamous cell carcinoma, benign lung tissue, colon adenocarcinoma, and colon benign tissue). Then, we performed preprocessing on the dataset to remove the noisy images and bring them into a standard format. The model's performance was evaluated in terms of classification accuracy and loss. We have achieved good accuracy results for all variants; however, the results of EfficientNetB2 stand excellent, with an accuracy of 97% for 260 × 260 pixels resolution images.

MLP-based classification of COVID-19 and skin diseases

Recent years have witnessed a growing interest in neural network-based medical image classification methods, which have demonstrated remarkable performance in this field. Typically, convolutional neural network (CNN) architectures have been commonly employed to extract local features. However, the transformer, a newly emerged architecture, has gained popularity due to its ability to explore the relevance of remote elements in an image through a self-attention mechanism. Despite this, it is crucial to establish not only local connectivity but also remote relationships between lesion features and capture the overall image structure to improve image classification accuracy. Therefore, to tackle the aforementioned issues, this paper proposes a network based on multilayer perceptrons (MLPs) that can learn the local features of medical images on the one hand and capture the overall feature information in both spatial and channel dimensions on the other hand, thus utilizing image features effectively. This paper has been extensively validated on COVID19-CT dataset and ISIC 2018 dataset, and the results show that the method in this paper is more competitive and has higher performance in medical image classification compared with existing methods. This shows that the use of MLP to capture image features and establish connections between lesions is expected to provide novel ideas for medical image classification tasks in the future.

MixNet-LD: An Automated Classification System for Multiple Lung Diseases Using Modified MixNet Model

The lungs are critical components of the respiratory system because they allow for the exchange of oxygen and carbon dioxide within our bodies. However, a variety of conditions can affect the lungs, resulting in serious health consequences. Lung disease treatment aims to control its severity, which is usually irrevocable. The fundamental objective of this endeavor is to build a consistent and automated approach for establishing the intensity of lung illness. This paper describes MixNet-LD, a unique automated approach aimed at identifying and categorizing the severity of lung illnesses using an upgraded pre-trained MixNet model. One of the first steps in developing the MixNet-LD system was to build a pre-processing strategy that uses Grad-Cam to decrease noise, highlight irregularities, and eventually improve the classification performance of lung illnesses. Data augmentation strategies were used to rectify the dataset's unbalanced distribution of classes and prevent overfitting. Furthermore, dense blocks were used to improve classification outcomes across the four severity categories of lung disorders. In practice, the MixNet-LD model achieves cutting-edge performance while maintaining model size and manageable complexity. The proposed approach was tested using a variety of datasets gathered from credible internet sources as well as a novel private dataset known as Pak-Lungs. A pre-trained model was used on the dataset to obtain important characteristics from lung disease images. The pictures were then categorized into categories such as normal, COVID-19, pneumonia, tuberculosis, and lung cancer using a linear layer of the SVM classifier with a linear activation function. The MixNet-LD system underwent testing in four distinct tests and achieved a remarkable accuracy of 98.5% on the difficult lung disease dataset. The acquired findings and comparisons demonstrate the MixNet-LD system's improved performance and learning capabilities. These findings show that the proposed approach may effectively increase the accuracy of classification models in medicinal image investigations. This research helps to develop new strategies for effective medical image processing in clinical settings.

Multiparametric Oncologic Hybrid Imaging: Machine Learning Challenges and Opportunities

BACKGROUND

Machine learning (ML) is considered an important technology for future data analysis in health care.

METHODS

The inherently technology-driven fields of diagnostic radiology and nuclear medicine will both benefit from ML in terms of image acquisition and reconstruction. Within the next few years, this will lead to accelerated image acquisition, improved image quality, a reduction of motion artifacts and - for PET imaging - reduced radiation exposure and new approaches for attenuation correction. Furthermore, ML has the potential to support decision making by a combined analysis of data derived from different modalities, especially in oncology. In this context, we see great potential for ML in multiparametric hybrid imaging and the development of imaging biomarkers.

RESULTS AND CONCLUSION

In this review, we will describe the basics of ML, present approaches in hybrid imaging of MRI, CT, and PET, and discuss the specific challenges associated with it and the steps ahead to make ML a diagnostic and clinical tool in the future.

KEY POINTS

· ML provides a viable clinical solution for the reconstruction, processing, and analysis of hybrid imaging obtained from MRI, CT, and PET..

Automatic evaluation of atlantoaxial subluxation in rheumatoid arthritis by a deep learning model

BACKGROUND

This work aims to develop a deep learning model, assessing atlantoaxial subluxation (AAS) in rheumatoid arthritis (RA), which can often be ambiguous in clinical practice.

METHODS

We collected 4691 X-ray images of the cervical spine of the 906 patients with RA. Among these images, 3480 were used for training the deep learning model, 803 were used for validating the model during the training process, and the remaining 408 were used for testing the performance of the trained model. The two-dimensional key points' detection model of Deep High-Resolution Representation Learning for Human Pose Estimation was adopted as the base convolutional neural network model. The model inferred four coordinates to calculate the atlantodental interval (ADI) and space available for the spinal cord (SAC). Finally, these values were compared with those by clinicians to evaluate the performance of the model.

RESULTS

Among the 408 cervical images for testing the performance, the trained model correctly identified the four coordinates in 99.5% of the dataset. The values of ADI and SAC were positively correlated among the model and two clinicians. The sensitivity of AAS diagnosis with ADI or SAC by the model was 0.86 and 0.97 respectively. The specificity of that was 0.57 and 0.5 respectively.

CONCLUSIONS

We present the development of a deep learning model for the evaluation of cervical lesions of patients with RA. The model was demonstrably shown to be useful for quantitative evaluation.

A Novel Strategy for Extracting Richer Semantic Information Based on Fault Detection in Power Transmission Lines

With the development of the smart grid, the traditional defect detection methods in transmission lines are gradually shifted to the combination of robots or drones and deep learning technology to realize the automatic detection of defects, avoiding the risks and computational costs of manual detection. Lightweight embedded devices such as drones and robots belong to small devices with limited computational resources, while deep learning mostly relies on deep neural networks with huge computational resources. And semantic features of deep networks are richer, which are also critical for accurately classifying morphologically similar defects for detection, helping to identify differences and classify transmission line components. Therefore, we propose a method to obtain advanced semantic features even in shallow networks. Combined with transfer learning, we change the image features (e.g., position and edge connectivity) under self-supervised learning during pre-training. This allows the pre-trained model to learn potential semantic feature representations rather than relying on low-level features. The pre-trained model then directs a shallow network to extract rich semantic features for downstream tasks. In addition, we introduce a category semantic fusion module (CSFM) to enhance feature fusion by utilizing channel attention to capture global and local information lost during compression and extraction. This module helps to obtain more category semantic information. Our experiments on a self-created transmission line defect dataset show the superiority of modifying low-level image information during pre-training when adjusting the number of network layers and embedding of the CSFM. The strategy demonstrates generalization on the publicly available PASCAL VOC dataset. Finally, compared with state-of-the-art methods on the synthetic fog insulator dataset (SFID), the strategy achieves comparable performance with much smaller network depths.

Lung Tumor Image Segmentation from Computer Tomography Images Using MobileNetV2 and Transfer Learning

BACKGROUND

Lung cancer is one of the most fatal cancers worldwide, and malignant tumors are characterized by the growth of abnormal cells in the tissues of lungs. Usually, symptoms of lung cancer do not appear until it is already at an advanced stage. The proper segmentation of cancerous lesions in CT images is the primary method of detection towards achieving a completely automated diagnostic system.

METHOD

In this work, we developed an improved hybrid neural network via the fusion of two architectures, MobileNetV2 and UNET, for the semantic segmentation of malignant lung tumors from CT images. The transfer learning technique was employed and the pre-trained MobileNetV2 was utilized as an encoder of a conventional UNET model for feature extraction. The proposed network is an efficient segmentation approach that performs lightweight filtering to reduce computation and pointwise convolution for building more features. Skip connections were established with the Relu activation function for improving model convergence to connect the encoder layers of MobileNetv2 to decoder layers in UNET that allow the concatenation of feature maps with different resolutions from the encoder to decoder. Furthermore, the model was trained and fine-tuned on the training dataset acquired from the Medical Segmentation Decathlon (MSD) 2018 Challenge.

RESULTS

The proposed network was tested and evaluated on 25% of the dataset obtained from the MSD, and it achieved a dice score of 0.8793, recall of 0.8602 and precision of 0.93. It is pertinent to mention that our technique outperforms the current available networks, which have several phases of training and testing.

Semi-Supervised Segmentation of Interstitial Lung Disease Patterns from CT Images via Self-Training with Selective Re-Training

Accurate segmentation of interstitial lung disease (ILD) patterns from computed tomography (CT) images is an essential prerequisite to treatment and follow-up. However, it is highly time-consuming for radiologists to pixel-by-pixel segment ILD patterns from CT scans with hundreds of slices. Consequently, it is hard to obtain large amounts of well-annotated data, which poses a huge challenge for data-driven deep learning-based methods. To alleviate this problem, we propose an end-to-end semi-supervised learning framework for the segmentation of ILD patterns (ESSegILD) from CT images via self-training with selective re-training. The proposed ESSegILD model is trained using a large CT dataset with slice-wise sparse annotations, i.e., only labeling a few slices in each CT volume with ILD patterns. Specifically, we adopt a popular semi-supervised framework, i.e., Mean-Teacher, that consists of a teacher model and a student model and uses consistency regularization to encourage consistent outputs from the two models under different perturbations. Furthermore, we propose introducing the latest self-training technique with a selective re-training strategy to select reliable pseudo-labels generated by the teacher model, which are used to expand training samples to promote the student model during iterative training. By leveraging consistency regularization and self-training with selective re-training, our proposed ESSegILD can effectively utilize unlabeled data from a partially annotated dataset to progressively improve the segmentation performance. Experiments are conducted on a dataset of 67 pneumonia patients with incomplete annotations containing over 11,000 CT images with eight different lung patterns of ILDs, with the results indicating that our proposed method is superior to the state-of-the-art methods.

Torsional nystagmus recognition based on deep learning for vertigo diagnosis

Introduction

Detection of torsional nystagmus can help identify the canal of origin in benign paroxysmal positional vertigo (BPPV). Most currently available pupil trackers do not detect torsional nystagmus. In view of this, a new deep learning network model was designed for the determination of torsional nystagmus.

Methods

The data set comes from the Eye, Ear, Nose and Throat (Eye&ENT) Hospital of Fudan University. In the process of data acquisition, the infrared videos were obtained from eye movement recorder. The dataset contains 24521 nystagmus videos. All torsion nystagmus videos were annotated by the ophthalmologist of the hospital. 80% of the data set was used to train the model, and 20% was used to test.

Results

Experiments indicate that the designed method can effectively identify torsional nystagmus. Compared with other methods, it has high recognition accuracy. It can realize the automatic recognition of torsional nystagmus and provides support for the posterior and anterior canal BPPV diagnosis.

Discussion

Our present work complements existing methods of 2D nystagmus analysis and could improve the diagnostic capabilities of VNG in multiple vestibular disorders. To automatically pick BPV requires detection of nystagmus in all 3 planes and identification of a paroxysm. This is the next research work to be carried out.

A review on blockchain for DNA sequence: security issues, application in DNA classification, challenges and future trends

In biological science, the study of DNA sequences is considered an important factor because it carries the genomic details that can be used by researchers and doctors for the early prediction of disease using DNA classification. The NCBI has the world's largest database of genetic sequences, but the security of this massive amount of data is currently the greatest issue. One of the options is to encrypt these genetic sequences using blockchain technology. As a result, this paper presents a survey on healthcare data breaches, the necessity for blockchain in healthcare, and the number of research studies done in this area. In addition, the report suggests DNA sequence classification for earlier disease identification and evaluates previous work in the field.

Is Convolutional Neural Network Accurate for Automatic Detection of Zygomatic Fractures on Computed Tomography?

PURPOSE

Zygomatic fractures involve complex anatomical structures of the mid-face and the diagnosis can be challenging and labor-consuming. This research is aimed to evaluate the performance of an automatic algorithm for the detection of zygomatic fractures based on convolutional neural network (CNN) on spiral computed tomography (CT).

MATERIALS AND METHODS

We designed a cross-sectional retrospective diagnostic trial study. Clinical records and CT scans of patients with zygomatic fractures were reviewed. The sample consisted of two types of patients with different zygomatic fractures statuses (positive or negative) in Peking University School of Stomatology from 2013 to 2019. All CT samples were randomly divided into three groups at a ratio of 6:2:2 as training set, validation set, and test set, respectively. All CT scans were viewed and annotated by three experienced maxillofacial surgeons, serving as the gold standard. The algorithm consisted of two modules as follows: (1) segmentation of the zygomatic region of CT based on U-Net, a type of CNN model; (2) detection of fractures based on Deep Residual Network 34(ResNet34). The region segmentation model was used first to detect and extract the zygomatic region, then the detection model was used to detect the fracture status. The Dice coefficient was used to evaluate the performance of the segmentation algorithm. The sensitivity and specificity were used to assess the performance of the detection model. The covariates included age, gender, duration of injury, and the etiology of fractures.

RESULTS

A total of 379 patients with an average age of 35.43 ± 12.74 years were included in the study. There were 203 nonfracture patients and 176 fracture patients with 220 sites of zygomatic fractures (44 patients underwent bilateral fractures). The Dice coefficientof zygomatic region detection model and gold standard verified by manual labeling were 0.9337 (coronal plane) and 0.9269 (sagittal plane), respectively. The sensitivity and specificity of the fracture detection model were 100% (p＞.05).

CONCLUSION

The performance of the algorithm based on CNNs was not statistically different from the gold standard (manual diagnosis) for zygomatic fracture detection in order for the algorithm to be applied clinically.

Deep learning-extracted CT imaging phenotypes predict response to total resection in colorectal cancer

BACKGROUND

Deep learning surpasses many traditional methods for many vision tasks, allowing the transformation of hierarchical features into more abstract, high-level features.

PURPOSE

To evaluate the prognostic value of preoperative computed tomography (CT) image texture features and deep learning self-learning high-throughput features (SHF) on postoperative overall survival in the treatment of patients with colorectal cancer (CRC).

MATERIAL AND METHODS

The dataset consisted of 810 enrolled patients with CRC confirmed from 10 November 2011 to 10 February 2018. In contrast, SHF extracted by deep learning with multi-task training mechanism and texture features were extracted from the CT with tumor volume region of interest, respectively, and combined with the Cox proportional hazard (CoxPH) model for initial validation to obtain a RAD score to classify patients into high- and low-risk groups. The SHF stability was further validated in combination with Neural Multi-Task Logistic Regression (N-MTLR) model. The overall recognition ability and accuracy of CoxPH and N-MTLR model were evaluated by C-index and Integrated Brier Score (IBS).

RESULTS

SHF had a more significant degree of differentiation than texture features. The result is (SHF vs. texture features: C-index: 0.884 vs. 0.611; IBS: 0.025 vs. 0.073) in the CoxPH model, and (SHF vs. texture features: C-index: 0.861 vs. 0.630; IBS: 0.024 vs. 0.065) in N-MTLR.

CONCLUSION

SHF is superior to texture features and has potential application for the preoperative prediction of the individualized treatment of CRC.