Texture Analysis in the Evaluation of Covid-19 Pneumonia in Chest X-Ray Images: a Proof of Concept Study

Comparison of the Classification Results Accuracy for CT Soft Tissue and Bone Reconstructions in Detecting the Porosity of a Spongy Tissue

The aim of the study was to compare the accuracy of the classification pertaining to the results of two types of soft tissue and bone reconstructions of the spinal CT in detecting the porosity of L1 vertebral body spongy tissue. The dataset for each type of reconstruction (high-resolution bone reconstruction and soft tissue reconstruction) included 400 sponge tissue images from 50 healthy patients and 50 patients with osteoporosis. Texture feature descriptors were calculated based on the statistical analysis of the grey image histogram, autoregression model, and wavelet transform. The data dimensional reduction was applied by feature selection using nine methods representing various approaches (filter, wrapper, and embedded methods). Eleven methods were used to build the classifier models. In the learning process, hyperparametric optimization based on the grid search method was applied. On this basis, the most effective model and the optimal subset of features for each selection method used were determined. In the case of bone reconstruction images, four models achieved a maximum accuracy of 92%, one of which had the highest sensitivity of 95%, with a specificity of 89%. For soft tissue reconstruction images, five models achieved the highest testing accuracy of 95%, whereas the other quality indices (TPR and TNR) were also equal to 95%. The research showed that the images derived from soft tissue reconstruction allow for obtaining more accurate values of texture parameters, which increases the accuracy of the classification and offers better possibilities for diagnosing osteoporosis.

Automatic detection of pneumonia in chest X-ray images using textural features

Fast and accurate diagnosis is critical for the triage and management of pneumonia, particularly in the current scenario of a COVID-19 pandemic, where this pathology is a major symptom of the infection. With the objective of providing tools for that purpose, this study assesses the potential of three textural image characterisation methods: radiomics, fractal dimension and the recently developed superpixel-based histon, as biomarkers to be used for training Artificial Intelligence (AI) models in order to detect pneumonia in chest X-ray images. Models generated from three different AI algorithms have been studied: K-Nearest Neighbors, Support Vector Machine and Random Forest. Two open-access image datasets were used in this study. In the first one, a dataset composed of paediatric chest X-ray, the best performing generated models achieved an 83.3% accuracy with 89% sensitivity for radiomics, 89.9% accuracy with 93.6% sensitivity for fractal dimension and 91.3% accuracy with 90.5% sensitivity for superpixels based histon. Second, a dataset derived from an image repository developed primarily as a tool for studying COVID-19 was used. For this dataset, the best performing generated models resulted in a 95.3% accuracy with 99.2% sensitivity for radiomics, 99% accuracy with 100% sensitivity for fractal dimension and 99% accuracy with 98.6% sensitivity for superpixel-based histons. The results confirm the validity of the tested methods as reliable and easy-to-implement automatic diagnostic tools for pneumonia.

Efficient COVID-19 CT Scan Image Segmentation by Automatic Clustering Algorithm

This article addresses automated segmentation and classification of COVID-19 and normal chest CT scan images. Segmentation is the preprocessing step for classification, and 12 DWT-PCA-based texture features extracted from the segmented image are utilized as input for the random forest machine-learning algorithm to classify COVID-19/non-COVID-19 disease. Diagnosing COVID-19 disease through an RT-PCR test is a time-consuming process. Sometimes, the RT-PCR test result is not accurate; that is, it has a false negative, which can cause a threat to the person’s life due to delay in starting the specified treatment. At this moment, there is an urgent need to develop a reliable automatic COVID-19 detection tool that can detect COVID-19 disease from chest CT scan images within a shorter period and can help doctors to start COVID-19 treatment at the earliest. In this article, a variant of the whale optimization algorithm named improved whale optimization algorithm (IWOA) is introduced. The efficiency of the IWOA is tested for unimodal (F1–F7), multimodal (F8–F13), and fixed-dimension multimodal (F14–F23) benchmark functions and is compared with the whale optimization algorithm (WOA), salp swarm optimization (SSA), and sine cosine algorithm (SCA). The experiment is carried out in 30 trials and population size, and iterations are set as 30 and 100 under each trial. IWOA achieves faster convergence than WOA, SSA, and SCA and enhances the exploitation and exploration phases of WOA, avoiding local entrapment. IWOA, WOA, SSA, and SCA utilized Otsu’s maximum between-class variance criteria as fitness function to compute optimal threshold values for multilevel medical CT scan image segmentation. Evaluation measures such as accuracy, specificity, precision, recall, Gmean, F_measure, SSIM, and 12 DWT-PCA-based texture features are computed. The experiment showed that the IWOA is efficient and achieved better segmentation evaluation measures and better segmentation mask in comparison with other methods. DWT-PCA-based texture features extracted from each of the 160 IWOA-, WOA-, SSA-, and SCA-based segmented images are fed into random forest for training, and random forest is tested with DWT-PCA-based texture features extracted from each of the 40 IWOA-, WOA-, SSA-, and SCA-based segmented images. Random forest has reported a promising classification accuracy of 97.49% for the DWT-PCA-based texture features, which are extracted from IWOA-based segmented images.

A deep and handcrafted features-based framework for diagnosis of COVID-19 from chest x-ray images

Automatic early diagnosis of COVID-19 with computer-aided tools is crucial for disease treatment and control. Radiology images of COVID-19 and other lung diseases like bacterial pneumonia, viral pneumonia have common features. Thus, this similarity makes it difficult for radiologists to detect COVID-19 cases. A reliable method for classifying non-COVID-19 and COVID-19 chest x-ray images could be useful to reduce triage process and diagnose. In this study, we develop an original framework (HANDEFU) that supports handcrafted, deep, and fusion-based feature extraction techniques for feature engineering. The user interactively builds any model by selecting feature extraction technique and classification method through the framework. Any feature extraction technique and model could then be added dynamically to the library of software at a later time upon request. The novelty of this study is that image preprocessing and diverse feature extraction and classification techniques are assembled under an original framework. In this study, this framework is utilized for diagnosing COVID-19 from chest x-ray images on an open-access dataset. All of the experimental results and performance evaluations on this dataset are performed with this software. In experimental studies, COVID-19 prediction is performed by 27 different models through software. The superior performance with accuracy of 99.36% is obtained by LBP+SVM model.

Cardiac Computed Tomography Radiomics-Based Approach for the Detection of Left Ventricular Remodeling in Patients with Arterial Hypertension

The aim of the study is to verify the feasibility of a radiomics based approach for the detection of LV remodeling in patients with arterial hypertension. Cardiac Computed Tomography (CCT) and clinical data of patients with and without history of arterial hypertension were collected. In one image per patient, on a 4-chamber view, left ventricle (LV) was segmented using a polygonal region of interest by two radiologists in consensus. A total of 377 radiomics features per region of interest were extracted. After dataset splitting (70:30 ratio), eleven classification models were tested for the discrimination of patients with and without arterial hypertension based on radiomics data. An Ensemble Machine Learning (EML) score was calculated from models with an accuracy >60%. Boruta algorithm was used to extract radiomic features discriminating between patients with and without history of hypertension. Pearson correlation coefficient was used to assess correlation between EML score and septum width in patients included in the test set. EML showed an accuracy, sensitivity and specificity of 0.7. Correlation between EML score and LV septum width was 0.53 (p-value < 0.0001). We considered LV septum width as a surrogate of myocardial remodeling in our population, and this is the reason why we can consider the EML score as a possible tool to evaluate myocardial remodeling. A CCT-based radiomic approach for the identification of LV remodeling is possible in patients with past medical history of arterial hypertension.

A Metabolomics-Based Screening Proposal for Colorectal Cancer

Colorectal cancer (CRC) is a high incidence disease, characterized by high morbidity and mortality rates. Early diagnosis remains challenging because fecal occult blood screening tests have performed sub-optimally, especially due to hemorrhoidal, inflammatory, and vascular diseases, while colonoscopy is invasive and requires a medical setting to be performed. The objective of the present study was to determine if serum metabolomic profiles could be used to develop a novel screening approach for colorectal cancer. Furthermore, the study evaluated the metabolic alterations associated with the disease. Untargeted serum metabolomic profiles were collected from 100 CRC subjects, 50 healthy controls, and 50 individuals with benign colorectal disease. Different machine learning models, as well as an ensemble model based on a voting scheme, were built to discern CRC patients from CTRLs. The ensemble model correctly classified all CRC and CTRL subjects (accuracy = 100%) using a random subset of the cohort as a test set. Relevant metabolites were examined in a metabolite-set enrichment analysis, revealing differences in patients and controls primarily associated with cell glucose metabolism. These results support a potential use of the metabolomic signature as a non-invasive screening tool for CRC. Moreover, metabolic pathway analysis can provide valuable information to enhance understanding of the pathophysiological mechanisms underlying cancer. Further studies with larger cohorts, including blind trials, could potentially validate the reported results.

Multisource Smart Computer-Aided System for Mining COVID-19 Infection Data

In this paper, we approach the problem of detecting and diagnosing COVID-19 infections using multisource scan images including CT and X-ray scans to assist the healthcare system during the COVID-19 pandemic. Here, a computer-aided diagnosis (CAD) system is proposed that utilizes analysis of the CT or X-ray to diagnose the impact of damage in the respiratory system per infected case. The CAD was utilized and optimized by hyper-parameters for shallow learning, e.g., SVM and deep learning. For the deep learning, mini-batch stochastic gradient descent was used to overcome fitting problems during transfer learning. The optimal parameter list values were found using the naïve Bayes technique. Our contributions are (i) a comparison among the detection rates of pre-trained CNN models, (ii) a suggested hybrid deep learning with shallow machine learning, (iii) an extensive analysis of the results of COVID-19 transition and informative conclusions through developing various transfer techniques, and (iv) a comparison of the accuracy of the previous models with the systems of the present study. The effectiveness of the proposed CAD is demonstrated using three datasets, either using an intense learning model as a fully end-to-end solution or using a hybrid deep learning model. Six experiments were designed to illustrate the superior performance of our suggested CAD when compared to other similar approaches. Our system achieves 99.94, 99.6, 100, 97.41, 99.23, and 98.94 accuracy for binary and three-class labels for the CT and two CXR datasets.

Prediction of Hepatocellular Carcinoma Response to Transcatheter Arterial Chemoembolization: A Real-World Study Based on Non-Contrast Computed Tomography Radiomics and General Image Features

Objective

To construct a predictive model of short-term response and overall survival for transcatheter arterial chemoembolization (TACE) treatment in hepatocellular carcinoma (HCC) patients based on non-contrast computed tomography (NC-CT) radiomics and clinical features.

Methods

Ninety-four HCC patients who underwent CT scanning 1 week before the first TACE treatment were retrospectively recruited and divided randomly into a training group (n = 47) and a validation group (n = 47). NC-CT radiomics data were extracted using MaZda software, and the compound model was calculated from radiomics and clinical features by logistic regression. The performance of the different models was compared by examining the area under the receiver operating characteristic curve (AUC). The prediction of prognosis was evaluated using survival analysis.

Results

Thirty NC-CT radiomic features were extracted and analyzed. The compound model was formed using four NC-CT run-length matrix (RLM) features and general image features, which included the maximum diameter (cm) of the tumor and the number of tumors (n). The AUCs of the model for TACE response were 0.840 and 0.815, whereas the AUCs of the six-and-twelve grade were 0.754 and 0.750 in the training and validation groups, respectively. HCC patients were divided into two groups using the cutoff value of the model: a group in which the TACE-response led to good survival and a group in which TACE-nonresponse caused poor prognosis.

Conclusion

Radiomic features from NC-CT predicted TACE-response. The compound model generated by NC-CT radiomics and clinical features is effective and directly predicts TACE-response and overall survival. The model may be used repeatedly and is easy to operate.

COVID-19 and the gastrointestinal tract: Source of infection or merely a target of the inflammatory process following SARS-CoV-2 infection?

Gastrointestinal (GI) symptoms have been described in a conspicuous percentage of coronavirus disease 2019 (COVID-19) patients. This clinical evidence is supported by the detection of viral RNA in stool, which also supports the hypothesis of a possible fecal-oral transmission route. The involvement of GI tract in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is corroborated by the theoretical assumption that angiotensin converting enzyme 2, which is a SARS-CoV-2 target receptor, is present along the GI tract. Studies have pointed out that gut dysbiosis may occur in COVID-19 patients, with a possible correlation with disease severity and with complications such as multisystem inflammatory syndrome in children. However, the question to be addressed is whether dysbiosis is a consequence or a contributing cause of SARS-CoV-2 infection. In such a scenario, pharmacological therapies aimed at decreasing GI permeability may be beneficial for COVID-19 patients. Considering the possibility of a fecal-oral transmission route, water and environmental sanitation play a crucial role for COVID-19 containment, especially in developing countries.