Efficient Pneumonia Detection in Chest Xray Images Using Deep Transfer Learning

Ensemble of Deep Learning Architectures with Machine Learning for Pneumonia Classification Using Chest X-rays

Pneumonia is a severe health concern, particularly for vulnerable groups, needing early and correct classification for optimal treatment. This study addresses the use of deep learning combined with machine learning classifiers (DLxMLCs) for pneumonia classification from chest X-ray (CXR) images. We deployed modified VGG19, ResNet50V2, and DenseNet121 models for feature extraction, followed by five machine learning classifiers (logistic regression, support vector machine, decision tree, random forest, artificial neural network). The approach we suggested displayed remarkable accuracy, with VGG19 and DenseNet121 models obtaining 99.98% accuracy when combined with random forest or decision tree classifiers. ResNet50V2 achieved 99.25% accuracy with random forest. These results illustrate the advantages of merging deep learning models with machine learning classifiers in boosting the speedy and accurate identification of pneumonia. The study underlines the potential of DLxMLC systems in enhancing diagnostic accuracy and efficiency. By integrating these models into clinical practice, healthcare practitioners could greatly boost patient care and results. Future research should focus on refining these models and exploring their application to other medical imaging tasks, as well as including explainability methodologies to better understand their decision-making processes and build trust in their clinical use. This technique promises promising breakthroughs in medical imaging and patient management.

The Effect of Simulated Dose Reduction on the Performance of Artificial Intelligence in Chest Radiography

Chest imaging plays a pivotal role in screening and monitoring patients, and various predictive artificial intelligence (AI) models have been developed in support of this. However, little is known about the effect of decreasing the radiation dose and, thus, image quality on AI performance. This study aims to design a low-dose simulation and evaluate the effect of this simulation on the performance of CNNs in plain chest radiography. Seven pathology labels and corresponding images from Medical Information Mart for Intensive Care datasets were used to train AI models at two spatial resolutions. These 14 models were tested using the original images, 50% and 75% low-dose simulations. We compared the area under the receiver operator characteristic (AUROC) of the original images and both simulations using DeLong testing. The average absolute change in AUROC related to simulated dose reduction for both resolutions was <0.005, and none exceeded a change of 0.014. Of the 28 test sets, 6 were significantly different. An assessment of predictions, performed through the splitting of the data by gender and patient positioning, showed a similar trend. The effect of simulated dose reductions on CNN performance, although significant in 6 of 28 cases, has minimal clinical impact. The effect of patient positioning exceeds that of dose reduction.

Improving deep learning U-Net++ by discrete wavelet and attention gate mechanisms for effective pathological lung segmentation in chest X-ray imaging

Since its introduction in 2015, the U-Net architecture used in Deep Learning has played a crucial role in medical imaging. Recognized for its ability to accurately discriminate small structures, the U-Net has received more than 2600 citations in academic literature, which motivated continuous enhancements to its architecture. In hospitals, chest radiography is the primary diagnostic method for pulmonary disorders, however, accurate lung segmentation in chest X-ray images remains a challenging task, primarily due to the significant variations in lung shapes and the presence of intense opacities caused by various diseases. This article introduces a new approach for the segmentation of lung X-ray images. Traditional max-pooling operations, commonly employed in conventional U-Net++ models, were replaced with the discrete wavelet transform (DWT), offering a more accurate down-sampling technique that potentially captures detailed features of lung structures. Additionally, we used attention gate (AG) mechanisms that enable the model to focus on specific regions in the input image, which improves the accuracy of the segmentation process. When compared with current techniques like Atrous Convolutions, Improved FCN, Improved SegNet, U-Net, and U-Net++, our method (U-Net++-DWT) showed remarkable efficacy, particularly on the Japanese Society of Radiological Technology dataset, achieving an accuracy of 99.1%, specificity of 98.9%, sensitivity of 97.8%, Dice Coefficient of 97.2%, and Jaccard Index of 96.3%. Its performance on the Montgomery County dataset further demonstrated its consistent effectiveness. Moreover, when applied to additional datasets of Chest X-ray Masks and Labels and COVID-19, our method maintained high performance levels, achieving up to 99.3% accuracy, thereby underscoring its adaptability and potential for broad applications in medical imaging diagnostics.

Updating methods for artificial intelligence-based clinical prediction models: a scoping review

OBJECTIVES

To give an overview of methods for updating artificial intelligence (AI)-based clinical prediction models based on new data.

STUDY DESIGN AND SETTING

We comprehensively searched Scopus and Embase up to August 2022 for articles that addressed developments, descriptions, or evaluations of prediction model updating methods. We specifically focused on articles in the medical domain involving AI-based prediction models that were updated based on new data, excluding regression-based updating methods as these have been extensively discussed elsewhere. We categorized and described the identified methods used to update the AI-based prediction model as well as the use cases in which they were used.

RESULTS

We included 78 articles. The majority of the included articles discussed updating for neural network methods (93.6%) with medical images as input data (65.4%). In many articles (51.3%) existing, pretrained models for broad tasks were updated to perform specialized clinical tasks. Other common reasons for model updating were to address changes in the data over time and cross-center differences; however, more unique use cases were also identified, such as updating a model from a broad population to a specific individual. We categorized the identified model updating methods into four categories: neural network-specific methods (described in 92.3% of the articles), ensemble-specific methods (2.5%), model-agnostic methods (9.0%), and other (1.3%). Variations of neural network-specific methods are further categorized based on the following: (1) the part of the original neural network that is kept, (2) whether and how the original neural network is extended with new parameters, and (3) to what extent the original neural network parameters are adjusted to the new data. The most frequently occurring method (n = 30) involved selecting the first layer(s) of an existing neural network, appending new, randomly initialized layers, and then optimizing the entire neural network.

CONCLUSION

We identified many ways to adjust or update AI-based prediction models based on new data, within a large variety of use cases. Updating methods for AI-based prediction models other than neural networks (eg, random forest) appear to be underexplored in clinical prediction research.

PLAIN LANGUAGE SUMMARY

AI-based prediction models are increasingly used in health care, helping clinicians with diagnosing diseases, guiding treatment decisions, and informing patients. However, these prediction models do not always work well when applied to hospitals, patient populations, or times different from those used to develop the models. Developing new models for every situation is neither practical nor desired, as it wastes resources, time, and existing knowledge. A more efficient approach is to adjust existing models to new contexts ('updating'), but there is limited guidance on how to do this for AI-based clinical prediction models. To address this, we reviewed 78 studies in detail to understand how researchers are currently updating AI-based clinical prediction models, and the types of situations in which these updating methods are used. Our findings provide a comprehensive overview of the available methods to update existing models. This is intended to serve as guidance and inspiration for researchers. Ultimately, this can lead to better reuse of existing models and improve the quality and efficiency of AI-based prediction models in health care.

Pneumonia Detection from Chest X-Ray Images Using Deep Learning and Transfer Learning for Imbalanced Datasets

Pneumonia remains a significant global health challenge, necessitating timely and accurate diagnosis for effective treatment. In recent years, deep learning techniques have emerged as powerful tools for automating pneumonia detection from chest X-ray images. This paper provides a comprehensive investigation into the application of deep learning for pneumonia detection, with an emphasis on overcoming the challenges posed by imbalanced datasets. The study evaluates the performance of various deep learning architectures, including visual geometry group (VGG), residual networks (ResNet), and Vision Transformers (ViT) along with strategies to mitigate the impact of imbalanced dataset, on publicly available datasets such as the Chest X-Ray Images (Pneumonia) dataset, BRAX dataset, and CheXpert dataset. Additionally, transfer learning from pre-trained models, such as ImageNet, is investigated to leverage prior knowledge for improved performance on pneumonia detection tasks. Our investigation extends to zero-shot and few-shot learning experiments on different geographical regions. The study also explores semi-supervised learning methods, including the Mean Teacher algorithm, to utilize unlabeled data effectively. Experimental results demonstrate the efficacy of transfer learning, data augmentation, and balanced weight in addressing imbalanced datasets, leading to improved accuracy and performance in pneumonia detection. Our findings emphasize the importance of selecting appropriate strategies based on dataset characteristics, with semi-supervised learning showing particular promise in leveraging unlabeled data. The findings highlight the potential of deep learning techniques in revolutionizing pneumonia diagnosis and treatment, paving the way for more efficient and accurate clinical workflows in the future.

Advanced federated ensemble internet of learning approach for cloud based medical healthcare monitoring system

Medical image machines serve as a valuable tool to monitor and diagnose a variety of diseases. However, manual and centralized interpretation are both error-prone and time-consuming due to malicious attacks. Numerous diagnostic algorithms have been developed to improve precision and prevent poisoning attacks by integrating symptoms, test methods, and imaging data. But in today's digital technology world, it is necessary to have a global cloud-based diagnostic artificial intelligence model that is efficient in diagnosis and preventing poisoning attacks and might be used for multiple purposes. We propose the Healthcare Federated Ensemble Internet of Learning Cloud Doctor System (FDEIoL) model, which integrates different Internet of Things (IoT) devices to provide precise and accurate interpretation without poisoning attack problems, thereby facilitating IoT-enabled remote patient monitoring for smart healthcare systems. Furthermore, the FDEIoL system model uses a federated ensemble learning strategy to provide an automatic, up-to-date global prediction model based on input local models from the medical specialist. This assures biomedical security by safeguarding patient data and preserving the integrity of diagnostic processes. The FDEIoL system model utilizes local model feature selection to discriminate between malicious and non-malicious local models, and ensemble strategies use positive and negative samples to optimize the performance of the test dataset, enhancing its capability for remote patient monitoring. The FDEIoL system model achieved an exceptional accuracy rate of 99.24% on the Chest X-ray dataset and 99.0% on the MRI dataset of brain tumors compared to centralized models, demonstrating its ability for precision diagnosis in IoT-enabled healthcare systems.

Data-driven classification and explainable-AI in the field of lung imaging

Detecting lung diseases in medical images can be quite challenging for radiologists. In some cases, even experienced experts may struggle with accurately diagnosing chest diseases, leading to potential inaccuracies due to complex or unseen biomarkers. This review paper delves into various datasets and machine learning techniques employed in recent research for lung disease classification, focusing on pneumonia analysis using chest X-ray images. We explore conventional machine learning methods, pretrained deep learning models, customized convolutional neural networks (CNNs), and ensemble methods. A comprehensive comparison of different classification approaches is presented, encompassing data acquisition, preprocessing, feature extraction, and classification using machine vision, machine and deep learning, and explainable-AI (XAI). Our analysis highlights the superior performance of transfer learning-based methods using CNNs and ensemble models/features for lung disease classification. In addition, our comprehensive review offers insights for researchers in other medical domains too who utilize radiological images. By providing a thorough overview of various techniques, our work enables the establishment of effective strategies and identification of suitable methods for a wide range of challenges. Currently, beyond traditional evaluation metrics, researchers emphasize the importance of XAI techniques in machine and deep learning models and their applications in classification tasks. This incorporation helps in gaining a deeper understanding of their decision-making processes, leading to improved trust, transparency, and overall clinical decision-making. Our comprehensive review serves as a valuable resource for researchers and practitioners seeking not only to advance the field of lung disease detection using machine learning and XAI but also from other diverse domains.

UniChest: Conquer-and-Divide Pre-Training for Multi-Source Chest X-Ray Classification

Vision-Language Pre-training (VLP) that utilizes the multi-modal information to promote the training efficiency and effectiveness, has achieved great success in vision recognition of natural domains and shown promise in medical imaging diagnosis for the Chest X-Rays (CXRs). However, current works mainly pay attention to the exploration on single dataset of CXRs, which locks the potential of this powerful paradigm on larger hybrid of multi-source CXRs datasets. We identify that although blending samples from the diverse sources offers the advantages to improve the model generalization, it is still challenging to maintain the consistent superiority for the task of each source due to the existing heterogeneity among sources. To handle this dilemma, we design a Conquer-and-Divide pre-training framework, termed as UniChest, aiming to make full use of the collaboration benefit of multiple sources of CXRs while reducing the negative influence of the source heterogeneity. Specially, the "Conquer" stage in UniChest encourages the model to sufficiently capture multi-source common patterns, and the "Divide" stage helps squeeze personalized patterns into different small experts (query networks). We conduct thorough experiments on many benchmarks, e.g., ChestX-ray14, CheXpert, Vindr-CXR, Shenzhen, Open-I and SIIM-ACR Pneumothorax, verifying the effectiveness of UniChest over a range of baselines, and release our codes and pre-training models at https://github.com/Elfenreigen/UniChest.

Bacteria Detection in Optical Endomicroscopy Images using Synthetic Images

Pneumonia, a lung-related illness often resulting from bacterial infection, requires quick and accurate identification, especially in intensive care situations. Optical endomicroscopy (OEM) offers a solution by providing real-time acquisition of in vivo and in situ optical biopsies, enhancing the speed of bacterial identification. However, the sheer volume of images produced by OEM for real-time analysis poses a significant challenge, potentially delaying critical treatments. Prior approaches to bacteria detection in OEM imagery have relied on unsupervised models. These models are hindered by either the need for manual threshold setting or high computational demands, making real-time analysis unfeasible. To address these challenges, supervised learning methods can be considered, as they have shown superior performance and efficiency in various medical applications. However, supervised learning approaches heavily depend on the availability of vast quantities of accurately labeled data, which is scarce for OEM images. To this end, in this paper we introduce a novel approach to generate synthetic bacteria within OEM image sequences, enabling the use of deep learning techniques. We developed two models to simulate bacterial movement and embedded these models into real, bacteria-free background images. To assess the efficacy of synthetic image sequences, we employed a 3D U-Net for training. The results revealed that the 3D U-Net, when trained on these synthetic sequences, exhibited a 3.86% enhancement in correlation with real annotations over state-of-the-art bacteria detection models.

Automated thorax disease diagnosis using multi-branch residual attention network

Chest X-ray (CXR) is an extensively utilized radiological modality for supporting the diagnosis of chest diseases. However, existing research approaches suffer from limitations in effectively integrating multi-scale CXR image features and are also hindered by imbalanced datasets. Therefore, there is a pressing need for further advancement in computer-aided diagnosis (CAD) of thoracic diseases. To tackle these challenges, we propose a multi-branch residual attention network (MBRANet) for thoracic disease diagnosis. MBRANet comprises three components. Firstly, to address the issue of inadequate extraction of spatial and positional information by the convolutional layer, a novel residual structure incorporating a coordinate attention (CA) module is proposed to extract features at multiple scales. Next, based on the concept of a Feature Pyramid Network (FPN), we perform multi-scale feature fusion in the following manner. Thirdly, we propose a novel Multi-Branch Feature Classifier (MFC) approach, which leverages the class-specific residual attention (CSRA) module for classification instead of relying solely on the fully connected layer. In addition, the designed BCEWithLabelSmoothing loss function improves the generalization ability and mitigates the problem of class imbalance by introducing a smoothing factor. We evaluated MBRANet on the ChestX-Ray14, CheXpert, MIMIC-CXR, and IU X-Ray datasets and achieved average AUCs of 0.841, 0.895, 0.805, and 0.745, respectively. Our method outperformed state-of-the-art baselines on these benchmark datasets.

A deep learning feature extraction-based hybrid approach for detecting pediatric pneumonia in chest X-ray images

Pneumonia is a disease caused by bacteria, viruses, and fungi that settle in the alveolar sacs of the lungs and can lead to serious health complications in humans. Early detection of pneumonia is necessary for early treatment to manage and cure the disease. Recently, machine learning-based pneumonia detection methods have focused on pneumonia in adults. Machine learning relies on manual feature engineering, whereas deep learning can automatically detect and extract features from data. This study proposes a deep learning feature extraction-based hybrid approach that combines deep learning and machine learning to detect pediatric pneumonia, which is difficult to standardize. The proposed hybrid approach enhances the accuracy of detecting pediatric pneumonia and simplifies the approach by eliminating the requirement for advanced feature extraction. The experiments indicate that the hybrid approach using a Medium Neural Network based on AlexNet feature extraction achieved a 97.9% accuracy rate and 98.0% sensitivity rate. The results show that the proposed approach achieved higher accuracy rates than state-of-the-art approaches.

A retrospective longitudinal assessment of artificial intelligence-assisted radiographic prediction of lower third molar eruption

Prediction of lower third molar eruption is crucial for its timely extraction. Therefore, the primary aim of this study was to investigate the prediction of lower third molar eruption and its uprighting with the assistance of an artificial intelligence (AI) tool. The secondary aim was identifying the incidence of fully erupted lower third molars with hygienic cleansability. In total, 771 patients having two panoramic radiographs were recruited, where the first radiograph was acquired at 8-15 years of age (T1) and the second acquisition was between 16 and 23 years (T2). The predictive model for third molar eruption could not be obtained as few teeth reached full eruption. However, uprighting model at T2 showed that in cases with sufficient retromolar space, an initial angulation of < 32° predicted uprighting. Full eruption was observed for 13.9% of the teeth, and only 1.7% showed hygienic cleansability. The predictions model of third molar uprighting could act as a valuable aid for guiding a clinician with the decision-making process of extracting third molars which fail to erupt in an upright fashion. In addition, a low incidence of fully erupted molars with hygienic cleansability suggest that a clinician might opt for prophylactic extraction.

Computer image analysis with artificial intelligence: a practical introduction to convolutional neural networks for medical professionals

Artificial intelligence tools, particularly convolutional neural networks (CNNs), are transforming healthcare by enhancing predictive, diagnostic, and decision-making capabilities. This review provides an accessible and practical explanation of CNNs for clinicians and highlights their relevance in medical image analysis. CNNs have shown themselves to be exceptionally useful in computer vision, a field that enables machines to 'see' and interpret visual data. Understanding how these models work can help clinicians leverage their full potential, especially as artificial intelligence continues to evolve and integrate into healthcare. CNNs have already demonstrated their efficacy in diverse medical fields, including radiology, histopathology, and medical photography. In radiology, CNNs have been used to automate the assessment of conditions such as pneumonia, pulmonary embolism, and rectal cancer. In histopathology, CNNs have been used to assess and classify colorectal polyps, gastric epithelial tumours, as well as assist in the assessment of multiple malignancies. In medical photography, CNNs have been used to assess retinal diseases and skin conditions, and to detect gastric and colorectal polyps during endoscopic procedures. In surgical laparoscopy, they may provide intraoperative assistance to surgeons, helping interpret surgical anatomy and demonstrate safe dissection zones. The integration of CNNs into medical image analysis promises to enhance diagnostic accuracy, streamline workflow efficiency, and expand access to expert-level image analysis, contributing to the ultimate goal of delivering further improvements in patient and healthcare outcomes.

A lightweight CORONA-NET for COVID-19 detection in X-ray images

Since December 2019, COVID-19 has posed the most serious threat to living beings. With the advancement of vaccination programs around the globe, the need to quickly diagnose COVID-19 in general with little logistics is fore important. As a consequence, the fastest diagnostic option to stop COVID-19 from spreading, especially among senior patients, should be the development of an automated detection system. This study aims to provide a lightweight deep learning method that incorporates a convolutional neural network (CNN), discrete wavelet transform (DWT), and a long short-term memory (LSTM), called CORONA-NET for diagnosing COVID-19 from chest X-ray images. In this system, deep feature extraction is performed by CNN, the feature vector is reduced yet strengthened by DWT, and the extracted feature is detected by LSTM for prediction. The dataset included 3000 X-rays, 1000 of which were COVID-19 obtained locally. Within minutes of the test, the proposed test platform's prototype can accurately detect COVID-19 patients. The proposed method achieves state-of-the-art performance in comparison with the existing deep learning methods. We hope that the suggested method will hasten clinical diagnosis and may be used for patients in remote areas where clinical labs are not easily accessible due to a lack of resources, location, or other factors.

An Efficient, Lightweight, Tiny 2D-CNN Ensemble Model to Detect Cardiomegaly in Heart CT Images

Cardiomegaly is a significant global health concern, especially in developing nations. Although advanced clinical care is available for newly diagnosed patients, many in resource-limited regions face late diagnoses and consequent increased mortality. This challenge is accentuated by a scarcity of radiography equipment and radiologists. Hence, we propose the development of a computer-aided diagnostic (CAD) system, specifically a lightweight, tiny 2D-CNN ensemble model, to facilitate early detection and, potentially, reduce mortality rates. Deep learning, with its subset of convolutional neural networks (CNN), has shown potential in visual applications, especially in medical image diagnosis. However, traditional deep CNNs often face compatibility issues with object-oriented human factor technology. Our proposed model aims to bridge this gap. Using CT scan images sourced from the Mendeley data center, our tiny 2D-CNN ensemble learning model achieved an accuracy of 96.32%, offering a promising tool for efficient and accurate cardiomegaly detection.

Convolutional Neural Networks (CNNs) for Pneumonia Classification on Pediatric Chest Radiographs

BACKGROUND

 Pneumonia is an infectious disease that is especially harmful to those with weak immune systems, such as children under the age of 5. While radiologists' diagnosis of pediatric pneumonia on chest radiographs (CXRs) is often accurate, subtle findings can be missed due to the subjective nature of the diagnosis process. Artificial intelligence (AI) techniques, such as convolutional neural networks (CNNs), can help make the process more objective and precise. However, off-the-shelf CNNs may perform poorly if they are not tuned to their appropriate hyperparameters. Our study aimed to identify the CNNs and their hyperparameter combinations (dropout, batch size, and optimizer) that optimize model performance.

METHODOLOGY

 Sixty models based on five CNNs (VGG 16, VGG 19, DenseNet 121, DenseNet 169, and InceptionResNet V2) and 12 hyperparameter combinations were tested. Adam, Root Mean Squared Propagation (RmsProp), and Mini-Batch Stochastic Gradient Descent (SGD) optimizers were used. Two batch sizes, 32 and 64, were utilized. A dropout rate of either 0.5 or 0.7 was used in all dropout layers. We used a deidentified CXR dataset of 4200 pneumonia (Figure 1a) and 1600 normal images (Figure 1b). Seventy percent of the CXRs in the dataset were used for training the model, 20% were used for validating the model, and 10% were used for testing the model. All CNNs were trained first on the ImageNet dataset. They were then trained, with frozen weights, on the CXR-containing dataset.  Results: Among the 60 models, VGG-19 (dropout of 0.5, batch size of 32, and Adam optimizer) was the most accurate. This model achieved an accuracy of 87.9%. A dropout of 0.5 consistently gave higher accuracy, area under the receiver operating characteristics curve (AUROC), and area under the precision-recall curve (AUPRC) compared to a dropout of 0.7. The CNNs InceptionResNet V2, DenseNet 169, VGG 16, and VGG 19 significantly outperformed the DenseNet121 CNN in accuracy and AUROC. The Adam and RmsProp optimizer had improved AUROC and AUPRC compared to the SGD optimizer. The batch size had no statistically significant effect on model performance.

CONCLUSION

 We recommend using low dropout rates (0.5) and RmsProp or Adam optimizer for pneumonia-detecting CNNs. Additionally, we discourage using the DenseNet121 CNN when other CNNs are available. Finally, the batch size may be set to any value, dependent on computational resources.

Joint Diagnosis of Pneumonia, COVID-19, and Tuberculosis from Chest X-ray Images: A Deep Learning Approach

Pneumonia, COVID-19, and tuberculosis are some of the most fatal and common lung diseases in the current era. Several approaches have been proposed in the literature for the diagnosis of individual diseases, since each requires a different feature set altogether, but few studies have been proposed for a joint diagnosis. A patient being diagnosed with one disease as negative may be suffering from the other disease, and vice versa. However, since said diseases are related to the lungs, there might be a likelihood of more than one disease being present in the same patient. In this study, a deep learning model that is able to detect the mentioned diseases from the chest X-ray images of patients is proposed. To evaluate the performance of the proposed model, multiple public datasets have been obtained from Kaggle. Consequently, the proposed model achieved 98.72% accuracy for all classes in general and obtained a recall score of 99.66% for Pneumonia, 99.35% for No-findings, 98.10% for Tuberculosis, and 96.27% for COVID-19, respectively. Furthermore, the model was tested using unseen data from the same augmented dataset and was proven to be better than state-of-the-art studies in the literature in terms of accuracy and other metrics.

Classification of spinal curvature types using radiography images: deep learning versus classical methods

Scoliosis is a spinal abnormality that has two types of curves (C-shaped or S-shaped). The vertebrae of the spine reach an equilibrium at different times, which makes it challenging to detect the type of curves. In addition, it may be challenging to detect curvatures due to observer bias and image quality. This paper aims to evaluate spinal deformity by automatically classifying the type of spine curvature. Automatic spinal curvature classification is performed using SVM and KNN algorithms, and pre-trained Xception and MobileNetV2 networks with SVM as the final activation function to avoid vanishing gradient. Different feature extraction methods should be used to investigate the SVM and KNN machine learning methods in detecting the curvature type. Features are extracted through the representation of radiographic images. These representations are of two groups: (i) Low-level image representation techniques such as texture features and (ii) local patch-based representations such as Bag of Words (BoW). Such features are utilized by various algorithms for classification by SVM and KNN. The feature extraction process is automated in pre-trained deep networks. In this study, 1000 anterior-posterior (AP) radiographic images of the spine were collected as a private dataset from Shafa Hospital, Tehran, Iran. The transfer learning was used due to the relatively small private dataset of anterior-posterior radiology images of the spine. Based on the results of these experiments, pre-trained deep networks were found to be approximately 10% more accurate than classical methods in classifying whether the spinal curvature is C-shaped or S-shaped. As a result of automatic feature extraction, it has been found that the pre-trained Xception and mobilenetV2 networks with SVM as the final activation function for controlling the vanishing gradient perform better than the classical machine learning methods of classification of spinal curvature types.

Automatic lung disease classification from the chest X-ray images using hybrid deep learning algorithm

The chest X-ray images provide vital information about the congestion cost-effectively. We propose a novel Hybrid Deep Learning Algorithm (HDLA) framework for automatic lung disease classification from chest X-ray images. The model consists of steps including pre-processing of chest X-ray images, automatic feature extraction, and detection. In a pre-processing step, our goal is to improve the quality of raw chest X-ray images using the combination of optimal filtering without data loss. The robust Convolutional Neural Network (CNN) is proposed using the pre-trained model for automatic lung feature extraction. We employed the 2D CNN model for the optimum feature extraction in minimum time and space requirements. The proposed 2D CNN model ensures robust feature learning with highly efficient 1D feature estimation from the input pre-processed image. As the extracted 1D features have suffered from significant scale variations, we optimized them using min-max scaling. We classify the CNN features using the different machine learning classifiers such as AdaBoost, Support Vector Machine (SVM), Random Forest (RM), Backpropagation Neural Network (BNN), and Deep Neural Network (DNN). The experimental results claim that the proposed model improves the overall accuracy by 3.1% and reduces the computational complexity by 16.91% compared to state-of-the-art methods.

Review on chest pathogies detection systems using deep learning techniques

Chest radiography is the standard and most affordable way to diagnose, analyze, and examine different thoracic and chest diseases. Typically, the radiograph is examined by an expert radiologist or physician to decide about a particular anomaly, if exists. Moreover, computer-aided methods are used to assist radiologists and make the analysis process accurate, fast, and more automated. A tremendous improvement in automatic chest pathologies detection and analysis can be observed with the emergence of deep learning. The survey aims to review, technically evaluate, and synthesize the different computer-aided chest pathologies detection systems. The state-of-the-art of single and multi-pathologies detection systems, which are published in the last five years, are thoroughly discussed. The taxonomy of image acquisition, dataset preprocessing, feature extraction, and deep learning models are presented. The mathematical concepts related to feature extraction model architectures are discussed. Moreover, the different articles are compared based on their contributions, datasets, methods used, and the results achieved. The article ends with the main findings, current trends, challenges, and future recommendations.

Direct tool for quantitative analysis of cell/object dynamic behavior - metastasis and far beyond

INTRODUCTION

The dynamics and depth of invasion as well as the ability of cancer cells to penetrate the walls of  lymphatic or blood vessels represent critical survival-influencing factors in cancer patients. Depending on the cell type and tissue environment, cancer cell invasion differ in terms of motility mechanism and migration modes. Thus, there is the need of effective models allowing not only for single cell invasion potential assessment but also for collective migration and expansive growth evaluation in 3D microenvironment e.g. basement membranes. To meet this task, the specimens should be compared and analyzed in terms of the dynamics of movement and the evolution of the shape.

OBJECTIVES

Our main objective was development of the mathematical method that enables fast and credible calculation of parameters of shape and position, namely standard deviations (σ_X, σ_Y), centroid position (μ_X, μ_Y) and correlation coefficient ρ, based only on the contour of the aggregate.

METHODS

In order to accomplish this goal we measured geometrical properties of aggregates of RGM1 cells seeded in 3D Geltrex basement membrane. Referential microscopic images were taken 24 and 48 h after seeding and cell group dynamics was registered over 8 h periods using time lapse microscopy.

RESULTS

Based on gathered data, we managed to develop and fully test universal numerical tool allowing for estimation of statistical parameters of cell groups and aggregates which then allows for the precise evaluation of their behavior within microenvironment with time.

CONCLUSION

We conclude, that our tool is suitable for any research on the metastatic potential and motility of cancer cells in a given microenvironment, regardless of the migration mechanism, which together with the advanced analysis like cell single-cell transcriptomic, proteomic, and chromatin accessibility data may allow to identify precise targets for anti-cancer therapies, to predict the degree of malignancy of neoplastic lesions as well as it can be useful during architecting therapeutic strategies. Moreover, the developed tool seems to be broadly applicable for assessment of behavioural dynamics of any population.

The effect of Gaussian noise on pneumonia detection on chest radiographs, using convolutional neural networks

INTRODUCTION

Chest X-rays (CXR) with under-exposure increase image noise and this may affect convolutional neural network (CNN) performance. This study aimed to train and validate CNNs for classifying pneumonia on CXR as normal or pneumonia acquired at different image noise levels.

METHODS

The study used the curated and publicly available "Chest X-Ray Pneumonia" dataset of 5856 AP CXR classified into 1583 normal, 4273 viral and bacterial pneumonia cases. Gaussian noise with zero mean was added to the images, at 5 image noise variance levels, corresponding to decreasing exposure. Each noise-level dataset was split into 80% for training, 10% for validation, and 10% for test data and then classified using custom trained sequential CNN architecture. Six classification tasks were developed for five Gaussian noise levels and the original dataset. Sensitivity, specificity, predictive values and accuracy were used as evaluation performance metrics.

RESULTS

CNN evaluation on the different datasets revealed no performance drop from the original dataset to the five datasets with different noise levels. Sensitivity, specificity and accuracy for the normal datasets were 98.7%, 76.1% and 90.2%. For the five Gaussian noise levels the sensitivity, specificity and accuracy ranged from 96.9% to 98.2%, 94.4%-98.7% and 96.8%-97.6%, respectively. A heat map was used for visual explanation of the CNNs.

CONCLUSION

The CNNs sensitivity maintained, and the specificity increased in distinguishing between normal and pneumonia CXR with the introduction of image noise.

IMPLICATIONS FOR PRACTICE

No performance drops of CNNs in distinguishing cases with and without pneumonia CXR with different Gaussian noise levels was observed. This has potential for decreasing radiation dose to patients or maintaining exposure parameters for patients that require additional radiographs.

ChestX-Ray6: Prediction of multiple diseases including COVID-19 from chest X-ray images using convolutional neural network

In the last few decades, several epidemic diseases have been introduced. In some cases, doctors and medical physicians are facing difficulties in identifying these diseases correctly. A machine can perform some of these identification tasks more accurately than a human if it is trained correctly. With time, the number of medical data is increasing. A machine can analyze this medical data and extract knowledge from this data, which can help doctors and medical physicians. This study proposed a lightweight convolutional neural network (CNN) named ChestX-ray6 that automatically detects pneumonia, COVID19, cardiomegaly, lung opacity, and pleural from digital chest x-ray images. Here multiple databases have been combined, containing 9,514 chest x-ray images of normal and other five diseases. The lightweight ChestX-ray6 model achieved an accuracy of 80% for the detection of six diseases. The ChestX-ray6 model has been saved and used for binary classification of normal and pneumonia patients to reveal the model's generalization power. The pre-trained ChestX-ray6 model has achieved an accuracy and recall of 97.94% and 98% for binary classification, which outweighs the state-of-the-art (SOTA) models.

Stacked ensemble learning based on deep convolutional neural networks for pediatric pneumonia diagnosis using chest X-ray images

Pneumonia is an acute respiratory infection caused by bacteria, viruses, or fungi and has become very common in children ranging from 1 to 5 years of age. Common symptoms of pneumonia include difficulty breathing due to inflamed or pus and fluid-filled alveoli. The United Nations Children's Fund reports nearly 800,000 deaths in children due to pneumonia. Delayed diagnosis and overpriced tests are the prime reason for the high mortality rate, especially in underdeveloped countries. A time and cost-efficient diagnosis tool: Chest X-rays, was thus accepted as the standard diagnostic test for pediatric pneumonia. However, the lower radiation levels for diagnosis in children make the task much more onerous and time-consuming. The mentioned challenges initiate the need for a computer-aided detection model that is instantaneous and accurate. Our work proposes a stacked ensemble learning of deep learning-based features for pediatric pneumonia classification. The extracted features from the global average pooling layer of the fine-tuned Xception model pretrained on ImageNet weights are sent to the Kernel Principal Component Analysis for dimensionality reduction. The dimensionally reduced features are further trained and validated on the stacking classifier. The stacking classifier consists of two stages; the first stage uses the Random-Forest classifier, K-Nearest Neighbors, Logistic Regression, XGB classifier, Support Vector Classifier (SVC), Nu-SVC, and MLP classifier. The second stage operates on Logistic Regression using the first stage predictions for the final classification with Stratified K-fold cross-validation to prevent overfitting. The model was tested on the publicly available pediatric pneumonia dataset, achieving an accuracy of 98.3%, precision of 99.29%, recall of 98.36%, F1-score of 98.83%, and an AUC score of 98.24%. The performance shows its reliability for real-time deployment in assisting radiologists and physicians.

Pediatric pneumonia diagnosis using stacked ensemble learning on multi-model deep CNN architectures

Pediatric pneumonia has drawn immense awareness due to the high mortality rates over recent years. The acute respiratory infection caused by bacteria, viruses, or fungi infects the lung region and hinders oxygen transport, making breathing difficult due to inflamed or pus and fluid-filled alveoli. Being non-invasive and painless, chest X-rays are the most common modality for pediatric pneumonia diagnosis. However, the low radiation levels for diagnosis in children make accurate detection challenging. This challenge initiates the need for an unerring computer-aided diagnosis model. Our work proposes Contrast Limited Adaptive Histogram Equalization for image enhancement and a stacking classifier based on the fusion of deep learning-based features for pediatric pneumonia diagnosis. The extracted features from the global average pooling layers of the fine-tuned MobileNet, DenseNet121, DenseNet169, and DenseNet201 are concatenated for the final classification using a stacked ensemble classifier. The stacking classifier uses Support Vector Classifier, Nu-SVC, Logistic Regression, K-Nearest Neighbor, Random Forest Classifier, Gaussian Naïve Bayes, AdaBoost classifier, Bagging Classifier, and Extra-trees Classifier for the first stage, and Nu-SVC as the meta-classifier. The stacking classifier validated using Stratified K-Fold cross-validation achieves an accuracy of 98.62%, precision of 98.99%, recall of 99.53%, F1 score of 99.26%, and an AUC score of 93.17% on the publicly available pediatric pneumonia dataset. We expect this model to greatly help the real-time diagnosis of pediatric pneumonia.

A framework for identification and classification of liver diseases based on machine learning algorithms

Hepatocellular carcinoma (HCC) is one of the most commonly seen liver disease. Most of HCC patients are diagnosed as Hepatitis B related cirrhosis simultaneously, especially in Asian countries. HCC is the fifth most common cancer and the second most common cause of cancer-related death in the World. HCC incidence rates have been rising in the past 3 decades, and it is expected to be doubled by 2030, if there is no effective means for its early diagnosis and management. The improvement of patient’s care, research, and policy is significantly based on accurate medical diagnosis, especially for malignant tumor patients. However, sometimes it is really difficult to get access to advanced and expensive diagnostic tools such as computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET-CT)., especially for people who resides in poverty-stricken area. Therefore, experts are searching for a framework for predicting of early liver diseases based on basic and simple examinations such as biochemical and routine blood tests, which are easily accessible all around the World. Disease identification and classification has been significantly enhanced by using artificial intelligence (AI) and machine learning (ML) in conjunction with clinical data. The goal of this research is to extract the most significant risk factors or clinical parameters for liver diseases in 525 patients based on clinical experience using machine learning algorithms, such as regularized regression (RR), logistic regression (LR), random forest (RF), decision tree (DT), and extreme gradient boosting (XGBoost). The results showed that RF classier had the best performance (accuracy = 0.762, recall = 0.843, F1-score = 0.775, and AUC = 0.999) among the five ML algorithms. And the important orders of 14 significant risk factors are as follows: Total bilirubin, gamma-glutamyl transferase (GGT), direct bilirubin, hemoglobin, age, platelet, alkaline phosphatase (ALP), aspartate transaminase (AST), creatinine, alanine aminotransferase (ALT), cholesterol, albumin, urea nitrogen, and white blood cells. ML classifiers might aid medical organizations in the early detection and classification of liver disease, which would be beneficial in low-income regions, and the relevance of risk factors would be helpful in the prevention and treatment of liver disease patients.

Chest X-ray analysis empowered with deep learning: A systematic review

Chest radiographs are widely used in the medical domain and at present, chest X-radiation particularly plays an important role in the diagnosis of medical conditions such as pneumonia and COVID-19 disease. The recent developments of deep learning techniques led to a promising performance in medical image classification and prediction tasks. With the availability of chest X-ray datasets and emerging trends in data engineering techniques, there is a growth in recent related publications. Recently, there have been only a few survey papers that addressed chest X-ray classification using deep learning techniques. However, they lack the analysis of the trends of recent studies. This systematic review paper explores and provides a comprehensive analysis of the related studies that have used deep learning techniques to analyze chest X-ray images. We present the state-of-the-art deep learning based pneumonia and COVID-19 detection solutions, trends in recent studies, publicly available datasets, guidance to follow a deep learning process, challenges and potential future research directions in this domain. The discoveries and the conclusions of the reviewed work have been organized in a way that researchers and developers working in the same domain can use this work to support them in taking decisions on their research.

Database and AI Diagnostic Tools Improve Understanding of Lung Damage, Correlation of Pulmonary Disease and Brain Damage in COVID-19

The COVID-19 pandemic caused a sharp increase in the interest in artificial intelligence (AI) as a tool supporting the work of doctors in difficult conditions and providing early detection of the implications of the disease. Recent studies have shown that AI has been successfully applied in the healthcare sector. The objective of this paper is to perform a systematic review to summarize the electroencephalogram (EEG) findings in patients with coronavirus disease (COVID-19) and databases and tools used in artificial intelligence algorithms, supporting the diagnosis and correlation between lung disease and brain damage, and lung damage. Available search tools containing scientific publications, such as PubMed and Google Scholar, were comprehensively evaluated and searched with open databases and tools used in AI algorithms. This work aimed to collect papers from the period of January 2019-May 2022 including in their resources the database from which data necessary for further development of algorithms supporting the diagnosis of the respiratory system can be downloaded and the correlation between lung disease and brain damage can be evaluated. The 10 articles which show the most interesting AI algorithms, trained by using open databases and associated with lung diseases, were included for review with 12 articles related to EEGs, which have/or may be related with lung diseases.

Multiclass Classification for Detection of COVID-19 Infection in Chest X-Rays Using CNN

Coronavirus took the world by surprise and caused a lot of trouble in all the important fields in life. The complexity of dealing with coronavirus lies in the fact that it is highly infectious and is a novel virus which is hard to detect with exact precision. The typical detection method for COVID-19 infection is the RT-PCR but it is a rather expensive method which is also invasive and has a high margin of error. Radiographies are a good alternative for COVID-19 detection given the experience of the radiologist and his learning capabilities. To make an accurate detection from chest X-Rays, deep learning technologies can be involved to analyze the radiographs, learn distinctive patterns of coronavirus' presence, find these patterns in the tested radiograph, and determine whether the sample is actually COVID-19 positive or negative. In this study, we propose a model based on deep learning technology using Convolutional Neural Networks and training it on a dataset containing a total of over 35,000 chest X-Ray images, nearly 16,000 for COVID-19 positive images, 15,000 for normal images, and 5,000 for pneumonia-positive images. The model's performance was assessed in terms of accuracy, precision, recall, and F1-score, and it achieved 99% accuracy, 0.98 precision, 1.02 recall, and 99.0% F1-score, thus outperforming other deep learning models from other studies.

The Use of Chest Radiographs and Machine Learning Model for the Rapid Detection of Pneumonitis in Pediatric

Pneumonia is a common lung disease that is the leading cause of death worldwide. It primarily affects children, accounting for 18% of all deaths in children under the age of five, the elderly, and patients with other diseases. There is a variety of imaging diagnosis techniques available today. While many of them are becoming more accurate, chest radiographs are still the most common method for detecting pulmonary infections due to cost and speed. A convolutional neural network (CNN) model has been developed to classify chest X-rays in JPEG format into normal, bacterial pneumonia, and viral pneumonia. The model was trained using data from an open Kaggle database. The data augmentation technique was used to improve the model's performance. A web application built with NextJS and hosted on AWS has also been designed. The model that was optimized using the data augmentation technique had slightly better precision than the original model. This model was used to create a web application that can process an image and provide a prediction to the user. A classification model was developed that generates a prediction with 78 percent accuracy. The precision of this calculation could be improved by increasing the epoch, among other subjects. With the help of artificial intelligence, this research study was aimed at demonstrating to the general public that deep-learning models can be created to assist health professionals in the early detection of pneumonia.

Pediatric chest radiograph interpretation: how far has artificial intelligence come? A systematic literature review

Most artificial intelligence (AI) studies have focused primarily on adult imaging, with less attention to the unique aspects of pediatric imaging. The objectives of this study were to (1) identify all publicly available pediatric datasets and determine their potential utility and limitations for pediatric AI studies and (2) systematically review the literature to assess the current state of AI in pediatric chest radiograph interpretation. We searched PubMed, Web of Science and Embase to retrieve all studies from 1990 to 2021 that assessed AI for pediatric chest radiograph interpretation and abstracted the datasets used to train and test AI algorithms, approaches and performance metrics. Of 29 publicly available chest radiograph datasets, 2 datasets included solely pediatric chest radiographs, and 7 datasets included pediatric and adult patients. We identified 55 articles that implemented an AI model to interpret pediatric chest radiographs or pediatric and adult chest radiographs. Classification of chest radiographs as pneumonia was the most common application of AI, evaluated in 65% of the studies. Although many studies report high diagnostic accuracy, most algorithms were not validated on external datasets. Most AI studies for pediatric chest radiograph interpretation have focused on a limited number of diseases, and progress is hindered by a lack of large-scale pediatric chest radiograph datasets.

5D Gauss Map Perspective to Image Encryption with Transfer Learning Validation

Encryption of visual data is a requirement of the modern day. This is obvious and greatly required due to widespread use of digital communication mediums, their wide range of applications, and phishing activities. Chaos approaches have been shown to be extremely effective among many encryption methods. However, low-dimensional chaotic schemes are characterized by restricted system components and fundamental structures. As a result, chaotic signal estimation algorithms may be utilized to anticipate system properties and their initial values to breach the security. High-dimensional chaotic maps on the other hand, have exceptional chaotic behavior and complex structure because of increased number of system parameters. Therefore, to overcome the shortcomings of the lower order chaotic map, this paper proposes a 5D Gauss Map for image encryption for the first time. The work presented here is an expansion of the Gauss Map’s current 1D form. The performance of the stated work is evaluated using some of the most important metrics as well as the different attacks in the field. In addition to traditional and well-established metrics such as PSNR, MSE, SSIM, Information Entropy, NPCR, UACI, and Correlation Coefficient that have been used to validate encryption schemes, classification accuracy is also verified using transfer learning. The simulation was done on the MATLAB platform, and the classification accuracy after the encryption-decryption process is compared.

Malignant Bone Tumors Diagnosis Using Magnetic Resonance Imaging Based on Deep Learning Algorithms

Background and Objectives: Malignant bone tumors represent a major problem due to their aggressiveness and low survival rate. One of the determining factors for improving vital and functional prognosis is the shortening of the time between the onset of symptoms and the moment when treatment starts. The objective of the study is to predict the malignancy of a bone tumor from magnetic resonance imaging (MRI) using deep learning algorithms. Materials and Methods: The cohort contained 23 patients in the study (14 women and 9 men with ages between 15 and 80). Two pretrained ResNet50 image classifiers are used to classify T1 and T2 weighted MRI scans. To predict the malignancy of a tumor, a clinical model is used. The model is a feed forward neural network whose inputs are patient clinical data and the output values of T1 and T2 classifiers. Results: For the training step, the accuracies of 93.67% for the T1 classifier and 86.67% for the T2 classifier were obtained. In validation, both classifiers obtained 95.00% accuracy. The clinical model had an accuracy of 80.84% for training phase and 80.56% for validation. The receiver operating characteristic curve (ROC) of the clinical model shows that the algorithm can perform class separation. Conclusions: The proposed method is based on pretrained deep learning classifiers which do not require a manual segmentation of the MRI images. These algorithms can be used to predict the malignancy of a tumor and on the other hand can shorten the time of their diagnosis and treatment process. While the proposed method requires minimal intervention from an imagist, it needs to be tested on a larger cohort of patients.

LungNet22: A Fine-Tuned Model for Multiclass Classification and Prediction of Lung Disease Using X-ray Images

In recent years, lung disease has increased manyfold, causing millions of casualties annually. To combat the crisis, an efficient, reliable, and affordable lung disease diagnosis technique has become indispensable. In this study, a multiclass classification of lung disease from frontal chest X-ray imaging using a fine-tuned CNN model is proposed. The classification is conducted on 10 disease classes of the lungs, namely COVID-19, Effusion, Tuberculosis, Pneumonia, Lung Opacity, Mass, Nodule, Pneumothorax, and Pulmonary Fibrosis, along with the Normal class. The dataset is a collective dataset gathered from multiple sources. After pre-processing and balancing the dataset with eight augmentation techniques, a total of 80,000 X-ray images were fed to the model for classification purposes. Initially, eight pre-trained CNN models, AlexNet, GoogLeNet, InceptionV3, MobileNetV2, VGG16, ResNet 50, DenseNet121, and EfficientNetB7, were employed on the dataset. Among these, the VGG16 achieved the highest accuracy at 92.95%. To further improve the classification accuracy, LungNet22 was constructed upon the primary structure of the VGG16 model. An ablation study was used in the work to determine the different hyper-parameters. Using the Adam Optimizer, the proposed model achieved a commendable accuracy of 98.89%. To verify the performance of the model, several performance matrices, including the ROC curve and the AUC values, were computed as well.

A cad system design based on HybridMultiscale convolutional Mantaray network for pneumonia diagnosis

Pneumonia is one of the diseases that people may encounter in any period of their lives. Recently, researches and developers all around the world are focussing on deep learning and image processing strategies to quicken the pneumonia diagnosis as those strategies are capable of processing numerous X-ray and computed tomography (CT) images. Clinicians need more time and appropriate experiences for making a diagnosis. Hence, a precise, reckless, and less expensive tool to detect pneumonia is necessary. Thus, this research focuses on classifying the pneumonia chest X-ray images by proposing a very efficient stacked approach to improve the image quality and hybridmultiscale convolutional mantaray feature extraction network model with high accuracy. The input dataset is restructured with the sake of a hybrid fuzzy colored and stacking approach. Then the deep feature extraction stage is processed with the aid of stacking dataset by hybrid multiscale feature extraction unit to extract multiple features. Also, the features and network size are diminished by the self-attention module (SAM) based convolutional neural network (CNN). In addition to this, the error in the proposed network model will get reduced with the aid of adaptivemantaray foraging optimization (AMRFO) approach. Finally, the support vector regression (SVR) is suggested to classify the presence of pneumonia. The proposed module has been compared with existing technique to prove the overall efficiency of the system. The huge collection of chest X-ray images from the kaggle dataset was emphasized to validate the proposed work. The experimental results reveal an outstanding performance of accuracy (97%), precision (95%) and f-score (96%) progressively.

Deep GRU-CNN Model for COVID-19 Detection From Chest X-Rays Data

In the current era, data is growing exponentially due to advancements in smart devices. Data scientists apply a variety of learning-based techniques to identify underlying patterns in the medical data to address various health-related issues. In this context, automated disease detection has now become a central concern in medical science. Such approaches can reduce the mortality rate through accurate and timely diagnosis. COVID-19 is a modern virus that has spread all over the world and is affecting millions of people. Many countries are facing a shortage of testing kits, vaccines, and other resources due to significant and rapid growth in cases. In order to accelerate the testing process, scientists around the world have sought to create novel methods for the detection of the virus. In this paper, we propose a hybrid deep learning model based on a convolutional neural network (CNN) and gated recurrent unit (GRU) to detect the viral disease from chest X-rays (CXRs). In the proposed model, a CNN is used to extract features, and a GRU is used as a classifier. The model has been trained on 424 CXR images with 3 classes (COVID-19, Pneumonia, and Normal). The proposed model achieves encouraging results of 0.96, 0.96, and 0.95 in terms of precision, recall, and f1-score, respectively. These findings indicate how deep learning can significantly contribute to the early detection of COVID-19 in patients through the analysis of X-ray scans. Such indications can pave the way to mitigate the impact of the disease. We believe that this model can be an effective tool for medical practitioners for early diagnosis.

Deep GRU-CNN Model for COVID-19 Detection From Chest X-Rays Data

In the current era, data is growing exponentially due to advancements in smart devices. Data scientists apply a variety of learning-based techniques to identify underlying patterns in the medical data to address various health-related issues. In this context, automated disease detection has now become a central concern in medical science. Such approaches can reduce the mortality rate through accurate and timely diagnosis. COVID-19 is a modern virus that has spread all over the world and is affecting millions of people. Many countries are facing a shortage of testing kits, vaccines, and other resources due to significant and rapid growth in cases. In order to accelerate the testing process, scientists around the world have sought to create novel methods for the detection of the virus. In this paper, we propose a hybrid deep learning model based on a convolutional neural network (CNN) and gated recurrent unit (GRU) to detect the viral disease from chest X-rays (CXRs). In the proposed model, a CNN is used to extract features, and a GRU is used as a classifier. The model has been trained on 424 CXR images with 3 classes (COVID-19, Pneumonia, and Normal). The proposed model achieves encouraging results of 0.96, 0.96, and 0.95 in terms of precision, recall, and f1-score, respectively. These findings indicate how deep learning can significantly contribute to the early detection of COVID-19 in patients through the analysis of X-ray scans. Such indications can pave the way to mitigate the impact of the disease. We believe that this model can be an effective tool for medical practitioners for early diagnosis.

Wearable technology to inform the prediction and diagnosis of cardiorespiratory events: a scoping review

BACKGROUND

The need for health systems that allow for continuous monitoring and early adverse event detection in individuals outside of the acute care setting has been highlighted by the global rise in chronic cardiorespiratory diseases and the recent COVID-19 pandemic. Currently, it is unclear what type of evidence exists concerning the use of physiological data collected from commercially available wrist and textile wearables to assist in clinical decision making. The aim of this review was therefore to systematically map and summarize the scientific literature surrounding the use of these wearables in clinical decision making as well as identify knowledge gaps to inform further research.

METHODOLOGY

Six electronic bibliographic databases were systematically searched (Ovid MEDLINE, EMBASE, CINAHL, PubMed, Scopus, and SportsDiscus). Publications from database inception to May 6, 2020 were reviewed for inclusion. Non-indexed literature relevant to this review was also searched systematically. Results were then collated, summarized and reported.

RESULTS

A total of 107 citations were retrieved and assessed for eligibility with 31 citations included in the final analysis. A review of the 31 papers revealed three major study designs which included (1) observational studies (n = 19), (2) case control series and reports (n = 8), and (3) reviews (n = 2). All papers examined the use of wearable monitoring devices for clinical decisions in the cardiovascular domain, with cardiac arrhythmias being the most studied. When compared to electrocardiogram (ECG) the performance of the wearables in facilitating clinical decisions varied depending upon the type of wearable, user's activity levels and setting in which they were employed. Observational studies collecting data in the inpatient and outpatient settings were equally represented. Eight case control series and reports were identified which reported on the use of wrist wearables in patients presenting to an emergency department or clinic to aid in the clinical diagnosis of a cardiovascular event. Two narrative reviews were identified which examined the impact of wearable devices in monitoring cardiovascular disease as well as potential challenges they may pose in the future.

CONCLUSIONS

To date, studies employing wearables to facilitate clinical decisions have largely focused upon the cardiovascular domain. Despite the ability of some wearables to collect physiological data accurately, there remains a need for a specialist physician to retrospectively review the raw data to make a definitive diagnosis. Analysis of the results has also highlighted gaps in the literature such as the absence of studies employing wearables to facilitate clinical decisions in the respiratory domain. The disproportionate study of wearables in atrial fibrillation detection in comparison to other cardiac arrhythmias and conditions, as well as the lack of diversity in the sample populations used prevents the generalizability of results.

Deep learning computer-aided detection system for pneumonia in febrile neutropenia patients: a diagnostic cohort study

Background

Diagnosis of pneumonia is critical in managing patients with febrile neutropenia (FN), however, chest X-ray (CXR) has limited performance in the detection of pneumonia. We aimed to evaluate the performance of a deep learning-based computer-aided detection (CAD) system in pneumonia detection in the CXRs of consecutive FN patients and investigated whether CAD could improve radiologists’ diagnostic performance when used as a second reader.

Methods

CXRs of patients with FN (a body temperature ≥ 38.3 °C, or a sustained body temperature ≥ 38.0 °C for an hour; absolute neutrophil count < 500/mm³) obtained between January and December 2017 were consecutively included, from a single tertiary referral hospital. Reference standards for the diagnosis of pneumonia were defined by consensus of two thoracic radiologists after reviewing medical records and CXRs. A commercialized, deep learning-based CAD system was retrospectively applied to detect pulmonary infiltrates on CXRs. For comparing performance, five radiologists independently interpreted CXRs initially without the CAD results (radiologist-alone interpretation), followed by the interpretation with CAD. The sensitivities and specificities for detection of pneumonia were compared between radiologist-alone interpretation and interpretation with CAD. The standalone performance of the CAD was also evaluated, using area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. Moreover, sensitivity and specificity of standalone CAD were compared with those of radiologist-alone interpretation.

Results

Among 525 CXRs from 413 patients (52.3% men; median age 59 years), pneumonia was diagnosed in 128 (24.4%) CXRs. In the interpretation with CAD, average sensitivity of radiologists was significantly improved (75.4% to 79.4%, P = 0.003) while their specificity remained similar (75.4% to 76.8%, P = 0.101), compared to radiologist-alone interpretation. The CAD exhibited AUC, sensitivity, and specificity of 0.895, 88.3%, and 68.3%, respectively. The standalone CAD exhibited higher sensitivity (86.6% vs. 75.2%, P < 0.001) and lower specificity (64.8% vs. 75.4%, P < 0.001) compared to radiologist-alone interpretation.

Conclusions

In patients with FN, the deep learning-based CAD system exhibited radiologist-level performance in detecting pneumonia on CXRs and enhanced radiologists’ performance.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12890-021-01768-0.

Based on improved deep convolutional neural network model pneumonia image classification

Pneumonia remains the leading infectious cause of death in children under the age of five, killing about 700,000 children each year and affecting 7% of the world's population. X-ray images of lung become the key to the diagnosis of this disease, skilled doctors in the diagnosis of a certain degree of subjectivity, if the use of computer-aided medical diagnosis to automatically detect lung abnormalities, will improve the accuracy of diagnosis. This research aims to introduce a deep learning technology based on the combination of Xception neural network and long-term short-term memory (LSTM), which can realize automatic diagnosis of patients with pneumonia in X-ray images. First, the model uses the Xception network to extract the deep features of the data, passes the extracted features to the LSTM, and then the LSTM detects the extracted features, and finally selects the most needed features. Secondly, in the training set samples, the traditional cross-entropy loss cannot more balance the mismatch between categories. Therefore, this research combines Pearson's feature selection ideas, fusion of the correlation between the two loss functions, and optimizes the problem. The experimental results show that the accuracy rate of this paper is 96%, the receiver operator characteristic curve accuracy rate is 99%, the precision rate is 98%, the recall rate is 91%, and the F1 score accuracy rate is 94%. Compared with the existing technical methods, the research has achieved expected results on the currently available datasets. And assist doctors to provide higher reliability in the classification task of childhood pneumonia.

Weakly supervised pneumonia localization in chest X-rays using generative adversarial networks

PURPOSE

Automatic localization of pneumonia on chest X-rays (CXRs) is highly desirable both as an interpretive aid to the radiologist and for timely diagnosis of the disease. However, pneumonia's amorphous appearance on CXRs and complexity of normal anatomy in the chest present key challenges that hinder accurate localization. Existing studies in this area are either not optimized to preserve spatial information of abnormality or depend on expensive expert-annotated bounding boxes. We present a novel generative adversarial network (GAN)-based machine learning approach for this problem, which is weakly supervised (does not require any location annotations), was trained to retain spatial information, and can produce pixel-wise abnormality maps highlighting regions of abnormality (as opposed to bounding boxes around abnormality).

METHODS

Our method is based on the Wasserstein GAN framework and, to the best of our knowledge, the first application of GANs to this problem. Specifically, from an abnormal CXR as input, we generated the corresponding pseudo normal CXR image as output. The pseudo normal CXR is the "hypothetical" normal, if the same abnormal CXR were not to have any abnormalities. We surmise that the difference between the pseudo normal and the abnormal CXR highlights the pixels suspected to have pneumonia and hence is our output abnormality map. We trained our algorithm on an "unpaired" data set of abnormal and normal CXRs and did not require any location annotations such as bounding boxes/segmentations of abnormal regions. Furthermore, we incorporated additional prior knowledge/constraints into the model and showed that they help improve localization performance. We validated the model on a data set consisting of 14 184 CXRs from the Radiological Society of North America pneumonia detection challenge.

RESULTS

We evaluated our methods by comparing the generated abnormality maps with radiologist annotated bounding boxes using receiver operating characteristic (ROC) analysis, image similarity metrics such as normalized cross-correlation/mutual information, and abnormality detection rate.We also present visual examples of the abnormality maps, covering various scenarios of abnormality occurrence. Results demonstrate the ability to highlight regions of abnormality with the best method achieving an ROC area under the curve (AUC) of 0.77 and a detection rate of 85%.The GAN tended to perform better as prior knowledge/constraints were incorporated into the model.

CONCLUSIONS

We presented a novel GAN based approach for localizing pneumonia on CXRs that (1) does not require expensive hand annotated location ground truth; and (2) was trained to produce abnormality maps at the pixel level as opposed to bounding boxes. We demonstrated the efficacy of our methods via quantitative and qualitative results.

Limited generalizability of deep learning algorithm for pediatric pneumonia classification on external data

Purpose

(1) Develop a deep learning system (DLS) to identify pneumonia in pediatric chest radiographs, and (2) evaluate its generalizability by comparing its performance on internal versus external test datasets.

Methods

Radiographs of patients between 1 and 5 years old from the Guangzhou Women and Children’s Medical Center (Guangzhou dataset) and NIH ChestXray14 dataset were included. We utilized 5232 radiographs from the Guangzhou dataset to train a ResNet-50 deep convolutional neural network (DCNN) to identify pediatric pneumonia. DCNN testing was performed on a holdout set of 624 radiographs from the Guangzhou dataset (internal test set) and 383 radiographs from the NIH ChestXray14 dataset (external test set). Receiver operating characteristic curves were generated, and area under the curve (AUC) was compared via DeLong parametric method. Colored heatmaps were generated using class activation mapping (CAM) to identify important image pixels for DCNN decision-making.

Results

The DCNN achieved AUC of 0.95 and 0.54 for identifying pneumonia on internal and external test sets, respectively (p < 0.0001). Heatmaps generated by the DCNN showed the algorithm focused on clinically relevant features for images from the internal test set, but not for images from the external test set.

Conclusion

Our model had high performance when tested on an internal dataset but significantly lower accuracy when tested on an external dataset. Likewise, marked differences existed in the clinical relevance of features highlighted by heatmaps generated from internal versus external datasets. This study underscores potential limitations in the generalizability of such DLS models.

A Self-Activated CNN Approach for Multi-Class Chest-Related COVID-19 Detection

Chest diseases can be dangerous and deadly. They include many chest infections such as pneumonia, asthma, edema, and, lately, COVID-19. COVID-19 has many similar symptoms compared to pneumonia, such as breathing hardness and chest burden. However, it is a challenging task to differentiate COVID-19 from other chest diseases. Several related studies proposed a computer-aided COVID-19 detection system for the single-class COVID-19 detection, which may be misleading due to similar symptoms of other chest diseases. This paper proposes a framework for the detection of 15 types of chest diseases, including the COVID-19 disease, via a chest X-ray modality. Two-way classification is performed in proposed Framework. First, a deep learning-based convolutional neural network (CNN) architecture with a soft-max classifier is proposed. Second, transfer learning is applied using fully-connected layer of proposed CNN that extracted deep features. The deep features are fed to the classical Machine Learning (ML) classification methods. However, the proposed framework improves the accuracy for COVID-19 detection and increases the predictability rates for other chest diseases. The experimental results show that the proposed framework, when compared to other state-of-the-art models for diagnosing COVID-19 and other chest diseases, is more robust, and the results are promising.

Detection and classification of lung diseases for pneumonia and Covid-19 using machine and deep learning techniques

Since the arrival of the novel Covid-19, several types of researches have been initiated for its accurate prediction across the world. The earlier lung disease pneumonia is closely related to Covid-19, as several patients died due to high chest congestion (pneumonic condition). It is challenging to differentiate Covid-19 and pneumonia lung diseases for medical experts. The chest X-ray imaging is the most reliable method for lung disease prediction. In this paper, we propose a novel framework for the lung disease predictions like pneumonia and Covid-19 from the chest X-ray images of patients. The framework consists of dataset acquisition, image quality enhancement, adaptive and accurate region of interest (ROI) estimation, features extraction, and disease anticipation. In dataset acquisition, we have used two publically available chest X-ray image datasets. As the image quality degraded while taking X-ray, we have applied the image quality enhancement using median filtering followed by histogram equalization. For accurate ROI extraction of chest regions, we have designed a modified region growing technique that consists of dynamic region selection based on pixel intensity values and morphological operations. For accurate detection of diseases, robust set of features plays a vital role. We have extracted visual, shape, texture, and intensity features from each ROI image followed by normalization. For normalization, we formulated a robust technique to enhance the detection and classification results. Soft computing methods such as artificial neural network (ANN), support vector machine (SVM), K-nearest neighbour (KNN), ensemble classifier, and deep learning classifier are used for classification. For accurate detection of lung disease, deep learning architecture has been proposed using recurrent neural network (RNN) with long short-term memory (LSTM). Experimental results show the robustness and efficiency of the proposed model in comparison to the existing state-of-the-art methods.

Bayesian convolutional neural network estimation for pediatric pneumonia detection and diagnosis

BACKGROUND AND OBJECTIVES

Pneumonia is a disease that affects the lungs, making breathing difficult. Nowadays, pneumonia is the disease that kills the most children under the age of five in the world, and if no action is taken, pneumonia is estimated to kill 11 million children by the year 2030. Knowing that rapid and accurate diagnosis of pneumonia is a significant factor in reducing mortality, acceleration, or automation of the diagnostic process is highly desirable. The use of computational methods can decrease specialists' workload and even offer a second opinion, increasing the number of accurate diagnostics.

METHODS

This work proposes a method for constructing a specific convolutional neural network architecture to detect pneumonia and classify viral and bacterial types using Bayesian optimization from pre-trained networks.

RESULTS

The results obtained are promising, in the order of 0.964 accuracy for pneumonia detection and 0.957 accuracy for pneumonia type classification.

CONCLUSION

This research demonstrated the efficiency of CNN architecture estimation for detecting and diagnosing pneumonia using Bayesian optimization. The proposed network proved to have promising results, despite not using common preprocessing techniques such as histogram equalization and lung segmentation. This fact shows that the proposed method provides efficient and high-performance neural networks since image preprocessing is unnecessary.

S-CCCapsule: Pneumonia detection in chest X-ray images using skip-connected convolutions and capsule neural network

The squash function in capsule networks (CapsNets) dynamic routing is less capable of performing discrimination of non-informative capsules which leads to abnormal activation value distribution of capsules. In this paper, we propose vertical squash (VSquash) to improve the original squash by preventing the activation values of capsules in the primary capsule layer to shrink non-informative capsules, promote discriminative capsules and avoid high information sensitivity. Furthermore, a new neural network, (i) skip-connected convolutional capsule (S-CCCapsule), (ii) Integrated skip-connected convolutional capsules (ISCC) and (iii) Ensemble skip-connected convolutional capsules (ESCC) based on CapsNets are presented where the VSquash is applied in the dynamic routing. In order to achieve uniform distribution of coupling coefficient of probabilities between capsules, we use the Sigmoid function rather than Softmax function. Experiments on Guangzhou Women and Children’s Medical Center (GWCMC), Radiological Society of North America (RSNA) and Mendeley CXR Pneumonia datasets were performed to validate the effectiveness of our proposed methods. We found that our proposed methods produce better accuracy compared to other methods based on model evaluation metrics such as confusion matrix, sensitivity, specificity and Area under the curve (AUC). Our method for pneumonia detection performs better than practicing radiologists. It minimizes human error and reduces diagnosis time.