IoMT-Enabled Computer-Aided Diagnosis of Pulmonary Embolism from Computed Tomography Scans Using Deep Learning

Applications of Artificial Intelligence in Acute Thoracic Imaging

The applications of artificial intelligence (AI) in radiology are rapidly advancing with AI algorithms being used in a wide range of disease pathologies and clinical settings. Acute thoracic pathologies including rib fractures, pneumothoraces, and acute PE are associated with significant morbidity and mortality and their identification is crucial for prompt treatment. AI models which increase diagnostic accuracy, improve radiologist efficiency and reduce time to diagnosis of acute abnormalities in the thorax have the potential to significantly improve patient outcomes. The purpose of this review is to summarize the current applications of AI in acute thoracic imaging, highlighting their strengths, limitations, and future research opportunities.

Advancements in Machine Learning and Artificial Intelligence in the Radiological Detection of Pulmonary Embolism

Pulmonary embolism (PE) is a clinically challenging diagnosis that varies from silent to life-threatening symptoms. Timely diagnosis of the condition is subject to clinical assessment, D-dimer testing and radiological imaging. Computed tomography pulmonary angiogram (CTPA) is considered the gold standard imaging modality, although some cases can be missed due to reader dependency, resulting in adverse patient outcomes. Hence, it is crucial to implement faster and precise diagnostic strategies to help clinicians diagnose and treat PE patients promptly and mitigate morbidity and mortality. Machine learning (ML) and artificial intelligence (AI) are the newly emerging tools in the medical field, including in radiological imaging, potentially improving diagnostic efficacy. Our review of the studies showed that computer-aided design (CAD) and AI tools displayed similar to superior sensitivity and specificity in identifying PE on CTPA as compared to radiologists. Several tools demonstrated the potential in identifying minor PE on radiological scans showing promising ability to aid clinicians in reducing missed cases substantially. However, it is imperative to design sophisticated tools and conduct large clinical trials to integrate AI use in everyday clinical setting and establish guidelines for its ethical applicability. ML and AI can also potentially help physicians in formulating individualized management strategies to enhance patient outcomes.

SPE-YOLO: A deep learning model focusing on small pulmonary embolism detection

OBJECTIVES

By developing the deep learning model SPE-YOLO, the detection of small pulmonary embolism has been improved, leading to more accurate identification of this condition. This advancement aims to better serve medical diagnosis and treatment.

METHODS

This retrospective study analyzed images of 142 patients from Tianjin Medical University General Hospital using YOLOv8 as the foundational framework. Firstly, a small detection head P2 was added to better capture and identify small targets. Secondly, the SEAttention mechanism was integrated into the model to enhance focus on crucial features and optimize detection accuracy. Lastly, the feature extraction process was refined by introducing ODConv convolution to capture more comprehensive contextual information, thereby enhancing the detection performance of small pulmonary embolisms. The model's practical application ability was evaluated using 2000 cases from the RSNA dataset as an external test set.

RESULTS

In the Tianjin test set, our model achieved a precision of 84.20 % and an accuracy of 81.50 %. This represents an improvement of approximately 5 % and 4 % respectively compared to the original YOLOv8. F1 scores, recall rates and average accuracy have also increased by 4 %, 5 %, 6 %, respectively. In data from the external validation set of RSNA, SPE-YOLO exhibited its effectiveness with a sensitivity of 90.70 % and an accuracy of 86.45 %.

CONCLUSION

The SPE-YOLO algorithm demonstrates strong capability in identifying small pulmonary embolisms, offering clinicians a more accurate and efficient diagnostic tool. This advancement is expected to enhance the quality of pulmonary embolism diagnosis and support the progress of medical services.

Revolutionizing healthcare: a comparative insight into deep learning's role in medical imaging

Recently, Deep Learning (DL) models have shown promising accuracy in analysis of medical images. Alzeheimer Disease (AD), a prevalent form of dementia, uses Magnetic Resonance Imaging (MRI) scans, which is then analysed via DL models. To address the model computational constraints, Cloud Computing (CC) is integrated to operate with the DL models. Recent articles on DL-based MRI have not discussed datasets specific to different diseases, which makes it difficult to build the specific DL model. Thus, the article systematically explores a tutorial approach, where we first discuss a classification taxonomy of medical imaging datasets. Next, we present a case-study on AD MRI classification using the DL methods. We analyse three distinct models-Convolutional Neural Networks (CNN), Visual Geometry Group 16 (VGG-16), and an ensemble approach-for classification and predictive outcomes. In addition, we designed a novel framework that offers insight into how various layers interact with the dataset. Our architecture comprises an input layer, a cloud-based layer responsible for preprocessing and model execution, and a diagnostic layer that issues alerts after successful classification and prediction. According to our simulations, CNN outperformed other models with a test accuracy of 99.285%, followed by VGG-16 with 85.113%, while the ensemble model lagged with a disappointing test accuracy of 79.192%. Our cloud Computing framework serves as an efficient mechanism for medical image processing while safeguarding patient confidentiality and data privacy.

CNN-Based Kidney Segmentation Using a Modified CLAHE Algorithm

This paper presents an enhanced approach to kidney segmentation using a modified CLAHE preprocessing method, aimed at improving image clarity and CNN performance on the KiTS19 dataset. To assess the impact of the modified CLAHE method, we conducted quality evaluations using the BRISQUE metric, comparing the original, standard CLAHE and modified CLAHE versions of the dataset. The BRISQUE score decreased from 28.8 in the original dataset to 21.1 with the modified CLAHE method, indicating a significant improvement in image quality. Furthermore, CNN segmentation accuracy rose from 0.951 with the original dataset to 0.996 with the modified CLAHE method, outperforming the accuracy achieved with standard CLAHE preprocessing (0.969). These results highlight the benefits of the modified CLAHE method in refining image quality and enhancing segmentation performance. This study highlights the value of adaptive preprocessing in medical imaging workflows and shows that CNN-based kidney segmentation accuracy may be greatly increased by altering conventional CLAHE. Our method provides insightful information on optimizing preprocessing for medical imaging applications, leading to more accurate and dependable segmentation results for better clinical diagnosis.

NeuroHealth guardian: A novel hybrid approach for precision brain stroke prediction and healthcare analytics

Stroke is a severe illness, that requires early stroke detection and intervention, as this would help prevent the worsening of the condition. The research is done to solve stroke prediction problem, which may be divided into a number of sub-problems such as an individual's predisposition to develop stroke. To attain this objective, a multiturn dataset consisting of various health features, such as age, gender, hypertension, and glucose levels, takes a central role. A multiple approach was put forward concentrating on integrating the machine learning techniques, such as Logistic Regression, Naive Bayes, K-Nearest Neighbors, and Support Vector Machine (SV), together to develop an ensemble machine called Neuro-Health Guardian. The hypothesis "Neuro-Health Guardian Model" integrates these algorithms into one, purported to make stroke prediction more accurate. The topic dives into each instance of preparation of data for analysis, data visualization techniques, selection of the right model, training, testing, ensembling, evaluation, and prediction. The models are validated with error rate accounted from their accuracy, precision, recall, F1 score, and finally confusion matrices for a look. The study's result is showing that the ensemble model that combines the multiple algorithms has the edge over them and this is evidently by the fact that it can predict stroke rises. Additionally, accuracy, precision, recall, and F1 scores are measured in all models and the comparison is done to provide a clear comparison of the models' performance. In short, the article presented the formation of the ongoing stroke prediction that revealed the ensemble model as a good anticipation. Precise stroke predisposition forecasting can assist in early intervention thereby preventing stroke-related deaths, and limiting disability burden by stroke. The conclusions that have come out of this study offer a great action item for the development of predictive models related to stroke prevention and treatment.

Enhancing Automated Brain Tumor Detection Accuracy Using Artificial Intelligence Approaches for Healthcare Environments

Medical imaging and deep learning models are essential to the early identification and diagnosis of brain cancers, facilitating timely intervention and improving patient outcomes. This research paper investigates the integration of YOLOv5, a state-of-the-art object detection framework, with non-local neural networks (NLNNs) to improve brain tumor detection's robustness and accuracy. This study begins by curating a comprehensive dataset comprising brain MRI scans from various sources. To facilitate effective fusion, the YOLOv5 and NLNNs, K-means+, and spatial pyramid pooling fast+ (SPPF+) modules are integrated within a unified framework. The brain tumor dataset is used to refine the YOLOv5 model through the application of transfer learning techniques, adapting it specifically to the task of tumor detection. The results indicate that the combination of YOLOv5 and other modules results in enhanced detection capabilities in comparison to the utilization of YOLOv5 exclusively, proving recall rates of 86% and 83% respectively. Moreover, the research explores the interpretability aspect of the combined model. By visualizing the attention maps generated by the NLNNs module, the regions of interest associated with tumor presence are highlighted, aiding in the understanding and validation of the decision-making procedure of the methodology. Additionally, the impact of hyperparameters, such as NLNNs kernel size, fusion strategy, and training data augmentation, is investigated to optimize the performance of the combined model.

Modern imaging of acute pulmonary embolism

The first-choice imaging test for visualization of thromboemboli in the pulmonary vasculature in patients with suspected acute pulmonary embolism (PE) is multidetector computed tomography pulmonary angiography (CTPA) - a readily available and widely used imaging technique. Through technological advancements over the past years, alternative imaging techniques for the diagnosis of PE have become available, whilst others are still under investigation. In particular, the evolution of artificial intelligence (AI) is expected to enable further innovation in diagnostic management of PE. In this narrative review, current CTPA techniques and the emerging technology photon-counting CT (PCCT), as well as other modern imaging techniques of acute PE are discussed, including CTPA with iodine maps based on subtraction or dual-energy acquisition, single-photon emission CT (SPECT), magnetic resonance angiography (MRA), and magnetic resonance direct thrombus imaging (MRDTI). Furthermore, potential applications of AI are discussed.

An Enhanced Mask R-CNN Approach for Pulmonary Embolism Detection and Segmentation

Pulmonary embolism (PE) refers to the occlusion of pulmonary arteries by blood clots, posing a mortality risk of approximately 30%. The detection of pulmonary embolism within segmental arteries presents greater challenges compared with larger arteries and is frequently overlooked. In this study, we developed a computational method to automatically identify pulmonary embolism within segmental arteries using computed tomography (CT) images. The system architecture incorporates an enhanced Mask R-CNN deep neural network trained on PE-containing images. This network accurately localizes pulmonary embolisms in CT images and effectively delineates their boundaries. This study involved creating a local data set and evaluating the model predictions against pulmonary embolisms manually identified by expert radiologists. The sensitivity, specificity, accuracy, Dice coefficient, and Jaccard index values were obtained as 96.2%, 93.4%, 96.%, 0.95, and 0.89, respectively. The enhanced Mask R-CNN model outperformed the traditional Mask R-CNN and U-Net models. This study underscores the influence of Mask R-CNN's loss function on model performance, providing a basis for the potential improvement of Mask R-CNN models for object detection and segmentation tasks in CT images.

A Deep Auto-Optimized Collaborative Learning (DACL) model for disease prognosis using AI-IoMT systems

In modern healthcare, integrating Artificial Intelligence (AI) and Internet of Medical Things (IoMT) is highly beneficial and has made it possible to effectively control disease using networks of interconnected sensors worn by individuals. The purpose of this work is to develop an AI-IoMT framework for identifying several of chronic diseases form the patients' medical record. For that, the Deep Auto-Optimized Collaborative Learning (DACL) Model, a brand-new AI-IoMT framework, has been developed for rapid diagnosis of chronic diseases like heart disease, diabetes, and stroke. Then, a Deep Auto-Encoder Model (DAEM) is used in the proposed framework to formulate the imputed and preprocessed data by determining the fields of characteristics or information that are lacking. To speed up classification training and testing, the Golden Flower Search (GFS) approach is then utilized to choose the best features from the imputed data. In addition, the cutting-edge Collaborative Bias Integrated GAN (ColBGaN) model has been created for precisely recognizing and classifying the types of chronic diseases from the medical records of patients. The loss function is optimally estimated during classification using the Water Drop Optimization (WDO) technique, reducing the classifier's error rate. Using some of the well-known benchmarking datasets and performance measures, the proposed DACL's effectiveness and efficiency in identifying diseases is evaluated and compared.

A systematic review of artificial intelligence tools for chronic pulmonary embolism on CT pulmonary angiography

Background

Chronic pulmonary embolism (PE) may result in pulmonary hypertension (CTEPH). Automated CT pulmonary angiography (CTPA) interpretation using artificial intelligence (AI) tools has the potential for improving diagnostic accuracy, reducing delays to diagnosis and yielding novel information of clinical value in CTEPH. This systematic review aimed to identify and appraise existing studies presenting AI tools for CTPA in the context of chronic PE and CTEPH.

Methods

MEDLINE and EMBASE databases were searched on 11 September 2023. Journal publications presenting AI tools for CTPA in patients with chronic PE or CTEPH were eligible for inclusion. Information about model design, training and testing was extracted. Study quality was assessed using compliance with the Checklist for Artificial Intelligence in Medical Imaging (CLAIM).

Results

Five studies were eligible for inclusion, all of which presented deep learning AI models to evaluate PE. First study evaluated the lung parenchymal changes in chronic PE and two studies used an AI model to classify PE, with none directly assessing the pulmonary arteries. In addition, a separate study developed a CNN tool to distinguish chronic PE using 2D maximum intensity projection reconstructions. While another study assessed a novel automated approach to quantify hypoperfusion to help in the severity assessment of CTEPH. While descriptions of model design and training were reliable, descriptions of the datasets used in training and testing were more inconsistent.

Conclusion

In contrast to AI tools for evaluation of acute PE, there has been limited investigation of AI-based approaches to characterising chronic PE and CTEPH on CTPA. Existing studies are limited by inconsistent reporting of the data used to train and test their models. This systematic review highlights an area of potential expansion for the field of AI in medical image interpretation.There is limited knowledge of A systematic review of artificial intelligence tools for chronic pulmonary embolism in CT. This systematic review provides an assessment on research that examined deep learning algorithms in detecting CTEPH on CTPA images, the number of studies assessing the utility of deep learning on CTPA in CTEPH was unclear and should be highlighted.

Angiogenesis signaling in endometriosis: Molecules, diagnosis and treatment (Review)

Endometriosis (EM) is one of the most common diseases among women of reproductive age. The etiology and pathogenesis of EM remain unclear and therefore there is a lack of effective treatment measures, which affects physical and mental health, as well as the quality of life of patients with EM. Angiogenesis has become a hotspot for research on the pathogenesis of EM; the role of angiogenesis‑related serological markers and anti‑angiogenic therapy in the diagnosis and treatment of EM is promising for early diagnosis and treatment of EM. Angiogenesis in EM is subject to complex regulation by hormones, immunity and associated cytokines. Therefore, novel targets for angiogenesis therapy are also being discovered and developed. The present review summarized the pathological mechanisms of angiogenesis and the value of relevant markers in pathogenesis and diagnosis of EM, along with the status of research on anti‑angiogenic drugs in the treatment of EM. The role of angiogenesis in EM provides an important reference for treatment and diagnosis, but there is no uniform non‑invasive diagnostic marker and proven strategy for anti‑angiogenesis.

Al-Atawi A, Alwageed HS, Mehmood G, Khan F, Innab N. Detection of renal cell hydronephrosis in ultrasound kidney images: a study on the efficacy of deep convolutional neural networks

In the realm of medical imaging, the early detection of kidney issues, particularly renal cell hydronephrosis, holds immense importance. Traditionally, the identification of such conditions within ultrasound images has relied on manual analysis, a labor-intensive and error-prone process. However, in recent years, the emergence of deep learning-based algorithms has paved the way for automation in this domain. This study aims to harness the power of deep learning models to autonomously detect renal cell hydronephrosis in ultrasound images taken in close proximity to the kidneys. State-of-the-art architectures, including VGG16, ResNet50, InceptionV3, and the innovative Novel DCNN, were put to the test and subjected to rigorous comparisons. The performance of each model was meticulously evaluated, employing metrics such as F1 score, accuracy, precision, and recall. The results paint a compelling picture. The Novel DCNN model outshines its peers, boasting an impressive accuracy rate of 99.8%. In the same arena, InceptionV3 achieved a notable 90% accuracy, ResNet50 secured 89%, and VGG16 reached 85%. These outcomes underscore the Novel DCNN's prowess in the realm of renal cell hydronephrosis detection within ultrasound images. Moreover, this study offers a detailed view of each model's performance through confusion matrices, shedding light on their abilities to categorize true positives, true negatives, false positives, and false negatives. In this regard, the Novel DCNN model exhibits remarkable proficiency, minimizing both false positives and false negatives. In conclusion, this research underscores the Novel DCNN model's supremacy in automating the detection of renal cell hydronephrosis in ultrasound images. With its exceptional accuracy and minimal error rates, this model stands as a promising tool for healthcare professionals, facilitating early-stage diagnosis and treatment. Furthermore, the model's convergence rate and accuracy hold potential for enhancement through further exploration, including testing on larger and more diverse datasets and investigating diverse optimization strategies.

Opportunities and challenges of computer aided diagnosis in new millennium: A bibliometric analysis from 2000 to 2023

BACKGROUND

After entering the new millennium, computer-aided diagnosis (CAD) is rapidly developing as an emerging technology worldwide. Expanding the spectrum of CAD-related diseases is a possible future research trend. Nevertheless, bibliometric studies in this area have not yet been reported. This study aimed to explore the hotspots and frontiers of research on CAD from 2000 to 2023, which may provide a reference for researchers in this field.

METHODS

In this paper, we use bibliometrics to analyze CAD-related literature in the Web of Science database between 2000 and 2023. The scientometric softwares VOSviewer and CiteSpace were used to visually analyze the countries, institutions, authors, journals, references and keywords involved in the literature. Keywords burst analysis were utilized to further explore the current state and development trends of research on CAD.

RESULTS

A total of 13,970 publications were included in this study, with a noticeably rising annual publication trend. China and the United States are major contributors to the publication, with the United States being the dominant position in CAD research. The American research institutions, lead by the University of Chicago, are pioneers of CAD. Acharya UR, Zheng B and Chan HP are the most prolific authors. Institute of Electrical and Electronics Engineers Transactions on Medical Imaging focuses on CAD and publishes the most articles. New computer technologies related to CAD are in the forefront of attention. Currently, CAD is used extensively in breast diseases, pulmonary diseases and brain diseases.

CONCLUSION

Expanding the spectrum of CAD-related diseases is a possible future research trend. How to overcome the lack of large sample datasets and establish a universally accepted standard for the evaluation of CAD system performance are urgent issues for CAD development and validation. In conclusion, this paper provides valuable information on the current state of CAD research and future developments.

Automated detection and segmentation of pulmonary embolisms on computed tomography pulmonary angiography (CTPA) using deep learning but without manual outlining

We present a novel computer algorithm to automatically detect and segment pulmonary embolisms (PEs) on computed tomography pulmonary angiography (CTPA). This algorithm is based on deep learning but does not require manual outlines of the PE regions. Given a CTPA scan, both intra- and extra-pulmonary arteries were firstly segmented. The arteries were then partitioned into several parts based on size (radius). Adaptive thresholding and constrained morphological operations were used to identify suspicious PE regions within each part. The confidence of a suspicious region to be PE was scored based on its contrast in the arteries. This approach was applied to the publicly available RSNA Pulmonary Embolism CT Dataset (RSNA-PE) to identify three-dimensional (3-D) PE negative and positive image patches, which were used to train a 3-D Recurrent Residual U-Net (R2-Unet) to automatically segment PE. The feasibility of this computer algorithm was validated on an independent test set consisting of 91 CTPA scans acquired from a different medical institute, where the PE regions were manually located and outlined by a thoracic radiologist (>18 years' experience). An R2-Unet model was also trained and validated on the manual outlines using a 5-fold cross-validation method. The CNN model trained on the high-confident PE regions showed a Dice coefficient of 0.676±0.168 and a false positive rate of 1.86 per CT scan, while the CNN model trained on the manual outlines demonstrated a Dice coefficient of 0.647±0.192 and a false positive rate of 4.20 per CT scan. The former model performed significantly better than the latter model (p<0.01). The promising performance of the developed PE detection and segmentation algorithm suggests the feasibility of training a deep learning network without dedicating significant efforts to manual annotations of the PE regions on CTPA scans.

Classification of Parkinson's Disease in Patch-Based MRI of Substantia Nigra

Parkinson's disease (PD) is a chronic and progressive neurological disease that mostly shakes and compromises the motor system of the human brain. Patients with PD can face resting tremors, loss of balance, bradykinesia, and rigidity problems. Complex patterns of PD, i.e., with relevance to other neurological diseases and minor changes in brain structure, make the diagnosis of this disease a challenge and cause inaccuracy of about 25% in the diagnostics. The research community utilizes different machine learning techniques for diagnosis using handcrafted features. This paper proposes a computer-aided diagnostic system using a convolutional neural network (CNN) to diagnose PD. CNN is one of the most suitable models to extract and learn the essential features of a problem. The dataset is obtained from Parkinson's Progression Markers Initiative (PPMI), which provides different datasets (benchmarks), such as T2-weighted MRI for PD and other healthy controls (HC). The mid slices are collected from each MRI. Further, these slices are registered for alignment. Since the PD can be found in substantia nigra (i.e., the midbrain), the midbrain region of the registered T2-weighted MRI slice is selected using the freehand region of interest technique with a 33 × 33 sized window. Several experiments have been carried out to ensure the validity of the CNN. The standard measures, such as accuracy, sensitivity, specificity, and area under the curve, are used to evaluate the proposed system. The evaluation results show that CNN provides better accuracy than machine learning techniques, such as naive Bayes, decision tree, support vector machine, and artificial neural network.