AI-driven deep CNN approach for multi-label pathology classification using chest X-Rays

Classification of pulmonary diseases from chest radiographs using deep transfer learning

Pulmonary diseases are the leading causes of disabilities and deaths worldwide. Early diagnosis of pulmonary diseases can reduce the fatality rate. Chest radiographs are commonly used to diagnose pulmonary diseases. In clinical practice, diagnosing pulmonary diseases using chest radiographs is challenging due to Overlapping and complex anatomical Structures, variability in radiographs, and their quality. The availability of a medical specialist with extensive professional experience is profoundly required. With the use of Convolutional Neural Networks in the medical field, diagnosis can be improved by automatically detecting and classifying these diseases. This paper has explored the effectiveness of Convolutional Neural Networks and transfer learning to improve the predictive outcomes of fifteen different pulmonary diseases using chest radiographs. Our proposed deep transfer learning-based computational model achieved promising results as compared to existing state-of-the-art methods. Our model reported an overall specificity of 97.92%, a sensitivity of 97.30%, a precision of 97.94%, and an Area under the Curve of 97.61%. It has been observed that the promising results of our proposed model will be valuable tool for practitioners in decision-making and efficiently diagnosing various pulmonary diseases.

Multimodal integration to identify the invasion status of lung adenocarcinoma intraoperatively

Evaluating the invasiveness of lung adenocarcinoma is crucial for determining the appropriate surgical strategy, impacting postoperative outcomes. This study developed a multimodality model combining radiomics, intraoperative frozen section (FS) pathology, and clinical indicators to predict invasion status. The study enrolled 1,424 patients from two hospitals, divided into multimodal training, radiology testing, and pathology testing cohorts. A prospective validation cohort of 114 patients was selected between March and May 2023. The radiomics + pathology + clinical indicators multimodality model (multi-RPC model) achieved an area under the curve (AUC) of 0.921 (95% confidence interval [CI] 0.899-0.939) in the multimodal training cohort and 0.939 (95% CI 0.878-0.975) in the validation cohort, outperforming single- and dual-modality models. The multi-RPC model's predictive accuracy of 0.860 (95% CI 0.782-0.918) suggests that it could significantly reduce inappropriate surgical procedures, enhancing precision oncology by integrating multimodal information to guide surgical decisions.

Classification of Lung Diseases Using an Attention-Based Modified DenseNet Model

Lung diseases represent a significant global health threat, impacting both well-being and mortality rates. Diagnostic procedures such as Computed Tomography (CT) scans and X-ray imaging play a pivotal role in identifying these conditions. X-rays, due to their easy accessibility and affordability, serve as a convenient and cost-effective option for diagnosing lung diseases. Our proposed method utilized the Contrast-Limited Adaptive Histogram Equalization (CLAHE) enhancement technique on X-ray images to highlight the key feature maps related to lung diseases using DenseNet201. We have augmented the existing Densenet201 model with a hybrid pooling and channel attention mechanism. The experimental results demonstrate the superiority of our model over well-known pre-trained models, such as VGG16, VGG19, InceptionV3, Xception, ResNet50, ResNet152, ResNet50V2, ResNet152V2, MobileNetV2, DenseNet121, DenseNet169, and DenseNet201. Our model achieves impressive accuracy, precision, recall, and F1-scores of 95.34%, 97%, 96%, and 96%, respectively. We also provide visual insights into our model's decision-making process using Gradient-weighted Class Activation Mapping (Grad-CAM) to identify normal, pneumothorax, and atelectasis cases. The experimental results of our model in terms of heatmap may help radiologists improve their diagnostic abilities and labelling processes.

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 Review of Machine Learning Algorithms for Biomedical Applications

As the amount and complexity of biomedical data continue to increase, machine learning methods are becoming a popular tool in creating prediction models for the underlying biomedical processes. Although all machine learning methods aim to fit models to data, the methodologies used can vary greatly and may seem daunting at first. A comprehensive review of various machine learning algorithms per biomedical applications is presented. The key concepts of machine learning are supervised and unsupervised learning, feature selection, and evaluation metrics. Technical insights on the major machine learning methods such as decision trees, random forests, support vector machines, and k-nearest neighbors are analyzed. Next, the dimensionality reduction methods like principal component analysis and t-distributed stochastic neighbor embedding methods, and their applications in biomedical data analysis were reviewed. Moreover, in biomedical applications predominantly feedforward neural networks, convolutional neural networks, and recurrent neural networks are utilized. In addition, the identification of emerging directions in machine learning methodology will serve as a useful reference for individuals involved in biomedical research, clinical practice, and related professions who are interested in understanding and applying machine learning algorithms in their research or practice.

Efficient pneumonia detection using Vision Transformers on chest X-rays

Pneumonia is a widespread and acute respiratory infection that impacts people of all ages. Early detection and treatment of pneumonia are essential for avoiding complications and enhancing clinical results. We can reduce mortality, improve healthcare efficiency, and contribute to the global battle against a disease that has plagued humanity for centuries by devising and deploying effective detection methods. Detecting pneumonia is not only a medical necessity but also a humanitarian imperative and a technological frontier. Chest X-rays are a frequently used imaging modality for diagnosing pneumonia. This paper examines in detail a cutting-edge method for detecting pneumonia implemented on the Vision Transformer (ViT) architecture on a public dataset of chest X-rays available on Kaggle. To acquire global context and spatial relationships from chest X-ray images, the proposed framework deploys the ViT model, which integrates self-attention mechanisms and transformer architecture. According to our experimentation with the proposed Vision Transformer-based framework, it achieves a higher accuracy of 97.61%, sensitivity of 95%, and specificity of 98% in detecting pneumonia from chest X-rays. The ViT model is preferable for capturing global context, comprehending spatial relationships, and processing images that have different resolutions. The framework establishes its efficacy as a robust pneumonia detection solution by surpassing convolutional neural network (CNN) based architectures.

CheXNet and feature pyramid network: a fusion deep learning architecture for multilabel chest X-Ray clinical diagnoses classification

The existing multilabel X-Ray image learning tasks generally contain much information on pathology co-occurrence and interdependency, which is very important for clinical diagnosis. However, the challenging part of this subject is to accurately diagnose multiple diseases that occurred in a single X-Ray image since multiple levels of features are generated in the images, and create different features as in single label detection. Various works were developed to address this challenge with proposed deep learning architectures to improve classification performance and enrich diagnosis results with multi-probability disease detection. The objective is to create an accurate result and a faster inference system to support a quick diagnosis in the medical system. To contribute to this state-of-the-art, we designed a fusion architecture, CheXNet and Feature Pyramid Network (FPN), to classify and discriminate multiple thoracic diseases from chest X-Rays. This concept enables the model to extract while creating a pyramid of feature maps with different spatial resolutions that capture low-level and high-level semantic information to encounter multiple features. The model's effectiveness is evaluated using the NIH ChestXray14 dataset, with the Area Under Curve (AUC) and accuracy metrics used to compare the results against other cutting-edge approaches. The overall results demonstrate that our method outperforms other approaches and has become promising for multilabel disease classification in chest X-Rays, with potential applications in clinical practice. The result demonstrated that we achieved an average AUC of 0.846 and an accuracy of 0.914. Further, our proposed architecture diagnoses images in 0.013 s, faster than the latest approaches.

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.

Observer Performance Evaluation of a Deep Learning Model for Multilabel Classification of Active Tuberculosis Lung Zone-Wise Manifestations

Background Chest X-rays (CXRs) are widely used for cost-effective screening of active pulmonary tuberculosis despite their limitations in sensitivity and specificity when interpreted by clinicians or radiologists. To address this issue, computer-aided detection (CAD) algorithms, particularly deep learning architectures based on convolution, have been developed to automate the analysis of radiography imaging. Deep learning algorithms have shown promise in accurately classifying lung abnormalities using chest X-ray images. In this study, we utilized the EfficientNet B4 model, which was pre-trained on ImageNet with 380x380 input dimensions, using its weights for transfer learning, and was modified with a series of components including global average pooling, batch normalization, dropout, and a classifier with 12 image-wise and 44 segment-wise lung zone evaluation classes using sigmoid activation. Objectives Assess the clinical usefulness of our previously created EfficientNet B4 model in identifying lung zone-specific abnormalities related to active tuberculosis through an observer performance test involving a skilled clinician operating in tuberculosis-specific environments. Methods The ground truth was established by a radiologist who examined all sample CXRs to identify lung zone-wise abnormalities. An expert clinician working in tuberculosis-specific settings independently reviewed the same CXR with blinded access to the ground truth. Simultaneously, the CXRs were classified using the EfficientNet B4 model. The clinician's assessments were then compared with the model's predictions, and the agreement between the two was measured using the kappa coefficient, evaluating the model's performance in classifying active tuberculosis manifestations across lung zones. Results The results show a strong agreement (Kappa ≥0.81) seen for lung zone-wise abnormalities of pneumothorax, mediastinal shift, emphysema, fibrosis, calcifications, pleural effusion, and cavity. Substantial agreement (Kappa = 0.61-0.80) for cavity, mediastinal shift, volume loss, and collapsed lungs. The Kappa score for lung zone-wise abnormalities is moderate (0.41-0.60) for 39% of cases. In image-wise agreement, the EfficientNet B4 model's performance ranges from moderate to almost perfect across categories, while in lung zone-wise agreement, it varies from fair to almost perfect. The results show strong agreement between the EfficientNet B4 model and the human reader in detecting lung zone-wise and image-wise manifestations. Conclusion The clinical utility of the EfficientNet B4 models to detect the abnormalities can aid clinicians in primary care settings for screening and triaging tuberculosis where resources are constrained or overburdened.

High-precision multiclass classification of lung disease through customized MobileNetV2 from chest X-ray images

In this study, multiple lung diseases are diagnosed with the help of the Neural Network algorithm. Specifically, Emphysema, Infiltration, Mass, Pleural Thickening, Pneumonia, Pneumothorax, Atelectasis, Edema, Effusion, Hernia, Cardiomegaly, Pulmonary Fibrosis, Nodule, and Consolidation, are studied from the ChestX-ray14 dataset. A proposed fine-tuned MobileLungNetV2 model is employed for analysis. Initially, pre-processing is done on the X-ray images from the dataset using CLAHE to increase image contrast. Additionally, a Gaussian Filter, to denoise images, and data augmentation methods are used. The pre-processed images are fed into several transfer learning models; such as InceptionV3, AlexNet, DenseNet121, VGG19, and MobileNetV2. Among these models, MobileNetV2 performed with the highest accuracy of 91.6% in overall classifying lesions on Chest X-ray Images. This model is then fine-tuned to optimise the MobileLungNetV2 model. On the pre-processed data, the fine-tuned model, MobileLungNetV2, achieves an extraordinary classification accuracy of 96.97%. Using a confusion matrix for all the classes, it is determined that the model has an overall high precision, recall, and specificity scores of 96.71%, 96.83% and 99.78% respectively. The study employs the Grad-cam output to determine the heatmap of disease detection. The proposed model shows promising results in classifying multiple lesions on Chest X-ray images.

Deep learning based classification of multi-label chest X-ray images via dual-weighted metric loss

-Thoracic disease, like many other diseases, can lead to complications. Existing multi-label medical image learning problems typically include rich pathological information, such as images, attributes, and labels, which are crucial for supplementary clinical diagnosis. However, the majority of contemporary efforts exclusively focus on regression from input to binary labels, ignoring the relationship between visual features and semantic vectors of labels. In addition, there is an imbalance in data amount between diseases, which frequently causes intelligent diagnostic systems to make erroneous disease predictions. Therefore, we aim to improve the accuracy of the multi-label classification of chest X-ray images. Chest X-ray14 pictures were utilized as the multi-label dataset for the experiments in this study. By fine-tuning the ConvNeXt network, we got visual vectors, which we combined with semantic vectors encoded by BioBert to map the two different forms of features into a common metric space and made semantic vectors the prototype of each class in metric space. The metric relationship between images and labels is then considered from the image level and disease category level, respectively, and a new dual-weighted metric loss function is proposed. Finally, the average AUC score achieved in the experiment reached 0.826, and our model outperformed the comparison models.

Deep learning classification of active tuberculosis lung zones wise manifestations using chest X-rays: a multi label approach

Chest X-rays are the most economically viable diagnostic imaging test for active pulmonary tuberculosis screening despite the high sensitivity and low specificity when interpreted by clinicians or radiologists. Computer aided detection (CAD) algorithms, especially convolution based deep learning architecture, have been proposed to facilitate the automation of radiography imaging modalities. Deep learning algorithms have found success in classifying various abnormalities in lung using chest X-ray. We fine-tuned, validated and tested EfficientNetB4 architecture and utilized the transfer learning methodology for multilabel approach to detect lung zone wise and image wise manifestations of active pulmonary tuberculosis using chest X-ray. We used Area Under Receiver Operating Characteristic (AUC), sensitivity and specificity along with 95% confidence interval as model evaluation metrics. We also utilized the visualisation capabilities of convolutional neural networks (CNN), Gradient-weighted Class Activation Mapping (Grad-CAM) as post-hoc attention method to investigate the model and visualisation of Tuberculosis abnormalities and discuss them from radiological perspectives. EfficientNetB4 trained network achieved remarkable AUC, sensitivity and specificity of various pulmonary tuberculosis manifestations in intramural test set and external test set from different geographical region. The grad-CAM visualisations and their ability to localize the abnormalities can aid the clinicians at primary care settings for screening and triaging of tuberculosis where resources are constrained or overburdened.

Role of an Automated Deep Learning Algorithm for Reliable Screening of Abnormality in Chest Radiographs: A Prospective Multicenter Quality Improvement Study

In medical practice, chest X-rays are the most ubiquitous diagnostic imaging tests. However, the current workload in extensive health care facilities and lack of well-trained radiologists is a significant challenge in the patient care pathway. Therefore, an accurate, reliable, and fast computer-aided diagnosis (CAD) system capable of detecting abnormalities in chest X-rays is crucial in improving the radiological workflow. In this prospective multicenter quality-improvement study, we have evaluated whether artificial intelligence (AI) can be used as a chest X-ray screening tool in real clinical settings. Methods: A team of radiologists used the AI-based chest X-ray screening tool (qXR) as a part of their daily reporting routine to report consecutive chest X-rays for this prospective multicentre study. This study took place in a large radiology network in India between June 2021 and March 2022. Results: A total of 65,604 chest X-rays were processed during the study period. The overall performance of AI achieved in detecting normal and abnormal chest X-rays was good. The high negatively predicted value (NPV) of 98.9% was achieved. The AI performance in terms of area under the curve (AUC), NPV for the corresponding subabnormalities obtained were blunted CP angle (0.97, 99.5%), hilar dysmorphism (0.86, 99.9%), cardiomegaly (0.96, 99.7%), reticulonodular pattern (0.91, 99.9%), rib fracture (0.98, 99.9%), scoliosis (0.98, 99.9%), atelectasis (0.96, 99.9%), calcification (0.96, 99.7%), consolidation (0.95, 99.6%), emphysema (0.96, 99.9%), fibrosis (0.95, 99.7%), nodule (0.91, 99.8%), opacity (0.92, 99.2%), pleural effusion (0.97, 99.7%), and pneumothorax (0.99, 99.9%). Additionally, the turnaround time (TAT) decreased by about 40.63% from pre-qXR period to post-qXR period. Conclusions: The AI-based chest X-ray solution (qXR) screened chest X-rays and assisted in ruling out normal patients with high confidence, thus allowing the radiologists to focus more on assessing pathology on abnormal chest X-rays and treatment pathways.

A Hybrid Explainable Ensemble Transformer Encoder for Pneumonia Identification from Chest X-ray Images

INTRODUCTION

Pneumonia is a microorganism infection that causes chronic inflammation of the human lung cells. Chest X-ray imaging is the most well-known screening approach used for detecting pneumonia in the early stages. While chest-Xray images are mostly blurry with low illumination, a strong feature extraction approach is required for promising identification performance.

OBJECTIVES

A new hybrid explainable deep learning framework is proposed for accurate pneumonia disease identification using chest X-ray images.

METHODS

The proposed hybrid workflow is developed by fusing the capabilities of both ensemble convolutional networks and the Transformer Encoder mechanism. The ensemble learning backbone is used to extract strong features from the raw input X-ray images in two different scenarios: ensemble A (i.e., DenseNet201, VGG16, and GoogleNet) and ensemble B (i.e., DenseNet201, InceptionResNetV2, and Xception). Whereas, the Transformer Encoder is built based on the self-attention mechanism with multilayer perceptron (MLP) for accurate disease identification. The visual explainable saliency maps are derived to emphasize the crucial predicted regions on the input X-ray images. The end-to-end training process of the proposed deep learning models over all scenarios is performed for binary and multi-class classification tasks.

RESULTS

The proposed hybrid deep learning model recorded 99.21% classification performance in terms of overall accuracy and F1-score for the binary classification task, while it achieved 98.19% accuracy and 97.29% F1-score for multi-classification task. For the ensemble binary identification scenario, ensemble A recorded 97.22% accuracy and 97.14% F1-score, while ensemble B achieved 96.44% for both accuracy and F1-score. For the ensemble, multiclass identification scenario, ensemble A recorded 97.2% accuracy and 95.8% F1-score, while ensemble B recorded 96.4% accuracy and 94.9% F1-score.

CONCLUSION

The proposed hybrid deep learning framework could provide promising and encouraging explainable identification performance comparing with individual, ensemble models, or even the latest models in the literature. The code is available here: https://github.com/chiagoziemchima/Pneumonia_Identificaton.

AI-driven deep and handcrafted features selection approach for Covid-19 and chest related diseases identification

To identify various pneumonia types, a gap of 15% value is being created every five years. To fill this gap, accurate detection of chest disease is required in the healthcare department to avoid any serious issues in the future. Testing the affected lungs to detect a Coronavirus 2019 (COVID-19) using the same imaging modalities may detect some other chest diseases. This wrong diagnosis strongly needs a multidisciplinary approach to the right diagnosis of chest-related diseases. Only a few works till now are targeting pathological x-ray images. Many studies target only a single chest disease that is not enough to automate chest disease detection. Only a few studies regarding the observation of the COVID-19, but more cases are those where it can be misclassified as detecting techniques not providing any generic solution for all types of chest diseases. However, the existing studies can only detect if the person has COVID-19 or not. The proposed work significantly contributes to detecting COVID-19 and other chest diseases by providing useful analysis of chest-related diseases. One of our testing approaches achieves 90.22% accuracy for 15 types of chest disease with 100% correct classification of COVID-19. Though it analyzes the perfect detection as the accuracy level is high enough, but it would be an excellent decision to consider the proposed study until doctors can visually inspect the input images used by models that lead to its detection.

Performance Evaluation of the Deep Learning Based Convolutional Neural Network Approach for the Recognition of Chest X-Ray Images

Recent advancement in the field of deep learning has provided promising performance for the analysis of medical images. Every year, pneumonia is the leading cause for death of various children under the age of 5 years. Chest X-rays are the first technique that is used for the detection of pneumonia. Various deep learning and computer vision techniques can be used to determine the virus which causes pneumonia using Chest X-ray images. These days, it is possible to use Convolutional Neural Networks (CNN) for the classification and analysis of images due to the availability of a large number of datasets. In this work, a CNN model is implemented for the recognition of Chest X-ray images for the detection of Pneumonia. The model is trained on a publicly available Chest X-ray images dataset having two classes: Normal chest X-ray images and Pneumonic Chest X-ray images, where each class has 5000 Samples. 80% of the collected data is used for the purpose to train the model, and the rest for testing the model. The model is trained and validated using two optimizers: Adam and RMSprop. The maximum recognition accuracy of 98% is obtained on the validation dataset. The obtained results are further compared with the results obtained by other researchers for the recognition of biomedical images.

AI Based Diagnosis of Pneumonia

Pneumonia is a lung infection caused by bacteria, viruses and fungi. In this infection, the air sac (alveoli) of the lungs gets inflamed and breathing becomes difficult which causes mild to severe illness among people. They are diagnosed by performing chest X-ray, blood test, pulse oximetry. Pneumonia can also be identified using lung sounds that are recorded in the digital stethoscope. In this proposed work, a software is developed to diagnose pneumonia from the lung sound using gradient boosting algorithm. Lung sounds give enough symptoms for pneumonia identification. Lung sounds are recorded by doctors using Electronic Stethoscope. The recorded lung sounds are processed using audacity software. This software separates the required sound from unwanted noises. The healthy individual's audio files are labelled as 0 and the pneumonia patient's audio files are labelled as 1 for training the algorithm. During diagnosis study and the performance evaluation with various machine learning algorithms like support vector machine and k-nearest neighbours (KNN) algorithms, it was observed that the gradient boosting algorithm exhibits good identification property with 97 percent accuracy. This proposed method also reveals excellent diagnoses of pneumonia over other artificial intelligence and deep learning techniques. This method can also be used to predict Covid affected lungs sounds.

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.

Lung Disease Classification in CXR Images Using Hybrid Inception-ResNet-v2 Model and Edge Computing

Chest X-ray (CXR) imaging is one of the most widely used and economical tests to diagnose a wide range of diseases. However, even for expert radiologists, it is a challenge to accurately diagnose diseases from CXR samples. Furthermore, there remains an acute shortage of trained radiologists worldwide. In the present study, a range of machine learning (ML), deep learning (DL), and transfer learning (TL) approaches have been evaluated to classify diseases in an openly available CXR image dataset. A combination of the synthetic minority over-sampling technique (SMOTE) and weighted class balancing is used to alleviate the effects of class imbalance. A hybrid Inception-ResNet-v2 transfer learning model coupled with data augmentation and image enhancement gives the best accuracy. The model is deployed in an edge environment using Amazon IoT Core to automate the task of disease detection in CXR images with three categories, namely pneumonia, COVID-19, and normal. Comparative analysis has been given in various metrics such as precision, recall, accuracy, AUC-ROC score, etc. The proposed technique gives an average accuracy of 98.66%. The accuracies of other TL models, namely SqueezeNet, VGG19, ResNet50, and MobileNetV2 are 97.33%, 91.66%, 90.33%, and 76.00%, respectively. Further, a DL model, trained from scratch, gives an accuracy of 92.43%. Two feature-based ML classification techniques, namely support vector machine with local binary pattern (SVM + LBP) and decision tree with histogram of oriented gradients (DT + HOG) yield an accuracy of 87.98% and 86.87%, respectively.

A quantization assisted U-Net study with ICA and deep features fusion for breast cancer identification using ultrasonic data

Breast cancer is one of the leading causes of death in women worldwide-the rapid increase in breast cancer has brought about more accessible diagnosis resources. The ultrasonic breast cancer modality for diagnosis is relatively cost-effective and valuable. Lesion isolation in ultrasonic images is a challenging task due to its robustness and intensity similarity. Accurate detection of breast lesions using ultrasonic breast cancer images can reduce death rates. In this research, a quantization-assisted U-Net approach for segmentation of breast lesions is proposed. It contains two step for segmentation: (1) U-Net and (2) quantization. The quantization assists to U-Net-based segmentation in order to isolate exact lesion areas from sonography images. The Independent Component Analysis (ICA) method then uses the isolated lesions to extract features and are then fused with deep automatic features. Public ultrasonic-modality-based datasets such as the Breast Ultrasound Images Dataset (BUSI) and the Open Access Database of Raw Ultrasonic Signals (OASBUD) are used for evaluation comparison. The OASBUD data extracted the same features. However, classification was done after feature regularization using the lasso method. The obtained results allow us to propose a computer-aided design (CAD) system for breast cancer identification using ultrasonic modalities.

VGG19 Network Assisted Joint Segmentation and Classification of Lung Nodules in CT Images

Pulmonary nodule is one of the lung diseases and its early diagnosis and treatment are essential to cure the patient. This paper introduces a deep learning framework to support the automated detection of lung nodules in computed tomography (CT) images. The proposed framework employs VGG-SegNet supported nodule mining and pre-trained DL-based classification to support automated lung nodule detection. The classification of lung CT images is implemented using the attained deep features, and then these features are serially concatenated with the handcrafted features, such as the Grey Level Co-Occurrence Matrix (GLCM), Local-Binary-Pattern (LBP) and Pyramid Histogram of Oriented Gradients (PHOG) to enhance the disease detection accuracy. The images used for experiments are collected from the LIDC-IDRI and Lung-PET-CT-Dx datasets. The experimental results attained show that the VGG19 architecture with concatenated deep and handcrafted features can achieve an accuracy of 97.83% with the SVM-RBF classifier.

Pneumonia detection in chest X-ray images using an ensemble of deep learning models

Pneumonia is a respiratory infection caused by bacteria or viruses; it affects many individuals, especially in developing and underdeveloped nations, where high levels of pollution, unhygienic living conditions, and overcrowding are relatively common, together with inadequate medical infrastructure. Pneumonia causes pleural effusion, a condition in which fluids fill the lung, causing respiratory difficulty. Early diagnosis of pneumonia is crucial to ensure curative treatment and increase survival rates. Chest X-ray imaging is the most frequently used method for diagnosing pneumonia. However, the examination of chest X-rays is a challenging task and is prone to subjective variability. In this study, we developed a computer-aided diagnosis system for automatic pneumonia detection using chest X-ray images. We employed deep transfer learning to handle the scarcity of available data and designed an ensemble of three convolutional neural network models: GoogLeNet, ResNet-18, and DenseNet-121. A weighted average ensemble technique was adopted, wherein the weights assigned to the base learners were determined using a novel approach. The scores of four standard evaluation metrics, precision, recall, f1-score, and the area under the curve, are fused to form the weight vector, which in studies in the literature was frequently set experimentally, a method that is prone to error. The proposed approach was evaluated on two publicly available pneumonia X-ray datasets, provided by Kermany et al. and the Radiological Society of North America (RSNA), respectively, using a five-fold cross-validation scheme. The proposed method achieved accuracy rates of 98.81% and 86.85% and sensitivity rates of 98.80% and 87.02% on the Kermany and RSNA datasets, respectively. The results were superior to those of state-of-the-art methods and our method performed better than the widely used ensemble techniques. Statistical analyses on the datasets using McNemar’s and ANOVA tests showed the robustness of the approach. The codes for the proposed work are available at https://github.com/Rohit-Kundu/Ensemble-Pneumonia-Detection.

Deep-learning based detection of COVID-19 using lung ultrasound imagery

BACKGROUND

The COVID-19 pandemic has exposed the vulnerability of healthcare services worldwide, especially in underdeveloped countries. There is a clear need to develop novel computer-assisted diagnosis tools to provide rapid and cost-effective screening in places where massive traditional testing is not feasible. Lung ultrasound is a portable, easy to disinfect, low cost and non-invasive tool that can be used to identify lung diseases. Computer-assisted analysis of lung ultrasound imagery is a relatively recent approach that has shown great potential for diagnosing pulmonary conditions, being a viable alternative for screening and diagnosing COVID-19.

OBJECTIVE

To evaluate and compare the performance of deep-learning techniques for detecting COVID-19 infections from lung ultrasound imagery.

METHODS

We adapted different pre-trained deep learning architectures, including VGG19, InceptionV3, Xception, and ResNet50. We used the publicly available POCUS dataset comprising 3326 lung ultrasound frames of healthy, COVID-19, and pneumonia patients for training and fine-tuning. We conducted two experiments considering three classes (COVID-19, pneumonia, and healthy) and two classes (COVID-19 versus pneumonia and COVID-19 versus non-COVID-19) of predictive models. The obtained results were also compared with the POCOVID-net model. For performance evaluation, we calculated per-class classification metrics (Precision, Recall, and F1-score) and overall metrics (Accuracy, Balanced Accuracy, and Area Under the Receiver Operating Characteristic Curve). Lastly, we performed a statistical analysis of performance results using ANOVA and Friedman tests followed by post-hoc analysis using the Wilcoxon signed-rank test with the Holm's step-down correction.

RESULTS

InceptionV3 network achieved the best average accuracy (89.1%), balanced accuracy (89.3%), and area under the receiver operating curve (97.1%) for COVID-19 detection from bacterial pneumonia and healthy lung ultrasound data. The ANOVA and Friedman tests found statistically significant performance differences between models for accuracy, balanced accuracy and area under the receiver operating curve. Post-hoc analysis showed statistically significant differences between the performance obtained with the InceptionV3-based model and POCOVID-net, VGG19-, and ResNet50-based models. No statistically significant differences were found in the performance obtained with InceptionV3- and Xception-based models.

CONCLUSIONS

Deep learning techniques for computer-assisted analysis of lung ultrasound imagery provide a promising avenue for COVID-19 screening and diagnosis. Particularly, we found that the InceptionV3 network provides the most promising predictive results from all AI-based techniques evaluated in this work. InceptionV3- and Xception-based models can be used to further develop a viable computer-assisted screening tool for COVID-19 based on ultrasound imagery.

Adversarial Attack and Defence through Adversarial Training and Feature Fusion for Diabetic Retinopathy Recognition

Due to the rapid growth in artificial intelligence (AI) and deep learning (DL) approaches, the security and robustness of the deployed algorithms need to be guaranteed. The security susceptibility of the DL algorithms to adversarial examples has been widely acknowledged. The artificially created examples will lead to different instances negatively identified by the DL models that are humanly considered benign. Practical application in actual physical scenarios with adversarial threats shows their features. Thus, adversarial attacks and defense, including machine learning and its reliability, have drawn growing interest and, in recent years, has been a hot topic of research. We introduce a framework that provides a defensive model against the adversarial speckle-noise attack, the adversarial training, and a feature fusion strategy, which preserves the classification with correct labelling. We evaluate and analyze the adversarial attacks and defenses on the retinal fundus images for the Diabetic Retinopathy recognition problem, which is considered a state-of-the-art endeavor. Results obtained on the retinal fundus images, which are prone to adversarial attacks, are 99% accurate and prove that the proposed defensive model is robust.

An adaptive hybrid XdeepFM based deep Interest network model for click-through rate prediction system

Recent advances in communication enable individuals to use phones and computers to access information on the web. E-commerce has seen rapid development, e.g., Alibaba has nearly 12 hundred million customers in China. Click-Through Rate (CTR) forecasting is a primary task in the e-commerce advertisement system. From the traditional Logistic Regression algorithm to the latest popular deep neural network methods that follow a similar embedding and MLP, several algorithms are used to predict CTR. This research proposes a hybrid model combining the Deep Interest Network (DIN) and eXtreme Deep Factorization Machine (xDeepFM) to perform CTR prediction robustly. The cores of DIN and xDeepFM are attention and feature cross, respectively. DIN follows an adaptive local activation unit that incorporates the attention mechanism to adaptively learn user interest from historical behaviors related to specific advertisements. xDeepFM further includes a critical part, a Compressed Interactions Network (CIN), aiming to generate feature interactions at a vectorwise level implicitly. Furthermore, a CIN, plain DNN, and a linear part are combined into one unified model to form xDeepFM. The proposed end-to-end hybrid model is a parallel ensemble of models via multilayer perceptron. CIN and xDeepFM are trained in parallel, and their output is fed into a multilayer perceptron. We used the e-commerce Alibaba dataset with the focal loss as the loss function for experimental evaluation through online complex example mining (OHEM) in the training process. The experimental result indicates that the proposed hybrid model has better performance than other models.