Chest x-ray automated triage: a semiologic approach designed for clinical implementation, exploiting different types of labels through a combination of four Deep Learning architectures
Hospital Italiano de Buenos Aires（布宜诺斯艾利斯意大利医院）；Universidad Tecnológica Nacional（国家技术大学）
Candelaria Mosquera, Facundo Nahuel Diaz, Fernando Binder, Jose Martin Rabellino, Sonia Elizabeth Benitez, Alejandro Daniel Beresñak, Alberto Seehaus, Gabriel D… 展开作者
Candelaria Mosquera, Facundo Nahuel Diaz, Fernando Binder, Jose Martin Rabellino, Sonia Elizabeth Benitez, Alejandro Daniel Beresñak, Alberto Seehaus, Gabriel Ducrey, Jorge Alberto Ocantos, Daniel Roberto Luna
BACKGROUND AND OBJECTIVES: The multiple chest x-ray datasets released in the last years have ground-truth labels intended for different computer vision tasks, suggesting that performance in automated chest-xray interpretation might improve by using a method that can exploit diverse types of annotations. This work presents a Deep Learning method based on the late fusion of different convolutional architectures, that allows training with heterogeneous data with a simple implementation, and evaluates its performance on independent test data. We focused on obtaining a clinically useful tool that could be successfully integrated into a hospital workflow. MATERIALS AND METHODS: Based on expert opinion, we selected four target chest x-ray findings, namely lung opacities, fractures, pneumothorax and pleural effusion. For each finding we defined the most adequate type of ground-truth label, and built four training datasets combining images from public chest x-ray datasets and our institutional archive. We trained four different Deep Learning architectures and combined their outputs with a late fusion strategy, obtaining a unified tool. Performance was measured on two test datasets: an external openly-available dataset, and a retrospective institutional dataset, to estimate performance on local population. RESULTS: The external and local test sets had 4376 and 1064 images, respectively, for which the model showed an area under the Receiver Operating Characteristics curve of 0.75 (95%CI: 0.74-0.76) and 0.87 (95%CI: 0.86-0.89) in the detection of abnormal chest x-rays. For the local population, a sensitivity of 86% (95%CI: 84-90), and a specificity of 88% (95%CI: 86-90) were obtained, with no significant differences between demographic subgroups. We present examples of heatmaps to show the accomplished level of interpretability, examining true and false positives.
During the COVID-19 pandemic, there has been an emerging need for rapid, dedicated, and point-of-care COVID-19 patient disposition techniques to optimize resource utilization and clinical workflow. In view of this need, we present COVID-MobileXpert: a lightweight deep neural network (DNN) based mobile app that can use chest X-ray (CXR) for COVID-19 case screening and radiological trajectory prediction. We design and implement a novel three-player knowledge transfer and distillation (KTD) framework including a pre-trained attending physician (AP) network that extracts CXR imaging features from …
CONNECT Centre, Trinity College Dublin（都柏林圣三一大学CONNECT中心）；University of Sindh（信德大学）；Signy Advanced Technologies（西格尼先进技术公司）；Indian Institute of Technology, Dehli（印度理工学院德里分校）；King Faisal University（费萨尔国王大学）
The current COVID-19 pandemic has motivated the researchers to use artificial intelligence techniques for a potential alternative to reverse transcription-polymerase chain reaction (RT-PCR) due to the limited scale of testing. The chest X-ray (CXR) is one of the alternatives to achieve fast diagnosis but the unavailability of large-scale annotated data makes the clinical implementation of machine learning-based COVID detection difficult. Another issue is the usage of ImageNet pre-trained networks which does not extract reliable feature representations from medical images. In this paper, we pro…
The COVID-19 pandemic continues to spread and impact the well-being of the global population. The front-line modalities including computed tomography (CT) and X-ray play an important role for triaging COVID patients. Considering the limited access of resources (both hardware and trained personnel) and decontamination considerations, CT may not be ideal for triaging suspected subjects. Artificial intelligence (AI) assisted X-ray based applications for triaging and monitoring require experienced radiologists to identify COVID patients in a timely manner and to further delineate the disease regio…
COVID-19, also known as Novel Coronavirus Disease, is a highly contagious disease that first surfaced in China in late 2019. SARS-CoV-2 is a coronavirus that belongs to the vast family of coronaviruses that causes this disease. The sickness originally appeared in Wuhan, China in December 2019 and quickly spread to over 213 nations, becoming a global pandemic. Fever, dry cough, and tiredness are the most typical COVID-19 symptoms. Aches, pains, and difficulty breathing are some of the other symptoms that patients may face. The majority of these symptoms are indicators of respiratory infections …
Chest X-Ray (CXR) images are commonly used for clinical screening and diagnosis. Automatically writing reports for these images can considerably lighten the workload of radiologists for summarizing descriptive findings and conclusive impressions. The complex structures between and within sections of the reports pose a great challenge to the automatic report generation. Specifically, the section Impression is a diagnostic summarization over the section Findings; and the appearance of normality dominates each section over that of abnormality. Existing studies rarely explore and consider this fun…
National Institute of Technology, Hamirpur（国家理工学院哈米尔布尔分校）；Emory University School of Medicine（埃默里大学医学院）
The COVID-19 (coronavirus disease 2019) pandemic affected more than 186 million people with over 4 million deaths worldwide by June 2021. The magnitude of which has strained global healthcare systems. Chest Computed Tomography (CT) scans have a potential role in the diagnosis and prognostication of COVID-19. Designing a diagnostic system which is cost-efficient and convenient to operate on resource-constrained devices like mobile phones would enhance the clinical usage of chest CT scans and provide swift, mobile, and accessible diagnostic capabilities. This work proposes developing a novel And…
Christian Brothers University（基督教兄弟大学）；University of Dayton（代顿大学）
With a Coronavirus disease (COVID-19) case count exceeding 10 million worldwide, there is an increased need for a diagnostic capability. The main variables in increasing diagnostic capability are reduced cost, turnaround or diagnosis time, and upfront equipment cost and accessibility. Two candidates for machine learning COVID-19 diagnosis are Computed Tomography (CT) scans and plain chest X-rays. While CT scans score higher in sensitivity, they have a higher cost, maintenance requirement, and turnaround time as compared to plain chest X-rays. The use of portable chest X-radiograph (CXR) is rec…
Purpose: Considering several patients screened due to COVID-19 pandemic, computer-aided detection has strong potential in assisting clinical workflow efficiency and reducing the incidence of infections among radiologists and healthcare providers. Since many confirmed COVID-19 cases present radiological findings of pneumonia, radiologic examinations can be useful for fast detection. Therefore, chest radiography can be used to fast screen COVID-19 during the patient triage, thereby determining the priority of patient's care to help saturated medical facilities in a pandemic situation. Methods: I…
Indian Institute of Technology Delhi（德里印度理工学院）；University of Bath（巴斯大学）；Indian Institute of Technology Kanpur（坎普尔印度理工学院）；All India Institute of Medical Sciences Delhi（德里全印度医学科学研究所）
The exponential increase in COVID-19 patients is overwhelming healthcare systems across the world. With limited testing kits, it is impossible for every patient with respiratory illness to be tested using conventional techniques (RT-PCR). The tests also have long turn-around time, and limited sensitivity. Detecting possible COVID-19 infections on Chest X-Ray may help quarantine high risk patients while test results are awaited. X-Ray machines are already available in most healthcare systems, and with most modern X-Ray systems already digitized, there is no transportation time involved for the …
Andalusian Research Institute in Data Science and Computational Intelligence（安达卢西亚数据科学与计算智能研究所）；University of Granada（格拉纳达大学）；University of Vigo（维戈大学）；University of Alicante（阿利坎特大学）
Currently, Coronavirus disease (COVID-19), one of the most infectious diseases in the 21st century, is diagnosed using RT-PCR testing, CT scans and/or Chest X-Ray (CXR) images. CT (Computed Tomography) scanners and RT-PCR testing are not available in most medical centers and hence in many cases CXR images become the most time/cost effective tool for assisting clinicians in making decisions. Deep learning neural networks have a great potential for building COVID-19 triage systems and detecting COVID-19 patients, especially patients with low severity. Unfortunately, current databases do not allo…
Korea Advanced Institute of Science and Technology (KAIST)（韩国科学技术院）
Under the global pandemic of COVID-19, the use of artificial intelligence to analyze chest X-ray (CXR) image for COVID-19 diagnosis and patient triage is becoming important. Unfortunately, due to the emergent nature of the COVID-19 pandemic, a systematic collection of the CXR data set for deep neural network training is difficult. To address this problem, here we propose a patch-based convolutional neural network approach with a relatively small number of trainable parameters for COVID-19 diagnosis. The proposed method is inspired by our statistical analysis of the potential imaging biomarkers…
Khulna University of Engineering & Technology（库尔纳工程技术大学）；University Health Network（大学健康网络）；University of Toronto（多伦多大学）
The novel COVID-19 is a global pandemic disease overgrowing worldwide. Computer-aided screening tools with greater sensitivity is imperative for disease diagnosis and prognosis as early as possible. It also can be a helpful tool in triage for testing and clinical supervision of COVID-19 patients. However, designing such an automated tool from non-invasive radiographic images is challenging as many manually annotated datasets are not publicly available yet, which is the essential core requirement of supervised learning schemes. This article proposes a 3D Convolutional Neural Network (CNN)-based…
University of Michigan（密歇根大学）；Institute for Healthcare Policy & Innovation（医疗政策与创新研究所）；Department of Electrical Engineering and Computer Science（电气工程与计算机科学系）；Department of Radiology（放射科）；Department of Internal Medicine（内科）
While deep learning has shown promise in improving the automated diagnosis of disease based on chest X-rays, deep networks may exhibit undesirable behavior related to shortcuts. This paper studies the case of spurious class skew in which patients with a particular attribute are spuriously more likely to have the outcome of interest. For instance, clinical protocols might lead to a dataset in which patients with pacemakers are disproportionately likely to have congestive heart failure. This skew can lead to models that take shortcuts by heavily relying on the biased attribute. We explore this p…
Pakistan Institute of Engineering & Applied Sciences（巴基斯坦工程与应用科学学院）；PIEAS Artificial Intelligence Center (PAIC)（PIEAS人工智能中心）；Center for Mathematical Sciences（数学科学中心）
COVID-19 is a highly contagious respiratory infection that has affected a large population across the world and continues with its devastating consequences. It is imperative to detect COVID-19 at the earliest to limit the span of infection. In this work, a new classification technique CB-STM-RENet based on deep Convolutional Neural Network (CNN) and Channel Boosting is proposed for the screening of COVID-19 in chest X-Rays. In this connection, to learn the COVID-19 specific radiographic patterns, a new convolution block based on split-transform-merge (STM) is developed. This new block systemat…
In recent months the world has been surprised by the rapid advance of COVID-19. In order to face this disease and minimize its socio-economic impacts, in addition to surveillance and treatment, diagnosis is a crucial procedure. However, the realization of this is hampered by the delay and the limited access to laboratory tests, demanding new strategies to carry out case triage. In this scenario, deep learning models are being proposed as a possible option to assist the diagnostic process based on chest X-ray and computed tomography images. Therefore, this research aims to automate the process …
Stop TB Partnership（遏制结核病伙伴关系）；International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)（孟加拉国国际腹泻病研究中心）
Artificial intelligence (AI) products can be trained to recognize tuberculosis (TB)-related abnormalities on chest radiographs. Various AI products are available commercially, yet there is lack of evidence on how their performance compared with each other and with radiologists. We evaluated five AI software products for screening and triaging TB using a large dataset that had not been used to train any commercial AI products. Individuals (>=15 years old) presenting to three TB screening centers in Dhaka, Bangladesh, were recruited consecutively. All CXR were read independently by a group of th…
Florida International University（佛罗里达国际大学）；Technical University of Munich（慕尼黑工业大学）；Stanford University（斯坦福大学）
Chest X-ray radiography is one of the earliest medical imaging technologies and remains one of the most widely-used for diagnosis, screening, and treatment follow up of diseases related to lungs and heart. The literature in this field of research reports many interesting studies dealing with the challenging tasks of bone suppression and organ segmentation but performed separately, limiting any learning that comes with the consolidation of parameters that could optimize both processes. This study, and for the first time, introduces a multitask deep learning model that generates simultaneously t…
The field of medical diagnostics contains a wealth of challenges which closely resemble classical machine learning problems; practical constraints, however, complicate the translation of these endpoints naively into classical architectures. Many tasks in radiology, for example, are largely problems of multi-label classification wherein medical images are interpreted to indicate multiple present or suspected pathologies. Clinical settings drive the necessity for high accuracy simultaneously across a multitude of pathological outcomes and greatly limit the utility of tools which consider only a …
The global outbreak of the Coronavirus 2019 (COVID-19) has overloaded worldwide healthcare systems. Computer-aided diagnosis for COVID-19 fast detection and patient triage is becoming critical. This paper proposes a novel self-knowledge distillation based self-supervised learning method for COVID-19 detection from chest X-ray images. Our method can use self-knowledge of images based on similarities of their visual features for self-supervised learning. Experimental results show that our method achieved an HM score of 0.988, an AUC of 0.999, and an accuracy of 0.957 on the largest open COVID-19…
Performance Benchmarking and Optimisation of Clustering Algorithms for Local and Non-Local Similarity Measure in Medical Image Analysis
Department of Mathematics, Rhodes University, PO Box 94, Makhanda, 6140, South Africa（数学系，罗德斯大学）；Department of Statistics, Rhodes University, PO Box 94, Makhanda, 6140, South Africa（统计系，罗德斯大学）；National Institute for Theoretical and Computational Sciences (NITheCS), Stellenbosch 7600, South Africa（理论与计算科学国家研究所）
Carnegie Mellon University（卡内基梅隆大学）；University of Illinois at Urbana-Champaign（伊利诺伊大学厄巴纳-香槟分校）；Petuum Inc.（Petuum 公司）
Due to the shortage of COVID-19 viral testing kits and the long waiting time, radiology imaging is used to complement the screening process and triage patients into different risk levels. Deep learning based methods have taken an active role in automatically detecting COVID-19 disease in chest x-ray images, as witnessed in many recent works in early 2020. Most of these works first train a Convolutional Neural Network (CNN) on an existing large-scale chest x-ray image dataset and then fine-tune it with a COVID-19 dataset at a much smaller scale. However, direct transfer across datasets from dif…
The First Affiliated Hospital of USTC（中国科学技术大学附属第一医院）；University of Science and Technology of China（中国科学技术大学）；University of Science and Technology（科技大学）；The first affiliated hospital of Bengbu medical college（蚌埠医学院第一附属医院）；AItour（AItour公司）
Background: Triage of patients is important to control the pandemic of coronavirus disease 2019 (COVID-19), especially during the peak of the pandemic when clinical resources become extremely limited. Purpose: To develop a method that automatically segments and quantifies lung and pneumonia lesions with synthetic chest CT and assess disease severity in COVID-19 patients. Materials and Methods: In this study, we incorporated data augmentation to generate synthetic chest CT images using public available datasets (285 datasets from "Lung Nodule Analysis 2016"). The synthetic images and masks were…
In recent years, considerable progress has been made in the non-contact based detection of the respiration rate from video sequences. Common techniques either directly assess the movement of the chest due to breathing or are based on analyzing subtle color changes that occur as a result of hemodynamic properties of the skin tissue by means of remote photoplethysmography (rPPG). However, extracting hemodynamic parameters from rPPG is often difficult especially if the skin is not visible to the camera. In contrast, extracting respiratory signals from chest movements turned out to be a robust met…
The University of Texas Arlington（德克萨斯大学阿灵顿分校）；RIKEN（理化学研究所）；University of Tokyo（东京大学）；National Cancer Center Research Institute（国立癌症中心研究所）；National Library of Medicine - National Institutes of Health（美国国立卫生研究院国家医学图书馆）；Temple University（天普大学）
Medical visual question answering (VQA) aims to answer clinically relevant questions regarding input medical images. This technique has the potential to improve the efficiency of medical professionals while relieving the burden on the public health system, particularly in resource-poor countries. Existing medical VQA methods tend to encode medical images and learn the correspondence between visual features and questions without exploiting the spatial, semantic, or medical knowledge behind them. This is partially because of the small size of the current medical VQA dataset, which often includes…
The coronavirus disease 2019 (COVID-19) affects billions of lives around the world and has a significant impact on public healthcare. Due to rising skepticism towards the sensitivity of RT-PCR as screening method, medical imaging like computed tomography offers great potential as alternative. For this reason, automated image segmentation is highly desired as clinical decision support for quantitative assessment and disease monitoring. However, publicly available COVID-19 imaging data is limited which leads to overfitting of traditional approaches. To address this problem, we propose an innovat…
