3D lung segmentation is essential since it processes the volumetric information of the lungs, removes the unnecessary areas of the scan, and segments the actual area of the lungs in a 3D volume. Recently, the deep learning model, such as U-Net outperforms other network architectures for biomedical image segmentation. In this paper, we propose a novel model, namely, Recurrent Residual 3D U-Net (R2U3D), for the 3D lung segmentation task. In particular, the proposed model integrates 3D convolution into the Recurrent Residual Neural Network based on U-Net. It helps learn spatial dependencies in 3D and increases the propagation of 3D volumetric information. The proposed R2U3D network is trained on the publicly available dataset LUNA16 and it achieves state-of-the-art performance on both LUNA16 (testing set) and VESSEL12 dataset. In addition, we show that training the R2U3D model with a smaller number of CT scans, i.e., 100 scans, without applying data augmentation achieves an outstanding result in terms of Soft Dice Similarity Coefficient (Soft-DSC) of 0.9920.
Washington University School of Medicine(华盛顿大学医学院)
Deep Learning networks have established themselves as providing state of art performance for semantic segmentation. These techniques are widely applied specifically to medical detection, segmentation and classification. The advent of the U-Net based architecture has become particularly popular for this application. In this paper we present the Dense Recurrent Residual Convolutional Neural Network(Dense R2U CNN) which is a synthesis of Recurrent CNN, Residual Network and Dense Convolutional Network based on the U-Net model architecture. The residual unit helps training deeper network, while the…
Lung cancer has emerged as a severe disease that threatens human life and health. The precise segmentation of lung regions is a crucial prerequisite for localizing tumors, which can provide accurate information for lung image analysis. In this work, we first propose a lung image segmentation model using the NASNet-Large as an encoder and then followed by a decoder architecture, which is one of the most commonly used architectures in deep learning for image segmentation. The proposed NASNet-Large-decoder architecture can extract high-level information and expand the feature map to recover the s…
University of Iowa(爱荷华大学);Boston University(波士顿大学);University of Pennsylvania(宾夕法尼亚大学);University of Milano-Bicocca(米兰比可卡大学);San Gerardo Hospital(圣杰拉多医院)
The purpose of this study was to develop a fully-automated segmentation algorithm, robust to various density enhancing lung abnormalities, to facilitate rapid quantitative analysis of computed tomography images. A polymorphic training approach is proposed, in which both specifically labeled left and right lungs of humans with COPD, and nonspecifically labeled lungs of animals with acute lung injury, were incorporated into training a single neural network. The resulting network is intended for predicting left and right lung regions in humans with or without diffuse opacification and consolidati…
University of Turin(都灵大学);Fondazione Ricerca Molinette Onlus(莫利内特研究基金会(非营利组织))
The accurate and consistent border segmentation plays an important role in the tumor volume estimation and its treatment in the field of Medical Image Segmentation. Globally, Lung cancer is one of the leading causes of death and the early detection of lung nodules is essential for the early cancer diagnosis and survival rate of patients. The goal of this study was to demonstrate the feasibility of Deephealth toolkit including PyECVL and PyEDDL libraries to precisely segment lung nodules. Experiments for lung nodules segmentation has been carried out on UniToChest using PyECVL and PyEDDL, for d…
Imperial College London(帝国理工学院);The University of Hong Kong(香港大学)
Transfer learning (TL) for medical image segmentation helps deep learning models achieve more accurate performances when there are scarce medical images. This study focuses on completing segmentation of the ribs from lung ultrasound images and finding the best TL technique with U-Net, a convolutional neural network for precise and fast image segmentation. Two approaches of TL were used, using a pre-trained VGG16 model to build the U-Net (V-Unet) and pre-training U-Net network with grayscale natural salient object dataset (X-Unet). Visual results and dice coefficients (DICE) of the models were …
ARTORG Center for Biomedical Engineering Research, University of Bern(伯尔尼大学ARTORG生物医学工程研究中心);Department of Emergency Medicine, Bern University Hospital “Inselspital”(伯尔尼大学医院“Inselspital”急诊医学系);University Clinic for Pneumonology, Bern University Hospital “Inselspital”(伯尔尼大学医院“Inselspital”肺科大学诊所);Department of Diagnostic, Interventional and Pediatric Radiology, Bern University Hospital “Inselspital”(伯尔尼大学医院“Inselspital”诊断、介入和儿科放射学系);Bern University Hospital “Inselspital”(伯尔尼大学医院“Inselspital”);University of Bern(伯尔尼大学)
Early and accurate diagnosis of interstitial lung diseases (ILDs) is crucial for making treatment decisions, but can be challenging even for experienced radiologists. The diagnostic procedure is based on the detection and recognition of the different ILD pathologies in thoracic CT scans, yet their manifestation often appears similar. In this study, we propose the use of a deep purely convolutional neural network for the semantic segmentation of ILD patterns, as the basic component of a computer aided diagnosis (CAD) system for ILDs. The proposed CNN, which consists of convolutional layers with…
A variety of deep neural networks have been applied in medical image segmentation and achieve good performance. Unlike natural images, medical images of the same imaging modality are characterized by the same pattern, which indicates that same normal organs or tissues locate at similar positions in the images. Thus, in this paper we try to incorporate the prior knowledge of medical images into the structure of neural networks such that the prior knowledge can be utilized for accurate segmentation. Based on this idea, we propose a novel deep network called knowledge-based fully convolutional ne…
National Institutes of Health Clinical Center(美国国立卫生研究院临床中心);Beijing Institute of Big Data Research(北京大数据研究院)
Image segmentation is a fundamental problem in medical image analysis. In recent years, deep neural networks achieve impressive performances on many medical image segmentation tasks by supervised learning on large manually annotated data. However, expert annotations on big medical datasets are tedious, expensive or sometimes unavailable. Weakly supervised learning could reduce the effort for annotation but still required certain amounts of expertise. Recently, deep learning shows a potential to produce more accurate predictions than the original erroneous labels. Inspired by this, we introduce…
Deep learning (DL) based semantic segmentation methods have been providing state-of-the-art performance in the last few years. More specifically, these techniques have been successfully applied to medical image classification, segmentation, and detection tasks. One deep learning technique, U-Net, has become one of the most popular for these applications. In this paper, we propose a Recurrent Convolutional Neural Network (RCNN) based on U-Net as well as a Recurrent Residual Convolutional Neural Network (RRCNN) based on U-Net models, which are named RU-Net and R2U-Net respectively. The proposed …
The University of Tokyo(东京大学);National Institute for Quantum and Radiological Science and Technology(国立量子与放射科学技术研究所)
During the radiotherapy treatment of patients with lung cancer, the radiation delivered to healthy tissue around the tumor needs to be minimized, which is difficult because of respiratory motion and the latency of linear accelerator systems. In the proposed study, we first use the Lucas-Kanade pyramidal optical flow algorithm to perform deformable image registration of chest computed tomography scan images of four patients with lung cancer. We then track three internal points close to the lung tumor based on the previously computed deformation field and predict their position with a recurrent …
University of Waterloo(滑铁卢大学);Vector Institute for Artificial Intelligence(矢量人工智能研究所);University of Guelph(圭尔夫大学)
Many real-world tasks such as classification of digital histopathology images and 3D object detection involve learning from a set of instances. In these cases, only a group of instances or a set, collectively, contains meaningful information and therefore only the sets have labels, and not individual data instances. In this work, we present a permutation invariant neural network called Memory-based Exchangeable Model (MEM) for learning set functions. The MEM model consists of memory units that embed an input sequence to high-level features enabling the model to learn inter-dependencies among i…
The state of the art lung nodule detection studies rely on computationally expensive multi-stage frameworks to detect nodules from CT scans. To address this computational challenge and provide better performance, in this paper we propose S4ND, a new deep learning based method for lung nodule detection. Our approach uses a single feed forward pass of a single network for detection and provides better performance when compared to the current literature. The whole detection pipeline is designed as a single $3D$ Convolutional Neural Network (CNN) with dense connections, trained in an end-to-end ma…
The performance of a computer-aided automated diagnosis system of lung cancer from Computed Tomography (CT) volumetric images greatly depends on the accurate detection and segmentation of tumor regions. In this paper, we present Recurrent 3D-DenseUNet, a novel deep learning based architecture for volumetric lung tumor segmentation from CT scans. The proposed architecture consists of a 3D encoder block that learns to extract fine-grained spatial and coarse-grained temporal features, a recurrent block of multiple Convolutional Long Short-Term Memory (ConvLSTM) layers to extract fine-grained spat…
The University of Tokyo(东京大学);Japan Atomic Energy Commission(日本原子能委员会);National Institutes for Quantum and Radiological Science and Technology(日本量子科学技术研究开发机构)
During lung radiotherapy, the position of infrared reflective objects on the chest can be recorded to estimate the tumor location. However, radiotherapy systems have a latency inherent to robot control limitations that impedes the radiation delivery precision. Prediction with online learning of recurrent neural networks (RNN) allows for adaptation to non-stationary respiratory signals, but classical methods such as RTRL and truncated BPTT are respectively slow and biased. This study investigates the capabilities of unbiased online recurrent optimization (UORO) to forecast respiratory motion an…
School of Applied Mathematics, Xiamen University of Technology(厦门理工学院应用数学学院)
Lung image segmentation plays an important role in computer-aid pulmonary diseases diagnosis and treatment. This paper proposed a lung image segmentation method by generative adversarial networks. We employed a variety of generative adversarial networks and use its capability of image translation to perform image segmentation. The generative adversarial networks was employed to translate the original lung image to the segmented image. The generative adversarial networks based segmentation method was test on real lung image data set. Experimental results shows that the proposed method is effect…
Mohamed bin Zayed University of Artificial Intelligence(穆罕默德·本·扎耶德人工智能大学)
Lung cancer is a leading cause of death worldwide. Early-stage detection of lung cancer is essential for a more favorable prognosis. Radiogenomics is an emerging discipline that combines medical imaging and genomics features for modeling patient outcomes non-invasively. This study presents a radiogenomics pipeline that has: 1) a novel mixed architecture (RA-Seg) to segment lung cancer through attention and recurrent blocks; and 2) deep feature classifiers to distinguish Epidermal Growth Factor Receptor (EGFR) mutation status. We evaluate the proposed algorithm on multiple public datasets to as…
Kyoto University Graduate School of Medicine(京都大学医学研究科)
Rationale and objectives: Several studies have evaluated the usefulness of deep learning for lung segmentation using chest x-ray (CXR) images with small- or medium-sized abnormal findings. Here, we built a database including both CXR images with severe abnormalities and experts' lung segmentation results, and aimed to evaluate our network's efficacy in lung segmentation from these images. Materials and Methods: For lung segmentation, CXR images from the Japanese Society of Radiological Technology (JSRT, N = 247) and Montgomery databases (N = 138), were included, and 65 additional images depict…
National University of Sciences and Technology(国立科技大学)
An essential stage in computer aided diagnosis of chest X rays is automated lung segmentation. Due to rib cages and the unique modalities of each persons lungs, it is essential to construct an effective automated lung segmentation model. This paper presents a reliable model for the segmentation of lungs in chest radiographs. Our model overcomes the challenges by learning to ignore unimportant areas in the source Chest Radiograph and emphasize important features for lung segmentation. We evaluate our model on public datasets, Montgomery and Shenzhen. The proposed model has a DICE coefficient of…
Universitat Rovira i Virgili(罗维拉-威尔吉利大学);Robert Gordon University(罗伯特戈登大学);Aswan University(阿斯旺大学)
Lung cancer is deadly cancer that causes millions of deaths every year around the world. Accurate lung nodule detection and segmentation in computed tomography (CT) images is the most important part of diagnosing lung cancer in the early stage. Most of the existing systems are semi-automated and need to manually select the lung and nodules regions to perform the segmentation task. To address these challenges, we proposed a fully automated end-to-end lung nodule detection and segmentation system based on a deep learning approach. In this paper, we used Optimized Faster R-CNN; a state-of-the-art…
Wayne State Univ.(韦恩州立大学);NanoBioScience Institute, Wayne State Univ.(韦恩州立大学纳米生物科学研究所);University of Michigan(密歇根大学);Henry Ford Health System(亨利福特医疗系统)
Deep Neural Networks (DNN) are widely used to carry out segmentation tasks in biomedical images. Most DNNs developed for this purpose are based on some variation of the encoder-decoder U-Net architecture. Here we show that Res-CR-Net, a new type of fully convolutional neural network, which was originally developed for the semantic segmentation of microscopy images, and which does not adopt a U-Net architecture, is very effective at segmenting the lung fields in chest X-rays from either healthy patients or patients with a variety of lung pathologies.
Lung and Colon cancer are one of the leading causes of mortality and morbidity in adults. Histopathological diagnosis is one of the key components to discern cancer type. The aim of the present research is to propose a computer aided diagnosis system for diagnosing squamous cell carcinomas and adenocarcinomas of lung as well as adenocarcinomas of colon using convolutional neural networks by evaluating the digital pathology images for these cancers. Hereby, rendering artificial intelligence as useful technology in the near future. A total of 2500 digital images were acquired from LC25000 datase…
Lung nodules can be an alarming precursor to potential lung cancer. Missed nodule detections during chest radiograph analysis remains a common challenge among thoracic radiologists. In this work, we present a multi-task lung nodule detection algorithm for chest radiograph analysis. Unlike past approaches, our algorithm predicts a global-level label indicating nodule presence along with local-level labels predicting nodule locations using a Dual Head Network (DHN). We demonstrate the favorable nodule detection performance that our multi-task formulation yields in comparison to conventional meth…
Bharti School of Telecommunications Technology & Management, Indian Institute of Technology Delhi(印度理工学院德里分校巴蒂电信技术与管理学院);Teleradiology Solutions(远程放射学解决方案公司);CSIR-Institute of Genomics and Integrative Biology(CSIR基因组学与整合生物学研究所);Christian Medical College, Vellore(韦洛尔基督教医学院)
A chest radiograph, commonly called chest x-ray (CxR), plays a vital role in the diagnosis of various lung diseases, such as lung cancer, tuberculosis, pneumonia, and many more. Automated segmentation of the lungs is an important step to design a computer-aided diagnostic tool for examination of a CxR. Precise lung segmentation is considered extremely challenging because of variance in the shape of the lung caused by health issues, age, and gender. The proposed work investigates the use of an efficient deep convolutional neural network for accurate segmentation of lungs from CxR. We attempt an…
With an estimated 160,000 deaths in 2018, lung cancer is the most common cause of cancer death in the United States. Lung cancer CT screening has been shown to reduce mortality by up to 40% and is now included in US screening guidelines. Reducing the high error rates in lung cancer screening is imperative because of the high clinical and financial costs caused by diagnosis mistakes. Despite the use of standards for radiological diagnosis, persistent inter-grader variability and incomplete characterization of comprehensive imaging findings remain as limitations of current methods. These limitat…
Early detection of lung cancer is an effective way to improve the survival rate of patients. It is a critical step to have accurate detection of lung nodules in computed tomography (CT) images for the diagnosis of lung cancer. However, due to the heterogeneity of the lung nodules and the complexity of the surrounding environment, robust nodule detection has been a challenging task. In this study, we propose a two-stage convolutional neural network (TSCNN) architecture for lung nodule detection. The CNN architecture in the first stage is based on the improved UNet segmentation network to establ…
Cancer is the uncontrollable cell division of abnormal cells inside the human body, which can spread to other body organs. It is one of the non-communicable diseases (NCDs) and NCDs accounts for 71% of total deaths worldwide whereas lung cancer is the second most diagnosed cancer after female breast cancer. Cancer survival rate of lung cancer is only 19%. There are various methods for the diagnosis of lung cancer, such as X-ray, CT scan, PET-CT scan, bronchoscopy and biopsy. However, to know the subtype of lung cancer based on the tissue type H and E staining is widely used, where the staining…
National Engineering Laboratory for Integrated Aero-Space-Ground-Ocean Big Data Application Technology(国家空天地海一体化大数据应用技术国家工程实验室);School of Computer Science and Engineering, Northwestern Polytechnical University(西北工业大学计算机科学与工程学院)
Lung nodule malignancy prediction is an essential step in the early diagnosis of lung cancer. Besides the difficulties commonly discussed, the challenges of this task also come from the ambiguous labels provided by annotators, since deep learning models may learn, even amplify, the bias embedded in them. In this paper, we propose a multi-view "divide-and-rule" (MV-DAR) model to learn from both reliable and ambiguous annotations for lung nodule malignancy prediction. According to the consistency and reliability of their annotations, we divide nodules into three sets: a consistent and reliable s…
Imperial College London(伦敦帝国理工学院);Imperial College NHS Trust(帝国理工学院国民医疗服务信托)
Automated lobar segmentation allows regional evaluation of lung disease and is important for diagnosis and therapy planning. Advanced statistical workflows permitting such evaluation is a needed area within respiratory medicine; their adoption remains slow, with poor workflow accuracy. Diseased lung regions often produce high-density zones on CT images, limiting an algorithm's execution to specify damaged lobes due to oblique or lacking fissures. This impact motivated developing an improved machine learning method to segment lung lobes that utilises tracheobronchial tree information to enhance…
Jordan University of Science and Technology(约旦科技大学)
Purpose: The lung nodules localization in CT scan images is the most difficult task due to the complexity of the arbitrariness of shape, size, and texture of lung nodules. This is a challenge to be faced when coming to developing different solutions to improve detection systems. the deep learning approach showed promising results by using convolutional neural network (CNN), especially for image recognition and it's one of the most used algorithm in computer vision. Approach: we use (CNN) building blocks based on YOLOv5 (you only look once) to learn the features representations for nodule detec…
An early effective screening and grading of COVID-19 has become imperative towards optimizing the limited available resources of the medical facilities. An automated segmentation of the infected volumes in lung CT is expected to significantly aid in the diagnosis and care of patients. However, an accurate demarcation of lesions remains problematic due to their irregular structure and location(s) within the lung. A novel deep learning architecture, Composite Deep network with Feature Weighting (CDNetFW), is proposed for efficient delineation of infected regions from lung CT images. Initially a …
Amity School of Engineering and Technology, Amity University(阿米提大学阿米提工程技术学院);Dr. Ram Manohar Lohia Awadh University(拉姆·马诺哈尔·洛希亚博士阿瓦德大学)
Computer Aided Diagnosis has emerged as an indispensible technique for validating the opinion of radiologists in CT interpretation. This paper presents a deep 3D Convolutional Neural Network (CNN) architecture for automated CT scan-based lung cancer detection system. It utilizes three dimensional spatial information to learn highly discriminative 3 dimensional features instead of 2D features like texture or geometric shape whick need to be generated manually. The proposed deep learning method automatically extracts the 3D features on the basis of spatio-temporal statistics.The developed model …
Lung nodules are commonly missed in chest radiographs. We propose and evaluate P-AnoGAN, an unsupervised anomaly detection approach for lung nodules in radiographs. P-AnoGAN modifies the fast anomaly detection generative adversarial network (f-AnoGAN) by utilizing a progressive GAN and a convolutional encoder-decoder-encoder pipeline. Model training uses only unlabelled healthy lung patches extracted from the Indiana University Chest X-Ray Collection. External validation and testing are performed using healthy and unhealthy patches extracted from the ChestX-ray14 and Japanese Society for Radio…
In this work we present a method for lung nodules segmentation, their texture classification and subsequent follow-up recommendation from the CT image of lung. Our method consists of neural network model based on popular U-Net architecture family but modified for the joint nodule segmentation and its texture classification tasks and an ensemble-based model for the follow-up recommendation. This solution was evaluated within the LNDb medical imaging challenge and produced the best nodule segmentation result on the final leaderboard.
Government Medical College, Thiruvananthapuram(特里凡得琅政府医学院);Hospital Universitario Puerta de Hierro(普埃尔塔德耶罗大学医院)
Ultrasound is fast becoming an inevitable diagnostic tool for regular and continuous monitoring of the lung with the recent outbreak of COVID-19. In this work, a novel approach is presented to extract acoustic propagation-based features to automatically highlight the region below pleura, which is an important landmark in lung ultrasound (LUS). Subsequently, a multichannel input formed by using the acoustic physics-based feature maps is fused to train a neural network, referred to as LUSNet, to classify the LUS images into five classes of varying severity of lung infection to track the progress…
University of Iowa(爱荷华大学);University of California, Los Angeles(加利福尼亚大学洛杉矶分校);University of Utah(犹他大学)
Local tissue expansion of the lungs is typically derived by registering computed tomography (CT) scans acquired at multiple lung volumes. However, acquiring multiple scans incurs increased radiation dose, time, and cost, and may not be possible in many cases, thus restricting the applicability of registration-based biomechanics. We propose a generative adversarial learning approach for estimating local tissue expansion directly from a single CT scan. The proposed framework was trained and evaluated on 2500 subjects from the SPIROMICS cohort. Once trained, the framework can be used as a registr…
MESAHA-Net: Multi-Encoders based Self-Adaptive Hard Attention Network with Maximum Intensity Projections for Lung Nodule Segmentation in CT Scan
Department of Computer Science and Engineering, Seoul National University(计算机科学与工程系,首尔国立大学);Center for Artificial Intelligence in Medicine and Imaging, HealthHub Co. Ltd.(医学与影像人工智能中心,HealthHub公司);Department of Electrical and Computer Engineering, The University of Alabama(电气与计算机工程系,阿拉巴马大学);Department of Electrical Engineering, COMSATS University Islamabad(电气工程系,COMSATS大学伊斯兰堡分校)
Zhengzhou University(郑州大学);Ningbo Huamei Hospital, University of the Chinese Academy of Sciences(中国科学院大学宁波华美医院)
The spread of the novel coronavirus disease 2019 (COVID-19) has claimed millions of lives. Automatic segmentation of lesions from CT images can assist doctors with screening, treatment, and monitoring. However, accurate segmentation of lesions from CT images can be very challenging due to data and model limitations. Recently, Transformer-based networks have attracted a lot of attention in the area of computer vision, as Transformer outperforms CNN at a bunch of tasks. In this work, we propose a novel network structure that combines CNN and Transformer for the segmentation of COVID-19 lesions. …
HealthHub Co. Ltd.(HealthHub有限公司);Seoul National University(首尔国立大学);University of Southern Queensland(南昆士兰大学);Kyonggi University(京畿大学)
In this study, we propose a lung nodule detection scheme which fully incorporates the clinic workflow of radiologists. Particularly, we exploit Bi-Directional Maximum intensity projection (MIP) images of various thicknesses (i.e., 3, 5 and 10mm) along with a 3D patch of CT scan, consisting of 10 adjacent slices to feed into self-distillation-based Multi-Encoders Network (MEDS-Net). The proposed architecture first condenses 3D patch input to three channels by using a dense block which consists of dense units which effectively examine the nodule presence from 2D axial slices. This condensed info…
Huazhong University of Science and Technology(华中科技大学);Kennesaw State University(肯尼索州立大学)
An accurate segmentation of lung nodules in computed tomography (CT) images is critical to lung cancer analysis and diagnosis. However, due to the variety of lung nodules and the similarity of visual characteristics between nodules and their surroundings, a robust segmentation of nodules becomes a challenging problem. In this study, we propose the Dual-branch Residual Network (DB-ResNet) which is a data-driven model. Our approach integrates two new schemes to improve the generalization capability of the model: 1) the proposed model can simultaneously capture multi-view and multi-scale features…
Chongqing University(重庆大学);University of Science and Technology of China(中国科学技术大学)
Since radiologists have different training and clinical experiences, they may provide various segmentation annotations for a lung nodule. Conventional studies choose a single annotation as the learning target by default, but they waste valuable information of consensus or disagreements ingrained in the multiple annotations. This paper proposes an Uncertainty-Guided Segmentation Network (UGS-Net), which learns the rich visual features from the regions that may cause segmentation uncertainty and contributes to a better segmentation result. With an Uncertainty-Aware Module, this network can provi…
The University of Sydney(悉尼大学);Royal Prince Alfred Hospital(皇家阿尔弗雷德王子医院)
Accurate characterisation of visual attributes such as spiculation, lobulation, and calcification of lung nodules is critical in cancer management. The characterisation of these attributes is often subjective, which may lead to high inter- and intra-observer variability. Furthermore, lung nodules are often heterogeneous in the cross-sectional image slices of a 3D volume. Current state-of-the-art methods that score multiple attributes rely on deep learning-based multi-task learning (MTL) schemes. These methods, however, extract shared visual features across attributes and then examine each attr…
University of Michigan(密歇根大学);Imbio LLC(Imbio有限责任公司)
Early detection of lung cancer is critical for improvement of patient survival. To address the clinical need for efficacious treatments, genetically engineered mouse models (GEMM) have become integral in identifying and evaluating the molecular underpinnings of this complex disease that may be exploited as therapeutic targets. Assessment of GEMM tumor burden on histopathological sections performed by manual inspection is both time consuming and prone to subjective bias. Therefore, an interplay of needs and challenges exists for computer-aided diagnostic tools, for accurate and efficient analys…