Nowadays, pulmonary Computed Tomography Angiography (CTA) is the main tool for detecting Pulmonary Embolism (PE). However, manual interpretation of CTA volume requires a radiologist, which is time-consuming and error-prone due to the specific conditions of lung tissue, large volume of data, lack of experience, and eye fatigue. Therefore, Computer-Aided Design (CAD) systems are used as a second opinion for the diagnosis of PE. The purpose of this article is to review, evaluate, and compare the performance of deep learning and traditional-based CAD system for diagnosis PE and to help physicians and researchers in this field. In this study, all articles available in databases such as IEEE, ScienceDirect, Wiley, Springer, Nature, and Wolters Kluwer in the field of PE diagnosis were examined using traditional and deep learning methods. From 2002 to 2023, 23 papers were studied to extract the articles with the considered limitations. Each paper presents an automatic PE detection system that we evaluate using criteria such as sensitivity, False Positives (FP), and the number of datasets. This research work includes recent studies, state-of-the-art research works, and a more comprehensive overview compared to previously published review articles in this research area.
With more than 60,000 deaths annually in the United States, Pulmonary Embolism (PE) is among the most fatal cardiovascular diseases. It is caused by an artery blockage in the lung; confirming its presence is time-consuming and is prone to over-diagnosis. The utilization of automated PE detection systems is critical for diagnostic accuracy and efficiency. In this study we propose a two-stage attention-based CNN-LSTM network for predicting PE, its associated type (chronic, acute) and corresponding location (leftsided, rightsided or central) on computed tomography (CT) examinations. We trained ou…
National Yang Ming Chiao Tung University（国立阳明交通大学）；National Cheng Kung University Hospital（国立成功大学医院）；National Cheng Kung University（国立成功大学）
The clinical symptoms of pulmonary embolism (PE) are very diverse and non-specific, which makes it difficult to diagnose. In addition, pulmonary embolism has multiple triggers and is one of the major causes of vascular death. Therefore, if it can be detected and treated quickly, it can significantly reduce the risk of death in hospitalized patients. In the detection process, the cost of computed tomography pulmonary angiography (CTPA) is high, and angiography requires the injection of contrast agents, which increase the risk of damage to the patient. Therefore, this study will use a deep learn…
National Chiao-Tung University（国立交通大学）；National Cheng Kung University Hospital（国立成功大学附属医院）；College of Medicine, National Cheng Kung University（国立成功大学医学院）
This study was conducted to develop a computer-aided detection (CAD) system for triaging patients with pulmonary embolism (PE). The purpose of the system was to reduce the death rate during the waiting period. Computed tomography pulmonary angiography (CTPA) is used for PE diagnosis. Because CTPA reports require a radiologist to review the case and suggest further management, this creates a waiting period during which patients may die. Our proposed CAD method was thus designed to triage patients with PE from those without PE. In contrast to related studies involving CAD systems that identify k…
Athena-Research and Innovation Center in Information, Communication and Knowledge Technologies（雅典娜信息、通信与知识技术研究与创新中心）；Hellenic Open University（希腊开放大学）；Sismanogleio General Hospital（西斯马诺格利奥综合医院）
The main objective of this work is to utilize state-of-the-art deep learning approaches for the identification of pulmonary embolism in CTPA-Scans for COVID-19 patients, provide an initial assessment of their performance and, ultimately, provide a fast-track prototype solution (system). We adopted and assessed some of the most popular convolutional neural network architectures through transfer learning approaches, to strive to combine good model accuracy with fast training. Additionally, we exploited one of the most popular one-stage object detection models for the localization (through object…
National Yang Ming Chiao Tung University（阳明交通大学）；National Cheng Kung University Hospital（成功大学附属医院）；National Cheng Kung University（成功大学）
The purpose of this research is to develop a system that generates simulated computed tomography pulmonary angiography (CTPA) images clinically for pulmonary embolism diagnoses. Nowadays, CTPA images are the gold standard computerized detection method to determine and identify the symptoms of pulmonary embolism (PE), although performing CTPA is harmful for patients and also expensive. Therefore, we aim to detect possible PE patients through CT images. The system will simulate CTPA images with deep learning models for the identification of PE patients' symptoms, providing physicians with anothe…
Stanford University（斯坦福大学）；Duke University（杜克大学）；Arizona State University（亚利桑那州立大学）
Despite the routine use of electronic health record (EHR) data by radiologists to contextualize clinical history and inform image interpretation, the majority of deep learning architectures for medical imaging are unimodal, i.e., they only learn features from pixel-level information. Recent research revealing how race can be recovered from pixel data alone highlights the potential for serious biases in models which fail to account for demographics and other key patient attributes. Yet the lack of imaging datasets which capture clinical context, inclusive of demographics and longitudinal medica…
Arizona State University（亚利桑那州立大学）；Mayo Clinic（梅奥诊所）
Pulmonary embolism (PE) represents a thrombus ("blood clot"), usually originating from a lower extremity vein, that travels to the blood vessels in the lung, causing vascular obstruction and in some patients, death. This disorder is commonly diagnosed using CT pulmonary angiography (CTPA). Deep learning holds great promise for the computer-aided CTPA diagnosis (CAD) of PE. However, numerous competing methods for a given task in the deep learning literature exist, causing great confusion regarding the development of a CAD PE system. To address this confusion, we present a comprehensive analysis…
Ferdowsi University of Mashhad（马什哈德菲尔多西大学）；Universidad de Alicante（阿利坎特大学）；Sierra Research S.L.（塞拉研究有限公司）；Unidad de Radiodiagnostico, Madrid（马德里放射诊断科）；CIBERBBN（西班牙生物医学网络研究中心）；Brigham and Women’s Hospital（布里格姆妇女医院）；Corades S.L.（科拉德斯有限公司）；LNM Institute of Information Technology（LNM信息技术学院）；Arizona State University（亚利桑那州立大学）
Rationale: Computer aided detection (CAD) algorithms for Pulmonary Embolism (PE) algorithms have been shown to increase radiologists' sensitivity with a small increase in specificity. However, CAD for PE has not been adopted into clinical practice, likely because of the high number of false positives current CAD software produces. Objective: To generate a database of annotated computed tomography pulmonary angiographies, use it to compare the sensitivity and false positive rate of current algorithms and to develop new methods that improve such metrics. Methods: 91 Computed tomography pulmonary…
Yale University（耶鲁大学）；IBM Almaden Research Center（IBM阿尔马登研究中心）；New York University（纽约大学）
Pulmonary Embolism (PE) is a life-threatening disorder associated with high mortality and morbidity. Prompt diagnosis and immediate initiation of therapeutic action is important. We explored a deep learning model to detect PE on volumetric contrast-enhanced chest CT scans using a 2-stage training strategy. First, a residual convolutional neural network (ResNet) was trained using annotated 2D images. In addition to the classification loss, an attention loss was added during training to help the network focus attention on PE. Next, a recurrent network was used to scan sequentially through the fe…
Unified-protocol voxel-level pulmonary embolism annotations for three public CT angiography datasets
Technical University of Munich (TUM)（慕尼黑工业大学）；Munich Center for Machine Learning (MCML)（慕尼黑机器学习中心）；The Affiliated Hospital of Xuzhou Medical University（徐州医科大学附属医院）；The Third Affiliated Hospital of Soochow University（苏州大学附属第三医院）；The Affiliated Taizhou People’s Hospital of Nanjing Medical University（南京医科大学附属泰州人民医院）
PE-MVCNet: Multi-view and Cross-modal Fusion Network for Pulmonary Embolism Prediction
Hangzhou Dianzi University（杭州电子科技大学）；Dalian Polytechnic University（大连工业大学）；The Second Affiliated Hospital of The Chinese University of Hong Kong（香港中文大学第二附属医院）；Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences（中国科学院深圳先进技术研究院）；Shenzhen Institute of Information Technology（深圳信息职业技术学院）；Shenzhen Research Institute of Big Data（深圳大数据研究院）；Hangzhou Institute of Advanced Technology（杭州高等研究院）
Pulmonary embolisms (PE) are known to be one of the leading causes for cardiac-related mortality. Due to inherent variabilities in how PE manifests and the cumbersome nature of manual diagnosis, there is growing interest in leveraging AI tools for detecting PE. In this paper, we build a two-stage detection pipeline that is accurate, computationally efficient, robust to variations in PE types and kernels used for CT reconstruction, and most importantly, does not require dense annotations. Given the challenges in acquiring expert annotations in large-scale datasets, our approach produces state-o…
Karlsruhe Institute of Technology（卡尔斯鲁厄理工学院）；University Hospital Heidelberg（海德堡大学医院）；German Cancer Research Center（德国癌症研究中心）；University Hospital Essen（埃森大学医院）
Detector-based spectral computed tomography is a recent dual-energy CT (DECT) technology that offers the possibility of obtaining spectral information. From this spectral data, different types of images can be derived, amongst others virtual monoenergetic (monoE) images. MonoE images potentially exhibit decreased artifacts, improve contrast, and overall contain lower noise values, making them ideal candidates for better delineation and thus improved diagnostic accuracy of vascular abnormalities. In this paper, we are training convolutional neural networks~(CNN) that can emulate the generation …
Cross-Phase Mutual Learning Framework for Pulmonary Embolism Identification on Non-Contrast CT Scans
DAMO Academy, Alibaba Group（阿里巴巴达摩院）；School of Information Science and Technology, Fudan University（复旦大学信息科学与技术学院）；College of Computer Science and Technology, Zhejiang University（浙江大学计算机科学与技术学院）；The First Affiliated Hospital of Zhejiang University School of Medicine（浙江大学医学院附属第一医院）
X-ray2CTPA: Leveraging Diffusion Models to Enhance Pulmonary Embolism Classification
Faculty of Engineering, Tel Aviv University（工程学院，特拉维夫大学）；Division of Data-Driven and Digital Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai（数据驱动与数字医学部，医学部，Mount Sinai医学院）；Department of Diagnostic Imaging, Sheba Medical Center, Ramat Gan, Israel（诊断影像科，Sheba 医疗中心，Ramat Gan，以色列）；Department of Radiology, Icahn School of Medicine, Mount Sinai（放射科，Icahn医学院，Mount Sinai）
National Yang Ming Chiao Tung University（阳明交通大学）；National Cheng Kung University Hospital（国立成功大学医学院附设医院）；National Cheng Kung University（国立成功大学）
This study established a feature-enhanced adversarial semi-supervised semantic segmentation model to automatically annotate pulmonary embolism lesion areas in computed tomography pulmonary angiogram (CTPA) images. In current studies, all of the PE CTPA image segmentation methods are trained by supervised learning. However, the supervised learning models need to be retrained and the images need to be relabeled when the CTPA images come from different hospitals. This study proposed a semi-supervised learning method to make the model applicable to different datasets by adding a small amount of un…
SCUNet++: Swin-UNet and CNN Bottleneck Hybrid Architecture with Multi-Fusion Dense Skip Connection for Pulmonary Embolism CT Image Segmentation
Hangzhou Dianzi University（杭州电子科技大学）；Second Affiliated Hospital of the Chinese University of Hong Kong（香港中文大学第二附属医院）；Shenzhen Research Institute of Big Data（深圳市大数据研究院）
Lung cancer has the highest mortality rate of deadly cancers in the world. Early detection is essential to treatment of lung cancer. However, detection and accurate diagnosis of pulmonary nodules depend heavily on the experiences of radiologists and can be a heavy workload for them. Computer-aided diagnosis (CAD) systems have been developed to assist radiologists in nodule detection and diagnosis, greatly easing the workload while increasing diagnosis accuracy. Recent development of deep learning, greatly improved the performance of CAD systems. However, lack of model reliability and interpret…
Henan Provincial Chest Hospital（河南省胸科医院）；Harbin Institute of Technology（哈尔滨工业大学）；Huiying Medical Technology (Beijing) Co., Ltd.（慧影医疗科技（北京）有限公司）
Objective: We propose an end-to-end CNN-based locating model for pulmonary tuberculosis (TB) diagnosis in radiographs. This model makes full use of chest radiograph (X-ray) for its improved accessibility, reduced cost and high accuracy for TB disease. Methods: Several specialized improvements are proposed for detection task in medical field. A false positive (FP) restrictor head is introduced for FP reduction. Anchor-oriented network heads is proposed in the position regression section. An optimization of loss function is designed for hard example mining. Results: The experimental results show…
Diagnosis of pulmonary lesions from computed tomography (CT) is important but challenging for clinical decision making in lung cancer related diseases. Deep learning has achieved great success in computer aided diagnosis (CADx) area for lung cancer, whereas it suffers from label ambiguity due to the difficulty in the radiological diagnosis. Considering that invasive pathological analysis serves as the clinical golden standard of lung cancer diagnosis, in this study, we solve the label ambiguity issue via a large-scale radio-pathomics dataset containing 5,134 radiological CT images with patholo…
EMeRALDS: Electronic Medical Record Driven Automated Lung Nodule Detection and Classification in Thoracic CT Images
Faculty of Electrical and Electronics Engineering, University of Engineering（电气电子工程学院，工程大学）；Department of Engineering Sciences, University of Agder（工程科学系，阿格德大学）；Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Hospital（谢赫扎耶德小儿外科创新研究所，儿童医院）；School of Medicine and Health Sciences, George Washington University（医学与健康科学学院，乔治华盛顿大学）
College of Physics and Information Engineering, Fuzhou University（福州大学物理与信息工程学院）；Thoracic Department, Fujian Medical University Union Hospital（福建医科大学附属协和医院胸外科）
Background and Objective:Computer-aided diagnosis (CAD) systems promote diagnosis effectiveness and alleviate pressure of radiologists. A CAD system for lung cancer diagnosis includes nodule candidate detection and nodule malignancy evaluation. Recently, deep learning-based pulmonary nodule detection has reached satisfactory performance ready for clinical application. However, deep learning-based nodule malignancy evaluation depends on heuristic inference from low-dose computed tomography volume to malignant probability, which lacks clinical cognition. Methods:In this paper, we propose a joint…
