An ensemble classifier system for early diagnosis of acute lymphoblastic leukemia in blood microscopic images

An attention-based deep learning for acute lymphoblastic leukemia classification

The bone marrow overproduces immature cells in the malignancy known as Acute Lymphoblastic Leukemia (ALL). In the United States, about 6500 occurrences of ALL are diagnosed each year in both children and adults, comprising nearly 25% of pediatric cancer cases. Recently, many computer-assisted diagnosis (CAD) systems have been proposed to aid hematologists in reducing workload, providing correct results, and managing enormous volumes of data. Traditional CAD systems rely on hematologists' expertise, specialized features, and subject knowledge. Utilizing early detection of ALL can aid radiologists and doctors in making medical decisions. In this study, Deep Dilated Residual Convolutional Neural Network (DDRNet) is presented for the classification of blood cell images, focusing on eosinophils, lymphocytes, monocytes, and neutrophils. To tackle challenges like vanishing gradients and enhance feature extraction, the model incorporates Deep Residual Dilated Blocks (DRDB) for faster convergence. Conventional residual blocks are strategically placed between layers to preserve original information and extract general feature maps. Global and Local Feature Enhancement Blocks (GLFEB) balance weak contributions from shallow layers for improved feature normalization. The global feature from the initial convolution layer, when combined with GLFEB-processed features, reinforces classification representations. The Tanh function introduces non-linearity. A Channel and Spatial Attention Block (CSAB) is integrated into the neural network to emphasize or minimize specific feature channels, while fully connected layers transform the data. The use of a sigmoid activation function concentrates on relevant features for multiclass lymphoblastic leukemia classification The model was analyzed with Kaggle dataset (16,249 images) categorized into four classes, with a training and testing ratio of 80:20. Experimental results showed that DRDB, GLFEB and CSAB blocks' feature discrimination ability boosted the DDRNet model F1 score to 0.96 with minimal computational complexity and optimum classification accuracy of 99.86% and 91.98% for training and testing data. The DDRNet model stands out from existing methods due to its high testing accuracy of 91.98%, F1 score of 0.96, minimal computational complexity, and enhanced feature discrimination ability. The strategic combination of these blocks (DRDB, GLFEB, and CSAB) are designed to address specific challenges in the classification process, leading to improved discrimination of features crucial for accurate multi-class blood cell image identification. Their effective integration within the model contributes to the superior performance of DDRNet.

Immunotherapy of Hematological Malignancies of Human B-Cell Origin with CD19 CAR T Lymphocytes

Acute lymphoblastic leukemia (ALL) and non-Hodgkin's lymphoma (NHL) are hematological malignancies with high incidence rates that respond relatively well to conventional therapies. However, a major issue is the clinical emergence of patients with relapsed or refractory (r/r) NHL or ALL. In such circumstances, opportunities for complete remission significantly decline and mortality rates increase. The recent FDA approval of multiple cell-based therapies, Kymriah (tisagenlecleucel), Yescarta (axicabtagene ciloleucel), Tecartus (Brexucabtagene autoleucel KTE-X19), and Breyanzi (Lisocabtagene Maraleucel), has provided hope for those with r/r NHL and ALL. These new cell-based immunotherapies use genetically engineered chimeric antigen receptor (CAR) T-cells, whose success can be attributed to CAR's high specificity in recognizing B-cell-specific CD19 surface markers present on various B-cell malignancies and the subsequent initiation of anti-tumor activity. The efficacy of these treatments has led to promising results in many clinical trials, but relapses and adverse reactions such as cytokine release syndrome (CRS) and neurotoxicity (NT) remain pervasive, leaving areas for improvement in current and subsequent trials. In this review, we highlight the current information on traditional treatments of NHL and ALL, the design and manufacturing of various generations of CAR T-cells, the FDA approval of Kymriah, Yescarta Tecartus, and Breyanzi, and a summary of prominent clinical trials and the notable disadvantages of treatments. We further discuss approaches to potentially enhance CAR T-cell therapy for these malignancies, such as the inclusion of a suicide gene and use of FDA-approved drugs.

From microscope to micropixels: A rapid review of artificial intelligence for the peripheral blood film

Artificial intelligence (AI) and its application in classification of blood cells in the peripheral blood film is an evolving field in haematology. We performed a rapid review of the literature on AI and peripheral blood films, evaluating the condition studied, image datasets, machine learning models, training set size, testing set size and accuracy. A total of 283 studies were identified, encompassing 6 broad domains: malaria (n = 95), leukemia (n = 81), leukocytes (n = 72), mixed (n = 25), erythrocytes (n = 15) or Myelodysplastic syndrome (MDS) (n = 1). These publications have demonstrated high self-reported mean accuracy rates across various studies (95.5% for malaria, 96.0% for leukemia, 94.4% for leukocytes, 95.2% for mixed studies and 91.2% for erythrocytes), with an overall mean accuracy of 95.1%. Despite the high accuracy, the challenges toward real world translational usage of these AI trained models include the need for well-validated multicentre data, data standardisation, and studies on less common cell types and non-malarial blood-borne parasites.

Blood cell image segmentation and classification: a systematic review

Background

Blood diseases such as leukemia, anemia, lymphoma, and thalassemia are hematological disorders that relate to abnormalities in the morphology and concentration of blood elements, specifically white blood cells (WBC) and red blood cells (RBC). Accurate and efficient diagnosis of these conditions significantly depends on the expertise of hematologists and pathologists. To assist the pathologist in the diagnostic process, there has been growing interest in utilizing computer-aided diagnostic (CAD) techniques, particularly those using medical image processing and machine learning algorithms. Previous surveys in this domain have been narrowly focused, often only addressing specific areas like segmentation or classification but lacking a holistic view like segmentation, classification, feature extraction, dataset utilization, evaluation matrices, etc.

Methodology

This survey aims to provide a comprehensive and systematic review of existing literature and research work in the field of blood image analysis using deep learning techniques. It particularly focuses on medical image processing techniques and deep learning algorithms that excel in the morphological characterization of WBCs and RBCs. The review is structured to cover four main areas: segmentation techniques, classification methodologies, descriptive feature selection, evaluation parameters, and dataset selection for the analysis of WBCs and RBCs.

Results

Our analysis reveals several interesting trends and preferences among researchers. Regarding dataset selection, approximately 50% of research related to WBC segmentation and 60% for RBC segmentation opted for manually obtaining images rather than using a predefined dataset. When it comes to classification, 45% of the previous work on WBCs chose the ALL-IDB dataset, while a significant 73% of researchers focused on RBC classification decided to manually obtain images from medical institutions instead of utilizing predefined datasets. In terms of feature selection for classification, morphological features were the most popular, being chosen in 55% and 80% of studies related to WBC and RBC classification, respectively.

Conclusion

The diagnostic accuracy for blood-related diseases like leukemia, anemia, lymphoma, and thalassemia can be significantly enhanced through the effective use of CAD techniques, which have evolved considerably in recent years. This survey provides a broad and in-depth review of the techniques being employed, from image segmentation to classification, feature selection, utilization of evaluation matrices, and dataset selection. The inconsistency in dataset selection suggests a need for standardized, high-quality datasets to strengthen the diagnostic capabilities of these techniques further. Additionally, the popularity of morphological features indicates that future research could further explore and innovate in this direction.

Intra-nucleus mosaic pattern (InMop) and whole-cell Haralick combined-descriptor for identifying and characterizing acute leukemia blasts on single cell peripheral blood images

Acute leukemia is usually diagnosed when a test of peripheral blood shows at least 20% of abnormal immature cells (blasts), a figure even lower in case of recurrent cytogenetic abnormalities. Blast identification is crucial for white blood cell (WBC) counting, which depends on both identifying the cell type and characterizing the cellular morphology, processes susceptible of inter- and intraobserver variability. The present work introduces an image combined-descriptor to detect blasts and determine their probable lineage. This strategy uses an intra-nucleus mosaic pattern (InMop) descriptor that captures subtle nuclei differences within WBCs, and Haralick's statistics which quantify the local structure of both nucleus and cytoplasm. The InMop captures WBC inner-nucleus structure by applying a multiscale Shearlet decomposition over a repetitive pattern (mosaic) of automatically-segmented nuclei. As a complement, Haralick's statistics characterize the local structure of the whole cell from an intensity co-occurrence matrix representation. Both InMoP and Haralick-based descriptors are calculated using the b-channel from Lab color-space. The combined-descriptor is assessed by differentiating blasts from nonleukemic cells with support vector machine (SVM) classifiers and different transformation kernels, in two public and independent databases. The first database-D1 (n = 260) is composed of healthy and acute lymphoid leukemia (ALL) single cell images, and second database-D2 contains acute myeloid leukemia (AML) blasts (n = 3294) and nonblast (n = 15,071) cell images. In a first experiment, blasts versus nonblast differentiation is performed by training with a subset of D2 (n = 6588) and testing in D1 (n = 260), obtaining a training AUC of 0.991 ± 0.002 and AUC = 0.782 for the independent validation. A second experiment automatically differentiates AML blasts (260 images from D2) from ALL blasts (260 images from D1), with an AUC of 0.93. In a third experiment, state-of-the-art strategies, VGG16 and RESNEXT convolutional neural networks (CNN), separate blast from nonblast cells in both databases. The VGG16 showed an AUC of 0.673 and the RESNEXT of 0.75. Reported metrics for all the experiments are area under the ROC curve (AUC), accuracy and F1-score.

Morphological diagnosis of hematologic malignancy using feature fusion-based deep convolutional neural network

Leukemia is a cancer of white blood cells characterized by immature lymphocytes. Due to blood cancer, many people die every year. Hence, the early detection of these blast cells is necessary for avoiding blood cancer. A novel deep convolutional neural network (CNN) 3SNet that has depth-wise convolution blocks to reduce the computation costs has been developed to aid the diagnosis of leukemia cells. The proposed method includes three inputs to the deep CNN model. These inputs are grayscale and their corresponding histogram of gradient (HOG) and local binary pattern (LBP) images. The HOG image finds the local shape, and the LBP image describes the leukaemia cell's texture pattern. The suggested model was trained and tested with images from the AML-Cytomorphology_LMU dataset. The mean average precision (MAP) for the cell with less than 100 images in the dataset was 84%, whereas for cells with more than 100 images in the dataset was 93.83%. In addition, the ROC curve area for these cells is more than 98%. This confirmed proposed model could be an adjunct tool to provide a second opinion to a doctor.

Fuzzy Model for the Automatic Recognition of Human Dendritic Cells

Background and objective: Nowadays, foodborne illness is considered one of the most outgrowing diseases in the world, and studies show that its rate increases sharply each year. Foodborne illness is considered a public health problem which is caused by numerous factors, such as food intoxications, allergies, intolerances, etc. Mycotoxin is one of the food contaminants which is caused by various species of molds (or fungi), which, in turn, causes intoxications that can be chronic or acute. Thus, even low concentrations of Mycotoxin have a severely harmful impact on human health. It is, therefore, necessary to develop an assessment tool for evaluating their impact on the immune response. Recently, researchers have approved a new method of investigation using human dendritic cells, yet the analysis of the geometric properties of these cells is still visual. Moreover, this type of analysis is subjective, time-consuming, and difficult to perform manually. In this paper, we address the automation of this evaluation using image-processing techniques. Methods: Automatic classification approaches of microscopic dendritic cell images are developed to provide a fast and objective evaluation. The first proposed classifier is based on support vector machines (SVM) and Fisher's linear discriminant analysis (FLD) method. The FLD-SVM classifier does not provide satisfactory results due to the significant confusion between the inhibited cells on one hand, and the other two cell types (mature and immature) on the other hand. Then, another strategy was suggested to enhance dendritic cell recognition results that are emitted from microscopic images. This strategy is mainly based on fuzzy logic which allows us to consider the uncertainties and inaccuracies of the given data. Results: These proposed methods are tested on a real dataset consisting of 421 images of microscopic dendritic cells, where the fuzzy classification scheme efficiently improved the classification results by successfully classifying 96.77% of the dendritic cells. Conclusions: The fuzzy classification-based tools provide cell maturity and inhibition rates which help biologists evaluate severe health impacts caused by food contaminants.

Quantifying imbalanced classification methods for leukemia detection

Uncontrolled proliferation of B-lymphoblast cells is a common characterization of Acute Lymphoblastic Leukemia (ALL). B-lymphoblasts are found in large numbers in peripheral blood in malignant cases. Early detection of the cell in bone marrow is essential as the disease progresses rapidly if left untreated. However, automated classification of the cell is challenging, owing to its fine-grained variability with B-lymphoid precursor cells and imbalanced data points. Deep learning algorithms demonstrate potential for such fine-grained classification as well as suffer from the imbalanced class problem. In this paper, we explore different deep learning-based State-Of-The-Art (SOTA) approaches to tackle imbalanced classification problems. Our experiment includes input, GAN (Generative Adversarial Networks), and loss-based methods to mitigate the issue of imbalanced class on the challenging C-NMC and ALLIDB-2 dataset for leukemia detection. We have shown empirical evidence that loss-based methods outperform GAN-based and input-based methods in imbalanced classification scenarios.

Leukemia segmentation and classification: A comprehensive survey

Blood is made up of leukocytes (WBCs), erythrocytes (RBCs), and thrombocytes. The ratio of blood cancer diseases is increasing rapidly, among which leukemia is one of the famous cancer which may lead to death. Leukemia cancer is initiated by the unnecessary growth of immature WBCs present in the sponge tissues of bone marrow. It is generally analyzed by etiologists by perceiving slides of blood smear images under a microscope. The morphological features and blood cells count facilitated the etiologists to detect leukemia. Due to the late detection and expensive instruments used for leukemia analysis, the death rate has risen significantly. The fluorescence-based cell sorting technique and manual recounts using a hemocytometer are error-prone and imprecise. Leukemia detection methods consist of pre-processing, segmentation, features extraction, and classification. In this article, recent deep learning methodologies and challenges for leukemia detection are discussed. These methods are helpful to examine the microscopic blood smears images and for the detection of leukemia more accurately.

Optimizing a Deep Residual Neural Network with Genetic Algorithm for Acute Lymphoblastic Leukemia Classification

Acute lymphoblastic leukemia (ALL) is the most common childhood cancer worldwide, and it is characterized by the production of immature malignant cells in the bone marrow. Computer vision techniques provide automated analysis that can help specialists diagnose this disease. Microscopy image analysis is the most economical method for the initial screening of patients with ALL, but this task is subjective and time-consuming. In this study, we propose a hybrid model using a genetic algorithm (GA) and a residual convolutional neural network (CNN), ResNet-50V2, to predict ALL using microscopy images available in ALL-IDB dataset. However, accurate prediction requires suitable hyperparameters setup, and tuning these values manually still poses challenges. Hence, this paper uses GA to find the best hyperparameters that lead to the highest accuracy rate in the models. Also, we compare the performance of GA hyperparameter optimization with Random Search and Bayesian optimization methods. The results show that GA optimization improves the accuracy of the classifier, obtaining 98.46% in terms of accuracy. Additionally, our approach sheds new perspectives on identifying leukemia based on computer vision strategies, which could be an alternative for applications in a real-world scenario.

C-NMC: B-lineage acute lymphoblastic leukaemia: A blood cancer dataset

Development of computer-aided cancer diagnostic tools is an active research area owing to the advancements in deep-learning domain. Such technological solutions provide affordable and easily deployable diagnostic tools. Leukaemia, or blood cancer, is one of the leading cancers causing more than 0.3 million deaths every year. In order to aid the development of such an AI-enabled tool, we collected and curated a microscopic image dataset, namely C-NMC, of more than 15000 cancer cell images at a very high resolution of B-Lineage Acute Lymphoblastic Leukaemia (B-ALL). The dataset is prepared at the subject-level and contains images of both healthy and cancer patients. So far, this is the largest (as well as curated) dataset on B-ALL cancer in the public domain. C-NMC is available at The Cancer Imaging Archive (TCIA), USA and can be helpful for the research community worldwide for the development of B-ALL cancer diagnostic tools. This dataset was utilized in an international medical imaging challenge held at ISBI 2019 conference in Venice, Italy. In this paper, we present a detailed description and challenges of this dataset. We also present benchmarking results of all the methods applied so far on this dataset.

INASNET: Automatic identification of coronavirus disease (COVID-19) based on chest X-ray using deep neural network

Testing is one of the important methodologies used by various countries in order to fight against COVID-19 infection. The infection is considered as one of the deadliest ones although the mortality rate is not very high. COVID-19 infection is being caused by SARS-CoV2 which is termed as severe acute respiratory syndrome coronavirus 2 virus. To prevent the community, transfer among the masses, testing plays an important role. Efficient and quicker testing techniques helps in identification of infected person which makes it easier for to isolate the patient. Deep learning methods have proved their presence and effectiveness in medical image analysis and in the identification of some of the diseases like pneumonia. Authors have been proposed a deep learning mechanism and system to identify the COVID-19 infected patient on analyzing the X-ray images. Symptoms in the COVID-19 infection is well similar to the symptoms occurring in the influenza and pneumonia. The proposed model Inception Nasnet (INASNET) is being able to separate out and classify the X-ray images in the corresponding normal, COVID-19 infected or pneumonia infected classes. This testing method will be a boom for the doctors and for the state as it is a way cheaper method as compared to the other testing kits used by the healthcare workers for the diagnosis of the disease. Continuous analysis by convolutional neural network and regular evaluation will result in better accuracy and helps in eliminating the false-negative results. INASNET is based on the combined platform of InceptionNet and Neural network architecture search which will result in having higher and faster predictions. Regular testing, faster results, economically viable testing using X-ray images will help the front line workers to make a win over COVID-19.

Multi-Method Diagnosis of Blood Microscopic Sample for Early Detection of Acute Lymphoblastic Leukemia Based on Deep Learning and Hybrid Techniques

Leukemia is one of the most dangerous types of malignancies affecting the bone marrow or blood in all age groups, both in children and adults. The most dangerous and deadly type of leukemia is acute lymphoblastic leukemia (ALL). It is diagnosed by hematologists and experts in blood and bone marrow samples using a high-quality microscope with a magnifying lens. Manual diagnosis, however, is considered slow and is limited by the differing opinions of experts and other factors. Thus, this work aimed to develop diagnostic systems for two Acute Lymphoblastic Leukemia Image Databases (ALL_IDB1 and ALL_IDB2) for the early detection of leukemia. All images were optimized before being introduced to the systems by two overlapping filters: the average and Laplacian filters. This study consists of three proposed systems as follows: the first consists of the artificial neural network (ANN), feed forward neural network (FFNN), and support vector machine (SVM), all of which are based on hybrid features extracted using Local Binary Pattern (LBP), Gray Level Co-occurrence Matrix (GLCM) and Fuzzy Color Histogram (FCH) methods. Both ANN and FFNN reached an accuracy of 100%, while SVM reached an accuracy of 98.11%. The second proposed system consists of the convolutional neural network (CNN) models: AlexNet, GoogleNet, and ResNet-18, based on the transfer learning method, in which deep feature maps were extracted and classified with high accuracy. All the models obtained promising results for the early detection of leukemia in both datasets, with an accuracy of 100% for the AlexNet, GoogleNet, and ResNet-18 models. The third proposed system consists of hybrid CNN–SVM technologies, consisting of two blocks: CNN models for extracting feature maps and the SVM algorithm for classifying feature maps. All the hybrid systems achieved promising results, with AlexNet + SVM achieving 100% accuracy, Goog-LeNet + SVM achieving 98.1% accuracy, and ResNet-18 + SVM achieving 100% accuracy.

An intelligent approach for automated argument based legal text recognition and summarization using machine learning

It is essential to provide a structured data feed to the computer to accomplish any task so that it can process flawlessly to generate the desired output within minimal computational time. Generally, computer programmers should provide a structured data feed to the computer program for its successful execution. The hardcopy document should be scanned to generate its corresponding computer-readable softcopy version of the file. This process also proves to be a budget-friendly approach to disengage human resources from the entire process of record maintenance. Due to this automation, the workload of existing manpower is reduced to a significant level. This concept may prove beneficial for the delivery of any type of services to the ultimate beneficiary (i.e., citizen) in a minimal time frame. The administration has to deal with various issues of citizens due to the pressure of a huge population who seek legal help to resolve their issues, thereby leading to the filing of large numbers of pending legal cases at several courts of the country. To assist the victims with prompt delivery of justice and legal professionals in reducing their workload, this paper proposed a machine learning based automated legal model to enhance the efficiency of the legal support system with an accuracy of 94%.

An Attention-Based Convolutional Neural Network for Acute Lymphoblastic Leukemia Classification

Leukemia is a kind of blood cancer that influences people of all ages and is one of the leading causes of death worldwide. Acute lymphoblastic leukemia (ALL) is the most widely recognized type of leukemia found in the bone marrow of the human body. Traditional disease diagnostic techniques like blood and bone marrow examinations are slow and painful, resulting in the demand for non-invasive and fast methods. This work presents a non-invasive, convolutional neural network (CNN) based approach that utilizes medical images to perform the diagnosis task. The proposed solution consisting of a CNN-based model uses an attention module called Efficient Channel Attention (ECA) with the visual geometry group from oxford (VGG16) to extract better quality deep features from the image dataset, leading to better feature representation and better classification results. The proposed method shows that the ECA module helps to overcome morphological similarities between ALL cancer and healthy cell images. Various augmentation techniques are also employed to increase the quality and quantity of training data. We used the classification of normal vs. malignant cells (C-NMC) dataset and divided it into seven folds based on subject-level variability, which is usually ignored in previous methods. Experimental results show that our proposed CNN model can successfully extract deep features and achieved an accuracy of 91.1%. The obtained findings show that the proposed method may be utilized to diagnose ALL and would help pathologists.

Technological advances in electrochemical biosensors for the detection of disease biomarkers

With an increasing focus on health in contemporary society, interest in the diagnosis, treatment, and prevention of diseases has grown rapidly. Accordingly, the demand for biosensors for the early diagnosis of disease is increasing. However, the measurement range of existing electrochemical sensors is relatively high, which is not suitable for early disease diagnosis, requiring the detection of small amounts of biocomponents. Various attempts have been made to overcome this and amplify the signal, including binding with various labeling molecules, such as DNA, enzymes, nanoparticles, and carbon materials. Efforts are also being made to increase the sensitivity of electrochemical sensors, and the combination of nanomaterials, materials, and biotechnology offers the potential to increase sensitivity in a variety of ways. Recent studies suggest that electrochemical sensors can be a powerful tool in providing comprehensive insights into the targeting and detection of disease-associated biomarkers. Significant advances in nanomaterial and biomolecule approaches for improved sensitivity have resulted in the development of electrochemical biosensors capable of detecting multiple biomarkers in real time in clinically relevant samples. In this review, we have discussed the recent studies on electrochemical sensors for detection of diseases such as diabetes, degenerative diseases, and cancer. Further, we have highlighted new technologies to improve sensitivity using various materials, including DNA, enzymes, nanoparticles, and carbon materials.

Accurate Machine-Learning-Based classification of Leukemia from Blood Smear Images

BACKGROUND

Conventional identification of blood disorders based on visual inspection of blood smears through microscope is time consuming, error-prone and is limited by hematologist's physical acuity. Therefore, an automated optical image processing system is required to support the clinical decision-making.

MATERIALS AND METHODS

Blood smear slides (n = 250) were prepared from clinical samples, imaged and analyzed in Jimma Medical Center, Hematology department. Samples were collected, analyzed and preserved from out and in-patients. The system was able to categorize four common types of leukemia's such as acute and chronic myeloid leukemia; and acute and chronic lymphoblastic leukemia, through a robust image segmentation protocol, followed by classification using the support vector machine.

RESULTS

The system was able to classify leukemia types with an accuracy, sensitivity, specificity of 97.69%, 97.86% and 100%, respectively for the test datasets, and 97.5%, 98.55% and 100%, respectively, for the validation datasets. In addition, the system also showed an accuracy of 94.75% for the WBC counts that include both lymphocytes and monocytes. The computer-assisted diagnosis system took less than one minute for processing and assigning the leukemia types, compared to an average period of 30 minutes by unassisted manual approaches. Moreover, the automated system complements the healthcare workers' in their efforts, by improving the accuracy rates in diagnosis from ∼70% to over 97%.

CONCLUSION

Importantly, our module is designed to assist the healthcare facilities in the rural areas of sub-Saharan Africa, equipped with fewer experienced medical experts, especially in screening patients for blood associated diseases including leukemia.

On the Effectiveness of Leukocytes Classification Methods in a Real Application Scenario

Automating the analysis of digital microscopic images to identify the cell sub-types or the presence of illness has assumed a great importance since it aids the laborious manual process of review and diagnosis. In this paper, we have focused on the analysis of white blood cells. They are the body’s main defence against infections and diseases and, therefore, their reliable classification is very important. Current systems for leukocyte analysis are mainly dedicated to: counting, sub-types classification, disease detection or classification. Although these tasks seem very different, they share many steps in the analysis process, especially those dedicated to the detection of cells in blood smears. A very accurate detection step gives accurate results in the classification of white blood cells. Conversely, when detection is not accurate, it can adversely affect classification performance. However, it is very common in real-world applications that work on inaccurate or non-accurate regions. Many problems can affect detection results. They can be related to the quality of the blood smear images, e.g., colour and lighting conditions, absence of standards, or even density and presence of overlapping cells. To this end, we performed an in-depth investigation of the above scenario, simulating the regions produced by detection-based systems. We exploit various image descriptors combined with different classifiers, including CNNs, in order to evaluate which is the most suitable in such a scenario, when performing two different tasks: Classification of WBC subtypes and Leukaemia detection. Experimental results have shown that Convolutional Neural Networks are very robust in such a scenario, outperforming common machine learning techniques combined with hand-crafted descriptors. However, when exploiting appropriate images for model training, even simpler approaches can lead to accurate results in both tasks.

A Polylobar Nucleus Identifying and Extracting Method for Leukocyte Counting

Accurate counting of leukocytes is an important method for diagnosing human blood diseases. Because most nuclei of neutrophils and eosinophils are polylobar, it is easily confused with the unilobar nuclei in nucleus segmentation. Therefore, it is very essential to accurately identify and determine the polylobar leukocytes. In this paper, a polylobar nucleus identification and extracting method is proposed. Firstly, by using the Otsu threshold and area threshold method, the nuclei of leukocytes are accurately segmented. According to the morphological characteristics of polylobar leukocytes, the edges of the mitotic polylobar leukocytes are detected, and the numbers of polylobar leukocytes are determined according to the minimal distance rule. Therefore, the accurate counting of leukocytes can be realized. From the experimental results, we can see that using the Otsu method and the area threshold to segment the polylobar nuclear leukocytes, the segmentation ratio of the leukocyte nucleus reached 98.3%. After using the morphological features, the polylobar nuclear leukocytes can be accurately counted. The experimental results have verified the feasibility and practicability of the proposed method.

TAYLOR–MONARCH BUTTERFLY OPTIMIZATION-BASED SUPPORT VECTOR MACHINE FOR ACUTE LYMPHOBLASTIC LEUKEMIA CLASSIFICATION WITH BLOOD SMEAR MICROSCOPIC IMAGES

Acute lymphoblastic leukemia (ALL) is a serious hematological neoplasis that is characterized by the development of immature and abnormal growth of lymphoblasts. However, microscopic examination of bone marrow is the only way to achieve leukemia detection. Various methods are developed for automatic leukemia detection, but these methods are costly and time-consuming. Hence, an effective leukemia detection approach is designed using the proposed Taylor–monarch butterfly optimization-based support vector machine (Taylor–MBO-based SVM). However, the proposed Taylor–MBO is designed by integrating the Taylor series and MBO, respectively. The sparking process is designed to perform the automatic segmentation of blood smear images by estimating optimal threshold values. By extracting the features, such as texture features, statistical, and grid-based features from the segmented smear image, the performance of classification is increased with less training time. The kernel function of SVM is enabled to perform the leukemia classification such that the proposed Taylor–MBO algorithm accomplishes the training process of SVM. However, the proposed Taylor–MBO-based SVM obtained better performance using the metrics, such as accuracy, sensitivity, and specificity, with 94.5751, 95.526, and 94.570%, respectively.

A CNN-based unified framework utilizing projection loss in unison with label noise handling for multiple Myeloma cancer diagnosis

Multiple Myeloma (MM) is a malignancy of plasma cells. Similar to other forms of cancer, it demands prompt diagnosis for reducing the risk of mortality. The conventional diagnostic tools are resource-intense and hence, these solutions are not easily scalable for extending their reach to the masses. Advancements in deep learning have led to rapid developments in affordable, resource optimized, easily deployable computer-assisted solutions. This work proposes a unified framework for MM diagnosis using microscopic blood cell imaging data that addresses the key challenges of inter-class visual similarity of healthy versus cancer cells and that of the label noise of the dataset. To extract class distinctive features, we propose projection loss to maximize the projection of a sample's activation on the respective class vector besides imposing orthogonality constraints on the class vectors. This projection loss is used along with the cross-entropy loss to design a dual branch architecture that helps achieve improved performance and provides scope for targeting the label noise problem. Based on this architecture, two methodologies have been proposed to correct the noisy labels. A coupling classifier has also been proposed to resolve the conflicts in the dual-branch architecture's predictions. We have utilized a large dataset of 72 subjects (26 healthy and 46 MM cancer) containing a total of 74996 images (including 34555 training cell images and 40441 test cell images). This is so far the most extensive dataset on Multiple Myeloma cancer ever reported in the literature. An ablation study has also been carried out. The proposed architecture performs best with a balanced accuracy of 94.17% on binary cell classification of healthy versus cancer in the comparative performance with ten state-of-the-art architectures. Extensive experiments on two additional publicly available datasets of two different modalities have also been utilized for analyzing the label noise handling capability of the proposed methodology. The code will be available under https://github.com/shivgahlout/CAD-MM.

Recognition of acute lymphoblastic leukemia and lymphocytes cell subtypes in microscopic images using random forest classifier

Acute lymphoblastic leukemia (ALL) is the most frequently leukemia and categorized into three morphological subtypes named L1, L2 and L3. Early diagnosis of ALL plays a key role in treatment procedure especially in the case of children. Several similarities between morphology of three subtypes ALL (L1, L2, L3) and lymphocyte subtypes (normal, reactive and atypical) as noncancerous cells have remained a high challenge. Diagnosis of ALL and lymphocyte subtypes are done by microscopic viewing examination of cells in the peripheral blood samples by hematologists. Since this exam is time-consuming, boring and dependent on the skill of the hematologists, automatic systems are desired to overcome these limitations. In this study, 312 microscopic images including 958 cells are obtained from blood samples of 7 normal subjects and 14 patients. The first step of proposed system is image enhancement to decreases the effects of various luminosity situations with transformation from RGB to HSV color space and then applying histogram equalization on V channel for equalizing the grey level of image lightness. Nuclei segmentation from the blood cell images is the second step and performed using fuzzy c-means (FCM) clustering. After identify cluster of nuclei, we performed opening and closing process in morphological operation binary in order to remove extra noises and fill some minor holes in the nuclei. Moreover, to discrete the link between nuclei, watershed transform was applied. Then, a set of quantitative features (five geometric features about the size and figure of a cell and 36 statistical features about the spatial arrangement of intensities of nuclei image) are extracted to characterize the properties of these nuclei. In the next step, due to high number of features, the best features are selected by exhaustive search of all of the subsets of features and 13 features are selected. The final step is the classification of L1, L2, L3, normal, reactive and atypical cells by applying Random Forest (RF) classifier and result in 98% accuracy. We compared RF classifier with two other commonly classifiers named: MultiLayer Perceptron (MLP), and multi-SVM classifier with more success especially for recognition of L1, normal and reactive cells. So, this system can be used as an assistant diagnostic tool for hematologists to recognize subtypes of ALL and lymphocyte.

An Aggregated-Based Deep Learning Method for Leukemic B-lymphoblast Classification

Leukemia is a cancer of blood cells in the bone marrow that affects both children and adolescents. The rapid growth of unusual lymphocyte cells leads to bone marrow failure, which may slow down the production of new blood cells, and hence increases patient morbidity and mortality. Age is a crucial clinical factor in leukemia diagnosis, since if leukemia is diagnosed in the early stages, it is highly curable. Incidence is increasing globally, as around 412,000 people worldwide are likely to be diagnosed with some type of leukemia, of which acute lymphoblastic leukemia accounts for approximately 12% of all leukemia cases worldwide. Thus, the reliable and accurate detection of normal and malignant cells is of major interest. Automatic detection with computer-aided diagnosis (CAD) models can assist medics, and can be beneficial for the early detection of leukemia. In this paper, a single center study, we aimed to build an aggregated deep learning model for Leukemic B-lymphoblast classification. To make a reliable and accurate deep learner, data augmentation techniques were applied to tackle the limited dataset size, and a transfer learning strategy was employed to accelerate the learning process, and further improve the performance of the proposed network. The results show that our proposed approach was able to fuse features extracted from the best deep learning models, and outperformed individual networks with a test accuracy of 96.58% in Leukemic B-lymphoblast diagnosis.

Identification of significant risks in pediatric acute lymphoblastic leukemia (ALL) through machine learning (ML) approach

Pediatric acute lymphoblastic leukemia (ALL) through machine learning (ML) technique was analyzed to determine the significance of clinical and phenotypic variables as well as environmental conditions that can identify the underlying causes of child ALL. Fifty pediatric patients (n = 50) included who were diagnosed with acute lymphoblastic leukemia (ALL) according to the inclusion and exclusion criteria. Clinical variables comprised of the blood biochemistry (CBC, LFTs, RFTs) results, and distribution of type of ALL, i.e., T ALL or B ALL. Phenotypic data included the age, sex of the child, and consanguinity, while environmental factors included the habitat, socioeconomic status, and access to filtered drinking water. Fifteen different features/attributes were collected for each case individually. To retrieve most useful discriminating attributes, four different supervised ML algorithms were used including classification and regression trees (CART), random forest (RM), gradient boosted machine (GM), and C5.0 decision tree algorithm. To determine the accuracy of the derived CART algorithm on future data, a ten-fold cross validation was performed on the present data set. The ALL was common in children of age below 5 years in male patients whole belonged to middle class family of rural areas. (B-ALL) was most frequent as compared with T-ALL. The consanguinity was present in 54% of cases. Low levels of platelets and hemoglobin and high levels of white blood cells were reported in child ALL patients. CART provided the best and complete fit for the entire data set yielding a 99.83% model fit accuracy, and a misclassification of 0.17% on the entire sample space, while C5.0 reported 98.6%, random forest 94.44%, and gradient boosted machine resulted in 95.61% fitting. The variable importance of each primary discriminating attribute is platelet 43%, hemoglobin 24%, white blood cells 4%, and sex of the child 4%. An overall accuracy of 87.4% was recorded for the classifier. Platelet count abnormality can be considered as a major factor in predicting pediatric ALL. The machine learning algorithms can be applied efficiently to provide details for the prognosis for better treatment outcome. Graphical Abstract Identification of significant risks in pediatric acute lymphoblastic leukemia (ALL) through machine learning (ML) approach.

Accurate automatic detection of acute lymphatic leukemia using a refined simple classification

An improved classification technique is presented to identify automatically the acute lymphatic leukemia (ALL) subtypes. An adaptive segmentation procedure is performed on peripheral blood smear images to extract the main features (10 geometric features) from the segmented images of white blood cell (WBC), nucleus, and cytoplasm. To show the importance of the different extracted features for the diagnostic accuracy, a comprehensive study is made on all the possible permutation cases of the features using powerful classifiers which are K-nearest neighbor (KNN) at different metric functions, support vector machine (SVM) with different kernels, and artificial neural network (ANN). This procedure enables us to construct a feature map depending only on least number of features which lead to the highest diagnostic accuracy. It is found that the features map regarding the vacuoles in the cytoplasm and the regularity of the nucleus membrane gives the highest accurate results. The automatic classification for ALL subtypes based only on these two effective features is assessed using the receiver operating characteristic (ROC) curve and F₁ -score measures. It is confirmed that the present technique is highly accurate, and saves the effort and time of training.

Improved Dominance Soft Set Based Decision Rules with Pruning for Leukemia Image Classification

Acute lymphoblastic leukemia is a well-known type of pediatric cancer that affects the blood and bone marrow. If left untreated, it ends in fatal conditions due to its proliferation into the circulation system and other indispensable organs. All over the world, leukemia primarily attacks youngsters and grown-ups. The early diagnosis of leukemia is essential for the recovery of patients, particularly in the case of children. Computational tools for medical image analysis, therefore, have significant use and become the focus of research in medical image processing. The particle swarm optimization algorithm (PSO) is employed to segment the nucleus in the leukemia image. The texture, shape, and color features are extracted from the nucleus. In this article, an improved dominance soft set-based decision rules with pruning (IDSSDRP) algorithm is proposed to predict the blast and non-blast cells of leukemia. This approach proceeds with three distinct phases: (i) improved dominance soft set-based attribute reduction using AND operation in multi-soft set theory, (ii) generation of decision rules using dominance soft set, and (iii) rule pruning. The efficiency of the proposed system is compared with other benchmark classification algorithms. The research outcomes demonstrate that the derived rules efficiently classify cancer and non-cancer cells. Classification metrics are applied along with receiver operating characteristic (ROC) curve analysis to evaluate the efficiency of the proposed framework.

A decision tree to improve identification of pathogenic mutations in clinical practice

BACKGROUND

A variant of unknown significance (VUS) is a variant form of a gene that has been identified through genetic testing, but whose significance to the organism function is not known. An actual challenge in precision medicine is to precisely identify which detected mutations from a sequencing process have a suitable role in the treatment or diagnosis of a disease. The average accuracy of pathogenicity predictors is 85%. However, there is a significant discordance about the identification of mutational impact and pathogenicity among them. Therefore, manual verification is necessary for confirming the real effect of a mutation in its casuistic.

METHODS

In this work, we use variables categorization and selection for building a decision tree model, and later we measure and compare its accuracy with four known mutation predictors and seventeen supervised machine-learning (ML) algorithms.

RESULTS

The results showed that the proposed tree reached the highest precision among all tested variables: 91% for True Neutrals, 8% for False Neutrals, 9% for False Pathogenic, and 92% for True Pathogenic.

CONCLUSIONS

The decision tree exceptionally demonstrated high classification precision with cancer data, producing consistently relevant forecasts for the sample tests with an accuracy close to the best ones achieved from supervised ML algorithms. Besides, the decision tree algorithm is easier to apply in clinical practice by non-IT experts. From the cancer research community perspective, this approach can be successfully applied as an alternative for the determination of potential pathogenicity of VOUS.

Blob Detection and Deep Learning for Leukemic Blood Image Analysis

In microscopy, laboratory tests make use of cell counters or flow cytometers to perform tests on blood cells, like the complete blood count, rapidly. However, a manual blood smear examination is still needed to verify the counter results and to monitor patients under therapy. Moreover, the manual inspection permits the description of the cells’ appearance, as well as any abnormalities. Unfortunately, manual analysis is long and tedious, and its result can be subjective and error-prone. Nevertheless, using image processing techniques, it is possible to automate the entire workflow, both reducing the operators’ workload and improving the diagnosis results. In this paper, we propose a novel method for recognizing white blood cells from microscopic blood images and classify them as healthy or affected by leukemia. The presented system is tested on public datasets for leukemia detection, the SMC-IDB, the IUMS-IDB, and the ALL-IDB. The results are promising, achieving 100% accuracy for the first two datasets and 99.7% for the ALL-IDB in white cells detection and 94.1% in leukemia classification, outperforming the state-of-the-art.

SDCT-AuxNetθ: DCT augmented stain deconvolutional CNN with auxiliary classifier for cancer diagnosis

Acute lymphoblastic leukemia (ALL) is a pervasive pediatric white blood cell cancer across the globe. With the popularity of convolutional neural networks (CNNs), computer-aided diagnosis of cancer has attracted considerable attention. Such tools are easily deployable and are cost-effective. Hence, these can enable extensive coverage of cancer diagnostic facilities. However, the development of such a tool for ALL cancer was challenging so far due to the non-availability of a large training dataset. The visual similarity between the malignant and normal cells adds to the complexity of the problem. This paper discusses the recent release of a large dataset and presents a novel deep learning architecture for the classification of cell images of ALL cancer. The proposed architecture, namely, SDCT-AuxNet^θ is a 2-module framework that utilizes a compact CNN as the main classifier in one module and a Kernel SVM as the auxiliary classifier in the other one. While CNN classifier uses features through bilinear-pooling, spectral-averaged features are used by the auxiliary classifier. Further, this CNN is trained on the stain deconvolved quantity images in the optical density domain instead of the conventional RGB images. A novel test strategy is proposed that exploits both the classifiers for decision making using the confidence scores of their predicted class labels. Elaborate experiments have been carried out on our recently released public dataset of 15114 images of ALL cancer and healthy cells to establish the validity of the proposed methodology that is also robust to subject-level variability. A weighted F1 score of 94.8% is obtained that is best so far on this challenging dataset.

Cell Population Data-Driven Acute Promyelocytic Leukemia Flagging Through Artificial Neural Network Predictive Modeling

A targeted and timely offered treatment can be a benefitting tool for patients with acute promyelocytic leukemia (APML). Current round of study made use of potential morphological and immature fraction-related parameters (cell population data) generated during complete blood cell count (CBC), through artificial neural network (ANN) predictive modeling for early flagging of APML cases. We collected classical CBC items along with cell population data (CPD) from hematology analyzer at diagnosis of 1067 study subjects with hematological neoplasms. For morphological assessment, peripheral blood films were examined. Statistical and machine learning tools including principal component analysis (PCA) helped in the evaluation of predictive capacity of routine and CPD items. Then selected CBC item-driven ANN predictive modeling was developed to smartly use the hidden trend by increasing the auguring accuracy of these parameters in differentiation of APML cases. We found a characteristic triad based on lower (53.73) platelet count (PLT) with decreased/normal (4.72) immature fraction of platelet (IPF) with addition of significantly higher value (65.5) of DNA/RNA content-related neutrophil (NE-SFL) parameter in patients with APML against other hematological neoplasm's groups. On PCA, APML showed exceptionally significant variance for PLT, IPF, and NE-SFL. Through training of ANN predictive modeling, our selected CBC items successfully classify the APML group from non-APML groups at highly significant (0.894) AUC value with lower (2.3 percent) false prediction rate. Practical results of using our ANN model were found acceptable with value of 95.7% and 97.7% for training and testing data sets, respectively. We proposed that PLT, IPF, and NE-SFL could potentially be used for early flagging of APML cases in the hematology-oncology unit. CBC item-driven ANN modeling is a novel approach that substantially strengthen the predictive potential of CBC items, allowing the clinicians to be confident by the typical trend raised by these studied parameters.

Machine learning applications in the diagnosis of leukemia: Current trends and future directions

Machine learning (ML) offers opportunities to advance pathological diagnosis, especially with increasing trends in digitalizing microscopic images. Diagnosing leukemia is time-consuming and challenging in many areas globally and there is a growing trend in utilizing ML techniques for its diagnosis. In this review, we aimed to describe the literature of ML utilization in the diagnosis of the four common types of leukemia: acute lymphocytic leukemia (ALL), chronic lymphocytic leukemia (CLL), acute myeloid leukemia (AML), and chronic myelogenous leukemia (CML). Using a strict selection criterion, utilizing MeSH terminology and Boolean logic, an electronic search of MEDLINE and IEEE Xplore Digital Library was performed. The electronic search was complemented by handsearching of references of related studies and the top results of Google Scholar. The full texts of 58 articles were reviewed, out of which, 22 studies were included. The number of studies discussing ALL, AML, CLL, and CML was 12, 8, 3, and 1, respectively. No studies were prospectively applying algorithms in real-world scenarios. Majority of studies had small and homogenous samples and used supervised learning for classification tasks. 91% of the studies were performed after 2010, and 74% of the included studies applied ML algorithms to microscopic diagnosis of leukemia. The included studies illustrated the need to develop the field of ML research, including the transformation from solely designing algorithms to practically applying them clinically.

Automatic recognition of different types of acute leukaemia in peripheral blood by image analysis

AIMS

Morphological differentiation among different blast cell lineages is a difficult task and there is a lack of automated analysers able to recognise these abnormal cells. This study aims to develop a machine learning approach to predict the diagnosis of acute leukaemia using peripheral blood (PB) images.

METHODS

A set of 442 smears was analysed from 206 patients. It was split into a training set with 75% of these smears and a testing set with the remaining 25%. Colour clustering and mathematical morphology were used to segment cell images, which allowed the extraction of 2,867 geometric, colour and texture features. Several classification techniques were studied to obtain the most accurate classification method. Afterwards, the classifier was assessed with the images of the testing set. The final strategy was to predict the patient's diagnosis using the PB smear, and the final assessment was done with the cell images of the smears of the testing set.

RESULTS

The highest classification accuracy was achieved with the selection of 700 features with linear discriminant analysis. The overall classification accuracy for the six groups of cell types was 85.8%, while the overall classification accuracy for individual smears was 94% as compared with the true confirmed diagnosis.

CONCLUSIONS

The proposed method achieves a high diagnostic precision in the recognition of different types of blast cells among other mononuclear cells circulating in blood. It is the first encouraging step towards the idea of being a diagnostic support tool in the future.

Quick Leukocyte Nucleus Segmentation in Leukocyte Counting

The leukocyte nucleus quick segmentation is one of the key techniques in leukocyte real-time online scanning of human blood smear. We propose a quick leukocyte nucleus segmentation method based on the component difference in RGB color space. By analyzing the captured microscopic images of the peripheral blood smears from the autoscanning microscope, it is found that the difference values between B component and G component (B − G values) in the regions of the leukocyte nuclei and the platelets are much bigger than those in the other regions, even in the regions including the stains. So, the B − G values can segment the leukocyte nuclei and the platelets with an appropriate empirical threshold because the platelets are much smaller than the leukocyte nuclei, so the leukocyte nuclei can be segmented by size filtering. Also, only an 8 bit subtraction operation is performed for the B − G values, and it can improve the leukocyte nucleus segmentation speed significantly. Experimental results show that the proposed method performs well for the five types of leukocyte segmentation with a quick speed. It is very suitable for the real-time peripheral blood smear autoscanning test application. In addition, the five types of leukocytes can be counted accurately.

Convolutional Neural Networks for Recognition of Lymphoblast Cell Images

This paper presents the recognition for WHO classification of acute lymphoblastic leukaemia (ALL) subtypes. The two ALL subtypes considered are T-lymphoblastic leukaemia (pre-T) and B-lymphoblastic leukaemia (pre-B). They exhibit various characteristics which make it difficult to distinguish between subtypes from their mature cells, lymphocytes. In a common approach, handcrafted features must be well designed for this complex domain-specific problem. With deep learning approach, handcrafted feature engineering can be eliminated because a deep learning method can automate this task through the multilayer architecture of a convolutional neural network (CNN). In this work, we implement a CNN classifier to explore the feasibility of deep learning approach to identify lymphocytes and ALL subtypes, and this approach is benchmarked against a dominant approach of support vector machines (SVMs) applying handcrafted feature engineering. Additionally, two traditional machine learning classifiers, multilayer perceptron (MLP), and random forest are also applied for the comparison. The experiments show that our CNN classifier delivers better performance to identify normal lymphocytes and pre-B cells. This shows a great potential for image classification with no requirement of multiple preprocessing steps from feature engineering.

Convolutional Neural Networks for Recognition of Lymphoblast Cell Images

This paper presents the recognition for WHO classification of acute lymphoblastic leukaemia (ALL) subtypes. The two ALL subtypes considered are T-lymphoblastic leukaemia (pre-T) and B-lymphoblastic leukaemia (pre-B). They exhibit various characteristics which make it difficult to distinguish between subtypes from their mature cells, lymphocytes. In a common approach, handcrafted features must be well designed for this complex domain-specific problem. With deep learning approach, handcrafted feature engineering can be eliminated because a deep learning method can automate this task through the multilayer architecture of a convolutional neural network (CNN). In this work, we implement a CNN classifier to explore the feasibility of deep learning approach to identify lymphocytes and ALL subtypes, and this approach is benchmarked against a dominant approach of support vector machines (SVMs) applying handcrafted feature engineering. Additionally, two traditional machine learning classifiers, multilayer perceptron (MLP), and random forest are also applied for the comparison. The experiments show that our CNN classifier delivers better performance to identify normal lymphocytes and pre-B cells. This shows a great potential for image classification with no requirement of multiple preprocessing steps from feature engineering.

Image processing and machine learning in the morphological analysis of blood cells

INTRODUCTION

This review focuses on how image processing and machine learning can be useful for the morphological characterization and automatic recognition of cell images captured from peripheral blood smears.

METHODS

The basics of the 3 core elements (segmentation, quantitative features, and classification) are outlined, and recent literature is discussed. Although red blood cells are a significant part of this context, this study focuses on malignant lymphoid cells and blast cells.

RESULTS

There is no doubt that these technologies may help the cytologist to perform efficient, objective, and fast morphological analysis of blood cells. They may also help in the interpretation of some morphological features and may serve as learning and survey tools.

CONCLUSION

Although research is still needed, it is important to define screening strategies to exploit the potential of image-based automatic recognition systems integrated in the daily routine of laboratories along with other analysis methodologies.