Speckle reduction in medical ultrasound images using an unbiased non-local means method

DF-GAM: Cross-Domain Ultrasound Image High-Quality Reconstruction Using a Dual Frequency-Domain Guided Adaptation Model

OBJECTIVE

To enhance the quality of low-resolution (LR) ultrasound images and mitigate artifacts and speckle noise, which can impede accurate medical diagnosis, a novel method called the dual frequency-domain guided adaptation model (DF-GAM) is proposed. The method aims to achieve high-quality image reconstruction across diverse domains, including different ultrasound machines, diseases and phantom images.

METHODS

DF-GAM utilizes a dual-branch network architecture combined with frequency-domain self-adaptation and self-supervised edge regression. This approach enables cross-domain enhancement by focusing on the reconstruction of clear tissue structures and speckle patterns. The model is designed to adapt to various ultrasound imaging (USI) scenarios, ensuring its applicability in real-world clinical settings.

RESULTS

Experimental evaluations of DF-GAM were conducted using five different datasets. The results demonstrated the method's effectiveness, with DF-GAM outperforming existing enhancement techniques. The average peak signal-to-noise ratio (PSNR) achieved was 34.62, and the structural similarity index (SSIM) was 0.91, indicating a significant improvement in image quality compared to other methods.

CONCLUSION

DF-GAM shows great potential in improving medical image diagnosis and interpretation. Its ability to enhance LR ultrasound images across various domains without the need for extensive training data makes it a valuable tool for clinical use. The high PSNR and SSIM scores validate the method's effectiveness, suggesting that DF-GAM could significantly contribute to the field of USI diagnostics.

Investigation on ultrasound images for detection of fetal congenital heart defects

Congenital heart defects (CHD) are one of the serious problems that arise during pregnancy. Early CHD detection reduces death rates and morbidity but is hampered by the relatively low detection rates (i.e., 60%) of current screening technology. The detection rate could be increased by supplementing ultrasound imaging with fetal ultrasound image evaluation (FUSI) using deep learning techniques. As a result, the non-invasive foetal ultrasound image has clear potential in the diagnosis of CHD and should be considered in addition to foetal echocardiography. This review paper highlights cutting-edge technologies for detecting CHD using ultrasound images, which involve pre-processing, localization, segmentation, and classification. Existing technique of preprocessing includes spatial domain filter, non-linear mean filter, transform domain filter, and denoising methods based on Convolutional Neural Network (CNN); segmentation includes thresholding-based techniques, region growing-based techniques, edge detection techniques, Artificial Neural Network (ANN) based segmentation methods, non-deep learning approaches and deep learning approaches. The paper also suggests future research directions for improving current methodologies.

Breast ultrasound image despeckling using multi-filtering DFrFT and adaptive fast BM3D

Improving the quality of breast ultrasound images is of great significance for clinical diagnosis which can greatly boost the diagnostic accuracy of ultrasonography. However, due to the influence of ultrasound imaging principles and acquisition equipment, the collected ultrasound images naturally contain a large amount of speckle noise, which leads to a decrease in image quality and affects clinical diagnosis. To overcome this problem, we propose an improved denoising algorithm combining multi-filter DFrFT (Discrete Fractional Fourier Transform) and the adaptive fast BM3D (Block Matching and 3D collaborative filtering) method. Firstly, we provide the multi-filtering DFrFT method for preprocessing the original breast ultrasound image so as to remove some speckle noise early in fractional transformation domain. Based on the fractional frequency spectrum characteristics of breast ultrasound images, three types of filters are designed correspondingly in low, medium, and high frequency domains. And by integrating filtered images, the enhanced images are obtained which not only remove some speckle noise in background but also preserve the details of breast lesions. Secondly, for further enhancing the image quality on the basis of multi-filter DFrFT, we propose the adaptive fast BM3D method by introducing the DBSCAN-based super pixel segmentation to block matching process, which utilizes super pixel segmentation labels to provide a reference on how similar it is between target block and retrieval blocks. It reduces the number of blocks to be retrieved and make the matched blocks with more similar features. At last, the local noise parameter estimation is also adopted in the hard threshold filtering process of traditional BM3D algorithm to achieve local adaptive filtering and further improving the denoising effect. The synthetic data and real breast ultrasound data examples show that this combined method can improve the speckle suppression level and keep the fidelity of structure effectively without increasing time cost.

Research related to the diagnosis of prostate cancer based on machine learning medical images: A review

BACKGROUND

Prostate cancer is currently the second most prevalent cancer among men. Accurate diagnosis of prostate cancer can provide effective treatment for patients and greatly reduce mortality. The current medical imaging tools for screening prostate cancer are mainly MRI, CT and ultrasound. In the past 20 years, these medical imaging methods have made great progress with machine learning, especially the rise of deep learning has led to a wider application of artificial intelligence in the use of image-assisted diagnosis of prostate cancer.

METHOD

This review collected medical image processing methods, prostate and prostate cancer on MR images, CT images, and ultrasound images through search engines such as web of science, PubMed, and Google Scholar, including image pre-processing methods, segmentation of prostate gland on medical images, registration between prostate gland on different modal images, detection of prostate cancer lesions on the prostate.

CONCLUSION

Through these collated papers, it is found that the current research on the diagnosis and staging of prostate cancer using machine learning and deep learning is in its infancy, and most of the existing studies are on the diagnosis of prostate cancer and classification of lesions, and the accuracy is low, with the best results having an accuracy of less than 0.95. There are fewer studies on staging. The research is mainly focused on MR images and much less on CT images, ultrasound images.

DISCUSSION

Machine learning and deep learning combined with medical imaging have a broad application prospect for the diagnosis and staging of prostate cancer, but the research in this area still has more room for development.

Cardiovascular/Stroke Risk Stratification in Diabetic Foot Infection Patients Using Deep Learning-Based Artificial Intelligence: An Investigative Study

A diabetic foot infection (DFI) is among the most serious, incurable, and costly to treat conditions. The presence of a DFI renders machine learning (ML) systems extremely nonlinear, posing difficulties in CVD/stroke risk stratification. In addition, there is a limited number of well-explained ML paradigms due to comorbidity, sample size limits, and weak scientific and clinical validation methodologies. Deep neural networks (DNN) are potent machines for learning that generalize nonlinear situations. The objective of this article is to propose a novel investigation of deep learning (DL) solutions for predicting CVD/stroke risk in DFI patients. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) search strategy was used for the selection of 207 studies. We hypothesize that a DFI is responsible for increased morbidity and mortality due to the worsening of atherosclerotic disease and affecting coronary artery disease (CAD). Since surrogate biomarkers for CAD, such as carotid artery disease, can be used for monitoring CVD, we can thus use a DL-based model, namely, Long Short-Term Memory (LSTM) and Recurrent Neural Networks (RNN) for CVD/stroke risk prediction in DFI patients, which combines covariates such as office and laboratory-based biomarkers, carotid ultrasound image phenotype (CUSIP) lesions, along with the DFI severity. We confirmed the viability of CVD/stroke risk stratification in the DFI patients. Strong designs were found in the research of the DL architectures for CVD/stroke risk stratification. Finally, we analyzed the AI bias and proposed strategies for the early diagnosis of CVD/stroke in DFI patients. Since DFI patients have an aggressive atherosclerotic disease, leading to prominent CVD/stroke risk, we, therefore, conclude that the DL paradigm is very effective for predicting the risk of CVD/stroke in DFI patients.

Deep learning artificial intelligence framework for multiclass coronary artery disease prediction using combination of conventional risk factors, carotid ultrasound, and intraplaque neovascularization

OBJECTIVE

Cardiovascular disease (CVD) is a major healthcare challenge and therefore early risk assessment is vital. Previous assessment techniques use either "conventional CVD risk calculators (CCVRC)" or machine learning (ML) paradigms. These techniques are ad-hoc, unreliable, not fully automated, and have variabilities. We, therefore, introduce AtheroEdge-MCDLAI (AE3.0DL) windows-based platform using multiclass Deep Learning (DL) system.

METHODS

Data was collected on 500 patients having both carotid ultrasound and corresponding coronary angiography scores (CAS), measured as stenosis in coronary arteries and considered as the gold standard. A total of 39 covariates were used, clubbed into three clusters, namely (i) Office-based: age, gender, body mass index, smoker, hypertension, systolic blood pressure, and diastolic blood pressure; (ii) Laboratory-based: Hyperlipidemia, hemoglobin A1c, and estimated glomerular filtration rate; and (iii) Carotid ultrasound image phenotypes: maximum plaque height, total plaque area, and intra-plaque neovascularization. Baseline characteristics for four classes (target labels) having significant (p < 0.0001) values were calculated using Chi-square and ANOVA. For handling the cohort's imbalance in the risk classes, AE3.0DL used the synthetic minority over-sampling technique (SMOTE). AE3.0DL used Recurrent Neural Network (RNN) and Long Short-Term Memory (LSTM) DL models and the performance (accuracy and area-under-the-curve) was computed using 10-fold cross-validation (90% training, 10% testing) frameworks. AE3.0DL was validated and benchmarked.

RESULTS

The AE3.0DL using RNN and LSTM showed an accuracy and AUC (p < 0.0001) pairs as (95.00% and 0.98), and (95.34% and 0.99), respectively, and showed an improvement of 32.93% and 9.94% against CCVRC and ML, respectively. AE3.0DL runs in <1 s.

CONCLUSION

DL algorithms are a powerful paradigm for coronary artery disease (CAD) risk prediction and CVD risk stratification.

Brain Tumor Characterization Using Radiogenomics in Artificial Intelligence Framework

Brain tumor characterization (BTC) is the process of knowing the underlying cause of brain tumors and their characteristics through various approaches such as tumor segmentation, classification, detection, and risk analysis. The substantial brain tumor characterization includes the identification of the molecular signature of various useful genomes whose alteration causes the brain tumor. The radiomics approach uses the radiological image for disease characterization by extracting quantitative radiomics features in the artificial intelligence (AI) environment. However, when considering a higher level of disease characteristics such as genetic information and mutation status, the combined study of "radiomics and genomics" has been considered under the umbrella of "radiogenomics". Furthermore, AI in a radiogenomics' environment offers benefits/advantages such as the finalized outcome of personalized treatment and individualized medicine. The proposed study summarizes the brain tumor's characterization in the prospect of an emerging field of research, i.e., radiomics and radiogenomics in an AI environment, with the help of statistical observation and risk-of-bias (RoB) analysis. The PRISMA search approach was used to find 121 relevant studies for the proposed review using IEEE, Google Scholar, PubMed, MDPI, and Scopus. Our findings indicate that both radiomics and radiogenomics have been successfully applied aggressively to several oncology applications with numerous advantages. Furthermore, under the AI paradigm, both the conventional and deep radiomics features have made an impact on the favorable outcomes of the radiogenomics approach of BTC. Furthermore, risk-of-bias (RoB) analysis offers a better understanding of the architectures with stronger benefits of AI by providing the bias involved in them.

Multicenter Study on COVID-19 Lung Computed Tomography Segmentation with varying Glass Ground Opacities using Unseen Deep Learning Artificial Intelligence Paradigms: COVLIAS 1.0 Validation

Variations in COVID-19 lesions such as glass ground opacities (GGO), consolidations, and crazy paving can compromise the ability of solo-deep learning (SDL) or hybrid-deep learning (HDL) artificial intelligence (AI) models in predicting automated COVID-19 lung segmentation in Computed Tomography (CT) from unseen data leading to poor clinical manifestations. As the first study of its kind, “COVLIAS 1.0-Unseen” proves two hypotheses, (i) contrast adjustment is vital for AI, and (ii) HDL is superior to SDL. In a multicenter study, 10,000 CT slices were collected from 72 Italian (ITA) patients with low-GGO, and 80 Croatian (CRO) patients with high-GGO. Hounsfield Units (HU) were automatically adjusted to train the AI models and predict from test data, leading to four combinations—two Unseen sets: (i) train-CRO:test-ITA, (ii) train-ITA:test-CRO, and two Seen sets: (iii) train-CRO:test-CRO, (iv) train-ITA:test-ITA. COVILAS used three SDL models: PSPNet, SegNet, UNet and six HDL models: VGG-PSPNet, VGG-SegNet, VGG-UNet, ResNet-PSPNet, ResNet-SegNet, and ResNet-UNet. Two trained, blinded senior radiologists conducted ground truth annotations. Five types of performance metrics were used to validate COVLIAS 1.0-Unseen which was further benchmarked against MedSeg, an open-source web-based system. After HU adjustment for DS and JI, HDL (Unseen AI) > SDL (Unseen AI) by 4% and 5%, respectively. For CC, HDL (Unseen AI) > SDL (Unseen AI) by 6%. The COVLIAS-MedSeg difference was < 5%, meeting regulatory guidelines.Unseen AI was successfully demonstrated using automated HU adjustment. HDL was found to be superior to SDL.

Vascular Implications of COVID-19: Role of Radiological Imaging, Artificial Intelligence, and Tissue Characterization: A Special Report

The SARS-CoV-2 virus has caused a pandemic, infecting nearly 80 million people worldwide, with mortality exceeding six million. The average survival span is just 14 days from the time the symptoms become aggressive. The present study delineates the deep-driven vascular damage in the pulmonary, renal, coronary, and carotid vessels due to SARS-CoV-2. This special report addresses an important gap in the literature in understanding (i) the pathophysiology of vascular damage and the role of medical imaging in the visualization of the damage caused by SARS-CoV-2, and (ii) further understanding the severity of COVID-19 using artificial intelligence (AI)-based tissue characterization (TC). PRISMA was used to select 296 studies for AI-based TC. Radiological imaging techniques such as magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound were selected for imaging of the vasculature infected by COVID-19. Four kinds of hypotheses are presented for showing the vascular damage in radiological images due to COVID-19. Three kinds of AI models, namely, machine learning, deep learning, and transfer learning, are used for TC. Further, the study presents recommendations for improving AI-based architectures for vascular studies. We conclude that the process of vascular damage due to COVID-19 has similarities across vessel types, even though it results in multi-organ dysfunction. Although the mortality rate is ~2% of those infected, the long-term effect of COVID-19 needs monitoring to avoid deaths. AI seems to be penetrating the health care industry at warp speed, and we expect to see an emerging role in patient care, reduce the mortality and morbidity rate.

Eight pruning deep learning models for low storage and high-speed COVID-19 computed tomography lung segmentation and heatmap-based lesion localization: A multicenter study using COVLIAS 2.0

BACKGROUND

COVLIAS 1.0: an automated lung segmentation was designed for COVID-19 diagnosis. It has issues related to storage space and speed. This study shows that COVLIAS 2.0 uses pruned AI (PAI) networks for improving both storage and speed, wiliest high performance on lung segmentation and lesion localization.

METHOD

ology: The proposed study uses multicenter ∼9,000 CT slices from two different nations, namely, CroMed from Croatia (80 patients, experimental data), and NovMed from Italy (72 patients, validation data). We hypothesize that by using pruning and evolutionary optimization algorithms, the size of the AI models can be reduced significantly, ensuring optimal performance. Eight different pruning techniques (i) differential evolution (DE), (ii) genetic algorithm (GA), (iii) particle swarm optimization algorithm (PSO), and (iv) whale optimization algorithm (WO) in two deep learning frameworks (i) Fully connected network (FCN) and (ii) SegNet were designed. COVLIAS 2.0 was validated using "Unseen NovMed" and benchmarked against MedSeg. Statistical tests for stability and reliability were also conducted.

RESULTS

Pruning algorithms (i) FCN-DE, (ii) FCN-GA, (iii) FCN-PSO, and (iv) FCN-WO showed improvement in storage by 92.4%, 95.3%, 98.7%, and 99.8% respectively when compared against solo FCN, and (v) SegNet-DE, (vi) SegNet-GA, (vii) SegNet-PSO, and (viii) SegNet-WO showed improvement by 97.1%, 97.9%, 98.8%, and 99.2% respectively when compared against solo SegNet. AUC > 0.94 (p < 0.0001) on CroMed and > 0.86 (p < 0.0001) on NovMed data set for all eight EA model. PAI <0.25 s per image. DenseNet-121-based Grad-CAM heatmaps showed validation on glass ground opacity lesions.

CONCLUSIONS

Eight PAI networks that were successfully validated are five times faster, storage efficient, and could be used in clinical settings.

Deep Learning Paradigm for Cardiovascular Disease/Stroke Risk Stratification in Parkinson's Disease Affected by COVID-19: A Narrative Review

Background and Motivation: Parkinson's disease (PD) is one of the most serious, non-curable, and expensive to treat. Recently, machine learning (ML) has shown to be able to predict cardiovascular/stroke risk in PD patients. The presence of COVID-19 causes the ML systems to become severely non-linear and poses challenges in cardiovascular/stroke risk stratification. Further, due to comorbidity, sample size constraints, and poor scientific and clinical validation techniques, there have been no well-explained ML paradigms. Deep neural networks are powerful learning machines that generalize non-linear conditions. This study presents a novel investigation of deep learning (DL) solutions for CVD/stroke risk prediction in PD patients affected by the COVID-19 framework. Method: The PRISMA search strategy was used for the selection of 292 studies closely associated with the effect of PD on CVD risk in the COVID-19 framework. We study the hypothesis that PD in the presence of COVID-19 can cause more harm to the heart and brain than in non-COVID-19 conditions. COVID-19 lung damage severity can be used as a covariate during DL training model designs. We, therefore, propose a DL model for the estimation of, (i) COVID-19 lesions in computed tomography (CT) scans and (ii) combining the covariates of PD, COVID-19 lesions, office and laboratory arterial atherosclerotic image-based biomarkers, and medicine usage for the PD patients for the design of DL point-based models for CVD/stroke risk stratification. Results: We validated the feasibility of CVD/stroke risk stratification in PD patients in the presence of a COVID-19 environment and this was also verified. DL architectures like long short-term memory (LSTM), and recurrent neural network (RNN) were studied for CVD/stroke risk stratification showing powerful designs. Lastly, we examined the artificial intelligence bias and provided recommendations for early detection of CVD/stroke in PD patients in the presence of COVID-19. Conclusion: The DL is a very powerful tool for predicting CVD/stroke risk in PD patients affected by COVID-19.

Role of Artificial Intelligence in Radiogenomics for Cancers in the Era of Precision Medicine

Simple Summary

Recently, radiogenomics has played a significant role and offered a new understanding of cancer’s biology and behavior in response to standard therapy. It also provides a more precise prognosis, investigation, and analysis of the patient’s cancer. Over the years, Artificial Intelligence (AI) has provided a significant strength in radiogenomics. In this paper, we offer computational and oncological prospects of the role of AI in radiogenomics, as well as its offers, achievements, opportunities, and limitations in the current clinical practices.

Abstract

Radiogenomics, a combination of “Radiomics” and “Genomics,” using Artificial Intelligence (AI) has recently emerged as the state-of-the-art science in precision medicine, especially in oncology care. Radiogenomics syndicates large-scale quantifiable data extracted from radiological medical images enveloped with personalized genomic phenotypes. It fabricates a prediction model through various AI methods to stratify the risk of patients, monitor therapeutic approaches, and assess clinical outcomes. It has recently shown tremendous achievements in prognosis, treatment planning, survival prediction, heterogeneity analysis, reoccurrence, and progression-free survival for human cancer study. Although AI has shown immense performance in oncology care in various clinical aspects, it has several challenges and limitations. The proposed review provides an overview of radiogenomics with the viewpoints on the role of AI in terms of its promises for computational as well as oncological aspects and offers achievements and opportunities in the era of precision medicine. The review also presents various recommendations to diminish these obstacles.

Cardiovascular/Stroke Risk Assessment in Patients with Erectile Dysfunction-A Role of Carotid Wall Arterial Imaging and Plaque Tissue Characterization Using Artificial Intelligence Paradigm: A Narrative Review

PURPOSE

The role of erectile dysfunction (ED) has recently shown an association with the risk of stroke and coronary heart disease (CHD) via the atherosclerotic pathway. Cardiovascular disease (CVD)/stroke risk has been widely understood with the help of carotid artery disease (CTAD), a surrogate biomarker for CHD. The proposed study emphasizes artificial intelligence-based frameworks such as machine learning (ML) and deep learning (DL) that can accurately predict the severity of CVD/stroke risk using carotid wall arterial imaging in ED patients.

METHODS

Using the PRISMA model, 231 of the best studies were selected. The proposed study mainly consists of two components: (i) the pathophysiology of ED and its link with coronary artery disease (COAD) and CHD in the ED framework and (ii) the ultrasonic-image morphological changes in the carotid arterial walls by quantifying the wall parameters and the characterization of the wall tissue by adapting the ML/DL-based methods, both for the prediction of the severity of CVD risk. The proposed study analyzes the hypothesis that ML/DL can lead to an accurate and early diagnosis of the CVD/stroke risk in ED patients. Our finding suggests that the routine ED patient practice can be amended for ML/DL-based CVD/stroke risk assessment using carotid wall arterial imaging leading to fast, reliable, and accurate CVD/stroke risk stratification.

SUMMARY

We conclude that ML and DL methods are very powerful tools for the characterization of CVD/stroke in patients with varying ED conditions. We anticipate a rapid growth of these tools for early and better CVD/stroke risk management in ED patients.

Cardiovascular Risk Stratification in Diabetic Retinopathy via Atherosclerotic Pathway in COVID-19/non-COVID-19 Frameworks using Artificial Intelligence Paradigm: A Narrative Review

Diabetes is one of the main causes of the rising cases of blindness in adults. This microvascular complication of diabetes is termed diabetic retinopathy (DR) and is associated with an expanding risk of cardiovascular events in diabetes patients. DR, in its various forms, is seen to be a powerful indicator of atherosclerosis. Further, the macrovascular complication of diabetes leads to coronary artery disease (CAD). Thus, the timely identification of cardiovascular disease (CVD) complications in DR patients is of utmost importance. Since CAD risk assessment is expensive for low-income countries, it is important to look for surrogate biomarkers for risk stratification of CVD in DR patients. Due to the common genetic makeup between the coronary and carotid arteries, low-cost, high-resolution imaging such as carotid B-mode ultrasound (US) can be used for arterial tissue characterization and risk stratification in DR patients. The advent of artificial intelligence (AI) techniques has facilitated the handling of large cohorts in a big data framework to identify atherosclerotic plaque features in arterial ultrasound. This enables timely CVD risk assessment and risk stratification of patients with DR. Thus, this review focuses on understanding the pathophysiology of DR, retinal and CAD imaging, the role of surrogate markers for CVD, and finally, the CVD risk stratification of DR patients. The review shows a step-by-step cyclic activity of how diabetes and atherosclerotic disease cause DR, leading to the worsening of CVD. We propose a solution to how AI can help in the identification of CVD risk. Lastly, we analyze the role of DR/CVD in the COVID-19 framework.

Cardiovascular/Stroke Risk Stratification in Parkinson's Disease Patients Using Atherosclerosis Pathway and Artificial Intelligence Paradigm: A Systematic Review

Parkinson’s disease (PD) is a severe, incurable, and costly condition leading to heart failure. The link between PD and cardiovascular disease (CVD) is not available, leading to controversies and poor prognosis. Artificial Intelligence (AI) has already shown promise for CVD/stroke risk stratification. However, due to a lack of sample size, comorbidity, insufficient validation, clinical examination, and a lack of big data configuration, there have been no well-explained bias-free AI investigations to establish the CVD/Stroke risk stratification in the PD framework. The study has two objectives: (i) to establish a solid link between PD and CVD/stroke; and (ii) to use the AI paradigm to examine a well-defined CVD/stroke risk stratification in the PD framework. The PRISMA search strategy selected 223 studies for CVD/stroke risk, of which 54 and 44 studies were related to the link between PD-CVD, and PD-stroke, respectively, 59 studies for joint PD-CVD-Stroke framework, and 66 studies were only for the early PD diagnosis without CVD/stroke link. Sequential biological links were used for establishing the hypothesis. For AI design, PD risk factors as covariates along with CVD/stroke as the gold standard were used for predicting the CVD/stroke risk. The most fundamental cause of CVD/stroke damage due to PD is cardiac autonomic dysfunction due to neurodegeneration that leads to heart failure and its edema, and this validated our hypothesis. Finally, we present the novel AI solutions for CVD/stroke risk prediction in the PD framework. The study also recommends strategies for removing the bias in AI for CVD/stroke risk prediction using the PD framework.

A Powerful Paradigm for Cardiovascular Risk Stratification Using Multiclass, Multi-Label, and Ensemble-Based Machine Learning Paradigms: A Narrative Review

Background and Motivation: Cardiovascular disease (CVD) causes the highest mortality globally. With escalating healthcare costs, early non-invasive CVD risk assessment is vital. Conventional methods have shown poor performance compared to more recent and fast-evolving Artificial Intelligence (AI) methods. The proposed study reviews the three most recent paradigms for CVD risk assessment, namely multiclass, multi-label, and ensemble-based methods in (i) office-based and (ii) stress-test laboratories. Methods: A total of 265 CVD-based studies were selected using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) model. Due to its popularity and recent development, the study analyzed the above three paradigms using machine learning (ML) frameworks. We review comprehensively these three methods using attributes, such as architecture, applications, pro-and-cons, scientific validation, clinical evaluation, and AI risk-of-bias (RoB) in the CVD framework. These ML techniques were then extended under mobile and cloud-based infrastructure. Findings: Most popular biomarkers used were office-based, laboratory-based, image-based phenotypes, and medication usage. Surrogate carotid scanning for coronary artery risk prediction had shown promising results. Ground truth (GT) selection for AI-based training along with scientific and clinical validation is very important for CVD stratification to avoid RoB. It was observed that the most popular classification paradigm is multiclass followed by the ensemble, and multi-label. The use of deep learning techniques in CVD risk stratification is in a very early stage of development. Mobile and cloud-based AI technologies are more likely to be the future. Conclusions: AI-based methods for CVD risk assessment are most promising and successful. Choice of GT is most vital in AI-based models to prevent the RoB. The amalgamation of image-based strategies with conventional risk factors provides the highest stability when using the three CVD paradigms in non-cloud and cloud-based frameworks.

Four Types of Multiclass Frameworks for Pneumonia Classification and Its Validation in X-ray Scans Using Seven Types of Deep Learning Artificial Intelligence Models

Background and Motivation: The novel coronavirus causing COVID-19 is exceptionally contagious, highly mutative, decimating human health and life, as well as the global economy, by consistent evolution of new pernicious variants and outbreaks. The reverse transcriptase polymerase chain reaction currently used for diagnosis has major limitations. Furthermore, the multiclass lung classification X-ray systems having viral, bacterial, and tubercular classes—including COVID-19—are not reliable. Thus, there is a need for a robust, fast, cost-effective, and easily available diagnostic method. Method: Artificial intelligence (AI) has been shown to revolutionize all walks of life, particularly medical imaging. This study proposes a deep learning AI-based automatic multiclass detection and classification of pneumonia from chest X-ray images that are readily available and highly cost-effective. The study has designed and applied seven highly efficient pre-trained convolutional neural networks—namely, VGG16, VGG19, DenseNet201, Xception, InceptionV3, NasnetMobile, and ResNet152—for classification of up to five classes of pneumonia. Results: The database consisted of 18,603 scans with two, three, and five classes. The best results were using DenseNet201, VGG16, and VGG16, respectively having accuracies of 99.84%, 96.7%, 92.67%; sensitivity of 99.84%, 96.63%, 92.70%; specificity of 99.84, 96.63%, 92.41%; and AUC of 1.0, 0.97, 0.92 (p < 0.0001 for all), respectively. Our system outperformed existing methods by 1.2% for the five-class model. The online system takes <1 s while demonstrating reliability and stability. Conclusions: Deep learning AI is a powerful paradigm for multiclass pneumonia classification.

Human activity recognition in artificial intelligence framework: a narrative review

Human activity recognition (HAR) has multifaceted applications due to its worldly usage of acquisition devices such as smartphones, video cameras, and its ability to capture human activity data. While electronic devices and their applications are steadily growing, the advances in Artificial intelligence (AI) have revolutionized the ability to extract deep hidden information for accurate detection and its interpretation. This yields a better understanding of rapidly growing acquisition devices, AI, and applications, the three pillars of HAR under one roof. There are many review articles published on the general characteristics of HAR, a few have compared all the HAR devices at the same time, and few have explored the impact of evolving AI architecture. In our proposed review, a detailed narration on the three pillars of HAR is presented covering the period from 2011 to 2021. Further, the review presents the recommendations for an improved HAR design, its reliability, and stability. Five major findings were: (1) HAR constitutes three major pillars such as devices, AI and applications; (2) HAR has dominated the healthcare industry; (3) Hybrid AI models are in their infancy stage and needs considerable work for providing the stable and reliable design. Further, these trained models need solid prediction, high accuracy, generalization, and finally, meeting the objectives of the applications without bias; (4) little work was observed in abnormality detection during actions; and (5) almost no work has been done in forecasting actions. We conclude that: (a) HAR industry will evolve in terms of the three pillars of electronic devices, applications and the type of AI. (b) AI will provide a powerful impetus to the HAR industry in future.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10462-021-10116-x.

A hybrid deep learning paradigm for carotid plaque tissue characterization and its validation in multicenter cohorts using a supercomputer framework

BACKGROUND

Early and automated detection of carotid plaques prevents strokes, which are the second leading cause of death worldwide according to the World Health Organization. Artificial intelligence (AI) offers automated solutions for plaque tissue characterization. Recently, solo deep learning (SDL) models have been used, but they do not take advantage of the tandem connectivity offered by AI's hybrid nature. Therefore, this study explores the use of hybrid deep learning (HDL) models in a multicenter framework, making this study the first of its kind.

METHODS

We hypothesize that HDL techniques perform better than SDL and transfer learning (TL) techniques. We propose two kinds of HDL frameworks: (i) the fusion of two SDLs (Inception with ResNet) or (ii) 10 other kinds of tandem models that fuse SDL with ML. The system Atheromatic™ 2.0_HDL (AtheroPoint, CA, USA) was designed on an augmentation framework and three kinds of loss functions (cross-entropy, hinge, and mean-square-error) during training to determine the best optimization paradigm. These 11 combined HDL models were then benchmarked against one SDL model and five types of TL models; thus, this study considers a total of 17 AI models.

RESULTS

Among the 17 AI models, the best performing HDL system was that comprising CNN and decision tree (DT), as its accuracy and area-under-the-curve were 99.78 ± 1.05% and 0.99 (p<0.0001), respectively. These values are 6.4% and 3.2% better than those recorded for the SDL and TL models, respectively. We validated the performance of the HDL models with diagnostics odds ratio (DOR) and Cohen and Kappa statistics; here, HDL outperformed DL and TL by 23% and 7%, respectively. The online system ran in <2 s.

CONCLUSION

HDL is a fast, reliable, and effective tool for characterizing the carotid plaque for early stroke risk stratification.

Unseen Artificial Intelligence-Deep Learning Paradigm for Segmentation of Low Atherosclerotic Plaque in Carotid Ultrasound: A Multicenter Cardiovascular Study

BACKGROUND

The early detection of carotid wall plaque is recommended in the prevention of cardiovascular disease (CVD) in moderate-risk patients. Previous techniques for B-mode carotid atherosclerotic wall plaque segmentation used artificial intelligence (AI) methods on monoethnic databases, where training and testing are from the "same" ethnic group ("Seen AI"). Therefore, the versatility of the system is questionable. This is the first study of its kind that uses the "Unseen AI" paradigm where training and testing are from "different" ethnic groups. We hypothesized that deep learning (DL) models should perform in 10% proximity between "Unseen AI" and "Seen AI".

METHODOLOGY

Two cohorts from multi-ethnic groups (330 Japanese and 300 Hong Kong (HK)) were used for the validation of our hypothesis. We used a four-layered UNet architecture for the segmentation of the atherosclerotic wall with low plaque. "Unseen AI" (training: Japanese, testing: HK or vice versa) and "Seen AI" experiments (single ethnicity or mixed ethnicity) were performed. Evaluation was conducted by measuring the wall plaque area. Statistical tests were conducted for its stability and reliability.

RESULTS

When using the UNet DL architecture, the "Unseen AI" pair one (Training: 330 Japanese and Testing: 300 HK), the mean accuracy, dice-similarity, and correlation-coefficient were 98.55, 78.38, and 0.80 (p < 0.0001), respectively, while for "Unseen AI" pair two (Training: 300 HK and Testing: 330 Japanese), these were 98.67, 82.49, and 0.87 (p < 0.0001), respectively. Using "Seen AI", the same parameters were 99.01, 86.89 and 0.92 (p < 0.0001), respectively.

CONCLUSION

We demonstrated that "Unseen AI" was in close proximity (<10%) to "Seen AI", validating our DL model for low atherosclerotic wall plaque segmentation. The online system runs < 1 s.

Inter-Variability Study of COVLIAS 1.0: Hybrid Deep Learning Models for COVID-19 Lung Segmentation in Computed Tomography

Background: For COVID-19 lung severity, segmentation of lungs on computed tomography (CT) is the first crucial step. Current deep learning (DL)-based Artificial Intelligence (AI) models have a bias in the training stage of segmentation because only one set of ground truth (GT) annotations are evaluated. We propose a robust and stable inter-variability analysis of CT lung segmentation in COVID-19 to avoid the effect of bias. Methodology: The proposed inter-variability study consists of two GT tracers for lung segmentation on chest CT. Three AI models, PSP Net, VGG-SegNet, and ResNet-SegNet, were trained using GT annotations. We hypothesized that if AI models are trained on the GT tracings from multiple experience levels, and if the AI performance on the test data between these AI models is within the 5% range, one can consider such an AI model robust and unbiased. The K5 protocol (training to testing: 80%:20%) was adapted. Ten kinds of metrics were used for performance evaluation. Results: The database consisted of 5000 CT chest images from 72 COVID-19-infected patients. By computing the coefficient of correlations (CC) between the output of the two AI models trained corresponding to the two GT tracers, computing their differences in their CC, and repeating the process for all three AI-models, we show the differences as 0%, 0.51%, and 2.04% (all < 5%), thereby validating the hypothesis. The performance was comparable; however, it had the following order: ResNet-SegNet > PSP Net > VGG-SegNet. Conclusions: The AI models were clinically robust and stable during the inter-variability analysis on the CT lung segmentation on COVID-19 patients.

Restoration and enhancement of breast ultrasound images using extended complex diffusion based unsharp masking

Ultrasound is a well-known imaging modality for the interpretation of breast cancer. It is playing very important role for breast cancer detection that are missed by mammograms. The image acquisition is usually affected by the presence of noise, artifacts, and distortion. To overcome such type of issues, there is a need of image restoration and enhancement to improve the quality of image. This paper proposes a single framework for denoising and enhancement of ultrasound images, where a smoothing filter is replaced with an extended complex diffusion-based filter in an unsharp masking technique. The performance evaluation of the proposed method is tested on real ultrasound breast cancer images database and synthetic ultrasound image. The performance evaluation comprises qualitative and quantitative evaluation along with comparative analysis of pre-existing and proposed method. The quantitative evaluation metrics are mean squared error, peak-signal-to-noise ratio, correlation parameter, normalized absolute error, universal quality index, similarity structure index, edge preservation index, a measure of enhancement, a measure of enhancement by entropy, and second derivative like measurement. The result specifies that the proposed method is better suited approach for the removal of speckle noise which follows Rayleigh distribution, restoration of information, enhancement of abnormalities, and proper edge preservation.

Hybrid deep learning segmentation models for atherosclerotic plaque in internal carotid artery B-mode ultrasound

The automated and accurate carotid plaque segmentation in B-mode ultrasound (US) is an essential part of stroke risk stratification. Previous segmented methods used AtheroEdge™ 2.0 (AtheroPoint™, Roseville, CA) for the common carotid artery (CCA). This study focuses on automated plaque segmentation in the internal carotid artery (ICA) using solo deep learning (SDL) and hybrid deep learning (HDL) models. The methodology consists of a novel design of 10 types of SDL/HDL models (AtheroEdge™ 3.0 systems (AtheroPoint™, Roseville, CA) with a depth of four layers each. Five of the models use cross-entropy (CE)-loss, and the other five models use Dice similarity coefficient (DSC)-loss functions derived from UNet, UNet+, SegNet, SegNet-UNet, and SegNet-UNet+. The K10 protocol (Train:Test:90%:10%) was applied for all 10 models for training and predicting (segmenting) the plaque region, which was then quantified to compute the plaque area in mm². Further, the data augmentation effect was analyzed. The database consisted of 970 ICA B-mode US scans taken from 99 moderate to high-risk patients. Using the difference area threshold of 10 mm² between ground truth (GT) and artificial intelligence (AI), the area under the curve (AUC) values were 0.91, 0.911, 0.908, 0.905, and 0.898, all with a p-value of <0.001 (for CE-loss models) and 0.883, 0.889, 0.905, 0.889, and 0.907, all with a p-value of <0.001 (for DSC-loss models). The correlations between the AI-based plaque area and GT plaque area were 0.98, 0.96, 0.97, 0.98, and 0.97, all with a p-value of <0.001 (for CE-loss models) and 0.98, 0.98, 0.97, 0.98, and 0.98 (for DSC-loss models). Overall, the online system performs plaque segmentation in less than 1 s. We validate our hypothesis that HDL and SDL models demonstrate comparable performance. SegNet-UNet was the best-performing hybrid architecture.

Improved non-local self-similarity measures for effective speckle noise reduction in ultrasound images

BACKGROUND AND OBJECTIVE

In the observed medical ultrasound image, there is always some speckle noise which suppress the details of images and impairs the value of ultrasonography in diagnosis. This work present a novel despeckling method which effectively exploit non-local self-similarity for restoration of corrupted ultrasound images. The proposed approach consist of three stages. First, an improved optimized Bayesian non-local means (OBNLM) filter in which pixel patch is represented by a new vector form is used to get an preliminary estimation of noise-free image. Then, a new index called redundancy index of each pixel patch is calculated for determining which areas in image have low redundancy. Finally, another new vector form is used to represent pixel patch in areas with low redundancy obtained in second stage to recalculate filtered output, and the recalculated output is superimposed on preliminary estimation to generate final result of proposed method.

METHODS

The performance of proposed approach is evaluated on simulated and real ultrasound images. The experiments conducted on various test image illustrate that our proposed algorithm outperforms the various classic denoising algorithms included block matching 3-D (BM3D) and optimized Bayesian non-local means filter.

RESULTS

The objective evaluations and subjective visual inspection of denoised simulated and real ultrasound images demonstrate that the proposed algorithm can achieve superior performance than previously developed methods for speckle noise suppression.

CONCLUSIONS

The combined use of two new representations improve denoising and edge preserving capability of proposed filter apparently. The success of proposed algorithm would help in building the lay foundation for inventing the despeckling algorithms that can make fuller use of information in images.

Despeckling Algorithm for Removing Speckle Noise from Ultrasound Images

Ultrasound (US) imaging can examine human bodies of various ages; however, in the process of obtaining a US image, speckle noise is generated. The speckle noise inhibits physicians from accurately examining lesions; thus, a speckle noise removal method is essential technology. To enhance speckle noise elimination, we propose a novel algorithm using the characteristics of speckle noise and filtering methods based on speckle reducing anisotropic diffusion (SRAD) filtering, discrete wavelet transform (DWT) using symmetry characteristics, weighted guided image filtering (WGIF), and gradient domain guided image filtering (GDGIF). The SRAD filter is exploited as a preprocessing filter because it can be directly applied to a medical US image containing speckle noise without a log-compression. The wavelet domain has the advantage of suppressing the additive noise. Therefore, a homomorphic transformation is utilized to convert the multiplicative noise into additive noise. After two-level DWT decomposition is applied, to suppress the residual noise of an SRAD filtered image, GDGIF and WGIF are exploited to reduce noise from seven high-frequency sub-band images and one low-frequency sub-band image, respectively. Finally, a noise-free image is attained through inverse DWT and an exponential transform. The proposed algorithm exhibits excellent speckle noise elimination and edge conservation as compared with conventional denoising methods.

Depthwise Separable Convolutional Neural Network Model for Intra-Retinal Cyst Segmentation

Intra-retinal cysts (IRCs) are significant in detecting several ocular and retinal pathologies. Segmentation and quantification of IRCs from optical coherence tomography (OCT) scans is a challenging task due to present of speckle noise and scan intensity variations across the vendors. This work proposes a convolutional neural network (CNN) model with an encoder-decoder pair architecture for IRC segmentation across different cross-vendor OCT scans. Since deep CNN models have high computational complexity due to a large number of parameters, the proposed method of depthwise separable convolutional filters aids model generalizability and prevents model over-fitting. Also, the swish activation function is employed to prevent the vanishing gradient problem. The optima cyst segmentation challenge (OCSC) dataset with four different vendor OCT device scans is used to evaluate the proposed model. Our model achieves a mean Dice score of 0.74 and mean recall/precision rate of 0.72/0.82 across different imaging vendors and it outperforms existing algorithms on the OCSC dataset.

Medical Image Enhancement by a Bilateral Filter Using Optimization Technique

For researchers, denoising of Magnetic Resonance (MR) image is a greatest challenge in digital image processing. In this paper, the impulse noise and Rician noise in the medical MR images are removed by using Bilateral Filter (BF). The novel approaches are presented in this paper; Enhanced grasshopper optimization algorithm (EGOA) is used to optimize the BF parameters. To simulate the medical MR images (with different variances), the impulse and Rician noises are added. The EGOA is applied to the noisy image in searching regions of window size, spatial and intensity domain to obtain the filter parameters optimally. The PSNR is taken as fitness value for optimization. We examined the proposed technique results with other MR images After the optimal parameters assurance. In order to comprehend the BF parameters selection importance, the results of proposed denoising method is contrasted with other previously used BFs, genetic algorithm (GA), gravitational search algorithm (GSA) using the quality metrics such as signal-to-noise ratio (SNR), structural similarity index metric (SSIM), mean squared error (MSE), and PSNR. The outcome shows that the EOGA method with BF shows good results than the earlier methods in both edge preservation and noise elimination from medical MR images. The experimental results demonstrate the performance of the proposed method with the accuracy, computational time, and maximum deviation, Peak Signal to Noise Ratio (PSNR), MSE, SSIM, and entropy values of MR images over the existing methods.

Volumetric non-local-means based speckle reduction for optical coherence tomography

We present a novel tomographic non-local-means based despeckling technique, TNode, for optical coherence tomography. TNode is built upon a weighting similarity criterion derived for speckle in a three-dimensional similarity window. We present an implementation using a two-dimensional search window, enabling the despeckling of volumes in the presence of motion artifacts, and an implementation using a three-dimensional window with improved performance in motion-free volumes. We show that our technique provides effective speckle reduction, comparable with B-scan compounding or out-of-plane averaging, while preserving isotropic resolution, even to the level of speckle-sized structures. We demonstrate its superior despeckling performance in a phantom data set, and in an ophthalmic data set we show that small, speckle-sized retinal vessels are clearly preserved in intensity images en-face and in two orthogonal, cross-sectional views. TNode does not rely on dictionaries or segmentation and therefore can readily be applied to arbitrary optical coherence tomography volumes. We show that despeckled esophageal volumes exhibit improved image quality and detail, even in the presence of significant motion artifacts.

Segmentation of Intra-Retinal Cysts From Optical Coherence Tomography Images Using a Fully Convolutional Neural Network Model

Optical coherence tomography (OCT) is an imaging modality that is used extensively for ophthalmic diagnosis, near-histological visualization, and quantification of retinal abnormalities such as cysts, exudates, retinal layer disorganization, etc. Intra-retinal cysts (IRCs) occur in several macular disorders such as, diabetic macular edema, retinal vascular disorders, age-related macular degeneration, and inflammatory disorders. Automated segmentation of IRCs poses challenges owing to variations in the acquisition system scan intensities, speckle noise, and imaging artifacts. Several segmentation methods have been proposed in the literature for IRC segmentation on vendor-specific OCT images that lack generalizability across imaging systems. In this paper, we propose a fully convolutional network (FCN) model for vendor-independent IRC segmentation. The proposed method counteracts image noise variabilities and trains FCN models on OCT sub-images from the OPTIMA cyst segmentation challenge dataset (with four different vendor-specific images, namely, Cirrus, Nidek, Spectralis, and Topcon). Further, optimal data augmentation and model hyperparametrization are shown to prevent over-fitting for IRC area segmentation. The proposed method is evaluated on the test dataset with a recall/precision rate of 0.66/0.79 across imaging vendors. The Dice correlation coefficient of the proposed method outperforms that of the published algorithms in the OPTIMA cyst segmentation challenge with a Dice rate of 0.71 across the vendors.

Nonlocal total variation based on symmetric Kullback-Leibler divergence for the ultrasound image despeckling

Background

Ultrasound imaging is safer than other imaging modalities, because it is noninvasive and nonradiative. Speckle noise degrades the quality of ultrasound images and has negative effects on visual perception and diagnostic operations.

Methods

In this paper, a nonlocal total variation (NLTV) method for ultrasonic speckle reduction is proposed. A spatiogram similarity measurement is introduced for the similarity calculation between image patches. It is based on symmetric Kullback-Leibler (KL) divergence and signal-dependent speckle model for log-compressed ultrasound images. Each patch is regarded as a spatiogram, and the spatial distribution of each bin of the spatiogram is regarded as a weighted Gamma distribution. The similarity between the corresponding bins of the two spatiograms is computed by the symmetric KL divergence. The Split-Bregman fast algorithm is then used to solve the adapted NLTV object function. Kolmogorov-Smirnov (KS) test is performed on synthetic noisy images and real ultrasound images.

Results

We validate our method on synthetic noisy images and clinical ultrasound images. Three measures are adopted for the quantitative evaluation of the despeckling performance: the signal-to-noise ratio (SNR), structural similarity index (SSIM), and natural image quality evaluator (NIQE). For synthetic noisy images, when the noise level increases, the proposed algorithm achieves slightly higher SNRS than that of the other two algorithms, and the SSIMS yielded by the proposed algorithm is obviously higher than that of the other two algorithms. For liver, IVUS and 3DUS images, the NIQE values are 8.25, 6.42 and 9.01, all of which are higher than that of the other two algorithms.

Conclusions

The results of the experiments over synthetic and real ultrasound images demonstrate that the proposed method outperforms current state-of-the-art despeckling methods with respect to speckle reduction and tissue texture preservation.

A hybrid algorithm for speckle noise reduction of ultrasound images

BACKGROUND AND OBJECTIVE

Medical images are contaminated by multiplicative speckle noise which significantly reduce the contrast of ultrasound images and creates a negative effect on various image interpretation tasks. In this paper, we proposed a hybrid denoising approach which collaborate the both local and nonlocal information in an efficient manner. The proposed hybrid algorithm consist of three stages in which at first stage the use of local statistics in the form of guided filter is used to reduce the effect of speckle noise initially. Then, an improved speckle reducing bilateral filter (SRBF) is developed to further reduce the speckle noise from the medical images. Finally, to reconstruct the diffused edges we have used the efficient post-processing technique which jointly considered the advantages of both bilateral and nonlocal mean (NLM) filter for the attenuation of speckle noise efficiently.

METHODS

The performance of proposed hybrid algorithm is evaluated on synthetic, simulated and real ultrasound images. The experiments conducted on various test images demonstrate that our proposed hybrid approach outperforms the various traditional speckle reduction approaches included recently proposed NLM and optimized Bayesian-based NLM.

RESULTS

The results of various quantitative, qualitative measures and by visual inspection of denoise synthetic and real ultrasound images demonstrate that the proposed hybrid algorithm have strong denoising capability and able to preserve the fine image details such as edge of a lesion better than previously developed methods for speckle noise reduction.

CONCLUSIONS

The denoising and edge preserving capability of hybrid algorithm is far better than existing traditional and recently proposed speckle reduction (SR) filters. The success of proposed algorithm would help in building the lay foundation for inventing the hybrid algorithms for denoising of ultrasound images.

Rayleigh-maximum-likelihood bilateral filter for ultrasound image enhancement

Background

Ultrasound imaging plays an important role in computer diagnosis since it is non-invasive and cost-effective. However, ultrasound images are inevitably contaminated by noise and speckle during acquisition. Noise and speckle directly impact the physician to interpret the images and decrease the accuracy in clinical diagnosis. Denoising method is an important component to enhance the quality of ultrasound images; however, several limitations discourage the results because current denoising methods can remove noise while ignoring the statistical characteristics of speckle and thus undermining the effectiveness of despeckling, or vice versa. In addition, most existing algorithms do not identify noise, speckle or edge before removing noise or speckle, and thus they reduce noise and speckle while blurring edge details. Therefore, it is a challenging issue for the traditional methods to effectively remove noise and speckle in ultrasound images while preserving edge details.

Methods

To overcome the above-mentioned limitations, a novel method, called Rayleigh-maximum-likelihood switching bilateral filter (RSBF) is proposed to enhance ultrasound images by two steps: noise, speckle and edge detection followed by filtering. Firstly, a sorted quadrant median vector scheme is utilized to calculate the reference median in a filtering window in comparison with the central pixel to classify the target pixel as noise, speckle or noise-free. Subsequently, the noise is removed by a bilateral filter and the speckle is suppressed by a Rayleigh-maximum-likelihood filter while the noise-free pixels are kept unchanged. To quantitatively evaluate the performance of the proposed method, synthetic ultrasound images contaminated by speckle are simulated by using the speckle model that is subjected to Rayleigh distribution. Thereafter, the corrupted synthetic images are generated by the original image multiplied with the Rayleigh distributed speckle of various signal to noise ratio (SNR) levels and added with Gaussian distributed noise. Meanwhile clinical breast ultrasound images are used to visually evaluate the effectiveness of the method. To examine the performance, comparison tests between the proposed RSBF and six state-of-the-art methods for ultrasound speckle removal are performed on simulated ultrasound images with various noise and speckle levels.

Results

The results of the proposed RSBF are satisfying since the Gaussian noise and the Rayleigh speckle are greatly suppressed. The proposed method can improve the SNRs of the enhanced images to nearly 15 and 13 dB compared with images corrupted by speckle as well as images contaminated by speckle and noise under various SNR levels, respectively. The RSBF is effective in enhancing edge while smoothing the speckle and noise in clinical ultrasound images. In the comparison experiments, the proposed method demonstrates its superiority in accuracy and robustness for denoising and edge preserving under various levels of noise and speckle in terms of visual quality as well as numeric metrics, such as peak signal to noise ratio, SNR and root mean squared error.

Conclusions

The experimental results show that the proposed method is effective for removing the speckle and the background noise in ultrasound images. The main reason is that it performs a “detect and replace” two-step mechanism. The advantages of the proposed RBSF lie in two aspects. Firstly, each central pixel is classified as noise, speckle or noise-free texture according to the absolute difference between the target pixel and the reference median. Subsequently, the Rayleigh-maximum-likelihood filter and the bilateral filter are switched to eliminate speckle and noise, respectively, while the noise-free pixels are unaltered. Therefore, it is implemented with better accuracy and robustness than the traditional methods. Generally, these traits declare that the proposed RSBF would have significant clinical application.

A Decision Support System for Classification of Normal and Medical Renal Disease Using Ultrasound Images

Early detection of medical renal disease is important as the same may lead to chronic kidney disease which is an irreversible stage. The present work proposes an efficient decision support system for detection of medical renal disease using small feature space consisting of only second order GLCM statistical features computed from raw renal ultrasound images. The GLCM mean feature vector and GLCM range feature vector are computed for inter-pixel distance d varying from 1 to 10. These texture feature vectors are combined in various ways yielding GLCM ratio feature vector, GLCM additive feature vector and GLCM concatenated feature vector. The present work explores the potential of five texture feature vectors computed using GLCM statistics exhaustively for differential diagnosis between normal and MRD images using SVM classifier. The result of the study indicates that GLCM range feature vector computed with d = 1 yields the highest overall classification accuracy of 85.7% with individual classification accuracy values of 93.3% and 77.9% for normal and MRD classes respectively.