Recognition of peripheral blood cell images using convolutional neural networks

A hybrid approach based on multipath Swin transformer and ConvMixer for white blood cells classification

White blood cells (WBC) play an effective role in the body's defense against parasites, viruses, and bacteria in the human body. Also, WBCs are categorized based on their morphological structures into various subgroups. The number of these WBC types in the blood of non-diseased and diseased people is different. Thus, the study of WBC classification is quite significant for medical diagnosis. Due to the widespread use of deep learning in medical image analysis in recent years, it has also been used in WBC classification. Moreover, the ConvMixer and Swin transformer models, recently introduced, have garnered significant success by attaining efficient long contextual characteristics. Based on this, a new multipath hybrid network is proposed for WBC classification by using ConvMixer and Swin transformer. This proposed model is called Swin Transformer and ConvMixer based Multipath mixer (SC-MP-Mixer). In the SC-MP-Mixer model, firstly, features with strong spatial details are extracted with the ConvMixer. Then Swin transformer effectively handle these features with self-attention mechanism. In addition, the ConvMixer and Swin transformer blocks consist of a multipath structure to obtain better patch representations in the SC-MP-Mixer. To test the performance of the SC-MP-Mixer, experiments were performed on three WBC datasets with 4 (BCCD), 8 (PBC) and 5 (Raabin) classes. The experimental studies resulted in an accuracy of 99.65% for PBC, 98.68% for Raabin, and 95.66% for BCCD. When compared with the studies in the literature and the state-of-the-art models, it was seen that the SC-MP-Mixer had more effective classification results.

AML leukocyte classification method for small samples based on ACGAN

Leukemia is a class of hematologic malignancies, of which acute myeloid leukemia (AML) is the most common. Screening and diagnosis of AML are performed by microscopic examination or chemical testing of images of the patient's peripheral blood smear. In smear-microscopy, the ability to quickly identify, count, and differentiate different types of blood cells is critical for disease diagnosis. With the development of deep learning (DL), classification techniques based on neural networks have been applied to the recognition of blood cells. However, DL methods have high requirements for the number of valid datasets. This study aims to assess the applicability of the auxiliary classification generative adversarial network (ACGAN) in the classification task for small samples of white blood cells. The method is trained on the TCIA dataset, and the classification accuracy is compared with two classical classifiers and the current state-of-the-art methods. The results are evaluated using accuracy, precision, recall, and F1 score. The accuracy of the ACGAN on the validation set is 97.1 % and the precision, recall, and F1 scores on the validation set are 97.5 , 97.3, and 97.4 %, respectively. In addition, ACGAN received a higher score in comparison with other advanced methods, which can indicate that it is competitive in classification accuracy.

An Innovative Hybrid Model for Automatic Detection of White Blood Cells in Clinical Laboratories

Background: Microscopic examination of peripheral blood is a standard practice in clinical medicine. Although manual examination is considered the gold standard, it presents several disadvantages, such as interobserver variability, being quite time-consuming, and requiring well-trained professionals. New automatic digital algorithms have been developed to eliminate the disadvantages of manual examination and improve the workload of clinical laboratories. Objectives: Regular analysis of peripheral blood cells and careful interpretation of their results are critical for protecting individual health and early diagnosis of diseases. Because many diseases can occur due to this, this study aims to detect white blood cells automatically. Methods: A hybrid model has been developed for this purpose. In the developed model, feature extraction has been performed with MobileNetV2 and EfficientNetb0 architectures. In the next step, the neighborhood component analysis (NCA) method eliminated unnecessary features in the feature maps so that the model could work faster. Then, different features of the same image were combined, and the extracted features were combined to increase the model's performance. Results: The optimized feature map was classified into different classifiers in the last step. The proposed model obtained a competitive accuracy value of 95.6%. Conclusions: The results obtained in the proposed model show that the proposed model can be used in the detection of white blood cells.

A deep learning approach for automatic recognition of abnormalities in the cytoplasm of neutrophils

BACKGROUND AND OBJECTIVES

This study aims to develop and evaluate NeuNN, a system based on convolutional neural networks (CNN) and generative adversarial networks (GAN) for the automatic identification of normal neutrophils and those containing several types of inclusions or showing hypogranulation.

METHODS

From peripheral blood smears, a set of 5605 digital images was obtained with neutrophils belonging to seven categories: Normal neutrophils (NEU), Hypogranulated (HYP) or containing cryoglobulins (CRY), Döhle bodies (DB), Howell-Jolly body-like inclusions (HJBLI), Green-blue inclusions of death (GBI) and phagocytosed bacteria (BAC). The dataset utilized in this study has been made publicly available. The class of GBI was augmented using synthetic images generated by GAN. The NeuNN classification model is based on an EfficientNet-B7 architecture trained from scratch.

RESULTS

NeuNN achieved an overall performance of 94.3% accuracy on the test data set. Performance metrics, including sensitivity, specificity, precision, F1-Score, Jaccard index, and Matthews correlation coefficient indicated overall values of 94%, 99.1%, 94.3%, 94.3%, 89.6%, and 93.6%, respectively.

CONCLUSIONS

The proposed approach, combining data augmentation and classification techniques, allows for automated identification of morphological findings in neutrophils, such us inclusions or hypogranulation. The system can be used as a support tool for clinical pathologists to detect these specific abnormalities with clinical relevance.

Segmentation, feature extraction and classification of leukocytes leveraging neural networks, a comparative study

The gold standard of leukocyte differentiation is a manual examination of blood smears, which is not only time and labor intensive but also susceptible to human error. As to automatic classification, there is still no comparative study of cell segmentation, feature extraction, and cell classification, where a variety of machine and deep learning models are compared with home-developed approaches. In this study, both traditional machine learning of K-means clustering versus deep learning of U-Net, U-Net + ResNet18, and U-Net + ResNet34 were used for cell segmentation, producing segmentation accuracies of 94.36% versus 99.17% for the dataset of CellaVision and 93.20% versus 98.75% for the dataset of BCCD, confirming that deep learning produces higher performance than traditional machine learning in leukocyte classification. In addition, a series of deep-learning approaches, including AlexNet, VGG16, and ResNet18, was adopted to conduct feature extraction and cell classification of leukocytes, producing classification accuracies of 91.31%, 97.83%, and 100% of CellaVision as well as 81.18%, 91.64% and 97.82% of BCCD, confirming the capability of the increased deepness of neural networks in leukocyte classification. As to the demonstrations, this study further conducted cell-type classification of ALL-IDB2 and PCB-HBC datasets, producing high accuracies of 100% and 98.49% among all literature, validating the deep learning model used in this study.

Performance evaluation of the digital morphology analyser Sysmex DI-60 for white blood cell differentials in abnormal samples

Sysmex DI-60 enumerates and classifies leukocytes. Limited research has evaluated the performance of Sysmex DI-60 in abnormal samples, and most focused on leukopenic samples. We evaluate the efficacy of DI-60 in determining white blood cell (WBC) differentials in normal and abnormal samples in different WBC count. Peripheral blood smears (n = 166) were categorised into normal control and disease groups, and further divided into moderate and severe leucocytosis, mild leucocytosis, normal, mild leukopenia, and moderate and severe leukopenia groups based on WBC count. DI-60 preclassification and verification and manual counting results were assessed using Bland-Altman and Passing-Bablok regression analyses. The Kappa test compared the concordance in the abnormal cell detection between DI-60 and manual counting. DI-60 exhibited notable overall sensitivity and specificity for all cells, except basophils. The correlation between the DI-60 preclassification and manual counting was high for segmented neutrophils, band neutrophils, lymphocytes, and blasts, and improved for all cell classes after verification. The mean difference between DI-60 and manual counting for all cell classes was significantly high in moderate and severe leucocytosis (WBC > 30.0 × 109/L) and moderate and severe leukopenia (WBC < 1.5 × 109/L) groups. For blast cells, immature granulocytes, and atypical lymphocytes, the DI-60 verification results were similar to the manual counting results. Plasma cells showed poor agreement. In conclusion, DI-60 demonstrates consistent and reliable analysis of WBC differentials within the range of 1.5-30.0 × 109. Manual counting was indispensable in examining moderate and severe leucocytosis samples, moderate and severe leukopenia samples, and in enumerating of monocytes and plasma cells.

Classification of white blood cells (leucocytes) from blood smear imagery using machine and deep learning models: A global scoping review

Machine learning (ML) and deep learning (DL) models are being increasingly employed for medical imagery analyses, with both approaches used to enhance the accuracy of classification/prediction in the diagnoses of various cancers, tumors and bloodborne diseases. To date however, no review of these techniques and their application(s) within the domain of white blood cell (WBC) classification in blood smear images has been undertaken, representing a notable knowledge gap with respect to model selection and comparison. Accordingly, the current study sought to comprehensively identify, explore and contrast ML and DL methods for classifying WBCs. Following development and implementation of a formalized review protocol, a cohort of 136 primary studies published between January 2006 and May 2023 were identified from the global literature, with the most widely used techniques and best-performing WBC classification methods subsequently ascertained. Studies derived from 26 countries, with highest numbers from high-income countries including the United States (n = 32) and The Netherlands (n = 26). While WBC classification was originally rooted in conventional ML, there has been a notable shift toward the use of DL, and particularly convolutional neural networks (CNN), with 54.4% of identified studies (n = 74) including the use of CNNs, and particularly in concurrence with larger datasets and bespoke features e.g., parallel data pre-processing, feature selection, and extraction. While some conventional ML models achieved up to 99% accuracy, accuracy was shown to decrease in concurrence with decreasing dataset size. Deep learning models exhibited improved performance for more extensive datasets and exhibited higher levels of accuracy in concurrence with increasingly large datasets. Availability of appropriate datasets remains a primary challenge, potentially resolvable using data augmentation techniques. Moreover, medical training of computer science researchers is recommended to improve current understanding of leucocyte structure and subsequent selection of appropriate classification models. Likewise, it is critical that future health professionals be made aware of the power, efficacy, precision and applicability of computer science, soft computing and artificial intelligence contributions to medicine, and particularly in areas like medical imaging.

Helper T cell subsets: Development, function and clinical role in hypersensitivity reactions in the modern perspective

Helper T cells are traditionally classified into T helper 1 (TH1) and T helper 2 (TH2). The more recent discoveries of T helper 17 (TH17), follicular helper T cells (TFH) and regulatory T cells (Treg) enhanced our understanding on the mechanisms of immune function and hypersensitivity reactions, which shaped the modern perspective on the function and role of these different subsets of helper T cells in hypersensitivity reactions. Each subset of helper T cells has characteristic roles in different types of hypersensitivity reactions, hence giving rise to the respective characteristic clinical manifestations. The roles of helper T cells in allergic contact dermatitis (TH1-mediated), drug rash with eosinophilia and systemic symptoms (DRESS) syndrome (TH2-mediated), and acute generalised exanthematous pustulosis (AGEP) (TH17-mediated) are summarised in this article, demonstrating the correlation between the type of helper T cell involved and the clinical features. TFH plays crucial roles in antibody class-switch recombination; they may be implicated in antibody-mediated hypersensitivity reactions, but further research is warranted to delineate their exact pathogenic roles. The helper T cell subsets and their specific cytokine profiles implicated in different hypersensitivity reactions could be potential treatment targets by biologics, but more clinical trials are warranted to establish their clinical effectiveness.

Detection of circulating plasma cells in peripheral blood using deep learning-based morphological analysis

BACKGROUND

The presence of circulating plasma cells (CPCs) is an important laboratory indicator for the diagnosis, staging, risk stratification, and progression monitoring of multiple myeloma (MM). Early detection of CPCs in the peripheral blood (PB) followed by timely interventions can significantly improve MM prognosis and delay its progression. Although the conventional cell morphology examination remains the predominant method for CPC detection because of accessibility, its sensitivity and reproducibility are limited by technician expertise and cell quantity constraints. This study aims to develop an artificial intelligence (AI)-based automated system for a more sensitive and efficient CPC morphology detection.

METHODS

A total of 137 bone marrow smears and 72 PB smears from patients with at Zhongshan Hospital, Fudan University, were retrospectively reviewed. Using an AI-powered digital pathology platform, Morphogo, 305,019 cell images were collected for training. Morphogo's efficacy in CPC detection was evaluated with additional 184 PB smears (94 from patients with MM and 90 from those with other hematological malignancies) and compared with manual microscopy.

RESULTS

Morphogo achieved 99.64% accuracy, 89.03% sensitivity, and 99.68% specificity in classifying CPCs. At a 0.60 threshold, Morphogo achieved a sensitivity of 96.15%, which was approximately twice that of manual microscopy, with a specificity of 78.03%. Patients with CPCs detected by AI scanning had a significantly shorter median progression-free survival compared with those without CPC detection (18 months vs. 34 months, p< .01).

CONCLUSIONS

Morphogo is a highly sensitive system for the automated detection of CPCs, with potential applications in initial screening, prognosis prediction, and posttreatment monitoring for MM patients.

PLAIN LANGUAGE SUMMARY

Diagnosing and monitoring multiple myeloma (MM), a type of blood cancer, requires identifying and quantifying specific cells called circulating plasma cells (CPCs) in the blood. The conventional method for detecting CPCs is manual microscopic examination, which is time-consuming and lacks sensitivity. This study introduces a highly sensitive CPC detection method using an artificial intelligence-based system, Morphogo. It demonstrated remarkable sensitivity and accuracy, surpassing conventional microscopy. This advanced approach suggests that early and accurate CPC detection is achievable by morphology examination, making efficient CPC screening more accessible for patients with MM. This innovative system has the potential to be used in the diagnosis and risk assessment of MM.

Bio-net dataset: AI-based diagnostic solutions using peripheral blood smear images

Peripheral blood smear examination is one of the basic steps in the evaluation of different blood cells. It is a confirmatory step after an automated complete blood count analysis. Manual microscopy is time-consuming and requires professional laboratory expertise. Therefore, the turn-around time for peripheral smear in a health care center is approximately 3-4 hours. To avoid the traditional method of manual counting under the microscope a computerized automation of peripheral blood smear examination has been adopted, which is a challenging task in medical diagnostics. In recent times, deep learning techniques have overcome the challenges associated with human microscopic evaluation of peripheral smears and this has led to reduced cost and precise diagnosis. However, their application can be significantly improved by the availability of annotated datasets. This study presents a large customized annotated blood cell dataset (named the Bio-Net dataset from healthy individuals) and blood cell detection and counting in the peripheral blood smear images. A mini-version of the dataset for specialized WBC-based image processing tasks is also equipped to classify the healthy and mature WBCs in their respective classes. An object detection algorithm called You Only Look Once (YOLO) with a refashion disposition has been trained on the novel dataset to automatically detect and classify blood cells into RBCs, WBCs, and platelets and compare the results with other publicly available datasets to highlight the versatility. In short the introduction of the Bio-Net dataset and AI-powered detection and counting offers a significant potential for advancement in biomedical research for analyzing and understanding biological data.

Wide-field color imaging through multimode fiber with single wavelength illumination: plug-and-play approach

Multimode fiber (MMF) is extensively studied for its ability to transmit light modes in parallel, potentially minimizing optical fiber size in imaging. However, current research predominantly focuses on grayscale imaging, with limited attention to color studies. Existing colorization methods often involve costly white light lasers or multiple light sources, increasing optical system expenses and space. To achieve wide-field color images with typical monochromatic illumination MMF imaging system, we proposed a data-driven "colorization" approach and a neural network called SpeckleColorNet, merging U-Net and conditional GAN (cGAN) architectures, trained by a combined loss function. This approach, demonstrated on a 2-meter MMF system with single-wavelength illumination and the Peripheral Blood Cell (PBC) dataset, outperforms grayscale imaging and alternative colorization methods in readability, definition, detail, and accuracy. Our method aims to integrate MMF into clinical medicine and industrial monitoring, offering cost-effective high-fidelity color imaging. It serves as a plug-and-play replacement for conventional grayscale algorithms in MMF systems, eliminating the need for additional hardware.

White blood cells classification using multi-fold pre-processing and optimized CNN model

White blood cells (WBCs) play a vital role in immune responses against infections and foreign agents. Different WBC types exist, and anomalies within them can indicate diseases like leukemia. Previous research suffers from limited accuracy and inflated performance due to the usage of less important features. Moreover, these studies often focus on fewer WBC types, exaggerating accuracy. This study addresses the crucial task of classifying WBC types using microscopic images. This study introduces a novel approach using extensive pre-processing with data augmentation techniques to produce a more significant feature set to achieve more promising results. The study conducts experiments employing both conventional deep learning and transfer learning models, comparing performance with state-of-the-art machine and deep learning models. Results reveal that a pre-processed feature set and convolutional neural network classifier achieves a significantly better accuracy of 0.99. The proposed method demonstrates superior accuracy and computational efficiency compared to existing state-of-the-art works.

WBC YOLO-ViT: 2 Way - 2 stage white blood cell detection and classification with a combination of YOLOv5 and vision transformer

Accurate detection and classification of white blood cells, otherwise known as leukocytes, play a critical role in diagnosing and monitoring various illnesses. However, conventional methods, such as manual classification by trained professionals, must be revised in terms of accuracy, efficiency, and potential bias. Moreover, applying deep learning techniques to detect and classify white blood cells using microscopic images is challenging owing to limited data, resolution noise, irregular shapes, and varying colors from different sources. This study presents a novel approach integrating object detection and classification for numerous type-white blood cell. We designed a 2-way approach to use two types of images: WBC and nucleus. YOLO (fast object detection) and ViT (powerful image representation capabilities) are effectively integrated into 16 classes. The proposed model demonstrates an exceptional 96.449% accuracy rate in classification.

Evaluation of deep learning training strategies for the classification of bone marrow cell images

BACKGROUND AND OBJECTIVE

The classification of bone marrow (BM) cells by light microscopy is an important cornerstone of hematological diagnosis, performed thousands of times a day by highly trained specialists in laboratories worldwide. As the manual evaluation of blood or BM smears is very time-consuming and prone to inter-observer variation, new reliable automated systems are needed.

METHODS

We aim to improve the automatic classification performance of hematological cell types. Therefore, we evaluate four state-of-the-art Convolutional Neural Network (CNN) architectures on a dataset of 171,374 microscopic cytological single-cell images obtained from BM smears from 945 patients diagnosed with a variety of hematological diseases. We further evaluate the effect of an in-domain vs. out-of-domain pre-training, and assess whether class activation maps provide human-interpretable explanations for the models' predictions.

RESULTS

The best performing pre-trained model (Regnet_y_32gf) yields a mean precision, recall, and F1 scores of 0.787±0.060, 0.755±0.061, and 0.762±0.050, respectively. This is a 53.5% improvement in precision and 7.3% improvement in recall over previous results with CNNs (ResNeXt-50) that were trained from scratch. The out-of-domain pre-training apparently yields general feature extractors/filters that apply very well to the BM cell classification use case. The class activation maps on cell types with characteristic morphological features were found to be consistent with the explanations of a human domain expert. For example, the Auer rods in the cytoplasm were the predictive cellular feature for correctly classified images of faggot cells.

CONCLUSIONS

Our study provides data that can help hematology laboratories to choose the optimal training strategy for blood cell classification deep learning models to improve computer-assisted blood and bone marrow cell identification. It also highlights the need for more specific training data, i.e. images of difficult-to-classify classes, including cells labeled with disease information.

Clinical screening of Nocardia in sputum smears based on neural networks

Objective

Nocardia is clinically rare but highly pathogenic in clinical practice. Due to the lack of Nocardia screening methods, Nocardia is often missed in diagnosis, leading to worsening the condition. Therefore, this paper proposes a Nocardia screening method based on neural networks, aiming at quick Nocardia detection in sputum specimens with low costs and thereby reducing the missed diagnosis rate.

Methods

Firstly, sputum specimens were collected from patients who were infected with Nocardia, and a part of the specimens were mixed with new sputum specimens from patients without Nocardia infection to enhance the data diversity. Secondly, the specimens were converted into smears with Gram staining. Images were captured under a microscope and subsequently annotated by experts, creating two datasets. Thirdly, each dataset was divided into three subsets: the training set, the validation set and the test set. The training and validation sets were used for training networks, while the test set was used for evaluating the effeteness of the trained networks. Finally, a neural network model was trained on this dataset, with an image of Gram-stained sputum smear as input, this model determines the presence and locations of Nocardia instances within the image.

Results

After training, the detection network was evaluated on two datasets, resulting in classification accuracies of 97.3% and 98.3%, respectively. This network can identify Nocardia instances in about 24 milliseconds per image on a personal computer. The detection metrics of mAP50 on both datasets were 0.780 and 0.841, respectively.

Conclusion

The Nocardia screening method can accurately and efficiently determine whether Nocardia exists in the images of Gram-stained sputum smears. Additionally, it can precisely locate the Nocardia instances, assisting doctors in confirming the presence of Nocardia.

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.

Automated detection of apoptotic bodies and cells in label-free time-lapse high-throughput video microscopy using deep convolutional neural networks

MOTIVATION

Reliable label-free methods are needed for detecting and profiling apoptotic events in time-lapse cell-cell interaction assays. Prior studies relied on fluorescent markers of apoptosis, e.g. Annexin-V, that provide an inconsistent and late indication of apoptotic onset for human melanoma cells. Our motivation is to improve the detection of apoptosis by directly detecting apoptotic bodies in a label-free manner.

RESULTS

Our trained ResNet50 network identified nanowells containing apoptotic bodies with 92% accuracy and predicted the onset of apoptosis with an error of one frame (5 min/frame). Our apoptotic body segmentation yielded an IoU accuracy of 75%, allowing associative identification of apoptotic cells. Our method detected apoptosis events, 70% of which were not detected by Annexin-V staining.

AVAILABILITY AND IMPLEMENTATION

Open-source code and sample data provided at https://github.com/kwu14victor/ApoBDproject.

MDFF-Net: A multi-dimensional feature fusion network for breast histopathology image classification

Breast cancer is a common malignancy and early detection and treatment of it is crucial. Computer-aided diagnosis (CAD) based on deep learning has significantly advanced medical diagnostics, enhancing accuracy and efficiency in recent years. Despite the convenience, this technology also has certain limitations. When the morphological characteristics of the patient's pathological section are not evident or complex, certain small lesions or cells deep within the lesion cannot be recognized, and misdiagnosis is prone to occur. As a result, MDFF-Net, a CNN-based multidimensional feature fusion network, is proposed. The model consists of a one-dimensional feature extraction network, a two-dimensional feature extraction network, and a feature fusion classification network. The basic part of the two-dimensional feature extraction network is stacked by modules integrated with multi-scale channel shuffling networks and channel attention modules. Furthermore, inspired by natural language processing, this model integrates a one-dimensional feature extraction network to extract detailed information in the image to avoid misdiagnosis caused by insufficient information extraction such as cell morphological characteristics and differentiation degree. Finally, the extracted one-dimensional and two-dimensional features are fused in the feature fusion network and employed for the final classification. The effectiveness of MDFF-Net and classical classification models were evaluated on the BreakHis and the BACH datasets. According to experimental results, MDFF-Net achieves an accuracy of 98.86% on the BreakHis and 86.25% on the BACH dataset. Furthermore, to further assess the effectiveness of the model in other classification tasks, the colon cancer and the lung cancer datasets were employed for additional experiments, achieving a classification accuracy of 100% in both cases.

Automatic normalized digital color staining in the recognition of abnormal blood cells using generative adversarial networks

BACKGROUND AND OBJECTIVES

Combining knowledge of clinical pathologists and deep learning models is a growing trend in morphological analysis of cells circulating in blood to add objectivity, accuracy, and speed in diagnosing hematological and non-hematological diseases. However, the variability in staining protocols across different laboratories can affect the color of images and performance of automatic recognition models. The objective of this work is to develop, train and evaluate a new system for the normalization of color staining of peripheral blood cell images, so that it transforms images from different centers to map the color staining of a reference center (RC) while preserving the structural morphological features.

METHODS

The system has two modules, GAN1 and GAN2. GAN1 uses the PIX2PIX technique to fade original color images to an adaptive gray, while GAN2 transforms them into RGB normalized images. Both GANs have a similar structure, where the generator is a U-NET convolutional neural network with ResNet and the discriminator is a classifier with ResNet34 structure. Digitally stained images were evaluated using GAN metrics and histograms to assess the ability to modify color without altering cell morphology. The system was also evaluated as a pre-processing tool before cells undergo a classification process. For this purpose, a CNN classifier was designed for three classes: abnormal lymphocytes, blasts and reactive lymphocytes.

RESULTS

Training of all GANs and the classifier was performed using RC images, while evaluations were conducted using images from four other centers. Classification tests were performed before and after applying the stain normalization system. The overall accuracy reached a similar value around 96% in both cases for the RC images, indicating the neutrality of the normalization model for the reference images. On the contrary, it was a significant improvement in the classification performance when applying the stain normalization to the other centers. Reactive lymphocytes were the most sensitive to stain normalization, with true positive rates (TPR) increasing from 46.3% - 66% for the original images to 81.2% - 97.2% after digital staining. Abnormal lymphocytes TPR ranged from 31.9% - 95.7% with original images to 83% - 100% with digitally stained images. Blast class showed TPR ranges of 90.3% - 94.4% and 94.4% - 100%, for original and stained images, respectively.

CONCLUSIONS

The proposed GAN-based normalization staining approach improves the performance of classifiers with multicenter data sets by generating digitally stained images with a quality similar to the original images and adaptability to a reference staining standard. The system requires low computation cost and can help improve the performance of automatic recognition models in clinical settings.

Leukocyte subtype classification with multi-model fusion

Accurate classification of leukocytes is crucial for the diagnosis of hematologic malignancies, particularly leukemia. However, traditional leukocyte classification methods are time-consuming and subject to subjective interpretation by examiners. To address this issue, we aimed to develop a leukocyte classification system capable of accurately classifying 11 leukocyte classes, which would aid radiologists in diagnosing leukemia. Our proposed two-stage classification scheme involved a multi-model fusion based on ResNet for rough leukocyte classification, which focused on shape features, followed by fine-grained leukocyte classification using support vector machine for lymphocytes based on texture features. Our dataset consisted of 11,102 microscopic leukocyte images of 11 classes. Our proposed method achieved accurate leukocyte subtype classification with high levels of accuracy, sensitivity, specificity, and precision of 97.03 ± 0.05, 96.76 ± 0.05, 99.65 ± 0.05, and 96.54 ± 0.05, respectively, in the test set. The experimental results demonstrate that the leukocyte classification model based on multi-model fusion can effectively classify 11 leukocyte classes, providing valuable technical support for enhancing the performance of hematology analyzers.

Digital assessment of peripheral blood and bone marrow aspirate smears

The diagnosis of benign and neoplastic hematologic disorders relies on analysis of peripheral blood and bone marrow aspirate smears. As demonstrated by the widespread laboratory adoption of hematology analyzers for automated assessment of peripheral blood, digital analysis of these samples provides many significant benefits compared to relying solely on manual review. Nonetheless, analogous instruments for digital bone marrow aspirate smear assessment have yet to be clinically implemented. In this review, we first provide a historical overview detailing the implementation of hematology analyzers for digital peripheral blood assessment in the clinical laboratory, including the improvements in accuracy, scope, and throughput of current instruments over prior generations. We also describe recent research in digital peripheral blood assessment, particularly in the development of advanced machine learning models that may soon be incorporated into commercial instruments. Next, we provide an overview of recent research in digital assessment of bone marrow aspirate smears and how these approaches could soon lead to development and clinical adoption of instrumentation for automated bone marrow aspirate smear analysis. Finally, we describe the relative advantages and provide our vision for the future of digital assessment of peripheral blood and bone marrow aspirate smears, including what improvements we can soon expect in the hematology laboratory.

Classification and recognition of milk somatic cell images based on PolyLoss and PCAM-Reset50

Somatic cell count (SCC) is a fundamental approach for determining the quality of cattle and bovine milk. So far, different classification and recognition methods have been proposed, all with certain limitations. In this study, we introduced a new deep learning tool, i.e., an improved ResNet50 model constructed based on the residual network and fused with the position attention module and channel attention module to extract the feature information more effectively. In this paper, macrophages, lymphocytes, epithelial cells, and neutrophils were assessed. An image dataset for milk somatic cells was constructed by preprocessing to increase the diversity of samples. PolyLoss was selected as the loss function to solve the unbalanced category samples and difficult sample mining. The Adam optimization algorithm was used to update the gradient, while Warm-up was used to warm up the learning rate to alleviate the overfitting caused by small sample data sets and improve the model's generalization ability. The experimental results showed that the classification accuracy, precision rate, recall rate, and comprehensive evaluation index F value of the proposed model reached 97%, 94.5%, 90.75%, and 92.25%, respectively, indicating that the proposed model could effectively classify the milk somatic cell images, showing a better classification performance than five previous models (i.e., ResNet50, ResNet18, ResNet34, AlexNet andMobileNetv2). The accuracies of the ResNet18, ResNet34, ResNet50, AlexNet, MobileNetv2, and the new model were 95%, 93%, 93%, 56%, 37%, and 97%, respectively. In addition, the comprehensive evaluation index F1 showed the best effect, fully verifying the effectiveness of the proposed method in this paper. The proposed method overcame the limitations of image preprocessing and manual feature extraction by traditional machine learning methods and the limitations of manual feature selection, improving the classification accuracy and showing a strong generalization ability.

Few-shot learning using explainable Siamese twin network for the automated classification of blood cells

Automated classification of blood cells from microscopic images is an interesting research area owing to advancements of efficient neural network models. The existing deep learning methods rely on large data for network training and generating such large data could be time-consuming. Further, explainability is required via class activation mapping for better understanding of the model predictions. Therefore, we developed a Siamese twin network (STN) model based on contrastive learning that trains on relatively few images for the classification of healthy peripheral blood cells using EfficientNet-B3 as the base model. Hence, in this study, a total of 17,092 publicly accessible cell histology images were analyzed from which 6% were used for STN training, 6% for few-shot validation, and the rest 88% for few-shot testing. The proposed architecture demonstrates percent accuracies of 97.00, 98.78, 94.59, 95.70, 98.86, 97.09, 99.71, and 96.30 during 8-way 5-shot testing for the classification of basophils, eosinophils, immature granulocytes, erythroblasts, lymphocytes, monocytes, platelets, and neutrophils, respectively. Further, we propose a novel class activation mapping scheme that highlights the important regions in the test image for the STN model interpretability. Overall, the proposed framework could be used for a fully automated self-exploratory classification of healthy peripheral blood cells. The whole proposed framework demonstrates the Siamese twin network training and 8-way k-shot testing. The values indicate the amount of dissimilarity.

Detection of acute promyelocytic leukemia in peripheral blood and bone marrow with annotation-free deep learning

While optical microscopy inspection of blood films and bone marrow aspirates by a hematologist is a crucial step in establishing diagnosis of acute leukemia, especially in low-resource settings where other diagnostic modalities are not available, the task remains time-consuming and prone to human inconsistencies. This has an impact especially in cases of Acute Promyelocytic Leukemia (APL) that require urgent treatment. Integration of automated computational hematopathology into clinical workflows can improve the throughput of these services and reduce cognitive human error. However, a major bottleneck in deploying such systems is a lack of sufficient cell morphological object-labels annotations to train deep learning models. We overcome this by leveraging patient diagnostic labels to train weakly-supervised models that detect different types of acute leukemia. We introduce a deep learning approach, Multiple Instance Learning for Leukocyte Identification (MILLIE), able to perform automated reliable analysis of blood films with minimal supervision. Without being trained to classify individual cells, MILLIE differentiates between acute lymphoblastic and myeloblastic leukemia in blood films. More importantly, MILLIE detects APL in blood films (AUC 0.94 ± 0.04) and in bone marrow aspirates (AUC 0.99 ± 0.01). MILLIE is a viable solution to augment the throughput of clinical pathways that require assessment of blood film microscopy.

A deep learning model for detection of leukocytes under various interference factors

The accurate detection of leukocytes is the basis for the diagnosis of blood system diseases. However, diagnosing leukocyte disorders by doctors is time-consuming and requires extensive experience. Automated detection methods with high accuracy can improve detection efficiency and provide recommendations to inexperienced doctors. Current methods and instruments either fail to automate the identification process fully or have low performance and need suitable leukocyte data sets for further study. To improve the current status, we need to develop more intelligent strategies. This paper investigates fulfilling high-performance automatic detection for leukocytes using a deep learning-based method. We established a new dataset more suitable for leukocyte detection, containing 6273 images (8595 leukocytes) and considering nine common clinical interference factors. Based on the dataset, the performance evaluation of six mainstream detection models is carried out, and a more robust ensemble model is proposed. The mean of average precision (mAP) @IoU = 0.50:0.95 and mean of average recall (mAR)@IoU = 0.50:0.95 of the ensemble model on the test set are 0.853 and 0.922, respectively. The detection performance of poor-quality images is robust. For the first time, it is found that the ensemble model yields an accuracy of 98.84% for detecting incomplete leukocytes. In addition, we also compared the test results of different models and found multiple identical false detections of the models, then provided correct suggestions for the clinic.

Automatic generation of artificial images of leukocytes and leukemic cells using generative adversarial networks (syntheticcellgan)

BACKGROUND AND OBJECTIVES

Visual analysis of cell morphology has an important role in the diagnosis of hematological diseases. Morphological cell recognition is a challenge that requires experience and in-depth review by clinical pathologists. Within the new trend of introducing computer-aided diagnostic tools in laboratory medicine, models based on deep learning are being developed for the automatic identification of different types of cells in peripheral blood. In general, well-annotated large image sets are needed to train the models to reach a desired classification performance. This is especially relevant when it comes to discerning between cell images in which morphological differences are subtle and when it comes to low prevalent diseases with the consequent difficulty in collecting cell images. The objective of this work is to develop, train and validate SyntheticCellGAN (SCG), a new system for the automatic generation of artificial images of white blood cells, maintaining morphological characteristics very close to real cells found in practice in clinical laboratories.

METHODS

SCG is designed with two sequential generative adversarial networks. First, a Wasserstein structure is used to transform random noise vectors into low resolution images of basic mononuclear cells. Second, the concept of image-to-image translation is used to build specific models that transform the basic images into high-resolution final images with the realistic morphology of each cell type target: 1) the five groups of normal leukocytes (lymphocytes, monocytes, eosinophils, neutrophils and basophils); 2) atypical promyelocytes and hairy cells, which are two relevant cell types of complex morphology with low abundance in blood smears.

RESULTS

The images of the SCG system are evaluated with four experimental tests. In the first test we evaluated the generated images with quantitative metrics for GANs. In the second test, morphological verification of the artificial images is performed by expert clinical pathologists with 100% accuracy. In the third test, two classifiers based on convolutional neural networks (CNN) previously trained with images of real cells are used. Two sets of artificial images of the SCG system are classified with an accuracy of 95.36% and 94%, respectively. In the fourth test, three CNN classifiers are trained with artificial images of the SCG system. Real cells are identified with an accuracy ranging from 87.7% to 100%.

CONCLUSIONS

The SCG system has proven effective in creating images of all normal leukocytes and two low-prevalence cell classes associated with diseases such as acute promyelocyte leukemia and hairy cell leukemia. Once trained, the system requires low computational cost and can help augment high-quality image datasets to improve automatic recognition model training for clinical laboratory practice.

Recognizing the Differentiation Degree of Human Induced Pluripotent Stem Cell-Derived Retinal Pigment Epithelium Cells Using Machine Learning and Deep Learning-Based Approaches

Induced pluripotent stem cells (iPSCs) can be differentiated into mesenchymal stem cells (iPSC-MSCs), retinal ganglion cells (iPSC-RGCs), and retinal pigmental epithelium cells (iPSC-RPEs) to meet the demand of regeneration medicine. Since the production of iPSCs and iPSC-derived cell lineages generally requires massive and time-consuming laboratory work, artificial intelligence (AI)-assisted approach that can facilitate the cell classification and recognize the cell differentiation degree is of critical demand. In this study, we propose the multi-slice tensor model, a modified convolutional neural network (CNN) designed to classify iPSC-derived cells and evaluate the differentiation efficiency of iPSC-RPEs. We removed the fully connected layers and projected the features using principle component analysis (PCA), and subsequently classified iPSC-RPEs according to various differentiation degree. With the assistance of the support vector machine (SVM), this model further showed capabilities to classify iPSCs, iPSC-MSCs, iPSC-RPEs, and iPSC-RGCs with an accuracy of 97.8%. In addition, the proposed model accurately recognized the differentiation of iPSC-RPEs and showed the potential to identify the candidate cells with ideal features and simultaneously exclude cells with immature/abnormal phenotypes. This rapid screening/classification system may facilitate the translation of iPSC-based technologies into clinical uses, such as cell transplantation therapy.

Automatic identifying and counting blood cells in smear images by using single shot detector and Taguchi method

BACKGROUND

Researchers have tried to identify and count different blood cells in microscopic smear images by using deep learning methods of artificial intelligence to solve the highly time-consuming problem.

RESULTS

The three types of blood cells are platelets, red blood cells, and white blood cells. This study used the Resnet50 network as a backbone network of the single shot detector (SSD) for automatically identifying and counting different blood cells and, meanwhile, proposed a systematic method to find a better combination of algorithm hyperparameters of the Resnet50 network for promoting accuracy for identifying and counting blood cells. The Resnet50 backbone network of the SSD with its optimized algorithm hyperparameters, which is called the Resnet50-SSD model, was developed to enhance the feature extraction ability for identifying and counting blood cells. Furthermore, the algorithm hyperparameters of Resnet50 backbone networks of the SSD were optimized by the Taguchi experimental method for promoting detection accuracy of the Resnet50-SSD model. The experimental result shows that the detection accuracy of the Resnet50-SSD model with 512 × 512 × 3 input images was better than that of the Resnet50-SSD model with 300 × 300 × 3 input images on the test set of blood cells images. Additionally, the detection accuracy of the Resnet50-SSD model using the combination of algorithm hyperparameters got by the Taguchi method was better than that of the Resnet50-SSD model using the combination of algorithm hyperparameters given by the Matlab example.

CONCLUSION

In blood cell images acquired from the BCCD dataset, the proposed Resnet50-SSD model had higher accuracy in identifying and counting blood cells, especially white blood cells and red blood cells.

Multicentric evaluation of the variability of digital morphology performances also respect to the reference methods by optical microscopy

INTRODUCTION

Despite the important diagnostic role of peripheral blood morphology, cell classification is subjective. Automated image-processing systems (AIS) provide more accurate and objective morphological evaluation. The aims of this multicenter study were the evaluation of the intra and inter-laboratory variation between different AIS in cell pre-classification and after reclassification, compared with manual optical microscopy, the reference method.

METHODS

Six peripheral blood samples were included in this study, for each sample, 70 May-Grunwald and Giemsa stained PB smears were prepared from each specimen and 10 slides were delivered to the seven laboratories involved. Smears were processed by both optical microscopy (OM) and AIS. In addition, the assessment times of both methods were recorded.

RESULTS

Within-laboratory Reproducibility ranged between 4.76% and 153.78%; between-laboratory Precision ranged between 2.10% and 82.2%, while Total Imprecision ranged between 5.21% and 20.60%. The relative Bland Altman bias ranged between -0.01% and 20.60%. The mean of assessment times were 326 ± 110 s and 191 ± 68 s for AIS post reclassification and OM, respectively.

CONCLUSIONS

AIS can be helpful when the number of cell counted are low and can give advantages in terms of efficiency, objectivity and time saving in the morphological analysis of blood cells. They can also help in the interpretation of some morphological features and can serve as learning and investigation tools.

BCNet: A Deep Learning Computer-Aided Diagnosis Framework for Human Peripheral Blood Cell Identification

Blood cells carry important information that can be used to represent a person's current state of health. The identification of different types of blood cells in a timely and precise manner is essential to cutting the infection risks that people face on a daily basis. The BCNet is an artificial intelligence (AI)-based deep learning (DL) framework that was proposed based on the capability of transfer learning with a convolutional neural network to rapidly and automatically identify the blood cells in an eight-class identification scenario: Basophil, Eosinophil, Erythroblast, Immature Granulocytes, Lymphocyte, Monocyte, Neutrophil, and Platelet. For the purpose of establishing the dependability and viability of BCNet, exhaustive experiments consisting of five-fold cross-validation tests are carried out. Using the transfer learning strategy, we conducted in-depth comprehensive experiments on the proposed BCNet's architecture and test it with three optimizers of ADAM, RMSprop (RMSP), and stochastic gradient descent (SGD). Meanwhile, the performance of the proposed BCNet is directly compared using the same dataset with the state-of-the-art deep learning models of DensNet, ResNet, Inception, and MobileNet. When employing the different optimizers, the BCNet framework demonstrated better classification performance with ADAM and RMSP optimizers. The best evaluation performance was achieved using the RMSP optimizer in terms of 98.51% accuracy and 96.24% F1-score. Compared with the baseline model, the BCNet clearly improved the prediction accuracy performance 1.94%, 3.33%, and 1.65% using the optimizers of ADAM, RMSP, and SGD, respectively. The proposed BCNet model outperformed the AI models of DenseNet, ResNet, Inception, and MobileNet in terms of the testing time of a single blood cell image by 10.98, 4.26, 2.03, and 0.21 msec. In comparison to the most recent deep learning models, the BCNet model could be able to generate encouraging outcomes. It is essential for the advancement of healthcare facilities to have such a recognition rate improving the detection performance of the blood cells.

RCMNet: A deep learning model assists CAR-T therapy for leukemia

Acute leukemia is a type of blood cancer with a high mortality rate. Current therapeutic methods include bone marrow transplantation, supportive therapy, and chemotherapy. Although a satisfactory remission of the disease can be achieved, the risk of recurrence is still high. Therefore, novel treatments are demanding. Chimeric antigen receptor-T (CAR-T) therapy has emerged as a promising approach to treating and curing acute leukemia. To harness the therapeutic potential of CAR-T cell therapy for blood diseases, reliable cell morphological identification is crucial. Nevertheless, the identification of CAR-T cells is a big challenge posed by their phenotypic similarity with other blood cells. To address this substantial clinical challenge, herein we first construct a CAR-T dataset with 500 original microscopy images after staining. Following that, we create a novel integrated model called RCMNet (ResNet18 with Convolutional Block Attention Module and Multi-Head Self-Attention) that combines the convolutional neural network (CNN) and Transformer. The model shows 99.63% top-1 accuracy on the public dataset. Compared with previous reports, our model obtains satisfactory results for image classification. Although testing on the CAR-T cell dataset, a decent performance is observed, which is attributed to the limited size of the dataset. Transfer learning is adapted for RCMNet and a maximum of 83.36% accuracy is achieved, which is higher than that of other state-of-the-art models. This study evaluates the effectiveness of RCMNet on a big public dataset and translates it to a clinical dataset for diagnostic applications.

AIMIC: Deep Learning for Microscopic Image Classification

BACKGROUND AND OBJECTIVE

Deep learning techniques are powerful tools for image analysis. However, the lack of programming experience makes it difficult for novice users to apply this technology. This project aims to lower the barrier for clinical users to implement deep learning methods in microscopic image classification.

METHODS

In this study, an out-of-the-box software, AIMIC (artificial intelligence-based microscopy image classifier), was developed for users to apply deep learning technology in a code-free manner. The platform was equipped with state-of-the-art deep learning techniques and data preprocessing approaches. Furthermore, we evaluated the built-in networks on four benchmark microscopy image datasets to assist entry-level practitioners in selecting a suitable algorithm.

RESULTS

The entire deep learning pipeline, from training a new network to inferring unseen samples using the trained model, could be implemented on the proposed platform without the need for programming. In the evaluation experiments, the ResNeXt-50-32×4d outperformed other competitor algorithms in terms of average accuracy (96.83%) and average F1-score (96.82%). In addition, the MobileNet-V2 achieved a good balance between the performance (accuracy of 95.72%) and computational cost (inference time of 0.109s for identifying one sample).

CONCLUSIONS

The proposed AI platform allows people without programming experience to use artificial intelligence methods in microscopy image analysis. Besides, the ResNeXt-50-32×4d is a preferable solution for microscopic image classification, and MobileNet-V2 is most likely to be an alternative selection for the scenario when computing resources are limited.

An integrated and automated testing approach on Inception Restnet-V3 based on convolutional neural network for leukocytes image classification

OBJECTIVES

The leukocyte is a specialized immune cell that functions as the foundation of the immune system and keeps the body healthy. The WBC classification plays a vital role in diagnosing various disorders in the medical area, including infectious diseases, immune deficiencies, leukemia, and COVID-19. A few decades ago, Machine Learning algorithms classified WBC types required for image segmentation, and the feature extraction stages, but this new approach becomes automatic while existing models can be fine-tuned for specific classifications.

METHODS

The inception architecture and deep learning model-based Resnet connection are integrated into this article. Our proposed method, inception Resnet-v3, was used to classify WBCs into five categories using 15.7k images. Pathologists made diagnoses of all images so a model could be trained to classify five distinct types of cells.

RESULTS

After implementing the proposed architecture on a large dataset of 5 categories of human peripheral white blood cells, it achieved high accuracy than VGG, U-Net and Resnet. We tested our model with WBC images from additional public datasets such as the Kaagel data sets and Raabin data sets of which the accuracy was 98.80% and 98.95%.

CONCLUSIONS

Considering the large sample sizes, we believe the proposed method can be used for improving the diagnostic performance of clinical blood examinations as well as a promising alternative for machine learning. Test results obtained with the system have been satisfying, with outstanding values for Accuracy, Precision, Recall, Specificity and F1 Score.

Automatic detection of the parasite Trypanosoma cruzi in blood smears using a machine learning approach applied to mobile phone images

Chagas disease is a life-threatening illness caused by the parasite Trypanosoma cruzi. The diagnosis of the acute form of the disease is performed by trained microscopists who detect parasites in blood smear samples. Since this method requires a dedicated high-resolution camera system attached to the microscope, the diagnostic method is more expensive and often prohibitive for low-income settings. Here, we present a machine learning approach based on a random forest (RF) algorithm for the detection and counting of T. cruzi trypomastigotes in mobile phone images. We analyzed micrographs of blood smear samples that were acquired using a mobile device camera capable of capturing images in a resolution of 12 megapixels. We extracted a set of features that describe morphometric parameters (geometry and curvature), as well as color, and texture measurements of 1,314 parasites. The features were divided into train and test sets (4:1) and classified using the RF algorithm. The values of precision, sensitivity, and area under the receiver operating characteristic (ROC) curve of the proposed method were 87.6%, 90.5%, and 0.942, respectively. Automating image analysis acquired with a mobile device is a viable alternative for reducing costs and gaining efficiency in the use of the optical microscope.

A Deep Learning Approach for the Morphological Recognition of Reactive Lymphocytes in Patients with COVID-19 Infection

Laboratory medicine plays a fundamental role in the detection, diagnosis and management of COVID-19 infection. Recent observations of the morphology of cells circulating in blood found the presence of particular reactive lymphocytes (COVID-19 RL) in some of the infected patients and demonstrated that it was an indicator of a better prognosis of the disease. Visual morphological analysis is time consuming, requires smear review by expert clinical pathologists, and is prone to subjectivity. This paper presents a convolutional neural network system designed for automatic recognition of COVID-19 RL. It is based on the Xception71 structure and is trained using images of blood cells from real infected patients. An experimental study is carried out with a group of 92 individuals. The input for the system is a set of images selected by the clinical pathologist from the blood smear of a patient. The output is the prediction whether the patient belongs to the group associated with better prognosis of the disease. A threshold is obtained for the classification system to predict that the smear belongs to this group. With this threshold, the experimental test shows excellent performance metrics: 98.3% sensitivity and precision, 97.1% specificity, and 97.8% accuracy. The system does not require costly calculations and can potentially be integrated into clinical practice to assist clinical pathologists in a more objective smear review for early prognosis.

A method to classify bone marrow cells with rejected option

Bone marrow cell morphology has always been an important tool for the diagnosis of blood diseases. Still, it requires years of experience from a suitable person. Furthermore, the outcomes of their recognition are subjective and there is no objective quantitative standard. As a result, developing a deep learning automatic classification system for bone marrow cells is extremely important. However, typical classification machine learning systems only produce classification answers, and will not refuse to generate predictions when the prediction reliability is low. It will pose a big problem in some high-risk systems such as bone marrow cell recognition. This paper proposes a bone marrow cell classification method with rejected option (CMWRO) to classify 11 bone marrow cells. CMWRO is based on convolutional neural networks, ICP and SoftMax (CNN-ICP-SoftMax), containing a classifier with rejected option. When the rejected rate (RR) of tested samples is 0.3143, it can ensure that the precision, sensitivity, accuracy of the accepted samples reach 0.9921, 0.9917 and 0.9944 respectively. And the rejected samples will be handled by other ways, such as identified by doctors. Besides, the method has a good filtering effect on cell types that the classifier is not trained, such as abnormal cells and cells with less sample distribution. It can reach more than 82% in filtering efficiency. CMWRO improves the doctors' trust in the results of accepted samples to a certain extent. They only need to carefully identify the samples that CMWRO refuses to recognize, and finally combines the two results. It can greatly improve the efficiency and accuracy of bone marrow cell recognition.

Assessment of deep convolutional neural network models for species identification of forensically-important fly maggots based on images of posterior spiracles

Forensic entomology is the branch of forensic science that is related to using arthropod specimens found in legal issues. Fly maggots are one of crucial pieces of evidence that can be used for estimating post-mortem intervals worldwide. However, the species-level identification of fly maggots is difficult, time consuming, and requires specialized taxonomic training. In this work, a novel method for the identification of different forensically-important fly species is proposed using convolutional neural networks (CNNs). The data used for the experiment were obtained from a digital camera connected to a compound microscope. We compared the performance of four widely used models that vary in complexity of architecture to evaluate tradeoffs in accuracy and speed for species classification including ResNet-101, Densenet161, Vgg19_bn, and AlexNet. In the validation step, all of the studied models provided 100% accuracy for identifying maggots of 4 species including Chrysomya megacephala (Diptera: Calliphoridae), Chrysomya (Achoetandrus) rufifacies (Diptera: Calliphoridae), Lucilia cuprina (Diptera: Calliphoridae), and Musca domestica (Diptera: Muscidae) based on images of posterior spiracles. However, AlexNet showed the fastest speed to process the identification model and presented a good balance between performance and speed. Therefore, the AlexNet model was selected for the testing step. The results of the confusion matrix of AlexNet showed that misclassification was found between C. megacephala and C. (Achoetandrus) rufifacies as well as between C. megacephala and L. cuprina. No misclassification was found for M. domestica. In addition, we created a web-application platform called thefly.ai to help users identify species of fly maggots in their own images using our classification model. The results from this study can be applied to identify further species by using other types of images. This model can also be used in the development of identification features in mobile applications. This study is a crucial step for integrating information from biology and AI-technology to develop a novel platform for use in forensic investigation.

Atypical lymphoid cells circulating in blood in COVID-19 infection: morphology, immunophenotype and prognosis value

AIMS

Atypical lymphocytes circulating in blood have been reported in COVID-19 patients. This study aims to (1) analyse if patients with reactive lymphocytes (COVID-19 RL) show clinical or biological characteristics related to outcome; (2) develop an automatic system to recognise them in an objective way and (3) study their immunophenotype.

METHODS

Clinical and laboratory findings in 36 COVID-19 patients were compared between those showing COVID-19 RL in blood (18) and those without (18). Blood samples were analysed in Advia2120i and stained with May Grünwald-Giemsa. Digital images were acquired in CellaVisionDM96. Convolutional neural networks (CNNs) were used to accurately recognise COVID-19 RL. Immunophenotypic study was performed throughflow cytometry.

RESULTS

Neutrophils, D-dimer, procalcitonin, glomerular filtration rate and total protein values were higher in patients without COVID-19 RL (p<0.05) and four of these patients died. Haemoglobin and lymphocyte counts were higher (p<0.02) and no patients died in the group showing COVID-19 RL. COVID-19 RL showed a distinct deep blue cytoplasm with nucleus mostly in eccentric position. Through two sequential CNNs, they were automatically distinguished from normal lymphocytes and classical RL with sensitivity, specificity and overall accuracy values of 90.5%, 99.4% and 98.7%, respectively. Immunophenotypic analysis revealed COVID-19 RL are mostly activated effector memory CD4 and CD8 T cells.

CONCLUSION

We found that COVID-19 RL are related to a better evolution and prognosis. They can be detected by morphology in the smear review, being the computerised approach proposed useful to enhance a more objective recognition. Their presence suggests an abundant production of virus-specific T cells, thus explaining the better outcome of patients showing these cells circulating in blood.

WBC-AMNet: Automatic classification of WBC images using deep feature fusion network based on focalized attention mechanism

The recognition and classification of White Blood Cell (WBC) play a remarkable role in blood-related diseases (i.e., leukemia, infections) diagnosis. For the highly similar morphology of different WBC subtypes, it is too confused to classify the WBC effectively and accurately for visual observation of blood cell smears. This paper proposes a Deep Convolutional Neural Network (DCNN) with feature fusion strategies, named WBC-AMNet, for automatically classifying WBC subtypes based on focalized attention mechanism. To obtain more localized attention of CNN, the fusion features of the first and the last convolutional layer are extracted by focalized attention mechanism combining Squeeze-and-Excitation (SE) and Gather-Excite (GE) modules. The new method performs successfully in classifying monocytes, neutrophils, lymphocytes, and eosinophils on the complex background with an overall accuracy of 95.66%, better than that of general CNNs. The multi-classification accuracy of WBC-AMNet with the background segmentation is over 98% in all cases. In addition, Gradient-weighted Class Activation Mapping (Grad-CAM) is employed to visualize the attention heatmaps of different feature maps.

An Efficient Multi-Level Convolutional Neural Network Approach for White Blood Cells Classification

The evaluation of white blood cells is essential to assess the quality of the human immune system; however, the assessment of the blood smear depends on the pathologist’s expertise. Most machine learning tools make a one-level classification for white blood cell classification. This work presents a two-stage hybrid multi-level scheme that efficiently classifies four cell groups: lymphocytes and monocytes (mononuclear) and segmented neutrophils and eosinophils (polymorphonuclear). At the first level, a Faster R-CNN network is applied for the identification of the region of interest of white blood cells, together with the separation of mononuclear cells from polymorphonuclear cells. Once separated, two parallel convolutional neural networks with the MobileNet structure are used to recognize the subclasses in the second level. The results obtained using Monte Carlo cross-validation show that the proposed model has a performance metric of around 98.4% (accuracy, recall, precision, and F1-score). The proposed model represents a good alternative for computer-aided diagnosis (CAD) tools for supporting the pathologist in the clinical laboratory in assessing white blood cells from blood smear images.

Deep Learning Model for the Automatic Classification of White Blood Cells

Blood cell count is highly useful in identifying the occurrence of a particular disease or ailment. To successfully measure the blood cell count, sophisticated equipment that makes use of invasive methods to acquire the blood cell slides or images is utilized. These blood cell images are subjected to various data analyzing techniques that count and classify the different types of blood cells. Nowadays, deep learning-based methods are in practice to analyze the data. These methods are less time-consuming and require less sophisticated equipment. This paper implements a deep learning (D.L) model that uses the DenseNet121 model to classify the different types of white blood cells (WBC). The DenseNet121 model is optimized with the preprocessing techniques of normalization and data augmentation. This model yielded an accuracy of 98.84%, a precision of 99.33%, a sensitivity of 98.85%, and a specificity of 99.61%. The proposed model is simulated with four batch sizes (BS) along with the Adam optimizer and 10 epochs. It is concluded from the results that the DenseNet121 model has outperformed with batch size 8 as compared to other batch sizes. The dataset has been taken from the Kaggle having 12,444 images with the images of 3120 eosinophils, 3103 lymphocytes, 3098 monocytes, and 3123 neutrophils. With such results, these models could be utilized for developing clinically useful solutions that are able to detect WBC in blood cell images.

Automatic Detection and Counting of Blood Cells in Smear Images Using RetinaNet

A complete blood count is one of the significant clinical tests that evaluates overall human health and provides relevant information for disease diagnosis. The conventional strategies of blood cell counting include manual counting as well as counting using the hemocytometer and are tedious and time-consuming tasks. This research-based paper proposes an automatic software-based alternative method to count blood cells accurately using the RetinaNet deep learning network, which is used to recognize and classify objects in microscopic images. After training, the network automatically recognizes and counts red blood cells, white blood cells, and platelets. We tested a model trained on smear images and found that the trained model has generalized capabilities. We assessed the quality of detection and cell counting using performance measures, such as accuracy, sensitivity, precision, and F1-score. Moreover, we studied the dependence of the confidence thresholds and the number of learning epochs on the obtained results of recognition and counting. We compared the performance of the proposed approach with those obtained by other authors who dealt with the subject of cell counting and show that object detection and labeling can be an additional advantage in the task of counting objects.

Artificial Intelligence and Mapping a New Direction in Laboratory Medicine: A Review

BACKGROUND

Modern artificial intelligence (AI) and machine learning (ML) methods are now capable of completing tasks with performance characteristics that are comparable to those of expert human operators. As a result, many areas throughout healthcare are incorporating these technologies, including in vitro diagnostics and, more broadly, laboratory medicine. However, there are limited literature reviews of the landscape, likely future, and challenges of the application of AI/ML in laboratory medicine.

CONTENT

In this review, we begin with a brief introduction to AI and its subfield of ML. The ensuing sections describe ML systems that are currently in clinical laboratory practice or are being proposed for such use in recent literature, ML systems that use laboratory data outside the clinical laboratory, challenges to the adoption of ML, and future opportunities for ML in laboratory medicine.

SUMMARY

AI and ML have and will continue to influence the practice and scope of laboratory medicine dramatically. This has been made possible by advancements in modern computing and the widespread digitization of health information. These technologies are being rapidly developed and described, but in comparison, their implementation thus far has been modest. To spur the implementation of reliable and sophisticated ML-based technologies, we need to establish best practices further and improve our information system and communication infrastructure. The participation of the clinical laboratory community is essential to ensure that laboratory data are sufficiently available and incorporated conscientiously into robust, safe, and clinically effective ML-supported clinical diagnostics.

Automatic identification of malaria and other red blood cell inclusions using convolutional neural networks

Malaria is a serious disease responsible for thousands of deaths each year. Many efforts have been made to aid in the diagnosis of malaria using machine learning techniques, but to date, the presence of other elements that may interfere with the recognition of malaria has not been considered. We have developed the first deep learning model using convolutional neural networks capable of differentiating malaria-infected red blood cells from not only normal erythrocytes but also erythrocytes with other types of inclusions. 6415 images of red blood cells were segmented from digital images of 53 peripheral blood smears using thresholding and watershed transformation techniques. These images were used to train a VGG-16 architecture using transfer learning. Using an independent test set of 23 smears, this model was 99.5% accurate in classifying malaria parasites and other red blood cell inclusions. This model also exhibited sensitivity and specificity values of 100% and 91.7%, respectively, classifying a complete smear as infected or not infected. Our model represents a promising advance for automation in the identification of malaria-infected patients. The differentiation between malaria parasites and other red blood cell inclusions demonstrates the potential utility of our model in a real work environment.

BloodCaps: A capsule network based model for the multiclassification of human peripheral blood cells

BACKGROUND AND OBJECTIVE

The classification of human peripheral blood cells yields significance in the detection of inflammation, infections and blood cell disorders such as leukemia. Limitations in traditional algorithms for blood cell classification and increased computational processing power have allowed machine learning methods to be utilized for this clinically prevalent task.

METHODS

In the current work, we present BloodCaps, a capsule based model designed for the accurate multiclassification of a diverse and broad spectrum of blood cells.

RESULTS

Implemented on a large-scale dataset of 8 categories of human peripheral blood cells, the proposed architecture achieved an overall accuracy of 99.3%, outperforming convolutional neural networks such as AlexNet(81.5%), VGG16(97.8%), ResNet-18(95.9%) and InceptionV3(98.4%). Furthermore, we devised three new datasets(low-resolution dataset, small dataset, and low-resolution small dataset) from the original dataset, and tested BloodCaps in comparison with AlexNet, VGG16, ResNet-18, and InceptionV3. To further validate the applicability of our proposed model, we tested BloodCaps on additional public datasets such as the All IDB2, BCCD, and Cell Vision datasets. Compared with the reported results, BloodCaps showed the best performance in all three scenarios.

CONCLUSIONS

The proposed method proved superior in octal classification among all three datasets. We believe the proposed method represents a promising tool to improve the diagnostic performance of clinical blood examinations.