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Zhang S, He C, Wan Z, Shi N, Wang B, Liu X, Hou D. Diagnosis of pulmonary tuberculosis with 3D neural network based on multi-scale attention mechanism. Med Biol Eng Comput 2024; 62:1589-1600. [PMID: 38319503 DOI: 10.1007/s11517-024-03022-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/03/2024] [Indexed: 02/07/2024]
Abstract
This paper presents a novel multi-scale attention residual network (MAResNet) for diagnosing patients with pulmonary tuberculosis (PTB) by computed tomography (CT) images. First, a three-dimensional (3D) network structure is applied in MAResNet based on the continuity and correlation of nodal features on different slices of CT images. Secondly, MAResNet incorporates the residual module and Convolutional Block Attention Module (CBAM) to reuse the shallow features of CT images and focus on key features to enhance the feature distinguishability of images. In addition, multi-scale inputs can increase the global receptive field of the network, extract the location information of PTB, and capture the local details of nodules. The expression ability of both high-level and low-level semantic information in the network can also be enhanced. The proposed MAResNet shows excellent results, with overall 94% accuracy in PTB classification. MAResNet based on 3D CT images can assist doctors make more accurate diagnosis of PTB and alleviate the burden of manual screening. In the experiment, a called Grad-CAM was employed to enhance the class activation mapping (CAM) technique for analyzing the model's output, which can identify lesions in important parts of the lungs and make transparent decisions.
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Affiliation(s)
- Shidong Zhang
- Key Laboratory of Digital Medical Engineering of Hebei Province, College of Electronic and Information Engineering, Hebei University, Baoding, 071002, China
| | - Cong He
- Key Laboratory of Digital Medical Engineering of Hebei Province, College of Electronic and Information Engineering, Hebei University, Baoding, 071002, China.
| | - Zhenzhen Wan
- Key Laboratory of Digital Medical Engineering of Hebei Province, College of Electronic and Information Engineering, Hebei University, Baoding, 071002, China
| | - Ning Shi
- Key Laboratory of Digital Medical Engineering of Hebei Province, College of Electronic and Information Engineering, Hebei University, Baoding, 071002, China
| | - Bing Wang
- Department of Radiology, Beijing Chest Hospital, Capital Medical University, Beijing, 101149, China.
| | - Xiuling Liu
- Key Laboratory of Digital Medical Engineering of Hebei Province, College of Electronic and Information Engineering, Hebei University, Baoding, 071002, China
| | - Dailun Hou
- Department of Radiology, Beijing Chest Hospital, Capital Medical University, Beijing, 101149, China.
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Akhter Y, Singh R, Vatsa M. AI-based radiodiagnosis using chest X-rays: A review. Front Big Data 2023; 6:1120989. [PMID: 37091458 PMCID: PMC10116151 DOI: 10.3389/fdata.2023.1120989] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 01/06/2023] [Indexed: 04/25/2023] Open
Abstract
Chest Radiograph or Chest X-ray (CXR) is a common, fast, non-invasive, relatively cheap radiological examination method in medical sciences. CXRs can aid in diagnosing many lung ailments such as Pneumonia, Tuberculosis, Pneumoconiosis, COVID-19, and lung cancer. Apart from other radiological examinations, every year, 2 billion CXRs are performed worldwide. However, the availability of the workforce to handle this amount of workload in hospitals is cumbersome, particularly in developing and low-income nations. Recent advances in AI, particularly in computer vision, have drawn attention to solving challenging medical image analysis problems. Healthcare is one of the areas where AI/ML-based assistive screening/diagnostic aid can play a crucial part in social welfare. However, it faces multiple challenges, such as small sample space, data privacy, poor quality samples, adversarial attacks and most importantly, the model interpretability for reliability on machine intelligence. This paper provides a structured review of the CXR-based analysis for different tasks, lung diseases and, in particular, the challenges faced by AI/ML-based systems for diagnosis. Further, we provide an overview of existing datasets, evaluation metrics for different[][15mm][0mm]Q5 tasks and patents issued. We also present key challenges and open problems in this research domain.
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Zhan Y, Wang Y, Zhang W, Ying B, Wang C. Diagnostic Accuracy of the Artificial Intelligence Methods in Medical Imaging for Pulmonary Tuberculosis: A Systematic Review and Meta-Analysis. J Clin Med 2022; 12:303. [PMID: 36615102 PMCID: PMC9820940 DOI: 10.3390/jcm12010303] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/21/2022] [Accepted: 12/24/2022] [Indexed: 01/03/2023] Open
Abstract
Tuberculosis (TB) remains one of the leading causes of death among infectious diseases worldwide. Early screening and diagnosis of pulmonary tuberculosis (PTB) is crucial in TB control, and tend to benefit from artificial intelligence. Here, we aimed to evaluate the diagnostic efficacy of a variety of artificial intelligence methods in medical imaging for PTB. We searched MEDLINE and Embase with the OVID platform to identify trials published update to November 2022 that evaluated the effectiveness of artificial-intelligence-based software in medical imaging of patients with PTB. After data extraction, the quality of studies was assessed using quality assessment of diagnostic accuracy studies 2 (QUADAS-2). Pooled sensitivity and specificity were estimated using a bivariate random-effects model. In total, 3987 references were initially identified and 61 studies were finally included, covering a wide range of 124,959 individuals. The pooled sensitivity and the specificity were 91% (95% confidence interval (CI), 89-93%) and 65% (54-75%), respectively, in clinical trials, and 94% (89-96%) and 95% (91-97%), respectively, in model-development studies. These findings have demonstrated that artificial-intelligence-based software could serve as an accurate tool to diagnose PTB in medical imaging. However, standardized reporting guidance regarding AI-specific trials and multicenter clinical trials is urgently needed to truly transform this cutting-edge technology into clinical practice.
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Affiliation(s)
- Yuejuan Zhan
- Department of Respiratory and Critical Care Medicine, West China Medical School/West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yuqi Wang
- Department of Respiratory and Critical Care Medicine, West China Medical School/West China Hospital, Sichuan University, Chengdu 610041, China
| | - Wendi Zhang
- Department of Respiratory and Critical Care Medicine, West China Medical School/West China Hospital, Sichuan University, Chengdu 610041, China
| | - Binwu Ying
- Department of Laboratory Medicine, West China Medical School/West China Hospital, Sichuan University, Chengdu 610041, China
| | - Chengdi Wang
- Department of Respiratory and Critical Care Medicine, West China Medical School/West China Hospital, Sichuan University, Chengdu 610041, China
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Okolo GI, Katsigiannis S, Ramzan N. IEViT: An enhanced vision transformer architecture for chest X-ray image classification. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 226:107141. [PMID: 36162246 DOI: 10.1016/j.cmpb.2022.107141] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 08/02/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND OBJECTIVE Chest X-ray imaging is a relatively cheap and accessible diagnostic tool that can assist in the diagnosis of various conditions, including pneumonia, tuberculosis, COVID-19, and others. However, the requirement for expert radiologists to view and interpret chest X-ray images can be a bottleneck, especially in remote and deprived areas. Recent advances in machine learning have made possible the automated diagnosis of chest X-ray scans. In this work, we examine the use of a novel Transformer-based deep learning model for the task of chest X-ray image classification. METHODS We first examine the performance of the Vision Transformer (ViT) state-of-the-art image classification machine learning model for the task of chest X-ray image classification, and then propose and evaluate the Input Enhanced Vision Transformer (IEViT), a novel enhanced Vision Transformer model that can achieve improved performance on chest X-ray images associated with various pathologies. RESULTS Experiments on four chest X-ray image data sets containing various pathologies (tuberculosis, pneumonia, COVID-19) demonstrated that the proposed IEViT model outperformed ViT for all the data sets and variants examined, achieving an F1-score between 96.39% and 100%, and an improvement over ViT of up to +5.82% in terms of F1-score across the four examined data sets. IEViT's maximum sensitivity (recall) ranged between 93.50% and 100% across the four data sets, with an improvement over ViT of up to +3%, whereas IEViT's maximum precision ranged between 97.96% and 100% across the four data sets, with an improvement over ViT of up to +6.41%. CONCLUSIONS Results showed that the proposed IEViT model outperformed all ViT's variants for all the examined chest X-ray image data sets, demonstrating its superiority and generalisation ability. Given the relatively low cost and the widespread accessibility of chest X-ray imaging, the use of the proposed IEViT model can potentially offer a powerful, but relatively cheap and accessible method for assisting diagnosis using chest X-ray images.
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Affiliation(s)
| | | | - Naeem Ramzan
- University of the West of Scotland, High St., Paisley, PA1 2BE, UK
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Oloko-Oba M, Viriri S. A Systematic Review of Deep Learning Techniques for Tuberculosis Detection From Chest Radiograph. Front Med (Lausanne) 2022; 9:830515. [PMID: 35355598 PMCID: PMC8960068 DOI: 10.3389/fmed.2022.830515] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 02/14/2022] [Indexed: 11/27/2022] Open
Abstract
The high mortality rate in Tuberculosis (TB) burden regions has increased significantly in the last decades. Despite the possibility of treatment for TB, high burden regions still suffer inadequate screening tools, which result in diagnostic delay and misdiagnosis. These challenges have led to the development of Computer-Aided Diagnostic (CAD) system to detect TB automatically. There are several ways of screening for TB, but Chest X-Ray (CXR) is more prominent and recommended due to its high sensitivity in detecting lung abnormalities. This paper presents the results of a systematic review based on PRISMA procedures that investigate state-of-the-art Deep Learning techniques for screening pulmonary abnormalities related to TB. The systematic review was conducted using an extensive selection of scientific databases as reference sources that grant access to distinctive articles in the field. Four scientific databases were searched to retrieve related articles. Inclusion and exclusion criteria were defined and applied to each article to determine those included in the study. Out of the 489 articles retrieved, 62 were included. Based on the findings in this review, we conclude that CAD systems are promising in tackling the challenges of the TB epidemic and made recommendations for improvement in future studies.
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Tulo SK, Ramu P, Swaminathan R. Evaluation of Diagnostic Value of Mediastinum for Differentiation of Drug Sensitive, Multi and Extensively Drug Resistant Tuberculosis using Chest X-rays. Ing Rech Biomed 2022. [DOI: 10.1016/j.irbm.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Lu SY, Wang SH, Zhang X, Zhang YD. TBNet: a context-aware graph network for tuberculosis diagnosis. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 214:106587. [PMID: 34959158 DOI: 10.1016/j.cmpb.2021.106587] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 06/14/2023]
Abstract
Tuberculosis (TB) is an infectious bacterial disease. It can affect the human lungs, brain, bones, and kidneys. Pulmonary tuberculosis is the most common. This airborne bacterium can be transmitted with the droplets by coughing and sneezing. So far, the most convenient and effective method for diagnosing TB is through medical imaging. Computed tomography (CT) is the first choice for lung imaging in clinics because the conditions of the lungs can be interpreted from CT images. However, manual screening poses an enormous burden for radiologists, resulting in high inter-observer variances. Hence, developing computer-aided diagnosis systems to implement automatic TB diagnosis is an emergent and significant task for researchers and practitioners. This paper proposed a novel context-aware graph neural network called TBNet to detect TB from chest CT images METHODS: Traditional convolutional neural networks can extract high-level image features to achieve good classification performance on the ImageNet dataset. However, we observed that the spatial relationships between the feature vectors are beneficial for the classification because the feature vector may share some common characteristics with its neighboring feature vectors. To utilize this context information for the classification of chest CT images, we proposed to use a feature graph to generate context-aware features. Finally, a context-aware random vector functional-link net served as the classifier of the TBNet to identify these context-aware features as TB or normal RESULTS: The proposed TBNet produced state-of-the-art classification performance for detecting TB from healthy samples in the experiments CONCLUSIONS: Our TBNet can be an accurate and effective verification tool for manual screening in clinical diagnosis.
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Affiliation(s)
- Si-Yuan Lu
- School of Computing and Mathematical Sciences, University of Leicester, Leicester, LE1 7RH, UK.
| | - Shui-Hua Wang
- School of Computing and Mathematical Sciences, University of Leicester, Leicester, LE1 7RH, UK; School of Architecture Building and Civil engineering, Loughborough University, Loughborough, LE11 3TU, UK.
| | - Xin Zhang
- Department of Medical Imaging, The Fourth People's Hospital of Huai'an, Huai'an, Jiangsu Province, 223002, China.
| | - Yu-Dong Zhang
- School of Computing and Mathematical Sciences, University of Leicester, Leicester, LE1 7RH, UK.
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