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Mead K, Cross T, Roger G, Sabharwal R, Singh S, Giannotti N. MRI deep learning models for assisted diagnosis of knee pathologies: a systematic review. Eur Radiol 2024:10.1007/s00330-024-11105-8. [PMID: 39422725 DOI: 10.1007/s00330-024-11105-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 07/30/2024] [Accepted: 09/05/2024] [Indexed: 10/19/2024]
Abstract
OBJECTIVES Despite showing encouraging outcomes, the precision of deep learning (DL) models using different convolutional neural networks (CNNs) for diagnosis remains under investigation. This systematic review aims to summarise the status of DL MRI models developed for assisting the diagnosis of a variety of knee abnormalities. MATERIALS AND METHODS Five databases were systematically searched, employing predefined terms such as 'Knee AND 3D AND MRI AND DL'. Selected inclusion criteria were used to screen publications by title, abstract, and full text. The synthesis of results was performed by two independent reviewers. RESULTS Fifty-four articles were included. The studies focused on anterior cruciate ligament injuries (n = 19, 36%), osteoarthritis (n = 9, 17%), meniscal injuries (n = 13, 24%), abnormal knee appearance (n = 11, 20%), and other (n = 2, 4%). The DL models in this review primarily used the following CNNs: ResNet (n = 11, 21%), VGG (n = 6, 11%), DenseNet (n = 4, 8%), and DarkNet (n = 3, 6%). DL models showed high-performance metrics compared to ground truth. DL models for the detection of a specific injury outperformed those by up to 4.5% for general abnormality detection. CONCLUSION Despite the varied study designs used among the reviewed articles, DL models showed promising outcomes in the assisted detection of selected knee pathologies by MRI. This review underscores the importance of validating these models with larger MRI datasets to close the existing gap between current DL model performance and clinical requirements. KEY POINTS Question What is the status of DL model availability for knee pathology detection in MRI and their clinical potential? Findings Pathology-specific DL models reported higher accuracy compared to DL models for the detection of general abnormalities of the knee. DL model performance was mainly influenced by the quantity and diversity of data available for model training. Clinical relevance These findings should encourage future developments to improve patient care, support personalised diagnosis and treatment, optimise costs, and advance artificial intelligence-based medical imaging practices.
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Affiliation(s)
- Keiley Mead
- The University of Sydney School of Health Sciences, Sydney, NSW, Australia.
| | - Tom Cross
- The Stadium Sports Medicine Clinic, Sydney, NSW, Australia
| | - Greg Roger
- Vestech Medical Pty Limited, Sydney, NSW, Australia
- The University of Sydney School of Biomedical Engineering, Sydney, NSW, Australia
| | | | - Sahaj Singh
- PRP Diagnostic Imaging, Sydney, NSW, Australia
| | - Nicola Giannotti
- The University of Sydney School of Health Sciences, Sydney, NSW, Australia
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Siouras A, Moustakidis S, Chalatsis G, Bohoran TA, Hantes M, Vlychou M, Tasoulis S, Giannakidis A, Tsaopoulos D. Economical hybrid novelty detection leveraging global aleatoric semantic uncertainty for enhanced MRI-based ACL tear diagnosis. Comput Med Imaging Graph 2024; 117:102424. [PMID: 39241271 DOI: 10.1016/j.compmedimag.2024.102424] [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: 04/22/2024] [Revised: 08/23/2024] [Accepted: 08/23/2024] [Indexed: 09/08/2024]
Abstract
This study presents an innovative hybrid deep learning (DL) framework that reformulates the sagittal MRI-based anterior cruciate ligament (ACL) tear classification task as a novelty detection problem to tackle class imbalance. We introduce a highly discriminative novelty score, which leverages the aleatoric semantic uncertainty as this is modeled in the class scores outputted by the YOLOv5-nano object detection (OD) model. To account for tissue continuity, we propose using the global scores (probability vector) when the model is applied to the entire sagittal sequence. The second module of the proposed pipeline constitutes the MINIROCKET timeseries classification model for determining whether a knee has an ACL tear. To better evaluate the generalization capabilities of our approach, we also carry out cross-database testing involving two public databases (KneeMRI and MRNet) and a validation-only database from University General Hospital of Larissa, Greece. Our method consistently outperformed (p-value<0.05) the state-of-the-art (SOTA) approaches on the KneeMRI dataset and achieved better accuracy and sensitivity on the MRNet dataset. It also generalized remarkably good, especially when the model had been trained on KneeMRI. The presented framework generated at least 2.1 times less carbon emissions and consumed at least 2.6 times less energy, when compared with SOTA. The integration of aleatoric semantic uncertainty-based scores into a novelty detection framework, when combined with the use of lightweight OD and timeseries classification models, have the potential to revolutionize the MRI-based injury detection by setting a new precedent in diagnostic precision, speed and environmental sustainability. Our resource-efficient framework offers potential for widespread application.
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Affiliation(s)
- Athanasios Siouras
- Department of Computer Science and Biomedical Informatics, School of Science, University of Thessaly, Lamia 35131, Greece
| | | | - George Chalatsis
- Department of Orthopedic Surgery, Faculty of Medicine, University of Thessaly, Larissa 41500, Greece
| | - Tuan Aqeel Bohoran
- School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK
| | - Michael Hantes
- Department of Orthopedic Surgery, Faculty of Medicine, University of Thessaly, Larissa 41500, Greece
| | - Marianna Vlychou
- Department of Radiology, School of Health Sciences, University Hospital of Larissa, University of Thessaly, Mezourlo, Larissa 41500, Greece
| | - Sotiris Tasoulis
- Department of Computer Science and Biomedical Informatics, School of Science, University of Thessaly, Lamia 35131, Greece
| | - Archontis Giannakidis
- School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK; Archimedes Research Unit in Artificial Intelligence, Data Science and Algorithms, Marousi 15125, Greece.
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Sriraman H, Badarudeen S, Vats S, Balasubramanian P. A Systematic Review of Real-Time Deep Learning Methods for Image-Based Cancer Diagnostics. J Multidiscip Healthc 2024; 17:4411-4425. [PMID: 39281299 PMCID: PMC11397255 DOI: 10.2147/jmdh.s446745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Accepted: 07/17/2024] [Indexed: 09/18/2024] Open
Abstract
Deep Learning (DL) drives academics to create models for cancer diagnosis using medical image processing because of its innate ability to recognize difficult-to-detect patterns in complex, noisy, and massive data. The use of deep learning algorithms for real-time cancer diagnosis is explored in depth in this work. Real-time medical diagnosis determines the illness or condition that accounts for a patient's symptoms and outward physical manifestations within a predetermined time frame. With a waiting period of anywhere between 5 days and 30 days, there are currently several ways, including screening tests, biopsies, and other prospective methods, that can assist in discovering a problem, particularly cancer. This article conducts a thorough literature review to understand how DL affects the length of this waiting period. In addition, the accuracy and turnaround time of different imaging modalities is evaluated with DL-based cancer diagnosis. Convolutional neural networks are critical for real-time cancer diagnosis, with models achieving up to 99.3% accuracy. The effectiveness and cost of the infrastructure required for real-time image-based medical diagnostics are evaluated. According to the report, generalization problems, data variability, and explainable DL are some of the most significant barriers to using DL in clinical trials. Making DL applicable for cancer diagnosis will be made possible by explainable DL.
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Affiliation(s)
- Harini Sriraman
- School of Computer Science and Engineering, Vellore Institute of Technology, Chennai, 600127, India
| | - Saleena Badarudeen
- School of Computer Science and Engineering, Vellore Institute of Technology, Chennai, 600127, India
| | - Saransh Vats
- School of Computer Science and Engineering, Vellore Institute of Technology, Chennai, 600127, India
| | - Prakash Balasubramanian
- School of Computer Science and Engineering, Vellore Institute of Technology, Chennai, 600127, India
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Ruitenbeek HC, Oei EHG, Visser JJ, Kijowski R. Artificial intelligence in musculoskeletal imaging: realistic clinical applications in the next decade. Skeletal Radiol 2024; 53:1849-1868. [PMID: 38902420 DOI: 10.1007/s00256-024-04684-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/06/2024] [Accepted: 04/15/2024] [Indexed: 06/22/2024]
Abstract
This article will provide a perspective review of the most extensively investigated deep learning (DL) applications for musculoskeletal disease detection that have the best potential to translate into routine clinical practice over the next decade. Deep learning methods for detecting fractures, estimating pediatric bone age, calculating bone measurements such as lower extremity alignment and Cobb angle, and grading osteoarthritis on radiographs have been shown to have high diagnostic performance with many of these applications now commercially available for use in clinical practice. Many studies have also documented the feasibility of using DL methods for detecting joint pathology and characterizing bone tumors on magnetic resonance imaging (MRI). However, musculoskeletal disease detection on MRI is difficult as it requires multi-task, multi-class detection of complex abnormalities on multiple image slices with different tissue contrasts. The generalizability of DL methods for musculoskeletal disease detection on MRI is also challenging due to fluctuations in image quality caused by the wide variety of scanners and pulse sequences used in routine MRI protocols. The diagnostic performance of current DL methods for musculoskeletal disease detection must be further evaluated in well-designed prospective studies using large image datasets acquired at different institutions with different imaging parameters and imaging hardware before they can be fully implemented in clinical practice. Future studies must also investigate the true clinical benefits of current DL methods and determine whether they could enhance quality, reduce error rates, improve workflow, and decrease radiologist fatigue and burnout with all of this weighed against the costs.
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Affiliation(s)
- Huibert C Ruitenbeek
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Edwin H G Oei
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Jacob J Visser
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Richard Kijowski
- Department of Radiology, New York University Grossman School of Medicine, 660 First Avenue, 3rd Floor, New York, NY, 10016, USA.
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Pareek A, Ro DH, Karlsson J, Martin RK. Machine learning/artificial intelligence in sports medicine: state of the art and future directions. J ISAKOS 2024; 9:635-644. [PMID: 38336099 DOI: 10.1016/j.jisako.2024.01.013] [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: 12/16/2022] [Revised: 12/30/2023] [Accepted: 01/25/2024] [Indexed: 02/12/2024]
Abstract
Machine learning (ML) is changing the way health care is practiced and recent applications of these novel statistical techniques have started to impact orthopaedic sports medicine. Machine learning enables the analysis of large volumes of data to establish complex relationships between "input" and "output" variables. These relationships may be more complex than could be established through traditional statistical analysis and can lead to the ability to predict the "output" with high levels of accuracy. Supervised learning is the most common ML approach for healthcare data and recent studies have developed algorithms to predict patient-specific outcome after surgical procedures such as hip arthroscopy and anterior cruciate ligament reconstruction. Deep learning is a higher-level ML approach that facilitates the processing and interpretation of complex datasets through artificial neural networks that are inspired by the way the human brain processes information. In orthopaedic sports medicine, deep learning has primarily been used for automatic image (computer vision) and text (natural language processing) interpretation. While applications in orthopaedic sports medicine have been increasing exponentially, one significant barrier to widespread adoption of ML remains clinician unfamiliarity with the associated methods and concepts. The goal of this review is to introduce these concepts, review current machine learning models in orthopaedic sport medicine, and discuss future opportunities for innovation within the specialty.
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Affiliation(s)
- Ayoosh Pareek
- Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, 10021, USA; Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, 43180, Sweden.
| | - Du Hyun Ro
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, 03080, South Korea; CONNECTEVE Co., Ltd, Seoul, 03080, South Korea
| | - Jón Karlsson
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, 43180, Sweden
| | - R Kyle Martin
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, 55454, USA; Department of Orthopedic Surgery, CentraCare, Saint Cloud, MN, 56303, USA; Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, 0806, Norway
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Wang J, Luo J, Liang J, Cao Y, Feng J, Tan L, Wang Z, Li J, Hounye AH, Hou M, He J. Lightweight Attentive Graph Neural Network with Conditional Random Field for Diagnosis of Anterior Cruciate Ligament Tear. JOURNAL OF IMAGING INFORMATICS IN MEDICINE 2024; 37:688-705. [PMID: 38343260 PMCID: PMC11031558 DOI: 10.1007/s10278-023-00944-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/23/2023] [Accepted: 10/16/2023] [Indexed: 04/20/2024]
Abstract
Anterior cruciate ligament (ACL) tears are prevalent orthopedic sports injuries and are difficult to precisely classify. Previous works have demonstrated the ability of deep learning (DL) to provide support for clinicians in ACL tear classification scenarios, but it requires a large quantity of labeled samples and incurs a high computational expense. This study aims to overcome the challenges brought by small and imbalanced data and achieve fast and accurate ACL tear classification based on magnetic resonance imaging (MRI) of the knee. We propose a lightweight attentive graph neural network (GNN) with a conditional random field (CRF), named the ACGNN, to classify ACL ruptures in knee MR images. A metric-based meta-learning strategy is introduced to conduct independent testing through multiple node classification tasks. We design a lightweight feature embedding network using a feature-based knowledge distillation method to extract features from the given images. Then, GNN layers are used to find the dependencies between samples and complete the classification process. The CRF is incorporated into each GNN layer to refine the affinities. To mitigate oversmoothing and overfitting issues, we apply self-boosting attention, node attention, and memory attention for graph initialization, node updating, and correlation across graph layers, respectively. Experiments demonstrated that our model provided excellent performance on both oblique coronal data and sagittal data with accuracies of 92.94% and 91.92%, respectively. Notably, our proposed method exhibited comparable performance to that of orthopedic surgeons during an internal clinical validation. This work shows the potential of our method to advance ACL diagnosis and facilitates the development of computer-aided diagnosis methods for use in clinical practice.
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Affiliation(s)
- Jiaoju Wang
- School of Mathematics and Statistics, Central South University, Changsha, 410083, Hunan, China
| | - Jiewen Luo
- Department of Orthopaedic Surgery, Third Xiangya Hospital of Central South University, Changsha, 410013, Hunan, China
| | - Jiehui Liang
- Department of Orthopaedic Surgery, Third Xiangya Hospital of Central South University, Changsha, 410013, Hunan, China
| | - Yangbo Cao
- Department of Orthopaedic Surgery, Third Xiangya Hospital of Central South University, Changsha, 410013, Hunan, China
| | - Jing Feng
- Department of Orthopaedic Surgery, Third Xiangya Hospital of Central South University, Changsha, 410013, Hunan, China
| | - Lingjie Tan
- Department of Orthopaedic Surgery, Third Xiangya Hospital of Central South University, Changsha, 410013, Hunan, China
| | - Zhengcheng Wang
- Department of Orthopaedic Surgery, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, 750021, Ningxia Hui Autonomous Region, China
| | - Jingming Li
- School of Civil Engineeringand Architecture, Nanyang Normal University, Nanyang, 473061, Henan, China
| | - Alphonse Houssou Hounye
- School of Mathematics and Statistics, Central South University, Changsha, 410083, Hunan, China
| | - Muzhou Hou
- School of Mathematics and Statistics, Central South University, Changsha, 410083, Hunan, China.
| | - Jinshen He
- Department of Orthopaedic Surgery, Third Xiangya Hospital of Central South University, Changsha, 410013, Hunan, China.
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Santomartino SM, Kung J, Yi PH. Systematic review of artificial intelligence development and evaluation for MRI diagnosis of knee ligament or meniscus tears. Skeletal Radiol 2024; 53:445-454. [PMID: 37584757 DOI: 10.1007/s00256-023-04416-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/24/2023] [Accepted: 07/24/2023] [Indexed: 08/17/2023]
Abstract
OBJECTIVE The purpose of this systematic review was to summarize the results of original research studies evaluating the characteristics and performance of deep learning models for detection of knee ligament and meniscus tears on MRI. MATERIALS AND METHODS We searched PubMed for studies published as of February 2, 2022 for original studies evaluating development and evaluation of deep learning models for MRI diagnosis of knee ligament or meniscus tears. We summarized study details according to multiple criteria including baseline article details, model creation, deep learning details, and model evaluation. RESULTS 19 studies were included with radiology departments leading the publications in deep learning development and implementation for detecting knee injuries via MRI. Among the studies, there was a lack of standard reporting and inconsistently described development details. However, all included studies reported consistently high model performance that significantly supplemented human reader performance. CONCLUSION From our review, we found radiology departments have been leading deep learning development for injury detection on knee MRIs. Although studies inconsistently described DL model development details, all reported high model performance, indicating great promise for DL in knee MRI analysis.
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Affiliation(s)
- Samantha M Santomartino
- Drexel University College of Medicine, Philadelphia, PA, USA
- University of Maryland Medical Intelligent Imaging (UM2ii) Center, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Justin Kung
- Department of Orthopaedic Surgery, University of South Carolina, Columbia, SC, USA
| | - Paul H Yi
- University of Maryland Medical Intelligent Imaging (UM2ii) Center, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland, University of Maryland School of Medicine, Baltimore, MD, USA.
- Malone Center for Engineering in Healthcare, Johns Hopkins University, Baltimore Street First Floor Rm. 1172, Baltimore, MD, 21201, USA.
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Oeding JF, Krych AJ, Pearle AD, Kelly BT, Kunze KN. Medical Imaging Applications Developed Using Artificial Intelligence Demonstrate High Internal Validity Yet Are Limited in Scope and Lack External Validation. Arthroscopy 2024:S0749-8063(24)00099-9. [PMID: 38325497 DOI: 10.1016/j.arthro.2024.01.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 01/21/2024] [Accepted: 01/29/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE To (1) review definitions and concepts necessary to interpret applications of deep learning (DL; a domain of artificial intelligence that leverages neural networks to make predictions on media inputs such as images) and (2) identify knowledge and translational gaps in the literature to provide insight into specific areas for improvement as adoption of this technology continues. METHODS A comprehensive search of the literature was performed in December 2023 for articles regarding the use of DL in sports medicine. For each study, information regarding the joint of focus, specific anatomic structure/pathology to which DL was applied, imaging modality utilized, source of images used for model training and testing, data set size, model performance, and whether the DL model was externally validated was recorded. A numerical scale was used to rate each DL model's clinical impact, with 1 corresponding to proof-of-concept studies with little to no direct clinical impact and 5 corresponding to practice-changing clinical impact and ready for clinical deployment. RESULTS Fifty-five studies were identified, all of which were published within the past 5 years, while 82% were published within the past 3 years. Of the DL models identified, 84% were developed for classification tasks, 9% for automated measurements, and 7% for segmentation. A total of 62% of studies utilized magnetic resonance imaging as the imaging modality, 25% radiographs, and 7% ultrasound, while 1 study each used computed tomography, arthroscopic images, or arthroscopic video. Sixty-five percent of studies focused on the detection of tears (anterior cruciate ligament [ACL], rotator cuff [RC], and meniscus). The diagnostic performance of ACL tears, as determined by the area under the receiver operator curve (AUROC), ranged from 0.81 to 0.99 for ACL tears (excellent to near perfect), 0.83 to 0.94 for RC tears (excellent), and from 0.75 to 0.96 for meniscus tears (acceptable to excellent). In addition, 3 studies focused on detection of cartilage lesions had AUROC ranging from 0.90 to 0.92 (excellent performance). However, only 4 (7%) studies externally validated their models, suggesting that they may not be generalizable or may not perform well when applied to populations other than that used to develop the model. Finally, the mean clinical impact score was 2 (range, 1-3) on scale of 1 to 5, corresponding to limited clinical applicability. CONCLUSIONS DL models in orthopaedic sports medicine show generally excellent performance (high internal validity) but require external validation to facilitate clinical deployment. In addition, current models have low clinical applicability and fail to advance the field due to a focus on routine tasks and a narrow conceptual framework. LEVEL OF EVIDENCE Level IV, scoping review of Level I to IV studies.
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Affiliation(s)
- Jacob F Oeding
- Mayo Clinic Alix School of Medicine, Rochester, Minnesota, U.S.A
| | - Aaron J Krych
- Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Andrew D Pearle
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A
| | - Bryan T Kelly
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A
| | - Kyle N Kunze
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A..
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Andriollo L, Picchi A, Sangaletti R, Perticarini L, Rossi SMP, Logroscino G, Benazzo F. The Role of Artificial Intelligence in Anterior Cruciate Ligament Injuries: Current Concepts and Future Perspectives. Healthcare (Basel) 2024; 12:300. [PMID: 38338185 PMCID: PMC10855330 DOI: 10.3390/healthcare12030300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
The remarkable progress in data aggregation and deep learning algorithms has positioned artificial intelligence (AI) and machine learning (ML) to revolutionize the field of medicine. AI is becoming more and more prevalent in the healthcare sector, and its impact on orthopedic surgery is already evident in several fields. This review aims to examine the literature that explores the comprehensive clinical relevance of AI-based tools utilized before, during, and after anterior cruciate ligament (ACL) reconstruction. The review focuses on current clinical applications and future prospects in preoperative management, encompassing risk prediction and diagnostics; intraoperative tools, specifically navigation, identifying complex anatomic landmarks during surgery; and postoperative applications in terms of postoperative care and rehabilitation. Additionally, AI tools in educational and training settings are presented. Orthopedic surgeons are showing a growing interest in AI, as evidenced by the applications discussed in this review, particularly those related to ACL injury. The exponential increase in studies on AI tools applicable to the management of ACL tears promises a significant future impact in its clinical application, with growing attention from orthopedic surgeons.
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Affiliation(s)
- Luca Andriollo
- Robotic Prosthetic Surgery Unit—Sports Traumatology Unit, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy; (R.S.); (L.P.); (S.M.P.R.); (F.B.)
- Department of Orthopedics, Catholic University of the Sacred Heart, 00168 Rome, Italy
| | - Aurelio Picchi
- Unit of Orthopedics, Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (A.P.); (G.L.)
| | - Rudy Sangaletti
- Robotic Prosthetic Surgery Unit—Sports Traumatology Unit, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy; (R.S.); (L.P.); (S.M.P.R.); (F.B.)
| | - Loris Perticarini
- Robotic Prosthetic Surgery Unit—Sports Traumatology Unit, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy; (R.S.); (L.P.); (S.M.P.R.); (F.B.)
| | - Stefano Marco Paolo Rossi
- Robotic Prosthetic Surgery Unit—Sports Traumatology Unit, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy; (R.S.); (L.P.); (S.M.P.R.); (F.B.)
| | - Giandomenico Logroscino
- Unit of Orthopedics, Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (A.P.); (G.L.)
| | - Francesco Benazzo
- Robotic Prosthetic Surgery Unit—Sports Traumatology Unit, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy; (R.S.); (L.P.); (S.M.P.R.); (F.B.)
- Biomedical Sciences Area, IUSS University School for Advanced Studies, 27100 Pavia, Italy
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Champendal M, Müller H, Prior JO, Dos Reis CS. A scoping review of interpretability and explainability concerning artificial intelligence methods in medical imaging. Eur J Radiol 2023; 169:111159. [PMID: 37976760 DOI: 10.1016/j.ejrad.2023.111159] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/26/2023] [Accepted: 10/19/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE To review eXplainable Artificial Intelligence/(XAI) methods available for medical imaging/(MI). METHOD A scoping review was conducted following the Joanna Briggs Institute's methodology. The search was performed on Pubmed, Embase, Cinhal, Web of Science, BioRxiv, MedRxiv, and Google Scholar. Studies published in French and English after 2017 were included. Keyword combinations and descriptors related to explainability, and MI modalities were employed. Two independent reviewers screened abstracts, titles and full text, resolving differences through discussion. RESULTS 228 studies met the criteria. XAI publications are increasing, targeting MRI (n = 73), radiography (n = 47), CT (n = 46). Lung (n = 82) and brain (n = 74) pathologies, Covid-19 (n = 48), Alzheimer's disease (n = 25), brain tumors (n = 15) are the main pathologies explained. Explanations are presented visually (n = 186), numerically (n = 67), rule-based (n = 11), textually (n = 11), and example-based (n = 6). Commonly explained tasks include classification (n = 89), prediction (n = 47), diagnosis (n = 39), detection (n = 29), segmentation (n = 13), and image quality improvement (n = 6). The most frequently provided explanations were local (78.1 %), 5.7 % were global, and 16.2 % combined both local and global approaches. Post-hoc approaches were predominantly employed. The used terminology varied, sometimes indistinctively using explainable (n = 207), interpretable (n = 187), understandable (n = 112), transparent (n = 61), reliable (n = 31), and intelligible (n = 3). CONCLUSION The number of XAI publications in medical imaging is increasing, primarily focusing on applying XAI techniques to MRI, CT, and radiography for classifying and predicting lung and brain pathologies. Visual and numerical output formats are predominantly used. Terminology standardisation remains a challenge, as terms like "explainable" and "interpretable" are sometimes being used indistinctively. Future XAI development should consider user needs and perspectives.
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Affiliation(s)
- Mélanie Champendal
- School of Health Sciences HESAV, HES-SO, University of Applied Sciences Western Switzerland, Lausanne, CH, Switzerland; Faculty of Biology and Medicine, University of Lausanne, Lausanne, CH, Switzerland.
| | - Henning Müller
- Informatics Institute, University of Applied Sciences Western Switzerland (HES-SO Valais) Sierre, CH, Switzerland; Medical faculty, University of Geneva, CH, Switzerland.
| | - John O Prior
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, CH, Switzerland; Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital (CHUV), Lausanne, CH, Switzerland.
| | - Cláudia Sá Dos Reis
- School of Health Sciences HESAV, HES-SO, University of Applied Sciences Western Switzerland, Lausanne, CH, Switzerland.
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Li F, Zhai P, Yang C, Feng G, Yang J, Yuan Y. Automated diagnosis of anterior cruciate ligament via a weighted multi-view network. Front Bioeng Biotechnol 2023; 11:1268543. [PMID: 37885456 PMCID: PMC10598377 DOI: 10.3389/fbioe.2023.1268543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 09/22/2023] [Indexed: 10/28/2023] Open
Abstract
Objective: To build a three-dimensional (3D) deep learning-based computer-aided diagnosis (CAD) system and investigate its applicability for automatic detection of anterior cruciate ligament (ACL) of the knee joint in magnetic resonance imaging (MRI). Methods: In this study, we develop a 3D weighted multi-view convolutional neural network by fusing different views of MRI to detect ACL. The network is evaluated on two MRI datasets, the in-house MRI-ACL dataset and the publicly available MRNet-v1.0 dataset. In the MRI-ACL dataset, the retrospective study collects 100 cases, and four views per patient are included. There are 50 ACL patients and 50 normal patients, respectively. The MRNet-v1.0 dataset contains 1,250 cases with three views, of which 208 are ACL patients, and the rest are normal or other abnormal patients. Results: The area under the receiver operating characteristic curve (AUC) of the ACL diagnosis system is 97.00% and 92.86% at the optimal threshold for the MRI-ACL dataset and the MRNet-v1.0 dataset, respectively, indicating a high overall diagnostic accuracy. In comparison, the best AUC of the single-view diagnosis methods are 96.00% (MRI-ACL dataset) and 91.78% (MRNet-v1.0 dataset), and our method improves by about 1.00% and 1.08%. Furthermore, our method also improves by about 1.00% (MRI-ACL dataset) and 0.28% (MRNet-v1.0 dataset) compared with the multi-view network (i.e., MRNet). Conclusion: The presented 3D weighted multi-view network achieves superior AUC in diagnosing ACL, not only in the in-house MRI-ACL dataset but also in the publicly available MRNet-v1.0 dataset, which demonstrates its clinical applicability for the automatic detection of ACL.
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Affiliation(s)
- Feng Li
- Orthopedic Department, Ningbo No. 2 Hospital, Ningbo, China
| | - Penghua Zhai
- Center for Pattern Recognition and Intelligent Medicine, Guoke Ningbo Life science and Health industry Research Institute, Ningbo, China
| | - Chao Yang
- Orthopedic Department, Ningbo No. 2 Hospital, Ningbo, China
| | - Gong Feng
- Orthopedic Department, Ningbo No. 2 Hospital, Ningbo, China
| | - Ji Yang
- Orthopedic Department, Ningbo No. 2 Hospital, Ningbo, China
| | - Yi Yuan
- Orthopedic Department, Ningbo No. 2 Hospital, Ningbo, China
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12
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Shetty ND, Dhande R, Unadkat BS, Parihar P. A Comprehensive Review on the Diagnosis of Knee Injury by Deep Learning-Based Magnetic Resonance Imaging. Cureus 2023; 15:e45730. [PMID: 37868582 PMCID: PMC10590246 DOI: 10.7759/cureus.45730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 09/21/2023] [Indexed: 10/24/2023] Open
Abstract
The continual improvement in the field of medical diagnosis has led to the monopoly of using deep learning (DL)-based magnetic resonance imaging (MRI) for the diagnosis of knee injury related to meniscal injury, ligament injury including the cruciate ligaments, collateral ligaments and medial patella-femoral ligament, and cartilage injury. The present systematic review was done by PubMed and Directory of Open Access Journals (DOAJ), wherein we finalised 24 studies conducted on the accuracy of DL MRI studies for knee injury identification. The studies showed an accuracy of 72.5% to 100% indicating that DL MRI holds an equivalent performance as humans in decision-making and management of knee injuries. This further opens up future exploration for improving MRI-based diagnosis keeping in mind the limitations of verification bias and data imbalance in ground truth subjectivity.
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Affiliation(s)
- Neha D Shetty
- Department of Radiodiagnosis, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Rajasbala Dhande
- Department of Radiodiagnosis, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Bhavik S Unadkat
- Department of Radiodiagnosis, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pratapsingh Parihar
- Department of Radiodiagnosis, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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13
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Jung J, Lee H, Jung H, Kim H. Essential properties and explanation effectiveness of explainable artificial intelligence in healthcare: A systematic review. Heliyon 2023; 9:e16110. [PMID: 37234618 PMCID: PMC10205582 DOI: 10.1016/j.heliyon.2023.e16110] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 03/26/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023] Open
Abstract
Background Significant advancements in the field of information technology have influenced the creation of trustworthy explainable artificial intelligence (XAI) in healthcare. Despite improved performance of XAI, XAI techniques have not yet been integrated into real-time patient care. Objective The aim of this systematic review is to understand the trends and gaps in research on XAI through an assessment of the essential properties of XAI and an evaluation of explanation effectiveness in the healthcare field. Methods A search of PubMed and Embase databases for relevant peer-reviewed articles on development of an XAI model using clinical data and evaluating explanation effectiveness published between January 1, 2011, and April 30, 2022, was conducted. All retrieved papers were screened independently by the two authors. Relevant papers were also reviewed for identification of the essential properties of XAI (e.g., stakeholders and objectives of XAI, quality of personalized explanations) and the measures of explanation effectiveness (e.g., mental model, user satisfaction, trust assessment, task performance, and correctability). Results Six out of 882 articles met the criteria for eligibility. Artificial Intelligence (AI) users were the most frequently described stakeholders. XAI served various purposes, including evaluation, justification, improvement, and learning from AI. Evaluation of the quality of personalized explanations was based on fidelity, explanatory power, interpretability, and plausibility. User satisfaction was the most frequently used measure of explanation effectiveness, followed by trust assessment, correctability, and task performance. The methods of assessing these measures also varied. Conclusion XAI research should address the lack of a comprehensive and agreed-upon framework for explaining XAI and standardized approaches for evaluating the effectiveness of the explanation that XAI provides to diverse AI stakeholders.
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Affiliation(s)
- Jinsun Jung
- College of Nursing, Seoul National University, Seoul, Republic of Korea
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Hyungbok Lee
- College of Nursing, Seoul National University, Seoul, Republic of Korea
- Emergency Nursing Department, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyunggu Jung
- Department of Computer Science and Engineering, University of Seoul, Seoul, Republic of Korea
- Department of Artificial Intelligence, University of Seoul, Seoul, Republic of Korea
| | - Hyeoneui Kim
- College of Nursing, Seoul National University, Seoul, Republic of Korea
- Research Institute of Nursing Science, College of Nursing, Seoul National University, Seoul, Republic of Korea
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14
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Uyulan C, Erguzel TT, Turk O, Farhad S, Metin B, Tarhan N. A Class Activation Map-Based Interpretable Transfer Learning Model for Automated Detection of ADHD from fMRI Data. Clin EEG Neurosci 2023; 54:151-159. [PMID: 36052402 DOI: 10.1177/15500594221122699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Automatic detection of Attention Deficit Hyperactivity Disorder (ADHD) based on the functional Magnetic Resonance Imaging (fMRI) through Deep Learning (DL) is becoming a quite useful methodology due to the curse of-dimensionality problem of the data is solved. Also, this method proposes an invasive and robust solution to the variances in data acquisition and class distribution imbalances. In this paper, a transfer learning approach, specifically ResNet-50 type pre-trained 2D-Convolutional Neural Network (CNN) was used to automatically classify ADHD and healthy children. The results demonstrated that ResNet-50 architecture with 10-k cross-validation (CV) achieves an overall classification accuracy of 93.45%. The interpretation of the results was done via the Class Activation Map (CAM) analysis which showed that children with ADHD differed from controls in a wide range of brain areas including frontal, parietal and temporal lobes.
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Affiliation(s)
- Caglar Uyulan
- Department of Mechanical Engineering, Faculty of Engineering and Architecture, İzmir Katip Çelebi University, İzmir, Turkey
| | | | - Omer Turk
- Department of Computer Programming, Vocational School, Mardin Artuklu University, Mardin, Turkey
| | - Shams Farhad
- Department of Neuroscience, 232990Uskudar University, Istanbul, Turkey
| | - Baris Metin
- Department of Neuroscience, 232990Uskudar University, Istanbul, Turkey
| | - Nevzat Tarhan
- Department of Psychiatry, NPIstanbul Brain Hospital, Istanbul, Turkey
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15
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Deep convolutional feature details for better knee disorder diagnoses in magnetic resonance images. Comput Med Imaging Graph 2022; 102:102142. [PMID: 36446308 DOI: 10.1016/j.compmedimag.2022.102142] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 11/12/2022] [Accepted: 11/14/2022] [Indexed: 11/23/2022]
Abstract
Convolutional neural networks (CNNs) applied to magnetic resonance imaging (MRI) have demonstrated their ability in the automatic diagnosis of knee injuries. Despite the promising results, the currently available solutions do not take into account the particular anatomy of knee disorders. Existing works have shown that injuries are localized in small-sized knee regions near the center of MRI scans. Based on such insights, we propose MRPyrNet, a CNN architecture capable of extracting more relevant features from these regions. Our solution is composed of a Feature Pyramid Network with Pyramidal Detail Pooling, and can be plugged into any existing CNN-based diagnostic pipeline. The first module aims to enhance the CNN intermediate features to better detect the small-sized appearance of disorders, while the second one captures such kind of evidence by maintaining its detailed information. An extensive evaluation campaign is conducted to understand in-depth the potential of the proposed solution. The experimental results achieved demonstrate that the application of MRPyrNet to baseline methodologies improves their diagnostic capability, especially in the case of anterior cruciate ligament tear and meniscal tear because of MRPyrNet's ability in exploiting the relevant appearance features of such disorders. Code is available at https://github.com/matteo-dunnhofer/MRPyrNet.
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16
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Applying Lightweight Deep Learning-Based Virtual Vision Sensing Technology to Realize and Develop New Media Interactive Art Installation. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:9119316. [PMID: 35860644 PMCID: PMC9293493 DOI: 10.1155/2022/9119316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/12/2022] [Accepted: 05/28/2022] [Indexed: 01/14/2023]
Abstract
The work intends to optimize the situation that interactive art devices and remote control based on traditional technology cannot meet people’s actual needs to a certain extent. With the assistance of Lightweight Deep Learning (LDL) models, Interactive Artistic Installation (IAI) shows excellent creative potential in terms of dimension, space, and sense. Virtual Vision Sensing Technology (VST) explores the emotional semantics in the human-machine environment with the help of interactive art, finds the emotional interaction elements between human and machine, and promotes Human-Computer Interaction (HCI). From the perspective of the media elements of interactive art, this paper reviews the virtual VST that subverts the expression of interactive art. Then, from the perspective of artistic creation, the impact of virtual VST on IAI thinking, methods, and artistic experience is analyzed. Thereupon, a scene construction method is designed where the physical equipment is premodeled. The model is loaded in real time with visual information. The proposed method does not require complex vision and laser scanning equipment or high-configured computer systems. The proposed new media IAI model realizes the real-time loading of the scene model. According to the physical equipment dynamic information obtained by the visual data acquisition system, the proposed method can keep the virtual scene and physical models in motion synchronization. Finally, experiment results corroborate that the environment will significantly interfere with the experimental results. The training data set with boundary occlusion will be more suitable for model training and better test results (about 97% accuracy). Hence, the research content can make the Virtual Reality works have better performance, especially the sense of experience from the perspective of aesthetics. Meanwhile, it also enriches the research theory in the field of new media art installation technology.
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17
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Wang YP, Jheng YC, Sung KY, Lin HE, Hsin IF, Chen PH, Chu YC, Lu D, Wang YJ, Hou MC, Lee FY, Lu CL. Use of U-Net Convolutional Neural Networks for Automated Segmentation of Fecal Material for Objective Evaluation of Bowel Preparation Quality in Colonoscopy. Diagnostics (Basel) 2022; 12:diagnostics12030613. [PMID: 35328166 PMCID: PMC8947406 DOI: 10.3390/diagnostics12030613] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/22/2022] [Accepted: 02/24/2022] [Indexed: 12/29/2022] Open
Abstract
Background: Adequate bowel cleansing is important for colonoscopy performance evaluation. Current bowel cleansing evaluation scales are subjective, with a wide variation in consistency among physicians and low reported rates of accuracy. We aim to use machine learning to develop a fully automatic segmentation method for the objective evaluation of the adequacy of colon preparation. Methods: Colonoscopy videos were retrieved from a video data cohort and transferred to qualified images, which were randomly divided into training, validation, and verification datasets. The fecal residue was manually segmented. A deep learning model based on the U-Net convolutional network architecture was developed to perform automatic segmentation. The performance of the automatic segmentation was evaluated on the overlap area with the manual segmentation. Results: A total of 10,118 qualified images from 119 videos were obtained. The model averaged 0.3634 s to segmentate one image automatically. The models produced a strong high-overlap area with manual segmentation, with 94.7% ± 0.67% of that area predicted by our AI model, which correlated well with the area measured manually (r = 0.915, p < 0.001). The AI system can be applied in real-time qualitatively and quantitatively. Conclusions: We established a fully automatic segmentation method to rapidly and accurately mark the fecal residue-coated mucosa for the objective evaluation of colon preparation.
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Affiliation(s)
- Yen-Po Wang
- Endoscopy Center for Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan; (Y.-P.W.); (Y.-C.J.); (K.-Y.S.); (H.-E.L.); (I.-F.H.); (P.-H.C.); (D.L.); (M.-C.H.)
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan;
- Institute of Brain Science, National Yang Ming Chiao Tung University School of Medicine, Taipei 112, Taiwan
- Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei 112, Taiwan;
| | - Ying-Chun Jheng
- Endoscopy Center for Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan; (Y.-P.W.); (Y.-C.J.); (K.-Y.S.); (H.-E.L.); (I.-F.H.); (P.-H.C.); (D.L.); (M.-C.H.)
- Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei 112, Taiwan;
- Department of Medical Research, Taipei Veterans General Hospital, Taipei 112, Taiwan
| | - Kuang-Yi Sung
- Endoscopy Center for Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan; (Y.-P.W.); (Y.-C.J.); (K.-Y.S.); (H.-E.L.); (I.-F.H.); (P.-H.C.); (D.L.); (M.-C.H.)
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan;
- Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei 112, Taiwan;
| | - Hung-En Lin
- Endoscopy Center for Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan; (Y.-P.W.); (Y.-C.J.); (K.-Y.S.); (H.-E.L.); (I.-F.H.); (P.-H.C.); (D.L.); (M.-C.H.)
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan;
- Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei 112, Taiwan;
| | - I-Fang Hsin
- Endoscopy Center for Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan; (Y.-P.W.); (Y.-C.J.); (K.-Y.S.); (H.-E.L.); (I.-F.H.); (P.-H.C.); (D.L.); (M.-C.H.)
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan;
- Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei 112, Taiwan;
| | - Ping-Hsien Chen
- Endoscopy Center for Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan; (Y.-P.W.); (Y.-C.J.); (K.-Y.S.); (H.-E.L.); (I.-F.H.); (P.-H.C.); (D.L.); (M.-C.H.)
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan;
- Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei 112, Taiwan;
| | - Yuan-Chia Chu
- Information Management Office, Taipei Veterans General Hospital, Taipei 112, Taiwan;
- Big Data Center, Taipei Veterans General Hospital, Taipei 112, Taiwan
- Department of Information Management, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan
| | - David Lu
- Endoscopy Center for Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan; (Y.-P.W.); (Y.-C.J.); (K.-Y.S.); (H.-E.L.); (I.-F.H.); (P.-H.C.); (D.L.); (M.-C.H.)
| | - Yuan-Jen Wang
- Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei 112, Taiwan;
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei 112, Taiwan
| | - Ming-Chih Hou
- Endoscopy Center for Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan; (Y.-P.W.); (Y.-C.J.); (K.-Y.S.); (H.-E.L.); (I.-F.H.); (P.-H.C.); (D.L.); (M.-C.H.)
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan;
- Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei 112, Taiwan;
| | - Fa-Yauh Lee
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan;
- Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei 112, Taiwan;
| | - Ching-Liang Lu
- Endoscopy Center for Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan; (Y.-P.W.); (Y.-C.J.); (K.-Y.S.); (H.-E.L.); (I.-F.H.); (P.-H.C.); (D.L.); (M.-C.H.)
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan;
- Institute of Brain Science, National Yang Ming Chiao Tung University School of Medicine, Taipei 112, Taiwan
- Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei 112, Taiwan;
- Correspondence: ; Tel.: +886-2-2875-7272
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18
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Siouras A, Moustakidis S, Giannakidis A, Chalatsis G, Liampas I, Vlychou M, Hantes M, Tasoulis S, Tsaopoulos D. Knee Injury Detection Using Deep Learning on MRI Studies: A Systematic Review. Diagnostics (Basel) 2022; 12:537. [PMID: 35204625 PMCID: PMC8871256 DOI: 10.3390/diagnostics12020537] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/02/2022] [Accepted: 02/17/2022] [Indexed: 01/17/2023] Open
Abstract
The improved treatment of knee injuries critically relies on having an accurate and cost-effective detection. In recent years, deep-learning-based approaches have monopolized knee injury detection in MRI studies. The aim of this paper is to present the findings of a systematic literature review of knee (anterior cruciate ligament, meniscus, and cartilage) injury detection papers using deep learning. The systematic review was carried out following the PRISMA guidelines on several databases, including PubMed, Cochrane Library, EMBASE, and Google Scholar. Appropriate metrics were chosen to interpret the results. The prediction accuracy of the deep-learning models for the identification of knee injuries ranged from 72.5-100%. Deep learning has the potential to act at par with human-level performance in decision-making tasks related to the MRI-based diagnosis of knee injuries. The limitations of the present deep-learning approaches include data imbalance, model generalizability across different centers, verification bias, lack of related classification studies with more than two classes, and ground-truth subjectivity. There are several possible avenues of further exploration of deep learning for improving MRI-based knee injury diagnosis. Explainability and lightweightness of the deployed deep-learning systems are expected to become crucial enablers for their widespread use in clinical practice.
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Affiliation(s)
- Athanasios Siouras
- Department of Computer Science and Biomedical Informatics, School of Science, University of Thessaly, 35131 Lamia, Greece;
- Centre for Research and Technology Hellas, 38333 Volos, Greece;
| | | | - Archontis Giannakidis
- School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK;
| | - Georgios Chalatsis
- Department of Orthopedic Surgery, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece; (G.C.); (M.H.)
| | - Ioannis Liampas
- Department of Neurology, School of Medicine, University Hospital of Larissa, University of Thessaly, Mezourlo Hill, 41500 Larissa, Greece;
| | - Marianna Vlychou
- Department of Radiology, School of Health Sciences, University Hospital of Larissa, University of Thessaly, Mezourlo, 41500 Larissa, Greece;
| | - Michael Hantes
- Department of Orthopedic Surgery, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece; (G.C.); (M.H.)
| | - Sotiris Tasoulis
- Department of Computer Science and Biomedical Informatics, School of Science, University of Thessaly, 35131 Lamia, Greece;
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Anomaly Detection in Videos Using Two-Stream Autoencoder with Post Hoc Interpretability. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2021; 2021:7367870. [PMID: 34354745 PMCID: PMC8331293 DOI: 10.1155/2021/7367870] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/16/2021] [Accepted: 07/14/2021] [Indexed: 11/17/2022]
Abstract
The growing interest in deep learning approaches to video surveillance raises concerns about the accuracy and efficiency of neural networks. However, fast and reliable detection of abnormal events is still a challenging work. Here, we introduce a two-stream approach that offers an autoencoder-based structure for fast and efficient detection to facilitate anomaly detection from surveillance video without labeled abnormal events. Furthermore, we present post hoc interpretability of feature map visualization to show the process of feature learning, revealing uncertain and ambiguous decision boundaries in the video sequence. Experimental results on Avenue, UCSD Ped2, and Subway datasets show that our method can detect abnormal events well and explain the internal logic of the model at the object level.
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