Cloud-Based Automated Clinical Decision Support System for Detection and Diagnosis of Lung Cancer in Chest CT

Artificial intelligence in lung cancer screening: Detection, classification, prediction, and prognosis

BACKGROUND

The exceptional capabilities of artificial intelligence (AI) in extracting image information and processing complex models have led to its recognition across various medical fields. With the continuous evolution of AI technologies based on deep learning, particularly the advent of convolutional neural networks (CNNs), AI presents an expanded horizon of applications in lung cancer screening, including lung segmentation, nodule detection, false-positive reduction, nodule classification, and prognosis.

METHODOLOGY

This review initially analyzes the current status of AI technologies. It then explores the applications of AI in lung cancer screening, including lung segmentation, nodule detection, and classification, and assesses the potential of AI in enhancing the sensitivity of nodule detection and reducing false-positive rates. Finally, it addresses the challenges and future directions of AI in lung cancer screening.

RESULTS

AI holds substantial prospects in lung cancer screening. It demonstrates significant potential in improving nodule detection sensitivity, reducing false-positive rates, and classifying nodules, while also showing value in predicting nodule growth and pathological/genetic typing.

CONCLUSIONS

AI offers a promising supportive approach to lung cancer screening, presenting considerable potential in enhancing nodule detection sensitivity, reducing false-positive rates, and classifying nodules. However, the universality and interpretability of AI results need further enhancement. Future research should focus on the large-scale validation of new deep learning-based algorithms and multi-center studies to improve the efficacy of AI in lung cancer screening.

Development of a modified 3D region proposal network for lung nodule detection in computed tomography scans: a secondary analysis of lung nodule datasets

BACKGROUND

Low-dose computed tomography (LDCT) has been shown useful in early lung cancer detection. This study aimed to develop a novel deep learning model for detecting pulmonary nodules on chest LDCT images.

METHODS

In this secondary analysis, three lung nodule datasets, including Lung Nodule Analysis 2016 (LUNA16), Lung Nodule Received Operation (LNOP), and Lung Nodule in Health Examination (LNHE), were used to train and test deep learning models. The 3D region proposal network (RPN) was modified via a series of pruning experiments for better predictive performance. The performance of each modified deep leaning model was evaluated based on sensitivity and competition performance metric (CPM). Furthermore, the performance of the modified 3D RPN trained on three datasets was evaluated by 10-fold cross validation. Temporal validation was conducted to assess the reliability of the modified 3D RPN for detecting lung nodules.

RESULTS

The results of pruning experiments indicated that the modified 3D RPN composed of the Cross Stage Partial Network (CSPNet) approach to Residual Network (ResNet) Xt (CSP-ResNeXt) module, feature pyramid network (FPN), nearest anchor method, and post-processing masking, had the optimal predictive performance with a CPM of 92.2%. The modified 3D RPN trained on the LUNA16 dataset had the highest CPM (90.1%), followed by the LNOP dataset (CPM: 74.1%) and the LNHE dataset (CPM: 70.2%). When the modified 3D RPN trained and tested on the same datasets, the sensitivities were 94.6%, 84.8%, and 79.7% for LUNA16, LNOP, and LNHE, respectively. The temporal validation analysis revealed that the modified 3D RPN tested on LNOP test set achieved a CPM of 71.6% and a sensitivity of 85.7%, and the modified 3D RPN tested on LNHE test set had a CPM of 71.7% and a sensitivity of 83.5%.

CONCLUSION

A modified 3D RPN for detecting lung nodules on LDCT scans was designed and validated, which may serve as a computer-aided diagnosis system to facilitate lung nodule detection and lung cancer diagnosis.

MENet: A Mitscherlich function based ensemble of CNN models to classify lung cancer using CT scans

Lung cancer is one of the leading causes of cancer-related deaths worldwide. To reduce the mortality rate, early detection and proper treatment should be ensured. Computer-aided diagnosis methods analyze different modalities of medical images to increase diagnostic precision. In this paper, we propose an ensemble model, called the Mitscherlich function-based Ensemble Network (MENet), which combines the prediction probabilities obtained from three deep learning models, namely Xception, InceptionResNetV2, and MobileNetV2, to improve the accuracy of a lung cancer prediction model. The ensemble approach is based on the Mitscherlich function, which produces a fuzzy rank to combine the outputs of the said base classifiers. The proposed method is trained and tested on the two publicly available lung cancer datasets, namely Iraq-Oncology Teaching Hospital/National Center for Cancer Diseases (IQ-OTH/NCCD) and LIDC-IDRI, both of these are computed tomography (CT) scan datasets. The obtained results in terms of some standard metrics show that the proposed method performs better than state-of-the-art methods. The codes for the proposed work are available at https://github.com/SuryaMajumder/MENet.

Classification of lung cancer computed tomography images using a 3-dimensional deep convolutional neural network with multi-layer filter

Lung cancer creates pulmonary nodules in the patient's lung, which may be diagnosed early on using computer-aided diagnostics. A novel automated pulmonary nodule diagnosis technique using three-dimensional deep convolutional neural networks and multi-layered filter has been presented in this paper. For the suggested automated diagnosis of lung nodule, volumetric computed tomographic images are employed. The proposed approach generates three-dimensional feature layers, which retain the temporal links between adjacent slices of computed tomographic images. The use of several activation functions at different levels of the proposed network results in increased feature extraction and efficient classification. The suggested approach divides lung volumetric computed tomography pictures into malignant and benign categories. The suggested technique's performance is evaluated using three commonly used datasets in the domain: LUNA 16, LIDC-IDRI, and TCIA. The proposed method outperforms the state-of-the-art in terms of accuracy, sensitivity, specificity, F-1 score, false-positive rate, false-negative rate, and error rate.

Improved graph neural network-based green anaconda optimization for segmenting and classifying the lung cancer

Normal lung cells incur genetic damage over time, which causes unchecked cell growth and ultimately leads to lung cancer. Nearly 85% of lung cancer cases are caused by smoking, but there exists factual evidence that beta-carotene supplements and arsenic in water may raise the risk of developing the illness. Asbestos, polycyclic aromatic hydrocarbons, arsenic, radon gas, nickel, chromium and hereditary factors represent various lung cancer-causing agents. Therefore, deep learning approaches are employed to quicken the crucial procedure of diagnosing lung cancer. The effectiveness of these methods has increased when used to examine cancer histopathology slides. Initially, the data is gathered from the standard benchmark dataset. Further, the pre-processing of the collected images is accomplished using the Gabor filter method. The segmentation of these pre-processed images is done through the modified expectation maximization (MEM) algorithm method. Next, using the histogram of oriented gradient (HOG) scheme, the features are extracted from these segmented images. Finally, the classification of lung cancer is performed by the improved graph neural network (IGNN), where the parameter optimization of graph neural network (GNN) is done by the green anaconda optimization (GAO) algorithm in order to derive the accuracy maximization as the major objective function. This IGNN classifies lung cancer into normal, adeno carcinoma and squamous cell carcinoma as the final output. On comparison with existing methods with respect to distinct performance measures, the simulation findings reveal the betterment of the introduced method.

An ensemble of three-dimensional deep neural network models for multi-attribute scoring and classification of pulmonary nodules

Lung cancer is the uncontrolled growth of cells that originates in the lung parenchyma or cells that line the air passages. These cells divide rapidly to form malicious tumors. This paper proposes a multi-task ensemble of three dimensional (3D) deep neural network (DNN) based model, namely: pre-trained EfficientNetB0, BiGRU-based SEResNext101, and the proposed LungNet. The ensemble model performs binary classification and regression tasks to accurately classify the benign and malignant pulmonary nodules. This study also explores the attribute importance and proposes a domain knowledge-based regularization technique. The proposed model is evaluated on the public benchmark LIDC-IDRI dataset. Through a comparative study, it was shown that when coefficients generated by the random forest (RF) are used in the loss function, the proposed ensemble model offers a better prediction capability of the accuracy of 96.4% compared to the state-of-the-art methods. In addition, the receiver operating characteristic curves show that the proposed ensemble model has better performance than the base learners. Thus, the proposed CAD-based model can efficiently detect malignant pulmonary nodules.

An ensemble deep learning model for risk stratification of invasive lung adenocarcinoma using thin-slice CT

Lung cancer screening using computed tomography (CT) has increased the detection rate of small pulmonary nodules and early-stage lung adenocarcinoma. It would be clinically meaningful to accurate assessment of the nodule histology by CT scans with advanced deep learning algorithms. However, recent studies mainly focus on predicting benign and malignant nodules, lacking of model for the risk stratification of invasive adenocarcinoma. We propose an ensemble multi-view 3D convolutional neural network (EMV-3D-CNN) model to study the risk stratification of lung adenocarcinoma. We include 1075 lung nodules (≤30 mm and ≥4 mm) with preoperative thin-section CT scans and definite pathology confirmed by surgery. Our model achieves a state-of-art performance of 91.3% and 92.9% AUC for diagnosis of benign/malignant and pre-invasive/invasive nodules, respectively. Importantly, our model outperforms senior doctors in risk stratification of invasive adenocarcinoma with 77.6% accuracy [i.e., Grades 1, 2, 3]). It provides detailed predictive histological information for the surgical management of pulmonary nodules. Finally, for user-friendly access, the proposed model is implemented as a web-based system ( https://seeyourlung.com.cn ).

Multiple Field-of-View Based Attention Driven Network for Weakly Supervised Common Bile Duct Stone Detection

OBJECTIVE

Common bile duct (CBD) stones caused diseases are life-threatening. Because CBD stones locate in the distal part of the CBD and have relatively small sizes, detecting CBD stones from CT scans is a challenging issue in the medical domain.

METHODS AND PROCEDURES

We propose a deep learning based weakly-supervised method called multiple field-of-view based attention driven network (MFADNet) to detect CBD stones from CT scans based on image-level labels. Three dominant modules including a multiple field-of-view encoder, an attention driven decoder and a classification network are collaborated in the network. The encoder learns the feature of multi-scale contextual information while the decoder with the classification network is applied to locate the CBD stones based on spatial-channel attentions. To drive the learning of the whole network in a weakly-supervised and end-to-end trainable manner, four losses including the foreground loss, background loss, consistency loss and classification loss are proposed.

RESULTS

Compared with state-of-the-art weakly-supervised methods in the experiments, the proposed method can accurately classify and locate CBD stones based on the quantitative and qualitative results.

CONCLUSION

We propose a novel multiple field-of-view based attention driven network for a new medical application of CBD stone detection from CT scans while only image-levels are required to reduce the burdens of labeling and help physicians automatically diagnose CBD stones. The source code is available at https://github.com/nchucvml/MFADNet after acceptance.

CLINICAL IMPACT

Our deep learning method can help physicians localize relatively small CBD stones for effectively diagnosing CBD stone caused diseases.

Review on chest pathogies detection systems using deep learning techniques

Chest radiography is the standard and most affordable way to diagnose, analyze, and examine different thoracic and chest diseases. Typically, the radiograph is examined by an expert radiologist or physician to decide about a particular anomaly, if exists. Moreover, computer-aided methods are used to assist radiologists and make the analysis process accurate, fast, and more automated. A tremendous improvement in automatic chest pathologies detection and analysis can be observed with the emergence of deep learning. The survey aims to review, technically evaluate, and synthesize the different computer-aided chest pathologies detection systems. The state-of-the-art of single and multi-pathologies detection systems, which are published in the last five years, are thoroughly discussed. The taxonomy of image acquisition, dataset preprocessing, feature extraction, and deep learning models are presented. The mathematical concepts related to feature extraction model architectures are discussed. Moreover, the different articles are compared based on their contributions, datasets, methods used, and the results achieved. The article ends with the main findings, current trends, challenges, and future recommendations.

Ensemble learning-based feature engineering to analyze maternal health during pregnancy and health risk prediction

Maternal health is an important aspect of women’s health during pregnancy, childbirth, and the postpartum period. Specifically, during pregnancy, different health factors like age, blood disorders, heart rate, etc. can lead to pregnancy complications. Detecting such health factors can alleviate the risk of pregnancy-related complications. This study aims to develop an artificial neural network-based system for predicting maternal health risks using health data records. A novel deep neural network architecture, DT-BiLTCN is proposed that uses decision trees, a bidirectional long short-term memory network, and a temporal convolutional network. Experiments involve using a dataset of 1218 samples collected from maternal health care, hospitals, and community clinics using the IoT-based risk monitoring system. Class imbalance is resolved using the synthetic minority oversampling technique. DT-BiLTCN provides a feature set to obtain high accuracy results which in this case are provided by the support vector machine with a 98% accuracy. Maternal health exploratory data analysis reveals that the health conditions which are the strongest indications of health risk during pregnancy are diastolic and systolic blood pressure, heart rate, and age of pregnant women. Using the proposed model, timely prediction of health risks associated with pregnant women can be made thus mitigating the risk of health complications which helps to save lives.

Lung nodule diagnosis and cancer histology classification from computed tomography data by convolutional neural networks: A survey

Lung cancer is among the deadliest cancers. Besides lung nodule classification and diagnosis, developing non-invasive systems to classify lung cancer histological types/subtypes may help clinicians to make targeted treatment decisions timely, having a positive impact on patients' comfort and survival rate. As convolutional neural networks have proven to be responsible for the significant improvement of the accuracy in lung cancer diagnosis, with this survey we intend to: show the contribution of convolutional neural networks not only in identifying malignant lung nodules but also in classifying lung cancer histological types/subtypes directly from computed tomography data; point out the strengths and weaknesses of slice-based and scan-based approaches employing convolutional neural networks; and highlight the challenges and prospective solutions to successfully apply convolutional neural networks for such classification tasks. To this aim, we conducted a comprehensive analysis of relevant Scopus-indexed studies involved in lung nodule diagnosis and cancer histology classification up to January 2022, dividing the investigation in convolutional neural network-based approaches fed with planar or volumetric computed tomography data. Despite the application of convolutional neural networks in lung nodule diagnosis and cancer histology classification is a valid strategy, some challenges raised, mainly including the lack of publicly-accessible annotated data, together with the lack of reproducibility and clinical interpretability. We believe that this survey will be helpful for future studies involved in lung nodule diagnosis and cancer histology classification prior to lung biopsy by means of convolutional neural networks.

MS-ResNet: disease-specific survival prediction using longitudinal CT images and clinical data

PURPOSE

Medical imaging data of lung cancer in different stages contain a large amount of time information related to its evolution (emergence, development, or extinction). We try to explore the evolution process of lung images in time dimension to improve the prediction of lung cancer survival by using longitudinal CT images and clinical data jointly.

METHODS

In this paper, we propose an innovative multi-branch spatiotemporal residual network (MS-ResNet) for disease-specific survival (DSS) prediction by integrating the longitudinal computed tomography (CT) images at different times and clinical data. Specifically, we first extract the deep features from the multi-period CT images by an improved residual network. Then, the feature selection algorithm is used to select the most relevant feature subset from the clinical data. Finally, we integrate the deep features and feature subsets to take full advantage of the complementarity between the two types of data to generate the final prediction results.

RESULTS

The experimental results demonstrate that our MS-ResNet model is superior to other methods, achieving a promising 86.78% accuracy in the classification of short-survivor, med-survivor, and long-survivor.

CONCLUSION

In computer-aided prognostic analysis of cancer, the time dimension features of the course of disease and the integration of patient clinical data and CT data can effectively improve the prediction accuracy.

Design Computer-Aided Diagnosis System Based on Chest CT Evaluation of Pulmonary Nodules

At present, the diagnosis and treatment of lung cancer have always been one of the research hotspots in the medical field. Early diagnosis and treatment of this disease are necessary means to improve the survival rate of lung cancer patients and reduce their mortality. The introduction of computer-aided diagnosis technology can easily, quickly, and accurately identify the lung nodule area as an imaging feature of early lung cancer for the clinical diagnosis of lung cancer and is helpful for the quantitative analysis of the characteristics of lung nodules and is useful for distinguishing benign and malignant lung nodules. Growth provides an objective diagnostic reference standard. This paper studies ITK and VTK toolkits and builds a system platform with MFC. By studying the process of doctors diagnosing lung nodules, the whole system is divided into seven modules: suspected lung shadow detection, image display and image annotation, and interaction. The system passes through the entire lung nodule auxiliary diagnosis process and obtains the number of nodules, the number of malignant nodules, and the number of false positives in each set of lung CT images to analyze the performance of the auxiliary diagnosis system. In this paper, a lung region segmentation method is proposed, which makes use of the obvious differences between the lung parenchyma and other human tissues connected with it, as well as the position relationship and shape characteristics of each human tissue in the image. Experiments are carried out to solve the problems of lung boundary, inaccurate segmentation of lung wall, and depression caused by noise and pleural nodule adhesion. Experiments show that there are 2316 CT images in 8 sets of images of different patients, and the number of nodules is 56. A total of 49 nodules were detected by the system, 7 were missed, and the detection rate was 87.5%. A total of 64 false-positive nodules were detected, with an average of 8 per set of images. This shows that the system is effective for CT images of different devices, pixel pitch, and slice pitch and has high sensitivity, which can provide doctors with good advice.

Lung Cancer Detection and Improving Accuracy Using Linear Subspace Image Classification Algorithm

The ability to identify lung cancer at an early stage is critical, because it can help patients live longer. However, predicting the affected area while diagnosing cancer is a huge challenge. An intelligent computer-aided diagnostic system can be utilized to detect and diagnose lung cancer by detecting the damaged region. The suggested Linear Subspace Image Classification Algorithm (LSICA) approach classifies images in a linear subspace. This methodology is used to accurately identify the damaged region, and it involves three steps: image enhancement, segmentation, and classification. The spatial image clustering technique is used to quickly segment and identify the impacted area in the image. LSICA is utilized to determine the accuracy value of the affected region for classification purposes. Therefore, a lung cancer detection system with classification-dependent image processing is used for lung cancer CT imaging. Therefore, a new method to overcome these deficiencies of the process for detection using LSICA is proposed in this work on lung cancer. MATLAB has been used in all programs. A proposed system designed to easily identify the affected region with help of the classification technique to enhance and get more accurate results.

Medical imaging and nuclear medicine: a Lancet Oncology Commission

The diagnosis and treatment of patients with cancer requires access to imaging to ensure accurate management decisions and optimal outcomes. Our global assessment of imaging and nuclear medicine resources identified substantial shortages in equipment and workforce, particularly in low-income and middle-income countries (LMICs). A microsimulation model of 11 cancers showed that the scale-up of imaging would avert 3·2% (2·46 million) of all 76·0 million deaths caused by the modelled cancers worldwide between 2020 and 2030, saving 54·92 million life-years. A comprehensive scale-up of imaging, treatment, and care quality would avert 9·55 million (12·5%) of all cancer deaths caused by the modelled cancers worldwide, saving 232·30 million life-years. Scale-up of imaging would cost US$6·84 billion in 2020-30 but yield lifetime productivity gains of $1·23 trillion worldwide, a net return of $179·19 per $1 invested. Combining the scale-up of imaging, treatment, and quality of care would provide a net benefit of $2·66 trillion and a net return of $12·43 per $1 invested. With the use of a conservative approach regarding human capital, the scale-up of imaging alone would provide a net benefit of $209·46 billion and net return of $31·61 per $1 invested. With comprehensive scale-up, the worldwide net benefit using the human capital approach is $340·42 billion and the return per dollar invested is $2·46. These improved health and economic outcomes hold true across all geographical regions. We propose actions and investments that would enhance access to imaging equipment, workforce capacity, digital technology, radiopharmaceuticals, and research and training programmes in LMICs, to produce massive health and economic benefits and reduce the burden of cancer globally.

Machine intelligence for precision oncology

Despite various advances in cancer research, the incidence and mortality rates of malignant diseases have remained high. Accurate risk assessment, prevention, detection, and treatment of cancer tailored to the individual are major challenges in clinical oncology. Artificial intelligence (AI), a field of applied computer science, has shown promising potential of accelerating evolution of healthcare towards precision oncology. This article focuses on highlights of the application of data-driven machine learning (ML) and deep learning (DL) in translational research for cancer diagnosis, prognosis, treatment, and clinical outcomes. ML-based algorithms in radiological and histological images have been demonstrated to improve detection and diagnosis of cancer. DL-based prediction models in molecular or multi-omics datasets of cancer for biomarkers and targets enable drug discovery and treatment. ML approaches combining radiomics with genomics and other omics data enhance the power of AI in improving diagnosis, prognostication, and treatment of cancer. Ethical and regulatory issues involving patient confidentiality and data security impose certain limitations on practical implementation of ML in clinical oncology. However, the ultimate goal of application of AI in cancer research is to develop and implement multi-modal machine intelligence for improving clinical decision on individualized management of patients.

A survey on Machine learning based Medical Assistive systems in Current Oncological Sciences

BACKGROUND

Cancer is one of the life threatening disease which is affecting a large number of population worldwide. The cancer cells multiply inside the body without showing much symptoms on the surface of the skin thereby making it difficult to predict and detect at the onset of disease. Many organizations are working towards automating the process of cancer detection with minimal false detection rates.

INTRODUCTION

The machine learning algorithms serve to be a promising alternative to support health care practitioners to rule out the disease and predict the growth with various imaging and statistical analysis tools. The medical practitioners are utilizing the output of these algorithms to diagnose and design the course of treatment. These algorithms are capable of finding out the risk level of the patient and can reduce the mortality rate concerning to cancer disease.

METHOD

This article presents the existing state of art techniques for identifying cancer affecting human organs based on machine learning models. The supported set of imaging operations are also elaborated for each type of Cancer.

CONCLUSION

The CAD tools are the aid for the diagnostic radiologists for preliminary investigations and detecting the nature of tumor cells.

COVID-19 Detection Through Transfer Learning Using Multimodal Imaging Data

Detecting COVID-19 early may help in devising an appropriate treatment plan and disease containment decisions. In this study, we demonstrate how transfer learning from deep learning models can be used to perform COVID-19 detection using images from three most commonly used medical imaging modes X-Ray, Ultrasound, and CT scan. The aim is to provide over-stressed medical professionals a second pair of eyes through intelligent deep learning image classification models. We identify a suitable Convolutional Neural Network (CNN) model through initial comparative study of several popular CNN models. We then optimize the selected VGG19 model for the image modalities to show how the models can be used for the highly scarce and challenging COVID-19 datasets. We highlight the challenges (including dataset size and quality) in utilizing current publicly available COVID-19 datasets for developing useful deep learning models and how it adversely impacts the trainability of complex models. We also propose an image pre-processing stage to create a trustworthy image dataset for developing and testing the deep learning models. The new approach is aimed to reduce unwanted noise from the images so that deep learning models can focus on detecting diseases with specific features from them. Our results indicate that Ultrasound images provide superior detection accuracy compared to X-Ray and CT scans. The experimental results highlight that with limited data, most of the deeper networks struggle to train well and provides less consistency over the three imaging modes we are using. The selected VGG19 model, which is then extensively tuned with appropriate parameters, performs in considerable levels of COVID-19 detection against pneumonia or normal for all three lung image modes with the precision of up to 86% for X-Ray, 100% for Ultrasound and 84% for CT scans.

Non-Invasive Technique-Based Novel Corona(COVID-19) Virus Detection Using CNN

A novel human coronavirus 2 (SARS-CoV-2) is an extremely acute respiratory syndrome which was reported in Wuhan, China in the later half 2019. Most of its primary epidemiological aspects are not appropriately known, which has a direct effect on monitoring, practices and controls. The main objective of this work is to propose a high speed, accurate and highly sensitive CT scan approach for diagnosis of COVID19. The CT scan images display several small patches of shadows and interstitial shifts, particularly in the lung periphery. The proposed method utilizes the ResNet architecture Convolution Neural Network for training the images provided by the CT scan to diagnose the coronavirus-affected patients effectively. By comparing the testing images with the training images, the affected patient is identified accurately. The accuracy and specificity are obtained 95.09% and 81.89%, respectively, on the sample dataset based on CT images without the inclusion of another set of data such as geographical location, population density, etc. Also, the sensitivity is obtained 100% in this method. Based on the results, it is evident that the COVID-19 positive patients can be classified perfectly by using the proposed method.