Automatic detection of large pulmonary solid nodules in thoracic CT images

LGDNet: local feature coupling global representations network for pulmonary nodules detection

Detection of suspicious pulmonary nodules from lung CT scans is a crucial task in computer-aided diagnosis (CAD) systems. In recent years, various deep learning-based approaches have been proposed and demonstrated significant potential for addressing this task. However, existing deep convolutional neural networks exhibit limited long-range dependency capabilities and neglect crucial contextual information, resulting in reduced performance on detecting small-size nodules in CT scans. In this work, we propose a novel end-to-end framework called LGDNet for the detection of suspicious pulmonary nodules in lung CT scans by fusing local features and global representations. To overcome the limited long-range dependency capabilities inherent in convolutional operations, a dual-branch module is designed to integrate the convolutional neural network (CNN) branch that extracts local features with the transformer branch that captures global representations. To further address the issue of misalignment between local features and global representations, an attention gate module is proposed in the up-sampling stage to selectively combine misaligned semantic data from both branches, resulting in more accurate detection of small-size nodules. Our experiments on the large-scale LIDC dataset demonstrate that the proposed LGDNet with the dual-branch module and attention gate module could significantly improve the nodule detection sensitivity by achieving a final competition performance metric (CPM) score of 89.49%, outperforming the state-of-the-art nodule detection methods, indicating its potential for clinical applications in the early diagnosis of lung diseases.

A Bi-FPN-Based Encoder-Decoder Model for Lung Nodule Image Segmentation

Early detection and analysis of lung cancer involve a precise and efficient lung nodule segmentation in computed tomography (CT) images. However, the anonymous shapes, visual features, and surroundings of the nodules as observed in the CT images pose a challenging and critical problem to the robust segmentation of lung nodules. This article proposes a resource-efficient model architecture: an end-to-end deep learning approach for lung nodule segmentation. It incorporates a Bi-FPN (bidirectional feature network) between an encoder and a decoder architecture. Furthermore, it uses the Mish activation function and class weights of masks with the aim of enhancing the efficiency of the segmentation. The proposed model was extensively trained and evaluated on the publicly available LUNA-16 dataset consisting of 1186 lung nodules. To increase the probability of the suitable class of each voxel in the mask, a weighted binary cross-entropy loss of each sample of training was utilized as network training parameter. Moreover, on the account of further evaluation of robustness, the proposed model was evaluated on the QIN Lung CT dataset. The results of the evaluation show that the proposed architecture outperforms existing deep learning models such as U-Net with a Dice Similarity Coefficient of 82.82% and 81.66% on both datasets.

Pulmonary Nodule Detection Based on Multiscale Feature Fusion

As cancer with the highest morbidity and mortality in the world, lung cancer is characterized by pulmonary nodules in the early stage. The detection of pulmonary nodules is an important method for the early detection of lung cancer, which can greatly improve the survival rate of lung cancer patients. However, the accuracy of conventional detection methods for lung nodules is low. With the development of medical imaging technology, deep learning plays an increasingly important role in medical image detection, and pulmonary nodules can be accurately detected by CT images. Based on the above, a pulmonary nodule detection method based on deep learning is proposed. In the candidate nodule detection stage, the multiscale features and Faster R-CNN, a general-purpose detection framework based on deep learning, were combined together to improve the detection of small-sized lung nodules. In the false-positive nodule filtration stage, a 3D convolutional neural network based on multiscale fusion is designed to reduce false-positive nodules. The experiment results show that the candidate nodule detection model based on Faster R-CNN integrating multiscale features has achieved a sensitivity of 98.6%, 10% higher than that of the other single-scale model, the proposed method achieved a sensitivity of 90.5% at the level of 4 false-positive nodules per scan, and the CPM score reached 0.829. The results are higher than methods in other works of literature. It can be seen that the detection method of pulmonary nodules based on multiscale fusion has a higher detection rate for small nodules and improves the classification performance of true and false-positive pulmonary nodules. This will help doctors when making a lung cancer diagnosis.

Cross attention guided multi-scale feature fusion for false-positive reduction in pulmonary nodule detection

False-positive reduction is a crucial step of computer-aided diagnosis (CAD) system for pulmonary nodules detection and it plays an important role in lung cancer diagnosis. In this paper, we propose a novel cross attention guided multi-scale feature fusion method for false-positive reduction in pulmonary nodule detection. Specifically, a 3D SENet50 fed with a candidate nodule cube is applied as the backbone to acquire multi-scale coarse features. Then, the coarse features are refined and fused by the multi-scale fusion part to achieve a better feature extraction result. Finally, a 3D spatial pyramid pooling module is used to enhance receptive field and a distributed aligned linear classifier is applied to get the confidence score. In addition, each of the five nodule cubes with different sizes centering on every testing nodule position is fed into the proposed framework to obtain a confidence score separately and a weighted fusion method is used to improve the generalization performance of the model. Extensive experiments are conducted to demonstrate the effectiveness of the classification performance of the proposed model. The data used in our work is from the LUNA16 pulmonary nodule detection challenge. In this data set, the number of true-positive pulmonary nodules is 1,557, while the number of false-positive ones is 753,418. The new method is evaluated on the LUNA16 dataset and achieves the score of the competitive performance metric (CPM) 84.8%.

The influence of a deep learning image reconstruction algorithm on the image quality and auto-analysis of pulmonary nodules at ultra-low dose chest CT: a phantom study

BACKGROUND

To investigate the effect of a new deep learning image reconstruction (DLIR) algorithm on the detection, characterization and image quality of pulmonary nodules (PNs) in ultra-low dose chest computed tomography (CT) in comparison with the adaptive statistical iterative reconstruction (ASIR-V) algorithm.

METHODS

Nine artificial pulmonary nodules [six ground glass nodules (GGNs) and three solid nodules (SNs); density: -800 HU, -630 HU, 100 HU; diameter: 12 mm, 10 mm, 8 mm] were randomly placed in a thorax anthropomorphic phantom (Lungman, Kyoto Kagaku Inc.) and scanned on a 256-row CT (Revolution CT, GE Healthcare). Eight scans were performed at 70 kVp with different tube currents (20, 30, 50, 70, 90, 100, 120, 150 mA). Raw data were reconstructed using the filtered back projection (FBP), ASIR-V (30%, 50%, 80%) and DLIR (Low, Medium, High; TrueFidelity™) at 0.625 mm thickness. The effective radiation dose was recorded. All images were automatically analyzed using a commercially available artificial intelligence software (Intelligent 4D Imaging System for Chest CT 5.5, YITU Healthcare) and CT value, standard deviation (SD), long and short diameters of each nodule and SD of air (background) were measured. The detection rate, deformation degree (long diameter/short diameter), signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of pulmonary nodules were calculated.

RESULTS

Nodule CT values were the same in all mA settings for all three types of reconstruction algorithms (all P>0.05). DLIR groups had significantly lower SD and higher SNR and CNR values, with better overall image quality than ASIR-V and FBP groups at each mA, ranging from 65-85% reduction in SD, 67-83% increase in SNR with DLIR-H over 50%ASIR-V and 75-91% reduction in SD and 77-89% increase in SNR with DLIR-H over FBP (all P<0.05). At ultra-low dose conditions (30 mA), the DLIR-H images had the highest detection rate of PNs (100%). In addition, the DLIR-M had a minimal negative effect on the characterization of PNs.

CONCLUSIONS

DLIR algorithm can be a potential reconstruction technique to optimize image quality and improve detection rate of PNs in ultra-low dose lung screening.

How AI Can Help in the Diagnostic Dilemma of Pulmonary Nodules

Simple Summary

Pulmonary nodules are considered a sign of bronchogenic carcinoma, detecting them early will reduce their progression and can save lives. Lung cancer is the second most common type of cancer in both men and women. This manuscript discusses the current applications of artificial intelligence (AI) in lung segmentation as well as pulmonary nodule segmentation and classification using computed tomography (CT) scans, published in the last two decades, in addition to the limitations and future prospects in the field of AI.

Abstract

Pulmonary nodules are the precursors of bronchogenic carcinoma, its early detection facilitates early treatment which save a lot of lives. Unfortunately, pulmonary nodule detection and classification are liable to subjective variations with high rate of missing small cancerous lesions which opens the way for implementation of artificial intelligence (AI) and computer aided diagnosis (CAD) systems. The field of deep learning and neural networks is expanding every day with new models designed to overcome diagnostic problems and provide more applicable and simply used models. We aim in this review to briefly discuss the current applications of AI in lung segmentation, pulmonary nodule detection and classification.

Application of Deep Learning in Lung Cancer Imaging Diagnosis

Lung cancer is one of the malignant tumors with the highest fatality rate and nearest to our lives. It poses a great threat to human health and it mainly occurs in smokers. In our country, with the acceleration of industrialization, environmental pollution, and population aging, the cancer burden of lung cancer is increasing day by day. In the diagnosis of lung cancer, Computed Tomography (CT) images are a fairly common visualization tool. CT images visualize all tissues based on the absorption of X-rays. The diseased parts of the lung are collectively referred to as pulmonary nodules, the shape of nodules is different, and the risk of cancer will vary with the shape of nodules. Computer-aided diagnosis (CAD) is a very suitable method to solve this problem because the computer vision model can quickly scan every part of the CT image of the same quality for analysis and will not be affected by fatigue and emotion. The latest advances in deep learning enable computer vision models to help doctors diagnose various diseases, and in some cases, models have shown greater competitiveness than doctors. Based on the opportunity of technological development, the application of computer vision in medical imaging diagnosis of diseases has important research significance and value. In this paper, we have used a deep learning-based model on CT images of lung cancer and verified its effectiveness in the timely and accurate prediction of lungs disease. The proposed model has three parts: (i) detection of lung nodules, (ii) False Positive Reduction of the detected nodules to filter out "false nodules," and (iii) classification of benign and malignant lung nodules. Furthermore, different network structures and loss functions were designed and realized at different stages. Additionally, to fine-tune the proposed deep learning-based mode and improve its accuracy in the detection Lung Nodule Detection, Noudule-Net, which is a detection network structure that combines U-Net and RPN, is proposed. Experimental observations have verified that the proposed scheme has exceptionally improved the expected accuracy and precision ratio of the underlined disease.

Improving Classification Accuracy of Pulmonary Nodules using Simplified Deep Neural Network

Background:

Lung cancer is among the major causes of death in the world. Early detection of lung cancer is a major challenge. These encouraged the development of Computer-Aided Detection (CAD) system.

Objectives:

We designed a CAD system for performance improvement in detecting and classifying pulmonary nodules. Though the system will not replace radiologists, it will be helpful to them in order to accurately diagnose lung cancer.

Methods:

The architecture comprises of two steps, among which in the first step CT scans are pre-processed and the candidates are extracted using the positive and negative annotations provided along with the LUNA16 dataset, and the second step consists of three different neural networks for classifying the pulmonary nodules obtained from the first step. The models in the second step consist of 2D-Convolutional Neural Network (2D-CNN), Visual Geometry Group-16 (VGG-16) and simplified VGG-16, which independently classify pulmonary nodules.

Results:

The classification accuracies achieved for 2D-CNN, VGG-16 and simplified VGG-16 were 99.12%, 98.17% and 99.60%, respectively.

Conclusion:

The integration of deep learning techniques along with machine learning and image processing can serve as a good means of extracting pulmonary nodules and classifying them with improved accuracy. Based on these results, it can be concluded that the transfer learning concept will improve system performance. In addition, performance improves proper designing of the CAD system by considering the amount of dataset and the availability of computing power.

Accurate segmentation for different types of lung nodules on CT images using improved U-Net convolutional network

ABSTRACT

Since lung nodules on computed tomography images can have different shapes, contours, textures or locations and may be attached to neighboring blood vessels or pleural surfaces, accurate segmentation is still challenging. In this study, we propose an accurate segmentation method based on an improved U-Net convolutional network for different types of lung nodules on computed tomography images.The first phase is to segment lung parenchyma and correct the lung contour by applying α-hull algorithm. The second phase is to extract image pairs of patches containing lung nodules in the center and the corresponding ground truth and build an improved U-Net network with introduction of batch normalization.A large number of experiments manifest that segmentation performance of Dice loss has superior results than mean square error and Binary_crossentropy loss. The α-hull algorithm and batch normalization can improve the segmentation performance effectively. Our best result for Dice similar coefficient (0.8623) is also more competitive than other state-of-the-art segmentation algorithms.In order to segment different types of lung nodules accurately, we propose an improved U-Net network, which can improve the segmentation accuracy effectively. Moreover, this work also has practical value in helping radiologists segment lung nodules and diagnose lung cancer.

An efficient multi-path 3D convolutional neural network for false-positive reduction of pulmonary nodule detection

PURPOSE

Considering that false-positive and true pulmonary nodules are highly similar in shapes and sizes between lung computed tomography scans, we develop and evaluate a false-positive nodules reduction method applied to the computer-aided diagnosis system.

METHODS

To improve the pulmonary nodule diagnosis quality, a 3D convolutional neural networks (CNN) model is constructed to effectively extract spatial information of candidate nodule features through the hierarchical architecture. Furthermore, three paths corresponding to three receptive field sizes are adopted and concatenated in the network model, so that the feature information is fully extracted and fused to actively adapting to the changes in shapes, sizes, and contextual information between pulmonary nodules. In this way, the false-positive reduction is well implemented in pulmonary nodule detection.

RESULTS

Multi-path 3D CNN is performed on LUNA16 dataset, which achieves an average competitive performance metric score of 0.881, and excellent sensitivity of 0.952 and 0.962 occurs to 4, 8 FP/Scans.

CONCLUSION

By constructing a multi-path 3D CNN to fully extract candidate target features, it accurately identifies pulmonary nodules with different sizes, shapes, and background information. In addition, the proposed general framework is also suitable for similar 3D medical image classification tasks.

Clinical evaluation of a deep-learning-based computer-aided detection system for the detection of pulmonary nodules in a large teaching hospital

AIM

To evaluate a deep-learning-based computer-aided detection (DL-CAD) software system for pulmonary nodule detection on computed tomography (CT) images and assess its added value in the clinical practice of a large teaching hospital.

MATERIALS AND METHODS

A retrospective analysis was performed of 145 chest CT examinations by comparing the output of the DL-CAD software with a reference standard based on the consensus reading of three radiologists. For every nodule in each scan, the location, composition, and maximum diameter in the axial plane were recorded. The subgroup of chest CT examinations (n = 97) without any nodules was used to determine the negative predictive value at the given clinical sensitivity threshold setting.

RESULTS

The radiologists found 91 nodules and the CAD system 130 nodules of which 80 were true positive. The measured sensitivity was 88% and the mean false-positive rate was 1.04 false positives/scan. The negative predictive value was 95%. For 23 nodules, there was a size discrepancy of which 19 (83%) were measured smaller by the radiologist. The agreement of nodule composition between the CAD results and the reference standard was 95%.

CONCLUSIONS

The present study found a sensitivity of 88% and a false-positive rate of 1.04 false positives/scan, which match the vendor specification. Together with the measured negative predictive value of 95% the system performs very well; however, these rates are still not good enough to replace the radiologist, even for the specific task of nodule detection. Furthermore, a surprisingly high rate of overestimation of nodule size was observed, which can lead to too many follow-up examinations.

An Embedded Multi-branch 3D Convolution Neural Network for False Positive Reduction in Lung Nodule Detection

Numerous lung nodule candidates can be produced through an automated lung nodule detection system. Classifying these candidates to reduce false positives is an important step in the detection process. The objective during this paper is to predict real nodules from a large number of pulmonary nodule candidates. Facing the challenge of the classification task, we propose a novel 3D convolution neural network (CNN) to reduce false positives in lung nodule detection. The novel 3D CNN includes embedded multiple branches in its structure. Each branch processes a feature map from a layer with different depths. All of these branches are cascaded at their ends; thus, features from different depth layers are combined to predict the categories of candidates. The proposed method obtains a competitive score in lung nodule candidate classification on LUNA16 dataset with an accuracy of 0.9783, a sensitivity of 0.8771, a precision of 0.9426, and a specificity of 0.9925. Moreover, a good performance on the competition performance metric (CPM) is also obtained with a score of 0.830. As a 3D CNN, the proposed model can learn complete and three-dimensional discriminative information about nodules and non-nodules to avoid some misidentification problems caused due to lack of spatial correlation information extracted from traditional methods or 2D networks. As an embedded multi-branch structure, the model is also more effective in recognizing the nodules of various shapes and sizes. As a result, the proposed method gains a competitive score on the false positive reduction in lung nodule detection and can be used as a reference for classifying nodule candidates.

Automatic lung nodule detection in thoracic CT scans using dilated slice-wise convolutions

PURPOSE

Most state-of-the-art automated medical image analysis methods for volumetric data rely on adaptations of two-dimensional (2D) and three-dimensional (3D) convolutional neural networks (CNNs). In this paper, we develop a novel unified CNN-based model that combines the benefits of 2D and 3D networks for analyzing volumetric medical images.

METHODS

In our proposed framework, multiscale contextual information is first extracted from 2D slices inside a volume of interest (VOI). This is followed by dilated 1D convolutions across slices to aggregate in-plane features in a slice-wise manner and encode the information in the entire volume. Moreover, we formalize a curriculum learning strategy for a two-stage system (i.e., a system that consists of screening and false positive reduction), where the training samples are presented to the network in a meaningful order to further improve the performance.

RESULTS

We evaluated the proposed approach by developing a computer-aided detection (CADe) system for lung nodules. Our results on 888 CT exams demonstrate that the proposed approach can effectively analyze volumetric data by achieving a sensitivity of > 0.99 in the screening stage and a sensitivity of > 0.96 at eight false positives per case in the false positive reduction stage.

CONCLUSION

Our experimental results show that the proposed method provides competitive results compared to state-of-the-art 3D frameworks. In addition, we illustrate the benefits of curriculum learning strategies in two-stage systems that are of common use in medical imaging applications.

Attention-embedded complementary-stream CNN for false positive reduction in pulmonary nodule detection

False positive reduction plays a key role in computer-aided detection systems for pulmonary nodule detection in computed tomography (CT) scans. However, this remains a challenge owing to the heterogeneity and similarity of anisotropic pulmonary nodules. In this study, a novel attention-embedded complementary-stream convolutional neural network (AECS-CNN) is proposed to obtain more representative features of nodules for false positive reduction. The proposed network comprises three function blocks: 1) attention-guided multi-scale feature extraction, 2) complementary-stream block with an attention module for feature integration, and 3) classification block. The inputs of the network are multi-scale 3D CT volumes due to variations in nodule sizes. Subsequently, a gradual multi-scale feature extraction block with an attention module was applied to acquire more contextual information regarding the nodules. A subsequent complementary-stream integration block with an attention module was utilized to learn the significantly complementary features. Finally, the candidates were classified using a fully connected layer block. An exhaustive experiment on the LUNA16 challenge dataset was conducted to verify the effectiveness and performance of the proposed network. The AECS-CNN achieved a sensitivity of 0.92 with 4 false positives per scan. The results indicate that the attention mechanism can improve the network performance in false positive reduction, the proposed AECS-CNN can learn more representative features, and the attention module can guide the network to learn the discriminated feature channels and the crucial information embedded in the data, thereby effectively enhancing the performance of the detection system.

Multiscale CNN with compound fusions for false positive reduction in lung nodule detection

Pulmonary lung nodules are often benign at the early stage but they could easily become malignant and metastasize to other locations in later stages. Morphological characteristics of these nodule instances vary largely in terms of their size, shape, and texture. There are also other co-existing lung anatomical structures such as lung walls and blood vessels surrounding these nodules resulting in complex contextual information. As a result, their early diagnosis to enable decisive intervention using Computer-Aided Diagnosis (CAD) systems face serious challenges, especially at low false positive rates. In this paper, we propose a new Convolutional Neural Network (CNN) architecture called Multiscale CNN with Compound Fusions (MCNN-CF) for this purpose which uses multiscale 3D patches as inputs and performs a fusion of intermediate features at two different depths of the network in two diverse fashions. The network is trained by a new iterative training procedure adapted to circumvent the class imbalance problem and obtained a Competitive Performance Metric (CPM) score of 0.948 when tested on the LUNA16 dataset. Experimental results illustrate the robustness of the proposed system which has increased the confidence of the prediction probabilities in the detection of the most variety of nodules.

Multi-level 3D Densenets for False-positive Reduction in Lung Nodule Detection Based on Chest Computed Tomography

OBJECTIVE

False-positive nodule reduction is a crucial part of a computer-aided detection (CADe) system, which assists radiologists in accurate lung nodule detection. In this research, a novel scheme using multi-level 3D DenseNet framework is proposed to implement false-positive nodule reduction task.

METHODS

Multi-level 3D DenseNet models were extended to differentiate lung nodules from falsepositive nodules. First, different models were fed with 3D cubes with different sizes for encoding multi-level contextual information to meet the challenges of the large variations of lung nodules. In addition, image rotation and flipping were utilized to upsample positive samples which consisted of a positive sample set. Furthermore, the 3D DenseNets were designed to keep low-level information of nodules, as densely connected structures in DenseNet can reuse features of lung nodules and then boost feature propagation. Finally, the optimal weighted linear combination of all model scores obtained the best classification result in this research.

RESULTS

The proposed method was evaluated with LUNA16 dataset which contained 888 thin-slice CT scans. The performance was validated via 10-fold cross-validation. Both the Free-response Receiver Operating Characteristic (FROC) curve and the Competition Performance Metric (CPM) score show that the proposed scheme can achieve a satisfactory detection performance in the falsepositive reduction track of the LUNA16 challenge.

CONCLUSION

The result shows that the proposed scheme can be significant for false-positive nodule reduction task.

2D CNN versus 3D CNN for false-positive reduction in lung cancer screening

Purpose: To clarify whether and to what extent three-dimensional (3D) convolutional neural network (CNN) is superior to 2D CNN when applied to reduce false-positive nodule detections in the scenario of low-dose computed tomography (CT) lung cancer screening. Approach: We established a dataset consisting of 1600 chest CT examinations acquired on different subjects from various sources. There were in total 18,280 candidate nodules in these CT examinations, among which 9185 were nodules and 9095 were not nodules. For each candidate nodule, we extracted a number of cubic subvolumes with a dimension of 72 × 72 × 72    mm 3 by rotating the CT examinations randomly for 25 times prior to the extraction of the axis-aligned subvolumes. These subvolumes were split into three groups in a ratio of 8 ∶ 1 ∶ 1 for training, validation, and independent testing purposes. We developed a multiscale CNN architecture and implemented its 2D and 3D versions to classify pulmonary nodules into two categories, namely true positive and false positive. The performance of the 2D/3D-CNN classification schemes was evaluated using the area under the receiver operating characteristic curves (AUC). The p -values and the 95% confidence intervals (CI) were calculated. Results: The AUC for the optimal 2D-CNN model is 0.9307 (95% CI: 0.9285 to 0.9330) with a sensitivity of 92.70% and a specificity of 76.21%. The 3D-CNN model with the best performance had an AUC of 0.9541 (95% CI: 0.9495 to 0.9583) with a sensitivity of 89.98% and a specificity of 87.30%. The developed multiscale CNN architecture had a better performance than the vanilla architecture did. Conclusions: The 3D-CNN model has a better performance in false-positive reduction compared with its 2D counterpart; however, the improvement is relatively limited and demands more computational resources for training purposes.

Detection of pulmonary nodules based on a multiscale feature 3D U-Net convolutional neural network of transfer learning

A new computer-aided detection scheme is proposed, the 3D U-Net convolutional neural network, based on multiscale features of transfer learning to automatically detect pulmonary nodules from the thoracic region containing background and noise. The test results can be used as reference information for doctors to assist in the detection of early lung cancer. The proposed scheme is composed of three major steps: First, the pulmonary parenchyma area is segmented by various methods. Then, the 3D U-Net convolutional neural network model with a multiscale feature structure is built. The network model structure is subsequently fine-tuned by the transfer learning method based on weight, and the optimal parameters are selected in the network model. Finally, datasets are extracted to train the fine-tuned 3D U-Net network model to detect pulmonary nodules. The five-fold cross-validation method is used to obtain the experimental results for the LUNA16 and TIANCHI17 datasets. The experimental results show that the scheme not only has obvious advantages in the detection of medium and large-sized nodules but also has an accuracy rate of more than 70% for the detection of small-sized nodules. The scheme provides automatic and accurate detection of pulmonary nodules that reduces the overfitting rate and training time and improves the efficiency of the algorithm. It can assist doctors in the diagnosis of lung cancer and can be extended to other medical image detection and recognition fields.

Automated lung cancer diagnosis using three-dimensional convolutional neural networks

Lung cancer is the deadliest cancer worldwide. It has been shown that early detection using low-dose computer tomography (LDCT) scans can reduce deaths caused by this disease. We present a general framework for the detection of lung cancer in chest LDCT images. Our method consists of a nodule detector trained on the LIDC-IDRI dataset followed by a cancer predictor trained on the Kaggle DSB 2017 dataset and evaluated on the IEEE International Symposium on Biomedical Imaging (ISBI) 2018 Lung Nodule Malignancy Prediction test set. Our candidate extraction approach is effective to produce accurate candidates with a recall of 99.6%. In addition, our false positive reduction stage classifies successfully the candidates and increases precision by a factor of 2000. Our cancer predictor obtained a ROC AUC of 0.913 and was ranked 1st place at the ISBI 2018 Lung Nodule Malignancy Prediction challenge. Graphical abstract.

Automatic Pulmonary Nodule Detection in CT Scans Using Convolutional Neural Networks Based on Maximum Intensity Projection

Accurate pulmonary nodule detection is a crucial step in lung cancer screening. Computer-aided detection (CAD) systems are not routinely used by radiologists for pulmonary nodule detection in clinical practice despite their potential benefits. Maximum intensity projection (MIP) images improve the detection of pulmonary nodules in radiological evaluation with computed tomography (CT) scans. Inspired by the clinical methodology of radiologists, we aim to explore the feasibility of applying MIP images to improve the effectiveness of automatic lung nodule detection using convolutional neural networks (CNNs). We propose a CNN-based approach that takes MIP images of different slab thicknesses (5 mm, 10 mm, 15 mm) and 1 mm axial section slices as input. Such an approach augments the two-dimensional (2-D) CT slice images with more representative spatial information that helps discriminate nodules from vessels through their morphologies. Our proposed method achieves sensitivity of 92.7% with 1 false positive per scan and sensitivity of 94.2% with 2 false positives per scan for lung nodule detection on 888 scans in the LIDC-IDRI dataset. The use of thick MIP images helps the detection of small pulmonary nodules (3 mm-10 mm) and results in fewer false positives. Experimental results show that utilizing MIP images can increase the sensitivity and lower the number of false positives, which demonstrates the effectiveness and significance of the proposed MIP-based CNNs framework for automatic pulmonary nodule detection in CT scans. The proposed method also shows the potential that CNNs could gain benefits for nodule detection by combining the clinical procedure.

Spline curve deformation model with prior shapes for identifying adhesion boundaries between large lung tumors and tissues around lungs in CT images

PURPOSE

Automated segmentation of lung tumors attached to anatomic structures such as the chest wall or mediastinum remains a technical challenge because of the similar Hounsfield units of these structures. To address this challenge, we propose herein a spline curve deformation model that combines prior shapes to correct large spatially contiguous errors (LSCEs) in input shapes derived from image-appearance cues.The model is then used to identify the adhesion boundaries between large lung tumors and tissue around the lungs.

METHODS

The deformation of the whole curve is driven by the transformation of the control points (CPs) of the spline curve, which are influenced by external and internal forces. The external force drives the model to fit the positions of the non-LSCEs of the input shapes while the internal force ensures the local similarity of the displacements of the neighboring CPs. The proposed model corrects the gross errors in the lung input shape caused by large lung tumors, where the initial lung shape for the model is inferred from the training shapes by shape group-based sparse prior information and the input lung shape is inferred by adaptive-thresholding-based segmentation followed by morphological refinement.

RESULTS

The accuracy of the proposed model is verified by applying it to images of lungs with either moderate large-sized (ML) tumors or giant large-sized (GL) tumors. The quantitative results in terms of the averages of the dice similarity coefficient (DSC) and the Jaccard similarity index (SI) are 0.982 ± 0.006 and 0.965 ± 0.012 for segmentation of lungs adhered by ML tumors, and 0.952 ± 0.048 and 0.926 ± 0.059 for segmentation of lungs adhered by GL tumors, which give 0.943 ± 0.021 and 0.897 ± 0.041 for segmentation of the ML tumors, and 0.907 ± 0.057 and 0.888 ± 0.091 for segmentation of the GL tumors, respectively. In addition, the bidirectional Hausdorff distances are 5.7 ± 1.4 and 11.3 ± 2.5 mm for segmentation of lungs with ML and GL tumors, respectively.

CONCLUSIONS

When combined with prior shapes, the proposed spline curve deformation can deal with large spatially consecutive errors in object shapes obtained from image-appearance information. We verified this method by applying it to the segmentation of lungs with large tumors adhered to the tissue around the lungs and the large tumors. Both the qualitative and quantitative results are more accurate and repeatable than results obtained with current state-of-the-art techniques.

Deep Learning for Lung Cancer Nodules Detection and Classification in CT Scans

Detecting malignant lung nodules from computed tomography (CT) scans is a hard and time-consuming task for radiologists. To alleviate this burden, computer-aided diagnosis (CAD) systems have been proposed. In recent years, deep learning approaches have shown impressive results outperforming classical methods in various fields. Nowadays, researchers are trying different deep learning techniques to increase the performance of CAD systems in lung cancer screening with computed tomography. In this work, we review recent state-of-the-art deep learning algorithms and architectures proposed as CAD systems for lung cancer detection. They are divided into two categories—(1) Nodule detection systems, which from the original CT scan detect candidate nodules; and (2) False positive reduction systems, which from a set of given candidate nodules classify them into benign or malignant tumors. The main characteristics of the different techniques are presented, and their performance is analyzed. The CT lung datasets available for research are also introduced. Comparison between the different techniques is presented and discussed.

An adaptive pulmonary nodule detection algorithm

Recently, lung cancer has been paid more and more attention. People have reached a consensus that early detection and early treatment can improve the survival rate of patients. Among them, pulmonary nodules are the important reference for doctors to determine the lung health. With the continuous improvement of CT image resolution, more suspected pulmonary nodule information appears from the impact of chest CT. How to relatively and accurately locate the suspected nodule location from a large number of CT images has brought challenges to the doctor's daily diagnosis. To solve the problem that the original DBSCAN clustering algorithm needs manual setting of the threshold, this paper proposes a region growing algorithm and an adaptive DBSCAN clustering algorithm to improve the accuracy of pulmonary nodule detection. The image is roughly processed and ROI (Regions of Interest) region is roughly extracted by CLAHE transform. The region growing algorithm is used to roughly process the adjacent region's expansibility and the suspected region in ROI, and mark the center point in the region and the boundary point of its point set. The mean value of region range is taken as the threshold value of DBSCAN clustering algorithm. The center of the point domain is used as the starting point of clustering, and the rough set of points is used as the MinPts threshold. Finally, the clustering results are labeled in the initial CT image. Experiments show that the pulmonary nodule detection method proposed in this paper effectively improves the accuracy of the detection results.

A Computer-Aided Detection System for the Detection of Lung Nodules Based on 3D-ResNet

In recent years, the research into automatic aided detection systems for pulmonary nodules has been extremely active. Most of the existing studies are based on 2D convolution neural networks, which cannot make full use of computed tomography’s (CT) 3D spatial information. To address this problem, a computer-aided detection (CAD) system for lung nodules based on a 3D residual network (3D-ResNet) inspired by cognitive science is proposed in this paper. In this system, we feed the slice information extracted from three different axis planes into the U-NET network set, and make the joint decision to generate a candidate nodule set, which is the input of the proposed 3D residual network after extraction. We extracted 3D samples with 40, 44, 48, 52, and 56 mm sides from each candidate nodule in the candidate set and feed them into the trained residual network to get the probability of positive nodule after re-sampling the 3D sample to 48 × 48 × 48 mm 3 . Finally, a joint judgment is made based on the probabilities of five 3D samples of different sizes to obtain the final result. Random rotation and translation and data amplification technology are used to prevent overfitting during network training. The detection intensity on the largest public data set (i.e., the Lung Image Database Consortium and Image Database Resource Initiative—LIDC-IDRI) reached 86.5% and 92.3% at 1 frame per second (FPs) and 4 FPs respectively using our algorithm, which is better than most CAD systems using 2D convolutional neural networks. In addition, a 3D residual network and a multi-section 2D convolution neural network were tested on the unrelated Tianchi dataset. The results indicate that 3D-ResNet has better feature extraction ability than multi-section 2D-ConvNet and is more suitable for reduction of false positive nodules.

Evolving the pulmonary nodules diagnosis from classical approaches to deep learning-aided decision support: three decades' development course and future prospect

PURPOSE

Lung cancer is the commonest cause of cancer deaths worldwide, and its mortality can be reduced significantly by performing early diagnosis and screening. Since the 1960s, driven by the pressing needs to accurately and effectively interpret the massive volume of chest images generated daily, computer-assisted diagnosis of pulmonary nodule has opened up new opportunities to relax the limitation from physicians' subjectivity, experiences and fatigue. And the fair access to the reliable and affordable computer-assisted diagnosis will fight the inequalities in incidence and mortality between populations. It has been witnessed that significant and remarkable advances have been achieved since the 1980s, and consistent endeavors have been exerted to deal with the grand challenges on how to accurately detect the pulmonary nodules with high sensitivity at low false-positive rate as well as on how to precisely differentiate between benign and malignant nodules. There is a lack of comprehensive examination of the techniques' development which is evolving the pulmonary nodules diagnosis from classical approaches to machine learning-assisted decision support. The main goal of this investigation is to provide a comprehensive state-of-the-art review of the computer-assisted nodules detection and benign-malignant classification techniques developed over three decades, which have evolved from the complicated ad hoc analysis pipeline of conventional approaches to the simplified seamlessly integrated deep learning techniques. This review also identifies challenges and highlights opportunities for future work in learning models, learning algorithms and enhancement schemes for bridging current state to future prospect and satisfying future demand.

CONCLUSION

It is the first literature review of the past 30 years' development in computer-assisted diagnosis of lung nodules. The challenges indentified and the research opportunities highlighted in this survey are significant for bridging current state to future prospect and satisfying future demand. The values of multifaceted driving forces and multidisciplinary researches are acknowledged that will make the computer-assisted diagnosis of pulmonary nodules enter into the main stream of clinical medicine and raise the state-of-the-art clinical applications as well as increase both welfares of physicians and patients. We firmly hold the vision that fair access to the reliable, faithful, and affordable computer-assisted diagnosis for early cancer diagnosis would fight the inequalities in incidence and mortality between populations, and save more lives.

Automatic classification of lung nodule candidates based on a novel 3D convolution network and knowledge transferred from a 2D network

OBJECTIVE

In the automatic lung nodule detection system, the authenticity of a large number of nodule candidates needs to be judged, which is a classification task. However, the variable shapes and sizes of the lung nodules have posed a great challenge to the classification of candidates. To solve this problem, we propose a method for classifying nodule candidates through three-dimensional (3D) convolution neural network (ConvNet) model which is trained by transferring knowledge from a multiresolution two-dimensional (2D) ConvNet model.

METHODS

In this scheme, a novel 3D ConvNet model is preweighted with the weights of the trained 2D ConvNet model, and then the 3D ConvNet model is trained with 3D image volumes. In this way, the knowledge transfer method can make 3D network easier to converge and make full use of the spatial information of nodules with different sizes and shapes to improve the classification accuracy.

RESULTS

The experimental results on 551 065 pulmonary nodule candidates in the LUNA16 dataset show that our method gains a competitive average score in the false-positive reduction track in lung nodule detection, with the sensitivities of 0.619 and 0.642 at 0.125 and 0.25 FPs per scan, respectively.

CONCLUSIONS

The proposed method can maintain satisfactory classification accuracy even when the false-positive rate is extremely small in the face of nodules of different sizes and shapes. Moreover, as a transfer learning idea, the method to transfer knowledge from 2D ConvNet to 3D ConvNet is the first attempt to carry out full migration of parameters of various layers including convolution layers, full connection layers, and classifier between different dimensional models, which is more conducive to utilizing the existing 2D ConvNet resources and generalizing transfer learning schemes.

MR-Forest: A Deep Decision Framework for False Positive Reduction in Pulmonary Nodule Detection

With the development of deep learning methods such as convolutional neural network (CNN), the accuracy of automated pulmonary nodule detection has been greatly improved. However, the high computational and storage costs of the large-scale network have been a potential concern for the future widespread clinical application. In this paper, an alternative Multi-ringed (MR)-Forest framework, against the resource-consuming neural networks (NN)-based architectures, has been proposed for false positive reduction in pulmonary nodule detection, which consists of three steps. First, a novel multi-ringed scanning method is used to extract the order ring facets (ORFs) from the surface voxels of the volumetric nodule models; Second, Mesh-LBP and mapping deformation are employed to estimate the texture and shape features. By sliding and resampling the multi-ringed ORFs, feature volumes with different lengths are generated. Finally, the outputs of multi-level are cascaded to predict the candidate class. On 1034 scans merging the dataset from the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine (AH-LUTCM) and the LUNA16 Challenge dataset, our framework performs enough competitiveness than state-of-the-art in false positive reduction task (CPM score of 0.865). Experimental results demonstrate that MR-Forest is a successful solution to satisfy both resource-consuming and effectiveness for automated pulmonary nodule detection. The proposed MR-forest is a general architecture for 3D target detection, it can be easily extended in many other medical imaging analysis tasks, where the growth trend of the targeting object is approximated as a spheroidal expansion.

Consistency of radiologists in identifying pulmonary nodules based on low-dose computed tomography

Background

To study the consistency of radiologists in identifying pulmonary nodules based on low-dose computed tomography (LDCT), and to analyze factors that affect the consistency.

Methods

A total of 750 LDCT cases were collected randomly from three medical centers. Three experienced chest radiologists independently evaluated and detected the pulmonary nodules on 625 cases of LDCT images. The detected nodules were classified into 3 groups: group I (detected by all radiologists); group II (detected by two radiologists); group III (detected by only one radiologist). The consistency with respect to the image features of individual nodules was assessed.

Results

A total of 1,206 nodules were identified by the three radiologists. There were 234 (19.4%) nodules in group I, 377 (31.3%) nodules in group II, and 595 (49.3%) nodules in group III. Logistic regression showed that the size, density, and location of the nodules correlated with the detection of nodules. Nodules sized great than or equal to 4 mm were more consistently identified than nodules sized less than 4 mm. Solid and calcified nodules were more consistently identified than sub-solid nodules. Nodules located in the outer zone were more consistently identified than hilar nodules.

Conclusions

There was considerable inter-reader variability with respect to identification of pulmonary nodules in LDCT. Larger nodules, solid or calcified nodules, and nodules located in the outer zone were more consistently identified.

Multi-Scale Heterogeneous 3D CNN for False-Positive Reduction in Pulmonary Nodule Detection, Based on Chest CT Images

Currently, lung cancer has one of the highest mortality rates because it is often caught too late. Therefore, early detection is essential to reduce the risk of death. Pulmonary nodules are considered key indicators of primary lung cancer. Developing an efficient and accurate computer-aided diagnosis system for pulmonary nodule detection is an important goal. Typically, a computer-aided diagnosis system for pulmonary nodule detection consists of two parts: candidate nodule extraction and false-positive reduction of candidate nodules. The reduction of false positives (FPs) of candidate nodules remains an important challenge due to morphological characteristics of nodule height changes and similar characteristics to other organs. In this study, we propose a novel multi-scale heterogeneous three-dimensional (3D) convolutional neural network (MSH-CNN) based on chest computed tomography (CT) images. There are three main strategies of the design: (1) using multi-scale 3D nodule blocks with different levels of contextual information as inputs; (2) using two different branches of 3D CNN to extract the expression features; (3) using a set of weights which are determined by back propagation to fuse the expression features produced by step 2. In order to test the performance of the algorithm, we trained and tested on the Lung Nodule Analysis 2016 (LUNA16) dataset, achieving an average competitive performance metric (CPM) score of 0.874 and a sensitivity of 91.7% at two FPs/scan. Moreover, our framework is universal and can be easily extended to other candidate false-positive reduction tasks in 3D object detection, as well as 3D object classification.

Unsupervised abnormality detection through mixed structure regularization (MSR) in deep sparse autoencoders

PURPOSE

The purpose of this study is to introduce and evaluate the mixed structure regularization (MSR) approach for a deep sparse autoencoder aimed at unsupervised abnormality detection in medical images. Unsupervised abnormality detection based on identifying outliers using deep sparse autoencoders is a very appealing approach for computer-aided detection systems as it requires only healthy data for training rather than expert annotated abnormality. However, regularization is required to avoid overfitting of the network to the training data.

METHODS

We used coronary computed tomography angiography (CCTA) datasets of 90 subjects with expert annotated centerlines. We segmented coronary lumen and wall using an automatic algorithm with manual corrections where required. We defined normal coronary cross section as cross sections with a ratio between lumen and wall areas larger than 0.8. We divided the datasets into training, validation, and testing groups in a tenfold cross-validation scheme. We trained a deep sparse overcomplete autoencoder model for normality modeling with random structure and noise augmentation. We assessed the performance of our deep sparse autoencoder with MSR without denoising (SAE-MSR) and with denoising (SDAE-MSR) in comparison to deep sparse autoencoder (SAE), and deep sparse denoising autoencoder (SDAE) models in the task of detecting coronary artery disease from CCTA data on the test group.

RESULTS

The SDAE-MSR achieved the best aggregated area under the curve (AUC) with a 20% improvement and the best aggregated Average Precision (AP) with a 30% improvement upon the SAE and SDAE (AUC: 0.78 to 0.94, AP: 0.66 to 0.86) in distinguishing between coronary cross sections with mild stenosis (stenosis grade < 0.3) and coronary cross sections with severe stenosis (stenosis grade > 0.7). The improvements were statistically significant (Mann-Whitney U-test, P < 0.001). Similarly, The SDAE-MSR achieved the best aggregated AUC (AP) with an 18% (18%) improvement upon the SAE and SDAE (AUC: 0.71 to 0.84, AP: 0.68 to 0.80). The improvements were statistically significant (Mann-Whitney U-test, P < 0.05).

CONCLUSION

Deep sparse autoencoders with MSR in addition to explicit sparsity regularization term and stochastic corruption of the input data with Gaussian noise have the potential to improve unsupervised abnormality detection using deep-learning compared to common deep autoencoders.

Multi-scale gradual integration CNN for false positive reduction in pulmonary nodule detection

Lung cancer is a global and dangerous disease, and its early detection is crucial for reducing the risks of mortality. In this regard, it has been of great interest in developing a computer-aided system for pulmonary nodules detection as early as possible on thoracic CT scans. In general, a nodule detection system involves two steps: (i) candidate nodule detection at a high sensitivity, which captures many false positives and (ii) false positive reduction from candidates. However, due to the high variation of nodule morphological characteristics and the possibility of mistaking them for neighboring organs, candidate nodule detection remains a challenge. In this study, we propose a novel Multi-scale Gradual Integration Convolutional Neural Network (MGI-CNN), designed with three main strategies: (1) to use multi-scale inputs with different levels of contextual information, (2) to use abstract information inherent in different input scales with gradual integration, and (3) to learn multi-stream feature integration in an end-to-end manner. To verify the efficacy of the proposed network, we conducted exhaustive experiments on the LUNA16 challenge datasets by comparing the performance of the proposed method with state-of-the-art methods in the literature. On two candidate subsets of the LUNA16 dataset, i.e., V1 and V2, our method achieved an average CPM of 0.908 (V1) and 0.942 (V2), outperforming comparable methods by a large margin. Our MGI-CNN is implemented in Python using TensorFlow and the source code is available from https://github.com/ku-milab/MGICNN.

Improving Accuracy of Lung Nodule Classification Using Deep Learning with Focal Loss

Early detection and classification of pulmonary nodules using computer-aided diagnosis (CAD) systems is useful in reducing mortality rates of lung cancer. In this paper, we propose a new deep learning method to improve classification accuracy of pulmonary nodules in computed tomography (CT) scans. Our method uses a novel 15-layer 2D deep convolutional neural network architecture for automatic feature extraction and classification of pulmonary candidates as nodule or nonnodule. Focal loss function is then applied to the training process to boost classification accuracy of the model. We evaluated our method on the LIDC/IDRI dataset extracted by the LUNA16 challenge. The experiments showed that our deep learning method with focal loss is a high-quality classifier with an accuracy of 97.2%, sensitivity of 96.0%, and specificity of 97.3%.

Evaluating the performance of a deep learning-based computer-aided diagnosis (DL-CAD) system for detecting and characterizing lung nodules: Comparison with the performance of double reading by radiologists

Background

The study was conducted to evaluate the performance of a state‐of‐the‐art commercial deep learning‐based computer‐aided diagnosis (DL‐CAD) system for detecting and characterizing pulmonary nodules.

Methods

Pulmonary nodules in 346 healthy subjects (male: female = 221:125, mean age 51 years) from a lung cancer screening program conducted from March to November 2017 were screened using a DL‐CAD system and double reading independently, and their performance in nodule detection and characterization were evaluated. An expert panel combined the results of the DL‐CAD system and double reading as the reference standard.

Results

The DL‐CAD system showed a higher detection rate than double reading, regardless of nodule size (86.2% vs. 79.2%; P < 0.001): nodules ≥ 5 mm (96.5% vs. 88.0%; P = 0.008); nodules < 5 mm (84.3% vs. 77.5%; P < 0.001). However, the false positive rate (per computed tomography scan) of the DL‐CAD system (1.53, 529/346) was considerably higher than that of double reading (0.13, 44/346; P < 0.001). Regarding nodule characterization, the sensitivity and specificity of the DL‐CAD system for distinguishing solid nodules > 5 mm (90.3% and 100.0%, respectively) and ground‐glass nodules (100.0% and 96.1%, respectively) were close to that of double reading, but dropped to 55.5% and 93%, respectively, when discriminating part solid nodules.

Conclusion

Our DL‐CAD system detected significantly more nodules than double reading. In the future, false positive findings should be further reduced and characterization accuracy improved.

Classification of lung nodules in CT scans using three-dimensional deep convolutional neural networks with a checkpoint ensemble method

BACKGROUND

Accurately detecting and examining lung nodules early is key in diagnosing lung cancers and thus one of the best ways to prevent lung cancer deaths. Radiologists spend countless hours detecting small spherical-shaped nodules in computed tomography (CT) images. In addition, even after detecting nodule candidates, a considerable amount of effort and time is required for them to determine whether they are real nodules. The aim of this paper is to introduce a high performance nodule classification method that uses three dimensional deep convolutional neural networks (DCNNs) and an ensemble method to distinguish nodules between non-nodules.

METHODS

In this paper, we use a three dimensional deep convolutional neural network (3D DCNN) with shortcut connections and a 3D DCNN with dense connections for lung nodule classification. The shortcut connections and dense connections successfully alleviate the gradient vanishing problem by allowing the gradient to pass quickly and directly. Connections help deep structured networks to obtain general as well as distinctive features of lung nodules. Moreover, we increased the dimension of DCNNs from two to three to capture 3D features. Compared with shallow 3D CNNs used in previous studies, deep 3D CNNs more effectively capture the features of spherical-shaped nodules. In addition, we use an alternative ensemble method called the checkpoint ensemble method to boost performance.

RESULTS

The performance of our nodule classification method is compared with that of the state-of-the-art methods which were used in the LUng Nodule Analysis 2016 Challenge. Our method achieves higher competition performance metric (CPM) scores than the state-of-the-art methods using deep learning. In the experimental setup ESB-ALL, the 3D DCNN with shortcut connections and the 3D DCNN with dense connections using the checkpoint ensemble method achieved the highest CPM score of 0.910.

CONCLUSION

The result demonstrates that our method of using a 3D DCNN with shortcut connections, a 3D DCNN with dense connections, and the checkpoint ensemble method is effective for capturing 3D features of nodules and distinguishing nodules between non-nodules.

Automatic nodule detection for lung cancer in CT images: A review

Automatic lung nodule detection has great significance for treating lung cancer and increasing patient survival. This work summarizes a critical review of recent techniques for automatic lung nodule detection in computed tomography images. This review indicates the current tendency and obtained progress as well as future challenges in this field. This research covered the databases including Web of Science, PubMed, and the Press, including IEEE Xplore and Science Direct, up to May 2018. Each part of the paper is summarized carefully in terms of the method and validation results for better comparison. Based on the results, some techniques show better performance for lung nodule detection. However, researchers should pay attention to the existing challenges, such as high sensitivity with a low false positive rate, large and different patient databases, developing or optimizing the detection technique of various types of lung nodules with different sizes, shapes, textures and locations, combining electronic medical records and picture archiving and communication systems, building efficient feature sets for better classification and promoting the cooperation and communication between academic institutions and medical organizations. We believe that automatic computer-aided detection systems will be developed with strong robustness, high efficiency and security assurance. This review will be helpful for professional researchers and radiologists to further learn about the latest techniques in computer-aided detection systems.

Small lung nodules detection based on local variance analysis and probabilistic neural network

BACKGROUND AND OBJECTIVE

In medical examinations doctors use various techniques in order to provide to the patients an accurate analysis of their actual state of health. One of the commonly used methodologies is the x-ray screening. This examination very often help to diagnose some diseases of chest organs. The most frequent cause of wrong diagnosis lie in the radiologist's difficulty in interpreting the presence of lungs carcinoma in chest X-ray. In such circumstances, an automated approach could be highly advantageous as it provides important help in medical diagnosis.

METHODS

In this paper we propose a new classification method of the lung carcinomas. This method start with the localization and extraction of the lung nodules by computing, for each pixel of the original image, the local variance obtaining an output image (variance image) with the same size of the original image. In the variance image we find the local maxima and then by using the locations of these maxima in the original image we found the contours of the possible nodules in lung tissues. However after this segmentation stage we find many false nodules. Therefore to discriminate the true ones we use a probabilistic neural network as classifier.

RESULTS

The performance of our approach is 92% of correct classifications, while the sensitivity is 95% and the specificity is 89.7%. The misclassification errors are due to the fact that network confuses false nodules with the true ones (6%) and true nodules with the false ones (2%).

CONCLUSIONS

Several researchers have proposed automated algorithms to detect and classify pulmonary nodules but these methods fail to detect low-contrast nodules and have a high computational complexity, in contrast our method is relatively simple but at the same time provides good results and can detect low-contrast nodules. Furthermore, in this paper is presented a new algorithm for training the PNN neural networks that allows to obtain PNNs with many fewer neurons compared to the neural networks obtained by using the training algorithms present in the literature. So considerably lowering the computational burden of the trained network and at same time keeping the same performances.

Evolutionary image simplification for lung nodule classification with convolutional neural networks

PURPOSE

Understanding decisions of deep learning techniques is important. Especially in the medical field, the reasons for a decision in a classification task are as crucial as the pure classification results. In this article, we propose a new approach to compute relevant parts of a medical image. Knowing the relevant parts makes it easier to understand decisions.

METHODS

In our approach, a convolutional neural network is employed to learn structures of images of lung nodules. Then, an evolutionary algorithm is applied to compute a simplified version of an unknown image based on the learned structures by the convolutional neural network. In the simplified version, irrelevant parts are removed from the original image.

RESULTS

In the results, we show simplified images which allow the observer to focus on the relevant parts. In these images, more than 50% of the pixels are simplified. The simplified pixels do not change the meaning of the images based on the learned structures by the convolutional neural network. An experimental analysis shows the potential of the approach. Besides the examples of simplified images, we analyze the run time development.

CONCLUSIONS

Simplified images make it easier to focus on relevant parts and to find reasons for a decision. The combination of an evolutionary algorithm employing a learned convolutional neural network is well suited for the simplification task. From a research perspective, it is interesting which areas of the images are simplified and which parts are taken as relevant.