Comparison and Validation of Deep Learning Models for the Diagnosis of Pneumonia

Clinical applications of artificial intelligence in identification and management of bacterial infection: Systematic review and meta-analysis

Pneumonia is declared a global emergency public health crisis in children less than five age and the geriatric population. Recent advancements in deep learning models could be utilized effectively for the timely and early diagnosis of pneumonia in immune-compromised patients to avoid complications. This systematic review and meta-analysis utilized PRISMA guidelines for the selection of ten articles included in this study. The literature search was done through electronic databases including PubMed, Scopus, and Google Scholar from 1st January 2016 till 1 July 2023. Overall studies included a total of 126,610 images and 1706 patients in this meta-analysis. At a 95% confidence interval, for pooled sensitivity was 0.90 (0.85-0.94) and I2 statistics 90.20 (88.56 - 91.92). The pooled specificity for deep learning models' diagnostic accuracy was 0.89 (0.86---0.92) and I2 statistics 92.72 (91.50 - 94.83). I2 statistics showed low heterogeneity across studies highlighting consistent and reliable estimates, and instilling confidence in these findings for researchers and healthcare practitioners. The study highlighted the recent deep learning models single or in combination with high accuracy, sensitivity, and specificity to ensure reliable use for bacterial pneumonia identification and differentiate from other viral, fungal pneumonia in children and adults through chest x-rays and radiographs.

Improving Computer-Aided Thoracic Disease Diagnosis through Comparative Analysis Using Chest X-ray Images Taken at Different Times

Medical professionals in thoracic medicine routinely analyze chest X-ray images, often comparing pairs of images taken at different times to detect lesions or anomalies in patients. This research aims to design a computer-aided diagnosis system that enhances the efficiency of thoracic physicians in comparing and diagnosing X-ray images, ultimately reducing misjudgments. The proposed system encompasses four key components: segmentation, alignment, comparison, and classification of lung X-ray images. Utilizing a public NIH Chest X-ray14 dataset and a local dataset gathered by the Chiayi Christian Hospital in Taiwan, the efficacy of both the traditional methods and deep-learning methods were compared. Experimental results indicate that, in both the segmentation and alignment stages, the deep-learning method outperforms the traditional method, achieving higher average IoU, detection rates, and significantly reduced processing time. In the comparison stage, we designed nonlinear transfer functions to highlight the differences between pre- and post-images through heat maps. In the classification stage, single-input and dual-input network architectures were proposed. The inclusion of difference information in single-input networks enhances AUC by approximately 1%, and dual-input networks achieve a 1.2-1.4% AUC increase, underscoring the importance of difference images in lung disease identification and classification based on chest X-ray images. While the proposed system is still in its early stages and far from clinical application, the results demonstrate potential steps forward in the development of a comprehensive computer-aided diagnostic system for comparative analysis of chest X-ray images.

Deep Learning-Based Computer-Aided Detection System for Preoperative Chest Radiographs to Predict Postoperative Pneumonia

RATIONALE AND OBJECTIVES

The role of preoperative chest radiography (CR) for prediction of postoperative pneumonia remains uncertain. We aimed to develop and validate a prediction model for postoperative pneumonia incorporating findings of preoperative CRs evaluated by a deep learning-based computer-aided detection (DL-CAD) system MATERIALS AND METHODS: This retrospective study included consecutive patients who underwent surgery between January 2019 and March 2020 and divided into development (surgery in 2019) and validation (surgery between January and March 2020) cohorts. Preoperative CRs obtained within 1-month before surgery were analyzed with a commercialized DL-CAD that provided probability values for the presence of 10 different abnormalities in CRs. Logistic regression models to predict postoperative pneumonia were built using clinical variables (clinical model), and both clinical variables and DL-CAD results for preoperative CRs (DL-CAD model). The discriminative performances of the models were evaluated by area under the receiver operating characteristic curves.

RESULTS

In development cohort (n = 19,349; mean age, 57 years; 11,392 men), DL-CAD results for pulmonary nodules (odds ratio [OR, for 1% increase in probability value], 1.007; p = 0.021), consolidation (OR, 1.019; p < 0.001), and cardiomegaly (OR, 1.013; p < 0.001) were independent predictors of postoperative pneumonia and were included in the DL-CAD model. In validation cohort (n = 4957; mean age, 56 years; 2848 men), the DL-CAD model exhibited a higher AUROC than the clinical model (0.843 vs. 0.815; p = 0.012).

CONCLUSION

Abnormalities in preoperative CRs evaluated by a DL-CAD were independent risk factors for postoperative pneumonia. Using DL-CAD results for preoperative CRs led to an improved prediction of postoperative pneumonia.

Pneumonia Detection Using Enhanced Convolutional Neural Network Model on Chest X-Ray Images

Pneumonia, caused by microorganisms, is a severely contagious disease that damages one or both the lungs of the patients. Early detection and treatment are typically favored to recover infected patients since untreated pneumonia can lead to major complications in the elderly (>65 years) and children (<5 years). The objectives of this work are to develop several models to evaluate big X-ray images (XRIs) of the chest, to determine whether the images show/do not show signs of pneumonia, and to compare the models based on their accuracy, precision, recall, loss, and receiver operating characteristic area under the ROC curve scores. Enhanced convolutional neural network (CNN), VGG-19, ResNet-50, and ResNet-50 with fine-tuning are some of the deep learning (DL) algorithms employed in this study. By training the transfer learning model and enhanced CNN model using a big data set, these techniques are used to identify pneumonia. The data set for the study was obtained from Kaggle. It should be noted that the data set has been expanded to include further records. This data set included 5863 chest XRIs, which were categorized into 3 different folders (i.e., train, val, test). These data are produced every day from personnel records and Internet of Medical Things devices. According to the experimental findings, the ResNet-50 model showed the lowest accuracy, that is, 82.8%, while the enhanced CNN model showed the highest accuracy of 92.4%. Owing to its high accuracy, enhanced CNN was regarded as the best model in this study. The techniques developed in this study outperformed the popular ensemble techniques, and the models showed better results than those generated by cutting-edge methods. Our study implication is that a DL models can detect the progression of pneumonia, which improves the general diagnostic accuracy and gives patients new hope for speedy treatment. Since enhanced CNN and ResNet-50 showed the highest accuracy compared with other algorithms, it was concluded that these techniques could be effectively used to identify pneumonia after performing fine-tuning.

AI-based radiodiagnosis using chest X-rays: A review

Chest Radiograph or Chest X-ray (CXR) is a common, fast, non-invasive, relatively cheap radiological examination method in medical sciences. CXRs can aid in diagnosing many lung ailments such as Pneumonia, Tuberculosis, Pneumoconiosis, COVID-19, and lung cancer. Apart from other radiological examinations, every year, 2 billion CXRs are performed worldwide. However, the availability of the workforce to handle this amount of workload in hospitals is cumbersome, particularly in developing and low-income nations. Recent advances in AI, particularly in computer vision, have drawn attention to solving challenging medical image analysis problems. Healthcare is one of the areas where AI/ML-based assistive screening/diagnostic aid can play a crucial part in social welfare. However, it faces multiple challenges, such as small sample space, data privacy, poor quality samples, adversarial attacks and most importantly, the model interpretability for reliability on machine intelligence. This paper provides a structured review of the CXR-based analysis for different tasks, lung diseases and, in particular, the challenges faced by AI/ML-based systems for diagnosis. Further, we provide an overview of existing datasets, evaluation metrics for different[][15mm][0mm]Q5 tasks and patents issued. We also present key challenges and open problems in this research domain.

Image Recognition of Pediatric Pneumonia Based on Fusion of Texture Features and Depth Features

Pneumonia is one of the diseases that seriously endangers human health, and it is also the leading cause of death of children under the age of five in China. The most commonly used imaging examination method for radiologists is mainly based on chest X-ray images. Still, imaging errors often result during imaging examinations due to objective factors such as visual fatigue and lack of experience. Therefore, this paper proposes a feature fusion model, FC-VGG, based on the fusion of texture features (local binary pattern LBP and directional gradient histogram HOG) and depth features. The model improves model performance by adding detailed information in texture features to the convolutional neural network while making the model more suitable for clinical use. We input the X-ray image with texture features into the modified VGG16 model, C-VGG, and then add the Add fusion method to C-VGG for feature fusion so that FC-VGG is obtained, so FC-VGG has texture features detailed information and abstract information of deep features. Through experiments, our model has achieved 92.19% accuracy in recognizing children's pneumonia images, 93.44% average precision, 92.19% average recall, and 92.81% average F1 coefficient, and the model performance exceeds existing deep learning models and traditional feature recognition algorithms.

Pediatric chest radiograph interpretation: how far has artificial intelligence come? A systematic literature review

Most artificial intelligence (AI) studies have focused primarily on adult imaging, with less attention to the unique aspects of pediatric imaging. The objectives of this study were to (1) identify all publicly available pediatric datasets and determine their potential utility and limitations for pediatric AI studies and (2) systematically review the literature to assess the current state of AI in pediatric chest radiograph interpretation. We searched PubMed, Web of Science and Embase to retrieve all studies from 1990 to 2021 that assessed AI for pediatric chest radiograph interpretation and abstracted the datasets used to train and test AI algorithms, approaches and performance metrics. Of 29 publicly available chest radiograph datasets, 2 datasets included solely pediatric chest radiographs, and 7 datasets included pediatric and adult patients. We identified 55 articles that implemented an AI model to interpret pediatric chest radiographs or pediatric and adult chest radiographs. Classification of chest radiographs as pneumonia was the most common application of AI, evaluated in 65% of the studies. Although many studies report high diagnostic accuracy, most algorithms were not validated on external datasets. Most AI studies for pediatric chest radiograph interpretation have focused on a limited number of diseases, and progress is hindered by a lack of large-scale pediatric chest radiograph datasets.

A cad system design based on HybridMultiscale convolutional Mantaray network for pneumonia diagnosis

Pneumonia is one of the diseases that people may encounter in any period of their lives. Recently, researches and developers all around the world are focussing on deep learning and image processing strategies to quicken the pneumonia diagnosis as those strategies are capable of processing numerous X-ray and computed tomography (CT) images. Clinicians need more time and appropriate experiences for making a diagnosis. Hence, a precise, reckless, and less expensive tool to detect pneumonia is necessary. Thus, this research focuses on classifying the pneumonia chest X-ray images by proposing a very efficient stacked approach to improve the image quality and hybridmultiscale convolutional mantaray feature extraction network model with high accuracy. The input dataset is restructured with the sake of a hybrid fuzzy colored and stacking approach. Then the deep feature extraction stage is processed with the aid of stacking dataset by hybrid multiscale feature extraction unit to extract multiple features. Also, the features and network size are diminished by the self-attention module (SAM) based convolutional neural network (CNN). In addition to this, the error in the proposed network model will get reduced with the aid of adaptivemantaray foraging optimization (AMRFO) approach. Finally, the support vector regression (SVR) is suggested to classify the presence of pneumonia. The proposed module has been compared with existing technique to prove the overall efficiency of the system. The huge collection of chest X-ray images from the kaggle dataset was emphasized to validate the proposed work. The experimental results reveal an outstanding performance of accuracy (97%), precision (95%) and f-score (96%) progressively.

Bayesian-based optimized deep learning model to detect COVID-19 patients using chest X-ray image data

Coronavirus Disease 2019 (COVID-19) is extremely infectious and rapidly spreading around the globe. As a result, rapid and precise identification of COVID-19 patients is critical. Deep Learning has shown promising performance in a variety of domains and emerged as a key technology in Artificial Intelligence. Recent advances in visual recognition are based on image classification and artefacts detection within these images. The purpose of this study is to classify chest X-ray images of COVID-19 artefacts in changed real-world situations. A novel Bayesian optimization-based convolutional neural network (CNN) model is proposed for the recognition of chest X-ray images. The proposed model has two main components. The first one utilizes CNN to extract and learn deep features. The second component is a Bayesian-based optimizer that is used to tune the CNN hyperparameters according to an objective function. The used large-scale and balanced dataset comprises 10,848 images (i.e., 3616 COVID-19, 3616 normal cases, and 3616 Pneumonia). In the first ablation investigation, we compared Bayesian optimization to three distinct ablation scenarios. We used convergence charts and accuracy to compare the three scenarios. We noticed that the Bayesian search-derived optimal architecture achieved 96% accuracy. To assist qualitative researchers, address their research questions in a methodologically sound manner, a comparison of research method and theme analysis methods was provided. The suggested model is shown to be more trustworthy and accurate in real world.

Evaluating Deep Neural Network Architectures with Transfer Learning for Pneumonitis Diagnosis

Pneumonitis is an infectious disease that causes the inflammation of the air sac. It can be life-threatening to the very young and elderly. Detection of pneumonitis from X-ray images is a significant challenge. Early detection and assistance with diagnosis can be crucial. Recent developments in the field of deep learning have significantly improved their performance in medical image analysis. The superior predictive performance of the deep learning methods makes them ideal for pneumonitis classification from chest X-ray images. However, training deep learning models can be cumbersome and resource-intensive. Reusing knowledge representations of public models trained on large-scale datasets through transfer learning can help alleviate these challenges. In this paper, we compare various image classification models based on transfer learning with well-known deep learning architectures. The Kaggle chest X-ray dataset was used to evaluate and compare our models. We apply basic data augmentation and fine-tune our feed-forward classification head on the models pretrained on the ImageNet dataset. We observed that the DenseNet201 model outperforms other models with an AUROC score of 0.966 and a recall score of 0.99. We also visualize the class activation maps from the DenseNet201 model to interpret the patterns recognized by the model for prediction.

Deep learning for chest X-ray analysis: A survey

Recent advances in deep learning have led to a promising performance in many medical image analysis tasks. As the most commonly performed radiological exam, chest radiographs are a particularly important modality for which a variety of applications have been researched. The release of multiple, large, publicly available chest X-ray datasets in recent years has encouraged research interest and boosted the number of publications. In this paper, we review all studies using deep learning on chest radiographs published before March 2021, categorizing works by task: image-level prediction (classification and regression), segmentation, localization, image generation and domain adaptation. Detailed descriptions of all publicly available datasets are included and commercial systems in the field are described. A comprehensive discussion of the current state of the art is provided, including caveats on the use of public datasets, the requirements of clinically useful systems and gaps in the current literature.