Performance Analysis in Children of Traditional and Deep Learning CT Lung Nodule Computer-Aided Detection Systems Trained on Adults

BACKGROUND. Although primary lung cancer is rare in children, chest CT is commonly performed to assess for lung metastases in children with cancer. Lung nodule computer-aided detection (CAD) systems have been designed and studied primarily using adult training data, and the efficacy of such systems when applied to pediatric patients is poorly understood. OBJECTIVE. The purpose of this study was to evaluate in children the diagnostic performance of traditional and deep learning CAD systems trained with adult data for the detection of lung nodules on chest CT scans and to compare the ability of such systems to generalize to children versus to other adults. METHODS. This retrospective study included pediatric and adult chest CT test sets. The pediatric test set comprised 59 CT scans in 59 patients (30 boys, 29 girls; mean age, 13.1 years; age range, 4-17 years), which were obtained from November 30, 2018, to August 31, 2020; lung nodules were annotated by fellowship-trained pediatric radiologists as the reference standard. The adult test set was the publicly available adult Lung Nodule Analysis (LUNA) 2016 subset 0, which contained 89 deidentified scans with previously annotated nodules. The test sets were processed through the traditional FlyerScan (github.com/rhardie1/FlyerScanCT) and deep learning Medical Open Network for Artificial Intelligence (MONAI; github.com/Project-MONAI/model-zoo/releases) lung nodule CAD systems, which had been trained on separate sets of CT scans in adults. Sensitivity and false-positive (FP) frequency were calculated for nodules measuring 3-30 mm; nonoverlapping 95% CIs indicated significant differences. RESULTS. Operating at two FPs per scan, on pediatric testing data FlyerScan and MONAI showed significantly lower detection sensitivities of 68.4% (197/288; 95% CI, 65.1-73.0%) and 53.1% (153/288; 95% CI, 46.7-58.4%), respectively, than on adult LUNA 2016 subset 0 testing data (83.9% [94/112; 95% CI, 79.1-88.0%] and 95.5% [107/112; 95% CI, 90.0-98.4%], respectively). Mean nodule size was smaller (p < .001) in the pediatric testing data (5.4 ± 3.1 [SD] mm) than in the adult LUNA 2016 subset 0 testing data (11.0 ± 6.2 mm). CONCLUSION. Adult-trained traditional and deep learning-based lung nodule CAD systems had significantly lower sensitivity for detection on pediatric data than on adult data at a matching FP frequency. The performance difference may relate to the smaller size of pediatric lung nodules. CLINICAL IMPACT. The results indicate a need for pediatric-specific lung nodule CAD systems trained on data specific to pediatric patients.

Explainable Artificial Intelligence (XAI) for Deep Learning Based Medical Imaging Classification

Recently, deep learning has gained significant attention as a noteworthy division of artificial intelligence (AI) due to its high accuracy and versatile applications. However, one of the major challenges of AI is the need for more interpretability, commonly referred to as the black-box problem. In this study, we introduce an explainable AI model for medical image classification to enhance the interpretability of the decision-making process. Our approach is based on segmenting the images to provide a better understanding of how the AI model arrives at its results. We evaluated our model on five datasets, including the COVID-19 and Pneumonia Chest X-ray dataset, Chest X-ray (COVID-19 and Pneumonia), COVID-19 Image Dataset (COVID-19, Viral Pneumonia, Normal), and COVID-19 Radiography Database. We achieved testing and validation accuracy of 90.6% on a relatively small dataset of 6432 images. Our proposed model improved accuracy and reduced time complexity, making it more practical for medical diagnosis. Our approach offers a more interpretable and transparent AI model that can enhance the accuracy and efficiency of medical diagnosis.

Federated Learning for Medical Image Analysis with Deep Neural Networks

Medical image analysis using deep neural networks (DNN) has demonstrated state-of-the-art performance in image classification and segmentation tasks, aiding disease diagnosis. The accuracy of the DNN is largely governed by the quality and quantity of the data used to train the model. However, for the medical images, the critical security and privacy concerns regarding sharing of local medical data across medical establishments precludes exploiting the full DNN potential for clinical diagnosis. The federated learning (FL) approach enables the use of local model's parameters to train a global model, while ensuring data privacy and security. In this paper, we review the federated learning applications in medical image analysis with DNNs, highlight the security concerns, cover some efforts to improve FL model performance, and describe the challenges and future research directions.

Deep Convolutional Neural Networks for Detecting COVID-19 Using Medical Images: A Survey

Coronavirus Disease 2019 (COVID-19), which is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2), surprised the world in December 2019 and has threatened the lives of millions of people. Countries all over the world closed worship places and shops, prevented gatherings, and implemented curfews to stand against the spread of COVID-19. Deep Learning (DL) and Artificial Intelligence (AI) can have a great role in detecting and fighting this disease. Deep learning can be used to detect COVID-19 symptoms and signs from different imaging modalities, such as X-Ray, Computed Tomography (CT), and Ultrasound Images (US). This could help in identifying COVID-19 cases as a first step to curing them. In this paper, we reviewed the research studies conducted from January 2020 to September 2022 about deep learning models that were used in COVID-19 detection. This paper clarified the three most common imaging modalities (X-Ray, CT, and US) in addition to the DL approaches that are used in this detection and compared these approaches. This paper also provided the future directions of this field to fight COVID-19 disease.

Challenges, opportunities, and advances related to COVID-19 classification based on deep learning

The novel coronavirus disease, or COVID-19, is a hazardous disease. It is endangering the lives of many people living in more than two hundred countries. It directly affects the lungs. In general, two main imaging modalities: - computed tomography (CT) and chest x-ray (CXR) are used to achieve a speedy and reliable medical diagnosis. Identifying the coronavirus in medical images is exceedingly difficult for diagnosis, assessment, and treatment. It is demanding, time-consuming, and subject to human mistakes. In biological disciplines, excellent performance can be achieved by employing artificial intelligence (AI) models. As a subfield of AI, deep learning (DL) networks have drawn considerable attention than standard machine learning (ML) methods. DL models automatically carry out all the steps of feature extraction, feature selection, and classification. This study has performed comprehensive analysis of coronavirus classification using CXR and CT imaging modalities using DL architectures. Additionally, we have discussed how transfer learning is helpful in this regard. Finally, the problem of designing and implementing a system using computer-aided diagnostic (CAD) to find COVID-19 using DL approaches is highlighted a future research possibility.

MediNet: transfer learning approach with MediNet medical visual database

The rapid development of machine learning has increased interest in the use of deep learning methods in medical research. Deep learning in the medical field is used in disease detection and classification problems in the clinical decision-making process. Large amounts of labeled datasets are often required to train deep neural networks; however, in the medical field, the lack of a sufficient number of images in datasets and the difficulties encountered during data collection are among the main problems. In this study, we propose MediNet, a new 10-class visual dataset consisting of Rontgen (X-ray), Computed Tomography (CT), Magnetic Resonance Imaging (MRI), Ultrasound, and Histopathological images such as calcaneal normal, calcaneal tumor, colon benign colon adenocarcinoma, brain normal, brain tumor, breast benign, breast malignant, chest normal, chest pneumonia. AlexNet, VGG19-BN, Inception V3, DenseNet 121, ResNet 101, EfficientNet B0, Nested-LSTM + CNN, and proposed RdiNet deep learning algorithms are used in the transfer learning for pre-training and classification application. Transfer learning aims to apply previously learned knowledge in a new task. Seven algorithms were trained with the MediNet dataset, and the models obtained from these algorithms, namely feature vectors, were recorded. Pre-training models were used for classification studies on chest X-ray images, diabetic retinopathy, and Covid-19 datasets with the transfer learning technique. In performance measurement, an accuracy of 94.84% was obtained in the traditional classification study for the InceptionV3 model in the classification study performed on the Chest X-Ray Images dataset, and the accuracy was increased 98.71% after the transfer learning technique was applied. In the Covid-19 dataset, the classification success of the DenseNet121 model before pre-trained was 88%, while the performance after the transfer application with MediNet was 92%. In the Diabetic retinopathy dataset, the classification success of the Nested-LSTM + CNN model before pre-trained was 79.35%, while the classification success was 81.52% after the transfer application with MediNet. The comparison of results obtained from experimental studies observed that the proposed method produced more successful results.

Graphical abstract

Variational Autoencoder Based Imbalanced COVID-19 Detection Using Chest X-Ray Images

Early and fast detection of disease is essential for the fight against COVID-19 pandemic. Researchers have focused on developing robust and cost-effective detection methods using Deep learning based chest X-Ray image processing. However, such prediction models are often not well suited to address the challenge of highly imabalanced datasets. The current work is an attempt to address the issue by utilizing unsupervised Variational Auto Encoders (VAEs). Firstly, chest X-Ray images are converted to a latent space by learning the most important features using VAEs. Secondly, a wide range of well established data resampling techniques are used to balance the preexisting imbalanced classes in the latent vector form of the dataset. Finally, the modified dataset in the new feature space is used to train well known classification models to classify chest X-Ray images into three different classes viz., "COVID-19", "Pneumonia", and "Normal". In order to capture the quality of resampling methods, 10-folds cross validation technique is applied on the dataset. Extensive experimental analysis have been carried out and results so obtained indicate significant improvement in COVID-19 detection using the proposed VAE based method. Furthermore, the ingenuity of the results have been established by performing Wilcoxon rank test with 95% level of significance.

Early prediction of COVID-19 using ensemble of transfer learning

In the wake of the COVID-19 outbreak, automated disease detection has become a crucial part of medical science given the infectious nature of the coronavirus. This research aims to introduce a deep ensemble framework of transfer learning models for early prediction of COVID-19 from the respective chest X-ray images of the patients. The dataset used in this research was taken from the Kaggle repository having two classes-COVID-19 Positive and COVID-19 Negative. The proposed model achieved high accuracy on the test sample with minimum false positive prediction. It can assist doctors and technicians with early detection of COVID-19 infection. The patient's health can further be monitored remotely with the help of connected devices with the Internet, which may be termed as the Internet of Medical Things (IoMT). The proposed IoMT-based solution for the automatic detection of COVID-19 can be a significant step toward fighting the pandemic.

IMNets: Deep Learning Using an Incremental Modular Network Synthesis Approach for Medical Imaging Applications

Deep learning approaches play a crucial role in computer-aided diagnosis systems to support clinical decision-making. However, developing such automated solutions is challenging due to the limited availability of annotated medical data. In this study, we proposed a novel and computationally efficient deep learning approach to leverage small data for learning generalizable and domain invariant representations in different medical imaging applications such as malaria, diabetic retinopathy, and tuberculosis. We refer to our approach as Incremental Modular Network Synthesis (IMNS), and the resulting CNNs as Incremental Modular Networks (IMNets). Our IMNS approach is to use small network modules that we call SubNets which are capable of generating salient features for a particular problem. Then, we build up ever larger and more powerful networks by combining these SubNets in different configurations. At each stage, only one new SubNet module undergoes learning updates. This reduces the computational resource requirements for training and aids in network optimization. We compare IMNets against classic and state-of-the-art deep learning architectures such as AlexNet, ResNet-50, Inception v3, DenseNet-201, and NasNet for the various experiments conducted in this study. Our proposed IMNS design leads to high average classification accuracies of 97.0%, 97.9%, and 88.6% for malaria, diabetic retinopathy, and tuberculosis, respectively. Our modular design for deep learning achieves the state-of-the-art performance in the scenarios tested. The IMNets produced here have a relatively low computational complexity compared to traditional deep learning architectures. The largest IMNet tested here has 0.95 M of the learnable parameters and 0.08 G of the floating-point multiply–add (MAdd) operations. The simpler IMNets train faster, have lower memory requirements, and process images faster than the benchmark methods tested.

Computer-aided COVID-19 diagnosis and a comparison of deep learners using augmented CXRs

BACKGROUND

Coronavirus Disease 2019 (COVID-19) is contagious, producing respiratory tract infection, caused by a newly discovered coronavirus. Its death toll is too high, and early diagnosis is the main problem nowadays. Infected people show a variety of symptoms such as fatigue, fever, tastelessness, dry cough, etc. Some other symptoms may also be manifested by radiographic visual identification. Therefore, Chest X-Rays (CXR) play a key role in the diagnosis of COVID-19.

METHODS

In this study, we use Chest X-Rays images to develop a computer-aided diagnosis (CAD) of the disease. These images are used to train two deep networks, the Convolution Neural Network (CNN), and the Long Short-Term Memory Network (LSTM) which is an artificial Recurrent Neural Network (RNN). The proposed study involves three phases. First, the CNN model is trained on raw CXR images. Next, it is trained on pre-processed CXR images and finally enhanced CXR images are used for deep network CNN training. Geometric transformations, color transformations, image enhancement, and noise injection techniques are used for augmentation. From augmentation, we get 3,220 augmented CXRs as training datasets. In the final phase, CNN is used to extract the features of CXR imagery that are fed to the LSTM model. The performance of the four trained models is evaluated by the evaluation techniques of different models, including accuracy, specificity, sensitivity, false-positive rate, and receiver operating characteristic (ROC) curve.

RESULTS

We compare our results with other benchmark CNN models. Our proposed CNN-LSTM model gives superior accuracy (99.02%) than the other state-of-the-art models. Our method to get improved input, helped the CNN model to produce a very high true positive rate (TPR 1) and no false-negative result whereas false negative was a major problem while using Raw CXR images.

CONCLUSIONS

We conclude after performing different experiments that some image pre-processing and augmentation, remarkably improves the results of CNN-based models. It will help a better early detection of the disease that will eventually reduce the mortality rate of COVID.

A Fusion-Based Hybrid-Feature Approach for Recognition of Unconstrained Offline Handwritten Hindi Characters

Hindi is the official language of India and used by a large population for several public services like postal, bank, judiciary, and public surveys. Efficient management of these services needs language-based automation. The proposed model addresses the problem of handwritten Hindi character recognition using a machine learning approach. The pre-trained DCNN models namely; InceptionV3-Net, VGG19-Net, and ResNet50 were used for the extraction of salient features from the characters’ images. A novel approach of fusion is adopted in the proposed work; the DCNN-based features are fused with the handcrafted features received from Bi-orthogonal discrete wavelet transform. The feature size was reduced by the Principal Component Analysis method. The hybrid features were examined with popular classifiers namely; Multi-Layer Perceptron (MLP) and Support Vector Machine (SVM). The recognition cost was reduced by 84.37%. The model achieved significant scores of precision, recall, and F1-measure—98.78%, 98.67%, and 98.69%—with overall recognition accuracy of 98.73%.

Detection of COVID-19 Using Transfer Learning and Grad-CAM Visualization on Indigenously Collected X-ray Dataset

The COVID-19 outbreak began in December 2019 and has dreadfully affected our lives since then. More than three million lives have been engulfed by this newest member of the corona virus family. With the emergence of continuously mutating variants of this virus, it is still indispensable to successfully diagnose the virus at early stages. Although the primary technique for the diagnosis is the PCR test, the non-contact methods utilizing the chest radiographs and CT scans are always preferred. Artificial intelligence, in this regard, plays an essential role in the early and accurate detection of COVID-19 using pulmonary images. In this research, a transfer learning technique with fine tuning was utilized for the detection and classification of COVID-19. Four pre-trained models i.e., VGG16, DenseNet-121, ResNet-50, and MobileNet were used. The aforementioned deep neural networks were trained using the dataset (available on Kaggle) of 7232 (COVID-19 and normal) chest X-ray images. An indigenous dataset of 450 chest X-ray images of Pakistani patients was collected and used for testing and prediction purposes. Various important parameters, e.g., recall, specificity, F1-score, precision, loss graphs, and confusion matrices were calculated to validate the accuracy of the models. The achieved accuracies of VGG16, ResNet-50, DenseNet-121, and MobileNet are 83.27%, 92.48%, 96.49%, and 96.48%, respectively. In order to display feature maps that depict the decomposition process of an input image into various filters, a visualization of the intermediate activations is performed. Finally, the Grad-CAM technique was applied to create class-specific heatmap images in order to highlight the features extracted in the X-ray images. Various optimizers were used for error minimization purposes. DenseNet-121 outperformed the other three models in terms of both accuracy and prediction.

Transfer Learning for the Detection and Diagnosis of Types of Pneumonia including Pneumonia Induced by COVID-19 from Chest X-ray Images

Accurate early diagnosis of COVID-19 viral pneumonia, primarily in asymptomatic people, is essential to reduce the spread of the disease, the burden on healthcare capacity, and the overall death rate. It is essential to design affordable and accessible solutions to distinguish pneumonia caused by COVID-19 from other types of pneumonia. In this work, we propose a reliable approach based on deep transfer learning that requires few computations and converges faster. Experimental results demonstrate that our proposed framework for transfer learning is a potential and effective approach to detect and diagnose types of pneumonia from chest X-ray images with a test accuracy of 94.0%.

Willing or Hesitant? A Socioeconomic Study on the Potential Acceptance of COVID-19 Vaccine in Japan

The worldwide COVID-19 vaccination program is already underway, raising hopes and aspirations to contain the spread of the COVID-19 pandemic that halted economic and social activities. However, the issue of vaccine effectiveness and its side-effects is influencing the potential acceptance of vaccines. In this uncertain situation, we used data from a nationwide survey in Japan during February 2021, following the Japanese government's initial phase of COVID-19 vaccination. Our results show that 47% of the respondents are willing to take a vaccine once it is available, while 22% are not willing and another 31% remain indecisive. Our ordered probit regression results show that demographic, socioeconomic, and behavioral variables such as gender, age, subjective health status, children, household income, household assets, financial literacy, future anxiety, and myopic view of the future are associated with willingness to take a COVID-19 vaccine. Our findings suggest that Japan's government should not adopt a one-size-fits-all policy to promote the vaccination program, but rather target people with specific socioeconomic backgrounds who are less willing and more hesitant to take a vaccine.

COVID-19 Detection Empowered with Machine Learning and Deep Learning Techniques: A Systematic Review

COVID-19 has infected 223 countries and caused 2.8 million deaths worldwide (at the time of writing this article), and the death rate is increasing continuously. Early diagnosis of COVID patients is a critical challenge for medical practitioners, governments, organizations, and countries to overcome the rapid spread of the deadly virus in any geographical area. In this situation, the previous epidemic evidence on Machine Learning (ML) and Deep Learning (DL) techniques encouraged the researchers to play a significant role in detecting COVID-19. Similarly, the rising scope of ML/DL methodologies in the medical domain also advocates its significant role in COVID-19 detection. This systematic review presents ML and DL techniques practiced in this era to predict, diagnose, classify, and detect the coronavirus. In this study, the data was retrieved from three prevalent full-text archives, i.e., Science Direct, Web of Science, and PubMed, using the search code strategy on 16 March 2021. Using professional assessment, among 961 articles retrieved by an initial query, only 40 articles focusing on ML/DL-based COVID-19 detection schemes were selected. Findings have been presented as a country-wise distribution of publications, article frequency, various data collection, analyzed datasets, sample sizes, and applied ML/DL techniques. Precisely, this study reveals that ML/DL technique accuracy lay between 80% to 100% when detecting COVID-19. The RT-PCR-based model with Support Vector Machine (SVM) exhibited the lowest accuracy (80%), whereas the X-ray-based model achieved the highest accuracy (99.7%) using a deep convolutional neural network. However, current studies have shown that an anal swab test is super accurate to detect the virus. Moreover, this review addresses the limitations of COVID-19 detection along with the detailed discussion of the prevailing challenges and future research directions, which eventually highlight outstanding issues.

An Accuracy vs. Complexity Comparison of Deep Learning Architectures for the Detection of COVID-19 Disease

In parallel with the vast medical research on clinical treatment of COVID-19, an important action to have the disease completely under control is to carefully monitor the patients. What the detection of COVID-19 relies on most is the viral tests, however, the study of X-rays is helpful due to the ease of availability. There are various studies that employ Deep Learning (DL) paradigms, aiming at reinforcing the radiography-based recognition of lung infection by COVID-19. In this regard, we make a comparison of the noteworthy approaches devoted to the binary classification of infected images by using DL techniques, then we also propose a variant of a convolutional neural network (CNN) with optimized parameters, which performs very well on a recent dataset of COVID-19. The proposed model’s effectiveness is demonstrated to be of considerable importance due to its uncomplicated design, in contrast to other presented models. In our approach, we randomly put several images of the utilized dataset aside as a hold out set; the model detects most of the COVID-19 X-rays correctly, with an excellent overall accuracy of 99.8%. In addition, the significance of the results obtained by testing different datasets of diverse characteristics (which, more specifically, are not used in the training process) demonstrates the effectiveness of the proposed approach in terms of an accuracy up to 93%.