Deep Learning-Based Approaches for Enhanced Diagnosis and Comprehensive Understanding of Carpal Tunnel Syndrome.

Carpal tunnel syndrome (CTS) is a prevalent medical condition resulting from compression of the median nerve in the hand, often caused by overuse or age-related factors. In this study, a total of 160 patients participated, including 80 individuals with CTS presenting varying levels of severity across different age groups. Numerous studies have explored the use of machine learning (ML) and deep learning (DL) techniques for CTS diagnosis. However, further research is required to fully leverage the potential of artificial intelligence (AI) technology in CTS diagnosis, addressing the challenges and limitations highlighted in the existing literature. In our work, we propose a novel approach for CTS diagnosis, prediction, and monitoring disease progression. The proposed framework consists of three main layers. Firstly, we employ three distinct DL models for CTS diagnosis. Through our experiments, the proposed approach demonstrates superior performance across multiple evaluation metrics, with an accuracy of 0.969%, precision of 0.982%, and recall of 0.963%. The second layer focuses on predicting the cross-sectional area (CSA) at 1, 3, and 6 months using ML models, aiming to forecast disease progression during therapy. The best-performing model achieves an accuracy of 0.9522, an R2 score of 0.667, a mean absolute error (MAE) of 0.0132, and a median squared error (MdSE) of 0.0639. The highest predictive performance is observed after 6 months. The third layer concentrates on assessing significant changes in the patients' health status through statistical tests, including significance tests, the Kruskal-Wallis test, and a two-way ANOVA test. These tests aim to determine the effect of injections on CTS treatment. The results reveal a highly significant reduction in symptoms, as evidenced by scores from the Symptom Severity Scale and Functional Status Scale, as well as a decrease in CSA after 1, 3, and 6 months following the injection. SHAP is then utilized to provide an understandable explanation of the final prediction. Overall, our study presents a comprehensive approach for CTS diagnosis, prediction, and monitoring, showcasing promising results in terms of accuracy, precision, and recall for CTS diagnosis, as well as effective prediction of disease progression and evaluation of treatment effectiveness through statistical analysis.

Predicting CTS Diagnosis and Prognosis Based on Machine Learning Techniques.

Carpal tunnel syndrome (CTS) is a clinical disease that occurs due to compression of the median nerve in the carpal tunnel. The determination of the severity of carpal tunnel syndrome is essential to provide appropriate therapeutic interventions. Machine learning (ML)-based modeling can be used to classify diseases, make decisions, and create new therapeutic interventions. It is also used in medical research to implement predictive models. However, despite the growth in medical research based on ML and Deep Learning (DL), CTS research is still relatively scarce. While a few studies have developed models to predict diagnosis of CTS, no ML model has been presented to classify the severity of CTS based on comprehensive clinical data. Therefore, this study developed new classification models for determining CTS severity using ML algorithms. This study included 80 patients with other diseases that have an overlap in symptoms with CTS, such as cervical radiculopathysasas, de quervian tendinopathy, and peripheral neuropathy, and 80 CTS patients who underwent ultrasonography (US)-guided median nerve hydrodissection. CTS severity was classified into mild, moderate, and severe grades. In our study, we aggregated the data from CTS patients and patients with other diseases that have an overlap in symptoms with CTS, such as cervical radiculopathysasas, de quervian tendinopathy, and peripheral neuropathy. The dataset was randomly split into training and test data, at 70% and 30%, respectively. The proposed model achieved promising results of 0.955%, 0.963%, and 0.919% in terms of classification accuracy, precision, and recall, respectively. In addition, we developed a machine learning model that predicts the probability of a patient improving after the hydro-dissection injection process based on the aggregated data after three different months (one, three, and six). The proposed model achieved accuracy after six months of 0.912%, after three months of 0.901%, and after one month 0.877%. The overall performance for predicting the prognosis after six months outperforms the prediction after one and three months. We utilized statistics tests (significance test, Spearman's correlation test, and two-way ANOVA test) to determine the effect of injection process in CTS treatment. Our data-driven decision support tools can be used to help determine which patients to operate on in order to avoid the associated risks and expenses of surgery.

Precise Identification of Prostate Cancer from DWI Using Transfer Learning.

Background and Objective: The use of computer-aided detection (CAD) systems can help radiologists make objective decisions and reduce the dependence on invasive techniques. In this study, a CAD system that detects and identifies prostate cancer from diffusion-weighted imaging (DWI) is developed. Methods: The proposed system first uses non-negative matrix factorization (NMF) to integrate three different types of features for the accurate segmentation of prostate regions. Then, discriminatory features in the form of apparent diffusion coefficient (ADC) volumes are estimated from the segmented regions. The ADC maps that constitute these volumes are labeled by a radiologist to identify the ADC maps with malignant or benign tumors. Finally, transfer learning is used to fine-tune two different previously-trained convolutional neural network (CNN) models (AlexNet and VGGNet) for detecting and identifying prostate cancer. Results: Multiple experiments were conducted to evaluate the accuracy of different CNN models using DWI datasets acquired at nine distinct b-values that included both high and low b-values. The average accuracy of AlexNet at the nine b-values was 89.2±1.5% with average sensitivity and specificity of 87.5±2.3% and 90.9±1.9%. These results improved with the use of the deeper CNN model (VGGNet). The average accuracy of VGGNet was 91.2±1.3% with sensitivity and specificity of 91.7±1.7% and 90.1±2.8%. Conclusions: The results of the conducted experiments emphasize the feasibility and accuracy of the developed system and the improvement of this accuracy using the deeper CNN.

Early diabetic retinopathy diagnosis based on local retinal blood vessel analysis in optical coherence tomography angiography (OCTA) images.

PURPOSE: This paper introduces a new computer-aided diagnosis (CAD) system for detecting early-stage diabetic retinopathy (DR) using optical coherence tomography angiography (OCTA) images. METHODS: The proposed DR-CAD system is based on the analysis of new local features that describe both the appearance and retinal structure in OCTA images. It starts with a new segmentation approach that has the ability to extract the blood vessels from superficial and deep retinal OCTA maps. The high capability of our segmentation approach stems from using a joint Markov-Gibbs random field stochastic model integrating a 3D spatial statistical model with a first-order appearance model of the blood vessels. Following the segmentation step, three new local features are estimated from the segmented vessels and the foveal avascular zone (FAZ): (a) vessels density, (b) blood vessel calibre, and (c) width of the FAZ. To distinguish mild DR patients from normal cases, the estimated three features are used to train and test a support vector machine (SVM) classifier with the radial basis function (RBF) kernel. RESULTS: On a cohort of 105 subjects, the presented DR-CAD system demonstrated an overall accuracy (ACC) of 94.3%, a sensitivity of 97.9%, a specificity of 87.0%, the area under the curve (AUC) of 92.4%, and a Dice similarity coefficient (DSC) of 95.8%. This in turn demonstrates the promise of the proposed CAD system as a supplemental tool for early detection of DR. CONCLUSION: We developed a new DR-CAD system that is capable of diagnosing DR in its early stage. The proposed system is based on extracting three different features from the segmented OCTA images, which reflect the changes in the retinal vasculature network.

Retracted: Early diabetic retinopathy diagnosis based on local retinal blood vessels analysis in optical coherence tomography angiography (OCTA) images.

The above article from Medical Physics, published online on 22 February 2018 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the authors, the journal Editor in Chief and John Wiley & Sons Ltd. The retraction has been agreed following an investigation carried out by the editors due to major overlap with a previously published article: British Journal of Ophthalmology (BJO) (Sandhu HS, Eladawi N, Elmogy M, et al Automated diabetic retinopathy detection using optical coherence tomography angiography: a pilot study, British Journal of Ophthalmology Published Online First: 23 January 2018. doi:10.1136/bjophthalmol-2017-311489.

Classification of retinal diseases based on OCT Images.

Optical Coherence Topography (OCT) is an emerging biomedical imaging technology that offers non-invasive real-time, high-resolution imaging of highly scattering tissues. It is widely used in ophthalmology to perform diagnostic imaging on the structure of the anterior eye and the retina. Clinical studies are carried out to assess the application of OCT for some retinal diseases. OCT can provide means for early detection for various types of diseases because morphological changes often occur before the physical symptoms of these diseases. In addition, follow-up imaging can assess treatment effectiveness and recurrence of a disease. A review in this area is needed to identify the results and the findings from OCT images in the field of retinal diseases and how to use these findings to help in clinical applications. This paper overviews the current techniques that are developed to determine the ability of OCT images for early detection/diagnosis of retinal diseases. Also, the paper remarks several challenges that face the researchers in the analysis of the OCT retinal images.

Automatic blood vessels segmentation based on different retinal maps from OCTA scans.

The retinal vascular network reflects the health of the retina, which is a useful diagnostic indicator of systemic vascular. Therefore, the segmentation of retinal blood vessels is a powerful method for diagnosing vascular diseases. This paper presents an automatic segmentation system for retinal blood vessels from Optical Coherence Tomography Angiography (OCTA) images. The system segments blood vessels from the superficial and deep retinal maps for normal and diabetic cases. Initially, we reduced the noise and improved the contrast of the OCTA images by using the Generalized Gauss-Markov random field (GGMRF) model. Secondly, we proposed a joint Markov-Gibbs random field (MGRF) model to segment the retinal blood vessels from other background tissues. It integrates both appearance and spatial models in addition to the prior probability model of OCTA images. The higher order MGRF (HO-MGRF) model in addition to the 1st-order intensity model are used to consider the spatial information in order to overcome the low contrast between vessels and other tissues. Finally, we refined the segmentation by extracting connected regions using a 2D connectivity filter. The proposed segmentation system was trained and tested on 47 data sets, which are 23 normal data sets and 24 data sets for diabetic patients. To evaluate the accuracy and robustness of the proposed segmentation framework, we used three different metrics, which are Dice similarity coefficient (DSC), absolute vessels volume difference (VVD), and area under the curve (AUC). The results on OCTA data sets (DSC=95.04±3.75%, VVD=8.51±1.49%, and AUC=95.20±1.52%) show the promise of the proposed segmentation approach.