Generalizable diagnosis of chest radiographs through attention-guided decomposition of images utilizing self-consistency loss.

BACKGROUND: Chest X-ray (CXR) is one of the most commonly performed imaging tests worldwide. Due to its wide usage, there is a growing need for automated and generalizable methods to accurately diagnose these images. Traditional methods for chest X-ray analysis often struggle with generalization across diverse datasets due to variations in imaging protocols, patient demographics, and the presence of overlapping anatomical structures. Therefore, there is a significant demand for advanced diagnostic tools that can consistently identify abnormalities across different patient populations and imaging settings. We propose a method that can provide a generalizable diagnosis of chest X-ray. METHOD: Our method utilizes an attention-guided decomposer network (ADSC) to extract disease maps from chest X-ray images. The ADSC employs one encoder and multiple decoders, incorporating a novel self-consistency loss to ensure consistent functionality across its modules. The attention-guided encoder captures salient features of abnormalities, while three distinct decoders generate a normal synthesized image, a disease map, and a reconstructed input image, respectively. A discriminator differentiates the real and the synthesized normal chest X-rays, enhancing the quality of generated images. The disease map along with the original chest X-ray image are fed to a DenseNet-121 classifier modified for multi-class classification of the input X-ray. RESULTS: Experimental results on multiple publicly available datasets demonstrate the effectiveness of our approach. For multi-class classification, we achieve up to a 3% improvement in AUROC score for certain abnormalities compared to the existing methods. For binary classification (normal versus abnormal), our method surpasses existing approaches across various datasets. In terms of generalizability, we train our model on one dataset and tested it on multiple datasets. The standard deviation of AUROC scores for different test datasets is calculated to measure the variability of performance across datasets. Our model exhibits superior generalization across datasets from diverse sources. CONCLUSIONS: Our model shows promising results for the generalizable diagnosis of chest X-rays. The impacts of using the attention mechanism and the self-consistency loss in our method are evident from the results. In the future, we plan to incorporate Explainable AI techniques to provide explanations for model decisions. Additionally, we aim to design data augmentation techniques to reduce class imbalance in our model.

An extremely lightweight CNN model for the diagnosis of chest radiographs in resource-constrained environments.

BACKGROUND: In recent years, deep learning methods have been successfully used for chest x-ray diagnosis. However, such deep learning models often contain millions of trainable parameters and have high computation demands. As a result, providing the benefits of cutting-edge deep learning technology to areas with low computational resources would not be easy. Computationally lightweight deep learning models may potentially alleviate this problem. PURPOSE: We aim to create a computationally lightweight model for the diagnosis of chest radiographs. Our model has only  0.14M parameters and  550 KB size. These make the proposed model potentially useful for deployment in resource-constrained environments. METHODS: We fuse the concept of depthwise convolutions with squeeze and expand blocks to design the proposed architecture. The basic building block of our model is called Depthwise Convolution In Squeeze and Expand (DCISE) block. Using these DCISE blocks, we design an extremely lightweight convolutional neural network model (ExLNet), a computationally lightweight convolutional neural network (CNN) model for chest x-ray diagnosis. RESULTS: We perform rigorous experiments on three publicly available datasets, namely, National Institutes of Health (NIH), VinBig ,and Chexpert for binary and multi-class classification tasks. We train the proposed architecture on NIH dataset and evaluate the performance on VinBig and Chexpert datasets. The proposed method outperforms several state-of-the-art approaches for both binary and multi-class classification tasks despite having a significantly less number of parameters. CONCLUSIONS: We design a lightweight CNN architecture for the chest x-ray classification task by introducing ExLNet which uses a novel DCISE blocks to reduce the computational burden. We show the effectiveness of the proposed architecture through various experiments performed on publicly available datasets. The proposed architecture shows consistent performance in binary as well as multi-class classification tasks and outperforms other lightweight CNN architectures. Due to a significant reduction in the computational requirements, our method can be useful for resource-constrained clinical environment as well.

Differential diagnosis of thyroid nodule capsules using random forest guided selection of image features.

Microscopic evaluation of tissue sections stained with hematoxylin and eosin is the current gold standard for diagnosing thyroid pathology. Digital pathology is gaining momentum providing the pathologist with additional cues to traditional routes when placing a diagnosis, therefore it is extremely important to develop new image analysis methods that can extract image features with diagnostic potential. In this work, we use histogram and texture analysis to extract features from microscopic images acquired on thin thyroid nodule capsules sections and demonstrate how they enable the differential diagnosis of thyroid nodules. Targeted thyroid nodules are benign (i.e., follicular adenoma) and malignant (i.e., papillary thyroid carcinoma and its sub-type arising within a follicular adenoma). Our results show that the considered image features can enable the quantitative characterization of the collagen capsule surrounding thyroid nodules and provide an accurate classification of the latter's type using random forest.

Discriminative ensemble learning for few-shot chest x-ray diagnosis.

Few-shot learning is an almost unexplored area in the field of medical image analysis. We propose a method for few-shot diagnosis of diseases and conditions from chest x-rays using discriminative ensemble learning. Our design involves a CNN-based coarse-learner in the first step to learn the general characteristics of chest x-rays. In the second step, we introduce a saliency-based classifier to extract disease-specific salient features from the output of the coarse-learner and classify based on the salient features. We propose a novel discriminative autoencoder ensemble to design the saliency-based classifier. The classification of the diseases is performed based on the salient features. Our algorithm proceeds through meta-training and meta-testing. During the training phase of meta-training, we train the coarse-learner. However, during the training phase of meta-testing, we train only the saliency-based classifier. Thus, our method is first-of-its-kind where the training phase of meta-training and the training phase of meta-testing are architecturally disjoint, making the method modular and easily adaptable to new tasks requiring the training of only the saliency-based classifier. Experiments show as high as ∼19% improvement in terms of F1 score compared to the baseline in the diagnosis of chest x-rays from publicly available datasets.

Generalized Zero-Shot Chest X-Ray Diagnosis Through Trait-Guided Multi-View Semantic Embedding With Self-Training.

Zero-shot learning (ZSL) is one of the most promising avenues of annotation-efficient machine learning. In the era of deep learning, ZSL techniques have achieved unprecedented success. However, the developments of ZSL methods have taken place mostly for natural images. ZSL for medical images has remained largely unexplored. We design a novel strategy for generalized zero-shot diagnosis of chest radiographs. In doing so, we leverage the potential of multi-view semantic embedding, a useful yet less-explored direction for ZSL. Our design also incorporates a self-training phase to tackle the problem of noisy labels alongside improving the performance for classes not seen during training. Through rigorous experiments, we show that our model trained on one dataset can produce consistent performance across test datasets from different sources including those with very different quality. Comparisons with a number of state-of-the-art techniques show the superiority of the proposed method for generalized zero-shot chest x-ray diagnosis.

Speckle Removal Using Diffusion Potential for Optical Coherence Tomography Images.

We propose a fast and accurate solution to speckle reduction targeted specifically at optical coherence tomography images. The proposed speckle removing filter is designed using a novel potential function based on the gradient of the local variance of intensity. After filtering, the spatially neighboring pixels with close values of intensities converge to uniform gray values, while the edges remain intact. This filtering process results in removal of speckle without destroying the edges of the desired object. The proposed filter also prevents the generation of any false edges. Detailed experimental analysis shows at least 1-dB improvement in the peak signal-to-noise ratio for spectral domain optical coherence tomography images. The method also shows superior edge preservation, contrast, and speed compared to the state of the art in speckle removing filters.

Improved Random Forest for Classification.

We propose an improved random forest classifier that performs classification with minimum number of trees. The proposed method iteratively removes some unimportant features. Based on the number of important and unimportant features, we formulate a novel theoretical upper limit on the number of trees to be added to the forest to ensure improvement in classification accuracy. Our algorithm converges with a reduced but important set of features. We prove that further addition of trees or further reduction of features does not improve classification performance. The efficacy of the proposed approach is demonstrated through experiments on benchmark datasets. We further use the proposed classifier to detect mitotic nuclei in the histopathological datasets of breast tissues. We also apply our method on the industrial dataset of dual phase steel microstructures to classify different phases. Results of our method on different datasets show significant reduction in average classification error compared to a number of competing methods.

Mitosis Detection for Invasive Breast Cancer Grading in Histopathological Images.

Histopathological grading of cancer not only offers an insight to the patients' prognosis but also helps in making individual treatment plans. Mitosis counts in histopathological slides play a crucial role for invasive breast cancer grading using the Nottingham grading system. Pathologists perform this grading by manual examinations of a few thousand images for each patient. Hence, finding the mitotic figures from these images is a tedious job and also prone to observer variability due to variations in the appearances of the mitotic cells. We propose a fast and accurate approach for automatic mitosis detection from histopathological images. We employ area morphological scale space for cell segmentation. The scale space is constructed in a novel manner by restricting the scales with the maximization of relative-entropy between the cells and the background. This results in precise cell segmentation. The segmented cells are classified in mitotic and non-mitotic category using the random forest classifier. Experiments show at least 12% improvement in F1 score on more than 450 histopathological images at 40× magnification.