A novel framework of multiclass skin lesion recognition from dermoscopic images using deep learning and explainable AI.

Skin cancer is a serious disease that affects people all over the world. Melanoma is an aggressive form of skin cancer, and early detection can significantly reduce human mortality. In the United States, approximately 97,610 new cases of melanoma will be diagnosed in 2023. However, challenges such as lesion irregularities, low-contrast lesions, intraclass color similarity, redundant features, and imbalanced datasets make improved recognition accuracy using computerized techniques extremely difficult. This work presented a new framework for skin lesion recognition using data augmentation, deep learning, and explainable artificial intelligence. In the proposed framework, data augmentation is performed at the initial step to increase the dataset size, and then two pretrained deep learning models are employed. Both models have been fine-tuned and trained using deep transfer learning. Both models (Xception and ShuffleNet) utilize the global average pooling layer for deep feature extraction. The analysis of this step shows that some important information is missing; therefore, we performed the fusion. After the fusion process, the computational time was increased; therefore, we developed an improved Butterfly Optimization Algorithm. Using this algorithm, only the best features are selected and classified using machine learning classifiers. In addition, a GradCAM-based visualization is performed to analyze the important region in the image. Two publicly available datasets-ISIC2018 and HAM10000-have been utilized and obtained improved accuracy of 99.3% and 91.5%, respectively. Comparing the proposed framework accuracy with state-of-the-art methods reveals improved and less computational time.

Leukocytes Classification for Leukemia Detection Using Quantum Inspired Deep Feature Selection.

Leukocytes, also referred to as white blood cells (WBCs), are a crucial component of the human immune system. Abnormal proliferation of leukocytes in the bone marrow leads to leukemia, a fatal blood cancer. Classification of various subtypes of WBCs is an important step in the diagnosis of leukemia. The method of automated classification of WBCs using deep convolutional neural networks is promising to achieve a significant level of accuracy, but suffers from high computational costs due to very large feature sets. Dimensionality reduction through intelligent feature selection is essential to improve the model performance with reduced computational complexity. This work proposed an improved pipeline for subtype classification of WBCs that relies on transfer learning for feature extraction using deep neural networks, followed by a wrapper feature selection approach based on a customized quantum-inspired evolutionary algorithm (QIEA). This algorithm, inspired by the principles of quantum physics, outperforms classical evolutionary algorithms in the exploration of search space. The reduced feature vector obtained from QIEA was then classified with multiple baseline classifiers. In order to validate the proposed methodology, a public dataset of 5000 images of five subtypes of WBCs was used. The proposed system achieves a classification accuracy of about 99% with a reduction of 90% in the size of the feature vector. The proposed feature selection method also shows a better convergence performance as compared to the classical genetic algorithm and a comparable performance to several existing works.

BRMI-Net: Deep Learning Features and Flower Pollination-Controlled Regula Falsi-Based Feature Selection Framework for Breast Cancer Recognition in Mammography Images.

The early detection of breast cancer using mammogram images is critical for lowering women's mortality rates and allowing for proper treatment. Deep learning techniques are commonly used for feature extraction and have demonstrated significant performance in the literature. However, these features do not perform well in several cases due to redundant and irrelevant information. We created a new framework for diagnosing breast cancer using entropy-controlled deep learning and flower pollination optimization from the mammogram images. In the proposed framework, a filter fusion-based method for contrast enhancement is developed. The pre-trained ResNet-50 model is then improved and trained using transfer learning on both the original and enhanced datasets. Deep features are extracted and combined into a single vector in the following phase using a serial technique known as serial mid-value features. The top features are then classified using neural networks and machine learning classifiers in the following stage. To accomplish this, a technique for flower pollination optimization with entropy control has been developed. The exercise used three publicly available datasets: CBIS-DDSM, INbreast, and MIAS. On these selected datasets, the proposed framework achieved 93.8, 99.5, and 99.8% accuracy, respectively. Compared to the current methods, the increase in accuracy and decrease in computational time are explained.

BC2NetRF: Breast Cancer Classification from Mammogram Images Using Enhanced Deep Learning Features and Equilibrium-Jaya Controlled Regula Falsi-Based Features Selection.

One of the most frequent cancers in women is breast cancer, and in the year 2022, approximately 287,850 new cases have been diagnosed. From them, 43,250 women died from this cancer. An early diagnosis of this cancer can help to overcome the mortality rate. However, the manual diagnosis of this cancer using mammogram images is not an easy process and always requires an expert person. Several AI-based techniques have been suggested in the literature. However, still, they are facing several challenges, such as similarities between cancer and non-cancer regions, irrelevant feature extraction, and weak training models. In this work, we proposed a new automated computerized framework for breast cancer classification. The proposed framework improves the contrast using a novel enhancement technique called haze-reduced local-global. The enhanced images are later employed for the dataset augmentation. This step aimed at increasing the diversity of the dataset and improving the training capability of the selected deep learning model. After that, a pre-trained model named EfficientNet-b0 was employed and fine-tuned to add a few new layers. The fine-tuned model was trained separately on original and enhanced images using deep transfer learning concepts with static hyperparameters' initialization. Deep features were extracted from the average pooling layer in the next step and fused using a new serial-based approach. The fused features were later optimized using a feature selection algorithm known as Equilibrium-Jaya controlled Regula Falsi. The Regula Falsi was employed as a termination function in this algorithm. The selected features were finally classified using several machine learning classifiers. The experimental process was conducted on two publicly available datasets-CBIS-DDSM and INbreast. For these datasets, the achieved average accuracy is 95.4% and 99.7%. A comparison with state-of-the-art (SOTA) technology shows that the obtained proposed framework improved the accuracy. Moreover, the confidence interval-based analysis shows consistent results of the proposed framework.

An Improved Skin Lesion Boundary Estimation for Enhanced-Intensity Images Using Hybrid Metaheuristics.

The demand for the accurate and timely identification of melanoma as a major skin cancer type is increasing daily. Due to the advent of modern tools and computer vision techniques, it has become easier to perform analysis. Skin cancer classification and segmentation techniques require clear lesions segregated from the background for efficient results. Many studies resolve the matter partly. However, there exists plenty of room for new research in this field. Recently, many algorithms have been presented to preprocess skin lesions, aiding the segmentation algorithms to generate efficient outcomes. Nature-inspired algorithms and metaheuristics help to estimate the optimal parameter set in the search space. This research article proposes a hybrid metaheuristic preprocessor, BA-ABC, to improve the quality of images by enhancing their contrast and preserving the brightness. The statistical transformation function, which helps to improve the contrast, is based on a parameter set estimated through the proposed hybrid metaheuristic model for every image in the dataset. For experimentation purposes, we have utilised three publicly available datasets, ISIC-2016, 2017 and 2018. The efficacy of the presented model is validated through some state-of-the-art segmentation algorithms. The visual outcomes of the boundary estimation algorithms and performance matrix validate that the proposed model performs well. The proposed model improves the dice coefficient to 94.6% in the results.

An efficient computer vision-based approach for acute lymphoblastic leukemia prediction.

Leukemia (blood cancer) diseases arise when the number of White blood cells (WBCs) is imbalanced in the human body. When the bone marrow produces many immature WBCs that kill healthy cells, acute lymphocytic leukemia (ALL) impacts people of all ages. Thus, timely predicting this disease can increase the chance of survival, and the patient can get his therapy early. Manual prediction is very expensive and time-consuming. Therefore, automated prediction techniques are essential. In this research, we propose an ensemble automated prediction approach that uses four machine learning algorithms K-Nearest Neighbor (KNN), Support Vector Machine (SVM), Random Forest (RF), and Naive Bayes (NB). The C-NMC leukemia dataset is used from the Kaggle repository to predict leukemia. Dataset is divided into two classes cancer and healthy cells. We perform data preprocessing steps, such as the first images being cropped using minimum and maximum points. Feature extraction is performed to extract the feature using pre-trained Convolutional Neural Network-based Deep Neural Network (DNN) architectures (VGG19, ResNet50, or ResNet101). Data scaling is performed by using the MinMaxScaler normalization technique. Analysis of Variance (ANOVA), Recursive Feature Elimination (RFE), and Random Forest (RF) as feature Selection techniques. Classification machine learning algorithms and ensemble voting are applied to selected features. Results reveal that SVM with 90.0% accuracy outperforms compared to other algorithms.

GestroNet: A Framework of Saliency Estimation and Optimal Deep Learning Features Based Gastrointestinal Diseases Detection and Classification.

In the last few years, artificial intelligence has shown a lot of promise in the medical domain for the diagnosis and classification of human infections. Several computerized techniques based on artificial intelligence (AI) have been introduced in the literature for gastrointestinal (GIT) diseases such as ulcer, bleeding, polyp, and a few others. Manual diagnosis of these infections is time consuming, expensive, and always requires an expert. As a result, computerized methods that can assist doctors as a second opinion in clinics are widely required. The key challenges of a computerized technique are accurate infected region segmentation because each infected region has a change of shape and location. Moreover, the inaccurate segmentation affects the accurate feature extraction that later impacts the classification accuracy. In this paper, we proposed an automated framework for GIT disease segmentation and classification based on deep saliency maps and Bayesian optimal deep learning feature selection. The proposed framework is made up of a few key steps, from preprocessing to classification. Original images are improved in the preprocessing step by employing a proposed contrast enhancement technique. In the following step, we proposed a deep saliency map for segmenting infected regions. The segmented regions are then used to train a pre-trained fine-tuned model called MobileNet-V2 using transfer learning. The fine-tuned model's hyperparameters were initialized using Bayesian optimization (BO). The average pooling layer is then used to extract features. However, several redundant features are discovered during the analysis phase and must be removed. As a result, we proposed a hybrid whale optimization algorithm for selecting the best features. Finally, the selected features are classified using an extreme learning machine classifier. The experiment was carried out on three datasets: Kvasir 1, Kvasir 2, and CUI Wah. The proposed framework achieved accuracy of 98.20, 98.02, and 99.61% on these three datasets, respectively. When compared to other methods, the proposed framework shows an improvement in accuracy.

Multiclass Skin Lesion Classification Using Hybrid Deep Features Selection and Extreme Learning Machine.

The variation in skin textures and injuries, as well as the detection and classification of skin cancer, is a difficult task. Manually detecting skin lesions from dermoscopy images is a difficult and time-consuming process. Recent advancements in the domains of the internet of things (IoT) and artificial intelligence for medical applications demonstrated improvements in both accuracy and computational time. In this paper, a new method for multiclass skin lesion classification using best deep learning feature fusion and an extreme learning machine is proposed. The proposed method includes five primary steps: image acquisition and contrast enhancement; deep learning feature extraction using transfer learning; best feature selection using hybrid whale optimization and entropy-mutual information (EMI) approach; fusion of selected features using a modified canonical correlation based approach; and, finally, extreme learning machine based classification. The feature selection step improves the system's computational efficiency and accuracy. The experiment is carried out on two publicly available datasets, HAM10000 and ISIC2018. The achieved accuracy on both datasets is 93.40 and 94.36 percent. When compared to state-of-the-art (SOTA) techniques, the proposed method's accuracy is improved. Furthermore, the proposed method is computationally efficient.

Breast Cancer Classification from Ultrasound Images Using Probability-Based Optimal Deep Learning Feature Fusion.

After lung cancer, breast cancer is the second leading cause of death in women. If breast cancer is detected early, mortality rates in women can be reduced. Because manual breast cancer diagnosis takes a long time, an automated system is required for early cancer detection. This paper proposes a new framework for breast cancer classification from ultrasound images that employs deep learning and the fusion of the best selected features. The proposed framework is divided into five major steps: (i) data augmentation is performed to increase the size of the original dataset for better learning of Convolutional Neural Network (CNN) models; (ii) a pre-trained DarkNet-53 model is considered and the output layer is modified based on the augmented dataset classes; (iii) the modified model is trained using transfer learning and features are extracted from the global average pooling layer; (iv) the best features are selected using two improved optimization algorithms known as reformed differential evaluation (RDE) and reformed gray wolf (RGW); and (v) the best selected features are fused using a new probability-based serial approach and classified using machine learning algorithms. The experiment was conducted on an augmented Breast Ultrasound Images (BUSI) dataset, and the best accuracy was 99.1%. When compared with recent techniques, the proposed framework outperforms them.

A Computer-Aided Diagnosis System Using Deep Learning for Multiclass Skin Lesion Classification.

In the USA, each year, almost 5.4 million people are diagnosed with skin cancer. Melanoma is one of the most dangerous types of skin cancer, and its survival rate is 5%. The development of skin cancer has risen over the last couple of years. Early identification of skin cancer can help reduce the human mortality rate. Dermoscopy is a technology used for the acquisition of skin images. However, the manual inspection process consumes more time and required much cost. The recent development in the area of deep learning showed significant performance for classification tasks. In this research work, a new automated framework is proposed for multiclass skin lesion classification. The proposed framework consists of a series of steps. In the first step, augmentation is performed. For the augmentation process, three operations are performed: rotate 90, right-left flip, and up and down flip. In the second step, deep models are fine-tuned. Two models are opted, such as ResNet-50 and ResNet-101, and updated their layers. In the third step, transfer learning is applied to train both fine-tuned deep models on augmented datasets. In the succeeding stage, features are extracted and performed fusion using a modified serial-based approach. Finally, the fused vector is further enhanced by selecting the best features using the skewness-controlled SVR approach. The final selected features are classified using several machine learning algorithms and selected based on the accuracy value. In the experimental process, the augmented HAM10000 dataset is used and achieved an accuracy of 91.7%. Moreover, the performance of the augmented dataset is better as compared to the original imbalanced dataset. In addition, the proposed method is compared with some recent studies and shows improved performance.

Internet of medical things embedding deep learning with data augmentation for mammogram density classification.

Females are approximately half of the total population worldwide, and most of them are victims of breast cancer (BC). Computer-aided diagnosis (CAD) frameworks can help radiologists to find breast density (BD), which further helps in BC detection precisely. This research detects BD automatically using mammogram images based on Internet of Medical Things (IoMT) supported devices. Two pretrained deep convolutional neural network models called DenseNet201 and ResNet50 were applied through a transfer learning approach. A total of 322 mammogram images containing 106 fatty, 112 dense, and 104 glandular cases were obtained from the Mammogram Image Analysis Society dataset. The pruning out irrelevant regions and enhancing target regions is performed in preprocessing. The overall classification accuracy of the BD task is performed and accomplished 90.47% through DensNet201 model. Such a framework is beneficial in identifying BD more rapidly to assist radiologists and patients without delay.

Maltoma veiled in the lung-a rare case of pulmonary and gastric maltoma.

Mucosa associated lymphoid tissue (MALT) is a type of B-cell lymphoma that is commonly observed in the gastrointestinal site, most frequently occurring in the stomach. However, the incidence of this type of lymphoma in the respiratory tract is very uncommon. We report a case of this rare clinical entity in a patient who presented with non-symptomatology and was diagnosed with pulmonary MALT lymphoma (pMALToma).

Brain tumor detection and multi-classification using advanced deep learning techniques.

A brain tumor is an uncontrolled development of brain cells in brain cancer if not detected at an early stage. Early brain tumor diagnosis plays a crucial role in treatment planning and patients' survival rate. There are distinct forms, properties, and therapies of brain tumors. Therefore, manual brain tumor detection is complicated, time-consuming, and vulnerable to error. Hence, automated computer-assisted diagnosis at high precision is currently in demand. This article presents segmentation through Unet architecture with ResNet50 as a backbone on the Figshare data set and achieved a level of 0.9504 of the intersection over union (IoU). The preprocessing and data augmentation concept were introduced to enhance the classification rate. The multi-classification of brain tumors is performed using evolutionary algorithms and reinforcement learning through transfer learning. Other deep learning methods such as ResNet50, DenseNet201, MobileNet V2, and InceptionV3 are also applied. Results thus obtained exhibited that the proposed research framework performed better than reported in state of the art. Different CNN, models applied for tumor classification such as MobileNet V2, Inception V3, ResNet50, DenseNet201, NASNet and attained accuracy 91.8, 92.8, 92.9, 93.1, 99.6%, respectively. However, NASNet exhibited the highest accuracy.

Microscopic brain tumor detection and classification using 3D CNN and feature selection architecture.

Brain tumor is one of the most dreadful natures of cancer and caused a huge number of deaths among kids and adults from the past few years. According to WHO standard, the 700,000 humans are being with a brain tumor and around 86,000 are diagnosed since 2019. While the total number of deaths due to brain tumors is 16,830 since 2019 and the average survival rate is 35%. Therefore, automated techniques are needed to grade brain tumors precisely from MRI scans. In this work, a new deep learning-based method is proposed for microscopic brain tumor detection and tumor type classification. A 3D convolutional neural network (CNN) architecture is designed at the first step to extract brain tumor and extracted tumors are passed to a pretrained CNN model for feature extraction. The extracted features are transferred to the correlation-based selection method and as the output, the best features are selected. These selected features are validated through feed-forward neural network for final classification. Three BraTS datasets 2015, 2017, and 2018 are utilized for experiments, validation, and accomplished an accuracy of 98.32, 96.97, and 92.67%, respectively. A comparison with existing techniques shows the proposed design yields comparable accuracy.

Purpura Fulminans: a Rare but Fierce Presentation of Pneumococcal Sepsis.

Infectious purpura fulminans (PF) is a rare presentation of disseminated intravascular coagulopathy (DIC) due to diffuse intravascular thrombosis and haemorrhagic infarction of the skin. PF can present in infancy/childhood or adulthood and usually presents as ecchymotic skin lesions, fever and hypotension. It is most commonly a consequence of sepsis related to Neisseria meningitidis, Streptococcus pneumoniae or Haemophilus influenzae. Despite aggressive management of sepsis with intravenous fluids, antibiotics, and conventional and nonconventional therapies, the condition still carries a mortality rate of 43%[1]. Streptococcus pneumoniae mostly presents with community-acquired pneumonia. We present a case of PF secondary to DIC related to Pneumococcal sepsis in an otherwise healthy and immunocompetent patient. LEARNING POINTS: Infectious purpura fulminans is a haematological emergency that demands early recognition and timely institution of therapy to prevent significant morbidity and mortality.A characteristic skin rash is a key diagnostic clue pointing to purpura fulminans, and should lead to prompt institution of therapy, as waiting for a skin biopsy result can delay the diagnosis and result in significant morbidity and mortality.Due to the lack of prospective data on management of the condition, various modalities, such as hyperbaric oxygen therapy and IVIG, still have questionable benefits. We therefore aim to expand knowledge of purpura fulminans management.

Classification of stomach infections: A paradigm of convolutional neural network along with classical features fusion and selection.

Automated detection and classification of gastric infections (i.e., ulcer, polyp, esophagitis, and bleeding) through wireless capsule endoscopy (WCE) is still a key challenge. Doctors can identify these endoscopic diseases by using the computer-aided diagnostic (CAD) systems. In this article, a new fully automated system is proposed for the recognition of gastric infections through multi-type features extraction, fusion, and robust features selection. Five key steps are performed-database creation, handcrafted and convolutional neural network (CNN) deep features extraction, a fusion of extracted features, selection of best features using a genetic algorithm (GA), and recognition. In the features extraction step, discrete cosine transform, discrete wavelet transform strong color feature, and VGG16-based CNN features are extracted. Later, these features are fused by simple array concatenation and GA is performed through which best features are selected based on K-Nearest Neighbor fitness function. In the last, best selected features are provided to Ensemble classifier for recognition of gastric diseases. A database is prepared using four datasets-Kvasir, CVC-ClinicDB, Private, and ETIS-LaribPolypDB with four types of gastric infections such as ulcer, polyp, esophagitis, and bleeding. Using this database, proposed technique performs better as compared to existing methods and achieves an accuracy of 96.5%.

Paraneoplastic Mononeuritis Multiplex: A Unique Presentation of Non-Hodgkin Lymphoma.

Mononeuritis multiplex (MM) is a common variant of a peripheral neuropathy which is characterized by neurological discrepancies that afflict two noncontiguous nerve systems. It is mostly associated with systemic illnesses such as diabetes mellitus, vasculitis, systemic lupus erythematosus (SLE), viral infections including human immunodeficiency virus (HIV) and paraneoplastic syndromes. Lymphoma is a common antecedent to paraneoplastic syndromes that cause peripheral neuropathies but a specific presentation of MM is a rare predicament per our literature analysis.

Skull Metastasis Extending to the Superior Sagittal Sinus: An Unfamiliar Presentation of Papillary Thyroid Carcinoma.

Thyroid cancer is the most common endocrine cancer in the world, with a rising global incidence over the last three decades. Papillary thyroid cancer (PTC) is the most common type of thyroid neoplasia, accounting for 74%-80% of all cases. Skull metastasis from a differentiated thyroid malignancy is a rare occurrence, while a subsequent dural involvement is even more inimitable. As such, a clinician requires a high degree of clinical suspicion and resultant radiographic evidence in order to make the diagnosis. Here we present the case of a 54-year-old male patient who presented with a pathological fracture of his right humerus, a midline frontal bone swelling and an asymptomatic neck mass. Further workup revealed follicular variant papillary thyroid carcinoma (FV-PTC) with distant metastasis to the calvarium. The conventional therapy for metastatic PTC includes a total thyroidectomy, removal of resectable metastatic lesions and a supplementation with radioactive iodine (RAI) and/or external beam radiation at the sites of the metastases. This case and our literature review illustrate that skull metastases should be considered in the clinical course of PTC so that appropriate management can be started.

Simultaneous Bilateral Spontaneous Pneumothorax: A Rare Complication of Osteosarcoma.

The lungs are a common site of metastatic spread of an osteosarcoma. An affiliated simultaneous bilateral spontaneous pneumothorax (SBSP) is a rare clinical sequela of this malignancy. In this case report, we present the clinical circumstances of a young teenager who presented to our clinical setting following a diagnosis of osteosarcoma. We also illustrate the postulated pathophysiology, the tools for diagnosis and a subsequent management for this rare clinical entity.

Jejunal Intussusception: A Rare Manifestation of a Primary Thyroid Non-Hodgkin Lymphoma.

Primary thyroid lymphoma (PTL) is an uncommon malignancy of the thyroid gland, with most lymphomas of the thyroid being almost exclusively of the non-Hodgkin's B cell variety. PTL requires a prompt diagnosis because of its ability to cause progressive compression symptoms, and its unusual presentation can make the diagnosis very challenging. Herein, we present a case of PTL in a young woman with an uncommon initial presentation and discuss the complications she faced during the surgery, as well as postoperatively, due to the compression of the trachea by the thyroid mass.