Artificial intelligence in histopathological image analysis of central nervous system tumours: A systematic review.

The convergence of digital pathology and artificial intelligence could assist histopathology image analysis by providing tools for rapid, automated morphological analysis. This systematic review explores the use of artificial intelligence for histopathological image analysis of digitised central nervous system (CNS) tumour slides. Comprehensive searches were conducted across EMBASE, Medline and the Cochrane Library up to June 2023 using relevant keywords. Sixty-eight suitable studies were identified and qualitatively analysed. The risk of bias was evaluated using the Prediction model Risk of Bias Assessment Tool (PROBAST) criteria. All the studies were retrospective and preclinical. Gliomas were the most frequently analysed tumour type. The majority of studies used convolutional neural networks or support vector machines, and the most common goal of the model was for tumour classification and/or grading from haematoxylin and eosin-stained slides. The majority of studies were conducted when legacy World Health Organisation (WHO) classifications were in place, which at the time relied predominantly on histological (morphological) features but have since been superseded by molecular advances. Overall, there was a high risk of bias in all studies analysed. Persistent issues included inadequate transparency in reporting the number of patients and/or images within the model development and testing cohorts, absence of external validation, and insufficient recognition of batch effects in multi-institutional datasets. Based on these findings, we outline practical recommendations for future work including a framework for clinical implementation, in particular, better informing the artificial intelligence community of the needs of the neuropathologist.

Enhancing brain tumor detection in MRI images through explainable AI using Grad-CAM with Resnet 50.

This study addresses the critical challenge of detecting brain tumors using MRI images, a pivotal task in medical diagnostics that demands high accuracy and interpretability. While deep learning has shown remarkable success in medical image analysis, there remains a substantial need for models that are not only accurate but also interpretable to healthcare professionals. The existing methodologies, predominantly deep learning-based, often act as black boxes, providing little insight into their decision-making process. This research introduces an integrated approach using ResNet50, a deep learning model, combined with Gradient-weighted Class Activation Mapping (Grad-CAM) to offer a transparent and explainable framework for brain tumor detection. We employed a dataset of MRI images, enhanced through data augmentation, to train and validate our model. The results demonstrate a significant improvement in model performance, with a testing accuracy of 98.52% and precision-recall metrics exceeding 98%, showcasing the model's effectiveness in distinguishing tumor presence. The application of Grad-CAM provides insightful visual explanations, illustrating the model's focus areas in making predictions. This fusion of high accuracy and explainability holds profound implications for medical diagnostics, offering a pathway towards more reliable and interpretable brain tumor detection tools.

Integrated approach of federated learning with transfer learning for classification and diagnosis of brain tumor.

Brain tumor classification using MRI images is a crucial yet challenging task in medical imaging. Accurate diagnosis is vital for effective treatment planning but is often hindered by the complex nature of tumor morphology and variations in imaging. Traditional methodologies primarily rely on manual interpretation of MRI images, supplemented by conventional machine learning techniques. These approaches often lack the robustness and scalability needed for precise and automated tumor classification. The major limitations include a high degree of manual intervention, potential for human error, limited ability to handle large datasets, and lack of generalizability to diverse tumor types and imaging conditions.To address these challenges, we propose a federated learning-based deep learning model that leverages the power of Convolutional Neural Networks (CNN) for automated and accurate brain tumor classification. This innovative approach not only emphasizes the use of a modified VGG16 architecture optimized for brain MRI images but also highlights the significance of federated learning and transfer learning in the medical imaging domain. Federated learning enables decentralized model training across multiple clients without compromising data privacy, addressing the critical need for confidentiality in medical data handling. This model architecture benefits from the transfer learning technique by utilizing a pre-trained CNN, which significantly enhances its ability to classify brain tumors accurately by leveraging knowledge gained from vast and diverse datasets.Our model is trained on a diverse dataset combining figshare, SARTAJ, and Br35H datasets, employing a federated learning approach for decentralized, privacy-preserving model training. The adoption of transfer learning further bolsters the model's performance, making it adept at handling the intricate variations in MRI images associated with different types of brain tumors. The model demonstrates high precision (0.99 for glioma, 0.95 for meningioma, 1.00 for no tumor, and 0.98 for pituitary), recall, and F1-scores in classification, outperforming existing methods. The overall accuracy stands at 98%, showcasing the model's efficacy in classifying various tumor types accurately, thus highlighting the transformative potential of federated learning and transfer learning in enhancing brain tumor classification using MRI images.

Integrating Text and Image Analysis: Exploring GPT-4V's Capabilities in Advanced Radiological Applications Across Subspecialties.

This study demonstrates that GPT-4V outperforms GPT-4 across radiology subspecialties in analyzing 207 cases with 1312 images from the Radiological Society of North America Case Collection.

BarlowTwins-CXR: enhancing chest X-ray abnormality localization in heterogeneous data with cross-domain self-supervised learning.

BACKGROUND: Chest X-ray imaging based abnormality localization, essential in diagnosing various diseases, faces significant clinical challenges due to complex interpretations and the growing workload of radiologists. While recent advances in deep learning offer promising solutions, there is still a critical issue of domain inconsistency in cross-domain transfer learning, which hampers the efficiency and accuracy of diagnostic processes. This study aims to address the domain inconsistency problem and improve autonomic abnormality localization performance of heterogeneous chest X-ray image analysis, particularly in detecting abnormalities, by developing a self-supervised learning strategy called "BarlwoTwins-CXR". METHODS: We utilized two publicly available datasets: the NIH Chest X-ray Dataset and the VinDr-CXR. The BarlowTwins-CXR approach was conducted in a two-stage training process. Initially, self-supervised pre-training was performed using an adjusted Barlow Twins algorithm on the NIH dataset with a Resnet50 backbone pre-trained on ImageNet. This was followed by supervised fine-tuning on the VinDr-CXR dataset using Faster R-CNN with Feature Pyramid Network (FPN). The study employed mean Average Precision (mAP) at an Intersection over Union (IoU) of 50% and Area Under the Curve (AUC) for performance evaluation. RESULTS: Our experiments showed a significant improvement in model performance with BarlowTwins-CXR. The approach achieved a 3% increase in mAP50 accuracy compared to traditional ImageNet pre-trained models. In addition, the Ablation CAM method revealed enhanced precision in localizing chest abnormalities. The study involved 112,120 images from the NIH dataset and 18,000 images from the VinDr-CXR dataset, indicating robust training and testing samples. CONCLUSION: BarlowTwins-CXR significantly enhances the efficiency and accuracy of chest X-ray image-based abnormality localization, outperforming traditional transfer learning methods and effectively overcoming domain inconsistency in cross-domain scenarios. Our experiment results demonstrate the potential of using self-supervised learning to improve the generalizability of models in medical settings with limited amounts of heterogeneous data. This approach can be instrumental in aiding radiologists, particularly in high-workload environments, offering a promising direction for future AI-driven healthcare solutions.

Federated learning for medical image analysis: A survey.

Machine learning in medical imaging often faces a fundamental dilemma, namely, the small sample size problem. Many recent studies suggest using multi-domain data pooled from different acquisition sites/centers to improve statistical power. However, medical images from different sites cannot be easily shared to build large datasets for model training due to privacy protection reasons. As a promising solution, federated learning, which enables collaborative training of machine learning models based on data from different sites without cross-site data sharing, has attracted considerable attention recently. In this paper, we conduct a comprehensive survey of the recent development of federated learning methods in medical image analysis. We have systematically gathered research papers on federated learning and its applications in medical image analysis published between 2017 and 2023. Our search and compilation were conducted using databases from IEEE Xplore, ACM Digital Library, Science Direct, Springer Link, Web of Science, Google Scholar, and PubMed. In this survey, we first introduce the background of federated learning for dealing with privacy protection and collaborative learning issues. We then present a comprehensive review of recent advances in federated learning methods for medical image analysis. Specifically, existing methods are categorized based on three critical aspects of a federated learning system, including client end, server end, and communication techniques. In each category, we summarize the existing federated learning methods according to specific research problems in medical image analysis and also provide insights into the motivations of different approaches. In addition, we provide a review of existing benchmark medical imaging datasets and software platforms for current federated learning research. We also conduct an experimental study to empirically evaluate typical federated learning methods for medical image analysis. This survey can help to better understand the current research status, challenges, and potential research opportunities in this promising research field.

DomainATM: Domain adaptation toolbox for medical data analysis.

Domain adaptation (DA) is an important technique for modern machine learning-based medical data analysis, which aims at reducing distribution differences between different medical datasets. A proper domain adaptation method can significantly enhance the statistical power by pooling data acquired from multiple sites/centers. To this end, we have developed the Domain Adaptation Toolbox for Medical data analysis (DomainATM) - an open-source software package designed for fast facilitation and easy customization of domain adaptation methods for medical data analysis. The DomainATM is implemented in MATLAB with a user-friendly graphical interface, and it consists of a collection of popular data adaptation algorithms that have been extensively applied to medical image analysis and computer vision. With DomainATM, researchers are able to facilitate fast feature-level and image-level adaptation, visualization and performance evaluation of different adaptation methods for medical data analysis. More importantly, the DomainATM enables the users to develop and test their own adaptation methods through scripting, greatly enhancing its utility and extensibility. An overview characteristic and usage of DomainATM is presented and illustrated with three example experiments, demonstrating its effectiveness, simplicity, and flexibility. The software, source code, and manual are available online.

Deep Learning and Medical Image Analysis for COVID-19 Diagnosis and Prediction.

The coronavirus disease 2019 (COVID-19) pandemic has imposed dramatic challenges to health-care organizations worldwide. To combat the global crisis, the use of thoracic imaging has played a major role in the diagnosis, prediction, and management of COVID-19 patients with moderate to severe symptoms or with evidence of worsening respiratory status. In response, the medical image analysis community acted quickly to develop and disseminate deep learning models and tools to meet the urgent need of managing and interpreting large amounts of COVID-19 imaging data. This review aims to not only summarize existing deep learning and medical image analysis methods but also offer in-depth discussions and recommendations for future investigations. We believe that the wide availability of high-quality, curated, and benchmarked COVID-19 imaging data sets offers the great promise of a transformative test bed to develop, validate, and disseminate novel deep learning methods in the frontiers of data science and artificial intelligence.

Nuclei instance segmentation from histopathology images using Bayesian dropout based deep learning.

BACKGROUND: The deterministic deep learning models have achieved state-of-the-art performance in various medical image analysis tasks, including nuclei segmentation from histopathology images. The deterministic models focus on improving the model prediction accuracy without assessing the confidence in the predictions. METHODS: We propose a semantic segmentation model using Bayesian representation to segment nuclei from the histopathology images and to further quantify the epistemic uncertainty. We employ Bayesian approximation with Monte-Carlo (MC) dropout during the inference time to estimate the model's prediction uncertainty. RESULTS: We evaluate the performance of the proposed approach on the PanNuke dataset, which consists of 312 visual fields from 19 organ types. We compare the nuclei segmentation accuracy of our approach with that of a fully convolutional neural network, U-Net, SegNet, and the state-of-the-art Hover-net. We use F1-score and intersection over union (IoU) as the evaluation metrics. The proposed approach achieves a mean F1-score of 0.893 ± 0.008 and an IoU value of 0.868 ± 0.003 on the test set of the PanNuke dataset. These results outperform the Hover-net, which has a mean F1-score of 0.871 ± 0.010 and an IoU value of 0.840 ± 0.032. CONCLUSIONS: The proposed approach, which incorporates Bayesian representation and Monte-Carlo dropout, demonstrates superior performance in segmenting nuclei from histopathology images compared to existing models such as U-Net, SegNet, and Hover-net. By considering the epistemic uncertainty, our model provides a more reliable estimation of the prediction confidence. These findings highlight the potential of Bayesian deep learning for improving medical image analysis tasks and can contribute to the development of more accurate and reliable computer-aided diagnostic systems.

Gender imbalance in medical imaging datasets produces biased classifiers for computer-aided diagnosis.

Artificial intelligence (AI) systems for computer-aided diagnosis and image-based screening are being adopted worldwide by medical institutions. In such a context, generating fair and unbiased classifiers becomes of paramount importance. The research community of medical image computing is making great efforts in developing more accurate algorithms to assist medical doctors in the difficult task of disease diagnosis. However, little attention is paid to the way databases are collected and how this may influence the performance of AI systems. Our study sheds light on the importance of gender balance in medical imaging datasets used to train AI systems for computer-assisted diagnosis. We provide empirical evidence supported by a large-scale study, based on three deep neural network architectures and two well-known publicly available X-ray image datasets used to diagnose various thoracic diseases under different gender imbalance conditions. We found a consistent decrease in performance for underrepresented genders when a minimum balance is not fulfilled. This raises the alarm for national agencies in charge of regulating and approving computer-assisted diagnosis systems, which should include explicit gender balance and diversity recommendations. We also establish an open problem for the academic medical image computing community which needs to be addressed by novel algorithms endowed with robustness to gender imbalance.

Diversity Learning Based on Multi-Latent Space for Medical Image Visual Question Generation.

Auxiliary clinical diagnosis has been researched to solve unevenly and insufficiently distributed clinical resources. However, auxiliary diagnosis is still dominated by human physicians, and how to make intelligent systems more involved in the diagnosis process is gradually becoming a concern. An interactive automated clinical diagnosis with a question-answering system and a question generation system can capture a patient's conditions from multiple perspectives with less physician involvement by asking different questions to drive and guide the diagnosis. This clinical diagnosis process requires diverse information to evaluate a patient from different perspectives to obtain an accurate diagnosis. Recently proposed medical question generation systems have not considered diversity. Thus, we propose a diversity learning-based visual question generation model using a multi-latent space to generate informative question sets from medical images. The proposed method generates various questions by embedding visual and language information in different latent spaces, whose diversity is trained by our newly proposed loss. We have also added control over the categories of generated questions, making the generated questions directional. Furthermore, we use a new metric named similarity to accurately evaluate the proposed model's performance. The experimental results on the Slake and VQA-RAD datasets demonstrate that the proposed method can generate questions with diverse information. Our model works with an answering model for interactive automated clinical diagnosis and generates datasets to replace the process of annotation that incurs huge labor costs.

Visual Features for Improving Endoscopic Bleeding Detection Using Convolutional Neural Networks.

The presented paper investigates the problem of endoscopic bleeding detection in endoscopic videos in the form of a binary image classification task. A set of definitions of high-level visual features of endoscopic bleeding is introduced, which incorporates domain knowledge from the field. The high-level features are coupled with respective feature descriptors, enabling automatic capture of the features using image processing methods. Each of the proposed feature descriptors outputs a feature activation map in the form of a grayscale image. Acquired feature maps can be appended in a straightforward way to the original color channels of the input image and passed to the input of a convolutional neural network during the training and inference steps. An experimental evaluation is conducted to compare the classification ROC AUC of feature-extended convolutional neural network models with baseline models using regular color image inputs. The advantage of feature-extended models is demonstrated for the Resnet and VGG convolutional neural network architectures.

A Two-Stage Automatic Color Thresholding Technique.

Thresholding is a prerequisite for many computer vision algorithms. By suppressing the background in an image, one can remove unnecessary information and shift one's focus to the object of inspection. We propose a two-stage histogram-based background suppression technique based on the chromaticity of the image pixels. The method is unsupervised, fully automated, and does not need any training or ground-truth data. The performance of the proposed method was evaluated using a printed circuit assembly (PCA) board dataset and the University of Waterloo skin cancer dataset. Accurately performing background suppression in PCA boards facilitates the inspection of digital images with small objects of interest, such as text or microcontrollers on a PCA board. The segmentation of skin cancer lesions will help doctors to automate skin cancer detection. The results showed a clear and robust background-foreground separation across various sample images under different camera or lighting conditions, which the naked implementation of existing state-of-the-art thresholding methods could not achieve.

Convolution Neural Networks and Self-Attention Learners for Alzheimer Dementia Diagnosis from Brain MRI.

Alzheimer's disease (AD) is the most common form of dementia. Computer-aided diagnosis (CAD) can help in the early detection of associated cognitive impairment. The aim of this work is to improve the automatic detection of dementia in MRI brain data. For this purpose, we used an established pipeline that includes the registration, slicing, and classification steps. The contribution of this research was to investigate for the first time, to our knowledge, three current and promising deep convolutional models (ResNet, DenseNet, and EfficientNet) and two transformer-based architectures (MAE and DeiT) for mapping input images to clinical diagnosis. To allow a fair comparison, the experiments were performed on two publicly available datasets (ADNI and OASIS) using multiple benchmarks obtained by changing the number of slices per subject extracted from the available 3D voxels. The experiments showed that very deep ResNet and DenseNet models performed better than the shallow ResNet and VGG versions tested in the literature. It was also found that transformer architectures, and DeiT in particular, produced the best classification results and were more robust to the noise added by increasing the number of slices. A significant improvement in accuracy (up to 7%) was achieved compared to the leading state-of-the-art approaches, paving the way for the use of CAD approaches in real-world applications.

Advancing Brain Tumor Classification through Fine-Tuned Vision Transformers: A Comparative Study of Pre-Trained Models.

This paper presents a comprehensive study on the classification of brain tumor images using five pre-trained vision transformer (ViT) models, namely R50-ViT-l16, ViT-l16, ViT-l32, ViT-b16, and ViT-b32, employing a fine-tuning approach. The objective of this study is to advance the state-of-the-art in brain tumor classification by harnessing the power of these advanced models. The dataset utilized for experimentation consists of a total of 4855 images in the training set and 857 images in the testing set, encompassing four distinct tumor classes. The performance evaluation of each model is conducted through an extensive analysis encompassing precision, recall, F1-score, accuracy, and confusion matrix metrics. Among the models assessed, ViT-b32 demonstrates exceptional performance, achieving a high accuracy of 98.24% in accurately classifying brain tumor images. Notably, the obtained results outperform existing methodologies, showcasing the efficacy of the proposed approach. The contributions of this research extend beyond conventional methods, as it not only employs cutting-edge ViT models but also surpasses the performance of existing approaches for brain tumor image classification. This study not only demonstrates the potential of ViT models in medical image analysis but also provides a benchmark for future research in the field of brain tumor classification.

Spleen Tissue Segmentation Algorithm for Cryo-Imaging Data.

Spleen tissue segmentation is an essential process for analyzing various immunological diseases as observed in the cryo-imaging data. Because manual labeling of the spleen tissue by human experts is not efficient, an automatic segmentation algorithm is needed. In this study, we developed a novel algorithm for automatically segmenting spleen substructures including white pulp and red pulp for the first time. The algorithm is designed for datasets created by a cryo-imaging system. This unique technology can effectively enable cellular tracking anywhere in the whole mouse with single-cell sensitivity. The proposed algorithm consists of four components: initial spleen mask creation, feature extraction, Supervised Patch-based Fuzzy c-Mean (spFCM) classification, and post-processing. The algorithm accurately and efficiently labeled spleen tissues in all experiment settings. The algorithm also improved the spleen segmentation throughput by 90 folds as compared to the manual segmentation. Moreover, we show that our novel spFCM algorithm outperformed traditional fast-learning classifiers as well as the U-Net deep-learning model in many aspects. Two major contributions of this paper are (1) an explainable algorithm for segmenting spleen tissues in cryo-images for the first time and (2) an spFCM algorithm as a new classifier. We also discussed that our work can be beneficial to researchers who work not only in the fields of graft-versus-host disease (GVHD) mouse models, but also in that of other immunological disease models where spleen analysis is essential. Future work building upon our research may lay the foundations for biomedical studies that utilize cryo-imaging technology.

EyeCNN: exploring the potential of convolutional neural networks for identification of multiple eye diseases through retinal imagery.

BACKGROUND: The eyes are the most important part of the human body as these are directly connected to the brain and help us perceive the imagery in daily life whereas, eye diseases are mostly ignored and underestimated until it is too late. Diagnosing eye disorders through manual diagnosis by the physician can be very costly and time taking. OBJECTIVE: Thus, to tackle this, a novel method namely EyeCNN is proposed for identifying eye diseases through retinal images using EfficientNet B3. METHODS: A dataset of retinal imagery of three diseases, i.e. Diabetic Retinopathy, Glaucoma, and Cataract is used to train 12 convolutional networks while EfficientNet B3 was the topperforming model out of all 12 models with a testing accuracy of 94.30%. RESULTS: After preprocessing of the dataset and training of models, various experimentations were performed to see where our model stands. The evaluation was performed using some well-defined measures and the final model was deployed on the Streamlit server as a prototype for public usage. The proposed model has the potential to help diagnose eye diseases early, which can facilitate timely treatment. CONCLUSION: The use of EyeCNN for classifying eye diseases has the potential to aid ophthalmologists in diagnosing conditions accurately and efficiently. This research may also lead to a deeper understanding of these diseases and it may lead to new treatments. The webserver of EyeCNN can be accessed at ( https://abdulrafay97-eyecnn-app-rd9wgz.streamlit.app/ ).

Triple-kernel gated attention-based multiple instance learning with contrastive learning for medical image analysis.

In machine learning, multiple instance learning is a method evolved from supervised learning algorithms, which defines a "bag" as a collection of multiple examples with a wide range of applications. In this paper, we propose a novel deep multiple instance learning model for medical image analysis, called triple-kernel gated attention-based multiple instance learning with contrastive learning. It can be used to overcome the limitations of the existing multiple instance learning approaches to medical image analysis. Our model consists of four steps. i) Extracting the representations by a simple convolutional neural network using contrastive learning for training. ii) Using three different kernel functions to obtain the importance of each instance from the entire image and forming an attention map. iii) Based on the attention map, aggregating the entire image together by attention-based MIL pooling. iv) Feeding the results into the classifier for prediction. The results on different datasets demonstrate that the proposed model outperforms state-of-the-art methods on binary and weakly supervised classification tasks. It can provide more efficient classification results for various disease models and additional explanatory information.

Multi-task Deep Learning of Myocardial Blood Flow and Cardiovascular Risk Traits from PET Myocardial Perfusion Imaging.

BACKGROUND: Advanced cardiac imaging with positron emission tomography (PET) is a powerful tool for the evaluation of known or suspected cardiovascular disease. Deep learning (DL) offers the possibility to abstract highly complex patterns to optimize classification and prediction tasks. METHODS AND RESULTS: We utilized DL models with a multi-task learning approach to identify an impaired myocardial flow reserve (MFR <2.0 ml/g/min) as well as to classify cardiovascular risk traits (factors), namely sex, diabetes, arterial hypertension, dyslipidemia and smoking at the individual-patient level from PET myocardial perfusion polar maps using transfer learning. Performance was assessed on a hold-out test set through the area under receiver operating curve (AUC). DL achieved the highest AUC of 0.94 [0.87-0.98] in classifying an impaired MFR in reserve perfusion polar maps. Fine-tuned DL for the classification of cardiovascular risk factors yielded the highest performance in the identification of sex from stress polar maps (AUC = 0.81 [0.73, 0.88]). Identification of smoking achieved an AUC = 0.71 [0.58, 0.85] from the analysis of rest polar maps. The identification of dyslipidemia and arterial hypertension showed poor performance and was not statistically significant. CONCLUSION: Multi-task DL for the evaluation of quantitative PET myocardial perfusion polar maps is able to identify an impaired MFR as well as cardiovascular risk traits such as sex, smoking and possibly diabetes at the individual-patient level.

Radiomics for precision medicine: Current challenges, future prospects, and the proposal of a new framework.

The advancement of artificial intelligence concurrent with the development of medical imaging techniques provided a unique opportunity to turn medical imaging from mostly qualitative, to further quantitative and mineable data that can be explored for the development of clinical decision support systems (cDSS). Radiomics, a method for the high throughput extraction of hand-crafted features from medical images, and deep learning -the data driven modeling techniques based on the principles of simplified brain neuron interactions, are the most researched quantitative imaging techniques. Many studies reported on the potential of such techniques in the context of cDSS. Such techniques could be highly appealing due to the reuse of existing data, automation of clinical workflows, minimal invasiveness, three-dimensional volumetric characterization, and the promise of high accuracy and reproducibility of results and cost-effectiveness. Nevertheless, there are several challenges that quantitative imaging techniques face, and need to be addressed before the translation to clinical use. These challenges include, but are not limited to, the explainability of the models, the reproducibility of the quantitative imaging features, and their sensitivity to variations in image acquisition and reconstruction parameters. In this narrative review, we report on the status of quantitative medical image analysis using radiomics and deep learning, the challenges the field is facing, propose a framework for robust radiomics analysis, and discuss future prospects.