Abstract

Lung ultrasound (LUS) is a cheap, safe and non-invasive imaging modality that can be performed at patient bed-side. However, to date LUS is not widely adopted due to lack of trained personnel required for interpreting the acquired LUS frames. In this work we propose a framework for training deep artificial neural networks for interpreting LUS, which may promote broader use of LUS. When using LUS to evaluate a patient’s condition, both anatomical phenomena (e.g., the pleural line, presence of consolidations), as well as sonographic artifacts (such as A- and B-lines) are of importance. In our framework, we integrate domain knowledge into deep neural networks by inputting anatomical features and LUS artifacts in the form of additional channels containing pleural and vertical artifacts masks along with the raw LUS frames. By explicitly supplying this domain knowledge, standard off-the-shelf neural networks can be rapidly and efficiently finetuned to accomplish various tasks on LUS data, such as frame classification or semantic segmentation. Our framework allows for a unified treatment of LUS frames captured by either convex or linear probes. We evaluated our proposed framework on the task of COVID-19 severity assessment using the ICLUS dataset. In particular, we finetuned simple image classification models to predict per-frame COVID-19 severity score. We also trained a semantic segmentation model to predict per-pixel COVID-19 severity annotations. Using the combined raw LUS frames and the detected lines for both tasks, our off-the-shelf models performed better than complicated models specifically designed for these tasks, exemplifying the efficacy of our framework.

Highlights

  • The diagnosis and treatment of respiratory diseases rely on the use of various imaging modalities

  • Instead of designing taskspecific Deep neural networks (DNN) for lung ultrasound (LUS) analysis, we propose a framework that integrates LUS domain knowledge into the inputs used by standard DNNs

  • We demonstrate the efficacy of our framework on COVID19 severity assessment, both on LUS frame classification as well as the task of semantic segmentation

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Summary

INTRODUCTION

The diagnosis and treatment of respiratory diseases rely on the use of various imaging modalities. We detect the pleural line and vertical artifacts (such as B-lines, “white lung” etc.) as a preprocessing stage This automatically extracted domain-specific information is fed, as additional input channels, much like RGB color channels in “natural images”, to a DL model alongside the raw LUS frame. These domain-specific channels allow the model to better tune and attend to relevant features and findings characteristic of this specific domain This approach for utilizing domain knowledge puts the focus on data preparation and alleviates the need to design task-specific DNNs. A similar approach, i.e., augmenting the raw input with additional masks, for analysing chest Xray of COVID-19 patients was proposed in [22]. Providing the model with this automatically extracted domain knowledge allows using simple off-the-shelf image classification neural network architectures, and rapidly and efficiently finetuning them to perform well on LUS data.

METHOD
Vertical artifacts estimation
Pleural line detection
DNN Models
Finetuning the models
COVID-19 SEVERITY GRADING RESULTS
Results
Ablation study
Effect of training set size
Vertical artifacts masks
SEMANTIC SEGMENTATION OF COVID-19 MARKERS
Findings
CONCLUSION
Full Text
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