Computer-assisted Diagnostics Research Articles

Computational pathology: an evolving concept.

The initial enthusiasm about computational pathology (CP) and artificial intelligence (AI) was that they will replace pathologists entirely on the way to fully automated diagnostics. It is becoming clear that currently this is not the immediate model to pursue. On top of the legal and regulatory complexities surrounding its implementation, the majority of tested machine learning (ML)-based predictive algorithms do not display the exquisite performance needed to render them unequivocal, standalone decision makers for matters with direct implications to human health. We are thus moving into a different model of "computer-assisted diagnostics", where AI is there to provide support, rather than replacing, the pathologist. Herein we focus on the practical aspects of CP, from a pathologist perspective. There is a wide range of potential applications where CP can enhance precision of pathology diagnosis, tailor prognostic and predictive information, as well as save time. There are, however, a number of potential limitations for CP that currently hinder their wider adoption in the clinical setting. We address the key necessary steps towards clinical implementation of computational pathology, discuss the significant obstacles that hinders its adoption in the clinical context and summarize some proposed solutions. We conclude that the advancement of CP in the clinic is a promising resource-intensive endeavour that requires broad and inclusive collaborations between academia, industry, and regulatory bodies.

IJCM_233A: Multicentric study to evaluate the effectiveness of AI based Thermal mammography compared with standard screening modalities in suspected breast cancer patients.

Background: Machine learning in computer-assisted diagnostics improves sensitivity of image analysis and reduces time and effort for interpretation. Compared to standard mammograms, a thermal scan is easily scalable and is a safer screening tool. We evaluate the performance of an Artificial Intelligence (AI) based thermographic screening tool) compared with other standard breast cancer screening modalities Objectives: To evaluate the effectiveness of AI based Thermal mammography compared with standard screening modalities in suspected breast cancer patients. Methodology: A prospective multicentre study was conducted to assess the non-inferiority of sensitivity of AI based Thermal mammography (Thermalytix) to that of standard modalities in detecting malignancy in subjects who show possible symptoms of suspected breast cancer. Standard screening modalities and Thermalytix were obtained and interpreted independently in a blinded fashion. A receiver operating characteristic (ROC) curve was constructed to identify the best cut-off point, non-inferiority margin of =10% to demonstrate the non-inferiority. Results: We recruited 314 symptomatic women who first underwent a thermal scan, followed by mammogram and/or ultrasound. At Youden’s Index of ROC curve, the test device had a sensitivity of 82.5% (95% CI 73.2 to 91.9) and specificity of 80.5% (95% CI 75.0 to 86.1) as compared with diagnostic mammogram, which had sensitivity of 92% (95% CI 80.7 to 97.8) and specificity of 45.9% (95% CI 34.3 to 57.9). The overall area under the curve (AUC) was 0.845. Conclusion: The high AUC in both women under 45 years and above 45 years shows the potential of Thermalytix to be a supplemental diagnostic modality for all ages

Integrating hybrid transfer learning with attention-enhanced deep learning models to improve breast cancer diagnosis.

Cancer, with its high fatality rate, instills fear in countless individuals worldwide. However, effective diagnosis and treatment can often lead to a successful cure. Computer-assisted diagnostics, especially in the context of deep learning, have become prominent methods for primary screening of various diseases, including cancer. Deep learning, an artificial intelligence technique that enables computers to reason like humans, has recently gained significant attention. This study focuses on training a deep neural network to predict breast cancer. With the advancements in medical imaging technologies such as X-ray, magnetic resonance imaging (MRI), and computed tomography (CT) scans, deep learning has become essential in analyzing and managing extensive image datasets. The objective of this research is to propose a deep-learning model for the identification and categorization of breast tumors. The system's performance was evaluated using the breast cancer identification (BreakHis) classification datasets from the Kaggle repository and the Wisconsin Breast Cancer Dataset (WBC) from the UCI repository. The study's findings demonstrated an impressive accuracy rate of 100%, surpassing other state-of-the-art approaches. The suggested model was thoroughly evaluated using F1-score, recall, precision, and accuracy metrics on the WBC dataset. Training, validation, and testing were conducted using pre-processed datasets, leading to remarkable results of 99.8% recall rate, 99.06% F1-score, and 100% accuracy rate on the BreakHis dataset. Similarly, on the WBC dataset, the model achieved a 99% accuracy rate, a 98.7% recall rate, and a 99.03% F1-score. These outcomes highlight the potential of deep learning models in accurately diagnosing breast cancer. Based on our research, it is evident that the proposed system outperforms existing approaches in this field.

Automated detection of fatal cerebral haemorrhage in postmortem CT data.

During the last years, the detection of different causes of death based on postmortem imaging findings became more and more relevant. Especially postmortem computed tomography (PMCT) as a non-invasive, relatively cheap, and fast technique is progressively used as an important imaging tool for supporting autopsies. Additionally, previous works showed that deep learning applications yielded robust results for in vivo medical imaging interpretation. In this work, we propose a pipeline to identify fatal cerebral haemorrhage on three-dimensional PMCT data. We retrospectively selected 81 PMCT cases from the database of our institute, whereby 36 cases suffered from a fatal cerebral haemorrhage as confirmed by autopsy. The remaining 45 cases were considered as neurologically healthy. Based on these datasets, six machine learning classifiers (k-nearest neighbour, Gaussian naive Bayes, logistic regression, decision tree, linear discriminant analysis, and support vector machine) were executed and two deep learning models, namely a convolutional neural network (CNN) and a densely connected convolutional network (DenseNet), were trained. For all algorithms, 80% of the data was randomly selected for training and 20% for validation purposes and a five-fold cross-validation was executed. The best-performing classification algorithm for fatal cerebral haemorrhage was the artificial neural network CNN, which resulted in an accuracy of 0.94 for all folds. In the future, artificial neural network algorithms may be applied by forensic pathologists as a helpful computer-assisted diagnostics tool supporting PMCT-based evaluation of cause of death.

A GENERATIVE MODEL FOR DEEP FAKE AUGMENTATION OF PHONOCARDIOGRAM AND ELECTROCARDIOGRAM SIGNALS USING LSGAN AND CYCLE GAN

In order to diagnose a range of cardiac conditions, it is important to conduct an accurate evaluation of either phonocardiogram (PCG) and electrocardiogram (ECG) data. Artificial intelligence and machine learning-based computer-assisted diagnostics are becoming increasingly commonplace in modern medicine, assisting clinicians in making life-or-death decisions. The requirement for an enormous amount of information for training to establish the framework for a deep learning-based technique is an empirical challenge in the field of medicine. This increases the risk of personal information being misused. As a direct result of this issue, there has been an explosion in the study of methods for creating synthetic patient data. Researchers have attempted to generate synthetic ECG or PCG readings. To balance the dataset, ECG data were first created on the MIT-BIH arrhythmia database using LS GAN and Cycle GAN. Next, using VGGNet, studies were conducted to classify arrhythmias for the synthesized ECG signals. The synthesized signals performed well and resembled the original signal and the obtained precision of 91.20%, recall of 89.52% and an F1 score of 90.35%.

Classification of cervical spine fractures using 8 variants EfficientNet with transfer learning

<span lang="EN-US">A part of the nerves that govern the human body are found in the spinal cord, and a fracture of the upper cervical spine (segment C1) can cause major injury, paralysis, and even death. The early detection of a cervical spine fracture in segment C1 is critical to the patient’s life. Imaging the spine using contemporary medical equipment, on the other hand, is time-consuming, costly, private, and often not available in mainstream medicine. To improve diagnosis speed, efficiency, and accuracy, a computer-assisted diagnostics system is necessary. A deep neural network (DNN) model was employed in this study to recognize and categorize pictures of cervical spine fractures in segment C1. We used EfficientNet from version B0 to B7 to detect the location of the fracture and assess whether a fracture in the C1 region of the cervical spine exists. The patient data group with over 350 picture slices developed the most accurate model utilizing the EfficientNet architecture version B6, according to the findings of this experiment. Validation accuracy is 99.4%, whereas training accuracy is 98.25%. In the testing method using test data, the accuracy value is 99.25%, the precision value is 94.3%, the recall value is 98%, and the F1-score value is 96%.</span>

Symposium 5

While magnetic resonance imaging (MRI) is the most established imaging modality to assess autoimmune myositis (AIM), there is a need for less expensive and more accessible tools. To analyze whether there is sufficient data from published literature to demonstrate that ultrasound presents good metric properties (truth, discrimination and feasibility) in AIM, the OMERACT ultrasound group for myositis performed a systematic literature review. The inclusion criteria required original research involving adult humans, reported in English, assessing ultrasound and elastography in patients with an AIM. Conference abstracts and computer-assisted diagnostics that focused on technique and not ultrasound domains were excluded. Approximately 2670 articles were identified. 41 full-text articles were included in the final analysis. There were 551 AIM patients studied. Eighteen studies (43.9%) had a control group, of which 15 (63.3%) were healthy controls. The age of participants (including controls) varied from 18 to 86 years, and most were females (59%). Diagnosis of AIM was largely biopsy-proven, although some were derived through clinical presentation, positive clinical imaging (ultrasound or otherwise) and/or electromyography and steroid responsiveness. The features examined with ultrasound in the 41 included articles consisted of: muscle echogenicity, bulk, atrophy, architecture, power Doppler, perfusion characteristics, shear wave modulus, shear wave velocity, elasticity index and fasciculations. 12 studies (29.2%) used quantitative methods to assess these characteristics, whilst others used semi-quantitative, dichotomous/binary and descriptive scoring systems. Criterion validity was met in 14 studies (12/14, 85.7%) and construct validity in 22 studies (22/25, 88.0%). Most published articles reported Level 3b to Level 5 evidence with varying degrees of bias. There was only one longitudinal study examining discrimination. Reliability and feasibility were under-reported. This was the first systematic review studying the utility of ultrasound in AIM, which suggested some evidence for criterion and construct validity. Further validation processes are underway.

Breast cancer detection using Histopathology Image with Mini-Batch Stochastic Gradient Descent and Convolutional Neural Network

Cancer is a devastating disease that has far-reaching effects on our culture and economy, in addition to the human lives it takes. Regarding budgetary responsibility, investing just in cancer treatment is not an option. Early diagnosis is a crucial part of the remedy that sometimes gets overlooked. Malignancy is often diagnosed and evaluated using Histopathology Images (HI), which are widely accepted as the gold standard in the field. Yet, even for experienced pathologists, analysing such images is challenging, which raises concerns of inter- and intra-observer variability. The analysis also requires a substantial investment of time and energy. One way that such an examination may be sped up is by making use of computer-assisted diagnostics devices. The purpose of this research is to create a comprehensive cancer detection system using images of breast and prostate histopathology stained with haematoxylin and eosin (H&E). Proposed here is work on improving colour normalisation methods, constructing an integrated model for nuclei segmentation and multiple objects overlap resolution, introducing and evaluating multi-level features for extracting relevant histopathological image and interpretable information, and developing classification algorithms for tasks such as cancer diagnosis, tumor identification, and tumor class labelling. Mini-Batch Stochastic Gradient Descent and Convolutional Neural Network which obtained statistical kappa value for breast cancer histopathology images shows a high degree of consistency in the classification task, with a range of 0.610.80 for benign and low grades and a range of 0.811.0 for medium and high rates. The Support Vector Machine (SVM), on the other hand, shows an almost perfect degree of consistency (0.811.0) across the several breast cancer picture classifications (benign, low, medium, and high).

Genomic and Phenotypic Biomarkers for Precision Medicine Guidance in Advanced Prostate Cancer.

Prostate cancer (PCa) is the second most diagnosed malignant neoplasm and is one of the leading causes of cancer-related death in men worldwide. Despite significant advances in screening and treatment of PCa, given the heterogeneity of this disease, optimal personalized therapeutic strategies remain limited. However, emerging predictive and prognostic biomarkers based on individual patient profiles in combination with computer-assisted diagnostics have the potential to guide precision medicine, where patients may benefit from therapeutic approaches optimally suited to their disease. Also, the integration of genotypic and phenotypic diagnostic methods is supporting better informed treatment decisions. Focusing on advanced PCa, this review discusses polygenic risk scores for screening of PCa and common genomic aberrations in androgen receptor (AR), PTEN-PI3K-AKT, and DNA damage response (DDR) pathways, considering clinical implications for diagnosis, prognosis, and treatment prediction. Furthermore, we evaluate liquid biopsy, protein biomarkers such as serum testosterone levels, SLFN11 expression, total alkaline phosphatase (tALP), neutrophil-to-lymphocyte ratio (NLR), tissue biopsy, and advanced imaging tools, summarizing current phenotypic biomarkers and envisaging more effective utilization of diagnostic and prognostic biomarkers in advanced PCa. We conclude that prognostic and treatment predictive biomarker discovery can improve the management of patients, especially in metastatic stages of advanced PCa. This will result in decreased mortality and enhanced quality of life and help design a personalized treatment regimen.

Ejection Fraction Estimation from Echocardiograms Using Optimal Left Ventricle Feature Extraction Based on Clinical Methods.

Echocardiography is one of the imaging systems most often utilized for assessing heart anatomy and function. Left ventricle ejection fraction (LVEF) is an important clinical variable assessed from echocardiography via the measurement of left ventricle (LV) parameters. Significant inter-observer and intra-observer variability is seen when LVEF is quantified by cardiologists using huge echocardiography data. Machine learning algorithms have the capability to analyze such extensive datasets and identify intricate patterns of structure and function of the heart that highly skilled observers might overlook, hence paving the way for computer-assisted diagnostics in this field. In this study, LV segmentation is performed on echocardiogram data followed by feature extraction from the left ventricle based on clinical methods. The extracted features are then subjected to analysis using both neural networks and traditional machine learning algorithms to estimate the LVEF. The results indicate that employing machine learning techniques on the extracted features from the left ventricle leads to higher accuracy than the utilization of Simpson's method for estimating the LVEF. The evaluations are performed on a publicly available echocardiogram dataset, EchoNet-Dynamic. The best results are obtained when DeepLab, a convolutional neural network architecture, is used for LV segmentation along with Long Short-Term Memory Networks (LSTM) for the regression of LVEF, obtaining a dice similarity coefficient of 0.92 and a mean absolute error of 5.736%.

Clinical utility of artificial intelligence assistance in histopathologic review of lymph node metastasis for gastric adenocarcinoma.

Advances in whole-slide image capture and computer image analyses using deep learning technologies have enabled the development of computer-assisted diagnostics in pathology. Herein, we built a deep learning algorithm to detect lymph node (LN) metastasis on whole-slide images of LNs retrieved from patients with gastric adenocarcinoma and evaluated its performance in clinical settings. We randomly selected 18 patients with gastric adenocarcinoma who underwent surgery with curative intent and were positive for LN metastasis at Chiba University Hospital. A ResNet-152-based assistance system was established to detect LN metastases and to outline regions that are highly probable for metastasis in LN images. Reference standards comprising 70 LN images from two different institutions were reviewed by six pathologists with or without algorithm assistance, and their diagnostic performances were compared between the two settings. No statistically significant differences were observed between these two settings regarding sensitivity, review time, or confidence levels in classifying macrometastases, isolated tumor cells, and metastasis-negative. Meanwhile, the sensitivity for detecting micrometastases significantly improved with algorithm assistance, although the review time was significantly longer than that without assistance. Analysis of the algorithm's sensitivity in detecting metastasis in the reference standard indicated an area under the curve of 0.869, whereas that for the detection of micrometastases was 0.785. A wide variety of histological types in gastric adenocarcinoma could account for these relatively low performances; however, this level of algorithm performance could suffice to help pathologists improve diagnostic accuracy.

Automated Classification of Brain Tumors from Magnetic Resonance Imaging Using Deep Learning.

Brain tumor classification is crucial for medical evaluation in computer-assisted diagnostics (CAD). However, manual diagnosis of brain tumors from magnetic resonance imaging (MRI) can be time-consuming and complex, leading to inaccurate detection and classification. This is mainly because brain tumor identification is a complex procedure that relies on different modules. The advancements in Deep Learning (DL) have assisted in the automated process of medical images and diagnostics for various medical conditions, which benefits the health sector. Convolutional Neural Network (CNN) is one of the most prominent DL methods for visual learning and image classification tasks. This study presents a novel CNN algorithm to classify the brain tumor types of glioma, meningioma, and pituitary. The algorithm was tested on benchmarked data and compared with the existing pre-trained VGG16, VGG19, ResNet50, MobileNetV2, and InceptionV3 algorithms reported in the literature. The experimental results have indicated a high classification accuracy of 98.04%, precision, recall, and f1-score success rate of 98%, respectively. The classification results proved that the most common kinds of brain tumors could be categorized with a high level of accuracy. The presented algorithm has good generalization capability and execution speed that can be helpful in the field of medicine to assist doctors in making prompt and accurate decisions associated with brain tumor diagnosis.

Application of deep learning for bronchial asthma diagnostics using respiratory sound recordings.

Methods of computer-assisted diagnostics that utilize deep learning techniques on recordings of respiratory sounds have been developed to diagnose bronchial asthma. In the course of the study an anonymous database containing audio files of respiratory sound recordings of patients suffering from different respiratory diseases and healthy volunteers has been accumulated and used to train the software and control its operation. The database consists of 1,238 records of respiratory sounds of patients and 133 records of volunteers. The age of tested persons was from 18 months to 47 years. The sound recordings were captured during calm breathing at four points: in the oral cavity, above the trachea, at the chest, the second intercostal space on the right side, and at the point on the back. The developed software provides binary classifications (diagnostics) of the type: "sick/healthy" and "asthmatic patient/non-asthmatic patient and healthy". For small test samples of 50 (control group) to 50 records (comparison group), the diagnostic sensitivity metric of the first classifier was 88%, its specificity metric -86% and accuracy metric -87%. The metrics for the classifier "asthmatic patient/non-asthmatic patient and healthy" were 92%, 82%, and 87%, respectively. The last model applied to analyze 941 records in asthmatic patients indicated the correct asthma diagnosis in 93% of cases. The proposed method is distinguished by the fact that the trained model enables diagnostics of bronchial asthma (including differential diagnostics) with high accuracy irrespective of the patient gender and age, stage of the disease, as well as the point of sound recording. The proposed method can be used as an additional screening method for preclinical bronchial asthma diagnostics and serve as a basis for developing methods of computer assisted patient condition monitoring including remote monitoring and real-time estimation of treatment effectiveness.

HI-MViT: A lightweight model for explainable skin disease classification based on modified MobileViT.

To develop an explainable lightweight skin disease high-precision classification model that can be deployed to the mobile terminal. In this study, we present HI-MViT, a lightweight network for explainable skin disease classification based on Modified MobileViT. HI-MViT is mainly composed of ordinary convolution, Improved-MV2, MobileViT block, global pooling, and fully connected layers. Improved-MV2 uses the combination of shortcut and depth classifiable convolution to substantially decrease the amount of computation while ensuring the efficient implementation of information interaction and memory. The MobileViT block can efficiently encode local and global information. In addition, semantic feature dimensionality reduction visualization and class activation mapping visualization methods are used for HI-MViT to further understand the attention area of the model when learning skin lesion images. The International Skin Imaging Collaboration has assembled and made available the ISIC series dataset. Experiments using the HI-MViT model on the ISIC-2018 dataset achieved scores of 0.931, 0.932, 0.961, and 0.977 on F1-Score, Accuracy, Average Precision (AP), and area under the curve (AUC). Compared with the top five algorithms of ISIC-2018 Task 3, Marco's average F1-Score, AP, and AUC have increased by 6.9%, 6.8%, and 0.8% compared with the suboptimal performance model. Compared with ConvNeXt, the most competitive convolutional neural network architecture, our model is 5.0%, 3.4%, 2.3%, and 2.2% higher in F1-Score, Accuracy, AP, and AUC, respectively. The experiments on the ISIC-2017 dataset also achieved excellent results, and all indicators were better than the top five algorithms of ISIC-2017 Task 3. Using the trained model to test on the PH2 dataset, an excellent performance score is obtained, which shows that it has good generalization performance. The skin disease classification model HI-MViT proposed in this article shows excellent classification performance and generalization performance in experiments. It demonstrates how the classification outcomes can be applied to dermatologists' computer-assisted diagnostics, enabling medical professionals to classify various dermoscopic images more rapidly and reliably.

Explanatory classification of CXR images into COVID-19, Pneumonia and Tuberculosis using deep learning and XAI

Chest X-ray (CXR) images are considered useful to monitor and investigate a variety of pulmonary disorders such as COVID-19, Pneumonia, and Tuberculosis (TB). With recent technological advancements, such diseases may now be recognized more precisely using computer-assisted diagnostics. Without compromising the classification accuracy and better feature extraction, deep learning (DL) model to predict four different categories is proposed in this study. The proposed model is validated with publicly available datasets of 7132 chest x-ray (CXR) images. Furthermore, results are interpreted and explained using Gradient-weighted Class Activation Mapping (Grad-CAM), Local Interpretable Modelagnostic Explanation (LIME), and SHapley Additive exPlanation (SHAP) for better understandably. Initially, convolution features are extracted to collect high-level object-based information. Next, shapely values from SHAP, predictability results from LIME, and heatmap from Grad-CAM are used to explore the black-box approach of the DL model, achieving average test accuracy of 94.31 ± 1.01% and validation accuracy of 94.54 ± 1.33 for 10-fold cross validation. Finally, in order to validate the model and qualify medical risk, medical sensations of classification are taken to consolidate the explanations generated from the eXplainable Artificial Intelligence (XAI) framework. The results suggest that XAI and DL models give clinicians/medical professionals persuasive and coherent conclusions related to the detection and categorization of COVID-19, Pneumonia, and TB.

Glaucoma Detection Using Image Processing and Supervised Learning for Classification.

A difficult challenge in the realm of biomedical engineering is the detection of physiological changes occurring inside the human body, which is a difficult undertaking. At the moment, these irregularities are graded manually, which is very difficult, time-consuming, and tiresome due to the many complexities associated with the methods involved in their identification. In order to identify illnesses at an early stage, the use of computer-assisted diagnostics has acquired increased attention as a result of the requirement of a disease detection system. The major goal of this proposed work is to build a computer-aided design (CAD) system to help in the early identification of glaucoma as well as the screening and treatment of the disease. The fundus camera is the most affordable image analysis modality available, and it meets the financial needs of the general public. The extraction of structural characteristics from the segmented optic disc and the segmented optic cup may be used to characterize glaucoma and determine its severity. For this study, the primary goal is to estimate the potential of the image analysis model for the early identification and diagnosis of glaucoma, as well as for the evaluation of ocular disorders. The suggested CAD system would aid the ophthalmologist in the diagnosis of ocular illnesses by providing a second opinion as a judgment made by human specialists in a controlled environment. An ensemble-based deep learning model for the identification and diagnosis of glaucoma is in its early stages now. This method's initial module is an ensemble-based deep learning model for glaucoma diagnosis, which is the first of its kind ever developed. It was decided to use three pretrained convolutional neural networks for the categorization of glaucoma. These networks included the residual network (ResNet), the visual geometry group network (VGGNet), and the GoogLeNet. It was necessary to use five different data sets in order to determine how well the proposed algorithm performed. These data sets included the DRISHTI-GS, the Optic Nerve Segmentation Database (DRIONS-DB), and the High-Resolution Fundus (HRF). Accuracy of 91.11% for the PSGIMSR data set and the sensitivity of 85.55% and specificity of 95.20% for the suggested ensemble architecture on the PSGIMSR data set were achieved. Similarly, accuracy rates of 95.63%, 98.67%, 95.64%, and 88.96% were achieved using the DRIONS-DB, HRF, DRISHTI-GS, and combined data sets, respectively.

A Transfer Learning-Enabled Optimized Extreme Deep Learning Paradigm for Diagnosis of COVID-19

Many respiratory infections around the world have been caused by coronaviruses. COVID-19 is one of the most serious coronaviruses due to its rapid spread between people and the lowest survival rate. There is a high need for computer-assisted diagnostics (CAD) in the area of artificial intelligence to help doctors and radiologists identify COVID-19 patients in cloud systems. Machine learning (ML) has been used to examine chest X-ray frames. In this paper, a new transfer learning-based optimized extreme deep learning paradigm is proposed to identify the chest X-ray picture into three classes, a pneumonia patient, a COVID-19 patient, or a normal person. First, three different pre-trained Convolutional Neural Network (CNN) models (resnet18, resnet25, densenet201) are employed for deep feature extraction. Second, each feature vector is passed through the binary Butterfly optimization algorithm (bBOA) to reduce the redundant features and extract the most representative ones, and enhance the performance of the CNN models. These selective features are then passed to an improved Extreme learning machine (ELM) using a BOA to classify the chest X-ray images. The proposed paradigm achieves a 99.48% accuracy in detecting covid-19 cases.

Prospects for early detection of keratoconus based on systems built for computer-assisted diagnostics of structural changes in the cornea

The article is devoted to the problem of diagnosing subclinical keratoconus (KK). The need to identify early signs of KK is primarily associated with the potential for the development of iatrogenic keratoectasia in cases of underdiagnosis of the disease when determining the conditions for laser keratorefractive surgery involving a decrease in the thickness of the cornea. Today generally accepted algorithms for early computer-assisted diagnosis of KK are mainly based on the analysis of various morphometric parameters of the cornea, reflecting changes in its shape and thickness induced by structural abnormalities. Direct detection of structural changes in the cornea characteristic of early KK requires the use of high-tech imaging methods that are not always applicable in everyday clinical practice. The promising approach proposed in this study is based on the fact that a digital image of a corneal «slice» obtained using serial analyzers such as the Scheimpflug camera widely used in clinical practice provides indirect information about the structure of the epithelial layer, the local thickening of which takes place in the initial stages KK. It is this criterion that underlies the proposed system of computer-assisted diagnosis of KK. The carried out studies have shown the high sensitivity of this algorithm, and its specificity can be increased by involving the known diagnostic indicators of KK.

Is Computer-Assisted Tissue Image Analysis the Future in Minimally Invasive Surgery? A Review on the Current Status of Its Applications.

Purpose: Computer-assisted tissue image analysis (CATIA) enables an optical biopsy of human tissue during minimally invasive surgery and endoscopy. Thus far, it has been implemented in gastrointestinal, endometrial, and dermatologic examinations that use computational analysis and image texture feature systems. We review and evaluate the impact of in vivo optical biopsies performed by tissue image analysis on the surgeon’s diagnostic ability and sampling precision and investigate how operation complications could be minimized. Methods: We performed a literature search in PubMed, IEEE, Xplore, Elsevier, and Google Scholar, which yielded 28 relevant articles. Our literature review summarizes the available data on CATIA of human tissues and explores the possibilities of computer-assisted early disease diagnoses, including cancer. Results: Hysteroscopic image texture analysis of the endometrium successfully distinguished benign from malignant conditions up to 91% of the time. In dermatologic studies, the accuracy of distinguishing nevi melanoma from benign disease fluctuated from 73% to 81%. Skin biopsies of basal cell carcinoma and melanoma exhibited an accuracy of 92.4%, sensitivity of 99.1%, and specificity of 93.3% and distinguished nonmelanoma and normal lesions from benign precancerous lesions with 91.9% and 82.8% accuracy, respectively. Gastrointestinal and endometrial examinations are still at the experimental phase. Conclusions: CATIA is a promising application for distinguishing normal from abnormal tissues during endoscopic procedures and minimally invasive surgeries. However, the efficacy of computer-assisted diagnostics in distinguishing benign from malignant states is still not well documented. Prospective and randomized studies are needed before CATIA is implemented in clinical practice.

Tooth Wear Evaluation System (TWES) 2.0-Reliability of diagnosis with and without computer-assisted evaluation.

Tooth wear is a multifactorial process, leading to the loss of dental hard tissues. Therefore, it is important to detect the level of tooth wear at an early stage, so monitoring can be initiated. The Tooth Wear Evaluation System (TWES) enables such a multistage diagnosis of tooth wear. The further developed TWES 2.0 contains a complete taxonomy of tooth wear, but its reliability has not yet been validated. The aim of the study was to examine in a randomised controlled trial (RCT) whether diagnoses made based on the TWES 2.0 are reproducible and whether this reproducibility is also achieved with computer-assisted diagnostics. 44 dental students received extensive training in TWES 2.0 assessment and taxonomy. The students each evaluated at least 10 (of the present 14) anonymised patient cases using gypsum models and high-resolution intra-oral photographs according to TWES 2.0. One half initially evaluated on paper; the other half used dedicated software (CMDfact / CMDbrux). After half of the patient cases (5), the evaluation methods were switched (AB/BA crossover design). The diagnoses were then evaluated for agreement with the predefined sample solution. Evaluation of agreement with the sample solution according to Cohen's kappa indicated a value of 0.46 for manual (traditional) evaluation; and 0.44 for computer-assisted evaluation. Evaluation of agreement between examiners was 0.38 for manual and 0.48 for computer-assisted evaluation (Fleiss' kappa). The results of this study proved that the taxonomy of the TWES 2.0has acceptable reliability and can thus be used by dentists. Accordingly, the system can be learned quickly even by untrained practitioners. Comparable results are achieved with computer-assisted evaluation.