X-ray Dataset Research Articles

Deep learning model for detection acute cardiogenic pulmonary edema in cases of preeclampsia

<span lang="EN-US">The physiological changes during the pregnancy period increase the risk of developing pulmonary edema and acute respiratory failure. This condition falls under critical medical emergencies associated with maternal mortality. This study utilized a convolutional neural networks (CNN) architectural model employing chest Xray dataset images. CNN utilizes the convolution process by moving a convolutional kernel of a certain size across an image, allowing the computer to derive new representative information from the multiplication of portions of the image with the utilized filter.</span><span lang="EN-US">To simplify, the vanishing gradient issue occurs when information dissipates before reaching its destination due to the lengthy path between input and output layers. This study was developed model for detection acute cardiogenic pulmonary Edema in pre-eclampsia cases using chest Xray images, implemented using PyTorch, Keras, and MxNet. The validated model achieved its optimum with accuracy 90.65% and binary cross-entropy loss (BCELoss) value of 0.4538. It exhibited an improved sensitivity value of 83.514% using a 5% dataset and a specificity value of 57.273%. This indicates an increase in sensitivity value by 83.514% using a 5% data set and a specificity value of 57.273%. The research results demonstrate an improvement in accuracy compared to several similar studies that also utilized CNN models.</span>

Pneumonia detection on x-ray image using improved depthwise separable convolutional neural networks

A single neural network model cannot capture intricate and diverse features due to its ability to learn only a finite set of patterns from the data. Additionally, training and utilising a single model can be computationally demanding. Experts propose incorporating multiple neural network models to address these constraints to extract complementary attributes. Previous research has highlighted challenges network models face, including difficulties in effectively capturing highly detailed spatial features, redundancy in network structure parameters, and restricted generalisation capabilities. This study introduces an innovative neural network architecture that combines the Xception module with the inverse residue structure to tackle these issues. Considering this, the paper presents a model for detecting pneumonia in X-ray images employing an improved depthwise separable convolutional network. This network architecture integrates the inverse residual structure from the MobileNetV2 model, using the rectified linear unit (ReLU) non-linear activation function throughout the entire network. The experimental results show an impressive recognition rate with a test accuracy of 97.24% on the chest x-ray dataset. This method can extract more profound and abstract image features while mitigating overfitting issues and enhancing the network's generalisation capacity.

Optimizing Cardiomegaly Detection: A Random Forest Approach to Processed Chest X-ray Imagery

This study explores the application of a Random Forest Classifier for the automated detection of Cardiomegaly from chest X-ray images, utilizing a dataset processed and derived from the NIH Chest X-ray Dataset. Given the crucial need for accurate and timely diagnosis of Cardiomegaly to inform appropriate treatment decisions, this research aims to determine the efficacy of machine learning models in augmenting diagnostic processes. Employing image pre-processing techniques such as Sobel filtering for edge detection and Hu Moments for feature extraction, the study enhances the input features for the model. The performance of the classifier was evaluated using a 5-fold cross-validation approach, yielding results with average accuracy, precision, recall, and F1-scores ranging approximately between 52% and 54%. These findings suggest a moderate level of reliability and consistency, indicating the potential utility of ensemble machine learning methods in medical imaging analysis. However, the variability in performance across different data subsets highlights the challenges and necessitates further optimization. This research contributes to the ongoing discourse on integrating machine learning into clinical settings, demonstrating the potential benefits and current limitations. Future research is recommended to expand the dataset variety, integrate advanced deep learning methodologies, and rigorously test these models in clinical environments. The findings hold significant implications for the development of automated diagnostic tools in healthcare, potentially leading to enhanced diagnostic accuracy and efficiency.

Classification and detection of dental images using meta-learning.

Meta-learning of dental X-rays is a machine learning technique that can be used to train models to perform new tasks quickly and with minimal input. Instead of just memorizing a task, this is accomplished through teaching a model how to learn. Algorithms for meta-learning are typically trained on a collection of training problems, each of which has a limited number of labelled instances. Multiple X-ray classification tasks, including the detection of pneumonia, coronavirus disease 2019, and other disorders, have demonstrated the effectiveness of meta-learning. Meta-learning has the benefit of allowing models to be trained on dental X-ray datasets that are too few for more conventional machine learning methods. Due to the high cost and lengthy collection process associated with dental imaging datasets, this is significant for dental X-ray classification jobs. The ability to train models that are more resistant to fresh input is another benefit of meta-learning.

Cross-modal similar clinical case retrieval using a modular model based on contrastive learning and k-nearest neighbor search

ObjectiveElectronic health record systems have made it possible for clinicians to use previously encountered similar cases to support clinical decision-making. However, most studies for similar case retrieval were based on single-modal data. The existing studies on cross-modal clinical case retrieval were limited. We aimed to develop a CRoss-Modal Retrieval (CRMR) model to retrieve similar clinical cases recorded in different data modalities. Materials and methodsThe publically available Medical Information Mart for Intensive Care-Chest X-ray (MIMIC-CXR) dataset was used for model development and testing. The CRMR model was designed as a modular model containing two feature extraction models, two feature transformation models, one feature transformation optimization model, and one case retrieval model. The ability to retrieve similar clinical cases recorded in different data modalities was facilitated by the use of contrastive deep learning and k-nearest neighbor search. ResultsThe average retrieval precision, denoted as AP@k, of the developed CRMR model, were 76.9 %@5, 76.7 %@10, 76.5 %@20, 76.3 %@50, and 77.9 %@100, respectively. Here k is the number of similar cases returned after retrieval. The average retrieval time varied from 0.013 ms to 0.016 ms with k varying from 5 to 100. Moreover, the model can retrieve similar cases with the same multiple radiographic manifestations as the query case. DiscussionThe CRMR model has shown promising cross-modal retrieval performance in clinical case analysis, with the potential for future scalability and improvement in handling diverse disease types and data modalities. The CRMR model has promising potential to aid clinicians in making optimal and explainable clinical decisions.

Integrated ensemble CNN and explainable AI for COVID-19 diagnosis from CT scan and X-ray images

In light of the ongoing battle against COVID-19, while the pandemic may eventually subside, sporadic cases may still emerge, underscoring the need for accurate detection from radiological images. However, the limited explainability of current deep learning models restricts clinician acceptance. To address this issue, our research integrates multiple CNN models with explainable AI techniques, ensuring model interpretability before ensemble construction. Our approach enhances both accuracy and interpretability by evaluating advanced CNN models on the largest publicly available X-ray dataset, COVIDx CXR-3, which includes 29,986 images, and the CT scan dataset for SARS-CoV-2 from Kaggle, which includes a total of 2,482 images. We also employed additional public datasets for cross-dataset evaluation, ensuring a thorough assessment of model performance across various imaging conditions. By leveraging methods including LIME, SHAP, Grad-CAM, and Grad-CAM++, we provide transparent insights into model decisions. Our ensemble model, which includes DenseNet169, ResNet50, and VGG16, demonstrates strong performance. For the X-ray image dataset, sensitivity, specificity, accuracy, F1-score, and AUC are recorded at 99.00%, 99.00%, 99.00%, 0.99, and 0.99, respectively. For the CT image dataset, these metrics are 96.18%, 96.18%, 96.18%, 0.9618, and 0.96, respectively. Our methodology bridges the gap between precision and interpretability in clinical settings by combining model diversity with explainability, promising enhanced disease diagnosis and greater clinician acceptance.

Blind image authentication using singular value decomposition with enhanced robustness by augmenting hamming code

Singular value decomposition (SVD) based image authentication has widespread applications for digital media protection including forensic and medical domains due to the high stability and robustness of singular values under small perturbations. However, most of these techniques are non-blind and have high redundancies for the extraction of secret data. The proposed scheme employs a blind extraction strategy by utilizing the intrinsic relationship of coefficient pairs of the U matrix of the host image blocks. This relationship is utilized to hide a secret binary bit after computing a threshold value in constant time. The host image underwent block-wise decomposition and hash-based randomization of blocks, followed by block-wise SVD for embedding secret bits in the U matrix. Hamming coded watermark is embedded for high precision extraction under active attacks. High imperceptibility and strong robustness are observed under attacks when tested across general purpose as well as image datasets and the system outperforms many existing works. Experimental observation shows the average PSNR between the host and marked image and average NCC between embedded and extracted watermark to be 36.98 dB and 0.999 respectively for the SIPI dataset whereas 52.7 dB and 1 respectively for the X-Ray dataset. The system exhibited high robustness under Salt-and-pepper noise (SAPN), Gaussian Noise (GAUN), Cropping (CRP), Median Filtering (MF), Histogram Equalization (HEQ), and Jpeg Compression (JPC) with average NCC values of 0.998, 1, 0.932, 0.999 and 0.967 respectively for X-Ray dataset. The time complexity O (M × N) is observed for both embedding and extraction algorithms for a host image of size M × N.

Significantly improving zero-shot X-ray pathology classification via fine-tuning pre-trained image-text encoders

Deep neural networks are increasingly used in medical imaging for tasks such as pathological classification, but they face challenges due to the scarcity of high-quality, expert-labeled training data. Recent efforts have utilized pre-trained contrastive image-text models like CLIP, adapting them for medical use by fine-tuning the model with chest X-ray images and corresponding reports for zero-shot pathology classification, thus eliminating the need for pathology-specific annotations. However, most studies continue to use the same contrastive learning objectives as in the general domain, overlooking the multi-labeled nature of medical image-report pairs. In this paper, we propose a new fine-tuning strategy that includes positive-pair loss relaxation and random sentence sampling. We aim to improve the performance of zero-shot pathology classification without relying on external knowledge. Our method can be applied to any pre-trained contrastive image-text encoder and easily transferred to out-of-domain datasets without further training, as it does not use external data. Our approach consistently improves overall zero-shot pathology classification across four chest X-ray datasets and three pre-trained models, with an average macro AUROC increase of 4.3%. Additionally, our method outperforms the state-of-the-art and marginally surpasses board-certified radiologists in zero-shot classification for the five competition pathologies in the CheXpert dataset.

Multimodal masked siamese network improves chest X-ray representation learning

Self-supervised learning methods for medical images primarily rely on the imaging modality during pretraining. Although such approaches deliver promising results, they do not take advantage of the associated patient or scan information collected within Electronic Health Records (EHR). This study aims to develop a multimodal pretraining approach for chest radiographs that considers EHR data incorporation as an additional modality that during training. We propose to incorporate EHR data during self-supervised pretraining with a Masked Siamese Network (MSN) to enhance the quality of chest radiograph representations. We investigate three types of EHR data, including demographic, scan metadata, and inpatient stay information. We evaluate the multimodal MSN on three publicly available chest X-ray datasets, MIMIC-CXR, CheXpert, and NIH-14, using two vision transformer (ViT) backbones, specifically ViT-Tiny and ViT-Small. In assessing the quality of the representations through linear evaluation, our proposed method demonstrates significant improvement compared to vanilla MSN and state-of-the-art self-supervised learning baselines. In particular, our proposed method achieves an improvement of of 2% in the Area Under the Receiver Operating Characteristic Curve (AUROC) compared to vanilla MSN and 5% to 8% compared to other baselines, including uni-modal ones. Furthermore, our findings reveal that demographic features provide the most significant performance improvement. Our work highlights the potential of EHR-enhanced self-supervised pretraining for medical imaging and opens opportunities for future research to address limitations in existing representation learning methods for other medical imaging modalities, such as neuro-, ophthalmic, and sonar imaging.

Leveraging summary of radiology reports with transformers

Two fundamental problems in health-care stem from patient handoff and triage. Doctors are often required to perform complex findings summarization to facilitate efficient communication with specialists and decision-making on the urgency of each case. To address these challenges, we present a state-of-the-art radiology report summarization model utilizing adjusted bidirectional encoder representation from transformers BERT-to-BERT encoder–decoder architecture. Our approach includes a novel method for augmenting medical data and a comprehensive performance analysis. Our best-performing model achieved a recall-oriented understudy for gisting evaluation-L F1 score of 58.75/100, outperforming specialized checkpoints with more sophisticated attention mechanisms. We also provide a data processing pipeline for future models developed on the MIMIC-chest X-ray dataset. The model introduced in this paper demonstrates significantly improved capacity in radiology report summarization, highlighting the potential for ensuring better clinical workflows and enhanced patient care.

Multi-task learning for calcaneus fracture diagnosis of X-ray images

Fracture diagnosis is critical in clinical settings, and imaging modalities like X-ray and CT scans are crucial for bone fracture diagnosis. Although X-ray scans are more convenient and affordable, they are prone to misdiagnosis and missed diagnosis due to the limited number of poses that can be observed and the uneven distribution of grayscales. Deep learning methods show great potential in improving the efficiency and accuracy of x-ray fracture diagnosis.This paper proposes MTL-DlinkNet, a multi-task learning model based on D-linkNet, that can perform both classification tasks for automatic identification of calcaneus fractures, and segmentation tasks for generation of regions of interest (RoI). The model achieves high accuracy (0.989 AUC) while annotating the data at the same time, making diagnosis more efficient and reducing the burden on doctors. The paper also presents an intelligent diagnostic tool for calcaneus fracture that assists doctors in clinical settings. The main contributions of this work include building a dataset of foot X-rays for fracture diagnosis, proposing a better-performing fracture diagnosis deep learning model, and developing an efficient diagnostic tool. Experimental results show that the MTL-DlinkNet model achieves better performance than the baseline models.Overall, this paper demonstrates the potential of deep learning methods in improving fracture diagnosis accuracy and efficiency, especially when multi-task learning is used, with practical applications in clinical settings.

MyThisYourThat for interpretable identification of systematic bias in federated learning for biomedical images

Distributed collaborative learning is a promising approach for building predictive models for privacy-sensitive biomedical images. Here, several data owners (clients) train a joint model without sharing their original data. However, concealed systematic biases can compromise model performance and fairness. This study presents MyThisYourThat (MyTH) approach, which adapts an interpretable prototypical part learning network to a distributed setting, enabling each client to visualize feature differences learned by others on their own image: comparing one client’s 'This’ with others’ 'That’. Our setting demonstrates four clients collaboratively training two diagnostic classifiers on a benchmark X-ray dataset. Without data bias, the global model reaches 74.14% balanced accuracy for cardiomegaly and 74.08% for pleural effusion. We show that with systematic visual bias in one client, the performance of global models drops to near-random. We demonstrate how differences between local and global prototypes reveal biases and allow their visualization on each client’s data without compromising privacy.

Enhancing representation in radiography-reports foundation model: a granular alignment algorithm using masked contrastive learning

Recently, multi-modal vision-language foundation models have gained significant attention in the medical field. While these models offer great opportunities, they still face crucial challenges, such as the requirement for fine-grained knowledge understanding in computer-aided diagnosis and the capability of utilizing very limited or even no task-specific labeled data in real-world clinical applications. In this study, we present MaCo, a masked contrastive chest X-ray foundation model that tackles these challenges. MaCo explores masked contrastive learning to simultaneously achieve fine-grained image understanding and zero-shot learning for a variety of medical imaging tasks. It designs a correlation weighting mechanism to adjust the correlation between masked chest X-ray image patches and their corresponding reports, thereby enhancing the model’s representation learning capabilities. To evaluate the performance of MaCo, we conducted extensive experiments using 6 well-known open-source X-ray datasets. The experimental results demonstrate the superiority of MaCo over 10 state-of-the-art approaches across tasks such as classification, segmentation, detection, and phrase grounding. These findings highlight the significant potential of MaCo in advancing a wide range of medical image analysis tasks.

Acquisition parameters influence AI recognition of race in chest x-rays and mitigating these factors reduces underdiagnosis bias

A core motivation for the use of artificial intelligence (AI) in medicine is to reduce existing healthcare disparities. Yet, recent studies have demonstrated two distinct findings: (1) AI models can show performance biases in underserved populations, and (2) these same models can be directly trained to recognize patient demographics, such as predicting self-reported race from medical images alone. Here, we investigate how these findings may be related, with an end goal of reducing a previously identified underdiagnosis bias. Using two popular chest x-ray datasets, we first demonstrate that technical parameters related to image acquisition and processing influence AI models trained to predict patient race, where these results partly reflect underlying biases in the original clinical datasets. We then find that mitigating the observed differences through a demographics-independent calibration strategy reduces the previously identified bias. While many factors likely contribute to AI bias and demographics prediction, these results highlight the importance of carefully considering data acquisition and processing parameters in AI development and healthcare equity more broadly.

Multi-modal transformer architecture for medical image analysis and automated report generation

Medical practitioners examine medical images, such as X-rays, write reports based on the findings, and provide conclusive statements. Manual interpretation of the results and report generation by examiners are time-consuming processes that lead to potential delays in diagnosis. We propose an automated report generation model for medical images leveraging an encoder–decoder architecture. Our model utilizes transformer architectures, including Vision Transformer (ViT) and its variants like Data Efficient Image Transformer (DEiT) and BERT pre-training image transformer (BEiT), as an encoder. These transformers are adapted for processing to extract and gain visual information from medical images. Reports are transformed into text embeddings, and the Generative Pre-trained Transformer (GPT2) model is used as a decoder to generate medical reports. Our model utilizes a cross-attention mechanism between the vision transformer and GPT2, which enables it to create detailed and coherent medical reports based on the visual information extracted by the encoder. In our model, we have extended the report generation with general knowledge, which is independent of the inputs and provides a comprehensive report in a broad sense. We conduct our experiments on the Indiana University X-ray dataset to demonstrate the effectiveness of our models. Generated medical reports from the model are evaluated using word overlap metrics such as Bleu scores, Rouge-L, retrieval augmentation answer correctness, and similarity metrics such as skip thought cs, greedy matching, vector extrema, and RAG answer similarity. Results show that our model is performing better than the recurrent models in terms of report generation, answer similarity, and word overlap metrics. By automating the report generation process and incorporating advanced transformer architectures and general knowledge, our approach has the potential to significantly improve the efficiency and accuracy of medical image analysis and report generation.

A binary particle swarm optimization-based pruning approach for environmentally sustainable and robust CNNs

Deep Convolutional Neural Networks (CNNs), continue to demonstrate remarkable performance across various tasks. However, their computational demands and energy consumption present significant drawbacks, restricting their practical deployment and contributing to a substantial carbon footprint. This paper addresses this challenge by proposing a novel method named Binary Particle Swarm Optimization Layer Pruner (BPSO-LPruner), aimed at achieving substantial computational reduction and mitigating environmental impact during CNN inference. BPSO-LPruner utilizes a constrained Binary Particle Swarm Optimization for CNN layer pruning, integrating a masked-bit strategy and a new population initialization strategy to enhance search performance. We illustrate the effectiveness of our method in reducing model computational costs and carbon footprint emissions while improving performance across multiple models (VGG16, VGG19, DenseNet-40, ResNet18, ResNet20, ResNet34, ResNet44, ResNet56, ResNet110, ResNet50, and MobileNetv2) and diverse datasets (CIFAR-10, CIFAR-100, Tiny-ImageNet, COVID-19 X-ray dataset). Promising results underscore the performance of the proposed method. Additionally, we demonstrate that layer pruning yields benefits beyond enhanced computational performance. Our experimentation reveals that BPSO-LPruner enhances the model’s reliability and robustness by effectively addressing variations in input data, inherent ambiguity in model parameters, and adversarial images.

Deep Learning-Based Diagnosis of Pneumonia Using Convolutional Neural Networks

Pneumonia is a respiratory illness characterized by lung inflammation, often caused by pathogens such as viruses, bacteria, or fungi. Timely detection of pneumonia is crucial for effective treatment. While chest X-rays are commonly used for diagnosis, manual interpretation can be time-consuming, particularly in areas with limited access to trained radiologists. Currently, deep learning models have emerged as an efficient method for pneumonia diagnosis. Numerous researchers are dedicated to enhancing pneumonia diagnostic capabilities through artificial intelligence methods. This study employs a convolutional neural network (CNN) for pneumonia diagnosis. The dataset used in this study consists of chest X-ray images of healthy individuals as well as those affected by bacterial and viral pneumonia. In this study, a CNN model is implemented using an imbalanced chest X-ray dataset with a weighted cross-entropy cost function. The outcome of the developed CNN model shows an accuracy of 75.84%, a precision of 83.16%, a recall of 68.37%, and an F1 score of 68.97% on the test dataset. Further tuning of the model’s hyperparameters is necessary to improve performance metrics.

An open chest X-ray dataset with benchmarks for automatic radiology report generation in French

Medical report generation (MRG), which aims to automatically generate a textual description of a specific medical image (e.g., a chest X-ray), has recently received increasing research interest. Building on the success of image captioning, MRG has become achievable. However, generating language-specific radiology reports poses a challenge for data-driven models due to their reliance on paired image-report chest X-ray datasets, which are labor-intensive, time-consuming, and costly. In this paper, we introduce a chest X-ray benchmark dataset, namely CASIA-CXR, consisting of high-resolution chest radiographs accompanied by narrative reports originally written in French. To the best of our knowledge, this is the first public chest radiograph dataset with medical reports in this particular language. Importantly, we propose a simple yet effective multimodal encoder–decoder contextually-guided framework for medical report generation in French. We validated our framework through intra-language and cross-language contextual analysis, supplemented by expert evaluation performed by radiologists. The dataset is freely available at: https://www.casia-cxr.net/.

Explaining transfer learning models for the detection of COVID-19 on X-ray lung images

Amidst the coronavirus disease 2019 (COVID-19) pandemic, researchers are exploring innovative approaches to enhance diagnostic accuracy. One avenue is utilizing deep learning models to analyze lung X-ray images for COVID-19 diagnosis, complementing existing tests like reverse transcription polymerase chain reaction (RT-PCR). However, trusting these models, often viewed as black boxes, presents a challenge. To address this, six explainable artificial intelligence (XAI) techniques: local interpretable model agnostic explanations (LIME), Shapley additive explanations (SHAP), integrated gradients, smooth-grad, gradient-weighted class activation mapping (Grad-CAM), and Layer-CAM are applied to interpret four transfer learning models. These models: VGG16, ResNet50, InceptionV3, and DenseNet121 are analyzed to understand their workings and the rationale behind their predictions. Validating the results with medical experts poses difficulties due to time and resource constraints, alongside the scarcity of annotated X-ray datasets. To address this, a voting mechanism employing different XAI methods across various models is proposed. This approach highlights regions of lung infection, potentially reducing individual model biases stemming from their structures. If successful, this research could pave the way for an automated system for annotating infection regions, bolstering confidence in predictions and aiding in the development of more effective diagnostic tools for COVID-19.

Three-Stage Framework for Accurate Pediatric Chest X-ray Diagnosis Using Self-Supervision and Transfer Learning on Small Datasets.

Pediatric respiratory disease diagnosis and subsequent treatment require accurate and interpretable analysis. A chest X-ray is the most cost-effective and rapid method for identifying and monitoring various thoracic diseases in children. Recent developments in self-supervised and transfer learning have shown their potential in medical imaging, including chest X-ray areas. In this article, we propose a three-stage framework with knowledge transfer from adult chest X-rays to aid the diagnosis and interpretation of pediatric thorax diseases. We conducted comprehensive experiments with different pre-training and fine-tuning strategies to develop transformer or convolutional neural network models and then evaluate them qualitatively and quantitatively. The ViT-Base/16 model, fine-tuned with the CheXpert dataset, a large chest X-ray dataset, emerged as the most effective, achieving a mean AUC of 0.761 (95% CI: 0.759-0.763) across six disease categories and demonstrating a high sensitivity (average 0.639) and specificity (average 0.683), which are indicative of its strong discriminative ability. The baseline models, ViT-Small/16 and ViT-Base/16, when directly trained on the Pediatric CXR dataset, only achieved mean AUC scores of 0.646 (95% CI: 0.641-0.651) and 0.654 (95% CI: 0.648-0.660), respectively. Qualitatively, our model excels in localizing diseased regions, outperforming models pre-trained on ImageNet and other fine-tuning approaches, thus providing superior explanations. The source code is available online and the data can be obtained from PhysioNet.