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Pneumonia is a form of acute respiratory infection affecting the lungs. Symptoms of viral and bacterial pneumonia are similar. Rapid diagnosis of the disease is difficult, since polymerase chain reaction-based methods, which have the greatest reliability, provide results in a few hours, while ensuring high requirements for compliance with the analysis technology and professionalism of the personnel. This study proposed a Concatenated CNN model for pneumonia detection combined with a fuzzy logic-based image improvement method. The fuzzy logic-based image enhancement process is based on a new fuzzification refinement algorithm, with significantly improved image quality and feature extraction for the CCNN model. Four datasets, original and upgraded images utilizing fuzzy entropy, standard deviation, and histogram equalization, were utilized to train the algorithm. The CCNN’s performance was demonstrated to be significantly improved by the upgraded datasets, with the fuzzy entropy-added dataset producing the best results. The suggested CCNN attained remarkable classification metrics, including 98.9% accuracy, 99.3% precision, 99.8% F1-score, and 99.6% recall. Experimental comparisons showed that the fuzzy logic-based enhancement worked significantly better than traditional image enhancement methods, resulting in higher diagnostic precision. This study demonstrates how well deep learning models and sophisticated image enhancement techniques work together to analyze medical images.

Abstract Background Nontuberculous mycobacterial lung disease (NTM-LD) and Mycobacterium tuberculosis lung disease (MTB-LD) have similar clinical characteristics. Therefore, NTM-LD is sometimes incorrectly diagnosed with MTB-LD and treated incorrectly. To solve these difficulties, we aimed to distinguish the two diseases in chest X-ray images using deep learning technology, which has been used in various fields recently. Methods We retrospectively collected chest X-ray images from 3314 patients infected with Mycobacterium tuberculosis (MTB) or nontuberculosis mycobacterium (NTM). After selecting the data according to the diagnostic criteria, various experiments were conducted to create the optimal deep learning model. A performance comparison was performed with the radiologist. Additionally, the model performance was verified using newly collected MTB-LD and NTM-LD patient data. Results Among the implemented deep learning models, the ensemble model combining EfficientNet B4 and ResNet 50 performed the best in the test data. Also, the ensemble model outperformed the radiologist on all evaluation metrics. In addition, the accuracy of the ensemble model was 0.85 for MTB-LD and 0.78 for NTM-LD on an additional validation dataset consisting of newly collected patients. Conclusions In previous studies, it was known that it was difficult to distinguish between MTB-LD and NTM-LD in chest X-ray images, but we have successfully distinguished the two diseases using deep learning methods. This study has the potential to aid clinical decisions if the two diseases need to be differentiated.

Medical professionals in thoracic medicine routinely analyze chest X-ray images, often comparing pairs of images taken at different times to detect lesions or anomalies in patients. This research aims to design a computer-aided diagnosis system that enhances the efficiency of thoracic physicians in comparing and diagnosing X-ray images, ultimately reducing misjudgments. The proposed system encompasses four key components: segmentation, alignment, comparison, and classification of lung X-ray images. Utilizing a public NIH Chest X-ray14 dataset and a local dataset gathered by the Chiayi Christian Hospital in Taiwan, the efficacy of both the traditional methods and deep-learning methods were compared. Experimental results indicate that, in both the segmentation and alignment stages, the deep-learning method outperforms the traditional method, achieving higher average IoU, detection rates, and significantly reduced processing time. In the comparison stage, we designed nonlinear transfer functions to highlight the differences between pre- and post-images through heat maps. In the classification stage, single-input and dual-input network architectures were proposed. The inclusion of difference information in single-input networks enhances AUC by approximately 1%, and dual-input networks achieve a 1.2–1.4% AUC increase, underscoring the importance of difference images in lung disease identification and classification based on chest X-ray images. While the proposed system is still in its early stages and far from clinical application, the results demonstrate potential steps forward in the development of a comprehensive computer-aided diagnostic system for comparative analysis of chest X-ray images.

Cardiothoracic diseases are a serious threat to human health and chest X-ray image is a great reference in diagnosis and treatment. At present, it has been a research hot-spot how to recognize chest X-ray image automatically and exactly by the computer vision technology, and many scholars have gotten the excited research achievements. While both emphysema and cardiomegaly often are associated, and the symptom of them are very similar, so the X-ray images discrimination for them led easily to misdiagnosis too. Therefore, some efforts are still expected to develop a higher precision and better performance deep learning model to recognize efficiently the two diseases. In this work, we construct an adaptive cross-transfer residual neural network (ACRnet) to identify emphysema, cardiomegaly and normal. We cross-transfer the information extracted by the residual block and adaptive structure to different levels in ACRnet, and the method avoids the reduction of the adaptive function by residual structure and improves the recognition performance of the model. To evaluate the recognition ability of ACRnet, four neural networks VGG16, InceptionV2, ResNet101 and CliqueNet are used for comparison. The results show that ACRnet has better recognition ability than other networks. In addition, we use the deep convolution generative adversarial network (DCGAN) to expand the original dataset and ACRnet's recognition ability is greatly improved.

Purpose: Many artificial intelligence-based computational procedures are developed to diagnose COVID-19 infection from chest X-ray (CXR) images, as diagnosis by CXR imaging is less time consuming and economically cheap compared to other detection procedures. Due to unavailability of skilled computer professionals and high computer architectural resource, majority of the employed methods are difficult to implement in rural and poor economic settings. Majority of such reports are devoid of codes and ignores related diseases (pneumonia). The absence of codes makes limitation in applying them widely. Hence, validation testing followed by evidence-based medical practice is difficult. The present work was aimed to develop a simple method that requires a less computational expertise and minimal level of computer resource, but with statistical inference. Materials and Methods: A Fast Fourier Transform-based (FFT) method was developed with GNU Octave, a free and open-source platform. This was employed to the images of CXR for further analysis. For statistical inference, two variables, i.e., the highest peak and number of peaks in the FFT distribution plot were considered. Results: The comparison of mean values among different groups (normal, COVID-19, viral, and bacterial pneumonia [BP]) showed statistical significance, especially when compared to normal, except between viral and BP groups. Conclusion: Parametric statistical inference from our result showed high level of significance (P < 0.001). This is comparable to the available artificial intelligence-based methods (where accuracy is about 94%). Developed method is easy, availability with codes, and requires a minimal level of computer resource and can be tested with a small sample size in different demography, and hence, be implemented in a poor socioeconomic setting.

Chest X-ray image is an important clinical diagnostic reference to lung diseases that is a serious threat to human health. At present, with the rapid development of computer vision and deep learning technology, many scholars have carried out the fruitful research on how to build a valid model for chest X-ray images recognition of lung diseases. While some efforts are still expected to improve the performance of the recognition model and enhance the interpretability of the recognition results. In this paper, we construct a multi-scale adaptive residual neural network (MARnet) to identify chest X-ray images of lung diseases. To make the model better extract image features, we cross-transfer the information extracted by residual block and the information extracted by adaptive structure to different layer, avoiding the reduction effect of residual structure on adaptive function. We compare MARnet with some classical neural networks, and the results show that MARnet achieves accuracy (ACC) of 83.3% and the area under ROC curve (AUC) of 0.97 in the identification of 4 kinds of typical lung X-ray images including nodules, atelectasis, normal and infection, which are higher than those of other methods. Moreover, to avoid the randomness of the train-test-split method, 5-fold cross-validation method is used to verify the generalization ability of the MARnet model and the results are satisfactory. Finally, the technique called Gradient-weighted Class Activation Mapping (Grad-CAM), is adopted to display significantly the discriminative regions of the images in the form of the heat map, which provides an explainable and more direct clinical diagnostic reference to lung diseases.

The COVID-19 pandemic has underscored the urgent need for rapid and accurate diagnosis facilitated by artificial intelligence (AI), particularly in computer-aided diagnosis using medical imaging. However, this context presents two notable challenges: high diagnostic accuracy demand and limited availability of medical data for training AI models. To address these issues, we proposed the implementation of a Masked AutoEncoder (MAE), an innovative self-supervised learning approach, for classifying 2D Chest X-ray images. Our approach involved performing imaging reconstruction using a Vision Transformer (ViT) model as the feature encoder, paired with a custom-defined decoder. Additionally, we fine-tuned the pretrained ViT encoder using a labeled medical dataset, serving as the backbone. To evaluate our approach, we conducted a comparative analysis of three distinct training methods: training from scratch, transfer learning, and MAE-based training, all employing COVID-19 chest X-ray images. The results demonstrate that MAE-based training produces superior performance, achieving an accuracy of 0.985 and an AUC of 0.9957. We explored the mask ratio influence on MAE and found ratio = 0.4 shows the best performance. Furthermore, we illustrate that MAE exhibits remarkable efficiency when applied to labeled data, delivering comparable performance to utilizing only 30% of the original training dataset. Overall, our findings highlight the significant performance enhancement achieved by using MAE, particularly when working with limited datasets. This approach holds profound implications for future disease diagnosis, especially in scenarios where imaging information is scarce.

Although the widespread use of digital imaging has enabled real-time image display, images in chest X-ray examinations can be confirmed by the radiologist’s eyes. Considering the development of deep learning (DL) technology, its application will make it possible to immediately determine the need for a retake, which is expected to further improve examination throughput. In this study, we developed software for evaluating chest X-ray images to determine whether a repeat radiographic examination is necessary, based on the combined application of DL technologies, and evaluated its accuracy. The target population was 4809 chest images from a public database. Three classification models (CLMs) for lung field defects, obstacle shadows, and the location of obstacle shadows and a semantic segmentation model (SSM) for the lung field regions were developed using a fivefold cross validation. The CLM was evaluated using the overall accuracy in the confusion matrix, the SSM was evaluated using the mean intersection over union (mIoU), and the DL technology-combined software was evaluated using the total response time on this software (RT) per image for each model. The results of each CLM with respect to lung field defects, obstacle shadows, and obstacle shadow location were 89.8%, 91.7%, and 91.2%, respectively. The mIoU of the SSM was 0.920, and the software RT was 3.64 × 10−2 s. These results indicate that the software can immediately and accurately determine whether a chest image needs to be re-scanned.

Coronavirus disease, frequently referred to as COVID-19, is a contagious and transmittable disease produced by the SARS-CoV-2 virus. The only solution to tackle this virus and reduce its spread is early diagnosis. Pathogenic laboratory tests such as the polymerase chain reaction (PCR) process take a long time. Also, they regularly produce incorrect results. However, they are still considered the critical standard for detecting the virus. Hence, there is a solid need to evolve computer-assisted diagnosis systems capable of providing quick and low-cost testing in areas where traditional testing procedures are not feasible. This study focuses on COVID-19 detection using X-ray images. The prime objective is to introduce a computer-assisted diagnosis (CAD) system to differentiate COVID-19 from healthy and pneumonia cases using X-ray image sequences. This work utilizes standard transfer-learning techniques for COVID-19 detection. It proposes the master–slave architecture using the most state-of-the-art Densenet201 and Squeezenet1_0 techniques for classifying the COVID-19 virus in chest X-ray image sequences. This paper compares the proposed models with other standard transfer-learning approaches for COVID-19. The performance metrics demonstrate that the proposed approach outperforms standard transfer-learning approaches. This research also fine-tunes hyperparameters and predicts the optimized learning rate to achieve the highest accuracy in the model. After fine-tuning the learning rate, the DenseNet201 model retrieves an accuracy of 83.33%, while the fastest model is SqueezeNet1_0, which retrieves an accuracy of 80%.

COVID-19 has led to a severe impact on the society and healthcare system, with early diagnosis and effective treatment becoming critical. The Chest X-ray (CXR) is the most time-saving and cost-effective tool for diagnosing COVID-19. However, manual diagnosis through human eyes is time-consuming and tends to introduce errors. With the challenge of a large number of infections and a shortage of medical resources, a fast and accurate diagnosis technique is required. Manual detection is time-consuming, depends on individual experience, and tends to easily introduce errors. Deep learning methods can be used to develop automated detection and computer-aided diagnosis. However, they require a large amount of data, which is not practical due to the limited annotated CXR images. In this research, SDViT, an approach based on transformers, is proposed for COVID-19 diagnosis through image classification. We propose three innovations, namely, self-supervised learning, detail correction path (DCP), and domain transfer, then add them to the ViT Transformer architecture. Based on experimental results, our proposed method achieves an accuracy of 95.2381%, which is better performance compared to well-established methods on the X-ray Image dataset, along with the highest precision (0.952310), recall (0.963964), and F1-score (0.958102). Extensive experiments show that our model achieves the best performance on the synthetic-covid-cxr dataset as well. The experimental results demonstrate the advantages of our design for the classification task of COVID-19 X-ray images.

Chest X-ray radiographic (CXR) imagery enables earlier and easier lung disease diagnosis. Therefore, in this paper, we propose a deep learning method using a transfer learning technique to classify lung diseases on CXR images to improve the efficiency and accuracy of computer-aided diagnostic systems’ (CADs’) diagnostic performance. Our proposed method is a one-step, end-to-end learning, which means that raw CXR images are directly inputted into a deep learning model (EfficientNet v2-M) to extract their meaningful features in identifying disease categories. We experimented using our proposed method on three classes of normal, pneumonia, and pneumothorax of the U.S. National Institutes of Health (NIH) data set, and achieved validation performances of loss = 0.6933, accuracy = 82.15%, sensitivity = 81.40%, and specificity = 91.65%. We also experimented on the Cheonan Soonchunhyang University Hospital (SCH) data set on four classes of normal, pneumonia, pneumothorax, and tuberculosis, and achieved validation performances of loss = 0.7658, accuracy = 82.20%, sensitivity = 81.40%, and specificity = 94.48%; testing accuracy of normal, pneumonia, pneumothorax, and tuberculosis classes was 63.60%, 82.30%, 82.80%, and 89.90%, respectively.

COVID-19 or novel coronavirus disease, which has already been declared as a worldwide pandemic, at first had an outbreak in a large city of China, named Wuhan. More than two hundred countries around the world have already been affected by this severe virus as it spreads by human interaction. Moreover, the symptoms of novel coronavirus are quite similar to the general seasonal flu. Screening of infected patients is considered as a critical step in the fight against COVID-19. As there are no distinctive COVID-19 positive case detection tools available, the need for supporting diagnostic tools has increased. Therefore, it is highly relevant to recognize positive cases as early as possible to avoid further spreading of this epidemic. However, there are several methods to detect COVID-19 positive patients, which are typically performed based on respiratory samples and among them, a critical approach for treatment is radiologic imaging or X-Ray imaging. Recent findings from X-Ray imaging techniques suggest that such images contain relevant information about the SARS-CoV-2 virus. Application of Deep Neural Network (DNN) techniques coupled with radiological imaging can be helpful in the accurate identification of this disease, and can also be supportive in overcoming the issue of a shortage of trained physicians in remote communities. In this article, we have introduced a VGG-16 (Visual Geometry Group, also called OxfordNet) Network-based Faster Regions with Convolutional Neural Networks (Faster R–CNN) framework to detect COVID-19 patients from chest X-Ray images using an available open-source dataset. Our proposed approach provides a classification accuracy of 97.36%, 97.65% of sensitivity, and a precision of 99.28%. Therefore, we believe this proposed method might be of assistance for health professionals to validate their initial assessment towards COVID-19 patients.

The field of explainable artificial intelligence (XAI) aims to build explainable and interpretable machine learning (or deep learning) methods without sacrificing prediction performance. Convolutional neural networks (CNNs) have been successful in making predictions, especially in image classification. These popular and well-documented successes use extremely deep CNNs such as VGG16, DenseNet121, and Xception. However, these well-known deep learning models use tens of millions of parameters based on a large number of pretrained filters that have been repurposed from previous data sets. Among these identified filters, a large portion contain no information yet remain as input features. Thus far, there is no effective method to omit these noisy features from a data set, and their existence negatively impacts prediction performance. In this paper, a novel interaction-based convolutional neural network (ICNN) is introduced that does not make assumptions about the relevance of local information. Instead, a model-free influence score (I-score) is proposed to directly extract the influential information from images to form important variable modules. This innovative technique replaces all pretrained filters found by trial-and-error with explainable, influential, and predictive variable sets (modules) determined by the I-score. In other words, future researchers need not rely on pretrained filters; the suggested algorithm identifies only the variables or pixels with high I-score values that are extremely predictive and important. The proposed method and algorithm were tested on real-world data set and a state-of-the-art prediction performance of 99.8% was achieved without sacrificing the explanatory power of the model. This proposed design can efficiently screen patients infected by COVID-19 before human diagnosis and can be a benchmark for addressing future XAI problems in large-scale data sets.

COVID-19, regarded as the deadliest virus of the 21st century, has claimed the lives of millions of people around the globe in less than two years. Since the virus initially affects the lungs of patients, X-ray imaging of the chest is helpful for effective diagnosis. Any method for automatic, reliable, and accurate screening of COVID-19 infection would be beneficial for rapid detection and reducing medical or healthcare professional exposure to the virus. In the past, Convolutional Neural Networks (CNNs) proved to be quite successful in the classification of medical images. In this study, an automatic deep learning classification method for detecting COVID-19 from chest X-ray images is suggested using a CNN. A dataset consisting of 3616 COVID-19 chest X-ray images and 10,192 healthy chest X-ray images was used. The original data were then augmented to increase the data sample to 26,000 COVID-19 and 26,000 healthy X-ray images. The dataset was enhanced using histogram equalization, spectrum, grays, cyan and normalized with NCLAHE before being applied to CNN models. Initially using the dataset, the symptoms of COVID-19 were detected by employing eleven existing CNN models; VGG16, VGG19, MobileNetV2, InceptionV3, NFNet, ResNet50, ResNet101, DenseNet, EfficientNetB7, AlexNet, and GoogLeNet. From the models, MobileNetV2 was selected for further modification to obtain a higher accuracy of COVID-19 detection. Performance evaluation of the models was demonstrated using a confusion matrix. It was observed that the modified MobileNetV2 model proposed in the study gave the highest accuracy of 98% in classifying COVID-19 and healthy chest X-rays among all the implemented CNN models. The second-best performance was achieved from the pre-trained MobileNetV2 with an accuracy of 97%, followed by VGG19 and ResNet101 with 95% accuracy for both the models. The study compares the compilation time of the models. The proposed model required the least compilation time with 2 h, 50 min and 21 s. Finally, the Wilcoxon signed-rank test was performed to test the statistical significance. The results suggest that the proposed method can efficiently identify the symptoms of infection from chest X-ray images better than existing methods.

Pneumonia is a contagious disease that causes ulcers of the lungs, and is one of the main reasons for death among children and the elderly in the world. Several deep learning models for detecting pneumonia from chest X-ray images have been proposed. One of the extreme challenges has been to find an appropriate and efficient model that meets all performance metrics. Proposing efficient and powerful deep learning models for detecting and classifying pneumonia is the main purpose of this work. In this paper, four different models are developed by changing the used deep learning method; two pre-trained models, ResNet152V2 and MobileNetV2, a Convolutional Neural Network (CNN), and a Long Short-Term Memory (LSTM). The proposed models are implemented and evaluated using Python and compared with recent similar research. The results demonstrate that our proposed deep learning framework improves accuracy, precision, F1-score, recall, and Area Under the Curve (AUC) by 99.22%, 99.43%, 99.44%, 99.44%, and 99.77%, respectively. As clearly illustrated from the results, the ResNet152V2 model outperforms other recently proposed works. Moreover, the other proposed models—MobileNetV2, CNN, and LSTM-CNN—achieved results with more than 91% in accuracy, recall, F1-score, precision, and AUC, and exceed the recently introduced models in the literature.

Automated detection of lung lesions on Chest X-ray images shows good performance to reduce lung cancer mortality. However, it is difficult to detect multiple lesions of single image well and truly, and additional efforts are needed to improve diagnostic efficiency and quality. In this paper, a multi-label classification model combining attention-based neural networks and association-specific contexts is proposed for the detection of multiple lesions on chest X-ray images. A convolutional neural network and a long short-term memory network are first aligned by an attention mechanism to take advantage of both image and text information for the detection, called CNN-ATTENTION-LSTM (CAL) network. In addition, a mining method of implicit association strength to obtain an association network of chest lesions (CLA) network is designed to guide the training of CAL network. The CLA network provides possible clinical relationships between lesions to help the CAL network obtain better predictions. Experimental results on ChestX-ray14 dataset show that our method outperforms some state-of-the-art models under the metrics of area under curve (AUC), precision, recall, and F-score and achieves up to 85.4% in the case of atelectasis and infiltration. It indicates that the method may be useful in the computer-aided detection of multiple lesions on chest X-ray images.