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The morphological characteristics of the foot arch and the plantar soft tissue thickness are pivotal in assessing foot health, which is associated with various foot and ankle pathologies. By applying deep learning image segmentation techniques to lateral weight-bearing X-ray images, this study investigates the correlation between foot arch morphology (FAM) and plantar soft tissue thickness (PSTT), examining influences of age and sex. Specifically, we use the DeepLab V3+ network model to accurately delineate the boundaries of the first metatarsal, talus, calcaneus, navicular bones, and overall foot, enabling rapid and automated measurements of FAM and PSTT. A retrospective dataset containing 1497 X-ray images is analyzed to explore associations between FAM, PSTT, and various demographic factors. Our findings contribute novel insights into foot morphology, offering robust tools for clinical assessments and interventions. The enhanced detection and diagnostic capabilities provided by precise data support facilitate population-based studies and the leveraging of big data in clinical settings., (© 2024. The Author(s).)

Purpose: Preoperative prudent patient selection plays a crucial role in knee osteoarthritis management but faces challenges in appropriate referrals such as total knee arthroplasty (TKA), unicompartmental knee arthroplasty (UKA) and nonoperative intervention. Deep learning (DL) techniques can build prediction models for treatment decision-making. The aim is to develop and evaluate a knee arthroplasty prediction pipeline using three-view X-rays to determine the suitable candidates for TKA, UKA or are not arthroplasty candidates., Methods: A study was conducted using three-view (anterior-posterior, lateral and patellar) X-rays and surgical data of patients undergoing TKA, UKA or nonarthroplasty interventions from sites A and B. Data from site A were used to derive and validate models. Data from site B were used as external test set. A DL pipeline combining YOLOv3 and ResNet-18 with confident learning (CL) was developed. Multiview Convolutional Neural Network, EfficientNet-b4, ResNet-101 and the proposed model without CL were also trained and tested. The models were evaluated using metrics such as area under the receiver operating characteristic curve (AUC), accuracy, precision, specificity, sensitivity and F1 score., Results: The data set comprised a total of 1779 knees. Of which 1645 knees were from site A as a derivation set and an internal validation cohort. The external validation cohort consisted of 134 knees. The internal validation cohort demonstrated superior performance for the proposed model augmented with CL, achieving an AUC of 0.94 and an accuracy of 85.9%. External validation further confirmed the model's generalisation, with an AUC of 0.93 and an accuracy of 82.1%. Comparative analysis with other neural network models showed the proposed model's superiority., Conclusions: The proposed DL pipeline, integrating YOLOv3, ResNet-18 and CL, provides accurate predictions for knee arthroplasty candidates based on three-view X-rays. This prediction model could be useful in performing decision making for the type of arthroplasty procedure in an automated fashion., Level of Evidence: Level III, diagnostic study., (© 2024 European Society of Sports Traumatology, Knee Surgery and Arthroscopy.)

Background: Pneumoconiosis has a significant impact on the quality of patient survival due to its difficult staging diagnosis and poor prognosis. This study aimed to develop a computer-aided diagnostic system for the screening and staging of pneumoconiosis based on a multi-stage joint deep learning approach using X-ray chest radiographs of pneumoconiosis patients., Methods: In this study, a total of 498 medical chest radiographs were obtained from the Department of Radiology of West China Fourth Hospital. The dataset was randomly divided into a training set and a test set at a ratio of 4:1. Following histogram equalization for image enhancement, the images were segmented using the U-Net model, and staging was predicted using a convolutional neural network classification model. We first used Efficient-Net for multi-classification staging diagnosis, but the results showed that stage I/II of pneumoconiosis was difficult to diagnose. Therefore, based on clinical practice we continued to improve the model by using the Res-Net 34 Multi-stage joint method., Results: Of the 498 cases collected, the classification model using the Efficient-Net achieved an accuracy of 83% with a Quadratic Weighted Kappa (QWK) score of 0.889. The classification model using the multi-stage joint approach of Res-Net 34 achieved an accuracy of 89% with an area under the curve (AUC) of 0.98 and a high QWK score of 0.94., Conclusions: In this study, the diagnostic accuracy of pneumoconiosis staging was significantly improved by an innovative combined multi-stage approach, which provided a reference for clinical application and pneumoconiosis screening., (© 2024. The Author(s).)

The increase in Cervical Spondylosis cases and the expansion of the affected demographic to younger patients have escalated the demand for X-ray screening. Challenges include variability in imaging technology, differences in equipment specifications, and the diverse experience levels of clinicians, which collectively hinder diagnostic accuracy. In response, a deep learning approach utilizing a ResNet-34 convolutional neural network has been developed. This model, trained on a comprehensive dataset of 1235 cervical spine X-ray images representing a wide range of projection angles, aims to mitigate these issues by providing a robust tool for diagnosis. Validation of the model was performed on an independent set of 136 X-ray images, also varied in projection angles, to ensure its efficacy across diverse clinical scenarios. The model achieved a classification accuracy of 89.7%, significantly outperforming the traditional manual diagnostic approach, which has an accuracy of 68.3%. This advancement demonstrates the viability of deep learning models to not only complement but enhance the diagnostic capabilities of clinicians in identifying Cervical Spondylosis, offering a promising avenue for improving diagnostic accuracy and efficiency in clinical settings.

Objectives: To investigate a comprehensive segmentation of chest X-ray (CXR) in promoting deep learning-based World Health Organization's (WHO) radiologically confirmed pneumonia diagnosis in children., Methods: A total of 4400 participants between January 2016 and June 2021were identified for a cross-sectional study and divided into primary endpoint pneumonia (PEP), other infiltrates, and normal groups according to WHO's diagnostic criteria. The CXR was divided into six segments of left lung, right lung, mediastinum, diaphragm, ext-left lung, and ext-right lung by adopting the RA-UNet. To demonstrate the benefits of lung field segmentation in pneumonia diagnosis, the segmented images and images that were not segmented, which constituted seven segmentation combinations, were fed into the CBAM-ResNet under a three-category classification comparison. The interpretability of the CBAM-ResNet for pneumonia diagnosis was also performed by adopting a Grad-CAM module., Results: The RA-UNet achieved a high spatial overlap between manual and automatic segmentation (averaged DSC = 0.9639). The CBAM-ResNet when fed with the six segments achieved superior three-category diagnosis performance (accuracy = 0.8243) over other segmentation combinations and deep learning models under comparison, which was increased by around 6% in accuracy, precision, specificity, sensitivity, F1-score, and around 3% in AUC. The Grad-CAM could capture the pneumonia lesions more accurately, generating a more interpretable visualization and enhancing the superiority and reliability of our study in assisting pediatric pneumonia diagnosis., Conclusions: The comprehensive segmentation of CXR could improve deep learning-based pneumonia diagnosis in childhood with a more reasonable WHO's radiological standardized pneumonia classification instead of conventional dichotomous bacterial pneumonia and viral pneumonia., Clinical Relevance Statement: The comprehensive segmentation of chest X-ray improves deep learning-based WHO confirmed pneumonia diagnosis in children, laying a strong foundation for the potential inclusion of computer-aided pediatric CXR readings in precise classification of pneumonia and PCV vaccine trials efficacy in children., Key Points: • The chest X-ray was comprehensively segmented into six anatomical structures of left lung, right lung, mediastinum, diaphragm, ext-left lung, and ext-right lung. • The comprehensive segmentation improved the three-category classification of primary endpoint pneumonia, other infiltrates, and normal with an increase by around 6% in accuracy, precision, specificity, sensitivity, F1-score, and around 3% in AUC. • The comprehensive segmentation gave rise to a more accurate and interpretable visualization results in capturing the pneumonia lesions., (© 2023. The Author(s), under exclusive licence to European Society of Radiology.)

Background: The study aimed to develop and validate a deep learning-based Computer Aided Triage (CADt) algorithm for detecting pleural effusion in chest radiographs using an active learning (AL) framework. This is aimed at addressing the critical need for a clinical grade algorithm that can timely diagnose pleural effusion, which affects approximately 1.5 million people annually in the United States., Methods: In this multisite study, 10,599 chest radiographs from 2006 to 2018 were retrospectively collected from an institution in Taiwan to train the deep learning algorithm. The AL framework utilized significantly reduced the need for expert annotations. For external validation, the algorithm was tested on a multisite dataset of 600 chest radiographs from 22 clinical sites in the United States and Taiwan, which were annotated by three U.S. board-certified radiologists., Results: The CADt algorithm demonstrated high effectiveness in identifying pleural effusion, achieving a sensitivity of 0.95 (95% CI: [0.92, 0.97]) and a specificity of 0.97 (95% CI: [0.95, 0.99]). The area under the receiver operating characteristic curve (AUC) was 0.97 (95% DeLong's CI: [0.95, 0.99]). Subgroup analyses showed that the algorithm maintained robust performance across various demographics and clinical settings., Conclusion: This study presents a novel approach in developing clinical grade CADt solutions for the diagnosis of pleural effusion. The AL-based CADt algorithm not only achieved high accuracy in detecting pleural effusion but also significantly reduced the workload required for clinical experts in annotating medical data. This method enhances the feasibility of employing advanced technological solutions for prompt and accurate diagnosis in medical settings., (© 2024. The Author(s).)

Adrenal vein sampling is required for the staging diagnosis of primary aldosteronism, and the frames in which the adrenal veins are presented are called key frames. Currently, the selection of key frames relies on the doctor's visual judgement which is time-consuming and laborious. This study proposes a key frame recognition algorithm based on deep learning. Firstly, wavelet denoising and multi-scale vessel-enhanced filtering are used to preserve the morphological features of the adrenal veins. Furthermore, by incorporating the self-attention mechanism, an improved recognition model called ResNet50-SA is obtained. Compared with commonly used transfer learning, the new model achieves 97.11% in accuracy, precision, recall, F 1 , and AUC, which is superior to other models and can help clinicians quickly identify key frames in adrenal veins.

Objective: A deep learning-based method for evaluating the quality of pediatric pelvic X-ray images is proposed to construct a diagnostic model and verify its clinical feasibility., Methods: Three thousand two hundred and forty-seven children with anteroposteric pelvic radiographs are retrospectively collected and randomly divided into training datasets, validation datasets and test datasets. Artificial intelligence model is conducted to evaluate the reliability of quality control model., Results: The diagnostic accuracy, area under ROC curve, sensitivity and specificity of the model are 99.4%, 0.993, 98.6% and 100.0%, respectively. The 95% consistency limit of the pelvic tilt index of the model is -0.052-0.072. The 95% consistency threshold of pelvic rotation index is -0.088-0.055., Conclusion: This is the first attempt to apply AI algorithm to the quality assessment of children's pelvic radiographs, and has significantly improved the diagnosis and treatment status of DDH in children.

Purpose: To develop and validate a deep learning radiomics (DLR) model that uses X-ray images to predict the classification of osteoporotic vertebral fractures (OVFs)., Material and Methods: The study encompassed a cohort of 942 patients, involving examinations of 1076 vertebrae through X-ray, CT, and MRI across three distinct hospitals. The OVFs were categorized as class 0, 1, or 2 based on the Assessment System of Thoracolumbar Osteoporotic Fracture. The dataset was divided randomly into four distinct subsets: a training set comprising 712 samples, an internal validation set with 178 samples, an external validation set containing 111 samples, and a prospective validation set consisting of 75 samples. The ResNet-50 architectural model was used to implement deep transfer learning (DTL), undergoing -pre-training separately on the RadImageNet and ImageNet datasets. Features from DTL and radiomics were extracted and integrated using X-ray images. The optimal fusion feature model was identified through least absolute shrinkage and selection operator logistic regression. Evaluation of the predictive capabilities for OVFs classification involved eight machine learning models, assessed through receiver operating characteristic curves employing the "One-vs-Rest" strategy. The Delong test was applied to compare the predictive performance of the superior RadImageNet model against the ImageNet model., Results: Following pre-training separately on RadImageNet and ImageNet datasets, feature selection and fusion yielded 17 and 12 fusion features, respectively. Logistic regression emerged as the optimal machine learning algorithm for both DLR models. Across the training set, internal validation set, external validation set, and prospective validation set, the macro-average Area Under the Curve (AUC) based on the RadImageNet dataset surpassed those based on the ImageNet dataset, with statistically significant differences observed (P<0.05). Utilizing the binary "One-vs-Rest" strategy, the model based on the RadImageNet dataset demonstrated superior efficacy in predicting Class 0, achieving an AUC of 0.969 and accuracy of 0.863. Predicting Class 1 yielded an AUC of 0.945 and accuracy of 0.875, while for Class 2, the AUC and accuracy were 0.809 and 0.692, respectively., Conclusion: The DLR model, based on the RadImageNet dataset, outperformed the ImageNet model in predicting the classification of OVFs, with generalizability confirmed in the prospective validation set., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Zhang, Xia, Liu, Niu, Tang, Xia, Liu, Zhang, Liang, Zhang, Tang and Zhang.)

Background: Chronic obstructive pulmonary disease (COPD) is underdiagnosed with the current gold standard measure pulmonary function test (PFT). A more sensitive and simple option for early detection and severity evaluation of COPD could benefit practitioners and patients., Methods: In this multicenter retrospective study, frontal chest X-ray (CXR) images and related clinical information of 1055 participants were collected and processed. Different deep learning algorithms and transfer learning models were trained to classify COPD based on clinical data and CXR images from 666 subjects, and validated in internal test set based on 284 participants. External test including 105 participants was also performed to verify the generalization ability of the learning algorithms in diagnosing COPD. Meanwhile, the model was further used to evaluate disease severity of COPD by predicting different grads., Results: The Ensemble model showed an AUC of 0.969 in distinguishing COPD by simultaneously extracting fusion features of clinical parameters and CXR images in internal test, better than models that used clinical parameters (AUC = 0.963) or images (AUC = 0.946) only. For the external test set, the AUC slightly declined to 0.934 in predicting COPD based on clinical parameters and CXR images. When applying the Ensemble model to determine disease severity of COPD, the AUC reached 0.894 for three-classification and 0.852 for five-classification respectively., Conclusion: The present study used DL algorithms to screen COPD and predict disease severity based on CXR imaging and clinical parameters. The models showed good performance and the approach might be an effective case-finding tool with low radiation dose for COPD diagnosis and staging., (© 2024. The Author(s).)

Background: Dental caries diagnosis requires the manual inspection of diagnostic bitewing images of the patient, followed by a visual inspection and probing of the identified dental pieces with potential lesions. Yet the use of artificial intelligence, and in particular deep-learning, has the potential to aid in the diagnosis by providing a quick and informative analysis of the bitewing images., Methods: A dataset of 13,887 bitewings from the HUNT4 Oral Health Study were annotated individually by six different experts, and used to train three different object detection deep-learning architectures: RetinaNet (ResNet50), YOLOv5 (M size), and EfficientDet (D0 and D1 sizes). A consensus dataset of 197 images, annotated jointly by the same six dental clinicians, was used for evaluation. A five-fold cross validation scheme was used to evaluate the performance of the AI models., Results: The trained models show an increase in average precision and F1-score, and decrease of false negative rate, with respect to the dental clinicians. When compared against the dental clinicians, the YOLOv5 model shows the largest improvement, reporting 0.647 mean average precision, 0.548 mean F1-score, and 0.149 mean false negative rate. Whereas the best annotators on each of these metrics reported 0.299, 0.495, and 0.164 respectively., Conclusion: Deep-learning models have shown the potential to assist dental professionals in the diagnosis of caries. Yet, the task remains challenging due to the artifacts natural to the bitewing images., (© 2024. The Author(s).)

Musculoskeletal conditions affect an estimated 1.7 billion people worldwide, causing intense pain and disability. These conditions lead to 30 million emergency room visits yearly, and the numbers are only increasing. However, diagnosing musculoskeletal issues can be challenging, especially in emergencies where quick decisions are necessary. Deep learning (DL) has shown promise in various medical applications. However, previous methods had poor performance and a lack of transparency in detecting shoulder abnormalities on X-ray images due to a lack of training data and better representation of features. This often resulted in overfitting, poor generalisation, and potential bias in decision-making. To address these issues, a new trustworthy DL framework has been proposed to detect shoulder abnormalities (such as fractures, deformities, and arthritis) using X-ray images. The framework consists of two parts: same-domain transfer learning (TL) to mitigate imageNet mismatch and feature fusion to reduce error rates and improve trust in the final result. Same-domain TL involves training pre-trained models on a large number of labelled X-ray images from various body parts and fine-tuning them on the target dataset of shoulder X-ray images. Feature fusion combines the extracted features with seven DL models to train several ML classifiers. The proposed framework achieved an excellent accuracy rate of 99.2%, F1Score of 99.2%, and Cohen's kappa of 98.5%. Furthermore, the accuracy of the results was validated using three visualisation tools, including gradient-based class activation heat map (Grad CAM), activation visualisation, and locally interpretable model-independent explanations (LIME). The proposed framework outperformed previous DL methods and three orthopaedic surgeons invited to classify the test set, who obtained an average accuracy of 79.1%. The proposed framework has proven effective and robust, improving generalisation and increasing trust in the final results., Competing Interests: NO authors have competing interests., (Copyright: © 2024 Alzubaidi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objectives: Coronary angiography (CAG)-derived physiology methods have been developed in an attempt to simplify and increase the usage of coronary physiology, based mostly on dynamic fluid computational algorithms. We aimed to develop a different approach based on artificial intelligence methods, which has seldom been explored., Methods: Consecutive patients undergoing invasive instantaneous free-wave ratio (iFR) measurements were included. We developed artificial intelligence (AI) models capable of classifying target lesions as positive (iFR ≤ 0.89) or negative (iFR > 0.89). The predictions were then compared to the true measurements., Results: Two hundred-fifty measurements were included, and 3 models were developed. Model 3 had the best overall performance: accuracy, negative predictive value (NPV), positive predictive value (PPV), sensitivity, and specificity were 69%, 88%, 44%, 74%, and 67%, respectively. Performance differed per target vessel. For the left anterior descending artery (LAD), model 3 had the highest accuracy (66%), while model 2 the highest NPV (86%) and sensitivity (91%). PPV was always low/modest. Model 1 had the highest specificity (68%). For the right coronary artery, model 1's accuracy was 86%, NPV was 97%, and specificity was 87%, but all models had low PPV (maximum 25%) and low/modest sensitivity (maximum 60%). For the circumflex, model 1 performed best: accuracy, NPV, PPV, sensitivity, and specificity were 69%, 96%, 24%, 80%, and 68%, respectively., Conclusions: We developed 3 AI models capable of binary iFR estimation from CAG images. Despite modest accuracy, the consistently high NPV is of potential clinical significance, as it would enable avoiding further invasive maneuvers after CAG. This pivotal study offers proof of concept for further development.

Pneumonia is a disease caused by bacteria, viruses, and fungi that settle in the alveolar sacs of the lungs and can lead to serious health complications in humans. Early detection of pneumonia is necessary for early treatment to manage and cure the disease. Recently, machine learning-based pneumonia detection methods have focused on pneumonia in adults. Machine learning relies on manual feature engineering, whereas deep learning can automatically detect and extract features from data. This study proposes a deep learning feature extraction-based hybrid approach that combines deep learning and machine learning to detect pediatric pneumonia, which is difficult to standardize. The proposed hybrid approach enhances the accuracy of detecting pediatric pneumonia and simplifies the approach by eliminating the requirement for advanced feature extraction. The experiments indicate that the hybrid approach using a Medium Neural Network based on AlexNet feature extraction achieved a 97.9% accuracy rate and 98.0% sensitivity rate. The results show that the proposed approach achieved higher accuracy rates than state-of-the-art approaches., (© 2023. Australasian College of Physical Scientists and Engineers in Medicine.)

Background: Pulmonary arterial hypertension is a serious medical condition. However, the condition is often misdiagnosed or a rather long delay occurs from symptom onset to diagnosis, associated with decreased 5-year survival. In this study, we developed and tested a deep-learning algorithm to detect pulmonary arterial hypertension using chest X-ray (CXR) images., Methods: From the image archive of Chiba University Hospital, 259 CXR images from 145 patients with pulmonary arterial hypertension and 260 CXR images from 260 control patients were identified; of which 418 were used for training and 101 were used for testing. Using the testing dataset for each image, the algorithm outputted a numerical value from 0 to 1 (the probability of the pulmonary arterial hypertension score). The training process employed a binary cross-entropy loss function with stochastic gradient descent optimization (learning rate parameter, α = 0.01). In addition, using the same testing dataset, the algorithm's ability to identify pulmonary arterial hypertension was compared with that of experienced doctors., Results: The area under the curve (AUC) of the receiver operating characteristic curve for the detection ability of the algorithm was 0.988. Using an AUC threshold of 0.69, the sensitivity and specificity of the algorithm were 0.933 and 0.982, respectively. The AUC of the algorithm's detection ability was superior to that of the doctors., Conclusion: The CXR image-derived deep-learning algorithm had superior pulmonary arterial hypertension detection capability compared with that of experienced doctors., (© 2024. The Author(s).)

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.

Accurate identification and localization of multiple abnormalities are crucial steps in the interpretation of chest X-rays (CXRs); however, the lack of a large CXR dataset with bounding boxes severely constrains accurate localization research based on deep learning. We created a large CXR dataset named CXR-AL14, containing 165,988 CXRs and 253,844 bounding boxes. On the basis of this dataset, a deep-learning-based framework was developed to identify and localize 14 common abnormalities and calculate the cardiothoracic ratio (CTR) simultaneously. The mean average precision values obtained by the model for 14 abnormalities reached 0.572-0.631 with an intersection-over-union threshold of 0.5, and the intraclass correlation coefficient of the CTR algorithm exceeded 0.95 on the held-out, multicentre and prospective test datasets. This framework shows an excellent performance, good generalization ability and strong clinical applicability, which is superior to senior radiologists and suitable for routine clinical settings., (© 2024. The Author(s).)

Microplastics (MPs) and nanoplastics (NPs) are global pollutants with emerging concerns. Methods to predict and screen their toxicity are crucial. Elemental dyshomeostasis can be used to assess toxicity of environmental pollutants. Non-targeted metallomics, combining synchrotron radiation X-ray fluorescence (SRXRF) and machine learning, has successfully differentiated cancer patients from healthy individuals. The whole idea of this work is to screen the phytotoxicity of nano polyethylene terephthalate (nPET) and micro polyethylene terephthalate (mPET) through non-targeted metallomics with SRXRF and deep learning algorithms. Firstly, Seed germination, seedling growth, photosynthetic changes, and antioxidant activity were used to evaluate the toxicity of mPET and nPET. It was showed that nPET, at 10 mg/L, was more toxic to rice seedlings, inhibiting growth and impairing chlorophyll content, MDA content, and SOD activity compared to mPET. Then, rice seedling leaves exposed to nPET or mPET was examined with SRXRF, and the SRXRF data was differentiated with deep learning algorithms. It was showed that the one-dimensional convolutional neural network (1D-CNN) model achieved 98.99% accuracy without data preprocessing in screening mPET and nPET exposure. In all, non-targeted metallomics with SRXRF and 1D-CNN can effectively screen the exposure and phytotoxicity of nPET/mPET and potentially other emerging pollutants. Further research is needed to assess the phytotoxicity of different types of MPs/NPs using non-targeted metallomics., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Artificial intelligence (AI) seems promising in diagnosing pneumonia on chest x-rays (CXR), but deep learning (DL) algorithms have primarily been compared with radiologists, whose diagnosis can be not completely accurate. Therefore, we evaluated the accuracy of DL in diagnosing pneumonia on CXR using a more robust reference diagnosis., Methods: We trained a DL convolutional neural network model to diagnose pneumonia and evaluated its accuracy in two prospective pneumonia cohorts including 430 patients, for whom the reference diagnosis was determined a posteriori by a multidisciplinary expert panel using multimodal data. The performance of the DL model was compared with that of senior radiologists and emergency physicians reviewing CXRs and that of radiologists reviewing computed tomography (CT) performed concomitantly., Results: Radiologists and DL showed a similar accuracy on CXR for both cohorts (p ≥ 0.269): cohort 1, radiologist 1 75.5% (95% confidence interval 69.1-80.9), radiologist 2 71.0% (64.4-76.8), DL 71.0% (64.4-76.8); cohort 2, radiologist 70.9% (64.7-76.4), DL 72.6% (66.5-78.0). The accuracy of radiologists and DL was significantly higher (p ≤ 0.022) than that of emergency physicians (cohort 1 64.0% [57.1-70.3], cohort 2 63.0% [55.6-69.0]). Accuracy was significantly higher for CT (cohort 1 79.0% [72.8-84.1], cohort 2 89.6% [84.9-92.9]) than for CXR readers including radiologists, clinicians, and DL (all p-values < 0.001)., Conclusions: When compared with a robust reference diagnosis, the performance of AI models to identify pneumonia on CXRs was inferior than previously reported but similar to that of radiologists and better than that of emergency physicians., Relevance Statement: The clinical relevance of AI models for pneumonia diagnosis may have been overestimated. AI models should be benchmarked against robust reference multimodal diagnosis to avoid overestimating its performance., Trial Registration: NCT02467192 , and NCT01574066 ., Key Point: • We evaluated an openly-access convolutional neural network (CNN) model to diagnose pneumonia on CXRs. • CNN was validated against a strong multimodal reference diagnosis. • In our study, the CNN performance (area under the receiver operating characteristics curve 0.74) was lower than that previously reported when validated against radiologists' diagnosis (0.99 in a recent meta-analysis). • The CNN performance was significantly higher than emergency physicians' (p ≤ 0.022) and comparable to that of board-certified radiologists (p ≥ 0.269)., (© 2024. The Author(s).)

Background: This Special Report summarizes the 2022 AAPM Grand Challenge on Deep-Learning spectral Computed Tomography (DL-spectral CT) image reconstruction., Purpose: The purpose of the challenge is to develop the most accurate image reconstruction algorithm possible for solving the inverse problem associated with a fast kilovolt switching dual-energy CT scan using a three tissue-map decomposition. Participants could choose to use a deep-learning (DL), iterative, or a hybrid approach., Methods: The challenge is based on a 2D breast CT simulation, where the simulated breast phantom consists of three tissue maps: adipose, fibroglandular, and calcification distributions. The phantom specification is stochastic so that multiple realizations can be generated for DL approaches. A dual-energy scan is simulated where the x-ray source potential of successive views alternates between 50 and 80 kilovolts (kV). A total of 512 views are generated, yielding 256 views for each source voltage. We generate 50 and 80 kV images by use of filtered back-projection (FBP) on negative logarithm processed transmission data. For participants who develop a DL approach, 1000 cases are available. Each case consists of the three 512 × 512 tissue maps, 50 and 80-kV transmission data sets and their corresponding FBP images. The goal of the DL network would then be to predict the material maps from either the transmission data, FBP images, or a combination of the two. For participants developing a physics-based approach, all of the required modeling parameters are made available: geometry, spectra, and tissue attenuation curves. The provided information also allows for hybrid approaches where physics is exploited as well as information about the scanned object derived from the 1000 training cases. Final testing is performed by computation of root-mean-square error (RMSE) for predictions on the tissue maps from 100 new cases., Results: Test phase submission were received from 18 research groups. Of the 18 submissions, 17 were results obtained with algorithms that involved DL. Only the second place finishing team developed a physics-based image reconstruction algorithm. Both the winning and second place teams had highly accurate results where the RMSE was nearly zero to single floating point precision. Results from the top 10 also achieved a high degree of accuracy; and as a result, this special report outlines the methodology developed by each of these groups., Conclusions: The DL-spectral CT challenge successfully established a forum for developing image reconstruction algorithms that address an important inverse problem relevant for spectral CT., (© 2023 The Authors. Medical Physics published by Wiley Periodicals LLC on behalf of American Association of Physicists in Medicine.)

Objectives: To aid in selecting the optimal artificial intelligence (AI) solution for clinical application, we directly compared performances of selected representative custom-trained or commercial classification, detection and segmentation models for fracture detection on musculoskeletal radiographs of the distal radius by aligning their outputs., Design and Setting: This single-centre retrospective study was conducted on a random subset of emergency department radiographs from 2008 to 2018 of the distal radius in Germany., Materials and Methods: An image set was created to be compatible with training and testing classification and segmentation models by annotating examinations for fractures and overlaying fracture masks, if applicable. Representative classification and segmentation models were trained on 80% of the data. After output binarisation, their derived fracture detection performances as well as that of a standard commercially available solution were compared on the remaining X-rays (20%) using mainly accuracy and area under the receiver operating characteristic (AUROC)., Results: A total of 2856 examinations with 712 (24.9%) fractures were included in the analysis. Accuracies reached up to 0.97 for the classification model, 0.94 for the segmentation model and 0.95 for BoneView. Cohen's kappa was at least 0.80 in pairwise comparisons, while Fleiss' kappa was 0.83 for all models. Fracture predictions were visualised with all three methods at different levels of detail, ranking from downsampled image region for classification over bounding box for detection to single pixel-level delineation for segmentation., Conclusions: All three investigated approaches reached high performances for detection of distal radius fractures with simple preprocessing and postprocessing protocols on the custom-trained models. Despite their underlying structural differences, selection of one's fracture analysis AI tool in the frame of this study reduces to the desired flavour of automation: automated classification, AI-assisted manual fracture reading or minimised false negatives., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

A deep learning model was developed to identify osteoporosis from chest X-ray (CXR) features with high accuracy in internal and external validation. It has significant prognostic implications, identifying individuals at higher risk of all-cause mortality. This Artificial Intelligence (AI)-enabled CXR strategy may function as an early detection screening tool for osteoporosis. The aim of this study was to develop a deep learning model (DLM) to identify osteoporosis via CXR features and investigate the performance and clinical implications. This study collected 48,353 CXRs with the corresponding T score according to Dual energy X-ray Absorptiometry (DXA) from the academic medical center. Among these, 35,633 CXRs were used to identify CXR- Osteoporosis (CXR-OP). Another 12,720 CXRs were used to validate the performance, which was evaluated by the area under the receiver operating characteristic curve (AUC). Furthermore, CXR-OP was tested to assess the long-term risks of mortality, which were evaluated by Kaplan‒Meier survival analysis and the Cox proportional hazards model. The DLM utilizing CXR achieved AUCs of 0.930 and 0.892 during internal and external validation, respectively. The group that underwent DXA with CXR-OP had a higher risk of all-cause mortality (hazard ratio [HR] 2.59, 95% CI: 1.83-3.67), and those classified as CXR-OP in the group without DXA also had higher all-cause mortality (HR: 1.67, 95% CI: 1.61-1.72) in the internal validation set. The external validation set produced similar results. Our DLM uses CXRs for early detection of osteoporosis, aiding physicians to identify those at risk. It has significant prognostic implications, improving life quality and reducing mortality. AI-enabled CXR strategy may serve as a screening tool., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: The novel coronavirus pandemic has caused a global health crisis, placing immense strain on healthcare systems worldwide. Chest X-ray technology has emerged as a critical tool for the diagnosis and treatment of COVID-19. However, the manual interpretation of chest X-ray films has proven to be inefficient and time-consuming, necessitating the development of an automated classification system., Objective: In response to the challenges posed by the COVID-19 pandemic, we aimed to develop a deep learning model that accurately classifies chest X-ray images, specifically focusing on lung regions, to enhance the efficiency and accuracy of COVID-19 and pneumonia diagnosis., Methods: We have proposed a novel deep network called "FocusNet" for precise segmentation of lung regions in chest radiographs. This segmentation allows for the accurate extraction of lung contours from chest X-ray images, which are then input into the classification network, ResNet18. By training the model on these segmented lung datasets, we sought to improve the accuracy of classification., Results: The performance of our proposed system was evaluated on three types of lung regions in normal individuals, COVID-19 patients, and those with pneumonia. The average accuracy of the segmentation model (FocusNet) in segmenting lung regions was found to be above 90%. After reclassification of the segmented lung images, the specificities and sensitivities for normal, COVID-19, and pneumonia were excellent, with values of 98.00%, 99.00%, 99.50%, and 98.50%, 100.00%, and 99.00%, respectively. ResNet18 achieved impressive area under the curve (AUC) values of 0.99, 1.00, and 0.99 for classifying normal, COVID-19, and pneumonia, respectively, on the segmented lung datasets. Moreover, the AUC values of the three groups increased by 0.02, 0.02, and 0.06, respectively, when compared to the direct classification of unsegmented original images. Overall, the accuracy of lung region classification after processing the datasets was 99.3%., Conclusion: Our deep learning-based automated chest X-ray classification system, incorporating lung region segmentation using FocusNet and subsequent classification with ResNet18, has significantly improved the accuracy of diagnosing respiratory lung diseases, including COVID-19. The proposed approach has great potential to revolutionize the diagnosis of COVID-19 and other respiratory lung diseases, offering a valuable tool to support healthcare professionals during health crises., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Medical imaging, specifically chest X-ray image analysis, is a crucial component of early disease detection and screening in healthcare. Deep learning techniques, such as convolutional neural networks (CNNs), have emerged as powerful tools for computer-aided diagnosis (CAD) in chest X-ray image analysis. These techniques have shown promising results in automating tasks such as classification, detection, and segmentation of abnormalities in chest X-ray images, with the potential to surpass human radiologists. In this review, we provide an overview of the importance of chest X-ray image analysis, historical developments, impact of deep learning techniques, and availability of labeled databases. We specifically focus on advancements and challenges in radiology report generation using deep learning, highlighting potential future advancements in this area. The use of deep learning for report generation has the potential to reduce the burden on radiologists, improve patient care, and enhance the accuracy and efficiency of chest X-ray image analysis in medical imaging., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Mohammed Yasser Ouis reports financial support was provided by New Brunswick Innovation Foundation. Mohammed Yasser Ouis reports financial support was provided by New Brunswick Health Research Foundation., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Radiotherapy serves as a pivotal treatment modality for malignant tumors. However, the accuracy of radiotherapy is significantly compromised due to respiratory-induced fluctuations in the size, shape, and position of the tumor. To address this challenge, we introduce a deep learning-anchored, volumetric tumor tracking methodology that employs single-angle X-ray projection images. This process involves aligning the intraoperative two-dimensional (2D) X-ray images with the pre-treatment three-dimensional (3D) planning Computed Tomography (CT) scans, enabling the extraction of the 3D tumor position and segmentation. Prior to therapy, a bespoke patient-specific tumor tracking model is formulated, leveraging a hybrid data augmentation, style correction, and registration network to create a mapping from single-angle 2D X-ray images to the corresponding 3D tumors. During the treatment phase, real-time X-ray images are fed into the trained model, producing the respective 3D tumor positioning. Rigorous validation conducted on actual patient lung data and lung phantoms attests to the high localization precision of our method at lowered radiation doses, thus heralding promising strides towards enhancing the precision of radiotherapy., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

The reconstruction of blood velocity in a vessel from contrast enhanced x-ray computed tomography projections is a complex inverse problem. It can be formulated as reconstruction problem with a partial differential equation constraint. A solution can be estimated with the a variational adjoint method and proper orthogonal decomposition (POD) basis. In this work, we investigate new inversion approaches based on PODs coupled with deep learning methods. The effectiveness of the reconstruction methods is shown with simulated realistic stationary blood flows in a vessel. The methods outperform the reduced adjoint method and show large speed-up at the online stage., (© 2023 John Wiley & Sons Ltd.)

Comprehensive management approaches for patients with ischemic heart disease (IHD) are important aids for prognostication and treatment planning. While single-modality deep neural networks (DNNs) have shown promising performance for detecting cardiac abnormalities, the potential benefits of using DNNs for multimodality risk assessment in patients with IHD have not been reported. The purpose of this study was to investigate the effectiveness of multimodality risk assessment in patients with IHD using a DNN that utilizes 12-lead electrocardiograms (ECGs) and chest X-rays (CXRs), with the prediction of major adverse cardiovascular events (MACEs) being of particular concern.DNN models were applied to detection of left ventricular systolic dysfunction (LVSD) on ECGs and identification of cardiomegaly findings on CXRs. A total of 2107 patients who underwent elective percutaneous coronary intervention were categorized into 4 groups according to the models' outputs: Dual-modality high-risk (n = 105), ECG high-risk (n = 181), CXR high-risk (n = 392), and No-risk (n = 1,429).A total of 342 MACEs were observed. The incidence of a MACE was the highest in the Dual-modality high-risk group (P < 0.001). Multivariate Cox hazards analysis for predicting MACE revealed that the Dual-modality high-risk group had a significantly higher risk of MACE than the No-risk group (hazard ratio (HR): 2.370, P < 0.001), the ECG high-risk group (HR: 1.906, P = 0.010), and the CXR high-risk group (HR: 1.624, P = 0.018), after controlling for confounding factors.The results suggest the usefulness of multimodality risk assessment using DNN models applied to 12-lead ECG and CXR data from patients with IHD.

Objective: Deep learning is an advanced machine-learning approach that is used in several medical fields. Here, we developed a deep learning model using an object detection algorithm to identify the L5 vertebra on anteroposterior lumbar spine radiographs, and assessed its detection accuracy., Methods: We retrospectively recruited 150 participants for whom both anteroposterior whole-spine and lumbar spine radiographs were available. The anteroposterior lumbar spine radiographs of these patients were used as the input data. Of the 150 images, 105 (70%) were randomly selected as the training set, and the remaining 45 (30%) were assigned to the validation set. YOLOv5x, of the YOLOv5 family model, was used to detect the L5 vertebra area., Results: The mean average precisions 0.5 and 0.75 of the trained L5 detection model were 99.2% and 96.9%, respectively. The model's precision was 95.7% and its recall was 97.8%. Furthermore, 93.3% of the validation data were correctly detected., Conclusion: Our deep learning model showed an outstanding ability to identify L5 vertebrae.

COVID-19 detection is mainly based on molecular testing, especially polymerase chain reaction (PCR) analyses, to find the occurrence of the virus's genetic material in respiratory samples. Computed tomography (CT) scans and X-rays are the two chest imaging techniques, which may provide more details on lungs, aiding in the diagnosis. Radiological findings in COVID-19 cases typically involve special features such as bilateral involvement, ground-glass opacities, and consolidation of the lungs. Deep learning (DL) methods, particularly convolutional neural networks (CNNs) are used for analyzing COVID-19 infection. By training these techniques on large datasets of annotated chest X-rays (CXRs), researches have attained superior outcomes in precisely detecting the possible COVID-19 cases. Leveraging artificial intelligence together with radiological expertise holds great potential for facilitating prompt intervention in the ongoing global efforts and improving the efficiency of early detection. This article focuses on the design of mother optimization algorithm with DL-enabled detection and classification (MOA-DLEDC) technique for COVID-19 diagnosis using CXR images. In the MOA-DLEDC technique, the adaptive median filtering (AMF) approach is used to eliminate the existence of noise. In addition, the complex and intrinsic feature patterns are derived from the Efficient DenseNet model. Besides, the hyperparameter optimization of the Efficient DenseNet model takes place using MOA. For the COVID-19 detection process, the MOA-DLEDC technique applies sparse autoencoder (SAE) model. A detailed set of experiments was conducted on the CXR dataset to highlight the promising results of the MOA-DLEDC technique. The extensive results inferred that the used technique gains superior performance over other models with maximum accuracy of 99.59 %. [ABSTRACT FROM AUTHOR]

Summary: Pneumonia disease progress rapidly leading to missed diagnosis and diagnosis error. However, it is significant to be diagnosed accurately as well as adopted timely treatments, particularly for children and elderly people over 65. In the first place, we propose a novel method for data augmentation to expand non‐case samples in order to solve the problem of imbalance of the raw data. Then we have designed a neural network based on separable convolution layers, using deep learning to classify between Pneumonia cases and normal cases from chest X‐ray images. Finally, well‐known performance measures are utilized to evaluate our model, obtaining the following results: Accuracy (0.97), AUC (0.99), Sensitivity (0.98), Specificity (0.98), Precision (0.95), F1‐Score (0.97), and Youden Index (0.90). Simultaneously, we highlighted the proposed neural network recognition area via Class Activation Method for the purpose of providing an explainable diagnosis. Compared with the‐state‐of‐art models, our model performed better, and it may be regarded as an alternative in countries or regions lack of the relevant equipment and professional radiologists. [ABSTRACT FROM AUTHOR]

Dental caries occurs from the interaction between oral bacteria and sugars, generating acids that damage teeth over time. The importance of X-ray images for detecting oral problems is undeniable in dentistry. With technological advances, it is feasible to identify these lesions using techniques such as deep learning, machine learning, and image processing. Therefore, the survey and systematization of these methods are essential to determining the main computational approaches for identifying caries in X-ray images. In this systematic review, we investigated the primary computational methods used for classifying, detecting, and segmenting caries in X-ray images. Following the PRISMA methodology, we selected relevant studies and analyzed their methods, strengths, limitations, imaging modalities, evaluation metrics, datasets, and classification techniques. The review encompassed 42 studies retrieved from the Science Direct, IEEExplore, ACM Digital, and PubMed databases from the Computer Science and Health areas. The results indicate that 12% of the included articles utilized public datasets, with deep learning being the predominant approach, accounting for 69% of the studies. The majority of these studies (76%) focused on classifying dental caries, either in binary or multiclass classification. Panoramic imaging was the most commonly used radiographic modality, representing 29% of the cases studied. Overall, our systematic review provides a comprehensive overview of the computational methods employed in identifying caries in radiographic images and highlights trends, patterns, and challenges in this research field. [ABSTRACT FROM AUTHOR]

This paper addresses the significant problem of identifying the relevant background and contextual literature related to deep learning (DL) as an evolving technology in order to provide a comprehensive analysis of the application of DL to the specific problem of pneumonia detection via chest X-ray (CXR) imaging, which is the most common and cost-effective imaging technique available worldwide for pneumonia diagnosis. This paper in particular addresses the key period associated with COVID-19, 2020–2023, to explain, analyze, and systematically evaluate the limitations of approaches and determine their relative levels of effectiveness. The context in which DL is applied as both an aid to and an automated substitute for existing expert radiography professionals, who often have limited availability, is elaborated in detail. The rationale for the undertaken research is provided, along with a justification of the resources adopted and their relevance. This explanatory text and the subsequent analyses are intended to provide sufficient detail of the problem being addressed, existing solutions, and the limitations of these, ranging in detail from the specific to the more general. Indeed, our analysis and evaluation agree with the generally held view that the use of transformers, specifically, vision transformers (ViTs), is the most promising technique for obtaining further effective results in the area of pneumonia detection using CXR images. However, ViTs require extensive further research to address several limitations, specifically the following: biased CXR datasets, data and code availability, the ease with which a model can be explained, systematic methods of accurate model comparison, the notion of class imbalance in CXR datasets, and the possibility of adversarial attacks, the latter of which remains an area of fundamental research. [ABSTRACT FROM AUTHOR]

Identifying calcifications in mammograms is crucial for early breast cancer detection, and semi-supervised learning, which utilizes a small dataset for supervised learning combined with deep learning, is anticipated to be an effective approach for automating this identification process. This study explored the impact of semi-supervised learning on identifying mammographic calcifications by including 712 mammographic images from 252 patients in public datasets. Initially, 212 mammogram images were segmented into patches and classified visually for calcification presence. A subset of these patches, derived from 169 mammogram images, was used to train a ResNet50-based classifier. The classifier was evaluated using patches generated from 43 mammograms as a test data set. Additionally, 500 more mammogram images were processed into patches and analyzed using the trained ResNet50 model, with semi-supervised learning applied to patches exceeding certain classification probabilities. This process aimed to enhance the classifier's accuracy and achieve improvements over the initial model. The findings indicated that semi-supervised learning significantly benefits the accuracy of calcification detection in mammography, underscoring its utility in enhancing diagnostic methodologies. [ABSTRACT FROM AUTHOR]

The increasing global incidence of COVID-19 necessitates the rapid development of a reliable method for diagnosing the disease. The virus is spreading so quickly, that medical personnel are having a difficult time identifying patients who are infected with COVID-19. This is because the symptoms of other chest diseases such as pneumonia, tuberculosis, pneumothorax, lung cancer, and consolidation lung are like COVID-19. Additionally, there is a dearth of testing kits, and it is challenging to ascertain whether the kits provide reliable results. The second problem that occurs is the transfer of data between hospitals located in different parts of the world while adhering to the stringent confidentiality standards imposed by various organizations. When it comes to training a global deep learning model, the major concerns are protecting privacy and constructing a model through collaborative efforts. In this study, we propose a collaborative federated learning (FL) system that makes use of deep learning (DL) models to filter COVID-19 from multiple chest infections (including pneumonia, tuberculosis, pneumothorax, lung cancer, and consolidation lung) using chest X-rays (CXR) obtained from a variety of medical institutions without necessitating the sharing of patient data. We investigate a variety of essential features and components of FL environments, including naturally occurring imbalanced data distributions and non-independent and non-identically distributed (non-IID) data sets, amongst other things. This research study investigates four different DL models, which include Vgg19, DenseNet169, InceptionV3, and DenseNet201. The proposed system experimentally presents that the FL framework achieves better results with these models trained by sharing data. These findings will provide medical institutions with the confidence they need to apply collaborative methods and harness private data to fast construct a credible model for identifying multiple chest diseases. [ABSTRACT FROM AUTHOR]

This paper aims to address the detection of COVID-19 by developing an accurate and efficient diagnostic system using chest X-ray images. The research utilizes open-source Kaggle data comprising four categories: COVID-19, Lung-Opacity, Normal, and Viral Pneumonia. The proposed system employs convolutional neural networks (CNNs), including VGG19, RNN-LSTM, and inceptionv3. Results vary among the methodologies, with VGG19 achieving 26% accuracy, RNN-LSTM attaining 25% accuracy (28% with preprocessing), and inceptionv3 with histogram equalization achieving 83% accuracy. A CNN designed from scratch demonstrates the highest performance, with an accuracy of 93% (96% with histogram equalization). The findings emphasize the potential of AI techniques in enhancing disease diagnosis, particularly in distinguishing COVID-19 from other conditions, thereby facilitating timely and effective interventions. [ABSTRACT FROM AUTHOR]

Quick and accurate diagnosis of COVID‐19 is crucial in preventing its transmission. Chest X‐ray (CXR) imaging is often used for diagnosis, however, even experienced radiologists may misinterpret the results, necessitating computer‐aided diagnosis. Deep learning has yielded favourable results previously, but overfitting, excessive variance, and generalization errors may occur due to noise and limited datasets. Ensemble learning can improve predictions by using robust techniques. Therefore, this study, proposes two‐fold strategy that combines advanced and robust algorithms, including DenseNet201, EfficientNetB7, and Xception, to achieve faster and more accurate COVID‐19 detection. Segmented lung images were generated from CXR images using the residual U‐Net model, and two attention‐based ensemble neural networks were used for classification. The COVID‐19 radiography dataset was used to evaluate the proposed approach, which achieved an accuracy of 98.21%, 93.4%, and 89.06% for two, three, and four classes respectively which outperformed previous studies by a significant margin considering COVID, viral pneumonia, and lung opacity simultaneously. Despite the similarity in CXR images of COVID, pneumonia, and lung opacity, the proposed approach achieved 89.06% accuracy, demonstrating its ability to recognize distinguishable features. The developed algorithm is expected to have applications in clinics for diagnosing different diseases using X‐ray images. [ABSTRACT FROM AUTHOR]

When solving a structure of a protein from single‐wavelength anomalous diffraction X‐ray data, the initial phases obtained by phasing from an anomalously scattering substructure usually need to be improved by an iterated electron‐density modification. In this manuscript, the use of convolutional neural networks (CNNs) for segmentation of the initial experimental phasing electron‐density maps is proposed. The results reported demonstrate that a CNN with U‐net architecture, trained on several thousands of electron‐density maps generated mainly using X‐ray data from the Protein Data Bank in a supervised learning, can improve current density‐modification methods. [ABSTRACT FROM AUTHOR]

Objectives: Scaphoid fractures are usually diagnosed using X-rays, a low-sensitivity modality. Artificial intelligence (AI) using Convolutional Neural Networks (CNNs) has been explored for diagnosing scaphoid fractures in X-rays. The aim of this systematic review and meta-analysis is to evaluate the use of AI for detecting scaphoid fractures on X-rays and analyze its accuracy and usefulness. Materials and methods: This study followed the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and PRISMA-Diagnostic Test Accuracy. A literature search was conducted in the PubMed database for original articles published until July 2023. The risk of bias and applicability were evaluated using the QUADAS-2 tool. A bivariate diagnostic random-effects meta-analysis was conducted, and the results were analyzed using the Summary Receiver Operating Characteristic (SROC) curve. Results: Ten studies met the inclusion criteria and were all retrospective. The AI's diagnostic performance for detecting scaphoid fractures ranged from AUC 0.77 to 0.96. Seven studies were included in the meta-analysis, with a total of 3373 images. The meta-analysis pooled sensitivity and specificity were 0.80 and 0.89, respectively. The meta-analysis overall AUC was 0.88. The QUADAS-2 tool found high risk of bias and concerns about applicability in 9 out of 10 studies. Conclusions: The current results of AI's diagnostic performance for detecting scaphoid fractures in X-rays show promise. The results show high overall sensitivity and specificity and a high SROC result. Further research is needed to compare AI's diagnostic performance to human diagnostic performance in a clinical setting. Clinical relevance statement: Scaphoid fractures are prone to be missed secondary to assessment with a low sensitivity modality and a high occult fracture rate. AI systems can be beneficial for clinicians and radiologists to facilitate early diagnosis, and avoid missed injuries. Key Points: • Scaphoid fractures are common and some can be easily missed in X-rays. • Artificial intelligence (AI) systems demonstrate high diagnostic performance for the diagnosis of scaphoid fractures in X-rays. • AI systems can be beneficial in diagnosing both obvious and occult scaphoid fractures. [ABSTRACT FROM AUTHOR]

Normalization is utilized to remove outliers from the dataset and address network bias. In this research, MeanVariance-Softmax-Rescale (MVSR) and Min-Max normalizations are employed in various combinations for the diagnosis of COVID-19 using a Convolutional Neural Network (CNN)-based Deep Learning (DL) model, aimed at enhancing network accuracy. To accomplish this, the CNN model is developed within the Google Colab environment and trained using a publicly available dataset consisting of chest X-ray images related to COVID-19. The dataset is normalized using different combinations of the MVSR and Min-Max normalization algorithms to compare model accuracy. Each normalized dataset is used for model training, and subsequently, each trained model has been saved as a .h5 file and loaded into the Kria KV260 Vision AI Starter Kit FPGA for the testing phase. The most accurate results are obtained when MVSR and Min-Max normalizations are applied simultaneously. This highperforming scenario is re-evaluated with COVID-19 and normal X-ray images on FPGA configuration. Experimentally, the highest accuracy is achieved in realtime with the MVSR+Min-Max scenario, reaching 93%. The model's precision, recall, and F1-Score values are determined as 0.91, 0.96, and 0.93, respectively. [ABSTRACT FROM AUTHOR]

Radiotherapy with cell cycle-specific anticancer agents has become an important option in the control of both primary tumors and metastases. Here, we used image analysis algorithms that enable quick segmentation and tracking to describe a radiobiological approach for the optimized selection of cell cycle-targeting anticancer drugs for radiotherapy. We confirmed cell cycle-synchronization using human cervical cancer HeLa cells expressing a fluorescent ubiquitination-based cell cycle indicator (FUCCI) as a cell cycle-monitoring probe. Cells synchronized in the G1 and G2 phases were irradiated with X rays at 0.5–2 Gy. Each cell was identified using Cellpose, a deep learning-based algorithm for cellular segmentation, and the velocity and direction of migration were analyzed using the TrackMate plugin in Fiji ImageJ. G1 phase synchronized cells showed a dose-dependent decrease in velocity after irradiation, while G2 cells tended to increase their velocity. The migration pattern of all cells appeared to be a random walk model, regardless of the exposure dose. In addition, we used cisplatin to arrest the cell cycle. HeLa-FUCCI cells arrested at the G2 phase via cisplatin treatment showed enhanced cell migration after X-ray exposure. These results indicated that anticancer agents that arrest the cell cycle of cancer cells in a specific phase may enhance cell migration after radiotherapy. Our approach, using cellular segmentation and tracking algorithms, could enhance the radiobiological assessment of cell cycle-specific migration after irradiation to aid in optimizing radiotherapy using cell cycle-targeting agents. [ABSTRACT FROM AUTHOR]

Since the unexpected upsurge of the severe acute respiratory syndrome coronavirus 2 (COVID-19) in 2019, it has rapidly spread all over the world. This viral pandemic has dramatically affected human health and daily life. Recent advances in artificial intelligence (AI) techniques are considered key enablers to expediting COVID-19 detection issues. In particular, the development of high-performance deep learning (DL) models with high levels of accuracy is a significant step towards a fast and high-precision method for the detection and diagnosis of COVID-19 infected patients. This paper proposes a convolutional neural network (CNN) model for the classification of COVID-19 positive infected and negative/normal patients. This model is applied to a dataset consisting of 3,000 chest X-ray images in 2 classes of diagnoses– COVID-19 and normal. The CNN is implemented via a Keras framework with a hyperparameter tuning technique, and a data augmentation technique is performed to achieve the best accuracy. Experimentally, the confusion matrix, precision-recall curve, and receiver operating characteristic curve (ROCC) are utilized to analyze the performance of the CNN model. Experimental results demonstrate that the CNN provides a high-performance classification of COVID-19 patients with a testing accuracy of 99% and a testing loss rate of 0.034. The Precision, Recall, F1-score, and the area under the ROCC for this model are 99.02%, 98.97%, 99%, and 100%, respectively. This model applied to X-ray images provides a quick and accurate approach to distinguishing between normal negative cases and COVID-19 infected patients, and should aid doctors and radiologists in the screening of COVID-19 patients. [ABSTRACT FROM AUTHOR]

Study design: Retrospective, mono-centric cohort research study. Objectives: The purpose of this study is to validate a novel artificial intelligence (AI)-based algorithm against human-generated ground truth for radiographic parameters of adolescent idiopathic scoliosis (AIS). Methods: An AI-algorithm was developed that is capable of detecting anatomical structures of interest (clavicles, cervical, thoracic, lumbar spine and sacrum) and calculate essential radiographic parameters in AP spine X-rays fully automatically. The evaluated parameters included T1-tilt, clavicle angle (CA), coronal balance (CB), lumbar modifier, and Cobb angles in the proximal thoracic (C-PT), thoracic, and thoracolumbar regions. Measurements from 2 experienced physicians on 100 preoperative AP full spine X-rays of AIS patients were used as ground truth and to evaluate inter-rater and intra-rater reliability. The agreement between human raters and AI was compared by means of single measure Intra-class Correlation Coefficients (ICC; absolute agreement; >.75 rated as excellent), mean error and additional statistical metrics. Results: The comparison between human raters resulted in excellent ICC values for intra- (range:.97-1) and inter-rater (.85-.99) reliability. The algorithm was able to determine all parameters in 100% of images with excellent ICC values (.78-.98). Consistently with the human raters, ICC values were typically smallest for C-PT (eg, rater 1A vs AI:.78, mean error: 4.7°) and largest for CB (.96, -.5 mm) as well as CA (.98,.2°). Conclusions: The AI-algorithm shows excellent reliability and agreement with human raters for coronal parameters in preoperative full spine images. The reliability and speed offered by the AI-algorithm could contribute to the efficient analysis of large datasets (eg, registry studies) and measurements in clinical practice. [ABSTRACT FROM AUTHOR]

Abstract COVID-19 is a worldwide epidemic that seriously affected the lives of people. Since its inception, physicians have tried their best to trace the virus and reduce its spread. Several diagnostic approaches have been reported to detect the coronavirus in research, clinical, and public health laboratories. Although the existing systems aid medical experts in the diagnosis, they still lack precise detection and may fail to detect COVID-19 in a timely manner. Therefore, in this study, we recommend two approaches i.e., the first approach is based on the VGGish network that focuses on vocal signals, such as breathing and coughing, and the second approach is based on ResNet50, which takes chest X-rays as input. With the help of VGGish, the patient’s cough, voice, and respiration audios have been classified as patient and non-patient achieving an accuracy of more than 98%. We also assessed the performance of several methods for X-ray classification, such as ResNet50, VGG16, VGG19, Densnet201, Inceptionv3, Darknet, GoogleNet, squeezeNet, and Alex-Net. TheResNet50 outpaced all supplementary CNN models with a precision of 94%. However, when we took both types of inputs simultaneously, the accuracy for detection was increased to 99.7%. After extensive experimentation, we believe that our proposed hybrid method is robust enough to take X-rays and audio as mel-spectrograms and identify COVID-19 at early stages, attaining an accuracy of 99.7%.

Abstract Background Pneumoconiosis has a significant impact on the quality of patient survival due to its difficult staging diagnosis and poor prognosis. This study aimed to develop a computer-aided diagnostic system for the screening and staging of pneumoconiosis based on a multi-stage joint deep learning approach using X-ray chest radiographs of pneumoconiosis patients. Methods In this study, a total of 498 medical chest radiographs were obtained from the Department of Radiology of West China Fourth Hospital. The dataset was randomly divided into a training set and a test set at a ratio of 4:1. Following histogram equalization for image enhancement, the images were segmented using the U-Net model, and staging was predicted using a convolutional neural network classification model. We first used Efficient-Net for multi-classification staging diagnosis, but the results showed that stage I/II of pneumoconiosis was difficult to diagnose. Therefore, based on clinical practice we continued to improve the model by using the Res-Net 34 Multi-stage joint method. Results Of the 498 cases collected, the classification model using the Efficient-Net achieved an accuracy of 83% with a Quadratic Weighted Kappa (QWK) score of 0.889. The classification model using the multi-stage joint approach of Res-Net 34 achieved an accuracy of 89% with an area under the curve (AUC) of 0.98 and a high QWK score of 0.94. Conclusions In this study, the diagnostic accuracy of pneumoconiosis staging was significantly improved by an innovative combined multi-stage approach, which provided a reference for clinical application and pneumoconiosis screening.

Abstract Background The study aimed to develop and validate a deep learning-based Computer Aided Triage (CADt) algorithm for detecting pleural effusion in chest radiographs using an active learning (AL) framework. This is aimed at addressing the critical need for a clinical grade algorithm that can timely diagnose pleural effusion, which affects approximately 1.5 million people annually in the United States. Methods In this multisite study, 10,599 chest radiographs from 2006 to 2018 were retrospectively collected from an institution in Taiwan to train the deep learning algorithm. The AL framework utilized significantly reduced the need for expert annotations. For external validation, the algorithm was tested on a multisite dataset of 600 chest radiographs from 22 clinical sites in the United States and Taiwan, which were annotated by three U.S. board-certified radiologists. Results The CADt algorithm demonstrated high effectiveness in identifying pleural effusion, achieving a sensitivity of 0.95 (95% CI: [0.92, 0.97]) and a specificity of 0.97 (95% CI: [0.95, 0.99]). The area under the receiver operating characteristic curve (AUC) was 0.97 (95% DeLong’s CI: [0.95, 0.99]). Subgroup analyses showed that the algorithm maintained robust performance across various demographics and clinical settings. Conclusion This study presents a novel approach in developing clinical grade CADt solutions for the diagnosis of pleural effusion. The AL-based CADt algorithm not only achieved high accuracy in detecting pleural effusion but also significantly reduced the workload required for clinical experts in annotating medical data. This method enhances the feasibility of employing advanced technological solutions for prompt and accurate diagnosis in medical settings.