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Abstract In this study, we developed a lightweight and rapid convolutional neural network (CNN) architecture for chest X-ray images; it primarily consists of a redesigned feature extraction (FE) module and multiscale feature (MF) module and validated using publicly available COVID-19 datasets. Experiments were conducted on multiple updated versions of the COVID-19 Radiography Database, a publicly accessible dataset on Kaggle. The database contained images categorized into three classes: COVID-19 coronavirus, viral or bacterial pneumonia, and normal. The results revealed that the proposed method achieved a training accuracy of 99.85% and a validation accuracy of 96.28% when detecting the three classes. In the test set, the optimal results were 96.03% accuracy for COVID-19, 97.10% accuracy for viral or bacterial pneumonia, and 97.86% accuracy for normal individuals. By reducing the computational requirements and improving the speed of the model, the proposed method can achieve real-time, low-error performance to help medical professionals with rapid diagnosis of COVID-19.

Abstract Viruses are submicroscopic agents that can infect other lifeforms and use their hosts’ cells to replicate themselves. Despite having simplistic genetic structures among all living beings, viruses are highly adaptable, resilient, and capable of causing severe complications in their hosts’ bodies. Due to their multiple transmission pathways, high contagion rate, and lethality, viruses pose the biggest biological threat both animal and plant species face. It is often challenging to promptly detect a virus in a host and accurately determine its type using manual examination techniques. However, computer-based automatic diagnosis methods, especially the ones using Transmission Electron Microscopy (TEM) images, have proven effective in instant virus identification. Using TEM images collected from a recent dataset, this article proposes a deep learning-based classification model to identify the virus type within those images. The methodology of this study includes two coherent image processing techniques to reduce the noise present in raw microscopy images and a functional Convolutional Neural Network (CNN) model for classification. Experimental results show that it can differentiate among 14 types of viruses with a maximum of 97.44% classification accuracy and F1-score, which asserts the effectiveness and reliability of the proposed method. Implementing this scheme will impart a fast and dependable virus identification scheme subsidiary to the thorough diagnostic procedures.

Abstract Lung cancer (LC) is a life-threatening and dangerous disease all over the world. However, earlier diagnoses and treatment can save lives. Earlier diagnoses of malevolent cells in the lungs responsible for oxygenating the human body and expelling carbon dioxide due to significant procedures are critical. Even though a computed tomography (CT) scan is the best imaging approach in the healthcare sector, it is challenging for physicians to identify and interpret the tumour from CT scans. LC diagnosis in CT scan using artificial intelligence (AI) can help radiologists in earlier diagnoses, enhance performance, and decrease false negatives. Deep learning (DL) for detecting lymph node contribution on histopathological slides has become popular due to its great significance in patient diagnoses and treatment. This study introduces a computer-aided diagnosis for LC by utilizing the Waterwheel Plant Algorithm with DL (CADLC-WWPADL) approach. The primary aim of the CADLC-WWPADL approach is to classify and identify the existence of LC on CT scans. The CADLC-WWPADL method uses a lightweight MobileNet model for feature extraction. Besides, the CADLC-WWPADL method employs WWPA for the hyperparameter tuning process. Furthermore, the symmetrical autoencoder (SAE) model is utilized for classification. An investigational evaluation is performed to demonstrate the significant detection outputs of the CADLC-WWPADL technique. An extensive comparative study reported that the CADLC-WWPADL technique effectively performs with other models with a maximum accuracy of 99.05% under the benchmark CT image dataset.

Abstract Background In computer-aided diagnosis (CAD) studies utilizing multireader multicase (MRMC) designs, missing data might occur when there are instances of misinterpretation or oversight by the reader or problems with measurement techniques. Improper handling of these missing data can lead to bias. However, little research has been conducted on addressing the missing data issue within the MRMC framework. Methods We introduced a novel approach that integrates multiple imputation with MRMC analysis (MI-MRMC). An elaborate simulation study was conducted to compare the efficacy of our proposed approach with that of the traditional complete case analysis strategy within the MRMC design. Furthermore, we applied these approaches to a real MRMC design CAD study on aneurysm detection via head and neck CT angiograms to further validate their practicality. Results Compared with traditional complete case analysis, the simulation study demonstrated the MI-MRMC approach provides an almost unbiased estimate of diagnostic capability, alongside satisfactory performance in terms of statistical power and the type I error rate within the MRMC framework, even in small sample scenarios. In the real CAD study, the proposed MI-MRMC method further demonstrated strong performance in terms of both point estimates and confidence intervals compared with traditional complete case analysis. Conclusion Within MRMC design settings, the adoption of an MI-MRMC approach in the face of missing data can facilitate the attainment of unbiased and robust estimates of diagnostic capability.

Integrating machine learning into medical diagnostics has revolutionized the field, particularly enhancing Computer-aided Diagnosis (CAD) systems. These systems assist healthcare professionals by leveraging medical data and machine learning algorithms for more accurate diagnosis and treatment plans. Mammography, an X-ray-based imaging technique, is pivotal in early breast cancer detection, enabling the differentiation between benign and malignant lesions. Recent studies have focused on developing deep learning-enabled mammography CAD systems, which have shown promising results in detecting, segmenting, and classifying anomalies in mammogram images. This comprehensive review presents an innovative system architecture for breast cancer detection, segmentation, and classification using deep learning within mammography CAD systems. It also explores publicly available mammogram datasets and the critical parameters for assessing deep learning system performance. The literature review is meticulously conducted using the PRISMA methodology to evaluate and synthesise novel research findings in this domain. This survey highlights the technological advancements and underlines the potential of deep learning in transforming mammographic analysis for breast cancer detection.

In this study, we developed a lightweight and rapid convolutional neural network (CNN) architecture for chest X-ray images; it primarily consists of a redesigned feature extraction (FE) module and multiscale feature (MF) module and validated using publicly available COVID-19 datasets. Experiments were conducted on multiple updated versions of the COVID-19 Radiography Database, a publicly accessible dataset on Kaggle. The database contained images categorized into three classes: COVID-19 coronavirus, viral or bacterial pneumonia, and normal. The results revealed that the proposed method achieved a training accuracy of 99.85% and a validation accuracy of 96.28% when detecting the three classes. In the test set, the optimal results were 96.03% accuracy for COVID-19, 97.10% accuracy for viral or bacterial pneumonia, and 97.86% accuracy for normal individuals. By reducing the computational requirements and improving the speed of the model, the proposed method can achieve real-time, low-error performance to help medical professionals with rapid diagnosis of COVID-19. [ABSTRACT FROM AUTHOR]

Breast cancer (BC) is a widespread and lethal cancer affecting women world- wide. Early diagnosis plays a pivotal role in ensuring survival, as late detection can result in a fatal outcome. Convolutional neural networks (CNNs) have made significant contributions to the task of medical imaging modalities and have dis- played promise in addressing this challenge. Recently, the success of the vision transformer (ViT) architecture has encouraged the use of the attention mecha- nism in computer-aided diagnosis (CAD) tasks. However, the ViT is known for its data-intensive nature and a substantial number of parameters and needs power- ful computer resources when training, which often leads to the same performance compared to CNNs. These challenges are particularly evident in tasks involving medical image datasets with complex images and limited data. This problem- atic situation led to the suggestion three of low-weight parameter systems based on convolution and attention techniques: vision transformer base model (ViT), compact convolution transformers (CCT), and lightweight mobile vision trans- formers (MVIT). These systems are developed by using the BreakHis dataset, which includes images captured at different magnification levels (40x, 100x, 200x, 400x), for both binary and multi classification of breast cancer subtypes. These low-weight hybrid ViT-CNN networks operate directly on input patches and convolution layers, to improve feature extraction and attention layers to train patches in all networks. This approach results in lower training time and fewer parameters while achieving accurate breast tumors classification. The proposed method is based on splitting the input image into patches and then focusing them on the area of cancerous lumps, providing a sequence of linear embedding of these patches as input. Second, we applied a convolution layer directly to the histopathology input patches, with the fewest possible modifications. Finally, we train patches in all transformer encoder layers to evaluate the performance of the classification of breast subtypes. The performance accuracies of our suggested models are 98.64% for VIT, 96.99% for CCT and 97.52% for MVIT. Moreover, the proposed models were compared with state-of-the-art models using the same dataset. Our study demonstrates how convolution and attention mechanisms can minimize computational training resources and decision time, to develop high- performing computer-aided analyses for breast cancer diagnosis. The source codes are accessible at https://github.com/abimouloud/ViT-CNN. [ABSTRACT FROM AUTHOR]

Knee Osteoarthritis (KOA), the most prevalent joint disease, significantly impacts elderly mobility due to progressive cartilage degeneration. Early prediction is crucial for preventing disease progression and guiding effective treatment plans. This paper proposes an EnsembleTL-ACO, fully automated, computer-aided diagnosis (CAD) system for accurate and rapid KOA severity grading. The proposed CAD system leverages an ensemble transfer learning strategy to extract robust deep features by fusing multiple deep learning models. It combines features from two consecutive AI models: (1) AlexNet for implicit class-wise deep feature extraction from preprocessed data, and (2) a custom IsrNet for further feature depth. Unsupervised k-means clustering based on PCA dimensionality reduction decomposes each class into subgroups, further refining features. Finally, Ant Colony Optimization (ACO) selects the most informative features. Evaluated on the Osteoarthritis Initiative (OAI) dataset, the proposed system achieves high accuracy in classifying the five KOA severity grades. With 1000 optimized features, it reaches average overall accuracies of 89.89% and 85.44% using Support Vector Machine (SVM) and K-Nearest Neighbor (KNN) classifiers, respectively. This surpasses recent deep learning methods, demonstrating significant improvement. This novel CAD system presents a promising solution for practical applications, offering an accurate AI-powered tool for KOA diagnosis and management. [ABSTRACT FROM AUTHOR]

Viruses are submicroscopic agents that can infect other lifeforms and use their hosts' cells to replicate themselves. Despite having simplistic genetic structures among all living beings, viruses are highly adaptable, resilient, and capable of causing severe complications in their hosts' bodies. Due to their multiple transmission pathways, high contagion rate, and lethality, viruses pose the biggest biological threat both animal and plant species face. It is often challenging to promptly detect a virus in a host and accurately determine its type using manual examination techniques. However, computer-based automatic diagnosis methods, especially the ones using Transmission Electron Microscopy (TEM) images, have proven effective in instant virus identification. Using TEM images collected from a recent dataset, this article proposes a deep learning-based classification model to identify the virus type within those images. The methodology of this study includes two coherent image processing techniques to reduce the noise present in raw microscopy images and a functional Convolutional Neural Network (CNN) model for classification. Experimental results show that it can differentiate among 14 types of viruses with a maximum of 97.44% classification accuracy and F1-score, which asserts the effectiveness and reliability of the proposed method. Implementing this scheme will impart a fast and dependable virus identification scheme subsidiary to the thorough diagnostic procedures. [ABSTRACT FROM AUTHOR]

The automatic retinal screening system (ARSS) is a valuable computer-aided diagnosis tool for healthcare providers and public health initiatives. The ARSS facilitates mass retinal screenings that analyse retinal images and detect early signs of vision-threatening retinal diseases. The degradation in retinal image's naturalness causes imprecise diagnosis. This paper proposed a quality assessment method that is suitable for ARSS and is important for closing care gaps and reducing healthcare costs in the field of healthcare. A no-reference (NR) quality assessment method utilizing natural scene statistics (NSS) and the multi-resolution approach is developed to detect retinal image quality. Image quality classification is performed combining NSS features and statistical featurenns of retinal image. A support vector machine classifier is used to map the retinal image features and find image quality. The proposed method is compared with existing NR image quality assessment methods. The results show that the proposed method has improved accuracy, recall, precision and F-measure values of 3.42%, 3.66%, 1.63% and 2.66%, respectively, over the competing methods, demonstrating its suitability for ARSS. [ABSTRACT FROM AUTHOR]

Automated segmentation of liver tumors on CT scans is essential for aiding diagnosis and assessing treatment. Computer-aided diagnosis can reduce the costs and errors associated with manual processes and ensure the provision of accurate and reliable clinical assessments. However, liver tumors in CT images vary significantly in size and have fuzzy boundaries, making it difficult for existing methods to achieve accurate segmentation. Therefore, this paper proposes MAEG-Net, a multi-scale adaptive feature fusion liver tumor segmentation network based on edge guidance. Specifically, we design a multi-scale adaptive feature fusion module that effectively incorporates multi-scale information to better guide the segmentation of tumors of different sizes. Additionally, to address the problem of blurred tumor boundaries in images, we introduce an edge-aware guidance module to improve the model's feature learning ability under these conditions. Evaluation results on the liver tumor dataset (LiTS2017) show that our method achieves a Dice coefficient of 71.84% and a VOE of 38.64%, demonstrating the best performance for liver tumor segmentation in CT images. [ABSTRACT FROM AUTHOR]

Simple Summary: Diagnosis of breast cancer goes through multiple processes. Recently, a variety of system-aided diagnosis (CAD) systems have been proposed as primary systems for initial diagnosis based on mammogram screenings. This paper enhances the diagnosis accuracy by using mammograms of both sides of the patient's breasts instead of the infected side only. In addition, the paper boosts CAD accuracy by adding patient information and medical history along with mammogram images' features. The proposed multimodal approach will serve as the nucleus for future work at both data and system levels to diagnose breast cancer and other diseases caused by various factors. Breast cancer has been one of the main causes of death among women recently, and it has been the focus of attention of many specialists and researchers in the health field. Because of its seriousness and spread speed, breast cancer-resisting methods, early diagnosis, diagnosis, and treatment have been the points of research discussion. Many computers-aided diagnosis (CAD) systems have been proposed to reduce the load on physicians and increase the accuracy of breast tumor diagnosis. To the best of our knowledge, combining patient information, including medical history, breast density, age, and other factors, with mammogram features from both breasts in craniocaudal (CC) and mediolateral oblique (MLO) views has not been previously investigated for breast tumor classification. In this paper, we investigated the effectiveness of using those inputs by comparing two combination approaches. The soft voting approach, produced from statistical information-based models (decision tree, random forest, K-nearest neighbor, Gaussian naive Bayes, gradient boosting, and MLP) and an image-based model (CNN), achieved 90% accuracy. Additionally, concatenating statistical and image-based features in a deep learning model achieved 93% accuracy. We found that it produced promising results that would enhance the CAD systems. As a result, this study finds that using both sides of mammograms outperformed the result of using only the infected side. In addition, integrating the mammogram features with statistical information enhanced the accuracy of the tumor classification. Our findings, based on a novel dataset, incorporate both patient information and four-view mammogram images, covering multiple classes: normal, benign, and malignant. [ABSTRACT FROM AUTHOR]

Computer-assisted diagnosis (CAD) plays a key role in cancer diagnosis or screening. Whereas, current CAD performs poorly on whole slide image (WSI) analysis, and thus fails to generalize well. This research aims to develop an automatic classification system to distinguish between different types of carcinomas. Obtaining rich deep features in multi-class classification while achieving high accuracy is still a challenging problem. The detection and classification of cancerous cells in WSI are quite challenging due to the misclassification of normal lumps and cancerous cells. This is due to cluttering, occlusion, and irregular cell distribution. Researchers in the past mostly obtained the hand-crafted features while neglecting the above-mentioned challenges which led to a reduction of the classification accuracy. To mitigate this problem we proposed an efficient dual attention-based network (CytoNet). The proposed network is composed of two main modules (i) Efficient-Net and (ii) Dual Attention Module (DAM). Efficient-Net is capable of obtaining higher accuracy and enhancing efficiency as compared to existing Convolutional Neural Networks (CNNs). It is also useful to obtain the most generic features as it has been trained on ImageNet. Whereas DAM is very robust in obtaining attention and targeted features while negating the background. In this way, the combination of an efficient and attention module is useful to obtain the robust, and intrinsic features to obtain comparable performance. Further, we evaluated the proposed network on two well-known datasets (i) Our generated thyroid dataset (ii) Mendeley Cervical dataset (Hussain in Data Brief, 2019) with enhanced performance compared to their counterparts. CytoNet demonstrated a 99% accuracy rate on the thyroid dataset in comparison to its counterpart. The precision, recall, and F1-score values achieved on the Mendeley Cervical dataset are 0.992, 0.985, and 0.977, respectively. The code implementation is available on GitHub. https://github.com/naveedilyas/CytoNet-An-Efficient-Dual-Attention-based-Automatic-Prediction-of-Cancer-Sub-types-in-Cytol. [ABSTRACT FROM AUTHOR]

Background To improve tuberculosis case-finding, rapid, non-sputum triage tests need to be developed according to the World Health Organization target product profile (TPP) (>90% sensitivity, >70% specificity). We prospectively evaluated and compared artificial intelligence–based, computer-aided detection software, CAD4TBv7, and C-reactive protein assay (CRP) as triage tests at health facilities in Lesotho and South Africa. Methods Adults (≥18 years) presenting with ≥1 of the 4 cardinal tuberculosis symptoms were consecutively recruited between February 2021 and April 2022. After informed consent, each participant underwent a digital chest X-ray for CAD4TBv7 and a CRP test. Participants provided 1 sputum sample for Xpert MTB/RIF Ultra and Xpert MTB/RIF and 1 for liquid culture. Additionally, an expert radiologist read the chest X-rays via teleradiology. For primary analysis, a composite microbiological reference standard (ie, positive culture or Xpert Ultra) was used. Results We enrolled 1392 participants, 48% were people with HIV and 24% had previously tuberculosis. The receiver operating characteristic curve for CAD4TBv7 and CRP showed an area under the curve of.87 (95% CI:.84–.91) and.80 (95% CI:.76–.84), respectively. At thresholds corresponding to 90% sensitivity, specificity was 68.2% (95% CI: 65.4–71.0%) and 38.2% (95% CI: 35.3–41.1%) for CAD4TBv7 and CRP, respectively. CAD4TBv7 detected tuberculosis as well as an expert radiologist. CAD4TBv7 almost met the TPP criteria for tuberculosis triage. Conclusions CAD4TBv7 is accurate as a triage test for patients with tuberculosis symptoms from areas with a high tuberculosis and HIV burden. The role of CRP in tuberculosis triage requires further research. Clinical Trials Registration Clinicaltrials.gov identifier: NCT04666311. [ABSTRACT FROM AUTHOR]

Background/Objectives: Computer-aided detection (CAD) systems for lung nodule detection often face challenges with 5 mm computed tomography (CT) scans, leading to missed nodules. This study assessed the efficacy of a deep learning-based slice thickness reduction technique from 5 mm to 1 mm to enhance CAD performance. Methods: In this retrospective study, 687 chest CT scans were analyzed, including 355 with nodules and 332 without nodules. CAD performance was evaluated on nodules, to which all three radiologists agreed. Results: The slice thickness reduction technique significantly improved the area under the receiver operating characteristic curve (AUC) for scan-level analysis from 0.867 to 0.902, with a p-value < 0.001, and nodule-level sensitivity from 0.826 to 0.916 at two false positives per scan. Notably, the performance showed greater improvements on smaller nodules than larger nodules. Qualitative analysis confirmed that nodules mistaken for ground glass on 5 mm scans could be correctly identified as part-solid on the refined 1 mm CT, thereby improving the diagnostic capability. Conclusions: Applying a deep learning-based slice thickness reduction technique significantly enhances CAD performance in lung nodule detection on chest CT scans, supporting the clinical adoption of refined 1 mm CT scans for more accurate diagnoses. [ABSTRACT FROM AUTHOR]

Glaucoma is one of the leading causes of visual impairment worldwide. If diagnosed too late, the disease can irreversibly cause severe damage to the optic nerve, resulting in permanent loss of central vision and blindness. Therefore, early diagnosis of the disease is critical. Recent advancements in machine learning techniques have greatly aided ophthalmologists in timely and efficient diagnosis through the use of automated systems. Training the machine learning models with the most informative features can significantly enhance their performance. However, selecting the most informative feature subset is a real challenge because there are 2n potential feature subsets for a dataset with n features, and the conventional feature selection techniques are also not very efficient. Thus, extracting relevant features from medical images and selecting the most informative is a challenging task. Additionally, a considerable field of study has evolved around the discovery and selection of highly influential features (characteristics) from a large number of features. Through the inclusion of the most informative features, this method has the potential to improve machine learning classifiers by enhancing their classification performance, reducing training and testing time, and lowering system diagnostic costs by incorporating the most informative features. This work aims in the same direction to propose a unique, novel, and highly efficient feature selection (FS) approach using the Whale Optimization Algorithm (WOA), the Grey Wolf Optimization Algorithm (GWO), and a hybridized version of these two metaheuristics. To the best of our knowledge, the use of these two algorithms and their amalgamated version for FS in human disease prediction, particularly glaucoma prediction, has been rare in the past. The objective is to create a highly influential subset of characteristics using this approach. The suggested FS strategy seeks to maximize classification accuracy while reducing the total number of characteristics used. We evaluated the efficacy of the proposed approach in classifying eye-related glaucoma illnesses. In this study, we aim to assist professionals in identifying glaucoma by utilizing a proposed clinical decision support system that integrates image processing, soft-computing algorithms, and machine learning, and validates it on benchmark fundus images. Initially, we extract 65 features from the 646 retinal fundus images in the ORIGA benchmark dataset, from which a subset of features is created. For two-class classification, different machine learning classifiers receive the elected features. Employing 5-fold and 10-fold stratified cross-validation has enhanced the generalized performance of the proposed model. We assess performance using several well-established statistical criteria. The tests show that the suggested computer-aided diagnosis (CAD) model has an F1-score of 97.50%, an accuracy score of 96.50%, a precision score of 97%, a sensitivity score of 98.10%, a specificity score of 93.30%, and an AUC score of 94.2% on the ORIGA dataset. To demonstrate its excellence, we compared the suggested approach's performance with other current state-of-the-art models. The suggested approach shows promising results in predicting glaucoma, potentially aiding in the early diagnosis and treatment of the disease. Furthermore, real-time applications showcase the proposed approach's suitability, enabling its deployment in areas lacking expert medical practitioners. Overburdened expert ophthalmologists can use this approach as a second opinion, as it requires very little time for processing the retinal fundus images. The proposed model can also aid, after incorporating required modifications, in making clinical decisions for various diseases like lung infection and, diabetic retinopathy. [ABSTRACT FROM AUTHOR]

Generalizability of AI colonoscopy algorithms is important for wider adoption in clinical practice. However, current techniques for evaluating performance on unseen data require expensive and time-intensive labels. We show that a "Masked Siamese Network" (MSN), trained to predict masked out regions of polyp images without labels, can predict the performance of Computer Aided Detection (CADe) of polyps on colonoscopies, without labels. This holds on Japanese colonoscopies even when MSN is only trained on Israeli colonoscopies, which differ in scoping hardware, endoscope software, screening guidelines, bowel preparation, patient demographics, and the use of techniques such as narrow-band imaging (NBI) and chromoendoscopy (CE). Since our technique uses neither colonoscopy-specific information nor labels, it has the potential to apply to more medical imaging domains. [ABSTRACT FROM AUTHOR]

Background: The integration of artificial intelligence (AI) into radiology aims to improve diagnostic accuracy and efficiency, particularly in settings with limited access to expert radiologists and in times of personnel shortage. However, challenges such as insufficient validation in actual real-world settings or automation bias should be addressed before implementing AI software in clinical routine. Methods: This cross-sectional study in a maximum care hospital assesses the concordance between diagnoses made by a commercial AI-based software and conventional radiological methods augmented by AI for four major thoracic pathologies in chest X-ray: fracture, pleural effusion, pulmonary nodule and pneumonia. Chest radiographs of 1506 patients (median age 66 years, 56.5% men) consecutively obtained between January and August 2023 were re-evaluated by the AI software InferRead DR Chest®. Results: Overall, AI software detected thoracic pathologies more often than radiologists (18.5% vs. 11.1%). In detail, it detected fractures, pneumonia, and nodules more frequently than radiologists, while radiologists identified pleural effusions more often. Reliability was highest for pleural effusions (0.63, 95%-CI 0.58–0.69), indicating good agreement, and lowest for fractures (0.39, 95%-CI 0.32–0.45), indicating moderate agreement. Conclusions: The tested software shows a high detection rate, particularly for fractures, pneumonia, and nodules, but hereby produces a nonnegligible number of false positives. Thus, AI-based software shows promise in enhancing diagnostic accuracy; however, cautious interpretation and human oversight remain crucial. [ABSTRACT FROM AUTHOR]

Peptic ulcers and stomach cancer are common conditions that impact the gastrointestinal (GI) system. Wireless capsule endoscopy (WCE) has emerged as a widely used, noninvasive technique for diagnosing these issues, providing valuable insights through the detailed imaging of the GI tract. Therefore, an early and accurate diagnosis of GI diseases is crucial for effective treatment. This paper introduces the Intelligent Learning Rate Controller (ILRC) mechanism that optimizes the training of deep learning (DL) models by adaptively adjusting the learning rate (LR) based on training progress. This helps improve convergence speed and reduce the risk of overfitting. The ILRC was applied to four DL models: EfficientNet-B0, ResNet101v2, InceptionV3, and InceptionResNetV2. These models were further enhanced using transfer learning, freezing layers, fine-tuning techniques, residual learning, and modern regularization methods. The models were evaluated on two datasets, the Kvasir-Capsule and KVASIR v2 datasets, which contain WCE images. The results demonstrated that the models, particularly when using ILRC, outperformed existing state-of-the-art methods in accuracy. On the Kvasir-Capsule dataset, the models achieved accuracies of up to 99.906%, and on the Kvasir-v2 dataset, they achieved up to 98.062%. This combination of techniques offers a robust solution for automating the detection of GI abnormalities in WCE images, significantly enhancing diagnostic efficiency and accuracy in clinical settings. [ABSTRACT FROM AUTHOR]

Conventional methods for tumor diagnosis suffer from two inherent limitations: they are time-consuming and subjective. Computer-aided diagnosis (CAD) is an important approach for addressing these limitations. Pathology whole-slide images (WSIs) are high-resolution tissue images that have made significant contributions to cancer diagnosis and prognosis assessment. Due to the complexity of WSIs and the availability of only slide-level labels, multiple instance learning (MIL) has become the primary framework for WSI classification. However, most MIL methods fail to capture the interdependence among image patches within a WSI, which is crucial for accurate classification prediction. Moreover, due to the weak supervision of slide-level labels, overfitting may occur during the training process. To address these issues, this paper proposes a dual-attention-based multiple instance learning framework (DAMIL). DAMIL leverages the spatial relationships and channel information between WSI patches for classification prediction, without detailed pixel-level tumor annotations. The output of the model preserves the semantic variations in the latent space, enhances semantic disturbance invariance, and provides reliable class identification for the final slide-level representation. We validate the effectiveness of DAMIL on the most commonly used public dataset, Camelyon16. The results demonstrate that DAMIL outperforms the state-of-the-art methods in terms of classification accuracy (ACC), area under the curve (AUC), and F1-Score. Our model also allows for the examination of its interpretability by visualizing the dual-attention weights. To the best of our knowledge, this is the first attempt to use a dual-attention mechanism, considering both spatial and channel information, for whole-slide image classification. [ABSTRACT FROM AUTHOR]

The early and accurate detection of kidney stones is crucial for effective treatment and improved patient outcomes. This paper proposes a novel modification of the YOLOv5 model, specifically tailored for detecting kidney stones in CT images. Our approach integrates the squeeze-and-excitation (SE) block within the C3 block of the YOLOv5m architecture, thereby enhancing the ability of the model to recalibrate channel-wise dependencies and capture intricate feature relationships. This modification leads to significant improvements in the detection accuracy and reliability. Extensive experiments were conducted to evaluate the performance of the proposed model against standard YOLOv5 variants (nano-sized, small, and medium-sized). The results demonstrate that our model achieves superior performance metrics, including higher precision, recall, and mean average precision (mAP), while maintaining a balanced inference speed and model size suitable for real-time applications. The proposed methodology incorporates advanced noise reduction and data augmentation techniques to ensure the preservation of critical features and enhance the robustness of the training dataset. Additionally, a novel color-coding scheme for bounding boxes improves the clarity and differentiation of the detected stones, facilitating better analysis and understanding of the detection results. Our comprehensive evaluation using essential metrics, such as precision, recall, mAP, and intersection over union (IoU), underscores the efficacy of the proposed model for detecting kidney stones. The modified YOLOv5 model offers a robust, accurate, and efficient solution for medical imaging applications and represents a significant advancement in computer-aided diagnosis and kidney stone detection. [ABSTRACT FROM AUTHOR]

The editorial discusses the effectiveness of artificial intelligence (AI) in improving colonoscopy quality for colorectal cancer (CRC) screening. AI, through computer-aided detection (CADe) and characterization (CADx), has shown promise in increasing adenoma detection rates (ADR) and polyp detection rates (PDR). However, there are limitations to AI implementation, such as the need for extensive training data and potential increased procedure time. While some studies have shown significant improvements in colonoscopy markers with AI, others have reported mixed results, indicating the need for further research and consideration of confounding factors before widespread adoption of AI in healthcare. [Extracted from the article]

Background: Correctly diagnosing and accurately distinguishing mycoplasma pneumonia in children has consistently posed a challenge in clinical practice, as it can directly impact the prognosis of affected children. To address this issue, we analyzed chest X-rays (CXR) using various deep learning models to diagnose pediatric mycoplasma pneumonia. Methods: We collected 578 cases of children with mycoplasma infection and 191 cases of children with virus infection, with available CXR sets. Three deep convolutional neural networks (ResNet50, DenseNet121, and EfficientNetv2-S) were used to distinguish mycoplasma pneumonia from viral pneumonia based on CXR. Accuracy, area under the curve (AUC), sensitivity, and specificity were used to evaluate the performance of the model. Visualization was also achieved through the use of Class Activation Mapping (CAM), providing more transparent and interpretable classification results. Results: Of the three models evaluated, ResNet50 outperformed the others. Pretrained with the ZhangLabData dataset, the ResNet50 model achieved 80.00% accuracy in the validation set. The model also showed robustness in two test sets, with accuracy of 82.65 and 83.27%, and AUC values of 0.822 and 0.758. In the test results using ImageNet pre-training weights, the accuracy of the ResNet50 model in the validation set was 80.00%; the accuracy in the two test sets was 81.63 and 62.91%; and the corresponding AUC values were 0.851 and 0.776. The sensitivity values were 0.884 and 0.595, and the specificity values were 0.655 and 0.814. Conclusions: This study demonstrates that deep convolutional networks utilizing transfer learning are effective in detecting mycoplasma pneumonia based on chest X-rays (CXR). This suggests that, in the near future, such computer-aided detection approaches can be employed for the early screening of pneumonia pathogens. This has significant clinical implications for the rapid diagnosis and appropriate medical intervention of pneumonia, potentially enhancing the prognosis for affected children. [ABSTRACT FROM AUTHOR]

Introduction: Colorectal cancer (CRC) is one of the main causes of deaths worldwide. Early detection and diagnosis of its precursor lesion, the polyp, is key to reduce its mortality and to improve procedure efficiency. During the last two decades, several computational methods have been proposed to assist clinicians in detection, segmentation and classification tasks but the lack of a common public validation framework makes it difficult to determine which of them is ready to be deployed in the exploration room. Methods: This study presents a complete validation framework and we compare several methodologies for each of the polyp characterization tasks. Results: Results show that the majority of the approaches are able to provide good performance for the detection and segmentation task, but that there is room for improvement regarding polyp classification. Discussion: While studied show promising results in the assistance of polyp detection and segmentation tasks, further research should be done in classification task to obtain reliable results to assist the clinicians during the procedure. The presented framework provides a standarized method for evaluating and comparing different approaches, which could facilitate the identification of clinically prepared assisting methods. [ABSTRACT FROM AUTHOR]

Psoriasis, being a chronic, inflammatory, lifelong skin disorder, has become a major threat to the human population. The precise and effective diagnosis of psoriasis continues to be difficult for clinicians due to its varied nature. In northern India, the prevalence of psoriasis among adult population ranges from 0.44 to 2.8%. Chronic plaque psoriasis accounts for over 90% of cases. This study utilized a dataset of 325 raw images collected from a reputable local hospital using a digital camera under uniform lighting conditions. These images were processed to generate 496 image patches (both diseased and normal), which were then normalized and resized for model training. An automated psoriasis image recognition framework was developed using four state-of-the-art deep transfer learning models: VGG16, VGG19, MobileNetV1, and ResNet-50. The convolutional layers adopted various edge, shape, and color filters to generate the feature map for psoriasis detection. Each pre-trained model was adapted with two dense layers, one dropout layer, and one output layer to classify input images. Among these models, MobileNetV1 achieved the best performance, with 94.84% sensitivity, 89.37% specificity, and 97.24% overall accuracy. Hyper-parameter tuning was performed using grid search to optimize learning rates, batch sizes, and dropout rates. The AdaGrad (Adaptive gradient)) optimizer was chosen for its adaptive learning rate capabilities, facilitating quicker convergence in model performance. Consequently, the methodology's performance improved to 94.25% sensitivity, 96.42% specificity, and 99.13% overall accuracy. The model's performance was also compared with non-machine learning-based diagnostic methods, yielding a Dice coefficient of 0.98. However, the model's effectiveness is dependent upon high-quality input images, as poor image conditions may affect accuracy, and it may not generalize well across diverse demographics or psoriasis variations, highlighting the need for varied training datasets for robustness. [ABSTRACT FROM AUTHOR]

The early and accurate diagnosis of brain tumors is critical for effective treatment planning, with Magnetic Resonance Imaging (MRI) serving as a key tool in the non-invasive examination of such conditions. Despite the advancements in Computer-Aided Diagnosis (CADx) systems powered by deep learning, the challenge of accurately classifying brain tumors from MRI scans persists due to the high variability of tumor appearances and the subtlety of early-stage manifestations. This work introduces a novel adaptation of the EfficientNetv2 architecture, enhanced with Global Attention Mechanism (GAM) and Efficient Channel Attention (ECA), aimed at overcoming these hurdles. This enhancement not only amplifies the model's ability to focus on salient features within complex MRI images but also significantly improves the classification accuracy of brain tumors. Our approach distinguishes itself by meticulously integrating attention mechanisms that systematically enhance feature extraction, thereby achieving superior performance in detecting a broad spectrum of brain tumors. Demonstrated through extensive experiments on a large public dataset, our model achieves an exceptional high-test accuracy of 99.76%, setting a new benchmark in MRI-based brain tumor classification. Moreover, the incorporation of Grad-CAM visualization techniques sheds light on the model's decision-making process, offering transparent and interpretable insights that are invaluable for clinical assessment. By addressing the limitations inherent in previous models, this study not only advances the field of medical imaging analysis but also highlights the pivotal role of attention mechanisms in enhancing the interpretability and accuracy of deep learning models for brain tumor diagnosis. This research sets the stage for advanced CADx systems, enhancing patient care and treatment outcomes. [ABSTRACT FROM AUTHOR]

Simple Summary: Artificial intelligence, now one of the most promising frontiers of medicine, has a long and tumultuous history punctuated by successes and failures. One of its successes was its application to medical images. We reconstruct the timeline of the advancements in this field, from its origins in the 1940s before crossing medical images to early applications of machine learning to radiology, to the present era where artificial intelligence is revolutionizing radiology. Artificial intelligence (AI), the wide spectrum of technologies aiming to give machines or computers the ability to perform human-like cognitive functions, began in the 1940s with the first abstract models of intelligent machines. Soon after, in the 1950s and 1960s, machine learning algorithms such as neural networks and decision trees ignited significant enthusiasm. More recent advancements include the refinement of learning algorithms, the development of convolutional neural networks to efficiently analyze images, and methods to synthesize new images. This renewed enthusiasm was also due to the increase in computational power with graphical processing units and the availability of large digital databases to be mined by neural networks. AI soon began to be applied in medicine, first through expert systems designed to support the clinician's decision and later with neural networks for the detection, classification, or segmentation of malignant lesions in medical images. A recent prospective clinical trial demonstrated the non-inferiority of AI alone compared with a double reading by two radiologists on screening mammography. Natural language processing, recurrent neural networks, transformers, and generative models have both improved the capabilities of making an automated reading of medical images and moved AI to new domains, including the text analysis of electronic health records, image self-labeling, and self-reporting. The availability of open-source and free libraries, as well as powerful computing resources, has greatly facilitated the adoption of deep learning by researchers and clinicians. Key concerns surrounding AI in healthcare include the need for clinical trials to demonstrate efficacy, the perception of AI tools as 'black boxes' that require greater interpretability and explainability, and ethical issues related to ensuring fairness and trustworthiness in AI systems. Thanks to its versatility and impressive results, AI is one of the most promising resources for frontier research and applications in medicine, in particular for oncological applications. [ABSTRACT FROM AUTHOR]

Simple Summary: In liver surgery, the complex and individualized nature of liver vascular anatomy makes planning and execution challenging. Traditional 2D intraoperative ultrasonography (IOUS) often suffers from interpretability issues due to noise and artifacts. This paper introduces an AI-based model, the "2D-weighted U-Net model," designed to enhance real-time IOUS navigation by accurately segmenting key blood vessels, including the inferior vena cava, hepatic veins, portal vein, and its major branches. Our deep learning model demonstrated high performance, with Dice scores ranging from 0.84 to 0.96 across different vessels. This advancement promises improved precision in liver resection procedures and sets the stage for future development of real-time multi-label segmentation for broader liver vasculature. Background/Objectives: In the field of surgical medicine, the planning and execution of liver resection procedures present formidable challenges, primarily attributable to the intricate and highly individualized nature of liver vascular anatomy. In the current surgical milieu, intraoperative ultrasonography (IOUS) has become indispensable; however, traditional 2D ultrasound imaging's interpretability is hindered by noise and speckle artifacts. Accurate identification of critical structures for preservation during hepatectomy requires advanced surgical skills. Methods: An AI-based model that can help detect and recognize vessels including the inferior vena cava (IVC); the right (RHV), middle (MHV), and left (LVH) hepatic veins; the portal vein (PV) and its major first and second order branches the left portal vein (LPV), right portal vein (RPV), and right anterior (RAPV) and posterior (RPPV) portal veins, for real-time IOUS navigation can be of immense value in liver surgery. This research aims to advance the capabilities of IOUS-guided interventions by applying an innovative AI-based approach named the "2D-weigthed U-Net model" for the segmentation of multiple blood vessels in real-time IOUS video frames. Results: Our proposed deep learning (DL) model achieved a mean Dice score of 0.92 for IVC, 0.90 for RHV, 0.89 for MHV, 0.86 for LHV, 0.95 for PV, 0.93 for LPV, 0.84 for RPV, 0.85 for RAPV, and 0.96 for RPPV. Conclusion: In the future, this research will be extended for real-time multi-label segmentation of extended vasculature in the liver, followed by the translation of our model into the surgical suite. [ABSTRACT FROM AUTHOR]

Simple Summary: Currently, pathologists use ultrastaging to detect whether cancer has spread to the lymph nodes. This process is time-consuming and expensive. Our pilot study explored the use of a deep learning algorithm to help detect cancer spread to lymph nodes of early-stage cervical cancer patients. Using this technology could make the detection process faster, more efficient, and less costly. We evaluated an algorithm that was originally designed to identify cancer spread to lymph nodes in breast and colon cancer in cervical cancer patients. The study included 21 women with different types of early-stage cervical cancer. The algorithm was used to analyze 47 lymph node samples and successfully identified all cases where cancer had spread, showing 100% accuracy. Although the algorithm was initially developed for other cancers, it proved highly effective in this new population. More prospective research in a larger group of patients is needed to confirm its cost-effectiveness. Background/objectives: Pathological ultrastaging, an essential part of sentinel lymph node (SLN) mapping, involves serial sectioning and immunohistochemical (IHC) staining in order to reliably detect clinically relevant metastases. However, ultrastaging is labor-intensive, time-consuming, and costly. Deep learning algorithms offer a potential solution by assisting pathologists in efficiently assessing serial sections for metastases, reducing workload and costs while enhancing accuracy. This proof-of-principle study evaluated the effectiveness of a deep learning algorithm for SLN metastasis detection in early-stage cervical cancer. Methods: We retrospectively analyzed whole slide images (WSIs) of hematoxylin and eosin (H&E)-stained SLNs from early-stage cervical cancer patients diagnosed with an SLN metastasis with either H&E or IHC. A CE-IVD certified commercially available deep learning algorithm, initially developed for detection of breast and colon cancer lymph node metastases, was employed off-label to assess its sensitivity in cervical cancer. Results: This study included 21 patients with early-stage cervical cancer, comprising 15 with squamous cell carcinoma, five with adenocarcinoma, and one with clear cell carcinoma. Among these patients, 10 had macrometastases and 11 had micrometastases in at least one SLN. The algorithm was applied to evaluate H&E WSIs of 47 SLN specimens, including 22 that were negative for metastasis, 13 with macrometastases, and 12 with micrometastases in the H&E slides. The algorithm detected all H&E macro- and micrometastases with 100% sensitivity. Conclusions: This proof-of-principle study demonstrated high sensitivity of a deep learning algorithm for detection of clinically relevant SLN metastasis in early-stage cervical cancer, despite being originally developed for adenocarcinomas of the breast and colon. Our findings highlight the potential of leveraging an existing algorithm for use in cervical cancer, warranting further prospective validation in a larger population. [ABSTRACT FROM AUTHOR]

Background: Artificial intelligence (AI) using deep learning systems has recently been utilized in various medical fields. In the field of gastroenterology, AI is primarily implemented in image recognition and utilized in the realm of gastrointestinal (GI) endoscopy. In GI endoscopy, computer-aided detection/diagnosis (CAD) systems assist endoscopists in GI neoplasm detection or differentiation of cancerous or noncancerous lesions. Several AI systems for colorectal polyps have already been applied in colonoscopy clinical practices. In esophagogastroduodenoscopy, a few CAD systems for upper GI neoplasms have been launched in Asian countries. The usefulness of these CAD systems in GI endoscopy has been gradually elucidated. Summary: In this review, we outline recent articles on several studies of endoscopic AI systems for GI neoplasms, focusing on esophageal squamous cell carcinoma (ESCC), esophageal adenocarcinoma (EAC), gastric cancer (GC), and colorectal polyps. In ESCC and EAC, computer-aided detection (CADe) systems were mainly developed, and a recent meta-analysis study showed sensitivities of 91.2% and 93.1% and specificities of 80% and 86.9%, respectively. In GC, a recent meta-analysis study on CADe systems demonstrated that their sensitivity and specificity were as high as 90%. A randomized controlled trial (RCT) also showed that the use of the CADe system reduced the miss rate. Regarding computer-aided diagnosis (CADx) systems for GC, although RCTs have not yet been conducted, most studies have demonstrated expert-level performance. In colorectal polyps, multiple RCTs have shown the usefulness of the CADe system for improving the polyp detection rate, and several CADx systems have been shown to have high accuracy in colorectal polyp differentiation. Key Messages: Most analyses of endoscopic AI systems suggested that their performance was better than that of nonexpert endoscopists and equivalent to that of expert endoscopists. Thus, endoscopic AI systems may be useful for reducing the risk of overlooking lesions and improving the diagnostic ability of endoscopists. [ABSTRACT FROM AUTHOR]

There is an emerging role of artificial intelligence (AI) in endoscopy with studies on early systems showing promising results. However, various limitations inhibit widespread use. The aim of this study was to ascertain the sentiments of endoscopists and understand the benefits and barriers towards adoption of AI systems into healthcare. An anonymous online 18-question survey was disseminated to gastroenterology and surgical departments across UK. A total of 75 endoscopists completed the questionnaire. The majority felt that AI would increase adenoma detection rate (ADR) (72.8%) and aid lesion characterisation (78.6%). However, only a quarter of respondents were either moderately or very familiar with AI, and there was no consensus on necessity of AI in endoscopy. The key barriers identified were cost, accessibility and lack of guidelines. Endoscopists believe AI systems will have a positive impact on endoscopy; however, these systems must provide quality assurance through large clinical trials before adoption. [ABSTRACT FROM AUTHOR]

Coronavirus Disease 2019 (COVID-19) is extremely contagious with a very high mortality rate. Effective and early diagnosis of COVID-19 is therefore crucial when treating patients and limiting its spread. The currently available methods for reliably identifying COVID are time-consuming. Infected people display various symptoms, some of which can be manifested by radiographic imaging such as chest X-rays and CT scans. Recently, many advanced machine learning and deep learning models have been proposed for predicting COVID using chest X-rays and CT scans that have paved the way for computer-aided COVID-19 diagnosis (CACD) systems. Unfortunately, most of these studies employ specific model(s) using a specific dataset making comparison difficult and inconclusive. We still lack a clear picture on which technique is best for a reliable CACD system. In this study, we provide a comprehensive analysis to determine if a CACD system can be developed that can reliably and automatically predict COVID-19 with zero human intervention using currently available tools and techniques? For this purpose, we explore and implement five machine learning models (SVM, LR, RF, KNN and ANN) and three pre-trained deep learning classifiers (VGG-16, Xception and ResNet-50) to compare their performance using 17 benchmark chest X-rays and CT-scans datasets to predict normal and infected samples. Using different classifiers and different datasets, we show that VGG16 with a superior average accuracy (99.10%) is the most suited classifier for CACD when chest X-rays are used. For CT scans, RF can also be used in addition to VGG16 as both records an average accuracy of 93% overall CT scan datasets. Based on the number of experiments, and an average accuracy of 99.10% for the chest X-rays datasets, we conclude that a reliable CACD system is possible. [ABSTRACT FROM AUTHOR]

Objective: Computer-aided diagnosis (CAD) significantly enhances the accurate and early detection of breast cancer. The segmentation step, which is crucial in CAD methods, employs different algorithms for image segmentation as documented in the literature. Segmentation in detecting breast lesions using CAD may affect the features extracted from the images and, accordingly, the classification results. These segmentation methods have advantages and limitations when compared to each other. No study in the literature has yet explored feature matrices obtained by different segmentation methods using different performance criteria. This study aims to investigate the effects of different segmentation methods used in image processing on mammography images for breast cancer detection. Materials and Methods: In the preprocessing step, images are enhanced using median filtering, Contrast Limited Adaptive Histogram Equalization (CLAHE), and unsharp masking. Texture features are extracted from the regions of interest (ROI) using texture analysis techniques, coupled with an elastic network technique for feature reduction. Results: The performance of five different segmentation algorithms was compared using various performance measures such as accuracy, sensitivity, and specificity, alongside different classification methods. The k-means algorithm showed higher performance compared to other segmentation methods. It exhibited high efficacy, achieving an accuracy of 1.00 and 0.989 with Support Vector Machine (SVM) and Random Forest (RF) classifiers, respectively. Conclusion: Segmentation methods used in image processing were found to have an impact on classification results. These computer-aided systems can be instrumental in patient classification. [ABSTRACT FROM AUTHOR]

Purpose: Aortic stenosis (AS) is a common cardiovascular condition where early detection of left ventricular (LV) dysfunction is essential for timely intervention and optimal management. Current echocardiographic measurements, such as ejection fraction (EF), are insensitive to minor changes in LV function, and strain imaging is typically limited to the global longitudinal strain (GLS) parameter due to robustness issues. This study introduces a novel, fully automatic algorithm to enhance the detection of LV dysfunction in AS patients using multiple strain imaging parameters. Methods: We applied supervised machine‐learning techniques to classify data from 82 severe AS patients, 96 chest pain subjects, and 319 healthy volunteers. Results: Our model significantly outperformed EF and GLS in distinguishing AS patients from healthy volunteers (area under the curve [AUC] = 0.97 vs. 0.88 and 0.82, respectively). It also surpassed EF and GLS in differentiating AS patients from chest pain subjects (AUC = 0.95 vs. 0.90 and 0.55, respectively). Conclusion: This novel, clinically interpretable model leverages the potential of strain imaging to enhance diagnostic accuracy and guide clinical decision‐making in LV dysfunction, thereby improving clinical practice. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Ultrasound in conjunction with mammography imaging, plays a vital role in the early detection and diagnosis of breast cancer. However, speckle noise affects medical ultrasound images and degrades visual radiological interpretation. Speckle carries information about the interactions of the ultrasound pulse with the tissue microstructure, which generally causes several difficulties in identifying malignant and benign regions. The application of deep learning in image denoising has gained more attention in recent years. OBJECTIVES: The main objective of this work is to reduce speckle noise while preserving features and details in breast ultrasound images using GAN models. METHODS: We proposed two GANs models (Conditional GAN and Wasserstein GAN) for speckle-denoising public breast ultrasound databases: BUSI, DATASET A, AND UDIAT (DATASET B). The Conditional GAN model was trained using the Unet architecture, and the WGAN model was trained using the Resnet architecture. The image quality results in both algorithms were measured by Peak Signal to Noise Ratio (PSNR, 35–40 dB) and Structural Similarity Index (SSIM, 0.90–0.95) standard values. RESULTS: The experimental analysis clearly shows that the Conditional GAN model achieves better breast ultrasound despeckling performance over the datasets in terms of PSNR = 38.18 dB and SSIM = 0.96 with respect to the WGAN model (PSNR = 33.0068 dB and SSIM = 0.91) on the small ultrasound training datasets. CONCLUSIONS: The observed performance differences between CGAN and WGAN will help to better implement new tasks in a computer-aided detection/diagnosis (CAD) system. In future work, these data can be used as CAD input training for image classification, reducing overfitting and improving the performance and accuracy of deep convolutional algorithms. [ABSTRACT FROM AUTHOR]

Background/Aims: This study aimed to evaluate the effectiveness of the GI Genius (Medtronic) module in clinical practice, focusing on the adenoma detection rate (ADR) during colonoscopy. Computer-aided polyp detection (CADe) systems using artificial intelligence have been shown to improve adenoma detection in controlled trials. However, the effectiveness of these systems in clinical practice has recently been questioned. Methods: This single-center prospective observational study was conducted at the University Hospital of Southern Denmark and included all individuals referred for colonoscopy between November 2020 and January 2021. The primary outcome was ADR, comparing patients examined with CADe to those examined without it. The selection of patients to be examined with the CADe module was completely random. Results: A total of 502 patients were analyzed (318 in the control group and 184 in the CADe group). The overall ADR was 32.1% with a slight increase in the CADe group (34.7% vs. 30.5%). Multivariable analysis showed a very modest and statistically insignificant increase in ADR (risk ratio, 1.12; 95% confidence interval, 0.88–1.43). Conclusions: The use of CADe in clinical practice did not increase ADR with statistical significance when compared to colonoscopy without CADe. These findings suggest that the impact of CADe systems in everyday clinical practice are modest. [ABSTRACT FROM AUTHOR]

Background/Aims: Alzheimer's Disease (AD) is a progressive neurodegenerative disorder that severely affects cognitive functions and memory. Early detection is crucial for timely intervention and improved patient outcomes. However, traditional diagnostic tools, such as MRI and PET scans, are costly and less accessible. This study aims to develop an automated, cost-effective digital diagnostic approach using deep learning (DL) and computer-aided detection (CAD) methods for early AD identification and classification. Methods: The proposed framework utilizes pretrained convolutional neural networks (CNNs) for feature extraction, integrated with two classifiers: multi-class support vector machine (MSVM) and artificial neural network (ANN). A dataset categorized into four groups--non-demented, very mild demented, mild demented, and moderate demented--was employed for evaluation. To optimize the classification process, a texture-based algorithm was applied for feature reduction, enhancing computational efficiency and reducing processing time. Results: The system demonstrated high statistical performance, achieving an accuracy of 91%, precision of 95%, and recall of 90%. Among the initial set of twenty-two texture features, seven were identified as particularly effective in differentiating normal cases from mild AD stages, significantly streamlining the classification process. These results validate the robustness and efficacy of the proposed DLbased CAD system. Conclusions: This study presents a reliable and affordable solution for early AD detection and diagnosis. The proposed system outperforms existing state-of-theart models and offers a valuable tool for timely treatment planning. Future research should explore its application to larger, more diverse datasets and investigate integration with other imaging modalities, such as MRI, to further enhance diagnostic precision. [ABSTRACT FROM AUTHOR]

This paper aims to provide a structured analysis of the performance metrics used in computer-aided detection (CAD) systems, specifically focusing on lung nodule detection in computed tomography (CT) images. By examining key metrics along with their respective strengths and limitations, this study offers guidelines to assist in selecting appropriate metrics. Evaluation methods for CAD systems for lung nodule detection are primarily categorized into per-scan and per-nodule approaches. For per-scan analysis, a key metric is the area under the receiver operating characteristic (ROC) curve (AUROC), which evaluates the ability of the system to distinguish between scans with and without nodules. For per-nodule analysis, the nodule-level sensitivity at fixed false positives per scan is often used, supplemented by the free-response receiver operating characteristic (FROC) curve and the competition performance metric (CPM). However, the CPM does not provide normalized scores because it theoretically ranges from zero to infinity and largely varies depending on the characteristics of the data. To address the advantages and limitations of ROC and FROC curves, an alternative FROC (AFROC) was introduced to combine the strengths of both per-scan and per-nodule analyses. This paper discusses the principles of each metric and their relative strengths, providing insights into their clinical implications and practical utility. [ABSTRACT FROM AUTHOR]

Given the complexity of oral mucosal disease diagnosis and the limitations in the precision of traditional object detection methods, this study aims to develop a high-accuracy artificial intelligence-assisted diagnostic approach based on the SegFormer semantic segmentation model. This method is designed to automatically segment lesion areas in white-light images of oral mucosal diseases, providing objective and quantifiable evidence for clinical diagnosis. This study utilized a dataset of oral mucosal diseases provided by the Affiliated Stomatological Hospital of Zhejiang University School of Medicine, comprising 838 high-resolution images of three diseases: oral lichen planus, oral leukoplakia, and oral submucous fibrosis. These images were annotated at the pixel level by oral specialists using Labelme software (v5.5.0) to construct a semantic segmentation dataset. This study designed a SegFormer model based on the Transformer architecture, employed cross-validation to divide training and testing sets, and compared SegFormer models of different capacities with classical segmentation models such as UNet and DeepLabV3. Quantitative metrics including the Dice coefficient and mIoU were evaluated, and a qualitative visual analysis of the segmentation results was performed to comprehensively assess model performance. The SegFormer-B2 model achieved optimal performance on the test set, with a Dice coefficient of 0.710 and mIoU of 0.786, significantly outperforming other comparative algorithms. The visual results demonstrate that this model could accurately segment the lesion areas of three common oral mucosal diseases. The SegFormer model proposed in this study effectively achieves the precise automatic segmentation of three common oral mucosal diseases, providing a reliable auxiliary tool for clinical diagnosis. It shows promising prospects in improving the efficiency and accuracy of oral mucosal disease diagnosis and has potential clinical application value. [ABSTRACT FROM AUTHOR]

The most commonly occurring cancer in the world is breast cancer with more than 500,000 cases across the world. The detection mechanism for breast cancer is endoscopist-dependent and necessitates a skilled pathologist. However, in recent years many computer-aided diagnoses (CADs) have been used to diagnose and classify breast cancer using traditional RGB images that analyze the images only in three-color channels. Nevertheless, hyperspectral imaging (HSI) is a pioneering non-destructive testing (NDT) image-processing technique that can overcome the disadvantages of traditional image processing which analyzes the images in a wide-spectrum band. Eight studies were selected for systematic diagnostic test accuracy (DTA) analysis based on the results of the Quadas-2 tool. Each of these studies' techniques is categorized according to the ethnicity of the data, the methodology employed, the wavelength that was used, the type of cancer diagnosed, and the year of publication. A Deeks' funnel chart, forest charts, and accuracy plots were created. The results were statistically insignificant, and there was no heterogeneity among these studies. The methods and wavelength bands that were used with HSI technology to detect breast cancer provided high sensitivity, specificity, and accuracy. The meta-analysis of eight studies on breast cancer diagnosis using HSI methods reported average sensitivity, specificity, and accuracy of 78%, 89%, and 87%, respectively. The highest sensitivity and accuracy were achieved with SVM (95%), while CNN methods were the most commonly used but had lower sensitivity (65.43%). Statistical analyses, including meta-regression and Deeks' funnel plots, showed no heterogeneity among the studies and highlighted the evolving performance of HSI techniques, especially after 2019. [ABSTRACT FROM AUTHOR]

This study evaluates the potential of an AI-based computer-aided detection (AI-CAD) system in digital mammography for predicting pathologic complete response (pCR) in breast cancer patients after neoadjuvant chemotherapy (NAC). A retrospective analysis of 132 patients who underwent NAC and surgery between January 2020 and December 2022 was performed. Pre- and post-NAC mammograms were analyzed using conventional CAD and AI-CAD systems, with negative exams defined by the absence of marked abnormalities. Two radiologists reviewed mammography, ultrasound, MRI, and diffusion-weighted imaging (DWI). Concordance rates between CAD and AI-CAD were calculated, and the diagnostic performance, including the area under the receiver operating characteristics curve (AUC), was assessed. The pre-NAC concordance rates were 90.9% for CAD and 97% for AI-CAD, while post-NAC rates were 88.6% for CAD and 89.4% for AI-CAD. The MRI had the highest diagnostic performance for pCR prediction, with AI-CAD performing comparably to other modalities. Univariate analysis identified significant predictors of pCR, including AI-CAD, mammography, ultrasound, MRI, histologic grade, ER, PR, HER2, and Ki-67. In multivariable analysis, negative MRI, histologic grade 3, and HER2 positivity remained significant predictors. In conclusion, this study demonstrates that AI-CAD in digital mammography shows the potential to examine the pCR of breast cancer patients following NAC. [ABSTRACT FROM AUTHOR]

The traditional medical image segmentation network has a large number of parameters and slow computing speed, and cannot applies effectively to the real-time detection technology. To address this issue, this paper proposed a lightweight medical image segmentation network called SPTFormer. Firstly, this network constructed a self-blocking Transformer module, which reshaped the feature map through an adaptive blocking strategy and utilized parallel computing to improve the attention operation speed while paying attention to local detail features. Secondly, this network constructed an SR-CNN module, which used the shift-restored operation to improve the ability to capture local spatial information. By experimenting on ISIC 2018, BUSI, CVC-ClinicDB and 2018 data science bowl, compared with the TransUNet model based on Transformer, the accuracy of the proposed network improves by 4.28%, 3.74%, 6.50%, and 1. 16%, respectively, the GPU computation time reduces by 58%. The proposed network has better performance in medical image segmentation applications, which can well balance the network accuracy and complexity, and provides a new solution for real-time computer-aided diagnosis. [ABSTRACT FROM AUTHOR]

Blindness is preventable by early detection of ocular abnormalities. Computer-aided diagnosis for ocular abnormalities is built by analyzing retinal imaging modalities, for instance, Color Fundus Photography (CFP). This research aims to propose a multi-label detection of 28 ocular abnormalities consisting of frequent and rare abnormalities from a single CFP by using transformer-based semantic dictionary learning. Rare labels are usually ignored because of a lack of features. We tackle this condition by adding the co-occurrence dependency factor to the model from the linguistic features of the labels. The model learns the relation between spatial features and linguistic features represented as a semantic dictionary. The proposed method treats the semantic dictionary as one of the main important parts of the model. It acts as the query while the spatial features are the key and value. The experiments are conducted on the RFMiD dataset. The results show that the proposed method achieves the top 30% in Evaluation Set on the RFMiD dataset challenge. It also shows that treating the semantic dictionary as one of the strong factors in model detection increases the performance when compared with the method that treats the semantic dictionary as a weak factor. [ABSTRACT FROM AUTHOR]

Background Computer-aided detection (CADe) has been developed to improve detection during colonoscopy. After initial reports of high efficacy, there has been an increasing recognition of variability in the effectiveness of CADe systems. The aim of this study was to evaluate a CADe system in a varied colonoscopy population. Methods A multicenter, randomized trial was conducted at seven hospitals (both university and non-university) in Europe and Canada. Participants referred for diagnostic, non-immunochemical fecal occult blood test (iFOBT) screening, or surveillance colonoscopy were randomized (1:1) to undergo CADe-assisted or conventional colonoscopy by experienced endoscopists. Participants with insufficient bowel preparation were excluded from the analysis. The primary outcome was adenoma detection rate (ADR). Secondary outcomes included adenomas per colonoscopy (APC) and sessile serrated lesions (SSLs) per colonoscopy. Results 581 participants were enrolled, of whom 497 were included in the final analysis: 250 in the CADe arm and 247 in the conventional colonoscopy arm. The indication was surveillance in 202/497 colonoscopies (40.6 %), diagnostic in 199/497 (40.0 %), and non-iFOBT screening in 96/497 (19.3 %). Overall, ADR (38.4 % vs. 37.7 %; P = 0.43) and APC (0.66 vs. 0.66; P = 0.97) were similar between CADe and conventional colonoscopy. SSLs per colonoscopy was increased (0.30 vs. 0.19; P = 0.049) in the CADe arm vs. the conventional colonoscopy arm. Conclusions In this study conducted by experienced endoscopists, CADe did not result in a statistically significant increase in ADR. However, the ADR of our control group substantially surpassed our sample size assumptions, increasing the risk of an underpowered trial. [ABSTRACT FROM AUTHOR]

The Chinese Thyroid Imaging Reporting and Data System (C‐TIRADS) standard is based on the Chinese current medical context. However, at present, there is a lack of C‐TIRADS‐based automatic computer‐aided diagnosis system for thyroid nodule ultrasound images, and the existing algorithms for detecting and recognizing thyroid nodules are basically for the dichotomous classification of benign and malignant. We used the DETR (detection transformer) model as a baseline model and carried out model enhancements to address the shortcomings of unsatisfactory classification accuracy and difficulty in detecting small thyroid nodules in the DETR model. First, to investigate the method of acquiring multi‐scale features of thyroid nodule ultrasound images, we choose TResNet‐L as the feature extraction network and introduce multi‐scale feature information and group convolution, thereby enhancing the model's multi‐label classification accuracy. Second, a parallel decoder architecture for multi‐label thyroid nodule ultrasound image classification is designed to enhance the learning of correlation between pathological feature class labels, aiming to improve the multi‐label classification accuracy of the detection model. Third, the loss function of the detection model is improved. We propose a linear combination of Smooth L1‐Loss and CIoU Loss as the model's bounding box loss function and asymmetric loss as the model's multi‐label classification loss function, aiming to further improve the detection model's detection accuracy for small thyroid nodules. The experiment results show that the improved DETR model achieves an AP of 92.4% and 81.6% with IoU thresholds of 0.5 and 0.75, respectively. [ABSTRACT FROM AUTHOR]

The aim of this meta-analysis was to assess the diagnostic performance of deep learning (DL) and ultrasound in breast cancer diagnosis. Additionally, we categorized the included studies into two subgroups: B-mode ultrasound diagnostic subgroup and multimodal ultrasound diagnostic subgroup, and compared the performance differences of DL algorithms in breast cancer diagnosis using only B-mode ultrasound or multimodal ultrasound. We conducted a comprehensive search for relevant studies published from January 01, 2017 to July 31, 2023 in the MEDLINE and EMBASE databases. The quality of the included studies was evaluated using the QUADAS-2 tool and radiomics quality scores (RQS). Meta-analysis was performed using R software. Inter-study heterogeneity was assessed by I^2 values and Q-test P-values, with sources of heterogeneity analyzed through a random effects model based on test results. Summary receiver operating characteristics (SROC) curves were used for meta-analysis across multiple trials, while combined sensitivity, specificity, and AUC were calculated to quantify prediction accuracy. Subgroup analysis and sensitivity analyses were also conducted to identify potential sources of study heterogeneity. Publication bias was assessed using the funnel plot method. (PROSPERO identifier: CRD42024545758). The 20 studies included a total of 14,955 cases, with 4197 cases used for model testing. Among these cases were 1582 breast cancer patients and 2615 benign or other breast lesions. The combined sensitivity, specificity, and AUC values across all studies were found to be 0.93, 0.90, and 0.732, respectively. In subgroup analysis, the multimodal subgroup demonstrated superior performance with combined sensitivity, specificity, and AUC values of 0.93, 0.88, and 0.787, respectively; whereas the combined sensitivity, specificity, and AUC value for the model B subgroup was at a level of 0.92, 0.91, and 0.642, respectively. The integration of DL with ultrasound demonstrates high accuracy in the adjunctive diagnosis of breast cancer, while the fusion of DL and multimodal breast ultrasound exhibits superior diagnostic efficacy compared to B-mode ultrasound alone. • The application of deep learning in the diagnosis of breast cancer is promising. • Deep learning-based computer-aided detection demonstrates high accuracy. • Multimodal breast ultrasound is expected to enhance the diagnostic accuracy. [ABSTRACT FROM AUTHOR]

Medical imaging plays a pivotal role in diagnostic medicine with technologies like Magnetic Resonance Imagining (MRI), Computed Tomography (CT), Positron Emission Tomography (PET), and ultrasound scans being widely used to assist radiologists and medical experts in reaching concrete diagnosis. Given the recent massive uplift in the storage and processing capabilities of computers, and the publicly available big data, Artificial Intelligence (AI) has also started contributing to improving diagnostic radiology. Edge computing devices and handheld gadgets can serve as useful tools to process medical data in remote areas with limited network and computational resources. In this research, the capabilities of multiple platforms are evaluated for the real-time deployment of diagnostic tools. MRI classification and segmentation applications developed in previous studies are used for testing the performance using different hardware and software configurations. Cost–benefit analysis is carried out using a workstation with a NVIDIA Graphics Processing Unit (GPU), Jetson Xavier NX, Raspberry Pi 4B, and Android phone, using MATLAB, Python, and Android Studio. The mean computational times for the classification app on the PC, Jetson Xavier NX, and Raspberry Pi are 1.2074, 3.7627, and 3.4747 s, respectively. On the low-cost Android phone, this time is observed to be 0.1068 s using the Dynamic Range Quantized TFLite version of the baseline model, with slight degradation in accuracy. For the segmentation app, the times are 1.8241, 5.2641, 6.2162, and 3.2023 s, respectively, when using JPEG inputs. The Jetson Xavier NX and Android phone stand out as the best platforms due to their compact size, fast inference times, and affordability. [ABSTRACT FROM AUTHOR]

Objectives: To identify lymphatic vascular space invasion (LVSI) and lymphatic node metastasis (LNM) status of endometrial cancer (EC) patients, using radiomics based on MRI images. Methods: Five hundred and ninety-eight EC patients between January 2015 and September 2020 from two institutions were retrospectively included. Tumoral regions on DWI, T1CE, and T2W images were manually outlined. Radiomics features were extracted from tumor region and peri-tumor region of different thicknesses. We established sub-models to select features from each smaller category. Using this method, we separately constructed radiomic signatures for intra-tumoral and peri-tumoral images using different sequences. We constructed intra-tumoral and peri-tumoral models by combining their features, and a multi-sequence model by combining logits. Models were trained with 397 patients and validated with 170 internal and 31 external patients. Results: For LVSI positive/LNM positive status identification, the multi-parameter MRI radiomics model achieved the area under curve (AUC) values of 0.771 (95%CI: [0.692–0.849])/0.801 (95%CI: [0.704, 0.898]) and 0.864 (95%CI: [0.728–1.000])/0.976 (95%CI: [0.919, 1.000]) in internal and external test cohorts, respectively. Conclusions: Intra-tumoral and peri-tumoral radiomics signatures based on mpMRI can both be used to identify LVSI or LNM status in EC patients non-invasively. Further studies on LVSI and LNM should pay attention to both of them. [ABSTRACT FROM AUTHOR]

Objective: Scaphoid fractures, particularly occult and non-displaced fractures, are difficult to detect using traditional X-ray methods because of their subtle appearance and variability in bone density. This study proposes a two-stage CNN approach to detect and classify scaphoid fractures using anterior–posterior (AP) and lateral (LA) X-ray views for more accurate diagnosis. Methods: This study emphasizes the use of multi-view X-ray images (AP and LA views) to improve fracture detection and classification. The multi-view fusion module helps integrate information from both views to enhance detection accuracy, particularly for occult fractures that may not be visible in a single view. The proposed method includes two stages, which are stage 1: detect the scaphoid bone using Faster RCNN and a Feature Pyramid Network (FPN) for region proposal and small object detection. The detection accuracy for scaphoid localization is 100%, with Intersection over Union (IoU) scores of 0.8662 for AP views and 0.8478 for LA views. And stage 2: perform fracture classification using a ResNet backbone and FPN combined with a multi-view fusion module to combine features from both AP and LA views. This stage achieves a classification accuracy of 89.94%, recall of 87.33%, and precision of 90.36%. Results: The proposed model performs well in both scaphoid bone detection and fracture classification. The multi-view fusion approach significantly improves recall and accuracy in detecting fractures compared to single-view approaches. In scaphoid detection, both AP and LA views achieved 100% detection accuracy. In fracture detection, using multi-view fusion, the accuracy for AP views reached 87.16%, and for LA views, it reached 83.83%. Conclusions: The multi-view fusion model effectively improves the detection of scaphoid fractures, particularly in cases of occult and non-displaced fractures. The model provides a reliable, automated approach to assist clinicians in detecting and diagnosing scaphoid fractures more efficiently. [ABSTRACT FROM AUTHOR]