Computer Aided Classification of X-ray Images from Pediatric Pneumonia Subjects Collected in Developing Countries

Pneumonia is a lower tract respiratory infection due to bacteria or viruses. It is a severe disease in the pediatric population. Pneumonia is the leading cause of mortality in children under five years worldwide. One of the problems with pneumonia is the diagnosis, as the symptoms of pneumonia may overlap with other diseases, such as asthma and bronchiolitis. In this work, we propose to develop a method for classifying pneumonia and non-pneumonia using X-ray images. We collected 60 X-ray images from Dr. Sardjito Hospital, Yogyakarta, Indonesia, and the dataset from Kaggle. We processed these images through pre-processing algorithms to enhance the image quality, segmentation, white pixel computation, and classification. The novelty of our method is using the ratio of the white pixels from edge detection using the Canny algorithm with the white pixels from segmentation for classifying pneumonia/non-pneumonia. In the Kaggle dataset, our proposed method achieved an accuracy of 86.7%, a sensitivity of 100%, and a specificity of 85%. The classification using the dataset from Dr. Sardjito Hospital yields sensitivity, specificity, and accuracy of 80%, 60%, and 66.7%, respectively. Despite the low performance in the results, we proved our novel feature, ratio of white pixels, can be used to classify pneumonia/non-pneumonia. We also identified that the local dataset is essential in the algorithm development as it has a different quality from the dataset from modern countries. Further, our simple method can be developed further to support pneumonia diagnosis in resource-limited settings where the advanced computing devices or cloud connection are not available.