Search Results (16)

Governments and health authorities emphasize the importance of early detection of breast cancer, usually through mammography, to improve prognosis, increase therapeutic options and achieve optimum outcomes. Despite technological advances and the advent of full-field digital mammography (FFDM), diagnosis of breast abnormalities on mammographic images remains a challenge due to qualitative variations in different tissue types and densities. Highly accurate computer-aided diagnosis (CADx) systems could assist in the differentiation between normal and abnormal tissue and the classification of abnormal tissue as benign or malignant. In this paper, classical, advanced fuzzy sets and fusion techniques for image enhancement were combined with three different thresholding methods (Global, Otsu and type-2 fuzzy sets threshold) and three different classifying techniques (K-means, FCM and ANFIS) for the classification of breast masses on FFDM. The aim of this paper is to identify the performance of the advanced fuzzy sets, fuzzy sets type-2 segmentation, decisions based on K-means and FCM, and the ANFIS classifier. Sixty-three combinations were evaluated on ninety-seven digital mammographic masses (sixty-five benign and thirty-two malignant). The performance of the sixty-three combinations was evaluated by estimating the accuracy, the F1 score, and the area under the curve (AUC). LH-XWW enhancement method with Otsu thresholding and FCM classifier outperformed all other combinations with an accuracy of 95.17%, F1 score of 89.42% and AUC of 0.91. This algorithm seems to offer a promising CADx system for breast cancer diagnosis on FFDM. Full article

A well-researched field is the development of Computer Aided Diagnosis (CADx) Systems for the benign-malignant classification of abnormalities detected by mammography. Due to the nature of the breast parenchyma, there are significant uncertainties about the shape and geometry of the abnormalities that may lead to an inaccurate diagnosis. These same uncertainties give mammograms a fuzzy character that is essential to the application of fuzzy processing. Fuzzy set theory considers uncertainty in the form of a membership function, and therefore fuzzy sets can process imperfect data if this imperfection originates from vagueness and ambiguity rather than randomness. Fuzzy contrast enhancement can improve edge detection and, by extension, the quality of related classification features. In this paper, classical (Linguistic hedges and fuzzy enhancement functions), advanced fuzzy sets (Intuitionistic fuzzy set (ΙFS), Pythagorean fuzzy set (PFS), and Fermatean fuzzy sets (FFS)), and a Genetic Algorithm optimizer are proposed to enhance the contrast of mammographic features. The advanced fuzzy sets provide better information on the uncertainty of the membership function. As a result, the intuitionistic method had the best overall performance, but most of the techniques could be used efficiently, depending on the problem that needed to be solved. Linguistic methods could provide a more manageable way of spreading the histogram, revealing more extreme values than the conventional methods. A fusion technique of the enhanced mammography images with Ordered Weighted Average operators (OWA) achieves a good-quality final image. Full article

Colorectal cancer is associated with a high mortality rate and significant patient risk. Images obtained during a colonoscopy are used to make a diagnosis, highlighting the importance of timely diagnosis and treatment. Using techniques of deep learning could enhance the diagnostic accuracy of existing systems. Using the most advanced deep learning techniques, a brand-new EnsemDeepCADx system for accurate colorectal cancer diagnosis has been developed. The optimal accuracy is achieved by combining Convolutional Neural Networks (CNNs) with transfer learning via bidirectional long short-term memory (BILSTM) and support vector machines (SVM). Four pre-trained CNN models comprise the ADaDR-22, ADaR-22, and DaRD-22 ensemble CNNs: AlexNet, DarkNet-19, DenseNet-201, and ResNet-50. In each of its stages, the CADx system is thoroughly evaluated. From the CKHK-22 mixed dataset, colour, greyscale, and local binary pattern (LBP) image datasets and features are utilised. In the second stage, the returned features are compared to a new feature fusion dataset using three distinct CNN ensembles. Next, they incorporate ensemble CNNs with SVM-based transfer learning by comparing raw features to feature fusion datasets. In the final stage of transfer learning, BILSTM and SVM are combined with a CNN ensemble. The testing accuracy for the ensemble fusion CNN DarD-22 using BILSTM and SVM on the original, grey, LBP, and feature fusion datasets was optimal (95.96%, 88.79%, 73.54%, and 97.89%). Comparing the outputs of all four feature datasets with those of the three ensemble CNNs at each stage enables the EnsemDeepCADx system to attain its highest level of accuracy. Full article

Hypertensive retinopathy (HR) is a serious eye disease that causes the retinal arteries to change. This change is mainly due to the fact of high blood pressure. Cotton wool patches, bleeding in the retina, and retinal artery constriction are affected lesions of HR symptoms. An ophthalmologist often makes the diagnosis of eye-related diseases by analyzing fundus images to identify the stages and symptoms of HR. The likelihood of vision loss can significantly decrease the initial detection of HR. In the past, a few computer-aided diagnostics (CADx) systems were developed to automatically detect HR eye-related diseases using machine learning (ML) and deep learning (DL) techniques. Compared to ML methods, the CADx systems use DL techniques that require the setting of hyperparameters, domain expert knowledge, a huge training dataset, and a high learning rate. Those CADx systems have shown to be good for automating the extraction of complex features, but they cause problems with class imbalance and overfitting. By ignoring the issues of a small dataset of HR, a high level of computational complexity, and the lack of lightweight feature descriptors, state-of-the-art efforts depend on performance enhancement. In this study, a pretrained transfer learning (TL)-based MobileNet architecture is developed by integrating dense blocks to optimize the network for the diagnosis of HR eye-related disease. We developed a lightweight HR-related eye disease diagnosis system, known as Mobile-HR, by integrating a pretrained model and dense blocks. To increase the size of the training and test datasets, we applied a data augmentation technique. The outcomes of the experiments show that the suggested approach was outperformed in many cases. This Mobile-HR system achieved an accuracy of 99% and an F1 score of 0.99 on different datasets. The results were verified by an expert ophthalmologist. These results indicate that the Mobile-HR CADx model produces positive outcomes and outperforms state-of-the-art HR systems in terms of accuracy. Full article

Growing evidence indicates that artificial intelligence (AI) applied to medicine is here to stay. In gastroenterology, AI computer vision applications have been stated as a research priority. The two main AI system categories are computer-aided polyp detection (CADe) and computer-assisted diagnosis (CADx). However, other fields of expansion are those related to colonoscopy quality, such as methods to objectively assess colon cleansing during the colonoscopy, as well as devices to automatically predict and improve bowel cleansing before the examination, predict deep submucosal invasion, obtain a reliable measurement of colorectal polyps and accurately locate colorectal lesions in the colon. Although growing evidence indicates that AI systems could improve some of these quality metrics, there are concerns regarding cost-effectiveness, and large and multicentric randomized studies with strong outcomes, such as post-colonoscopy colorectal cancer incidence and mortality, are lacking. The integration of all these tasks into one quality-improvement device could facilitate the incorporation of AI systems in clinical practice. In this manuscript, the current status of the role of AI in colonoscopy is reviewed, as well as its current applications, drawbacks and areas for improvement. Full article

(1) Background: Once lung lesions are identified on CT scans, they must be characterized by assessing the risk of malignancy. Despite the promising performance of computer-aided systems, some limitations related to the study design and technical issues undermine these tools’ efficiency; an “intelligent agent” to detect and non-invasively characterize lung lesions on CT scans is proposed. (2) Methods: Two main modules tackled the detection of lung nodules on CT scans and the diagnosis of each nodule into benign and malignant categories. Computer-aided detection (CADe) and computer aided-diagnosis (CADx) modules relied on deep learning techniques such as Retina U-Net and the convolutional neural network; (3) Results: Tests were conducted on one publicly available dataset and two local datasets featuring CT scans acquired with different devices to reveal deep learning performances in “real-world” clinical scenarios. The CADe module reached an accuracy rate of 78%, while the CADx’s accuracy, specificity, and sensitivity stand at 80%, 73%, and 85.7%, respectively; (4) Conclusions: Two different deep learning techniques have been adapted for CADe and CADx purposes in both publicly available and private CT scan datasets. Experiments have shown adequate performance in both detection and diagnosis tasks. Nevertheless, some drawbacks still characterize the supervised learning paradigm employed in networks such as CNN and Retina U-Net in real-world clinical scenarios, with CT scans from different devices with different sensors’ fingerprints and spatial resolution. Continuous reassessment of CADe and CADx’s performance is needed during their implementation in clinical practice. Full article

Inflammatory breast cancer (IBC) is an aggressive type of breast cancer. It leads to a significantly shorter survival than other types of breast cancer in the U.S. The American Joint Committee on Cancer (AJCC) defines the diagnosis based on specific criteria. However, the clinical presentation of IBC in North Africa (Egypt, Morocco, and Tunisia) does not agree, in many cases, with the AJCC criteria. Healthcare providers with expertise in IBC diagnosis are limited because of the rare nature of the disease. This paper reviewed current imaging modalities for IBC diagnosis and proposed a computer-aided diagnosis system using bilateral mammograms for early and improved diagnosis. The National Institute of Cancer in Egypt provided the image dataset consisting of IBC and non-IBC cancer cases. Type 1 and Type 2 fuzzy logic classifiers use the IBC markers that the expert team identified and extracted carefully. As this research is a pioneering work in its field, we focused on breast skin thickening, its percentage, the level of nipple retraction, bilateral breast density asymmetry, and the ratio of the breast density of both breasts in bilateral digital mammogram images. Granulomatous mastitis cases are not included in the dataset. The system’s performance is evaluated according to the accuracy, recall, precision, F1 score, and area under the curve. The system achieved accuracy in the range of 92.3–100%. Full article

Hypertensive retinopathy (HR) is a retinal disorder, linked to high blood pressure. The incidence of HR-eye illness is directly related to the severity and duration of hypertension. It is critical to identify and analyze HR at an early stage to avoid blindness. There are presently only a few computer-aided systems (CADx) designed to recognize HR. Instead, those systems concentrated on collecting features from many retinopathy-related HR lesions and then classifying them using traditional machine learning algorithms. Consequently, those CADx systems required complicated image processing methods and domain-expert knowledge. To address these issues, a new CAD-HR system is proposed to advance depth-wise separable CNN (DSC) with residual connection and a linear support vector machine (LSVM). Initially, the data augmentation approach is used on retina graphics to enhance the size of the datasets. Afterward, this DSC approach is applied to retinal images to extract robust features. The retinal samples are then classified as either HR or non-HR using an LSVM classifier as the final step. The statistical investigation of 9500 retinograph images from two publicly available and one private source is undertaken to assess the accuracy. Several experimental results demonstrate that the CAD-HR model requires less computational time and fewer parameters to categorize HR. On average, the CAD-HR achieved a sensitivity (SE) of 94%, specificity (SP) of 96%, accuracy (ACC) of 95% and area under the receiver operating curve (AUC) of 0.96. This confirms that the CAD-HR system can be used to correctly diagnose HR. Full article

Computer-aided diagnosis/detection (CADx) systems have been used to help doctors in improving the quality of diagnosis and treatment processes in many serious diseases such as breast cancer, brain stroke, lung cancer, and bone fracture. However, the performance of such systems has not been completely accurate. The key factor in CADx systems is to localize positive disease lesions from the captured medical images. This step is important as it is used not only to localize lesions but also to reduce the effect of noise and normal regions on the overall CADx system. In this research, we proposed a method to enhance the segmentation performance of thyroid nodules in ultrasound images based on information fusion of suggestion and enhancement segmentation networks. Experimental results with two open databases of thyroid digital image databases and 3DThyroid databases showed that our method resulted in a higher performance compared to current up-to-date methods. Full article

Screening diabetic retinopathy, a major cause of blindness, is time-consuming for ophthalmologists and has some constrains in achieving full coverage and attendance. The handheld fundus camera EyeFundusScope was recently developed to expand the scale of screening, drawing on images acquired in primary care and telescreening made by ophthalmologists or a computer-aided diagnosis (CADx) system. This study aims to assess the diagnostic accuracy of the interpretation of images captured using EyeFundusScope and perform its technical evaluation, including image quality, functionality, usability, and acceptance in a real-world clinical setting. Physicians and nurses without training in ophthalmology will use EyeFundusScope to take pictures of the retinas of patients with diabetes and the images will be classified for the presence or absence of diabetic retinopathy and image quality by a panel of ophthalmologists. A subgroup of patients will also be examined with the reference standard tabletop fundus camera. Screening results provided by the CADx system on images taken with EyeFundusScope will be compared against the ophthalmologists’ analysis of images taken with the tabletop fundus camera. Diagnostic accuracy measures with 95% confidence intervals (CIs) will be calculated for positive and negative test results. Proportion of each category of image quality will be presented. Usability and acceptance results will be presented qualitatively. Full article

Controlling spread of resistance genes from wastewater to aquatic systems requires more knowledge on how resistance genes are acquired and transmitted. Whole genomic sequences from sewage-associated staphylococcus isolates (20 S. aureus, 2 Staphylococcus warneri, and 2 Staphylococcus delphini) were analyzed for the presence of antibiotic resistance genes (ARGs) and metal resistance genes (MRGs). Plasmid sequences were identified in each isolate to investigate co-carriage of ARGs and MRGs within. BLASTN analysis showed that 67% of the isolates carried more than one ARG. The carriage of multiple plasmids was observed more in CC5 than CC8 S. aureus strains. Plasmid exchange was observed in all staphylococcus species except the two S. delphini isolates that carried multiple MRGs, no ARGs, and no plasmids. 85% of S. aureus isolates carried the blaZ gene, 76% co-carried blaZ with cadD and cadX, with 62% of these isolates carrying blaZ, cadD, and cadX on the same plasmid. The co-carriage of ARGs and MRGs in S. warneri isolates, and carriage of MRGs in S. delphini, without plasmids suggests non-conjugative transmission routes for gene acquisition. More studies are required that focus on the transduction and transformation routes of transmission to prevent interspecies exchange of ARGs and MRGs in sewage-associated systems. Full article

Medulloblastoma (MB) is a dangerous malignant pediatric brain tumor that could lead to death. It is considered the most common pediatric cancerous brain tumor. Precise and timely diagnosis of pediatric MB and its four subtypes (defined by the World Health Organization (WHO)) is essential to decide the appropriate follow-up plan and suitable treatments to prevent its progression and reduce mortality rates. Histopathology is the gold standard modality for the diagnosis of MB and its subtypes, but manual diagnosis via a pathologist is very complicated, needs excessive time, and is subjective to the pathologists’ expertise and skills, which may lead to variability in the diagnosis or misdiagnosis. The main purpose of the paper is to propose a time-efficient and reliable computer-aided diagnosis (CADx), namely MB-AI-His, for the automatic diagnosis of pediatric MB and its subtypes from histopathological images. The main challenge in this work is the lack of datasets available for the diagnosis of pediatric MB and its four subtypes and the limited related work. Related studies are based on either textural analysis or deep learning (DL) feature extraction methods. These studies used individual features to perform the classification task. However, MB-AI-His combines the benefits of DL techniques and textural analysis feature extraction methods through a cascaded manner. First, it uses three DL convolutional neural networks (CNNs), including DenseNet-201, MobileNet, and ResNet-50 CNNs to extract spatial DL features. Next, it extracts time-frequency features from the spatial DL features based on the discrete wavelet transform (DWT), which is a textural analysis method. Finally, MB-AI-His fuses the three spatial-time-frequency features generated from the three CNNs and DWT using the discrete cosine transform (DCT) and principal component analysis (PCA) to produce a time-efficient CADx system. MB-AI-His merges the privileges of different CNN architectures. MB-AI-His has a binary classification level for classifying among normal and abnormal MB images, and a multi-classification level to classify among the four subtypes of MB. The results of MB-AI-His show that it is accurate and reliable for both the binary and multi-class classification levels. It is also a time-efficient system as both the PCA and DCT methods have efficiently reduced the training execution time. The performance of MB-AI-His is compared with related CADx systems, and the comparison verified the powerfulness of MB-AI-His and its outperforming results. Therefore, it can support pathologists in the accurate and reliable diagnosis of MB and its subtypes from histopathological images. It can also reduce the time and cost of the diagnosis procedure which will correspondingly lead to lower death rates. Full article

Gastric cancer has a high mortality rate worldwide, but it can be prevented with early detection through regular gastroscopy. Herein, we propose a deep learning-based computer-aided diagnosis (CADx) system applying data augmentation to help doctors classify gastroscopy images as normal or abnormal. To improve the performance of deep learning, a large amount of training data are required. However, the collection of medical data, owing to their nature, is highly expensive and time consuming. Therefore, data were generated through deep convolutional generative adversarial networks (DCGAN), and 25 augmentation policies optimized for the CIFAR-10 dataset were implemented through AutoAugment to augment the data. Accordingly, a gastroscopy image was augmented, only high-quality images were selected through an image quality-measurement method, and gastroscopy images were classified as normal or abnormal through the Xception network. We compared the performances of the original training dataset, which did not improve, the dataset generated through the DCGAN, the dataset augmented through the augmentation policies of CIFAR-10, and the dataset combining the two methods. The dataset combining the two methods delivered the best performance in terms of accuracy (0.851) and achieved an improvement of 0.06 over the original training dataset. We confirmed that augmenting data through the DCGAN and CIFAR-10 augmentation policies is most suitable for the classification model for normal and abnormal gastric endoscopy images. The proposed method not only solves the medical-data problem but also improves the accuracy of gastric disease diagnosis. Full article

Colorectal polyps are critical indicators of colorectal cancer (CRC). Blue Laser Imaging and Linked Color Imaging are two modalities that allow improved visualization of the colon. In conjunction with the Blue Laser Imaging (BLI) Adenoma Serrated International Classification (BASIC) classification, endoscopists are capable of distinguishing benign and pre-malignant polyps. Despite these advancements, this classification still prevails a high misclassification rate for pre-malignant colorectal polyps. This work proposes a computer aided diagnosis (CADx) system that exploits the additional information contained in two novel imaging modalities, enabling more informative decision-making during colonoscopy. We train and benchmark six commonly used CNN architectures and compare the results with 19 endoscopists that employed the standard clinical classification model (BASIC). The proposed CADx system for classifying colorectal polyps achieves an area under the curve (AUC) of 0.97. Furthermore, we incorporate visual explanatory information together with a probability score, jointly computed from White Light, Blue Laser Imaging, and Linked Color Imaging. Our CADx system for automatic polyp malignancy classification facilitates future advances towards patient safety and may reduce time-consuming and costly histology assessment. Full article

Breast cancer is a highly prevalent disease in females that may lead to mortality in severe cases. The mortality can be subsided if breast cancer is diagnosed at an early stage. The focus of this study is to detect breast malignancy through computer-aided diagnosis (CADx). In the first phase of this work, Hilbert transform is employed to reconstruct B-mode images from the raw data followed by the marker-controlled watershed transformation to segment the lesion. The methods based only on texture analysis are quite sensitive to speckle noise and other artifacts. Therefore, a hybrid feature set is developed after the extraction of shape-based and texture features from the breast lesion. Decision tree, k-nearest neighbor (KNN), and ensemble decision tree model via random under-sampling with Boost (RUSBoost) are utilized to segregate the cancerous lesions from the benign ones. The proposed technique is tested on OASBUD (Open Access Series of Breast Ultrasonic Data) and breast ultrasound (BUS) images collected at Baheya Hospital Egypt (BHE). The OASBUD dataset contains raw ultrasound data obtained from 100 patients containing 52 malignant and 48 benign lesions. The dataset collected at BHE contains 210 malignant and 437 benign images. The proposed system achieved promising accuracy of 97% with confidence interval (CI) of 91.48% to 99.38% for OASBUD and 96.6% accuracy with CI of 94.90% to 97.86% for the BHE dataset using ensemble method. Full article