The CXR-LT series is a community-driven initiative designed to enhance lung disease classification using chest X-rays (CXR). It tackles challenges in open long-tailed lung disease classification and enhances the measurability of state-of-the-art techniques. The first event, CXR-LT 2023, aimed to achieve these goals by providing high-quality benchmark CXR data for model development and conducting comprehensive evaluations to identify ongoing issues impacting lung disease classification performance. Building on the success of CXR-LT 2023, the CXR-LT 2024 expands the dataset to 377,110 chest X-rays (CXRs) and 45 disease labels, including 19 new rare disease findings. It also introduces a new focus on zero-shot learning to address limitations identified in the previous event. Specifically, CXR-LT 2024 features three tasks: (i) long-tailed classification on a large, noisy test set, (ii) long-tailed classification on a manually annotated "gold standard" subset, and (iii) zero-shot generalization to five previously unseen disease findings. This paper provides an overview of CXR-LT 2024, detailing the data curation process and consolidating state-of-the-art solutions, including the use of multimodal models for rare disease detection, advanced generative approaches to handle noisy labels, and zero-shot learning strategies for unseen diseases. Additionally, the expanded dataset enhances disease coverage to better represent real-world clinical settings, offering a valuable resource for future research. By synthesizing the insights and innovations of participating teams, we aim to advance the development of clinically realistic and generalizable diagnostic models for chest radiography.
Cancer-related death is now more common than ever with cancer of the lungs being the leading cause of it. In such regards, the survival percentage for individuals with lung cancer must be increased through early identification. In this paper, we propose a machine learning-based approach for lung cancer detection using data from patients. The proposed method has three stages: preprocessing, feature extraction, and classification. In preprocessing, we extracted the necessary data from the dataset we collected. In the feature extraction stage, we processed the raw data while keeping the original information unchanged, in order for the classifier to work on. Finally, in the classification stage, we use 6 different classifier models to classify the extracted features. We evaluated the proposed method on a publicly available dataset from Kaggle of lung cancer causes and age. The results of the trial confirm the feasibility of the suggested strategy to achieve high accuracy, sensitivity, specificity, and AUC score. In conclusion, using machine learning, The suggested approach offers a powerful and efficient way to detect lung cancer. The proposed method can potentially assist in the detection of lung cancer, thereby improving the survival rate of lung cancer patients.
Respiratory diseases are the world’s third leading cause of mortality. Early detection is critical in dealing with respiratory diseases, as it improves the effectiveness of intervention, including treatment and reducing the spread. The main aim of this article is to propose a novel lightweight inception network to classify a wide spectrum of respiratory diseases using lung sound signals. The proposed framework consists of three stages: 1) preprocessing; 2) mel spectrogram extraction and conversion into a three-channel image; and 3) classification of the mel spectrogram images into different pathological classes using the proposed lightweight inception network, namely, respiratory disease lightweight inception network (RDLINet). Utilizing the proposed architecture, we have achieved a high classification accuracy of 96.6%, 99.6%, and 94.0% for seven-class classification, six-class classification, and healthy versus asthma classification. To the best of our knowledge, this is the first work on seven-class respiratory disease classification using lung sounds. Whereas, our proposed network outperforms all the existing published works for six-class and binary classifications. The suggested framework makes use of deep-learning methods and offers a standardized evaluation with strong categorization capabilities. In order to distinguish between a wide range of respiratory diseases, our study is a pioneering one that focuses exclusively on lung sounds. The proposed framework can be translated into real-time clinical application, which will facilitate the prospect of automated respiratory health screening using lung sounds.
Classifying chest radiographs is a time-consuming and challenging task, even for experienced radiologists. This provides an area for improvement due to the difficulty in precisely distinguishing between conditions such as pleural effusion, pneumothorax, and pneumonia. We propose a novel transfer learning model for multi-label lung disease classification, utilizing the CheXpert dataset with over 12,617 images of frontal radiographs being analyzed. By integrating RadGraph parsing for efficient annotation extraction, we enhance the model's ability to accurately classify multiple lung diseases from complex medical images. The proposed model achieved an F1 score of 0.69 and an AUROC of 0.86, demonstrating its potential for clinical applications. Also explored was the use of Natural Language Processing (NLP) to parse report metadata and address uncertainties in disease classification. By comparing uncertain reports with more certain cases, the NLP-enhanced model improves its ability to conclusively classify conditions. This research highlights the connection between deep learning and NLP, underscoring their potential to enhance radiological diagnostics and aid in the efficient analysis of chest radiographs.
Lung diseases have become a prevalent problem throughout the United States, affecting over 34 million people. Accurate and timely diagnosis of the different types of lung diseases is critical, and Artificial Intelligence (AI) methods could speed up these processes. A dual-stage vision transformer is built throughout this research by integrating a Vision Transformer (ViT) and a Swin Transformer to classify 14 different lung diseases from X-ray scans of patients with these diseases. The proposed model achieved an accuracy of 92.06% on a label-level when making predictions on an unseen testing subset of the dataset after data preprocessing and training the neural network. The model showed promise for accurately classifying lung diseases and diagnosing patients who suffer from these harmful diseases.
Many people die from lung-related diseases every year. X-ray is an effective way to test if one is diagnosed with a lung-related disease or not. This study concentrates on categorizing three distinct types of lung X-rays: those depicting healthy lungs, those showing lung opacities, and those indicative of viral pneumonia. Accurately diagnosing the disease at an early phase is critical. In this paper, five different pre-trained models will be tested on the Lung X-ray Image Dataset. SqueezeNet, VGG11, ResNet18, DenseNet, and MobileNetV2 achieved accuracies of 0.64, 0.85, 0.87, 0.88, and 0.885, respectively. MobileNetV2, as the best-performing pre-trained model, will then be further analyzed as the base model. Eventually, our own model, MobileNet-Lung based on MobileNetV2, with fine-tuning and an additional layer of attention within feature layers, was invented to tackle the lung disease classification task and achieved an accuracy of 0.933. This result is significantly improved compared with all five pre-trained models.
Due to domain shift, deep learning image classifiers perform poorly when applied to a domain different from the training one. For instance, a classifier trained on chest X-ray (CXR) images from one hospital may not generalize to images from another hospital due to variations in scanner settings or patient characteristics. In this paper, we introduce our CROCODILE framework, showing how tools from causality can foster a model's robustness to domain shift via feature disentanglement, contrastive learning losses, and the injection of prior knowledge. This way, the model relies less on spurious correlations, learns the mechanism bringing from images to prediction better, and outperforms baselines on out-of-distribution (OOD) data. We apply our method to multi-label lung disease classification from CXRs, utilizing over 750000 images from four datasets. Our bias-mitigation method improves domain generalization and fairness, broadening the applicability and reliability of deep learning models for a safer medical image analysis. Find our code at: https://github.com/gianlucarloni/crocodile.
This paper is the first to present a novel, non-contact method that utilizes orthogonal frequency division multiplexing (OFDM) signals (of frequency 5.23 GHz, emitted by a software defined radio) to radio-expose the pulmonary patients in order to differentiate between five prevalent respiratory diseases, i.e., Asthma, Chronic obstructive pulmonary disease (COPD), Interstitial lung disease (ILD), Pneumonia (PN), and Tuberculosis (TB). The fact that each pulmonary disease leads to a distinct breathing pattern, and thus modulates the OFDM signal in a different way, motivates us to acquire OFDM-Breathe dataset, first of its kind. It consists of 13,920 seconds of raw RF data (at 64 distinct OFDM frequencies) that we have acquired from a total of 116 subjects in a hospital setting (25 healthy control subjects, and 91 pulmonary patients). Among the 91 patients, 25 have Asthma, 25 have COPD, 25 have TB, 5 have ILD, and 11 have PN. We implement a number of machine and deep learning models in order to do lung disease classification using OFDM-Breathe dataset. The vanilla convolutional neural network outperforms all the models with an accuracy of 97%, and stands out in terms of precision, recall, and F1-score. The ablation study reveals that it is sufficient to radio-observe the human chest on seven different microwave frequencies only, in order to make a reliable diagnosis (with 96% accuracy) of the underlying lung disease. This corresponds to a sensing overhead that is merely 10.93% of the allocated bandwidth. This points to the feasibility of 6G integrated sensing and communication (ISAC) systems of future where 89.07% of bandwidth still remains available for information exchange amidst on-demand health sensing. Through 6G ISAC, this work provides a tool for mass screening for respiratory diseases (e.g., COVID-19) at public places.
Lung diseases remain a critical global health concern, and it's crucial to have accurate and quick ways to diagnose them. This work focuses on classifying different lung diseases into five groups: viral pneumonia, bacterial pneumonia, COVID, tuberculosis, and normal lungs. Employing advanced deep learning techniques, we explore a diverse range of models including CNN, hybrid models, ensembles, transformers, and Big Transfer. The research encompasses comprehensive methodologies such as hyperparameter tuning, stratified k-fold cross-validation, and transfer learning with fine-tuning.Remarkably, our findings reveal that the Xception model, fine-tuned through 5-fold cross-validation, achieves the highest accuracy of 96.21\%. This success shows that our methods work well in accurately identifying different lung diseases. The exploration of explainable artificial intelligence (XAI) methodologies further enhances our understanding of the decision-making processes employed by these models, contributing to increased trust in their clinical applications.
In recent years, advancements in deep learning techniques have considerably enhanced the efficiency and accuracy of medical diagnostics. In this work, a novel approach using multi-task learning (MTL) for the simultaneous classification of lung sounds and lung diseases is proposed. Our proposed model leverages MTL with four different deep learning models such as 2D CNN, ResNet50, MobileNet and Densenet to extract relevant features from the lung sound recordings. The ICBHI 2017 Respiratory Sound Database was employed in the current study. The MTL for MobileNet model performed better than the other models considered, with an accuracy of74\% for lung sound analysis and 91\% for lung diseases classification. Results of the experimentation demonstrate the efficacy of our approach in classifying both lung sounds and lung diseases concurrently. In this study,using the demographic data of the patients from the database, risk level computation for Chronic Obstructive Pulmonary Disease is also carried out. For this computation, three machine learning algorithms namely Logistic Regression, SVM and Random Forest classifierswere employed. Among these ML algorithms, the Random Forest classifier had the highest accuracy of 92\%.This work helps in considerably reducing the physician's burden of not just diagnosing the pathology but also effectively communicating to the patient about the possible causes or outcomes.
Interstitial lung diseases (ILD) present diagnostic challenges due to their varied manifestations and overlapping imaging features. To address this, we propose a machine learning approach that utilizes CLIP, a multimodal (image and text) self-supervised model, for ILD classification. We extensively integrate zero-shot CLIP throughout our workflow, starting from the initial extraction of image patches from volumetric CT scans and proceeding to ILD classification using "patch montages". Furthermore, we investigate how domain adaptive pretraining (DAPT) CLIP with task-specific images (CT "patch montages" extracted with ILD-specific prompts for CLIP) and/or text (lung-specific sections of radiology reports) affects downstream ILD classification performance. By leveraging CLIP-extracted "patch montages" and DAPT, we achieve strong zero-shot ILD classification results, including an AUROC of 0.893, without the need for any labeled training data. This work highlights the versatility and potential of multimodal models like CLIP for medical image classification tasks where labeled data is scarce.
Purpose: To investigate chest radiograph (CXR) classification performance of vision transformers (ViT) and interpretability of attention-based saliency using the example of pneumothorax classification. Materials and Methods: In this retrospective study, ViTs were fine-tuned for lung disease classification using four public data sets: CheXpert, Chest X-Ray 14, MIMIC CXR, and VinBigData. Saliency maps were generated using transformer multimodal explainability and gradient-weighted class activation mapping (GradCAM). Classification performance was evaluated on the Chest X-Ray 14, VinBigData, and SIIM-ACR data sets using the area under the receiver operating characteristic curve analysis (AUC) and compared with convolutional neural networks (CNNs). The explainability methods were evaluated with positive/negative perturbation, sensitivity-n, effective heat ratio, intra-architecture repeatability and interarchitecture reproducibility. In the user study, three radiologists classified 160 CXRs with/without saliency maps for pneumothorax and rated their usefulness. Results: ViTs had comparable CXR classification AUCs compared with state-of-the-art CNNs 0.95 (95% CI: 0.943, 0.950) versus 0.83 (95%, CI 0.826, 0.842) on Chest X-Ray 14, 0.84 (95% CI: 0.769, 0.912) versus 0.83 (95% CI: 0.760, 0.895) on VinBigData, and 0.85 (95% CI: 0.847, 0.861) versus 0.87 (95% CI: 0.868, 0.882) on SIIM ACR. Both saliency map methods unveiled a strong bias toward pneumothorax tubes in the models. Radiologists found 47% of the attention-based saliency maps useful and 39% of GradCAM. The attention-based methods outperformed GradCAM on all metrics. Conclusion: ViTs performed similarly to CNNs in CXR classification, and their attention-based saliency maps were more useful to radiologists and outperformed GradCAM.
Suppression of thoracic bone shadows on chest X-rays (CXRs) has been indicated to improve the diagnosis of pulmonary disease. Previous approaches can be categorized as unsupervised physical and supervised deep learning models. Nevertheless, with physical models able to preserve morphological details but at the cost of extremely long processing time, existing DL methods face challenges of gathering sufficient/qualitative ground truth (GT) for robust training, thus leading to failure in maintaining clinically acceptable false positive rates. We hereby propose a generalizable yet efficient workflow of two stages: (1) training pairs generation with GT bone shadows eliminated in by a physical model in spatially transformed gradient fields. (2) fully supervised image denoising network training on stage-one datasets for fast rib removal on incoming CXRs. For step two, we designed a densely connected network called SADXNet, combined with peak signal to noise ratio and multi-scale structure similarity index measure objective minimization to suppress bony structures. The SADXNet organizes spatial filters in U shape (e.g., X=7; filters = 16, 64, 256, 512, 256, 64, 16) and preserves the feature map dimension throughout the network flow. Visually, SADXNet can suppress the rib edge and that near the lung wall/vertebra without jeopardizing the vessel/abnormality conspicuity. Quantitively, it achieves RMSE of ~0 during testing with one prediction taking <1s. Downstream tasks including lung nodule detection as well as common lung disease classification and localization are used to evaluate our proposed rib suppression mechanism. We observed 3.23% and 6.62% area under the curve (AUC) increase as well as 203 and 385 absolute false positive decrease for lung nodule detection and common lung disease localization, separately.
Masked Autoencoder (MAE) has recently been shown to be effective in pre-training Vision Transformers (ViT) for natural image analysis. By reconstructing full images from partially masked inputs, a ViT encoder aggregates contextual information to infer masked image regions. We believe that this context aggregation ability is particularly essential to the medical image domain where each anatomical structure is functionally and mechanically connected to other structures and regions. Because there is no ImageNet-scale medical image dataset for pre-training, we investigate a self pre-training paradigm with MAE for medical image analysis tasks. Our method pre-trains a ViT on the training set of the target data instead of another dataset. Thus, self pre-training can benefit more scenarios where pre-training data is hard to acquire. Our experimental results show that MAE self pre-training markedly improves diverse medical image tasks including chest X-ray disease classification, abdominal CT multi-organ segmentation, and MRI brain tumor segmentation. Code is available at https://github.com/cvlab-stonybrook/SelfMedMAE
Clinical evidence has shown that rib-suppressed chest X-rays (CXRs) can improve the reliability of pulmonary disease diagnosis. However, previous approaches on generating rib-suppressed CXR face challenges in preserving details and eliminating rib residues. We hereby propose a GAN-based disentanglement learning framework called Rib Suppression GAN, or RSGAN, to perform rib suppression by utilizing the anatomical knowledge embedded in unpaired computed tomography (CT) images. In this approach, we employ a residual map to characterize the intensity difference between CXR and the corresponding rib-suppressed result. To predict the residual map in CXR domain, we disentangle the image into structure- and contrast-specific features and transfer the rib structural priors from digitally reconstructed radiographs (DRRs) computed by CT. Furthermore, we employ additional adaptive loss to suppress rib residue and preserve more details. We conduct extensive experiments based on 1,673 CT volumes, and four benchmarking CXR datasets, totaling over 120K images, to demonstrate that (i) our proposed RSGAN achieves superior image quality compared to the state-of-the-art rib suppression methods; (ii) combining CXR with our rib-suppressed result leads to better performance in lung disease classification and tuberculosis area detection.
In supervised learning for medical image analysis, sample selection methodologies are fundamental to attain optimum system performance promptly and with minimal expert interactions (e.g. label querying in an active learning setup). In this paper we propose a novel sample selection methodology based on deep features leveraging information contained in interpretability saliency maps. In the absence of ground truth labels for informative samples, we use a novel self supervised learning based approach for training a classifier that learns to identify the most informative sample in a given batch of images. We demonstrate the benefits of the proposed approach, termed Interpretability-Driven Sample Selection (IDEAL), in an active learning setup aimed at lung disease classification and histopathology image segmentation. We analyze three different approaches to determine sample informativeness from interpretability saliency maps: (i) an observational model stemming from findings on previous uncertainty-based sample selection approaches, (ii) a radiomics-based model, and (iii) a novel data-driven self-supervised approach. We compare IDEAL to other baselines using the publicly available NIH chest X-ray dataset for lung disease classification, and a public histopathology segmentation dataset (GLaS), demonstrating the potential of using interpretability information for sample selection in active learning systems. Results show our proposed self supervised approach outperforms other approaches in selecting informative samples leading to state of the art performance with fewer samples.
Prediction of respiratory diseases such as COPD(Chronic obstructive pulmonary disease), URTI(upper respiratory tract infection), Bronchiectasis, Pneumonia, Bronchiolitis with the help of deep neural networks or deep learning. We have constructed a deep neural network model that takes in respiratory sound as input and classifies the condition of its respiratory system. It not only classifies among the above-mentioned disease but also classifies if a person’s respiratory system is healthy or not with higher accuracy and precision.
Large, labeled datasets have driven deep learning methods to achieve expert-level performance on a variety of medical imaging tasks. We present CheXpert, a large dataset that contains 224,316 chest radiographs of 65,240 patients. We design a labeler to automatically detect the presence of 14 observations in radiology reports, capturing uncertainties inherent in radiograph interpretation. We investigate different approaches to using the uncertainty labels for training convolutional neural networks that output the probability of these observations given the available frontal and lateral radiographs. On a validation set of 200 chest radiographic studies which were manually annotated by 3 board-certified radiologists, we find that different uncertainty approaches are useful for different pathologies. We then evaluate our best model on a test set composed of 500 chest radiographic studies annotated by a consensus of 5 board-certified radiologists, and compare the performance of our model to that of 3 additional radiologists in the detection of 5 selected pathologies. On Cardiomegaly, Edema, and Pleural Effusion, the model ROC and PR curves lie above all 3 radiologist operating points. We release the dataset to the public as a standard benchmark to evaluate performance of chest radiograph interpretation models. The dataset is freely available at https://stanfordmlgroup.github.io/competitions/chexpert .
Transfer learning is a machine learning technique designed to improve generalization performance by using pre-trained parameters obtained from other learning tasks. For image recognition tasks, many previous studies have reported that, when transfer learning is applied to deep neural networks, performance improves, despite having limited training data. This paper proposes a two-stage feature transfer learning method focusing on the recognition of textural medical images. During the proposed method, a model is successively trained with massive amounts of natural images, some textural images, and the target images. We applied this method to the classification task of textural X-ray computed tomography images of diffuse lung diseases. In our experiment, the two-stage feature transfer achieves the best performance compared to a from-scratch learning and a conventional single-stage feature transfer. We also investigated the robustness of the target dataset, based on size. Two-stage feature transfer shows better robustness than the other two learning methods. Moreover, we analyzed the feature representations obtained from DLDs imagery inputs for each feature transfer models using a visualization method. We showed that the two-stage feature transfer obtains both edge and textural features of DLDs, which does not occur in conventional single-stage feature transfer models.
Chest X-ray is one of the most accessible medical imaging technique for diagnosis of multiple diseases. With the availability of ChestX-ray14, which is a massive dataset of chest X-ray images and provides annotations for 14 thoracic diseases; it is possible to train Deep Convolutional Neural Networks (DCNN) to build Computer Aided Diagnosis (CAD) systems. In this work, we experiment a set of deep learning models and present a cascaded deep neural network that can diagnose all 14 pathologies better than the baseline and is competitive with other published methods. Our work provides the quantitative results to answer following research questions for the dataset: 1) What loss functions to use for training DCNN from scratch on ChestX-ray14 dataset that demonstrates high class imbalance and label co occurrence? 2) How to use cascading to model label dependency and to improve accuracy of the deep learning model?