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Publications

Publications by Alexandre Henrique Neto

2022

Literature Review on Artificial Intelligence Methods for Glaucoma Screening, Segmentation, and Classification

Authors
Camara, J; Neto, A; Pires, IM; Villasana, MV; Zdravevski, E; Cunha, A;

Publication
JOURNAL OF IMAGING

Abstract
Artificial intelligence techniques are now being applied in different medical solutions ranging from disease screening to activity recognition and computer-aided diagnosis. The combination of computer science methods and medical knowledge facilitates and improves the accuracy of the different processes and tools. Inspired by these advances, this paper performs a literature review focused on state-of-the-art glaucoma screening, segmentation, and classification based on images of the papilla and excavation using deep learning techniques. These techniques have been shown to have high sensitivity and specificity in glaucoma screening based on papilla and excavation images. The automatic segmentation of the contours of the optic disc and the excavation then allows the identification and assessment of the glaucomatous disease's progression. As a result, we verified whether deep learning techniques may be helpful in performing accurate and low-cost measurements related to glaucoma, which may promote patient empowerment and help medical doctors better monitor patients.

2022

Evaluations of Deep Learning Approaches for Glaucoma Screening Using Retinal Images from Mobile Device

Authors
Neto, A; Camara, J; Cunha, A;

Publication
SENSORS

Abstract
Glaucoma is a silent disease that leads to vision loss or irreversible blindness. Current deep learning methods can help glaucoma screening by extending it to larger populations using retinal images. Low-cost lenses attached to mobile devices can increase the frequency of screening and alert patients earlier for a more thorough evaluation. This work explored and compared the performance of classification and segmentation methods for glaucoma screening with retinal images acquired by both retinography and mobile devices. The goal was to verify the results of these methods and see if similar results could be achieved using images captured by mobile devices. The used classification methods were the Xception, ResNet152 V2 and the Inception ResNet V2 models. The models' activation maps were produced and analysed to support glaucoma classifier predictions. In clinical practice, glaucoma assessment is commonly based on the cup-to-disc ratio (CDR) criterion, a frequent indicator used by specialists. For this reason, additionally, the U-Net architecture was used with the Inception ResNet V2 and Inception V3 models as the backbone to segment and estimate CDR. For both tasks, the performance of the models reached close to that of state-of-the-art methods, and the classification method applied to a low-quality private dataset illustrates the advantage of using cheaper lenses.

2022

Artificial Intelligence for Upper Gastrointestinal Endoscopy: A Roadmap from Technology Development to Clinical Practice

Authors
Renna, F; Martins, M; Neto, A; Cunha, A; Libanio, D; Dinis-Ribeiro, M; Coimbra, M;

Publication
DIAGNOSTICS

Abstract
Stomach cancer is the third deadliest type of cancer in the world (0.86 million deaths in 2017). In 2035, a 20% increase will be observed both in incidence and mortality due to demographic effects if no interventions are foreseen. Upper GI endoscopy (UGIE) plays a paramount role in early diagnosis and, therefore, improved survival rates. On the other hand, human and technical factors can contribute to misdiagnosis while performing UGIE. In this scenario, artificial intelligence (AI) has recently shown its potential in compensating for the pitfalls of UGIE, by leveraging deep learning architectures able to efficiently recognize endoscopic patterns from UGIE video data. This work presents a review of the current state-of-the-art algorithms in the application of AI to gastroscopy. It focuses specifically on the threefold tasks of assuring exam completeness (i.e., detecting the presence of blind spots) and assisting in the detection and characterization of clinical findings, both gastric precancerous conditions and neoplastic lesion changes. Early and promising results have already been obtained using well-known deep learning architectures for computer vision, but many algorithmic challenges remain in achieving the vision of AI-assisted UGIE. Future challenges in the roadmap for the effective integration of AI tools within the UGIE clinical practice are discussed, namely the adoption of more robust deep learning architectures and methods able to embed domain knowledge into image/video classifiers as well as the availability of large, annotated datasets.

2023

Colonoscopic Polyp Detection with Deep Learning Assist

Authors
Neto, A; Couto, D; Coimbra, MT; Cunha, A;

Publication
Proceedings of the 18th International Joint Conference on Computer Vision, Imaging and Computer Graphics Theory and Applications, VISIGRAPP 2023, Volume 4: VISAPP, Lisbon, Portugal, February 19-21, 2023.

Abstract
Colorectal cancer is the third most common cancer and the second cause of cancer-related deaths in the world. Colonoscopic surveillance is extremely important to find cancer precursors such as adenomas or serrated polyps. Identifying small or flat polyps can be challenging during colonoscopy and highly dependent on the colonoscopist's skills. Deep learning algorithms can enable improvement of polyp detection rate and consequently assist to reduce physician subjectiveness and operation errors. This study aims to compare YOLO object detection architecture with self-attention models. In this study, the Kvasir-SEG polyp dataset, composed of 1000 colonoscopy annotated still images, were used to train (700 images) and validate (300images) the performance of polyp detection algorithms. Well-defined architectures such as YOLOv4 and different YOLOv5 models were compared with more recent algorithms that rely on self-attention mechanisms, namely the DETR model, to understand which technique can be more helpful and reliable in clinical practice. In the end, the YOLOv5 proved to be the model achieving better results for polyp detection with 0.81 mAP, however, the DETR had 0.80 mAP proving to have the potential of reaching similar performances when compared to more well-established architectures. © 2023 by SCITEPRESS - Science and Technology Publications, Lda.

2022

Preliminary Study of Deep Learning Algorithms for Metaplasia Detection in Upper Gastrointestinal Endoscopy

Authors
Neto, A; Ferreira, S; Libânio, D; Ribeiro, MD; Coimbra, MT; Cunha, A;

Publication
Wireless Mobile Communication and Healthcare - 11th EAI International Conference, MobiHealth 2022, Virtual Event, November 30 - December 2, 2022, Proceedings

Abstract
Precancerous conditions such as intestinal metaplasia (IM) have a key role in gastric cancer development and can be detected during endoscopy. During upper gastrointestinal endoscopy (UGIE), misdiagnosis can occur due to technical and human factors or by the nature of the lesions, leading to a wrong diagnosis which can result in no surveillance/treatment and impairing the prevention of gastric cancer. Deep learning systems show great potential in detecting precancerous gastric conditions and lesions by using endoscopic images and thus improving and aiding physicians in this task, resulting in higher detection rates and fewer operation errors. This study aims to develop deep learning algorithms capable of detecting IM in UGIE images with a focus on model explainability and interpretability. In this work, white light and narrow-band imaging UGIE images collected in the Portuguese Institute of Oncology of Porto were used to train deep learning models for IM classification. Standard models such as ResNet50, VGG16 and InceptionV3 were compared to more recent algorithms that rely on attention mechanisms, namely the Vision Transformer (ViT), trained in 818 UGIE images (409 normal and 409 IM). All the models were trained using a 5-fold cross-validation technique and for validation, an external dataset will be tested with 100 UGIE images (50 normal and 50 IM). In the end, explainability methods (Grad-CAM and attention rollout) were used for more clear and more interpretable results. The model which performed better was ResNet50 with a sensitivity of 0.75 (±0.05), an accuracy of 0.79 (±0.01), and a specificity of 0.82 (±0.04). This model obtained an AUC of 0.83 (±0.01), where the standard deviation was 0.01, which means that all iterations of the 5-fold cross-validation have a more significant agreement in classifying the samples than the other models. The ViT model showed promising performance, reaching similar results compared to the remaining models. © 2023, ICST Institute for Computer Sciences, Social Informatics and Telecommunications Engineering.

2023

Gastric cancer detection based on Colorectal Cancer transfer learning

Authors
Nobrega, S; Neto, A; Coimbra, M; Cunha, A;

Publication
2023 IEEE 7TH PORTUGUESE MEETING ON BIOENGINEERING, ENBENG

Abstract
Gastric Cancer (GC) and Colorectal Cancer (CRC) are some of the most common cancers in the world. The most common diagnostic methods are upper endoscopy and biopsy. Possible expert distractions can lead to late diagnosis. GC is a less studied malignancy than CRC, leading to scarce public data that difficult the use of AI detection methods, unlike CRC where public data are available. Considering that CRC endoscopic images present some similarities with GC, a CRC Transfer Learning approach could be used to improve AI GC detectors. This paper evaluates a novel Transfer Learning approach for real-time GC detection, using a YOLOv4 model pre-trained on CRC detection. The results achieved are promising since GC detection improved relatively to the traditional Transfer Learning strategy.

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