2021
Autores
Polonia, A; Campelos, S; Ribeiro, A; Aymore, I; Pinto, D; Biskup Fruzynska, M; Veiga, RS; Canas Marques, R; Aresta, G; Araujo, T; Campilho, A; Kwok, S; Aguiar, P; Eloy, C;
Publicação
AMERICAN JOURNAL OF CLINICAL PATHOLOGY
Abstract
Objectives: This study evaluated the usefulness of artificial intelligence (AI) algorithms as tools in improving the accuracy of histologic classification of breast tissue. Methods: Overall, 100 microscopic photographs (test A) and 152 regions of interest in whole-slide images (test B) of breast tissue were classified into 4 classes: normal, benign, carcinoma in situ (CIS), and invasive carcinoma. The accuracy of 4 pathologists and 3 pathology residents were evaluated without and with the assistance of algorithms. Results: In test A, algorithm A had accuracy of 0.87, with the lowest accuracy in the benign class (0.72). The observers had average accuracy of 0.80, and most clinically relevant discordances occurred in distinguishing benign from CIS (7.1% of classcations). With the assistance of algorithm A, the observers significantly increased their average accuracy to 0.88. In test B, algorithm B had accuracy of 0.49, with the lowest accuracy in the CIS class (0.06). Me observers had average accuracy of 0.86, and most clinically relevant discordances occurred in distinguishing benign from CIS (6.3% of classifications). With the assistance of algorithm B, the observers maintained their average accuracy. Conclusions: AI tools can increase the classification accuracy of pathologists in the setting of breast lesions.
2024
Autores
Pereira, SC; Mendonca, AM; Campilho, A; Sousa, P; Lopes, CT;
Publicação
ARTIFICIAL INTELLIGENCE IN MEDICINE
Abstract
Machine Learning models need large amounts of annotated data for training. In the field of medical imaging, labeled data is especially difficult to obtain because the annotations have to be performed by qualified physicians. Natural Language Processing (NLP) tools can be applied to radiology reports to extract labels for medical images automatically. Compared to manual labeling, this approach requires smaller annotation efforts and can therefore facilitate the creation of labeled medical image data sets. In this article, we summarize the literature on this topic spanning from 2013 to 2023, starting with a meta-analysis of the included articles, followed by a qualitative and quantitative systematization of the results. Overall, we found four types of studies on the extraction of labels from radiology reports: those describing systems based on symbolic NLP, statistical NLP, neural NLP, and those describing systems combining or comparing two or more of the latter. Despite the large variety of existing approaches, there is still room for further improvement. This work can contribute to the development of new techniques or the improvement of existing ones.
2024
Autores
Ferreira, ICA; Venkadesh, KV; Jacobs, C; Coimbra, M; Campilho, A;
Publicação
BIOMEDICAL SIGNAL PROCESSING AND CONTROL
Abstract
Objective: This study aims to forecast the progression of lung cancer by estimating the future diameter of lung nodules. Methods: This approach uses as input the tabular data, axial images from tomography scans, and both data types, employing a ResNet50 model for image feature extraction and direct analysis of patient information for tabular data. The data are processed through a neural network before prediction. In the training phase, class weights are assigned based on the rarity of different types of nodules within the dataset, in alignment with nodule management guidelines. Results: Tabular data alone yielded the most accurate results, with a mean absolute deviation of 0.99 mm. For malignant nodules, the best performance, marked by a deviation of 2.82 mm, was achieved using tabular data applying Lung-RADS class weights during training. The tabular data results highlight the influence of using the initial nodule size as an input feature. These results surpass the literature reference of 348-day volume doubling time for malignant nodules. Conclusion: The developed predictive model is optimized for integration into a clinical workflow after detecting, segmenting, and classifying nodules. It provides accurate growth forecasts, establishing a more objective basis for determining follow-up intervals. Significance: With lung cancer's low survival rates, the capacity for precise nodule growth prediction represents a significant breakthrough. This methodology promises to revolutionize patient care and management, enhancing the chances for early risk assessment and effective intervention.
2024
Autores
Ferreira, CA; Ramos, I; Coimbra, M; Campilho, A;
Publicação
2024 IEEE 22ND MEDITERRANEAN ELECTROTECHNICAL CONFERENCE, MELECON 2024
Abstract
Lung cancer represents a significant health concern necessitating diligent monitoring of individuals at risk. While the detection of pulmonary nodules warrants clinical attention, not all cases require immediate surgical intervention, often calling for a strategic approach to follow-up decisions. The Lung-RADS guideline serves as a cornerstone in clinical practice, furnishing structured recommendations based on various nodule characteristics, including size, calcification, and texture, outlined within established reference tables. However, the reliance on labor-intensive manual measurements underscores the potential advantages of integrating decision support systems into this process. Herein, we propose a feature-based methodology aimed at enhancing clinical decision-making by automating the assessment of nodules in computed tomography scans. Leveraging algorithms tailored for nodule calcification, texture analysis, and segmentation, our approach facilitates the automated classification of follow-up recommendations aligned with Lung-RADS criteria. Comparison with a previously reported end-to-end image-based classification method revealed competitive performance, with the feature-based approach achieving an accuracy of 0.701 +/- 0.026, while the end-to-end method attained 0.727 +/- 0.020. The inherent explainability of the feature-based approach offers distinct advantages, allowing clinicians to scrutinize and modify individual features to address disagreements or rectify inaccuracies, thereby tailoring follow-up recommendations to patient profiles.
2024
Autores
Pereira, SC; Rocha, J; Campilho, A; Mendonça, AM;
Publicação
HELIYON
Abstract
Although the classification of chest radiographs has long been an extensively researched topic, interest increased significantly with the onset of the COVID-19 pandemic. Existing results are promising; however, the radiological similarities between COVID-19 and other types of respiratory diseases limit the success of conventional image classification approaches that focus on single instances. This study proposes a novel perspective that conceptualizes COVID-19 pneumonia as a deviation from a normative distribution of typical pneumonia patterns. Using a population- based approach, our approach utilizes distributional anomaly detection. This method diverges from traditional instance-wise approaches by focusing on sets of scans instead of individual images. Using an autoencoder to extract feature representations, we present instance-based and distribution-based assessments of the separability between COVID-positive and COVIDnegative pneumonia radiographs. The results demonstrate that the proposed distribution-based methodology outperforms conventional instance-based techniques in identifying radiographic changes associated with COVID-positive cases. This underscores its potential as an early warning system capable of detecting significant distributional shifts in radiographic data. By continuously monitoring these changes, this approach offers a mechanism for early identification of emerging health trends, potentially signaling the onset of new pandemics and enabling prompt public health responses.
2023
Autores
Pereira, SC; Rochal, J; Gaudio, A; Smailagic, A; Campilhol, A; Mendonca, AM;
Publicação
MEDICAL IMAGING WITH DEEP LEARNING, VOL 227
Abstract
Deep learning-based models are widely used for disease classification in chest radiographs. This exam can be performed in one of two projections (posteroanterior or anteroposterior), depending on the direction that the X-ray beam travels through the body. Since projection visibly affects the way anatomical structures appear in the scans, it may introduce bias in classifiers, especially when spurious correlations between a given disease and a projection occur. This paper examines the influence of chest radiograph projection on the performance of deep learning-based classification models and proposes an approach to mitigate projection-induced bias. Results show that a DenseNet-121 model is better at classifying images from the most representative projection in the data set, suggesting that projection is taken into account by the classifier. Moreover, this model can classify chest X-ray projection better than any of the fourteen radiological findings considered, without being explicitly trained for that task, putting it at high risk for projection bias. We propose a label-conditional gradient reversal framework to make the model insensitive to projection, by forcing the extracted features to be simultaneously good for disease classification and bad for projection classification, resulting in a framework with reduced projection-induced bias.
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