Common pitfalls and recommendations for using machine learning to detect and prognosticate for COVID-19 using chest radiographs and CT scans

Abstract: Machine learning methods offer great promise for fast and accurate detection and prognostication of coronavirus disease 2019 (COVID-19) from standard-of-care chest radiographs (CXR) and chest computed tomography (CT) images. Many articles have been published in 2020 describing new machine learning-based models for both of these tasks, but it is unclear which are of potential clinical utility. In this systematic review, we consider all published papers and preprints, for the period from 1 January 2020 to 3 October 2020, which describe new machine learning models for the diagnosis or prognosis of COVID-19 from CXR or CT images. All manuscripts uploaded to bioRxiv, medRxiv and arXiv along with all entries in EMBASE and MEDLINE in this timeframe are considered. Our search identified 2,212 studies, of which 415 were included after initial screening and, after quality screening, 62 studies were included in this systematic review. Our review finds that none of the models identified are of potential clinical use due to methodological flaws and/or underlying biases. This is a major weakness, given the urgency with which validated COVID-19 models are needed. To address this, we give many recommendations which, if followed, will solve these issues and lead to higher-quality model development and well-documented manuscripts

Optimization of neural networks for deep learning and applications to CT image segmentation

[eng] During the last few years, AI development in deep learning has been going so fast that even important researchers, politicians, and entrepreneurs are signing petitions to try to slow it down. The newest methods for natural language processing and image generation are achieving results so unbelievable that people are seriously starting to think they can be dangerous for society. In reality, they are not dangerous (at the moment) even if we have to admit we reached a point where we have no more control over the flux of data inside the deep networks. It is impossible to open a modern deep neural network and interpret how it processes the information and, in many cases, explain how or why it gives back that particular result. One of the goals of this doctoral work has been to study the behavior of weights in convolutional neural networks and in transformers. We hereby present a work that demonstrates how to invert 3x3 convolutions after training a neural network able to learn how to classify images, with the future aim of having precisely invertible convolutional neural networks. We demonstrate that a simple network can learn to classify images on an open-source dataset without loss in accuracy, with respect to a non-invertible one. All that with the ability to reconstruct the original image without detectable error (on 8-bit images) in up to 20 convolutions stacked in a row. We present a thorough comparison between our method and the standard. We tested the performances of the five most used transformers for image classification on an open- source dataset. Studying the embedded matrices, we have been able to provide two criteria that can help transformers learn with a training time reduction of up to 30% and with no impact on classification accuracy. The evolution of deep learning techniques is also touching the field of digital health. With tens of thousands of new start-ups and more than 1B $ of investments only in the last year, this field is growing rapidly and promising to revolutionize healthcare. In this thesis, we present several neural networks for the segmentation of lungs, lung nodules, and areas affected by pneumonia induced by COVID-19, in chest CT scans. The architecturesm we used are all residual convolutional neural networks inspired by UNet and Inception. We customized them with novel loss functions and layers studied to achieve high performances on these particular applications. The errors on the surface of nodule segmentation masks are not over 1mm in more than 99% of the cases. Our algorithm for COVID-19 lesion detection has a specificity of 100% and overall accuracy of 97.1%. In general, it surpasses the state-of-the-art in all the considered statistics, using UNet as a benchmark. Combining these with other algorithms able to detect and predict lung cancer, the whole work was presented in a European innovation program and judged of high interest by worldwide experts. With this work, we set the basis for the future development of better AI tools in healthcare and scientific investigation into the fundamentals of deep learning.[spa] Durante los últimos años, el desarrollo de la IA en el aprendizaje profundo ha ido tan rápido que Incluso importantes investigadores, políticos y empresarios están firmando peticiones para intentar para ralentizarlo. Los métodos más nuevos para el procesamiento y la generación de imágenes y lenguaje natural, están logrando resultados tan increíbles que la gente está empezando a preocuparse seriamente. Pienso que pueden ser peligrosos para la sociedad. En realidad, no son peligrosos (al menos de momento) incluso si tenemos que admitir que llegamos a un punto en el que ya no tenemos control sobre el flujo de datos dentro de las redes profundas. Es imposible abrir una moderna red neuronal profunda e interpretar cómo procesa la información y, en muchos casos, explique cómo o por qué devuelve ese resultado en particular, uno de los objetivos de este doctorado. El trabajo ha consistido en estudiar el comportamiento de los pesos en redes neuronales convolucionales y en transformadores. Por la presente presentamos un trabajo que demuestra cómo invertir 3x3 convoluciones después de entrenar una red neuronal capaz de aprender a clasificar imágenes, con el objetivo futuro de tener redes neuronales convolucionales precisamente invertibles. Nosotros queremos demostrar que una red simple puede aprender a clasificar imágenes en un código abierto conjunto de datos sin pérdida de precisión, con respecto a uno no invertible. Todo eso con la capacidad de reconstruir la imagen original sin errores detectables (en imágenes de 8 bits) en hasta 20 convoluciones apiladas en fila. Presentamos una exhaustiva comparación entre nuestro método y el estándar. Probamos las prestaciones de los cinco transformadores más utilizados para la clasificación de imágenes en abierto. conjunto de datos de origen. Al estudiar las matrices incrustadas, hemos sido capaz de proporcionar dos criterios que pueden ayudar a los transformadores a aprender con un tiempo de capacitación reducción de hasta el 30% y sin impacto en la precisión de la clasificación. La evolución de las técnicas de aprendizaje profundo también está afectando al campo de la salud digital. Con decenas de miles de nuevas empresas y más de mil millones de dólares en inversiones sólo en el año pasado, este campo está creciendo rápidamente y promete revolucionar la atención médica. En esta tesis, presentamos varias redes neuronales para la segmentación de pulmones, nódulos pulmonares, y zonas afectadas por neumonía inducida por COVID-19, en tomografías computarizadas de tórax. La arquitectura que utilizamos son todas redes neuronales convolucionales residuales inspiradas en UNet. Las personalizamos con nuevas funciones y capas de pérdida, estudiado para lograr altos rendimientos en estas aplicaciones particulares. Los errores en la superficie de las máscaras de segmentación de los nódulos no supera 1 mm en más del 99% de los casos. Nuestro algoritmo para la detección de lesiones de COVID-19 tiene una especificidad del 100% y en general precisión del 97,1%. En general supera el estado del arte en todos los aspectos considerados, estadísticas, utilizando UNet como punto de referencia. Combinando estos con otros algoritmos capaces de detectar y predecir el cáncer de pulmón, todo el trabajo se presentó en una innovación europea programa y considerado de gran interés por expertos de todo el mundo. Con este trabajo, sentamos las bases para el futuro desarrollo de mejores herramientas de IA en Investigación sanitaria y científica sobre los fundamentos del aprendizaje profundo

Research on prognostic risk assessment model for acute ischemic stroke based on imaging and multidimensional data

Accurately assessing the prognostic outcomes of patients with acute ischemic stroke and adjusting treatment plans in a timely manner for those with poor prognosis is crucial for intervening in modifiable risk factors. However, there is still controversy regarding the correlation between imaging-based predictions of complications in acute ischemic stroke. To address this, we developed a cross-modal attention module for integrating multidimensional data, including clinical information, imaging features, treatment plans, prognosis, and complications, to achieve complementary advantages. The fused features preserve magnetic resonance imaging (MRI) characteristics while supplementing clinical relevant information, providing a more comprehensive and informative basis for clinical diagnosis and treatment. The proposed framework based on multidimensional data for activity of daily living (ADL) scoring in patients with acute ischemic stroke demonstrates higher accuracy compared to other state-of-the-art network models, and ablation experiments confirm the effectiveness of each module in the framework

Deep learning for unsupervised domain adaptation in medical imaging: Recent advancements and future perspectives

Deep learning has demonstrated remarkable performance across various tasks in medical imaging. However, these approaches primarily focus on supervised learning, assuming that the training and testing data are drawn from the same distribution. Unfortunately, this assumption may not always hold true in practice. To address these issues, unsupervised domain adaptation (UDA) techniques have been developed to transfer knowledge from a labeled domain to a related but unlabeled domain. In recent years, significant advancements have been made in UDA, resulting in a wide range of methodologies, including feature alignment, image translation, self-supervision, and disentangled representation methods, among others. In this paper, we provide a comprehensive literature review of recent deep UDA approaches in medical imaging from a technical perspective. Specifically, we categorize current UDA research in medical imaging into six groups and further divide them into finer subcategories based on the different tasks they perform. We also discuss the respective datasets used in the studies to assess the divergence between the different domains. Finally, we discuss emerging areas and provide insights and discussions on future research directions to conclude this survey.Comment: Under Revie

Systems Radiology and Personalized Medicine

Medicine has evolved into a high level of specialization using the very detailed imaging of organs. This has impressively solved a multitude of acute health-related problems linked to single-organ diseases. Many diseases and pathophysiological processes, however, involve more than one organ. An organ-based approach is challenging when considering disease prevention and caring for elderly patients, or those with systemic chronic diseases or multiple co-morbidities. In addition, medical imaging provides more than a pretty picture. Much of the data are now revealed by quantitating algorithms with or without artificial intelligence. This Special Issue on “Systems Radiology and Personalized Medicine” includes reviews and original studies that show the strengths and weaknesses of structural and functional whole-body imaging for personalized medicine