CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison

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 .Comment: Published in AAAI 201

High-Throughput Classification of Radiographs Using Deep Convolutional Neural Networks.

The study aimed to determine if computer vision techniques rooted in deep learning can use a small set of radiographs to perform clinically relevant image classification with high fidelity. One thousand eight hundred eighty-five chest radiographs on 909 patients obtained between January 2013 and July 2015 at our institution were retrieved and anonymized. The source images were manually annotated as frontal or lateral and randomly divided into training, validation, and test sets. Training and validation sets were augmented to over 150,000 images using standard image manipulations. We then pre-trained a series of deep convolutional networks based on the open-source GoogLeNet with various transformations of the open-source ImageNet (non-radiology) images. These trained networks were then fine-tuned using the original and augmented radiology images. The model with highest validation accuracy was applied to our institutional test set and a publicly available set. Accuracy was assessed by using the Youden Index to set a binary cutoff for frontal or lateral classification. This retrospective study was IRB approved prior to initiation. A network pre-trained on 1.2 million greyscale ImageNet images and fine-tuned on augmented radiographs was chosen. The binary classification method correctly classified 100 % (95 % CI 99.73-100 %) of both our test set and the publicly available images. Classification was rapid, at 38 images per second. A deep convolutional neural network created using non-radiological images, and an augmented set of radiographs is effective in highly accurate classification of chest radiograph view type and is a feasible, rapid method for high-throughput annotation

Benchmarking Deep Learning Models for Tooth Structure Segmentation.

A wide range of deep learning (DL) architectures with varying depths are available, with developers usually choosing one or a few of them for their specific task in a nonsystematic way. Benchmarking (i.e., the systematic comparison of state-of-the art architectures on a specific task) may provide guidance in the model development process and may allow developers to make better decisions. However, comprehensive benchmarking has not been performed in dentistry yet. We aimed to benchmark a range of architecture designs for 1 specific, exemplary case: tooth structure segmentation on dental bitewing radiographs. We built 72 models for tooth structure (enamel, dentin, pulp, fillings, crowns) segmentation by combining 6 different DL network architectures (U-Net, U-Net++, Feature Pyramid Networks, LinkNet, Pyramid Scene Parsing Network, Mask Attention Network) with 12 encoders from 3 different encoder families (ResNet, VGG, DenseNet) of varying depth (e.g., VGG13, VGG16, VGG19). On each model design, 3 initialization strategies (ImageNet, CheXpert, random initialization) were applied, resulting overall into 216 trained models, which were trained up to 200 epochs with the Adam optimizer (learning rate = 0.0001) and a batch size of 32. Our data set consisted of 1,625 human-annotated dental bitewing radiographs. We used a 5-fold cross-validation scheme and quantified model performances primarily by the F1-score. Initialization with ImageNet or CheXpert weights significantly outperformed random initialization (P < 0.05). Deeper and more complex models did not necessarily perform better than less complex alternatives. VGG-based models were more robust across model configurations, while more complex models (e.g., from the ResNet family) achieved peak performances. In conclusion, initializing models with pretrained weights may be recommended when training models for dental radiographic analysis. Less complex model architectures may be competitive alternatives if computational resources and training time are restricting factors. Models developed and found superior on nondental data sets may not show this behavior for dental domain-specific tasks

A Survey on Deep Learning in Medical Image Analysis

Deep learning algorithms, in particular convolutional networks, have rapidly become a methodology of choice for analyzing medical images. This paper reviews the major deep learning concepts pertinent to medical image analysis and summarizes over 300 contributions to the field, most of which appeared in the last year. We survey the use of deep learning for image classification, object detection, segmentation, registration, and other tasks and provide concise overviews of studies per application area. Open challenges and directions for future research are discussed.Comment: Revised survey includes expanded discussion section and reworked introductory section on common deep architectures. Added missed papers from before Feb 1st 201

Multiclass classification for chest x-ray images based on lesion location in lung zones

Innovation in radiology technology has generated numerous kinds of medical images like the chest X-ray (CXR).This image is used to find common problem in lung like the lesion through scanning process in lung area which is divided into six zones.By classifying the CXR images with common feature like the lesion location, we can ensure efficient image retrieval.Recently, Support Vector Machine (SVM) has turn out to be a well-known method for image classification.While many previous studies have reported the achievement of SVM in classifying images, yet there is still problem with this technique for multiclass classification.Since SVM is a binary classification technique, its ability is limited to classifying features between two classes at one time. Therefore, it is difficult to classify CXR images which contain many image features.Realizing the problem, we proposed an application method for multiclass classification with SVM to the CXR images based on the lesion position in the lung zones.The multiclass classification application is executed on the CXR images taken from Japan Society of Radiology Technology dataset.Lesion coordinates were selected as the classification input while the lung zones becomes the labels. The multiclass classification is performed with RBF kernel and the classification accuracy is tested to attain the classifiers performance.Overall, it can be concluded that the percentage of the classification accuracy is high with the highest accuracy percentage recorded at 98.7% while the lowest was 94.8%.Meanwhile, the average classification accuracy was recorded at 96.9%. The result obtained revealed that the SVM classifiers generated have successfully classified the lesion location correctly according to the lung zones

A multi-stage GAN for multi-organ chest X-ray image generation and segmentation

Multi-organ segmentation of X-ray images is of fundamental importance for computer aided diagnosis systems. However, the most advanced semantic segmentation methods rely on deep learning and require a huge amount of labeled images, which are rarely available due to both the high cost of human resources and the time required for labeling. In this paper, we present a novel multi-stage generation algorithm based on Generative Adversarial Networks (GANs) that can produce synthetic images along with their semantic labels and can be used for data augmentation. The main feature of the method is that, unlike other approaches, generation occurs in several stages, which simplifies the procedure and allows it to be used on very small datasets. The method has been evaluated on the segmentation of chest radiographic images, showing promising results. The multistage approach achieves state-of-the-art and, when very few images are used to train the GANs, outperforms the corresponding single-stage approach

Towards long-tailed, multi-label disease classification from chest X-ray: Overview of the CXR-LT challenge

Many real-world image recognition problems, such as diagnostic medical imaging exams, are "long-tailed" \unicode{x2013} there are a few common findings followed by many more relatively rare conditions. In chest radiography, diagnosis is both a long-tailed and multi-label problem, as patients often present with multiple findings simultaneously. While researchers have begun to study the problem of long-tailed learning in medical image recognition, few have studied the interaction of label imbalance and label co-occurrence posed by long-tailed, multi-label disease classification. To engage with the research community on this emerging topic, we conducted an open challenge, CXR-LT, on long-tailed, multi-label thorax disease classification from chest X-rays (CXRs). We publicly release a large-scale benchmark dataset of over 350,000 CXRs, each labeled with at least one of 26 clinical findings following a long-tailed distribution. We synthesize common themes of top-performing solutions, providing practical recommendations for long-tailed, multi-label medical image classification. Finally, we use these insights to propose a path forward involving vision-language foundation models for few- and zero-shot disease classification