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A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Machine Learning and Artificial Intelligence in Diagnostics".

Deadline for manuscript submissions: closed (31 October 2021) | Viewed by 23837

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Prof. Dr. Cesar A. Moran

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Guest Editor

University of Texas MD Anderson Cancer Center, Houston, TX, USA
Interests: thoracic pathology (lung, pleura, and mediastinum)
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Precision medicine, more specifically artificial intelligence (AI) in the diagnosis and treatment of pulmonary diseases has evolved in important ways. The developments in thoracic imaging, thoracic pathology, and thoracic oncology are meaningful components that play a role in bringing those modalities to the bedside. Digital radiology as well as digital pathology are becoming portable specialties that, combined with advance oncological algorithms, can be used for the betterment of patients afflicted by the different thoracic diseases. Such technological advancements should not be limited to neoplastic diseases but should also include other non-neoplastic processes in which such technology is applicable. In our current practice, the team approach to disease seems to have a better impact on the clinical outcomes of patients; therefore, it is highly important that these technologies, as they advance, become part of the armamentaria of tools that all clinicians need to be familiar with, and possibly by having this team approach, the different aspects of our individual specialties will also expand.

Diagnostics is dedicating one Special Issue to the role of AI in pulmonary diseases, knowing of the technological advancement that is taking place. The goal is to bring such advancements to all individuals involved in the care of patients afflicted by the gamut of pulmonary diseases. It is our hope that you will contribute to this Special Issue whether in pathology, radiology, oncology, or pulmonary medicine.

Prof. Cesar A. Moran
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (7 papers)

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Research

14 pages, 3142 KiB

Open AccessArticle

Machine Learning Approaches for Predicting Acute Respiratory Failure, Ventilator Dependence, and Mortality in Chronic Obstructive Pulmonary Disease

by Kuang-Ming Liao, Chung-Feng Liu, Chia-Jung Chen and Yu-Ting Shen

Diagnostics 2021, 11(12), 2396; https://doi.org/10.3390/diagnostics11122396 - 20 Dec 2021

Cited by 8 | Viewed by 2782

Abstract

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of mortality and contributes to high morbidity worldwide. Patients with COPD have a higher risk for acute respiratory failure, ventilator dependence, and mortality after hospitalization compared with the general population. Accurate and early risk detection will provide more information for early management and better decision making. This study aimed to build prediction models using patients’ characteristics, laboratory data, and comorbidities for early detection of acute respiratory failure, ventilator dependence, and mortality in patients with COPD after hospitalization. We retrospectively collected the electronic medical records of 5061 patients with COPD in three hospitals of the Chi Mei Medical Group, Taiwan. After data cleaning, we built three prediction models for acute respiratory failure, ventilator dependence, and mortality using seven machine learning algorithms. Based on the AUC value, the best model for mortality was built by the XGBoost algorithm (AUC = 0.817), the best model for acute respiratory failure was built by random forest algorithm (AUC = 0.804), while the best model for ventilator dependence was built by LightGBM algorithm (AUC = 0.809). A web service application was implemented with the best models and integrated into the existing hospital information system for physician’s trials and evaluations. Our machine learning models exhibit excellent predictive quality and can therefore provide physicians with a useful decision-making reference for the adverse prognosis of COPD patients. Full article

(This article belongs to the Special Issue Artificial Intelligence in Lung Diseases)

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11 pages, 2133 KiB

Open AccessArticle

Evaluation of a Novel Content-Based Image Retrieval System for the Differentiation of Interstitial Lung Diseases in CT Examinations

by Tobias Pogarell, Nadine Bayerl, Matthias Wetzl, Jan-Peter Roth, Christoph Speier, Alexander Cavallaro, Michael Uder and Peter Dankerl

Diagnostics 2021, 11(11), 2114; https://doi.org/10.3390/diagnostics11112114 - 15 Nov 2021

Cited by 4 | Viewed by 1922

Abstract

To evaluate the reader’s diagnostic performance against the ground truth with and without the help of a novel content-based image retrieval system (CBIR) that retrieves images with similar CT patterns from a database of 79 different interstitial lung diseases. We evaluated three novice readers’ and three resident physicians‘ (with at least three years of experience) diagnostic performance evaluating 50 different CTs featuring 10 different patterns (e.g., honeycombing, tree-in bud, ground glass, bronchiectasis, etc.) and 24 different diseases (sarcoidosis, UIP, NSIP, Aspergillosis, COVID-19 pneumonia etc.). The participants read the cases first without assistance (and without feedback regarding correctness), and with a 2-month interval in a random order with the assistance of the novel CBIR. To invoke the CBIR, a ROI is placed into the pathologic pattern by the reader and the system retrieves diseases with similar patterns. To further narrow the differential diagnosis, the readers can consult an integrated textbook and have the possibility of selecting high-level semantic features representing clinical information (chronic, infectious, smoking status, etc.). We analyzed readers’ accuracy without and with CBIR assistance and further tested the hypothesis that the CBIR would help to improve diagnostic performance utilizing Wilcoxon signed rank test. The novice readers demonstrated an unassisted accuracy of 18/28/44%, and an assisted accuracy of 84/82/90%, respectively. The resident physicians demonstrated an unassisted accuracy of 56/56/70%, and an assisted accuracy of 94/90/96%, respectively. For each reader, as well as overall, Sign test demonstrated statistically significant (p < 0.01) difference between the unassisted and the assisted reads. For students and physicians, Chi²-test and Mann-Whitney-U test demonstrated statistically significant (p < 0.01) difference for unassisted reads and statistically insignificant (p > 0.01) difference for assisted reads. The evaluated CBIR relying on pattern analysis and featuring the option to filter the results of the CBIR by predominant characteristics of the diseases via selecting high-level semantic features helped to drastically improve novices’ and resident physicians’ accuracy in diagnosing interstitial lung diseases in CT. Full article

(This article belongs to the Special Issue Artificial Intelligence in Lung Diseases)

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12 pages, 3417 KiB

Open AccessArticle

Automated Radiology Alert System for Pneumothorax Detection on Chest Radiographs Improves Efficiency and Diagnostic Performance

by Cheng-Yi Kao, Chiao-Yun Lin, Cheng-Chen Chao, Han-Sheng Huang, Hsing-Yu Lee, Chia-Ming Chang, Kang Sung, Ting-Rong Chen, Po-Chang Chiang, Li-Ting Huang, Bow Wang, Yi-Sheng Liu, Jung-Hsien Chiang, Chien-Kuo Wang and Yi-Shan Tsai

Diagnostics 2021, 11(7), 1182; https://doi.org/10.3390/diagnostics11071182 - 29 Jun 2021

Cited by 7 | Viewed by 3097

Abstract

We aimed to set up an Automated Radiology Alert System (ARAS) for the detection of pneumothorax in chest radiographs by a deep learning model, and to compare its efficiency and diagnostic performance with the existing Manual Radiology Alert System (MRAS) at the tertiary medical center. This study retrospectively collected 1235 chest radiographs with pneumothorax labeling from 2013 to 2019, and 337 chest radiographs with negative findings in 2019 were separated into training and validation datasets for the deep learning model of ARAS. The efficiency before and after using the model was compared in terms of alert time and report time. During parallel running of the two systems from September to October 2020, chest radiographs prospectively acquired in the emergency department with age more than 6 years served as the testing dataset for comparison of diagnostic performance. The efficiency was improved after using the model, with mean alert time improving from 8.45 min to 0.69 min and the mean report time from 2.81 days to 1.59 days. The comparison of the diagnostic performance of both systems using 3739 chest radiographs acquired during parallel running showed that the ARAS was better than the MRAS as assessed in terms of sensitivity (recall), area under receiver operating characteristic curve, and F1 score (0.837 vs. 0.256, 0.914 vs. 0.628, and 0.754 vs. 0.407, respectively), but worse in terms of positive predictive value (PPV) (precision) (0.686 vs. 1.000). This study had successfully designed a deep learning model for pneumothorax detection on chest radiographs and set up an ARAS with improved efficiency and overall diagnostic performance. Full article

(This article belongs to the Special Issue Artificial Intelligence in Lung Diseases)

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9 pages, 902 KiB

Open AccessArticle

A Comparative Evaluation of Computed Tomography Images for the Classification of Spirometric Severity of the Chronic Obstructive Pulmonary Disease with Deep Learning

by Hiroyuki Sugimori, Kaoruko Shimizu, Hironi Makita, Masaru Suzuki and Satoshi Konno

Diagnostics 2021, 11(6), 929; https://doi.org/10.3390/diagnostics11060929 - 21 May 2021

Cited by 8 | Viewed by 2294

Abstract

Recently, deep learning applications in medical imaging have been widely applied. However, whether it is sufficient to simply input the entire image or whether it is necessary to preprocess the setting of the supervised image has not been sufficiently studied. This study aimed to create a classifier trained with and without preprocessing for the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification using CT images and to evaluate the classification accuracy of the GOLD classification by confusion matrix. According to former GOLD 0, GOLD 1, GOLD 2, and GOLD 3 or 4, eighty patients were divided into four groups (n = 20). The classification models were created by the transfer learning of the ResNet50 network architecture. The created models were evaluated by confusion matrix and AUC. Moreover, the rearranged confusion matrix for former stages 0 and ≥1 was evaluated by the same procedure. The AUCs of original and threshold images for the four-class analysis were 0.61 ± 0.13 and 0.64 ± 0.10, respectively, and the AUCs for the two classifications of former GOLD 0 and GOLD ≥ 1 were 0.64 ± 0.06 and 0.68 ± 0.12, respectively. In the two-class classification by threshold image, recall and precision were over 0.8 in GOLD ≥ 1, and in the McNemar–Bowker test, there was some symmetry. The results suggest that the preprocessed threshold image can be possibly used as a screening tool for GOLD classification without pulmonary function tests, rather than inputting the normal image into the convolutional neural network (CNN) for CT image learning. Full article

(This article belongs to the Special Issue Artificial Intelligence in Lung Diseases)

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12 pages, 3321 KiB

Open AccessArticle

Efficiently Classifying Lung Sounds through Depthwise Separable CNN Models with Fused STFT and MFCC Features

by Shing-Yun Jung, Chia-Hung Liao, Yu-Sheng Wu, Shyan-Ming Yuan and Chuen-Tsai Sun

Diagnostics 2021, 11(4), 732; https://doi.org/10.3390/diagnostics11040732 - 20 Apr 2021

Cited by 42 | Viewed by 3894

Abstract

Lung sounds remain vital in clinical diagnosis as they reveal associations with pulmonary pathologies. With COVID-19 spreading across the world, it has become more pressing for medical professionals to better leverage artificial intelligence for faster and more accurate lung auscultation. This research aims to propose a feature engineering process that extracts the dedicated features for the depthwise separable convolution neural network (DS-CNN) to classify lung sounds accurately and efficiently. We extracted a total of three features for the shrunk DS-CNN model: the short-time Fourier-transformed (STFT) feature, the Mel-frequency cepstrum coefficient (MFCC) feature, and the fused features of these two. We observed that while DS-CNN models trained on either the STFT or the MFCC feature achieved an accuracy of 82.27% and 73.02%, respectively, fusing both features led to a higher accuracy of 85.74%. In addition, our method achieved 16 times higher inference speed on an edge device and only 0.45% less accuracy than RespireNet. This finding indicates that the fusion of the STFT and MFCC features and DS-CNN would be a model design for lightweight edge devices to achieve accurate AI-aided detection of lung diseases. Full article

(This article belongs to the Special Issue Artificial Intelligence in Lung Diseases)

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10 pages, 940 KiB

Open AccessArticle

Comparison and Fusion of Machine Learning Algorithms for Prospective Validation of PET/CT Radiomic Features Prognostic Value in Stage II-III Non-Small Cell Lung Cancer

by Shima Sepehri, Olena Tankyevych, Taman Upadhaya, Dimitris Visvikis, Mathieu Hatt and Catherine Cheze Le Rest

Diagnostics 2021, 11(4), 675; https://doi.org/10.3390/diagnostics11040675 - 09 Apr 2021

Cited by 18 | Viewed by 4770

Abstract

Machine learning (ML) algorithms for selecting and combining radiomic features into multiparametric prediction models have become popular; however, it has been shown that large variations in performance can be obtained by relying on different approaches. The purpose of this study was to evaluate the potential benefit of combining different algorithms into an improved consensus for the final prediction, as it has been shown in other fields. Methods: The evaluation was carried out in the context of the use of radiomics from ¹⁸F-FDG PET/CT images for predicting outcome in stage II-III Non-Small Cell Lung Cancer. A cohort of 138 patients was exploited for the present analysis. Eighty-seven patients had been previously recruited retrospectively for another study and were used here for training and internal validation. We also used data from prospectively recruited patients (n = 51) for testing. Three different machine learning pipelines relying on embedded feature selection were trained to predict overall survival (OS) as a binary classification: Support Vector machines (SVMs), Random Forests (RFs), and Logistic Regression (LR). Two different clinical endpoints were investigated: median OS or OS shorter than 6 months. The fusion of the three approaches was implemented using two different strategies: majority voting on the binary outputs or averaging of the output probabilities. Results: Our results confirm previous findings, highlighting that different ML pipelines select different sets of features and reach different classification performances (accuracy in the testing set ranging between 63% and 67% for median OS, and between 75% and 80% for OS < 6 months). Generating a consensus improved the performance for both endpoints; with the probabilities averaging strategy outperforming the majority voting (accuracy of 78% vs. 71% for median OS and 89 vs. 84% for OS < 6 months). Overall, the performance of these radiomic-based models outperformed the standard clinical staging in both endpoints (accuracy of 58% and 53% accuracy in the testing set for each endpoint). Conclusion: Although obtained in a small cohort of patients, our results suggest that a consensus of machine learning algorithms can improve performance in the context of radiomics. The resulting prognostic stratification in the prospective testing cohort is higher than when relying on the clinical stage. This could be of interest for clinical practice as it could help to identify patients with higher risk amongst stage II and III patients, who could benefit from intensified treatment and/or more frequent follow-up after treatment. Full article

(This article belongs to the Special Issue Artificial Intelligence in Lung Diseases)

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12 pages, 1200 KiB

Open AccessArticle

Value of Shape and Texture Features from ¹⁸F-FDG PET/CT to Discriminate between Benign and Malignant Solitary Pulmonary Nodules: An Experimental Evaluation

by Barbara Palumbo, Francesco Bianconi, Isabella Palumbo, Mario Luca Fravolini, Matteo Minestrini, Susanna Nuvoli, Maria Lina Stazza, Maria Rondini and Angela Spanu

Diagnostics 2020, 10(9), 696; https://doi.org/10.3390/diagnostics10090696 - 15 Sep 2020

Cited by 30 | Viewed by 3132

Abstract

In this paper, we investigate the role of shape and texture features from

^{18}

F-FDG PET/CT to discriminate between benign and malignant solitary pulmonary nodules. To this end, we retrospectively evaluated cross-sectional data from 111 patients (64 males, 47 females, age = 67.5 [...] Read more.

In this paper, we investigate the role of shape and texture features from

^{18}

n = 39

) or malignant (

n = 72

) solitary pulmonary nodules. Eighteen three-dimensional imaging features, including conventional, texture, and shape features from PET and CT were tested for significant differences (Wilcoxon-Mann-Withney) between the benign and malignant groups. Prediction models based on different feature sets and three classification strategies (Classification Tree, k-Nearest Neighbours, and Naïve Bayes) were also evaluated to assess the potential benefit of shape and texture features compared with conventional imaging features alone. Eight features from CT and 15 from PET were significantly different between the benign and malignant groups. Adding shape and texture features increased the performance of both the CT-based and PET-based prediction models with overall accuracy gain being 3.4–11.2 pp and 2.2–10.2 pp, respectively. In conclusion, we found that shape and texture features from

^{18}

F-FDG PET/CT can lead to a better discrimination between benign and malignant lung nodules by increasing the accuracy of the prediction models by an appreciable margin. Full article

(This article belongs to the Special Issue Artificial Intelligence in Lung Diseases)

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