Evaluating progress in automatic chest X-ray radiology report generation
Ontology highlight
ABSTRACT:
SUBMITTER: Yu F
PROVIDER: S-EPMC10499844 | biostudies-literature | 2023 Aug
REPOSITORIES: biostudies-literature
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Project description: Not available
| S-EPMC10534271 | biostudies-literature
Project description:Due to its widespread availability, low cost, feasibility at the patient's bedside and accessibility even in low-resource settings, chest X-ray is one of the most requested examinations in radiology departments. Whilst it provides essential information on thoracic pathology, it can be difficult to interpret and is prone to diagnostic errors, particularly in the emergency setting. The increasing availability of large chest X-ray datasets has allowed the development of reliable Artificial Intelligence (AI) tools to help radiologists in everyday clinical practice. AI integration into the diagnostic workflow would benefit patients, radiologists, and healthcare systems in terms of improved and standardized reporting accuracy, quicker diagnosis, more efficient management, and appropriateness of the therapy. This review article aims to provide an overview of the applications of AI for chest X-rays in the emergency setting, emphasizing the detection and evaluation of pneumothorax, pneumonia, heart failure, and pleural effusion.
| S-EPMC9858224 | biostudies-literature
Project description:High quality radiology reporting of chest X-ray images is of core importance for high-quality patient diagnosis and care. Automatically generated reports can assist radiologists by reducing their workload and even may prevent errors. Machine Learning (ML) models for this task take an X-ray image as input and output a sequence of words. In this work, we show that ML models for this task based on the popular encoder-decoder approach, like 'Show, Attend and Tell' (SA&T) have similar or worse performance than models that do not use the input image, called unconditioned baseline. An unconditioned model achieved diagnostic accuracy of 0.91 on the IU chest X-ray dataset, and significantly outperformed SA&T (0.877) and other popular ML models (p-value < 0.001). This unconditioned model also outperformed SA&T and similar ML methods on the BLEU-4 and METEOR metrics. Also, an unconditioned version of SA&T obtained by permuting the reports generated from images of the test set, achieved diagnostic accuracy of 0.862, comparable to that of SA&T (p-value ≥ 0.05).
| S-EPMC8629217 | biostudies-literature
Project description:Fast and accurate diagnosis is critical for the triage and management of pneumonia, particularly in the current scenario of a COVID-19 pandemic, where this pathology is a major symptom of the infection. With the objective of providing tools for that purpose, this study assesses the potential of three textural image characterisation methods: radiomics, fractal dimension and the recently developed superpixel-based histon, as biomarkers to be used for training Artificial Intelligence (AI) models in order to detect pneumonia in chest X-ray images. Models generated from three different AI algorithms have been studied: K-Nearest Neighbors, Support Vector Machine and Random Forest. Two open-access image datasets were used in this study. In the first one, a dataset composed of paediatric chest X-ray, the best performing generated models achieved an 83.3% accuracy with 89% sensitivity for radiomics, 89.9% accuracy with 93.6% sensitivity for fractal dimension and 91.3% accuracy with 90.5% sensitivity for superpixels based histon. Second, a dataset derived from an image repository developed primarily as a tool for studying COVID-19 was used. For this dataset, the best performing generated models resulted in a 95.3% accuracy with 99.2% sensitivity for radiomics, 99% accuracy with 100% sensitivity for fractal dimension and 99% accuracy with 98.6% sensitivity for superpixel-based histons. The results confirm the validity of the tested methods as reliable and easy-to-implement automatic diagnostic tools for pneumonia.
| S-EPMC8966154 | biostudies-literature
Project description:The field of radiology imaging has experienced a remarkable increase in using of deep learning (DL) algorithms to support diagnostic and treatment decisions. This rise has led to the development of Explainable AI (XAI) system to improve the transparency and trust of complex DL methods. However, XAI systems face challenges in gaining acceptance within the healthcare sector, mainly due to technical hurdles in utilizing these systems in practice and the lack of human-centered evaluation/validation. In this study, we focus on visual XAI systems applied to DL-enabled diagnostic system in chest radiography. In particular, we conduct a user study to evaluate two prominent visual XAI techniques from the human perspective. To this end, we created two clinical scenarios for diagnosing pneumonia and COVID-19 using DL techniques applied to chest X-ray and CT scans. The achieved accuracy rates were 90% for pneumonia and 98% for COVID-19. Subsequently, we employed two well-known XAI methods, Grad-CAM (Gradient-weighted Class Activation Mapping) and LIME (Local Interpretable Model-agnostic Explanations), to generate visual explanations elucidating the AI decision-making process. The visual explainability results were shared through a user study, undergoing evaluation by medical professionals in terms of clinical relevance, coherency, and user trust. In general, participants expressed a positive perception of the use of XAI systems in chest radiography. However, there was a noticeable lack of awareness regarding their value and practical aspects. Regarding preferences, Grad-CAM showed superior performance over LIME in terms of coherency and trust, although concerns were raised about its clinical usability. Our findings highlight key user-driven explainability requirements, emphasizing the importance of multi-modal explainability and the necessity to increase awareness of XAI systems among medical practitioners. Inclusive design was also identified as a crucial need to ensure better alignment of these systems with user needs.
| S-EPMC11463756 | biostudies-literature
Project description:The automated generation of radiology reports provides X-rays and has tremendous potential to enhance the clinical diagnosis of diseases in patients. A new research direction is gaining increasing attention that involves the use of hybrid approaches based on natural language processing and computer vision techniques to create auto medical report generation systems. The auto report generator, producing radiology reports, will significantly reduce the burden on doctors and assist them in writing manual reports. Because the sensitivity of chest X-ray (CXR) findings provided by existing techniques not adequately accurate, producing comprehensive explanations for medical photographs remains a difficult task. A novel approach to address this issue was proposed, based on the continuous integration of convolutional neural networks and long short-term memory for detecting diseases, followed by the attention mechanism for sequence generation based on these diseases. Experimental results obtained by using the Indiana University CXR and MIMIC-CXR datasets showed that the proposed model attained the current state-of-the-art efficiency as opposed to other solutions of the baseline. BLEU-1, BLEU-2, BLEU-3, and BLEU-4 were used as the evaluation metrics.
| S-EPMC8736265 | biostudies-literature
Project description:PurposeThe development of a robust model for automatic identification of COVID-19 based on chest x-rays has been a widely addressed topic over the last couple of years; however, the scarcity of good quality images sets, and their limited size, have proven to be an important obstacle to obtain reliable models. In fact, models proposed so far have suffered from over-fitting erroneous features instead of learning lung features, a phenomenon known as shortcut learning. In this research, a new image classification methodology is proposed that attempts to mitigate this problem.MethodsTo this end, annotation by expert radiologists of a set of images was performed. The lung region was then segmented and a new classification strategy based on a patch partitioning that improves the resolution of the convolution neural network is proposed. In addition, a set of native images, used as an external evaluation set, is released.ResultsThe best results were obtained for the 6-patch splitting variant with 0.887 accuracy, 0.85 recall and 0.848 F1score on the external validation set.ConclusionThe results show that the proposed new strategy maintains similar values between internal and external validation, which gives our model generalization power, making it available for use in hospital settings.Supplementary informationThe online version contains supplementary material available at 10.1007/s12553-022-00704-4.
| S-EPMC9647770 | biostudies-literature
Project description:The lethal novel coronavirus disease 2019 (COVID-19) pandemic is affecting the health of the global population severely, and a huge number of people may have to be screened in the future. There is a need for effective and reliable systems that perform automatic detection and mass screening of COVID-19 as a quick alternative diagnostic option to control its spread. A robust deep learning-based system is proposed to detect the COVID-19 using chest X-ray images. Infected patient's chest X-ray images reveal numerous opacities (denser, confluent, and more profuse) in comparison to healthy lungs images which are used by a deep learning algorithm to generate a model to facilitate an accurate diagnostics for multi-class classification (COVID vs. normal vs. bacterial pneumonia vs. viral pneumonia) and binary classification (COVID-19 vs. non-COVID). COVID-19 positive images have been used for training and model performance assessment from several hospitals of India and also from countries like Australia, Belgium, Canada, China, Egypt, Germany, Iran, Israel, Italy, Korea, Spain, Taiwan, USA, and Vietnam. The data were divided into training, validation and test sets. The average test accuracy of 97.11 ± 2.71% was achieved for multi-class (COVID vs. normal vs. pneumonia) and 99.81% for binary classification (COVID-19 vs. non-COVID). The proposed model performs rapid disease detection in 0.137 s per image in a system equipped with a GPU and can reduce the workload of radiologists by classifying thousands of images on a single click to generate a probabilistic report in real-time.
| S-EPMC7837255 | biostudies-literature
Project description:Automated radiology report generation has the potential to improve patient care and reduce the workload of radiologists. However, the path toward real-world adoption has been stymied by the challenge of evaluating the clinical quality of artificial intelligence (AI)-generated reports. We build a state-of-the-art report generation system for chest radiographs, called Flamingo-CXR, and perform an expert evaluation of AI-generated reports by engaging a panel of board-certified radiologists. We observe a wide distribution of preferences across the panel and across clinical settings, with 56.1% of Flamingo-CXR intensive care reports evaluated to be preferable or equivalent to clinician reports, by half or more of the panel, rising to 77.7% for in/outpatient X-rays overall and to 94% for the subset of cases with no pertinent abnormal findings. Errors were observed in human-written reports and Flamingo-CXR reports, with 24.8% of in/outpatient cases containing clinically significant errors in both report types, 22.8% in Flamingo-CXR reports only and 14.0% in human reports only. For reports that contain errors we develop an assistive setting, a demonstration of clinician-AI collaboration for radiology report composition, indicating new possibilities for potential clinical utility.
| S-EPMC11835717 | biostudies-literature
Project description:ObjectivesArtificial intelligence (AI)-based applications for augmenting radiological education are underexplored. Prior studies have demonstrated the effectiveness of simulation in radiological perception training. This study aimed to develop and make available a pure web-based application called Perception Trainer for perception training in lung nodule detection in chest X-rays.MethodsBased on open-access data, we trained a deep-learning model for lung segmentation in chest X-rays. Subsequently, an algorithm for artificial lung nodule generation was implemented and combined with the segmentation model to allow on-the-fly procedural insertion of lung nodules in chest X-rays. This functionality was integrated into an existing zero-footprint web-based DICOM viewer, and a dynamic HTML page was created to specify case generation parameters.ResultsThe result is an easily accessible platform-agnostic web application available at: https://castlemountain.dk/mulrecon/perceptionTrainer.html.The application allows the user to specify the characteristics of lung nodules to be inserted into chest X-rays, and it produces automated feedback regarding nodule detection performance. Generated cases can be shared through a uniform resource locator.ConclusionWe anticipate that the description and availability of our developed solution with open-sourced codes may help facilitate radiological education and stimulate the development of similar AI-augmented educational tools.Advances in knowledgeA web-based application applying AI-based techniques for radiological perception training was developed. The application demonstrates a novel approach for on-the-fly generation of cases in chest X-ray lung nodule detection employing deep-learning-based segmentation and lung nodule simulation.
| S-EPMC10646630 | biostudies-literature