A deep-learning-based framework for identifying and localizing multiple abnormalities and assessing cardiomegaly in chest X-ray.


Journal

Nature communications
ISSN: 2041-1723
Titre abrégé: Nat Commun
Pays: England
ID NLM: 101528555

Informations de publication

Date de publication:
14 Feb 2024
Historique:
received: 19 09 2022
accepted: 30 01 2024
medline: 15 2 2024
pubmed: 15 2 2024
entrez: 14 2 2024
Statut: epublish

Résumé

Accurate identification and localization of multiple abnormalities are crucial steps in the interpretation of chest X-rays (CXRs); however, the lack of a large CXR dataset with bounding boxes severely constrains accurate localization research based on deep learning. We created a large CXR dataset named CXR-AL14, containing 165,988 CXRs and 253,844 bounding boxes. On the basis of this dataset, a deep-learning-based framework was developed to identify and localize 14 common abnormalities and calculate the cardiothoracic ratio (CTR) simultaneously. The mean average precision values obtained by the model for 14 abnormalities reached 0.572-0.631 with an intersection-over-union threshold of 0.5, and the intraclass correlation coefficient of the CTR algorithm exceeded 0.95 on the held-out, multicentre and prospective test datasets. This framework shows an excellent performance, good generalization ability and strong clinical applicability, which is superior to senior radiologists and suitable for routine clinical settings.

Identifiants

pubmed: 38355644
doi: 10.1038/s41467-024-45599-z
pii: 10.1038/s41467-024-45599-z
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1347

Informations de copyright

© 2024. The Author(s).

Références

Wang, H. et al. Triple attention learning for classification of 14 thoracic diseases using chest radiography. Med Image Anal. 67, 101846 (2021).
doi: 10.1016/j.media.2020.101846 pubmed: 33129145
Nam, J. G. et al. Development and validation of a deep learning algorithm detecting 10 common abnormalities on chest radiographs. Eur. Respir. J. 57, 2003016 (2021).
doi: 10.1183/13993003.03061-2020
Shazia, A., Lai, K. W., Chuah, J. H., Shoaib, M. A. & Chao, O. Z. An Overview of Deep Learning Approaches in Chest Radiograph. IEEE Access 8, 182347–182354 (2020).
doi: 10.1109/ACCESS.2020.3028390
Dunnmon, J. A. et al. Assessment of Convolutional Neural Networks for Automated Classification of Chest Radiographs. Radiology 290, 537–544 (2019).
doi: 10.1148/radiol.2018181422 pubmed: 30422093
Sim, Y. et al. Deep Convolutional Neural Network-based Software Improves Radiologist Detection of Malignant Lung Nodules on Chest Radiographs. Radiology 294, 199–209 (2020).
doi: 10.1148/radiol.2019182465 pubmed: 31714194
Kim, Y. G. et al. Optimal matrix size of chest radiographs for computer-aided detection on lung nodule or mass with deep learning. Eur. Radio. 30, 4943–4951 (2020).
doi: 10.1007/s00330-020-06892-9
Hwang, E. J. et al. Development and Validation of a Deep Learning-based Automatic Detection Algorithm for Active Pulmonary Tuberculosis on Chest Radiographs. Clin. Infect. Dis. 69, 739–747 (2019).
doi: 10.1093/cid/ciy967 pubmed: 30418527
Taylor, A. G., Mielke, C. & Mongan, J. Automated detection of moderate and large pneumothorax on frontal chest X-rays using deep convolutional neural networks: A retrospective study. PLoS Med 15, e1002697 (2018).
doi: 10.1371/journal.pmed.1002697 pubmed: 30457991 pmcid: 6245672
Zech, J. R. et al. Variable generalization performance of a deep learning model to detect pneumonia in chest radiographs: A cross-sectional study. PLoS Med 15, e1002683 (2018).
doi: 10.1371/journal.pmed.1002683 pubmed: 30399157 pmcid: 6219764
Wang, H., Jia, H., Lu, L. & Xia, Y. Thorax-Net: An Attention Regularized Deep Neural Network for Classification of Thoracic Diseases on Chest Radiography. IEEE J. Biomed. Health Inf. 24, 475–485 (2020).
doi: 10.1109/JBHI.2019.2928369
Rajpurkar, P. et al. Deep learning for chest radiograph diagnosis: A retrospective comparison of the CheXNeXt algorithm to practicing radiologists. PLoS Med 15, e1002686 (2018).
doi: 10.1371/journal.pmed.1002686 pubmed: 30457988 pmcid: 6245676
Hwang, E. J. et al. Deep Learning for Chest Radiograph Diagnosis in the Emergency Department. Radiology 293, 573–580 (2019).
doi: 10.1148/radiol.2019191225 pubmed: 31638490
Wang, G. et al. A deep-learning pipeline for the diagnosis and discrimination of viral, non-viral and COVID-19 pneumonia from chest X-ray images. Nat. Biomed. Eng. 5, 509–521 (2021).
doi: 10.1038/s41551-021-00704-1 pubmed: 33859385 pmcid: 7611049
Zhe, L. et al. Thoracic Disease Identification and Localization with Limited Supervision. in 2018 IEEE/CVF Conference on Computer Vision and Pattern Recognition 8290-8299 (2018).
Cho, Y., Kim, Y. G., Lee, S. M., Seo, J. B. & Kim, N. Reproducibility of abnormality detection on chest radiographs using convolutional neural network in paired radiographs obtained within a short-term interval. Sci. Rep. 10, 17417 (2020).
doi: 10.1038/s41598-020-74626-4 pubmed: 33060837 pmcid: 7567088
Nguyen, H. Q. et al. VinDr-CXR: An open dataset of chest X-rays with radiologist’s annotations. Sci. Data 9, 429 (2022).
doi: 10.1038/s41597-022-01498-w pubmed: 35858929 pmcid: 9300612
Lin, C., Zheng, Y., Xiao, X. & Lin, J. CXR-RefineDet: Single-Shot Refinement Neural Network for Chest X-Ray Radiograph Based on Multiple Lesions Detection. J. Health. Eng. 2022, 4182191 (2022).
doi: 10.1155/2022/4182191
Nguyen, N.H. et al. Deployment and validation of an AI system for detecting abnormal chest radiographs in clinical settings. Front. digit. health 4, 890759 (2022).
Pouraliakbar, H. Chapter 6—Chest Radiography in Cardiovascular Disease. in Practical Cardiology (Second Edition) (eds. Maleki, M., Alizadehasl, A. & Haghjoo, M.) 111-129 (Elsevier, 2022).
Rajaraman, S., Sornapudi, S., Alderson, P. O., Folio, L. R. & Antani, S. K. Analyzing inter-reader variability affecting deep ensemble learning for COVID-19 detection in chest radiographs. PLoS One 15, e0242301 (2020).
doi: 10.1371/journal.pone.0242301 pubmed: 33180877 pmcid: 7660555
Wang, X. et al. ChestX-Ray8: Hospital-Scale Chest X-Ray Database and Benchmarks on Weakly-Supervised Classification and Localization of Common Thorax Diseases. in 2017 IEEE Conference on Computer Vision and Pattern Recognition (CVPR) 3462-3471 (2017).
Johnson, A. E. W. et al. MIMIC-CXR, a de-identified publicly available database of chest radiographs with free-text reports. Sci. Data 6, 317 (2019).
doi: 10.1038/s41597-019-0322-0 pubmed: 31831740 pmcid: 6908718
Bustos, A., Pertusa, A., Salinas, J. M. & de la Iglesia-Vayá, M. PadChest: A large chest x-ray image dataset with multi-label annotated reports. Med Image Anal. 66, 101797 (2020).
doi: 10.1016/j.media.2020.101797 pubmed: 32877839
Irvin, J. et al. CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison. Proc. AAAI Conf. Artif. Intell. 33, 590–597 (2019).
Guo, Y. et al. Deep learning with weak annotation from diagnosis reports for detection of multiple head disorders: a prospective, multicentre study. Lancet Digit Health 4, e584–e593 (2022).
doi: 10.1016/S2589-7500(22)00090-5 pubmed: 35725824
Çallı, E., Sogancioglu, E., van Ginneken, B., van Leeuwen, K. G. & Murphy, K. Deep learning for chest X-ray analysis: A survey. Med Image Anal. 72, 102125 (2021).
doi: 10.1016/j.media.2021.102125 pubmed: 34171622
Zhou, L. et al. Detection and Semiquantitative Analysis of Cardiomegaly, Pneumothorax, and Pleural Effusion on Chest Radiographs. Radio. Artif. Intell. 3, e200172 (2021).
doi: 10.1148/ryai.2021200172
Nam, J. G. et al. Automatic prediction of left cardiac chamber enlargement from chest radiographs using convolutional neural network. Eur. Radiol. 31, 8130–8140 (2021).
doi: 10.1007/s00330-021-07963-1 pubmed: 33942138
Liang, W. et al. Advances, challenges and opportunities in creating data for trustworthy AI. Nat. Mach. Intell. 4, 669–677 (2022).
doi: 10.1038/s42256-022-00516-1
Greenwald, N. F. et al. Whole-cell segmentation of tissue images with human-level performance using large-scale data annotation and deep learning. Nat. Biotechnol. 40, 555–565 (2022).
doi: 10.1038/s41587-021-01094-0 pubmed: 34795433
Maloca, P. M. et al. Validation of automated artificial intelligence segmentation of optical coherence tomography images. PLoS One 14, e0220063 (2019).
doi: 10.1371/journal.pone.0220063 pubmed: 31419240 pmcid: 6697318
Ge, Z., Liu, S., Wang, F., Li, Z. & Sun, J. YOLOX: Exceeding YOLO Series in 2021. Vol. published online Aug 6 https://doi.org/10.48550/arXiv.42107.08430 (preprint) (arXiv, 2021).
Ren, S., He, K., Girshick, R. & Sun, J. Faster R-CNN: Towards Real-Time Object Detection with Region Proposal Networks. IEEE Trans. Pattern Anal. Mach. Intell. 39, 1137–1149 (2017).
doi: 10.1109/TPAMI.2016.2577031 pubmed: 27295650
Lin, T. Y., Goyal, P., Girshick, R., He, K. & Dollar, P. Focal Loss for Dense Object Detection. IEEE Trans. Pattern Anal. Mach. Intell. 42, 318–327 (2020).
doi: 10.1109/TPAMI.2018.2858826 pubmed: 30040631
Oktay, O. et al. Attention U-Net: Learning Where to Look for the Pancreas. Vol. published online May 20 https://doi.org/10.48550/arXiv.41804.03999 (preprint) (arXiv, 2018).

Auteurs

Weijie Fan (W)

Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China.

Yi Yang (Y)

Department of Digital Medicine, School of Biomedical Engineering and Imaging Medicine, Army Medical University, Chongqing, 400038, P. R. China.

Jing Qi (J)

Department of Digital Medicine, School of Biomedical Engineering and Imaging Medicine, Army Medical University, Chongqing, 400038, P. R. China.

Qichuan Zhang (Q)

Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China.

Cuiwei Liao (C)

Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China.

Li Wen (L)

Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China.

Shuang Wang (S)

Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China.

Guangxian Wang (G)

Department of Radiology, People's Hospital of Banan, Chongqing Medical University, Chongqing, 401320, P. R. China.

Yu Xia (Y)

Department of Radiology, Xishui hospital of Traditional Chinese Medicine, Zunyi of Guizhou province, 564600, P. R. China.

Qihua Wu (Q)

Department of Radiology, People's Hospital of Nanchuan, Chongqing, 408400, P. R. China.

Xiaotao Fan (X)

Department of Radiology, Fengdu People's Hospital, Chongqing, 408200, P. R. China.

Xingcai Chen (X)

Department of Digital Medicine, School of Biomedical Engineering and Imaging Medicine, Army Medical University, Chongqing, 400038, P. R. China.

Mi He (M)

Department of Digital Medicine, School of Biomedical Engineering and Imaging Medicine, Army Medical University, Chongqing, 400038, P. R. China.

JingJing Xiao (J)

Department of Medical Engineering, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China.

Liu Yang (L)

Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China.

Yun Liu (Y)

Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China.

Jia Chen (J)

Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China.

Bing Wang (B)

Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China.

Lei Zhang (L)

Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China.

Liuqing Yang (L)

Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China.

Hui Gan (H)

Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China.

Shushu Zhang (S)

Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China.

Guofang Liu (G)

Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China.

Xiaodong Ge (X)

Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China.

Yuanqing Cai (Y)

Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China.

Gang Zhao (G)

Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China.

Xi Zhang (X)

Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China.

Mingxun Xie (M)

Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China.

Huilin Xu (H)

Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China.

Yi Zhang (Y)

Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China.

Jiao Chen (J)

Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China.

Jun Li (J)

Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China.

Shuang Han (S)

Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China.

Ke Mu (K)

Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China.

Shilin Xiao (S)

Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China.

Tingwei Xiong (T)

Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China.

Yongjian Nian (Y)

Department of Digital Medicine, School of Biomedical Engineering and Imaging Medicine, Army Medical University, Chongqing, 400038, P. R. China. yjnian@tmmu.edu.cn.

Dong Zhang (D)

Department of Radiology, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China. hszhangd@tmmu.edu.cn.

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