Deep learning algorithm for breast masses classification in mammograms

To compare the diagnostic efficiencies of deep learning single-modal and multi-modal for the classification of benign and malignant breast mass lesions. We retrospectively collected data from 203 patients (207 lesions, 101 benign and 106 malignant) with breast tumors who underwent breast magnetic resonance imaging (MRI) before surgery or biopsy between January 2014 and October 2020. Mass segmentation was performed based on the three dimensions-region of interest (3D-ROI) minimum bounding cube at the edge of the lesion. We established single-modal models based on a convolutional neural network (CNN) including T2WI and non-fs T1WI, the dynamic contrast-enhanced (DCE-MRI) first phase was pre-contrast T1WI (d1), and Phases 2, 4, and 6 were post-contrast T1WI (d2, d4, d6); and Multi-modal fusion models with a Sobel operator (four_mods:T2WI, non-fs-T1WI, d1, d2). Training set (n=145), validation set (n=22), and test set (n=40). Five-fold cross validation was performed. Accuracy, sensitivity, specificity, negative predictive value, positive predictive value, and area under the ROC curve (AUC) were used as evaluation indicators. Delong's test compared the diagnostic performance of the multi-modal and single-modal models. All models showed good performance, and the AUC values were all greater than 0.750. Among the single-modal models, T2WI, non-fs-T1WI, d1, and d2 had specificities of 77.1%, 77.2%, 80.2%, and 78.2%, respectively. d2 had the highest accuracy of 78.5% and showed the best diagnostic performance with an AUC of 0.827. The multi-modal model with the Sobel operator performed better than single-modal models, with an AUC of 0.887, sensitivity of 79.8%, specificity of 86.1%, and positive prediction value of 85.6%. Delong's test showed that the diagnostic performance of the multi-modal fusion models was higher than that of the six single-modal models (T2WI, non-fs-T1WI, d1, d2, d4, d6); the difference was statistically significant (p = 0.043, 0.017, 0.006, 0.017, 0.020, 0.004, all were greater than 0.05). Multi-modal fusion deep learning models with a Sobel operator had excellent diagnostic value in the classification of breast masses, and further increase the efficiency of diagnosis.

Simultaneous detection and classification of breast masses in digital mammograms via a deep learning YOLO-based CAD system

Detection of suspicious masses in mammograms play a vital role in early diagnosis of breast cancer, to reduce the death rate among women. The presence of masses and calcification’s in mammograms is distinguishing signs for breast cancer diagnosis. But in some cases, due to contrast variation, fuzzy boundaries and presence of noise in mammograms, segmentation and detection of masses is challenging assignment. This paper presents a new segmentation approach to detect masses in mammographic images. The proposed approach consist of artifacts elimination and pectoral region extraction, suspicious mass enhancement using dual morphological operation technique and finally, extraction of Regions of Interest (ROIs) from background using scaled Reyni entropy. The proposed system has been tested on two data-sets i.e. mini- Mammographic Image Analysis Society (mini-MIAS) and Digital Database for Screening Mammography (DDSM), over 50 and 90 mammograms respectively. Performance achieved with proposed system in terms of True Positive Fraction (TPF) yields 93.2% and 93.9% respectively, at the rate of 1.48 and 0.74 average False Positive per Image (FP/I), tested on both Cranio-Caudal (CC) and Medio-Lateral Oblique (MLO) views. The obtained experimental results demonstrates that proposed method gives improved results for mass detection and can be useful for radiologists in diagnosis of breast cancer at early stage.

Breast cancer diagnosis in digitized mammograms using curvelet moments

In the field of data security, biometric security is a significant emerging concern. The multimodal biometrics system with enhanced accuracy and detection rate for smart environments is still a significant challenge. The fusion of an electrocardiogram (ECG) signal with a fingerprint is an effective multimodal recognition system. In this work, unimodal and multimodal biometric systems using Convolutional Neural Network (CNN) are conducted and compared with traditional methods using different levels of fusion of fingerprint and ECG signal. This study is concerned with the evaluation of the effectiveness of proposed parallel and sequential multimodal biometric systems with various feature extraction and classification methods. Additionally, the performance of unimodal biometrics of ECG and fingerprint utilizing deep learning and traditional classification technique is examined. The suggested biometric systems were evaluated utilizing ECG (MIT-BIH) and fingerprint (FVC2004) databases. Additional tests are conducted to examine the suggested models with:1) virtual dataset without augmentation (ODB) and 2) virtual dataset with augmentation (VDB). The findings show that the optimum performance of the parallel multimodal achieved 0.96 Area Under the ROC Curve (AUC) and sequential multimodal achieved 0.99 AUC, in comparison to unimodal biometrics which achieved 0.87 and 0.99 AUCs, for the fingerprint and ECG biometrics, respectively. The overall performance of the proposed multimodal biometrics outperformed unimodal biometrics using CNN. Moreover, the performance of the suggested CNN model for ECG signal and sequential multimodal system based on neural network outperformed other systems. Lastly, the performance of the proposed systems is compared with previously existing works.

Introduction: For every percentage increase in adenoma detection rate (ADR), risk of interval colorectal cancer is reduced by 3%. Adenoma prevalence is estimated to be 50%. Ideally, ADR should reflect adenoma prevalence, yet ADR varies between 5 and 55% among colonoscopist. We hypothesize that computer-assisted polyp identification could help bring low ADRs closer to true prevalence and reduce interval colorectal cancer incidence. Methods: Utilizing our colonoscopy quality database (Qulaoscopy, Docbot, Inc,), we applied the VGG-16 model as starting point (see [1]), which is a convolutional neural network (CNN) with 16 convolutional layers that was trained on natural images as part of the ImageNet challenge. We then “fine-tuned” this CNN on a set of 9000 screening colonoscopy images originating from all locations in the colorectum (and half of which contain polyps) to classify the presence or absence of polyps in images. The RGB images are scaled to a size of 224x224 pixels for this purpose and the CNN is trained using ten-fold crossvalidation, i.e. we repeat the training and testing ten times with different parts of the data for training/testing the model. Results: On the task of classifying polyp versus non-polyp containing images we obtain an accuracy of 96% and AUC (area under the ROC curve) of 0.99, which is an almost perfect score (the maximum attainable AUC is 1). At a processing rate of 170 images per second, the algorithm was easily applied to live video. Conclusion: Our deep learning methology achieved extremely high accuracy for polyp detection in images and is proven applicable to live video. We predict that application of this technology during colonoscopy will assist all colonoscopist to achieve ADRs that approach true adenoma prevalence.Figure: AUC (area under the ROC curve) for Polyp Detection.

In recent days Mammography is most widely used techniques to detect the Breast cancer. Masses and calcifications are the abnormalities indicate the breast cancer. . Breast cancer is the leading cause of cancer deaths in women. Advanced technologies with existing imaging modalities improve breast cancer screening. Most of the Mammographic image data sets are not easily available. The Mammographic Image Analysis Society (MIAS) and Digital Database for Screening Mammography (DDSM) are the most easily available data set for Mammographic images. MAMMSIT is another data set for the mammographic image analysis. The mammogram data set is named as MAMMSIT and it contains Normal and Malignant group images of mammography. Our proposed data set provided with appropriate annotations details such as age, background tissue, ultra sound screen position (i.e., left and right) and BIRADS level are included in the database.

The objective was to study the dynamics of B-type natriuretic peptide (BNP) and its relationship with hemodynamic parameters during on-pump coronary artery bypass grafting (CABG), and to evaluate the informativeness of the biomarker as a predictor of myocardial dysfunction.Materials and methods. The study involved 127 patients aged 59 [54–66.75] years with ischemic heart disease who underwent CABG. The BNP blood level was determined in the operating room at stages: I – before surgery (BNP1 ), II – at the end of surgery (BNP2 ). Hemodynamic parameters were analyzed at the same stages. Correlation analysis, logistic regression with the calculation of the odds ratio (OR) and 95% confidence interval (95% CI) and ROC analysis with the calculation of the area under the ROC curve (AUC) were used.Results. BNP1 blood level was 49 [25.6–91.6], BNP2 – 90 [47.8–140.2] pg/ml (p < 0.0001). BNP1 correlated with central venous pressure (CVP) at stage I (rho = 0.212; p = 0.017) and with pulmonary artery wedge pressure (PAWP) at stage II (rho = 0.204; p = 0.045). BNP2 correlated with PAWP at stage II (rho = 0.204; p = 0.045). BNP1 > 52.1 pg/ml was the predictor of ICU length of stay > 24 hours (OR 1.0290, 95% CI 1.0154– 1.0427, p < 0.0001, AUC 0.775), BNP1 > 71 pg/ml was the predictor of inotropic index > 5 c. u. (OR 1.0076, 95% CI 1.0015–1.0138, p = 0.014, AUC 0.705) and BNP1 > 90.8 pg/ml was the predictor of vasoactive inotropic index > 10 c. u. (OR 1.0070, 95% CI 1.0014–1.0126, p = 0.013, AUC 0.727). BNP2 > 67.5 pg/ml was the predictor of ICU length of stay > 24 hours (OR 1.0179, 95% CI 1.0073–1.0287, p < 0.0009, AUC 0.763), BNP2 > 94.3 pg/ml was the predictor of inotropic index > 5 c. u. (OR 1.0063, 95% CI 1.0010–1.0117, p = 0.020, AUC 0.713), BNP2 > 144 pg/ml was the predictor of intra-aortic balloon pumping (OR 1.0037, 95% CI 1 .0000–1.0074, p = 0.048, AUC 0.854), BNP2 > 159 pg/ml was the predictor of vasoactive inotropic index > 10 c. u. (OR 1.0072, 95% CI 1.0006–1.0139, p = 0.033, AUC 0.729) and BNP2 > 161 pg/ml was the predictor of early mortality in the ICU (OR 1.0040, 95% CI 1, 0000-1.0080, p = 0.049, AUC 0.845). Conclusion. In 78.7% of patients undergoing on-pump CABG, BNP blood level does not exceed the upper limit of normal; by the end of surgery, the biomarker level increases by 32.9 [17.7–62.0] pg/ml. Before and at the end of surgery, BNP values are weakly correlated with CVP and PAWP and do not correlate with other hemodynamic parameters. Before surgery, BNP blood level in the range of 52.1–90.8 pg/ml are predictors of ICU stay > 24 hours (AUC 0.775), inotropic scale > 5 (AUC 0.705) and vasoactive-inotropic scale > 10 c. u. (AUC 0.727). At the end of surgery, BNP > 67.5 pg/ml is associated with an ICU stay > 24 hours (AUC 0.763), and BNP > 90.4 pg/ml is associated with inotropic scale > 5 c. u. (AUC 0.713). The BNP, increased to 144.0–161.0 pg/ml, indicates severe myocardial dysfunction, including hemodynamic support with intra-aortic balloon pumping (AUC 0.854), vasoactive-inotropic scale > 10 c. u. (AUC 0.729) and the risk of early mortality in the ICU (AUC 0.845).

To construct and validate the best predictive model for 28-day death risk in patients with septic shock based on different supervised machine learning algorithms. The patients with septic shock meeting the Sepsis-3 criteria were selected from Medical Information Mart for Intensive Care-IV v2.0 (MIMIC-IV v2.0). According to the principle of random allocation, 70% of these patients were used as the training set, and 30% as the validation set. Relevant predictive variables were extracted from three aspects: demographic characteristics and basic vital signs, serum indicators within 24 hours of intensive care unit (ICU) admission and complications possibly affecting indicators, functional scoring and advanced life support. The predictive efficacy of models constructed using five mainstream machine learning algorithms including decision tree classification and regression tree (CART), random forest (RF), support vector machine (SVM), linear regression (LR), and super learner [SL; combined CART, RF and extreme gradient boosting (XGBoost)] for 28-day death in patients with septic shock was compared, and the best algorithm model was selected. The optimal predictive variables were determined by intersecting the results from LASSO regression, RF, and XGBoost algorithms, and a predictive model was constructed. The predictive efficacy of the model was validated by drawing receiver operator characteristic curve (ROC curve), the accuracy of the model was assessed using calibration curves, and the practicality of the model was verified through decision curve analysis (DCA). A total of 3 295 patients with septic shock were included, with 2 164 surviving and 1 131 dying within 28 days, resulting in a mortality of 34.32%. Of these, 2 307 were in the training set (with 792 deaths within 28 days, a mortality of 34.33%), and 988 in the validation set (with 339 deaths within 28 days, a mortality of 34.31%). Five machine learning models were established based on the training set data. After including variables at three aspects, the area under the ROC curve (AUC) of RF, SVM, and LR machine learning algorithm models for predicting 28-day death in septic shock patients in the validation set was 0.823 [95% confidence interval (95%CI) was 0.795-0.849], 0.823 (95%CI was 0.796-0.849), and 0.810 (95%CI was 0.782-0.838), respectively, which were higher than that of the CART algorithm model (AUC = 0.750, 95%CI was 0.717-0.782) and SL algorithm model (AUC = 0.756, 95%CI was 0.724-0.789). Thus above three algorithm models were determined to be the best algorithm models. After integrating variables from three aspects, 16 optimal predictive variables were identified through intersection by LASSO regression, RF, and XGBoost algorithms, including the highest pH value, the highest albumin (Alb), the highest body temperature, the lowest lactic acid (Lac), the highest Lac, the highest serum creatinine (SCr), the highest Ca2+, the lowest hemoglobin (Hb), the lowest white blood cell count (WBC), age, simplified acute physiology score III (SAPS III), the highest WBC, acute physiology score III (APS III), the lowest Na+, body mass index (BMI), and the shortest activated partial thromboplastin time (APTT) within 24 hours of ICU admission. ROC curve analysis showed that the Logistic regression model constructed with above 16 optimal predictive variables was the best predictive model, with an AUC of 0.806 (95%CI was 0.778-0.835) in the validation set. The calibration curve and DCA curve showed that this model had high accuracy and the highest net benefit could reach 0.3, which was significantly outperforming traditional models based on single functional score [APS III score, SAPS III score, and sequential organ failure assessment (SOFA) score] with AUC (95%CI) of 0.746 (0.715-0.778), 0.765 (0.734-0.796), and 0.625 (0.589-0.661), respectively. The Logistic regression model, constructed using 16 optimal predictive variables including pH value, Alb, body temperature, Lac, SCr, Ca2+, Hb, WBC, SAPS III score, APS III score, Na+, BMI, and APTT, is identified as the best predictive model for the 28-day death risk in patients with septic shock. Its performance is stable, with high discriminative ability and accuracy.

In secondary analysis of electronic health records, a crucial task consists in correctly identifying the patient cohort under investigation. In many cases, the most valuable and relevant information for an accurate classification of medical conditions exist only in clinical narratives. Therefore, it is necessary to use natural language processing (NLP) techniques to extract and evaluate these narratives. The most commonly used approach to this problem relies on extracting a number of clinician-defined medical concepts from text and using machine learning techniques to identify whether a particular patient has a certain condition. However, recent advances in deep learning and NLP enable models to learn a rich representation of (medical) language. Convolutional neural networks (CNN) for text classification can augment the existing techniques by leveraging the representation of language to learn which phrases in a text are relevant for a given medical condition. In this work, we compare concept extraction based methods with CNNs and other commonly used models in NLP in ten phenotyping tasks using 1,610 discharge summaries from the MIMIC-III database. We show that CNNs outperform concept extraction based methods in almost all of the tasks, with an improvement in F1-score of up to 26 and up to 7 percentage points in area under the ROC curve (AUC). We additionally assess the interpretability of both approaches by presenting and evaluating methods that calculate and extract the most salient phrases for a prediction. The results indicate that CNNs are a valid alternative to existing approaches in patient phenotyping and cohort identification, and should be further investigated. Moreover, the deep learning approach presented in this paper can be used to assist clinicians during chart review or support the extraction of billing codes from text by identifying and highlighting relevant phrases for various medical conditions.

It is estimated that 7% of women in the western world will develop palpable breast cysts in their lifetime. Even though cysts have been correlated with risk of developing breast cancer, many of them are benign and do not require follow-up. We develop a method to discriminate benign solitary cysts from malignant masses in digital mammography. We think a system like this can have merit in the clinic as a decision aid or complementary to specialized modalities. We employ a deep convolutional neural network (CNN) to classify cyst and mass patches. Deep CNNs have been shown to be powerful classifiers, but need a large amount of training data for which medical problems are often difficult to come by. The key contribution of this paper is that we show good performance can be obtained on a small dataset by pretraining the network on a large dataset of a related task. We subsequently investigate the following: (a) when a mammographic exam is performed, two different views of the same breast are recorded. We investigate the merit of combining the output of the classifier from these two views. (b) We evaluate the importance of the resolution of the patches fed to the network. (c) A method dubbed tissue augmentation is subsequently employed, where we extract normal tissue from normal patches and superimpose this onto the actual samples aiming for a classifier invariant to occluding tissue. (d) We combine the representation extracted using the deep CNN with our previously developed features. We show that using the proposed deep learning method, an area under the ROC curve (AUC) value of 0.80 can be obtained on a set of benign solitary cysts and malignant mass findings recalled in screening. We find that it works significantly better than our previously developed approach by comparing the AUC of the ROC using bootstrapping. By combining views, the results can be further improved, though this difference was not found to be significant. We find no significant difference between using a resolution of 100 versus 200 micron. The proposed tissue augmentations give a small improvement in performance, but this improvement was also not found to be significant. The final system obtained an AUC of 0.80 with 95% confidence interval [0.78, 0.83], calculated using bootstrapping. The system works best for lesions larger than 27mm where it obtains an AUC value of 0.87. We have presented a computer-aided diagnosis (CADx) method to discriminate cysts from solid lesion in mammography using features from a deep CNN trained on a large set of mass candidates, obtaining an AUC of 0.80 on a set of diagnostic exams recalled from screening. We believe the system shows great potential and comes close to the performance of recently developed spectral mammography. We think the system can be further improved when more data and computational power becomes available.

Several artificial intelligence-based models have been presented for the detection of periodontal bone loss (PBL), mostly using convolutional neural networks, which are the state of the art in deep learning. Given the emerging breakthrough of transformer networks in computer vision, we aimed to evaluate various models for automatized PBL detection. An image data set of 21,819 anonymized periapical radiographs from the upper/lower and anterior/posterior regions was assessed by calibrated dentists according to PBL. Five vision transformer networks (ViT-base/ViT-large from Google, BEiT-base/BEiT-large from Microsoft, DeiT-base from Facebook/Meta) were utilized and evaluated. Accuracy (ACC), sensitivity (SE), specificity (SP), positive/negative predictive value (PPV/NPV) and area under the ROC curve (AUC) were statistically determined. The overall diagnostic ACC and AUC values ranged from 83.4 to 85.2% and 0.899 to 0.918 for all evaluated transformer networks, respectively. Differences in diagnostic performance were evident for lower (ACC 94.1-96.7%; AUC 0.944-0.970) and upper anterior (86.7-90.2%; 0.948-0.958) and lower (85.6-87.2%; 0.913-0.937) and upper posterior teeth (78.1-81.0%; 0.851-0.875). In this study, only minor differences among the tested networks were detected for PBL detection. To increase the diagnostic performance and to support the clinical use of such networks, further optimisations with larger and manually annotated image data sets are needed.

578 Background: Radical cystectomy (RC) is a standard treatment for patients with muscle invasive and certain high-risk non-invasive bladder cancers. Existing clinical risk calculators based for RC on standard regression methods have demonstrated poor, inaccurate predictions of post-operative risks and adverse outcomes. We aimed to build a risk calculator using novel machine learning methods to predict complication rates and other outcomes based on clinical characteristics of patients undergoing RC. Methods: Patients who had an RC for bladder cancer between 2019 and 2021 were pulled from the National Surgical Quality Improvement Database. Potential predictors included clinically meaningful characteristics such as patient demographics, pre-operative labs, comorbidities, pre-operative bowel and antibiotic preparations, and prior treatment history, as well as cystectomy-specific characteristics such as diversion type and surgical approach. Outcomes included risk of any complication, infectious complication, mortality, and readmissions. Logistic regression, random forest, and support vector machine algorithms were used to build predictive models. Models were optimized assessed with area under the ROC curve (AUROC) and average precision (AP). Results: 8,936 patients were included in the sample dataset. Random forest classifiers outperformed other models for predicting risk of any complication (AUROC = 0.662; AP = 0.66), infectious complication (AUROC = 0.615; AP = 0.20), and mortality (AUROC = 0.603; AP = 0.03). The logistic regression model best predicted readmissions (AUROC = 0.587; AP = 0.26). Top predictors of complication risk included operation time, glomerular filtration rate, and type of procedure (robotic vs. open). Infectious complication was best predicted by wound classification and diversion type, mortality was best predicted by BMI and operation time, and readmissions was predicted most by pre-existing renal failure and emergent cases. Conclusions: Machine learning-based risk calculators were more effective in predicting morbidity and mortality after RC compared to more standard predictive algorithms. Machine learning algorithms therefore demonstrate greater predictive potential when given a wide range of clinical characteristics. [Table: see text]

Research has shown that Convolutional Neural Networks (CNN) can be effectively applied to text classification as part of a predictive coding protocol. That said, most research to date has been conducted on data sets with short documents that do not reflect the variety of documents in real world document reviews. Using data from four actual reviews with documents of varying lengths, we compared CNN with other popular machine learning algorithms for text classification, including Logistic Regression, Support Vector Machine, and Random Forest. For each data set, classification models were trained with different training sample sizes using different learning algorithms. These models were then evaluated using a large randomly sampled test set of documents, and the results were compared using precision and recall curves. Our study demonstrates that CNN performed well, but that there was no single algorithm that performed the best across the combination of data sets and training sample sizes. These results will help advance research into the legal profession's use of machine learning algorithms that maximize performance.

Breast cancer is an important topic in medical image analysis because it is a high-risk disease and the leading cause of death in women. Early detection of breast cancer improves treatment outcomes, which can be achieved by identifying it using mammography images. Computer-aided diagnostic systems detect and classify medical images of breast lesions, allowing radiologists to make accurate diagnoses. Deep learning algorithms improved the performance of these diagnoses systems. We utilized efficient deep learning approaches to propose a system that can detect breast cancer in mammograms. The proposed approach adopted relies on two main elements: improving image contrast to enhance marginal information and extracting discriminatory features sufficient to improve overall classification quality, these improvements achieved based on a new model from scratch to focus on enhancing the accuracy and reliability of breast cancer detection. The model trained on the digital database for screening mammography (DDSM) dataset and compared with different convolutional neural network (CNN) models, namely EfficientNetB1, EfficientNetB5, ResNet-50, and ResNet101. Moreover, to enhance the feature selection process, we have integrated adam optimizer in our methodology. In evaluation, the proposed method achieved 96.5% accuracy across the dataset. These results show the effectiveness of this method in identifying breast cancer through images.