Deep Learning for Distinguishing Normal versus Abnormal Chest Radiographs and Generalization to Unseen Diseases

Chest radiography (CXR) is the most widely-used thoracic clinical imaging modality and is crucial for guiding the management of cardiothoracic conditions. The detection of specific CXR findings has been the main focus of several artificial intelligence (AI) systems. However, the wide range of possible CXR abnormalities makes it impractical to build specific systems to detect every possible condition. In this work, we developed and evaluated an AI system to classify CXRs as normal or abnormal. For development, we used a de-identified dataset of 248,445 patients from a multi-city hospital network in India. To assess generalizability, we evaluated our system using 6 international datasets from India, China, and the United States. Of these datasets, 4 focused on diseases that the AI was not trained to detect: 2 datasets with tuberculosis and 2 datasets with coronavirus disease 2019. Our results suggest that the AI system generalizes to new patient populations and abnormalities. In a simulated workflow where the AI system prioritized abnormal cases, the turnaround time for abnormal cases reduced by 7-28%. These results represent an important step towards evaluating whether AI can be safely used to flag cases in a general setting where previously unseen abnormalities exist.

Deep Adversarial Context-Aware Landmark Detection for Ultrasound Imaging

Real-time localization of prostate gland in trans-rectal ultrasound images is a key technology that is required to automate the ultrasound guided prostate biopsy procedures. In this paper, we propose a new deep learning based approach which is aimed at localizing several prostate landmarks efficiently and robustly. We propose a multitask learning approach primarily to make the overall algorithm more contextually aware. In this approach, we not only consider the explicit learning of landmark locations, but also build-in a mechanism to learn the contour of the prostate. This multitask learning is further coupled with an adversarial arm to promote the generation of feasible structures. We have trained this network using ~4000 labeled trans-rectal ultrasound images and tested on an independent set of images with ground truth landmark locations. We have achieved an overall Dice score of 92.6% for the adversarially trained multitask approach, which is significantly better than the Dice score of 88.3% obtained by only learning of landmark locations. The overall mean distance error using the adversarial multitask approach has also improved by 20% while reducing the standard deviation of the error compared to learning landmark locations only. In terms of computational complexity both approaches can process the images in real-time using standard computer with a standard CUDA enabled GPU.