Deep Learning in Computed Tomography Pulmonary Angiography Imaging: A Dual-Pronged Approach for Pulmonary Embolism Detection

Pulmonary Embolism (PE) is a critical medical condition characterized by obstructions in the pulmonary arteries. Despite being a major health concern, it often goes underdiagnosed leading to detrimental clinical outcomes. The increasing reliance on Computed Tomography Pulmonary Angiography for diagnosis presents challenges and a pressing need for enhanced diagnostic solutions. The primary objective of this study is to leverage deep learning techniques to enhance the Computer Assisted Diagnosis of PE. This study presents a comprehensive dual-pronged approach combining classification and detection for PE diagnosis. We introduce an Attention-Guided Convolutional Neural Network (AG-CNN) for classification, addressing both global and local lesion region. For detection, state-of-the-art models are employed to pinpoint potential PE regions. Different ensembling techniques further improve detection accuracy by combining predictions from different models. Finally, a heuristic strategy integrates classifier outputs with detection results, ensuring robust and accurate PE identification. Our attention-guided classification approach, tested on the Ferdowsi University of Mashhad's Pulmonary Embolism (FUMPE) dataset, outperformed the baseline model DenseNet-121 by achieving an 8.1% increase in the Area Under the Receiver Operating Characteristic. By employing ensemble techniques with detection models, the mean average precision (mAP) was considerably enhanced by a 4.7% increase. The classifier-guided framework further refined the mAP and F1 scores over the ensemble models. Our research offers a comprehensive approach to PE diagnostics using deep learning, addressing the prevalent issues of underdiagnosis and misdiagnosis. We aim to improve PE patient care by integrating AI solutions into clinical workflows, highlighting the potential of human-AI collaboration in medical diagnostics.