This study aims to investigate the effects of including patients' clinical information on the performance of deep learning (DL) classifiers for disease location in chest X-ray images. Although current classifiers achieve high performance using chest X-ray images alone, our interviews with radiologists indicate that clinical data is highly informative and essential for interpreting images and making proper diagnoses. In this work, we propose a novel architecture consisting of two fusion methods that enable the model to simultaneously process patients' clinical data (structured data) and chest X-rays (image data). Since these data modalities are in different dimensional spaces, we propose a spatial arrangement strategy, termed spatialization, to facilitate the multimodal learning process in a Mask R-CNN model. We performed an extensive experimental evaluation comprising three datasets with different modalities: MIMIC CXR (chest X-ray images), MIMIC IV-ED (patients' clinical data), and REFLACX (annotations of disease locations in chest X-rays). Results show that incorporating patients' clinical data in a DL model together with the proposed fusion methods improves the performance of disease localization in chest X-rays by 12\% in terms of Average Precision compared to a standard Mask R-CNN using only chest X-rays. Further ablation studies also emphasize the importance of multimodal DL architectures and the incorporation of patients' clinical data in disease localisation. The architecture proposed in this work is publicly available to promote the scientific reproducibility of our study (https://github.com/ChihchengHsieh/multimodal-abnormalities-detection).
This paper proposes a novel multimodal DL architecture incorporating medical images and eye-tracking data for abnormality detection in chest x-rays. Our results show that applying eye gaze data directly into DL architectures does not show superior predictive performance in abnormality detection chest X-rays. These results support other works in the literature and suggest that human-generated data, such as eye gaze, needs a more thorough investigation before being applied to DL architectures.
There is a growing need to assist radiologists in performing X-ray readings and diagnoses fast, comfortably, and effectively. As radiologists strive to maximize productivity, it is essential to consider the impact of reading rooms in interpreting complex examinations and ensure that higher volume and reporting speeds do not compromise patient outcomes. Virtual Reality (VR) is a disruptive technology for clinical practice in assessing X-ray images. We argue that conjugating eye-tracking with VR devices and Machine Learning may overcome obstacles posed by inadequate ergonomic postures and poor room conditions that often cause erroneous diagnostics when professionals examine digital images.