Fast-staged CNN Model for Accurate pulmonary diseases and Lung cancer detection

Pulmonary pathologies are a significant global health concern, often leading to fatal outcomes if not diagnosed and treated promptly. Chest radiography serves as a primary diagnostic tool, but the availability of experienced radiologists remains limited. Advances in Artificial Intelligence (AI) and machine learning, particularly in computer vision, offer promising solutions to address this challenge. This research evaluates a deep learning model designed to detect lung cancer, specifically pulmonary nodules, along with eight other lung pathologies, using chest radiographs. The study leverages diverse datasets comprising over 135,120 frontal chest radiographs to train a Convolutional Neural Network (CNN). A two-stage classification system, utilizing ensemble methods and transfer learning, is employed to first triage images into Normal or Abnormal categories and then identify specific pathologies, including lung nodules. The deep learning model achieves notable results in nodule classification, with a top-performing accuracy of 77%, a sensitivity of 0.713, a specificity of 0.776 during external validation, and an AUC score of 0.888. Despite these successes, some misclassifications were observed, primarily false negatives. In conclusion, the model demonstrates robust potential for generalization across diverse patient populations, attributed to the geographic diversity of the training dataset. Future work could focus on integrating ETL data distribution strategies and expanding the dataset with additional nodule-type samples to further enhance diagnostic accuracy.

Medical Slice Transformer: Improved Diagnosis and Explainability on 3D Medical Images with DINOv2

MRI and CT are essential clinical cross-sectional imaging techniques for diagnosing complex conditions. However, large 3D datasets with annotations for deep learning are scarce. While methods like DINOv2 are encouraging for 2D image analysis, these methods have not been applied to 3D medical images. Furthermore, deep learning models often lack explainability due to their "black-box" nature. This study aims to extend 2D self-supervised models, specifically DINOv2, to 3D medical imaging while evaluating their potential for explainable outcomes. We introduce the Medical Slice Transformer (MST) framework to adapt 2D self-supervised models for 3D medical image analysis. MST combines a Transformer architecture with a 2D feature extractor, i.e., DINOv2. We evaluate its diagnostic performance against a 3D convolutional neural network (3D ResNet) across three clinical datasets: breast MRI (651 patients), chest CT (722 patients), and knee MRI (1199 patients). Both methods were tested for diagnosing breast cancer, predicting lung nodule dignity, and detecting meniscus tears. Diagnostic performance was assessed by calculating the Area Under the Receiver Operating Characteristic Curve (AUC). Explainability was evaluated through a radiologist's qualitative comparison of saliency maps based on slice and lesion correctness. P-values were calculated using Delong's test. MST achieved higher AUC values compared to ResNet across all three datasets: breast (0.94$\pm$0.01 vs. 0.91$\pm$0.02, P=0.02), chest (0.95$\pm$0.01 vs. 0.92$\pm$0.02, P=0.13), and knee (0.85$\pm$0.04 vs. 0.69$\pm$0.05, P=0.001). Saliency maps were consistently more precise and anatomically correct for MST than for ResNet. Self-supervised 2D models like DINOv2 can be effectively adapted for 3D medical imaging using MST, offering enhanced diagnostic accuracy and explainability compared to convolutional neural networks.

Detection-Guided Deep Learning-Based Model with Spatial Regularization for Lung Nodule Segmentation

Lung cancer ranks as one of the leading causes of cancer diagnosis and is the foremost cause of cancer-related mortality worldwide. The early detection of lung nodules plays a pivotal role in improving outcomes for patients, as it enables timely and effective treatment interventions. The segmentation of lung nodules plays a critical role in aiding physicians in distinguishing between malignant and benign lesions. However, this task remains challenging due to the substantial variation in the shapes and sizes of lung nodules, and their frequent proximity to lung tissues, which complicates clear delineation. In this study, we introduce a novel model for segmenting lung nodules in computed tomography (CT) images, leveraging a deep learning framework that integrates segmentation and classification processes. This model is distinguished by its use of feature combination blocks, which facilitate the sharing of information between the segmentation and classification components. Additionally, we employ the classification outcomes as priors to refine the size estimation of the predicted nodules, integrating these with a spatial regularization technique to enhance precision. Furthermore, recognizing the challenges posed by limited training datasets, we have developed an optimal transfer learning strategy that freezes certain layers to further improve performance. The results show that our proposed model can capture the target nodules more accurately compared to other commonly used models. By applying transfer learning, the performance can be further improved, achieving a sensitivity score of 0.885 and a Dice score of 0.814.

Medical AI for Early Detection of Lung Cancer: A Survey

Lung cancer remains one of the leading causes of morbidity and mortality worldwide, making early diagnosis critical for improving therapeutic outcomes and patient prognosis. Computer-aided diagnosis (CAD) systems, which analyze CT images, have proven effective in detecting and classifying pulmonary nodules, significantly enhancing the detection rate of early-stage lung cancer. Although traditional machine learning algorithms have been valuable, they exhibit limitations in handling complex sample data. The recent emergence of deep learning has revolutionized medical image analysis, driving substantial advancements in this field. This review focuses on recent progress in deep learning for pulmonary nodule detection, segmentation, and classification. Traditional machine learning methods, such as SVM and KNN, have shown limitations, paving the way for advanced approaches like Convolutional Neural Networks (CNN), Recurrent Neural Networks (RNN), and Generative Adversarial Networks (GAN). The integration of ensemble models and novel techniques is also discussed, emphasizing the latest developments in lung cancer diagnosis. Deep learning algorithms, combined with various analytical techniques, have markedly improved the accuracy and efficiency of pulmonary nodule analysis, surpassing traditional methods, particularly in nodule classification. Although challenges remain, continuous technological advancements are expected to further strengthen the role of deep learning in medical diagnostics, especially for early lung cancer detection and diagnosis. A comprehensive list of lung cancer detection models reviewed in this work is available at https://github.com/CaiGuoHui123/Awesome-Lung-Cancer-Detection

Deep Learning-Based Channel Squeeze U-Structure for Lung Nodule Detection and Segmentation

This paper introduces a novel deep-learning method for the automatic detection and segmentation of lung nodules, aimed at advancing the accuracy of early-stage lung cancer diagnosis. The proposed approach leverages a unique "Channel Squeeze U-Structure" that optimizes feature extraction and information integration across multiple semantic levels of the network. This architecture includes three key modules: shallow information processing, channel residual structure, and channel squeeze integration. These modules enhance the model's ability to detect and segment small, imperceptible, or ground-glass nodules, which are critical for early diagnosis. The method demonstrates superior performance in terms of sensitivity, Dice similarity coefficient, precision, and mean Intersection over Union (IoU). Extensive experiments were conducted on the Lung Image Database Consortium (LIDC) dataset using five-fold cross-validation, showing excellent stability and robustness. The results indicate that this approach holds significant potential for improving computer-aided diagnosis systems, providing reliable support for radiologists in clinical practice and aiding in the early detection of lung cancer, especially in resource-limited settings

Lung-DETR: Deformable Detection Transformer for Sparse Lung Nodule Anomaly Detection

Accurate lung nodule detection for computed tomography (CT) scan imagery is challenging in real-world settings due to the sparse occurrence of nodules and similarity to other anatomical structures. In a typical positive case, nodules may appear in as few as 3% of CT slices, complicating detection. To address this, we reframe the problem as an anomaly detection task, targeting rare nodule occurrences in a predominantly normal dataset. We introduce a novel solution leveraging custom data preprocessing and Deformable Detection Transformer (Deformable- DETR). A 7.5mm Maximum Intensity Projection (MIP) is utilized to combine adjacent lung slices into single images, reducing the slice count and decreasing nodule sparsity. This enhances spatial context, allowing for better differentiation between nodules and other structures such as complex vascular structures and bronchioles. Deformable-DETR is employed to detect nodules, with a custom focal loss function to better handle the imbalanced dataset. Our model achieves state-of-the-art performance on the LUNA16 dataset with an F1 score of 94.2% (95.2% recall, 93.3% precision) on a dataset sparsely populated with lung nodules that is reflective of real-world clinical data.

MSDet: Receptive Field Enhanced Multiscale Detection for Tiny Pulmonary Nodule

Pulmonary nodules are critical indicators for the early diagnosis of lung cancer, making their detection essential for timely treatment. However, traditional CT imaging methods suffered from cumbersome procedures, low detection rates, and poor localization accuracy. The subtle differences between pulmonary nodules and surrounding tissues in complex lung CT images, combined with repeated downsampling in feature extraction networks, often lead to missed or false detections of small nodules. Existing methods such as FPN, with its fixed feature fusion and limited receptive field, struggle to effectively overcome these issues. To address these challenges, our paper proposed three key contributions: Firstly, we proposed MSDet, a multiscale attention and receptive field network for detecting tiny pulmonary nodules. Secondly, we proposed the extended receptive domain (ERD) strategy to capture richer contextual information and reduce false positives caused by nodule occlusion. We also proposed the position channel attention mechanism (PCAM) to optimize feature learning and reduce multiscale detection errors, and designed the tiny object detection block (TODB) to enhance the detection of tiny nodules. Lastly, we conducted thorough experiments on the public LUNA16 dataset, achieving state-of-the-art performance, with an mAP improvement of 8.8% over the previous state-of-the-art method YOLOv8. These advancements significantly boosted detection accuracy and reliability, providing a more effective solution for early lung cancer diagnosis. The code will be available at https://github.com/CaiGuoHui123/MSDet

Domain Adaptive Lung Nodule Detection in X-ray Image

Medical images from different healthcare centers exhibit varied data distributions, posing significant challenges for adapting lung nodule detection due to the domain shift between training and application phases. Traditional unsupervised domain adaptive detection methods often struggle with this shift, leading to suboptimal outcomes. To overcome these challenges, we introduce a novel domain adaptive approach for lung nodule detection that leverages mean teacher self-training and contrastive learning. First, we propose a hierarchical contrastive learning strategy to refine nodule representations and enhance the distinction between nodules and background. Second, we introduce a nodule-level domain-invariant feature learning (NDL) module to capture domain-invariant features through adversarial learning across different domains. Additionally, we propose a new annotated dataset of X-ray images to aid in advancing lung nodule detection research. Extensive experiments conducted on multiple X-ray datasets demonstrate the efficacy of our approach in mitigating domain shift impacts.

AttentNet: Fully Convolutional 3D Attention for Lung Nodule Detection

Motivated by the increasing popularity of attention mechanisms, we observe that popular convolutional (conv.) attention models like Squeeze-and-Excite (SE) and Convolutional Block Attention Module (CBAM) rely on expensive multi-layer perception (MLP) layers. These MLP layers significantly increase computational complexity, making such models less applicable to 3D image contexts, where data dimensionality and computational costs are higher. In 3D medical imaging, such as 3D pulmonary CT scans, efficient processing is crucial due to the large data volume. Traditional 2D attention generalized to 3D increases the computational load, creating demand for more efficient attention mechanisms for 3D tasks. We investigate the possibility of incorporating fully convolutional (conv.) attention in 3D context. We present two 3D fully conv. attention blocks, demonstrating their effectiveness in 3D context. Using pulmonary CT scans for 3D lung nodule detection, we present AttentNet, an automated lung nodule detection framework from CT images, performing detection as an ensemble of two stages, candidate proposal and false positive (FP) reduction. We compare the proposed 3D attention blocks to popular 2D conv. attention methods generalized to 3D modules and to self-attention units. For the FP reduction stage, we also use a joint analysis approach to aggregate spatial information from different contextual levels. We use LUNA-16 lung nodule detection dataset to demonstrate the benefits of the proposed fully conv. attention blocks compared to baseline popular lung nodule detection methods when no attention is used. Our work does not aim at achieving state-of-the-art results in the lung nodule detection task, rather to demonstrate the benefits of incorporating fully conv. attention within a 3D context.

Improving Representation of High-frequency Components for Medical Foundation Models

Foundation models have recently attracted significant attention for their impressive generalizability across diverse downstream tasks. However, these models are demonstrated to exhibit great limitations in representing high-frequency components and fine-grained details. In many medical imaging tasks, the precise representation of such information is crucial due to the inherently intricate anatomical structures, sub-visual features, and complex boundaries involved. Consequently, the limited representation of prevalent foundation models can result in significant performance degradation or even failure in these tasks. To address these challenges, we propose a novel pretraining strategy, named Frequency-advanced Representation Autoencoder (Frepa). Through high-frequency masking and low-frequency perturbation combined with adversarial learning, Frepa encourages the encoder to effectively represent and preserve high-frequency components in the image embeddings. Additionally, we introduce an innovative histogram-equalized image masking strategy, extending the Masked Autoencoder approach beyond ViT to other architectures such as Swin Transformer and convolutional networks. We develop Frepa across nine medical modalities and validate it on 32 downstream tasks for both 2D images and 3D volume data. Without fine-tuning, Frepa can outperform other self-supervised pretraining methods and, in some cases, even surpasses task-specific trained models. This improvement is particularly significant for tasks involving fine-grained details, such as achieving up to a +15% increase in DSC for retina vessel segmentation and a +7% increase in IoU for lung nodule detection. Further experiments quantitatively reveal that Frepa enables superior high-frequency representations and preservation in the embeddings, underscoring its potential for developing more generalized and universal medical image foundation models.