Deep Learning for Automated Screening of Tuberculosis from Indian Chest X-rays: Analysis and Update

Background and Objective: Tuberculosis (TB) is a significant public health issue and a leading cause of death worldwide. Millions of deaths can be averted by early diagnosis and successful treatment of TB patients. Automated diagnosis of TB holds vast potential to assist medical experts in expediting and improving its diagnosis, especially in developing countries like India, where there is a shortage of trained medical experts and radiologists. To date, several deep learning based methods for automated detection of TB from chest radiographs have been proposed. However, the performance of a few of these methods on the Indian chest radiograph data set has been suboptimal, possibly due to different texture of the lungs on chest radiographs of Indian subjects compared to other countries. Thus deep learning for accurate and automated diagnosis of TB on Indian datasets remains an important subject of research. Methods: The proposed work explores the performance of convolutional neural networks (CNNs) for the diagnosis of TB in Indian chest x-ray images. Three different pre-trained neural network models, AlexNet, GoogLenet, and ResNet are used to classify chest x-ray images into healthy or TB infected. The proposed approach does not require any pre-processing technique. Also, other works use pre-trained NNs as a tool for crafting features and then apply standard classification techniques. However, we attempt an end to end NN model based diagnosis of TB from chest x-rays. The proposed visualization tool can also be used by radiologists in the screening of large datasets. Results: The proposed method achieved 93.40% accuracy with 98.60% sensitivity to diagnose TB for the Indian population. Conclusions: The performance of the proposed method is also tested against techniques described in the literature. The proposed method outperforms the state of art on Indian and Shenzhen datasets.

[1]  Bram van Ginneken,et al.  Fusion of Local and Global Detection Systems to Detect Tuberculosis in Chest Radiographs , 2010, MICCAI.

[2]  Michela Sali,et al.  The Biology of Mycobacterium Tuberculosis Infection , 2013, Mediterranean journal of hematology and infectious diseases.

[3]  Clement J. McDonald,et al.  Automatic Tuberculosis Screening Using Chest Radiographs , 2014, IEEE Transactions on Medical Imaging.

[4]  Jian Sun,et al.  Deep Residual Learning for Image Recognition , 2015, 2016 IEEE Conference on Computer Vision and Pattern Recognition (CVPR).

[5]  Dumitru Erhan,et al.  Going deeper with convolutions , 2014, 2015 IEEE Conference on Computer Vision and Pattern Recognition (CVPR).

[6]  Bolei Zhou,et al.  Learning Deep Features for Discriminative Localization , 2015, 2016 IEEE Conference on Computer Vision and Pattern Recognition (CVPR).

[7]  João Francisco Valiati,et al.  Pre-trained convolutional neural networks as feature extractors for tuberculosis detection , 2017, Comput. Biol. Medicine.

[8]  Irene Cheng,et al.  Novel coarse-to-fine dual scale technique for tuberculosis cavity detection in chest radiographs , 2013, EURASIP J. Image Video Process..

[9]  F. Pfeiffer,et al.  Efficient Deep Network Architectures for Fast Chest X-Ray Tuberculosis Screening and Visualization , 2019, Scientific Reports.

[10]  N. Obuchowski Receiver operating characteristic curves and their use in radiology. , 2003, Radiology.

[11]  Anup Basu,et al.  A Hybrid Knowledge-Guided Detection Technique for Screening of Infectious Pulmonary Tuberculosis From Chest Radiographs , 2010, IEEE Transactions on Biomedical Engineering.

[12]  Zhijian Song,et al.  Computer-aided detection in chest radiography based on artificial intelligence: a survey , 2018, BioMedical Engineering OnLine.

[13]  Geoffrey E. Hinton,et al.  ImageNet classification with deep convolutional neural networks , 2012, Commun. ACM.

[14]  Andrew Zisserman,et al.  Very Deep Convolutional Networks for Large-Scale Image Recognition , 2014, ICLR.

[15]  Khalid Ashraf,et al.  Abnormality Detection and Localization in Chest X-Rays using Deep Convolutional Neural Networks , 2017, ArXiv.

[16]  Andrew P. Bradley,et al.  The use of the area under the ROC curve in the evaluation of machine learning algorithms , 1997, Pattern Recognit..

[17]  Indah Soesanti,et al.  Lung tuberculosis identification based on statistical feature of thoracic X-ray , 2013, 2013 International Conference on QiR.

[18]  U. Rajendra Acharya,et al.  Computer-Assisted Diagnosis of Tuberculosis: A First Order Statistical Approach to Chest Radiograph , 2012, Journal of Medical Systems.

[19]  O. M. Rijal,et al.  A statistical interpretation of the chest radiograph for the detection of pulmonary tuberculosis , 2010, 2010 IEEE EMBS Conference on Biomedical Engineering and Sciences (IECBES).

[20]  Andrew Y. Ng,et al.  CheXNet: Radiologist-Level Pneumonia Detection on Chest X-Rays with Deep Learning , 2017, ArXiv.

[21]  Ulas Bagci,et al.  Atlas-based rib-bone detection in chest X-rays , 2016, Comput. Medical Imaging Graph..

[22]  Stefan Jaeger,et al.  Two public chest X-ray datasets for computer-aided screening of pulmonary diseases. , 2014, Quantitative imaging in medicine and surgery.

[23]  P. Lakhani,et al.  Deep Learning at Chest Radiography: Automated Classification of Pulmonary Tuberculosis by Using Convolutional Neural Networks. , 2017, Radiology.