Background: Automated segmentation of coronary arteries is a crucial step for computer-aided coronary artery disease (CAD) diagnosis and treatment planning. Correct delineation of the coronary artery is challenging in X-ray coronary angiography (XCA) due to the low signal-to-noise ratio and confounding background structures.Methods: A novel ensemble framework for coronary artery segmentation in XCA images is proposed, which utilizes deep learning and filter-based features to construct models using the gradient boosting decision tree (GBDT) and deep forest classifiers. The proposed method was trained and tested on 130 XCA images. For each pixel of interest in the XCA images, a 37-dimensional feature vector was constructed based on (1) the statistics of multi-scale filtering responses in the morphological, spatial, and frequency domains; and (2) the feature maps obtained from trained deep neural networks. The performance of these models was compared with those of common deep neural networks on metrics including precision, sensitivity, specificity, F1 score, AUROC (the area under the receiver operating characteristic curve), and IoU (intersection over union).Results: With hybrid under-sampling methods, the best performing GBDT model achieved a mean F1 score of 0.874, AUROC of 0.947, sensitivity of 0.902, and specificity of 0.992; while the best performing deep forest model obtained a mean F1 score of 0.867, AUROC of 0.95, sensitivity of 0.867, and specificity of 0.993. Compared with the evaluated deep neural networks, both models had better or comparable performance for all evaluated metrics with lower standard deviations over the test images.Conclusions: The proposed feature-based ensemble method outperformed common deep convolutional neural networks in most performance metrics while yielding more consistent results. Such a method can be used to facilitate the assessment of stenosis and improve the quality of care in patients with CAD.

Optical colonoscopy is an essential diagnostic and prognostic tool for many gastrointestinal diseases, including cancer screening and staging, intestinal bleeding, diarrhea, abdominal symptom evaluation, and inflammatory bowel disease assessment. However, the evaluation, classification, and quantification of findings from colonoscopy are subject to inter-observer variation. Automated assessment of colonoscopy is of interest considering the subjectivity present in qualitative human interpretations of colonoscopy findings. Localization of the camera is essential to interpreting the meaning and context of findings for diseases evaluated by colonoscopy. In this study, we propose a camera localization system to estimate the relative location of the camera and classify the colon into anatomical segments. The camera localization system begins with non-informative frame detection and removal. Then a self-training end-to-end convolutional neural network is built to estimate the camera motion, where several strategies are proposed to improve its robustness and generalization on endoscopic videos. Using the estimated camera motion a camera trajectory can be derived and a relative location index calculated. Based on the estimated location index, anatomical colon segment classification is performed by constructing a colon template. The proposed motion estimation algorithm was evaluated on an external dataset containing the ground truth for camera pose. The experimental results show that the performance of the proposed method is superior to other published methods. The relative location index estimation and anatomical region classification were further validated using colonoscopy videos collected from routine clinical practice. This validation yielded an average accuracy in classification of 0.754, which is substantially higher than the performances obtained using location indices built from other methods.

The advanced learning paradigm, learning using privileged information (LUPI), leverages information in training that is not present at the time of prediction. In this study, we developed privileged logistic regression (PLR) models under the LUPI paradigm to detect acute respiratory distress syndrome (ARDS), with mechanical ventilation variables or chest x-ray image features employed in the privileged domain and electronic health records in the base domain. In model training, the objective of privileged logistic regression was designed to incorporate data from the privileged domain and encourage knowledge transfer across the privileged and base domains. An asymptotic analysis was also performed, yielding sufficient conditions under which the addition of privileged information increases the rate of convergence in the proposed model. Results for ARDS detection show that PLR models achieve better classification performances than logistic regression models trained solely on the base domain, even when privileged information is partially available. Furthermore, PLR models demonstrate performance on par with or superior to state-of-the-art models under the LUPI paradigm. As the proposed models are effective, easy to interpret, and highly explainable, they are ideal for other clinical applications where privileged information is at least partially available.

Missing data presents a challenge for machine learning applications specifically when utilizing electronic health records to develop clinical decision support systems. The lack of these values is due in part to the complex nature of clinical data in which the content is personalized to each patient. Several methods have been developed to handle this issue, such as imputation or complete case analysis, but their limitations restrict the solidity of findings. However, recent studies have explored how using some features as fully available privileged information can increase model performance including in SVM. Building on this insight, we propose a computationally efficient kernel SVM-based framework (l₂-SVMp+) that leverages partially available privileged information to guide model construction. Our experiments validated the superiority of l₂-SVMp+ over common approaches for handling missingness and previous implementations of SVMp+ in both digit recognition, disease classification and patient readmission prediction tasks. The performance improves as the percentage of available privileged information increases. Our results showcase the capability of l₂-SVMp+ to handle incomplete but important features in real-world medical applications, surpassing traditional SVMs that lack privileged information. Additionally, l₂-SVMp+ achieves comparable or superior model performance compared to imputed privileged features.

Acute Respiratory Distress Syndrome (ARDS) is a life-threatening lung injury for which early diagnosis and evidence-based treatment can improve patient outcomes. Chest X-rays (CXRs) play a crucial role in the identification of ARDS; however, their interpretation can be difficult due to non-specific radiological features, uncertainty in disease staging, and inter-rater variability among clinical experts, thus leading to prominent label noise issues. To address these challenges, this study proposes a novel approach that leverages label uncertainty from multiple annotators to enhance ARDS detection in CXR images. Label uncertainty information is encoded and supplied to the model as privileged information, a form of information exclusively available during the training stage and not during inference. By incorporating the Transfer and Marginalized (TRAM) network and effective knowledge transfer mechanisms, the detection model achieved a mean testing AUROC of 0.850, an AUPRC of 0.868, and an F1 score of 0.797. After removing equivocal testing cases, the model attained an AUROC of 0.973, an AUPRC of 0.971, and an F1 score of 0.921. As a new approach to addressing label noise in medical image analysis, the proposed model has shown superiority compared to the original TRAM, Confusion Estimation, and mean-aggregated label training. The overall findings highlight the effectiveness of the proposed methods in addressing label noise in CXRs for ARDS detection, with potential for use in other medical imaging domains that encounter similar challenges.

Optical colonoscopy is an essential diagnostic and prognostic tool for many gastrointestinal diseases, including cancer screening and staging, intestinal bleeding, diarrhea, abdominal symptom evaluation, and inflammatory bowel disease assessment. Automated assessment of colonoscopy is of interest considering the subjectivity present in qualitative human interpretations of colonoscopy findings. Localization of the camera is essential to interpreting the meaning and context of findings for diseases evaluated by colonoscopy. In this study, we propose a camera localization system to estimate the relative location of the camera and classify the colon into anatomical segments. The camera localization system begins with non-informative frame detection and removal. Then a self-training end-to-end convolutional neural network is built to estimate the camera motion, where several strategies are proposed to improve its robustness and generalization on endoscopic videos. Using the estimated camera motion a camera trajectory can be derived and a relative location index calculated. Based on the estimated location index, anatomical colon segment classification is performed by constructing a colon template. The proposed motion estimation algorithm was evaluated on an external dataset containing the ground truth for camera pose. The experimental results show that the performance of the proposed method is superior to other published methods. The relative location index estimation and anatomical region classification were further validated using colonoscopy videos collected from routine clinical practice. This validation yielded an average accuracy in classification of 0.754, which is substantially higher than the performances obtained using location indices built from other methods.