The variation in skin textures and injuries, as well as the detection and classification of skin cancer, is a difficult task. Manually detecting skin lesions from dermoscopy images is a difficult and time-consuming process. Recent advancements in the domains of the internet of things (IoT) and artificial intelligence for medical applications demonstrated improvements in both accuracy and computational time. In this paper, a new method for multiclass skin lesion classification using best deep learning feature fusion and an extreme learning machine is proposed. The proposed method includes five primary steps: image acquisition and contrast enhancement; deep learning feature extraction using transfer learning; best feature selection using hybrid whale optimization and entropy-mutual information (EMI) approach; fusion of selected features using a modified canonical correlation based approach; and, finally, extreme learning machine based classification. The feature selection step improves the system’s computational efficiency and accuracy. The experiment is carried out on two publicly available datasets, HAM10000 and ISIC2018. The achieved accuracy on both datasets is 93.40 and 94.36 percent. When compared to state-of-the-art (SOTA) techniques, the proposed method’s accuracy is improved. Furthermore, the proposed method is computationally efficient.

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Multiclass Skin Lesion Classification Using Hybrid Deep Features Selection and Extreme Learning Machine

Importance Clinical artificial intelligence (AI) algorithms have the potential to improve clinical care, but fair, generalizable algorithms depend on the clinical data on which they are trained and tested. Objective To assess whether data sets used for training diagnostic AI algorithms addressing skin disease are adequately described and to identify potential sources of bias in these data sets. Data sources In this scoping review, PubMed was used to search for peer-reviewed research articles published between January 1, 2015, and November 1, 2020, with the following paired search terms: deep learning and dermatology, artificial intelligence and dermatology, deep learning and dermatologist, and artificial intelligence and dermatologist. Study selection Studies that developed or tested an existing deep learning algorithm for triage, diagnosis, or monitoring using clinical or dermoscopic images of skin disease were selected, and the articles were independently reviewed by 2 investigators to verify that they met selection criteria. Consensus process Data set audit criteria were determined by consensus of all authors after reviewing existing literature to highlight data set transparency and sources of bias. Results A total of 70 unique studies were included. Among these studies, 1 065 291 images were used to develop or test AI algorithms, of which only 257 372 (24.2%) were publicly available. Only 14 studies (20.0%) included descriptions of patient ethnicity or race in at least 1 data set used. Only 7 studies (10.0%) included any information about skin tone in at least 1 data set used. Thirty-six of the 56 studies developing new AI algorithms for cutaneous malignant neoplasms (64.3%) met the gold standard criteria for disease labeling. Public data sets were cited more often than private data sets, suggesting that public data sets contribute more to new development and benchmarks. Conclusions and relevance This scoping review identified 3 issues in data sets that are used to develop and test clinical AI algorithms for skin disease that should be addressed before clinical translation: (1) sparsity of data set characterization and lack of transparency, (2) nonstandard and unverified disease labels, and (3) inability to fully assess patient diversity used for algorithm development and testing.

Lack of Transparency and Potential Bias in Artificial Intelligence Data Sets and Algorithms: A Scoping Review.

With the rapid development of information technology, the conception of smart healthcare has progressively come to the fore. Smart healthcare utilizes next-generation technologies, such as artificial intelligence, the Internet of Things (IoT), big data and cloud computing to transform intelligently the existing medical system-making it more efficient, more reliable, and personalized. In this work, skin data are collected using dedicated hardware from mobile health units-working as nodes. The collected samples are uploaded to the cloud for further processing using a novel multi-modal information fusion framework, which performs skin lesion segmentation, followed by classification. The proposed framework has two main functional blocks: Segmentation and classification. In each block, we have a performance booster, which works on the principle of information fusion. For lesion segmentation, a hybrid framework is proposed, which utilizes the complementary strengths of two convolutional neural network (CNN) architectures to generate the segmented images. The resultant binary images are later fused using joint probability distribution and marginal distribution function. For lesion classification, a 30-layered CNN architecture is designed, which is trained on the HAM10000 dataset. A novel summation discriminant correlation analysis technique is used to fuse the extracted features from two fully connected layers. To avoid feature redundancy, a feature selection method “Regular Falsi” is developed, which down samples the extracted features into the lower dimensions. The selected features are finally classified using an extreme learning machine classifier. Five skin benchmark datasets (ISBI2016, ISIC2017, ISBI2018, ISIC2019, and HAM10000) are used to evaluate both segmentation and classification frameworks using average accuracy, false-negative rate, sensitivity, and computational time, whose results are impressive compared to state-of-the-art methods.

Intelligent fusion-assisted skin lesion localization and classification for smart healthcare

Deep learning (DL) is a branch of machine learning and artificial intelligence that has been applied to many areas in different domains such as health care and drug design. Cancer prognosis estimates the ultimate fate of a cancer subject and provides survival estimation of the subjects. An accurate and timely diagnostic and prognostic decision will greatly benefit cancer subjects. DL has emerged as a technology of choice due to the availability of high computational resources. The main components in a standard computer-aided design (CAD) system are preprocessing, feature recognition, extraction and selection, categorization, and performance assessment. Reduction of costs associated with sequencing systems offers a myriad of opportunities for building precise models for cancer diagnosis and prognosis prediction. In this survey, we provided a summary of current works where DL has helped to determine the best models for the cancer diagnosis and prognosis prediction tasks. DL is a generic model requiring minimal data manipulations and achieves better results while working with enormous volumes of data. Aims are to scrutinize the influence of DL systems using histopathology images, present a summary of state-of-the-art DL methods, and give directions to future researchers to refine the existing methods.

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Deep Learning in Cancer Diagnosis and Prognosis Prediction: A Minireview on Challenges, Recent Trends, and Future Directions.

Background Patients with fractures are a common emergency presentation and may be misdiagnosed at radiologic imaging. An increasing number of studies apply artificial intelligence (AI) techniques to fracture detection as an adjunct to clinician diagnosis. Purpose To perform a systematic review and meta-analysis comparing the diagnostic performance in fracture detection between AI and clinicians in peer-reviewed publications and the gray literature (ie, articles published on preprint repositories). Materials and Methods A search of multiple electronic databases between January 2018 and July 2020 (updated June 2021) was performed that included any primary research studies that developed and/or validated AI for the purposes of fracture detection at any imaging modality and excluded studies that evaluated image segmentation algorithms. Meta-analysis with a hierarchical model to calculate pooled sensitivity and specificity was used. Risk of bias was assessed by using a modified Prediction Model Study Risk of Bias Assessment Tool, or PROBAST, checklist. Results Included for analysis were 42 studies, with 115 contingency tables extracted from 32 studies (55 061 images). Thirty-seven studies identified fractures on radiographs and five studies identified fractures on CT images. For internal validation test sets, the pooled sensitivity was 92% (95% CI: 88, 93) for AI and 91% (95% CI: 85, 95) for clinicians, and the pooled specificity was 91% (95% CI: 88, 93) for AI and 92% (95% CI: 89, 92) for clinicians. For external validation test sets, the pooled sensitivity was 91% (95% CI: 84, 95) for AI and 94% (95% CI: 90, 96) for clinicians, and the pooled specificity was 91% (95% CI: 81, 95) for AI and 94% (95% CI: 91, 95) for clinicians. There were no statistically significant differences between clinician and AI performance. There were 22 of 42 (52%) studies that were judged to have high risk of bias. Meta-regression identified multiple sources of heterogeneity in the data, including risk of bias and fracture type. Conclusion Artificial intelligence (AI) and clinicians had comparable reported diagnostic performance in fracture detection, suggesting that AI technology holds promise as a diagnostic adjunct in future clinical practice. Clinical trial registration no. CRD42020186641 © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Cohen and McInnes in this issue.

Artificial Intelligence in Fracture Detection: A Systematic Review and Meta-Analysis.

Skin cancer is among the 10 most common cancers. Recent research revealed the superiority of artificial intelligence (AI) over dermatologists to diagnose skin cancer from predesignated and cropped images. However, there remain several uncertainties for AI in diagnosing skin cancers, including lack of testing for consistency, lack of pathological proof or ambiguous comparisons. Hence, to develop a reliable, feasible and user-friendly platform to facilitate the automatic diagnostic algorithm is important. The aim of this study was to build a light-weight skin cancer classification model based on deep learning methods for aiding first-line medical care. The developed model can be deployed on cloud platforms as well as mobile devices for remote diagnostic applications. We reviewed the medical records and clinical images of patients who received a histological diagnosis of basal cell carcinoma, squamous cell carcinoma, melanoma, seborrheic keratosis and melanocytic nevus in 2006-2017 in the Department of Dermatology in Kaohsiung Chang Gung Memorial Hospital (KCGMH). We used the deep learning models to identify skin cancers and benign skin tumors in the manner of binary classification and multi-class classification in the KCGMH and HAM10000 datasets to construct a skin cancer classification model. The accuracy reached 89.5% for the binary classifications (benign vs malignant) in the KCGMH dataset; the accuracy was 85.8% in the HAM10000 dataset in seven-class classification and 72.1% in the KCGMH dataset in five-class classification. Our results demonstrate that our skin cancer classification model based on deep learning methods is a highly promising aid for the clinical diagnosis and early identification of skin cancers and benign tumors.

Development of a light-weight deep learning model for cloud applications and remote diagnosis of skin cancers

Fungal keratitis (FK) is the most devastating and vision-threatening microbial keratitis, but clinical diagnosis a great challenge. This study aimed to develop and verify a deep learning (DL)-based corneal photograph model for diagnosing FK. Corneal photos of laboratory-confirmed microbial keratitis were consecutively collected from a single referral center. A DL framework with DenseNet architecture was used to automatically recognize FK from the photo. The diagnoses of FK via corneal photograph for comparing DL-based models were made in the Expert and NCS-Oph group through a majority decision of three non-corneal specialty ophthalmologist and three corneal specialists, respectively. The average percentage of sensitivity, specificity, positive predictive value, and negative predictive value was approximately 71, 68, 60, and 78. The sensitivity was higher than that of the NCS-Oph (52%, P < .01), whereas the specificity was lower than that of the NCS-Oph (83%, P < .01). The average accuracy of around 70% was comparable with that of the NCS-Oph. Therefore, the sensitive DL-based diagnostic model is a promising tool for improving first-line medical care at rural area in early identification of FK.

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A deep learning approach in diagnosing fungal keratitis based on corneal photographs.

Background Identification of vertebral fractures (VFs) is critical for effective secondary fracture prevention owing to their association with the increasing risks of future fractures. Plain abdominal frontal radiographs (PARs) are a common investigation method performed for a variety of clinical indications and provide an ideal platform for the opportunistic identification of VF. This study uses a deep convolutional neural network (DCNN) to identify the feasibility for the screening, detection, and localization of VFs using PARs. Methods A DCNN was pretrained using ImageNet and retrained with 1306 images from the PARs database obtained between August 2015 and December 2018. The accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) were evaluated. The visualization algorithm gradient-weighted class activation mapping (Grad-CAM) was used for model interpretation. Results Only 46.6% (204/438) of the VFs were diagnosed in the original PARs reports. The algorithm achieved 73.59% accuracy, 73.81% sensitivity, 73.02% specificity, and an AUC of 0.72 in the VF identification. Conclusion Computer driven solutions integrated with the DCNN have the potential to identify VFs with good accuracy when used opportunistically on PARs taken for a variety of clinical purposes. The proposed model can help clinicians become more efficient and economical in the current clinical pathway of fragile fracture treatment.

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Benny Wei Yun Hsu

Papers

Development of a light-weight deep learning model for cloud applications and remote diagnosis of skin cancers

A deep learning approach in diagnosing fungal keratitis based on corneal photographs.

Application of deep learning algorithm to detect and visualize vertebral fractures on plain frontal radiographs.