The use of artificial intelligence, and the deep-learning subtype in particular, has been enabled by the use of labeled big data, along with markedly enhanced computing power and cloud storage, across all sectors. In medicine, this is beginning to have an impact at three levels: for clinicians, predominantly via rapid, accurate image interpretation; for health systems, by improving workflow and the potential for reducing medical errors; and for patients, by enabling them to process their own data to promote health. The current limitations, including bias, privacy and security, and lack of transparency, along with the future directions of these applications will be discussed in this article. Over time, marked improvements in accuracy, productivity, and workflow will likely be actualized, but whether that will be used to improve the patient-doctor relationship or facilitate its erosion remains to be seen.

High-performance medicine: the convergence of human and artificial intelligence

Convolutional neural network (CNN), a class of artificial neural networks that has become dominant in various computer vision tasks, is attracting interest across a variety of domains, including radiology. CNN is designed to automatically and adaptively learn spatial hierarchies of features through backpropagation by using multiple building blocks, such as convolution layers, pooling layers, and fully connected layers. This review article offers a perspective on the basic concepts of CNN and its application to various radiological tasks, and discusses its challenges and future directions in the field of radiology. Two challenges in applying CNN to radiological tasks, small dataset and overfitting, will also be covered in this article, as well as techniques to minimize them. Being familiar with the concepts and advantages, as well as limitations, of CNN is essential to leverage its potential in diagnostic radiology, with the goal of augmenting the performance of radiologists and improving patient care. • Convolutional neural network is a class of deep learning methods which has become dominant in various computer vision tasks and is attracting interest across a variety of domains, including radiology.
 • Convolutional neural network is composed of multiple building blocks, such as convolution layers, pooling layers, and fully connected layers, and is designed to automatically and adaptively learn spatial hierarchies of features through a backpropagation algorithm.
 • Familiarity with the concepts and advantages, as well as limitations, of convolutional neural network is essential to leverage its potential to improve radiologist performance and, eventually, patient care.

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Convolutional neural networks: an overview and application in radiology

Artificial intelligence (AI) is gradually changing medical practice. With recent progress in digitized data acquisition, machine learning and computing infrastructure, AI applications are expanding into areas that were previously thought to be only the province of human experts. In this Review Article, we outline recent breakthroughs in AI technologies and their biomedical applications, identify the challenges for further progress in medical AI systems, and summarize the economic, legal and social implications of AI in healthcare.

Artificial Intelligence in Healthcare

The development of decision support systems for pathology and their deployment in clinical practice have been hindered by the need for large manually annotated datasets. To overcome this problem, we present a multiple instance learning-based deep learning system that uses only the reported diagnoses as labels for training, thereby avoiding expensive and time-consuming pixel-wise manual annotations. We evaluated this framework at scale on a dataset of 44,732 whole slide images from 15,187 patients without any form of data curation. Tests on prostate cancer, basal cell carcinoma and breast cancer metastases to axillary lymph nodes resulted in areas under the curve above 0.98 for all cancer types. Its clinical application would allow pathologists to exclude 65–75% of slides while retaining 100% sensitivity. Our results show that this system has the ability to train accurate classification models at unprecedented scale, laying the foundation for the deployment of computational decision support systems in clinical practice.

Clinical-grade computational pathology using weakly supervised deep learning on whole slide images.

Summary Background Deep learning offers considerable promise for medical diagnostics. We aimed to evaluate the diagnostic accuracy of deep learning algorithms versus health-care professionals in classifying diseases using medical imaging. Methods In this systematic review and meta-analysis, we searched Ovid-MEDLINE, Embase, Science Citation Index, and Conference Proceedings Citation Index for studies published from Jan 1, 2012, to June 6, 2019. Studies comparing the diagnostic performance of deep learning models and health-care professionals based on medical imaging, for any disease, were included. We excluded studies that used medical waveform data graphics material or investigated the accuracy of image segmentation rather than disease classification. We extracted binary diagnostic accuracy data and constructed contingency tables to derive the outcomes of interest: sensitivity and specificity. Studies undertaking an out-of-sample external validation were included in a meta-analysis, using a unified hierarchical model. This study is registered with PROSPERO, CRD42018091176. Findings Our search identified 31 587 studies, of which 82 (describing 147 patient cohorts) were included. 69 studies provided enough data to construct contingency tables, enabling calculation of test accuracy, with sensitivity ranging from 9·7% to 100·0% (mean 79·1%, SD 0·2) and specificity ranging from 38·9% to 100·0% (mean 88·3%, SD 0·1). An out-of-sample external validation was done in 25 studies, of which 14 made the comparison between deep learning models and health-care professionals in the same sample. Comparison of the performance between health-care professionals in these 14 studies, when restricting the analysis to the contingency table for each study reporting the highest accuracy, found a pooled sensitivity of 87·0% (95% CI 83·0–90·2) for deep learning models and 86·4% (79·9–91·0) for health-care professionals, and a pooled specificity of 92·5% (95% CI 85·1–96·4) for deep learning models and 90·5% (80·6–95·7) for health-care professionals. Interpretation Our review found the diagnostic performance of deep learning models to be equivalent to that of health-care professionals. However, a major finding of the review is that few studies presented externally validated results or compared the performance of deep learning models and health-care professionals using the same sample. Additionally, poor reporting is prevalent in deep learning studies, which limits reliable interpretation of the reported diagnostic accuracy. New reporting standards that address specific challenges of deep learning could improve future studies, enabling greater confidence in the results of future evaluations of this promising technology. Funding None.

A comparison of deep learning performance against health-care professionals in detecting diseases from medical imaging: a systematic review and meta-analysis

This paper presents the ideas for the 2021 ImageCLEF lab that will be organized as part of the Conference and Labs of the Evaluation Forum—CLEF Labs 2021 in Bucharest, Romania. ImageCLEF is an ongoing evaluation initiative (active since 2003) that promotes the evaluation of technologies for annotation, indexing and retrieval of visual data with the aim of providing information access to large collections of images in various usage scenarios and domains. In 2021, the 19th edition of ImageCLEF will organize four main tasks: (i) a Medical task addressing visual question answering, a concept annotation and a tuberculosis classification task, (ii) a Coral task addressing the annotation and localisation of substrates in coral reef images, (iii) a DrawnUI task addressing the creation of websites from either a drawing or a screenshot by detecting the different elements present on the design and a new (iv) Aware task addressing the prediction of real-life consequences of online photo sharing. The strong participation in 2020, despite the COVID pandemic, with over 115 research groups registering and 40 submitting over 295 runs for the tasks shows an important interest in this benchmarking campaign. We expect the new tasks to attract at least as many researchers for 2021.

The 2021 ImageCLEF Benchmark: Multimedia Retrieval in Medical, Nature, Internet and Social Media Applications

Overview of ImageCLEF 2018

The results of the development of hardware and software system (micromodule), which detects and classifies underlying surface images of the Earth are presented. The micromodule can be installed on board of a light unmanned aerial vehicle (drone). The device has the size 5.2×7.4×3.1 cm, the weight52 g, runs on a Raspberry Pi Zero Wireless single-board microcomputer and uses a convolutional neural network based on MobileNetV2 architecture for real-time image classification. When developing the micromodule, the authors aimed to achieve a real-time image classification on inexpensive mobile equipment with low computing power so that the classification quality is  comparable  to  popular  deep  convolutional  network  architectures. The provided information could be useful for engineers and researchers who are developing compact budget mobile systems for processing, analyzing and recognition of images.

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Recognition of underlying surface using a convolutional neural network on a single-board computer

This paper presents a generalized approach for computing image gradient. It is predominantly aimed at detecting unclear and in certain circumstances even completely invisible borders in large 2D and 3D texture images. The method exploits the conventional approach of sliding window. Once two pixel/voxel sets are sub-sampled from orthogonal window halves, they are compared by a suitable technique (e.g., statistical t-test, SVM classier, comparison of parameters of two distributions) and the resultant measure of difference (e.g., t-value, the classification accuracy, skewness difference of two distributions etc.) is treated as the gradient magnitude. The bootstrap procedure is employed for increasing the accuracy of difference assessment of two pixel/voxel sets.

Highlighting Tumor Borders Using Generalized Gradient

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Vitali Liauchuk

Papers

The 2021 ImageCLEF Benchmark: Multimedia Retrieval in Medical, Nature, Internet and Social Media Applications

Overview of ImageCLEF 2018

Recognition of underlying surface using a convolutional neural network on a single-board computer

Highlighting Tumor Borders Using Generalized Gradient

Overview of ImageCLEFtuberculosis 2019