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Identifying cardiomegaly in chest X-rays: a cross-sectional study of evaluation and comparison between different transfer learning methods

Bougias, H., Georgiadou, E., Malamateniou, C. ORCID: 0000-0002-2352-8575 & Stogiannos, N. ORCID: 0000-0003-1378-6631 (2020). Identifying cardiomegaly in chest X-rays: a cross-sectional study of evaluation and comparison between different transfer learning methods. Acta Radiologica, 62(12), pp. 1601-1609. doi: 10.1177/0284185120973630

Abstract

BACKGROUND: Cardiomegaly is a relatively common incidental finding on chest X-rays; if left untreated, it can result in significant complications. Using Artificial Intelligence for diagnosing cardiomegaly could be beneficial, as this pathology may be underreported, or overlooked, especially in busy or under-staffed settings.

PURPOSE: To explore the feasibility of applying four different transfer learning methods to identify the presence of cardiomegaly in chest X-rays and to compare their diagnostic performance using the radiologists' report as the gold standard.

MATERIAL AND METHODS: Two thousand chest X-rays were utilized in the current study: 1000 were normal and 1000 had confirmed cardiomegaly. Of these exams, 80% were used for training and 20% as a holdout test dataset. A total of 2048 deep features were extracted using Google's Inception V3, VGG16, VGG19, and SqueezeNet networks. A logistic regression algorithm optimized in regularization terms was used to classify chest X-rays into those with presence or absence of cardiomegaly.

RESULTS: Diagnostic accuracy is reported by means of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), with the VGG19 network providing the best values of sensitivity (84%), specificity (83%), PPV (83%), NPV (84%), and overall accuracy (84,5%). The other networks presented sensitivity at 64.1%-82%, specificity at 77.1%-81.1%, PPV at 74%-81.4%, NPV at 68%-82%, and overall accuracy at 71%-81.3%.

CONCLUSION: Deep learning using transfer learning methods based on VGG19 network can be used for the automatic detection of cardiomegaly on chest X-ray images. However, further validation and training of each method is required before application to clinical cases.

Publication Type: Article
Additional Information: Bougias, Haralabos, Georgiadou, Eleni, Malamateniou, Christina and Stogiannos, Nikolaos (2020). Identifying cardiomegaly in chest X-rays: a cross-sectional study of evaluation and comparison between different transfer learning methods.. Acta Radiologica. Copyright © 2020, the authors. https://doi.org/10.1177/0284185120973630
Publisher Keywords: Artificial Intelligence, deep learning, transfer learning, cardiomegaly, validation
Subjects: R Medicine > RC Internal medicine
Departments: School of Health & Psychological Sciences > Midwifery & Radiography
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