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Automated segmentation and diagnosis of pneumothorax on chest X-rays with fully convolutional multi-scale ScSE-DenseNet: a retrospective study

Wang Q, Liu Q, Luo G, Liu Z, Huang J, Zhou Y, Zhou Y, Xu W et al.

BMC medical informatics and decision making, 2020

Abstract

BACKGROUND: Pneumothorax (PTX) may cause a life-threatening medical emergency with cardio-respiratory collapse that requires immediate intervention and rapid treatment. The screening and diagnosis of pneumothorax usually rely on chest radiographs. However, the pneumothoraces in chest X-rays may be very subtle with highly variable in shape and overlapped with the ribs or clavicles, which are often difficult to identify. Our objective was to create a large chest X-ray dataset for pneumothorax with pixel-level annotation and to train an automatic segmentation and diagnosis framework to assist radiologists to identify pneumothorax accurately and timely.

METHODS: In this study, an end-to-end deep learning framework is proposed for the segmentation and diagnosis of pneumothorax on chest X-rays, which incorporates a fully convolutional DenseNet (FC-DenseNet) with multi-scale module and spatial and channel squeezes and excitation (scSE) modules. To further improve the precision of boundary segmentation, we propose a spatial weighted cross-entropy loss function to penalize the target, background and contour pixels with different weights.

RESULTS: This retrospective study are conducted on a total of eligible 11,051 front-view chest X-ray images (5566 cases of PTX and 5485 cases of Non-PTX). The experimental results show that the proposed algorithm outperforms the five state-of-the-art segmentation algorithms in terms of mean pixel-wise accuracy (MPA) with [Formula: see text] and dice…

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Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.

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