Department of Information Engineering and Computer Science, University of Trento, Trento, Italy.
University of Massachusetts Dartmouth, MA, USA.
Comput Biol Med. 2024 Sep;180:109014. doi: 10.1016/j.compbiomed.2024.109014. Epub 2024 Aug 19.
Pneumonia is the leading cause of death among children around the world. According to WHO, a total of 740,180 lives under the age of five were lost due to pneumonia in 2019. Lung ultrasound (LUS) has been shown to be particularly useful for supporting the diagnosis of pneumonia in children and reducing mortality in resource-limited settings. The wide application of point-of-care ultrasound at the bedside is limited mainly due to a lack of training for data acquisition and interpretation. Artificial Intelligence can serve as a potential tool to automate and improve the LUS data interpretation process, which mainly involves analysis of hyper-echoic horizontal and vertical artifacts, and hypo-echoic small to large consolidations. This paper presents, Fused Lung Ultrasound Encoding-based Transformer (FLUEnT), a novel pediatric LUS video scoring framework for detecting lung consolidations using fused LUS encodings. Frame-level embeddings from a variational autoencoder, features from a spatially attentive ResNet-18, and encoded patient information as metadata combiningly form the fused encodings. These encodings are then passed on to the transformer for binary classification of the presence or absence of consolidations in the video. The video-level analysis using fused encodings resulted in a mean balanced accuracy of 89.3 %, giving an average improvement of 4.7 % points in comparison to when using these encodings individually. In conclusion, outperforming the state-of-the-art models by an average margin of 8 % points, our proposed FLUEnT framework serves as a benchmark for detecting lung consolidations in LUS videos from pediatric pneumonia patients.
肺炎是全球儿童死亡的主要原因。根据世界卫生组织的数据,2019 年,全球共有 740180 名五岁以下儿童因肺炎而死亡。肺部超声 (LUS) 已被证明对支持儿童肺炎的诊断和降低资源有限环境下的死亡率特别有用。床边即时超声的广泛应用主要受到数据采集和解释培训不足的限制。人工智能可以作为一种潜在的工具,用于自动化和改进 LUS 数据解释过程,该过程主要涉及对强回声水平和垂直伪影以及低回声小到大实变的分析。本文提出了一种基于融合肺部超声编码的变压器 (FLUEnT) 的新型儿科肺部超声视频评分框架,用于使用融合肺部超声编码检测肺部实变。来自变分自动编码器的帧级嵌入、来自空间注意 ResNet-18 的特征以及将患者信息作为元数据编码相结合,形成融合编码。然后将这些编码传递给变压器,用于对视频中是否存在实变进行二进制分类。使用融合编码进行视频级分析的平均平衡准确率为 89.3%,与单独使用这些编码相比,平均提高了 4.7%。总之,与最先进的模型相比,我们提出的 FLUEnT 框架平均提高了 8%的准确率,为检测儿科肺炎患者的肺部超声视频中的实变提供了一个基准。