Malainho Bárbara, Freitas João, Rodrigues Catarina, Tonelli Ana Claudia, Santanchè André, Carvalho-Filho Marco A, Fonseca Jaime C, Queirós Sandro
Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal.
ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.
J Imaging Inform Med. 2024 Dec 13. doi: 10.1007/s10278-024-01344-y.
Point-of-care ultrasound (POCUS) stands as a safe, portable, and cost-effective imaging modality for swift bedside patient examinations. Specifically, lung ultrasonography (LUS) has proven useful in evaluating both acute and chronic pulmonary conditions. Despite its clinical value, automatic LUS interpretation remains relatively unexplored, particularly in multi-label contexts. This work proposes a novel deep learning (DL) framework tailored for interpreting lung POCUS videos, whose outputs are the finding(s) present in these videos (such as A-lines, B-lines, or consolidations). The pipeline, based on a residual (2+1)D architecture, initiates with a pre-processing routine for video masking and standardisation, and employs a semi-supervised approach to harness available unlabeled data. Additionally, we introduce an ensemble modeling strategy that aggregates outputs from models trained to predict distinct label sets, thereby leveraging the hierarchical nature of LUS findings. The proposed framework and its building blocks were evaluated through extensive experiments with both multi-class and multi-label models, highlighting its versatility. In a held-out test set, the categorical proposal, suited for expedite triage, achieved an average F1-score of 92.4%, while the multi-label proposal, helpful for patient management and referral, achieved an average F1-score of 70.5% across five relevant LUS findings. Overall, the semi-supervised methodology contributed significantly to improved performance, while the proposed hierarchy-aware ensemble provided moderate additional gains.
床旁超声检查(POCUS)是一种安全、便携且经济高效的成像方式,可用于快速进行床边患者检查。具体而言,肺部超声检查(LUS)已被证明在评估急性和慢性肺部疾病方面很有用。尽管其具有临床价值,但自动LUS解读仍相对未被探索,尤其是在多标签情况下。这项工作提出了一种新颖的深度学习(DL)框架,专门用于解读肺部POCUS视频,其输出是这些视频中存在的发现(如A线、B线或实变)。该流程基于残差(2+1)D架构,首先进行视频掩码和标准化的预处理程序,并采用半监督方法来利用可用的未标记数据。此外,我们引入了一种集成建模策略,该策略汇总了为预测不同标签集而训练的模型的输出,从而利用了LUS发现的层次结构。通过对多类和多标签模型进行广泛实验,对所提出的框架及其构建模块进行了评估,突出了其通用性。在一个预留测试集中,适用于快速分诊的分类提议平均F1分数达到92.4%,而有助于患者管理和转诊的多标签提议在五个相关LUS发现上的平均F1分数达到70.5%。总体而言,半监督方法对性能提升有显著贡献,而所提出的层次感知集成提供了适度的额外增益。