Bhargava Reddy

Subhankar Chattoraj, Bhargava Reddy, Manoj Tadepalli et al.

Purpose:Chest X-ray (CXR) is an essential tool and one of the most prescribed imaging to detect pulmonary abnormalities, with a yearly estimate of over 2 billion imaging performed worldwide. However, the accurate and timely diagnosis of TB remains an unmet goal. The prevalence of TB is highest in low-middle-income countries, and the requirement of a portable, automated, and reliable solution is required. In this study, we compared the performance of DL-based devices on digital and analog CXR. The evaluated DL-based device can be used in resource-constraint settings. Methods: A total of 10,000 CXR DICOMs(.dcm) and printed photos of the films acquired with three different cellular phones - Samsung S8, iPhone 8, and iPhone XS along with their radiological report were retrospectively collected from various sites across India from April 2020 to March 2021. Results: 10,000 chest X-rays were utilized to evaluate the DL-based device in identifying radiological signs of TB. The AUC of qXR for detecting signs of tuberculosis on the original DICOMs dataset was 0.928 with a sensitivity of 0.841 at a specificity of 0.806. At an optimal threshold, the difference in the AUC of three cellular smartphones with the original DICOMs is 0.024 (2.55%), 0.048 (5.10%), and 0.038 (1.91%). The minimum difference demonstrates the robustness of the DL-based device in identifying radiological signs of TB in both digital and analog CXR.

Preetham Putha, Manoj Tadepalli, Bhargava Reddy et al.

Background: Chest X-rays are the most commonly performed, cost-effective diagnostic imaging tests ordered by physicians. A clinically validated AI system that can reliably separate normals from abnormals can be invaluble particularly in low-resource settings. The aim of this study was to develop and validate a deep learning system to detect various abnormalities seen on a chest X-ray. Methods: A deep learning system was trained on 2.3 million chest X-rays and their corresponding radiology reports to identify various abnormalities seen on a Chest X-ray. The system was tested against - 1. A three-radiologist majority on an independent, retrospectively collected set of 2000 X-rays(CQ2000) 2. Radiologist reports on a separate validation set of 100,000 scans(CQ100k). The primary accuracy measure was area under the ROC curve (AUC), estimated separately for each abnormality and for normal versus abnormal scans. Results: On the CQ2000 dataset, the deep learning system demonstrated an AUC of 0.92(CI 0.91-0.94) for detection of abnormal scans, and AUC(CI) of 0.96(0.94-0.98), 0.96(0.94-0.98), 0.95(0.87-1), 0.95(0.92-0.98), 0.93(0.90-0.96), 0.89(0.83-0.94), 0.91(0.87-0.96), 0.94(0.93-0.96), 0.98(0.97-1) for the detection of blunted costophrenic angle, cardiomegaly, cavity, consolidation, fibrosis, hilar enlargement, nodule, opacity and pleural effusion. The AUCs were similar on the larger CQ100k dataset except for detecting normals where the AUC was 0.86(0.85-0.86). Interpretation: Our study demonstrates that a deep learning algorithm trained on a large, well-labelled dataset can accurately detect multiple abnormalities on chest X-rays. As these systems improve in accuracy, applying deep learning to widen the reach of chest X-ray interpretation and improve reporting efficiency will add tremendous value in radiology workflows and public health screenings globally.