Contrast-enhanced ultrasonography parameters in neural network diagnosis of liver tumors

AIM:To study the role of time-intensity curve(TIC) analysis parameters in a complex system of neural networks designed to classify liver tumors.METHODS:We prospectively included 112 patients with hepatocellular carcinoma(HCC)(n = 41),hypervascular(n = 20) and hypovascular(n = 12) liver metastases,hepatic hemangiomas(n = 16) or focal fatty changes(n = 23) who underwent contrast-enhanced ultrasonography in the Research Center of Gastroenterology and Hepatology,Craiova,Romania.We recorded full length movies of all contrast uptake phases and post-processed them offline by selecting two areas of interest(one for the tumor and one for the healthy surrounding parenchyma) and consecutive TIC analysis.The difference in maximum intensities,the time to reaching them and the aspect of the late/portal phase,as quantified by the neural network and a ratio between median intensities of the central and peripheral areas were analyzed by a feed forward back propagation multi-layer neural network which was trained to classify data into five distinct classes,corresponding to each type of liver lesion.RESULTS:The neural network had 94.45% training accuracy(95% CI:89.31%-97.21%) and 87.12% testing accuracy(95% CI:86.83%-93.17%).The automatic classification process registered 93.2% sensitivity,89.7% specificity,94.42% positive predictive value and 87.57% negative predictive value.The artificial neural networks(ANN) incorrectly classified as hemangyomas three HCC cases and two hypervascular metastases,while in turn misclassifying four liver hemangyomas as HCC(one case) and hypervascular metastases(three cases).Comparatively,human interpretation of TICs showed 94.1% sensitivity,90.7% specificity,95.11% positive predictive value and 88.89% negative predictive value.The accuracy and specificity of the ANN diagnosis system was similar to that of human interpretation of the TICs(P = 0.225 and P = 0.451,respectively).Hepatocellular carcinoma cases showed contrast uptake during the arterial phase followed by wash-out in the portal and first seconds of the late phases.For the hypovascular metastases did not show significant contrast uptake during the arterial phase,which resulted in negative differences between the maximum intensities.We registered wash-out in the late phase for most of the hypervascular metastases.Liver hemangiomas had contrast uptake in the arterial phase without agent wash-out in the portallate phases.The focal fatty changes did not show any differences from surrounding liver parenchyma,resulting in similar TIC patterns and extracted parameters.CONCLUSION:Neural network analysis of contrastenhanced ultrasonography-obtained TICs seems a promising field of development for future techniques,providing fast and reliable diagnostic aid for the clinician.

Establishing and validating a spotted tongue recognition and extraction model based on multiscale convolutional neural network

Objective In tongue diagnosis,the location,color,and distribution of spots can be used to speculate on the viscera and severity of the heat evil.This work focuses on the image analysis method of artificial intelligence(AI)to study the spotted tongue recognition of traditional Chinese medicine(TCM).Methods A model of spotted tongue recognition and extraction is designed,which is based on the principle of image deep learning and instance segmentation.This model includes multiscale feature map generation,region proposal searching,and target region recognition.Firstly,deep convolution network is used to build multiscale low-and high-abstraction feature maps after which,target candidate box generation algorithm and selection strategy are used to select high-quality target candidate regions.Finally,classification network is used for classifying target regions and calculating target region pixels.As a result,the region segmentation of spotted tongue is obtained.Under non-standard illumination conditions,various tongue images were taken by mobile phones,and experiments were conducted.Results The spotted tongue recognition achieved an area under curve(AUC)of 92.40%,an accuracy of 84.30%with a sensitivity of 88.20%,a specificity of 94.19%,a recall of 88.20%,a regional pixel accuracy index pixel accuracy(PA)of 73.00%,a mean pixel accuracy(m PA)of73.00%,an intersection over union(Io U)of 60.00%,and a mean intersection over union(mIo U)of 56.00%.Conclusion The results of the study verify that the model is suitable for the application of the TCM tongue diagnosis system.Spotted tongue recognition via multiscale convolutional neural network(CNN)would help to improve spot classification and the accurate extraction of pixels of spot area as well as provide a practical method for intelligent tongue diagnosis of TCM.

移动医疗健康应用程序使用及需求现状的调查研究

目的探究医疗类APP应用现状及门诊患者中对医疗APP功能需求现状。方法以问卷调查的形式对673名门诊患者的一般资料、医疗类APP应用现状及功能发展需求进行调查。结果 47.8%的患者使用过医疗APP,其中辅助就诊类占76.7%;95.2%的患者对医疗APP持信任态度;患者对医疗APP的功能需求排序为:预约挂号为77.4%、健康咨询为65.5%、用药提醒为48.9%、远程诊疗为38.6%;信息需求排序为:日常医疗知识为74.1%、与自身疾病相关的知识为70.7%、急救知识为62.6%;超90%的患者对网络分诊为支持态度,其相关影响因素有年龄、性别、文化程度、收入水平。结论患者对于医疗APP的信任度较高但使用率低,患者对于网络分诊有所需求,患者对于分诊的准确性有较高要求。