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Tens of images can suffice to train neural networks for malignant leukocyte detection.

ABSTRACT: Convolutional neural networks (CNNs) excel as powerful tools for biomedical image classification. It is commonly assumed that training CNNs requires large amounts of annotated data. This is a bottleneck in many medical applications where annotation relies on expert knowledge. Here, we analyze the binary classification performance of a CNN on two independent cytomorphology datasets as a function of training set size. Specifically, we train a sequential model to discriminate non-malignant leukocytes from blast cells, whose appearance in the peripheral blood is a hallmark of leukemia. We systematically vary training set size, finding that tens of training images suffice for a binary classification with an ROC-AUC over 90%. Saliency maps and layer-wise relevance propagation visualizations suggest that the network learns to increasingly focus on nuclear structures of leukocytes as the number of training images is increased. A low dimensional tSNE representation reveals that while the two classes are separated already for a few training images, the distinction between the classes becomes clearer when more training images are used. To evaluate the performance in a multi-class problem, we annotated single-cell images from a acute lymphoblastic leukemia dataset into six different hematopoietic classes. Multi-class prediction suggests that also here few single-cell images suffice if differences between morphological classes are large enough. The incorporation of deep learning algorithms into clinical practice has the potential to reduce variability and cost, democratize usage of expertise, and allow for early detection of disease onset and relapse. Our approach evaluates the performance of a deep learning based cytology classifier with respect to size and complexity of the training data and the classification task.

SUBMITTER: Schouten JPE

PROVIDER: S-EPMC8042012 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:PurposeTo investigate the diagnostic accuracy of cascading convolutional neural network (CNN) for urinary stone detection on unenhanced CT images and to evaluate the performance of pretrained models enriched with labeled CT images across different scanners.Materials and methodsThis HIPAA-compliant, institutional review board-approved, retrospective clinical study used unenhanced abdominopelvic CT scans from 535 adults suspected of having urolithiasis. The scans were obtained on two scanners (scanner 1 [hereafter S1] and scanner 2 [hereafter S2]). A radiologist reviewed clinical reports and labeled cases for determination of reference standard. Stones were present on 279 (S1, 131; S2, 148) and absent on 256 (S1, 158; S2, 98) scans. One hundred scans (50 from each scanner) were randomly reserved as the test dataset, and the rest were used for developing a cascade of two CNNs: The first CNN identified the extent of the urinary tract, and the second CNN detected presence of stone. Nine variations of models were developed through the combination of different training data sources (S1, S2, or both [hereafter SB]) with (ImageNet, GrayNet) and without (Random) pretrained CNNs. First, models were compared for generalizability at the section level. Second, models were assessed by using area under the receiver operating characteristic curve (AUC) and accuracy at the patient level with test dataset from both scanners (n = 100).ResultsThe GrayNet-pretrained model showed higher classifier exactness than did ImageNet-pretrained or Random-initialized models when tested by using data from the same or different scanners at section level. At the patient level, the AUC for stone detection was 0.92-0.95, depending on the model. Accuracy of GrayNet-SB (95%) was higher than that of ImageNet-SB (91%) and Random-SB (88%). For stones larger than 4 mm, all models showed similar performance (false-negative results: two of 34). For stones smaller than 4 mm, the number of false-negative results for GrayNet-SB, ImageNet-SB, and Random-SB were one of 16, three of 16, and five of 16, respectively. GrayNet-SB identified stones in all 22 test cases that had obstructive uropathy.ConclusionA cascading model of CNNs can detect urinary tract stones on unenhanced CT scans with a high accuracy (AUC, 0.954). Performance and generalization of CNNs across scanners can be enhanced by using transfer learning with datasets enriched with labeled medical images.© RSNA, 2019Supplemental material is available for this article. : An earlier incorrect version appeared online. This article was corrected on August 6, 2019.

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Tens of images can suffice to train neural networks for malignant leukocyte detection.

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