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      Application of Convolutional Neural Network in the Diagnosis of Jaw Tumors

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          Abstract

          Objectives

          Ameloblastomas and keratocystic odontogenic tumors (KCOTs) are important odontogenic tumors of the jaw. While their radiological findings are similar, the behaviors of these two types of tumors are different. Precise preoperative diagnosis of these tumors can help oral and maxillofacial surgeons plan appropriate treatment. In this study, we created a convolutional neural network (CNN) for the detection of ameloblastomas and KCOTs.

          Methods

          Five hundred digital panoramic images of ameloblastomas and KCOTs were retrospectively collected from a hospital information system, whose patient information could not be identified, and preprocessed by inverse logarithm and histogram equalization. To overcome the imbalance of data entry, we focused our study on 2 tumors with equal distributions of input data. We implemented a transfer learning strategy to overcome the problem of limited patient data. Transfer learning used a 16-layer CNN (VGG-16) of the large sample dataset and was refined with our secondary training dataset comprising 400 images. A separate test dataset comprising 100 images was evaluated to compare the performance of CNN with diagnosis results produced by oral and maxillofacial specialists.

          Results

          The sensitivity, specificity, accuracy, and diagnostic time were 81.8%, 83.3%, 83.0%, and 38 seconds, respectively, for the CNN. These values for the oral and maxillofacial specialist were 81.1%, 83.2%, 82.9%, and 23.1 minutes, respectively.

          Conclusions

          Ameloblastomas and KCOTs could be detected based on digital panoramic radiographic images using CNN with accuracy comparable to that of manual diagnosis by oral maxillofacial specialists. These results demonstrate that CNN may aid in screening for ameloblastomas and KCOTs in a substantially shorter time.

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          Most cited references11

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          Deep Convolutional Neural Networks for Computer-Aided Detection: CNN Architectures, Dataset Characteristics and Transfer Learning

          Remarkable progress has been made in image recognition, primarily due to the availability of large-scale annotated datasets and the revival of deep CNN. CNNs enable learning data-driven, highly representative, layered hierarchical image features from sufficient training data. However, obtaining datasets as comprehensively annotated as ImageNet in the medical imaging domain remains a challenge. There are currently three major techniques that successfully employ CNNs to medical image classification: training the CNN from scratch, using off-the-shelf pre-trained CNN features, and conducting unsupervised CNN pre-training with supervised fine-tuning. Another effective method is transfer learning, i.e., fine-tuning CNN models pre-trained from natural image dataset to medical image tasks. In this paper, we exploit three important, but previously understudied factors of employing deep convolutional neural networks to computer-aided detection problems. We first explore and evaluate different CNN architectures. The studied models contain 5 thousand to 160 million parameters, and vary in numbers of layers. We then evaluate the influence of dataset scale and spatial image context on performance. Finally, we examine when and why transfer learning from pre-trained ImageNet (via fine-tuning) can be useful. We study two specific computer-aided detection (CADe) problems, namely thoraco-abdominal lymph node (LN) detection and interstitial lung disease (ILD) classification. We achieve the state-of-the-art performance on the mediastinal LN detection, with 85% sensitivity at 3 false positive per patient, and report the first five-fold cross-validation classification results on predicting axial CT slices with ILD categories. Our extensive empirical evaluation, CNN model analysis and valuable insights can be extended to the design of high performance CAD systems for other medical imaging tasks.
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            Interpretation of plain chest roentgenogram.

            Plain chest roentgenogram remains the most commonly ordered screening test for pulmonary disorders. Its lower sensitivity demands greater accuracy in interpretation. This greater accuracy can be achieved by adhering to an optimal and organized approach to interpretation. It is important for clinicians not to misread an abnormal chest radiograph (CXR) as normal. Clinicians can only acquire the confidence in making this determination if they read hundreds of normal CXRs. An individual should follow the same systematic approach to reading CXRs each time. All clinicians must make a concerted effort to read plain CXRs themselves first without reading the radiologist report and then discuss the findings with their radiology colleagues. Looking at the lateral CXR may shed light on 15% of the lung that is hidden from view on the posteroanterior film. Comparing prior films with the recent films is mandatory, when available, to confirm and/or extend differential diagnosis. This article outlines one of the many systematic approaches to interpreting CXRs and highlights the lesions that are commonly missed. A brief description of the limitations of CXR is also included.
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              Biomedical data privacy: problems, perspectives, and recent advances.

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                Author and article information

                Journal
                Healthc Inform Res
                Healthc Inform Res
                HIR
                Healthcare Informatics Research
                Korean Society of Medical Informatics
                2093-3681
                2093-369X
                July 2018
                31 July 2018
                : 24
                : 3
                : 236-241
                Affiliations
                [1 ]Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Trisakti University, Jakarta, Indonesia.
                [2 ]Faculty of Dentistry, Thammasat University, Pathumthani, Thailand.
                Author notes
                Corresponding Author: Siriwan Suebnukarn, DDS, PhD. Faculty of Dentistry, Thammasat University, Pathumthani 12121, Thailand. Tel: +66-81642-5582, siriwan.suebnukarn@ 123456gmail.com
                Article
                10.4258/hir.2018.24.3.236
                6085208
                30109156
                86bcb307-9242-4108-a583-be9425756cab
                © 2018 The Korean Society of Medical Informatics

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 20 May 2018
                : 19 July 2018
                : 24 July 2018
                Categories
                Original Article

                Bioinformatics & Computational biology
                artificial intelligence,ameloblastoma,odontogenic tumors,panoramic radiography,oral and maxillofacial surgeons

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