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Albiol, F., Corbi, A., & Albiol, A. (2019). Densitometric Radiographic Imaging With Contour Sensors. IEEE Access, 7, 18902–18914.
Abstract: We present the technical/physical foundations of a new imaging technique that combines ordinary radiographic information (generated by conventional X-ray settings) with the patient's volume to derive densitometric images. Traditionally, these images provide quantitative information about tissues densities. In our approach, they graphically enhance either soft or bony regions. After measuring the patient's volume with contour recognition devices, the physical traversed lengths within it (as the Roentgen beam intersects the patient) are calculated and pixel-wise associated with the original radiograph (X). In order to derive this map of lengths (L), the camera equations of the X-ray system and the contour sensor are determined. The patient's surface is also translated to the point-of-view of the X-ray beam and all its entrance/exit points are sought with the help of ray-casting methods. The derived L is applied to X as a physical operation (subtraction), obtaining soft tissue-(D-S) or bone-enhanced (D'(B)) figures. In the D-S type, the contained graphical information can be linearly mapped to the average electronic density (traversed by the X-ray beam). This feature represents an interesting proof-of-concept of associating density data to radiographs, but most important, their intensity histogram is objectively compressed, i.e., the dynamic range is more shrunk (compared against the corresponding X). This leads to other advantages: improvement in the visibility of border/edge areas (high gradient), extended manual window level/width manipulations during screening, and immediate correction of underexposed X instances. In the D-B' type, high-density elements are highlighted and easier to discern. All these results can be achieved with low-energy beam exposures, saving costs and dose. Future work will deepen this clinical side of our research. In contrast with other image-based modifiers, the proposed method is grounded on the measurement of a physical entity: the span of the X-ray beam within a body while undertaking a radiographic examination.
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Albiol, F., Corbi, A., & Albiol, A. (2016). Geometrical Calibration of X-Ray Imaging With RGB Cameras for 3D Reconstruction. IEEE Trans. Med. Imaging, 35(8), 1952–1961.
Abstract: We present a methodology to recover the geometrical calibration of conventional X-ray settings with the help of an ordinary video camera and visible fiducials that are present in the scene. After calibration, equivalent points of interest can be easily identifiable with the help of the epipolar geometry. The same procedure also allows the measurement of real anatomic lengths and angles and obtains accurate 3D locations from image points. Our approach completely eliminates the need for X-ray-opaque reference marks (and necessary supporting frames) which can sometimes be invasive for the patient, occlude the radiographic picture, and end up projected outside the imaging sensor area in oblique protocols. Two possible frameworks are envisioned: a spatially shifting X-ray anode around the patient/object and a moving patient that moves/rotates while the imaging system remains fixed. As a proof of concept, experiences with a device under test (DUT), an anthropomorphic phantom and a real brachytherapy session have been carried out. The results show that it is possible to identify common points with a proper level of accuracy and retrieve three-dimensional locations, lengths and shapes with a millimetric level of precision. The presented approach is simple and compatible with both current and legacy widespread diagnostic X-ray imaging deployments and it can represent a good and inexpensive alternative to other radiological modalities like CT.
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Albiol, A., Albiol, F., Paredes, R., Plasencia-Martinez, J. M., Blanco Barrio, A., Garcia Santos, J. M., et al. (2022). A comparison of Covid-19 early detection between convolutional neural networks and radiologists. Insights Imaging, 13(1), 122–12pp.
Abstract: Background The role of chest radiography in COVID-19 disease has changed since the beginning of the pandemic from a diagnostic tool when microbiological resources were scarce to a different one focused on detecting and monitoring COVID-19 lung involvement. Using chest radiographs, early detection of the disease is still helpful in resource-poor environments. However, the sensitivity of a chest radiograph for diagnosing COVID-19 is modest, even for expert radiologists. In this paper, the performance of a deep learning algorithm on the first clinical encounter is evaluated and compared with a group of radiologists with different years of experience. Methods The algorithm uses an ensemble of four deep convolutional networks, Ensemble4Covid, trained to detect COVID-19 on frontal chest radiographs. The algorithm was tested using images from the first clinical encounter of positive and negative cases. Its performance was compared with five radiologists on a smaller test subset of patients. The algorithm's performance was also validated using the public dataset COVIDx. Results Compared to the consensus of five radiologists, the Ensemble4Covid model achieved an AUC of 0.85, whereas the radiologists achieved an AUC of 0.71. Compared with other state-of-the-art models, the performance of a single model of our ensemble achieved nonsignificant differences in the public dataset COVIDx. Conclusion The results show that the use of images from the first clinical encounter significantly drops the detection performance of COVID-19. The performance of our Ensemble4Covid under these challenging conditions is considerably higher compared to a consensus of five radiologists. Artificial intelligence can be used for the fast diagnosis of COVID-19.
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Schaffter, T. et al, Albiol, F., & Caballero, L. (2020). Evaluation of Combined Artificial Intelligence and Radiologist Assessment to Interpret Screening Mammograms. JAMA Netw. Open, 3(3), e200265–15pp.
Abstract: Importance Mammography screening currently relies on subjective human interpretation. Artificial intelligence (AI) advances could be used to increase mammography screening accuracy by reducing missed cancers and false positives. Objective To evaluate whether AI can overcome human mammography interpretation limitations with a rigorous, unbiased evaluation of machine learning algorithms. Design, Setting, and Participants In this diagnostic accuracy study conducted between September 2016 and November 2017, an international, crowdsourced challenge was hosted to foster AI algorithm development focused on interpreting screening mammography. More than 1100 participants comprising 126 teams from 44 countries participated. Analysis began November 18, 2016. Main Outcomes and Measurements Algorithms used images alone (challenge 1) or combined images, previous examinations (if available), and clinical and demographic risk factor data (challenge 2) and output a score that translated to cancer yes/no within 12 months. Algorithm accuracy for breast cancer detection was evaluated using area under the curve and algorithm specificity compared with radiologists' specificity with radiologists' sensitivity set at 85.9% (United States) and 83.9% (Sweden). An ensemble method aggregating top-performing AI algorithms and radiologists' recall assessment was developed and evaluated. Results Overall, 144231 screening mammograms from 85580 US women (952 cancer positive <= 12 months from screening) were used for algorithm training and validation. A second independent validation cohort included 166578 examinations from 68008 Swedish women (780 cancer positive). The top-performing algorithm achieved an area under the curve of 0.858 (United States) and 0.903 (Sweden) and 66.2% (United States) and 81.2% (Sweden) specificity at the radiologists' sensitivity, lower than community-practice radiologists' specificity of 90.5% (United States) and 98.5% (Sweden). Combining top-performing algorithms and US radiologist assessments resulted in a higher area under the curve of 0.942 and achieved a significantly improved specificity (92.0%) at the same sensitivity. Conclusions and Relevance While no single AI algorithm outperformed radiologists, an ensemble of AI algorithms combined with radiologist assessment in a single-reader screening environment improved overall accuracy. This study underscores the potential of using machine learning methods for enhancing mammography screening interpretation. Question How do deep learning algorithms perform compared with radiologists in screening mammography interpretation? Findings In this diagnostic accuracy study using 144231 screening mammograms from 85580 women from the United States and 166578 screening mammograms from 68008 women from Sweden, no single artificial intelligence algorithm outperformed US community radiologist benchmarks; including clinical data and prior mammograms did not improve artificial intelligence performance. However, combining best-performing artificial intelligence algorithms with single-radiologist assessment demonstrated increased specificity. Meaning Integrating artificial intelligence to mammography interpretation in single-radiologist settings could yield significant performance improvements, with the potential to reduce health care system expenditures and address resource scarcity experienced in population-based screening programs. This diagnostic accuracy study evaluates whether artificial intelligence can overcome human mammography interpretation limits with a rigorous, unbiased evaluation of machine learning algorithms.
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Caballero, L., Albiol, F., Corbi Bellot, A., Domingo-Pardo, C., Leganes Nieto, J. L., Agramunt Ros, J., et al. (2018). Gamma-ray imaging system for real-time measurements in nuclear waste characterisation. J. Instrum., 13, P03016–23pp.
Abstract: Acompact, portable and large field-of-viewgamma camera that is able to identify, locate and quantify gamma-ray emitting radioisotopes in real-time has been developed. The device delivers spectroscopic and imaging capabilities that enable its use it in a variety of nuclear waste characterisation scenarios, such as radioactivity monitoring in nuclear power plants and more specifically for the decommissioning of nuclear facilities. The technical development of this apparatus and some examples of its application in field measurements are reported in this article. The performance of the presented gamma-camera is also benchmarked against other conventional techniques.
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