Dry eye disease (DED) has a prevalence of between 5 and 50%, depending on the diagnostic criteria used and population under study. However, it remains one of the most underdiagnosed and undertreated conditions in ophthalmology. Many tests used in the diagnosis of DED rely on an experienced observer for image interpretation, which may be considered subjective and result in variation in diagnosis. Since artificial intelligence (AI) systems are capable of advanced problem solving, use of such techniques could lead to more objective diagnosis. Although the term ‘AI’ is commonly used, recent success in its applications to medicine is mainly due to advancements in the sub-field of machine learning, which has been used to automatically classify images and predict medical outcomes. Powerful machine learning techniques have been harnessed to understand nuances in patient data and medical images, aiming for consistent diagnosis and stratification of disease severity. This is the first literature review on the use of AI in DED. We provide a brief introduction to AI, report its current use in DED research and its potential for application in the clinic. Our review found that AI has been employed in a wide range of DED clinical tests and research applications, primarily for interpretation of interferometry, slit-lamp and meibography images. While initial results are promising, much work is still needed on model development, clinical testing and standardisation.

Widely used traditional supervised deep learning methods require a large number of training samples but often fail to generalize on unseen datasets. Therefore, a more general application of any trained model is quite limited for medical imaging for clinical practice. Using separately trained models for each unique lesion category or a unique patient population will require sufficiently large curated datasets, which is not practical to use in a real-world clinical set-up. Few-shot learning approaches can not only minimize the need for an enormous number of reliable ground truth labels that are labour-intensive and expensive, but can also be used to model on a dataset coming from a new population. To this end, we propose to exploit an optimization-based implicit model agnostic meta-learning (iMAML) algorithm under few-shot settings for medical image segmentation. Our approach can leverage the learned weights from diverse but small training samples to perform analysis on unseen datasets with high accuracy. We show that, unlike classical few-shot learning approaches, our method improves generalization capability. To our knowledge, this is the first work that exploits iMAML for medical image segmentation and explores the strength of the model on scenarios such as meta-training on unique and mixed instances of lesion datasets. Our quantitative results on publicly available skin and polyp datasets show that the proposed method outperforms the naive supervised baseline model and two recent few-shot segmentation approaches by large margins. In addition, our iMAML approach shows an improvement of 2%–4% in dice score compared to its counterpart MAML for most experiments.

Colonoscopy is considered the gold standard for detection of colorectal cancer and its precursors. Existing examination methods are, however, hampered by high overall miss-rate, and many abnormalities are left undetected. Computer-Aided Diagnosis systems based on advanced machine learning algorithms are touted as a game-changer that can identify regions in the colon overlooked by the physicians during endoscopic examinations, and help detect and characterize lesions. In previous work, we have proposed the ResUNet++ architecture and demonstrated that it produces more efficient results compared with its counterparts U-Net and ResUNet. In this paper, we demonstrate that further improvements to the overall prediction performance of the ResUNet++ architecture can be achieved by using Conditional Random Field (CRF) and Test-Time Augmentation (TTA). We have performed extensive evaluations and validated the improvements using six publicly available datasets: Kvasir-SEG, CVC-ClinicDB, CVC-ColonDB, ETIS-Larib PolypDB, ASU-Mayo Clinic Colonoscopy Video Database, and CVC-VideoClinicDB. Moreover, we compare our proposed architecture and resulting model with other State-of-the-art methods. To explore the generalization capability of ResUNet++ on different publicly available polyp datasets, so that it could be used in a real-world setting, we performed an extensive cross-dataset evaluation. The experimental results show that applying CRF andTTA improves the performance on various polyp segmentation datasets both on the same dataset and cross-dataset. To check the model’s performance on difficult to detect polyps, we selected, with the help of an expert gastroenterologist,196sessile or flat polyps that are less than ten millimeters in size. This additional data has been made available as a subset of Kvasir-SEG. Our approaches showed good results for flat or sessile and smaller polyps, which are known to be one of the major reasons for high polyp miss-rates. This is one of the significant strengths of our work and indicates that our methods should be investigated further for use in clinical practice.

In recent years, the amount of data produced in the field of ART has increased exponentially. The diversity of data is large, ranging from videos to tabular data. At the same time, artificial intelligence (AI) is progressively used in medical practice and may become a promising tool to improve success rates with ART. AI models may compensate for the lack of objectivity in several critical procedures in fertility clinics, especially embryo and sperm assessments. Various models have been developed, and even though several of them show promising performance, there are still many challenges to overcome. In this review, we present recent research on AI in the context of ART. We discuss the strengths and weaknesses of the presented methods, especially regarding clinical relevance. We also address the pitfalls hampering successful use of AI in the clinic and discuss future possibilities and important aspects to make AI truly useful for ART.

Deep learning-based tools may annotate and interpret medical data more quickly, consistently, and accurately than medical doctors. However, as medical doctors are ultimately responsible for clinical decision-making, any deep learning-based prediction should be accompanied by an explanation that a human can understand. We present an approach called electrocardiogram gradient class activation map (ECGradCAM), which is used to generate attention maps and explain the reasoning behind deep learning-based decision-making in ECG analysis. Attention maps may be used in the clinic to aid diagnosis, discover new medical knowledge, and identify novel features and characteristics of medical tests. In this paper, we showcase how ECGradCAM attention maps can unmask how a novel deep learning model measures both amplitudes and intervals in 12-lead electrocardiograms, and we show an example of how attention maps may be used to develop novel ECG features.

Recent trials have evaluated the efficacy of deep convolutional neural network (CNN)-based AI systems to improve lesion detection and characterization in endoscopy. Impressive results are achieved, but many medical studies use a very small image resolution to save computing resources at the cost of losing details. Today, no conventions between resolution and performance exist, and monitoring the performance of various CNN architectures as a function of image resolution provides insights into how subtleties of different lesions on endoscopy affect performance. This can help set standards for image or video characteristics for future CNN-based models in gastrointestinal (GI) endoscopy. This study examines the performance of CNNs on the HyperKvasir dataset, consisting of 10,662 images from 23 different findings. We evaluate two CNN models for endoscopic image classification under quality distortions with image resolutions ranging from 32 × 32 to 512 × 512 pixels. The performance is evaluated using two-fold cross-validation and F1-score, maximum Matthews correlation coefficient (MCC), precision, and sensitivity as metrics. Increased performance was observed with higher image resolution for all findings in the dataset. MCC was achieved at image resolutions between 512 × 512 pixels for classification for the entire dataset after including all subclasses. The highest performance was observed with an MCC value of 0.9002 when the models were trained on the highest resolution and tested on the same resolution. Different resolutions and their effect on CNNs are explored. We show that image resolution has a clear influence on the performance which calls for standards in the field in the future.

Computer-aided detection, localization, and segmentation methods can help improve colonoscopy procedures. Even though many methods have been built to tackle automatic detection and segmentation of polyps, benchmarking of state-of-the-art methods still remains an open problem. This is due to the increasing number of researched computer vision methods that can be applied to polyp datasets. Benchmarking of novel methods can provide a direction to the development of automated polyp detection and segmentation tasks. Furthermore, it ensures that the produced results in the community are reproducible and provide a fair comparison of developed methods. In this paper, we benchmark several recent state-of-the-art methods using Kvasir-SEG, an open-access dataset of colonoscopy images for polyp detection, localization, and segmentation evaluating both method accuracy and speed. Whilst, most methods in literature have competitive performance over accuracy, we show that the proposed ColonSegNet achieved a better trade-off between an average precision of 0.8000 and mean IoU of 0.8100, and the fastest speed of 180 frames per second for the detection and localization task. Likewise, the proposed ColonSegNetachieved a competitive dice coefficient of 0.8206 and the best average speed of 182.38 frames per second for the segmentation task. Our comprehensive comparison with various state-of-the-art methods reveals the importance of benchmarking the deep learning methods for automated real-time polyp identification and delineations that can potentially transform current clinical practices and minimize miss-detection rates.

Fish crime is considered a global and serious problem for a healthy and sustainable development of one of mankind's important sources of food. Technological surveillance and control solutions are emerging as remedies to combat criminal activities, but such solutions might also come with impractical and negative side-effects and challenges. In this paper, we present the concept and design of a surveillance system in lieu of current surveillance trends striking a delicate balance between privacy of legal actors while simultaneously capturing evidence-based footage, sensory data, and forensic proofs of illicit activities. Our proposed novel approach is to assist human operators in the 24/7 surveillance loop of remote professional fishing activities with a privacy-preserving Artificial Intelligence (AI) surveillance system operating in the same proximity as the activities being surveyed. The system will primarily be using video surveillance data, but also other sensor data captured on the fishing vessel. Additionally, the system correlates with other sources such as reports from other fish catches in the approximate area and time, etc. Only upon true positive flagging of specific potentially illicit activities by the locally executing AI algorithms, can forensic evidence be accessed from this physical edge, the fishing vessel. Besides a more privacy-preserving solution, our edge-based AI system also benefits from much less data that has to be transferred over unreliable, low-bandwidth satellite-based networks.

Minimally Invasive Surgery (MIS) is a surgical intervention used to examine the organs inside the abdomen and has been widely used due to its effectiveness over open surgery. Due to the hardware improvements such as high definition cameras, this procedure has significantly improved and new software methods have open potential for computer-assisted procedures. However, there exists challenges and requirement to improve detection and tracking of the position of the instruments during these surgical procedures. To this end, we evaluate and compare some popular deep learning methods that can potentially be explored for the automated segmentation of surgical instruments in laparoscopy, an important step towards tool tracking. Our experimental results demonstrate that the Dual decoder attention network (DDANet) produces a superior result compared to other recent deep learning methods. DDANet produces a dice coefficient of 0.8739 and mean intersection over union of 0.8183 for the Robust Medical Instrument Segmentation (ROBUST-MIS) Challenge 2019 dataset, at a real-time speed of 101.36 frames per second which is critical for such procedures.

In this article, we present our ongoing work in the field of training police officers who conduct interviews with abused children. The objectives in this context are to protect vulnerable children from abuse, facilitate prosecution of offenders, and ensure that innocent adults are not accused of criminal acts. There is therefore a need for more data that can be used for improved interviewer training to equip police with the skills to conduct high-quality interviews. To support this important task, we propose to research a training program that utilizes different system components and multimodal data from the field of artificial intelligence such as chatbots, generation of visual content, text-to-speech, and speech-to-text. This program will be able to generate an almost unlimited amount of interview and also training data. The goal of combining all these different technologies and datatypes is to create an immersive and interactive child avatar that responds in a realistic way, to help to support the training of police interviewers, but can also produce synthetic data of interview situations that can be used to solve different problems in the same domain.

Precise and efficient automated identification of Gastrointestinal (GI) tract diseases can help doctors treat more patients and improve the rate of disease detection and identification. Currently, automatic analysis of diseases in the GI tract is a hot topic in both computer science and medical-related journals. Nevertheless, the evaluation of such an automatic analysis is often incomplete or simply wrong. Algorithms are often only tested on small and biased datasets, and cross-dataset evaluations are rarely performed. A clear understanding of evaluation metrics and machine learning models with cross datasets is crucial to bring research in the field to a new quality level. Towards this goal, we present comprehensive evaluations of five distinct machine learning models using Global Features and Deep Neural Networks that can classify 16 different key types of GI tract conditions, including pathological findings, anatomical landmarks, polyp removal conditions, and normal findings from images captured by common GI tract examination instruments. Inour evaluation, we introduce performance hexagons using six performance metrics such as recall, precision, specificity, accuracy, F1-score, and Matthews Correlation Coefficient to demonstrate how to determine the real capabilities of models rather than evaluatingthem shallowly. Furthermore, we perform cross-dataset evaluations using different datasets for training and testing. With these cross-dataset evaluations, we demonstrate the challenge of actually building a generalizable model that could be used across different hospitals. Our experiments clearly show that more sophisticated performance metrics and evaluation methods need to be applied to get reliable models rather than depending on evaluations of the splits of the same dataset, i.e., the performance metrics should always be interpreted together rather than relying on a single metric.

Intraoperative tracking of laparoscopic instruments is often a prerequisite for computer and robotic-assisted interventions. While numerous methods for detecting,  segmenting and tracking of medical instruments based on endoscopic video im-ages have been proposed in the literature, key limitations remain to be addressed:  Firstly, robustness, that is, the reliable performance of state-of-the-art methods when run on challenging images (e.g. in the presence of blood, smoke or motion artifacts).  Secondly, generalization; algorithms trained for a specific intervention in a specific hospital should generalize to other interventions or institutions. In an effort to promote solutions for these limitations,  we organized the Robust  Medical  Instrument  Segmentation (ROBUST-MIS) challenge as an international benchmarking competition with a specific focus on the robustness and generalization capabilities of algorithms.  For the first time in the field of endoscopic image processing, our challenge included a task on binary segmentation and also addressed multi-instance detection and segmentation.  The challenge was based on a surgical data set comprising 10,040 annotated images acquired from a total of 30 surgical procedures from three different types of surgery. The validation of the competing methods for the three tasks (binary segmentation, multi-instance detection and multi-instance segmentation) was performed in three different stages with an increasing domain gap between the training and the test data. The results confirm the initial hypothesis, namely that algorithm performance degrades with an increasing domain gap. While the average detection and segmentation quality of the best-performing algorithms is high, future research should concentrate on detection and segmentation of small, crossing, moving and transparent instrument(s) (parts). 

Gastrointestinal pathologies are periodically screened, biopsied, and resected using surgical tools. Usually, the procedures and the treated or resected areas are not specifically tracked or analysed during or after colonoscopies. Information regarding disease borders, development,  amount, and size of the resected area get lost. This can lead to poor follow-up and bothersome reassessment difficulties post-treatment. To improve the current standard and also to foster more research on the topic, we have released the  ``Kvasir-Instrument'' dataset, which consists of 590 annotated frames containing GI procedure tools such as snares, balloons, and biopsy forceps, etc. Besides the images, the dataset includes ground truth masks and bounding boxes and has been verified by two expert GI endoscopists. Additionally, we provide a baseline for the segmentation of the GI tools to promote research and algorithm development. We obtained a dice coefficient score of 0.9158 and a Jaccard index of 0.8578 using a classical U-Net architecture. A similar dice coefficient score was observed for DoubleUNet. The qualitative results showed that the model did not work for the images with specularity and the frames with multiple tools, while the best result for both methods was observed on all other types of images. Both qualitative and quantitative results show that the model performs reasonably good, but there is potential for further improvements.  Benchmarking using the dataset provides an opportunity for researchers to contribute to the field of automatic endoscopic diagnostic and therapeutic tool segmentation for GI endoscopy.

Deep Neural Networks (DNNs) have become the de-facto standard in computer vision, as well as in many other pattern recognition tasks. A key drawback of DNNs is that the training phase can be very computationally expensive. Organizations or individuals that cannot afford purchasing state-of-the-art hardware or tapping into cloud-hosted infrastructures may face a long waiting time before the training completes or might not be able to train a model at all. Investigating novel ways to reduce the training time could be a potential solution to alleviate this drawback, and thus enabling more rapid development of new algorithms and models. In this paper, we propose LightLayers, a method for reducing the number of trainable parameters in deep neural networks (DNN). The proposed LightLayers consists of LightDense andLightConv2D layer that are as efficient as regular Conv2D and Dense layers, but uses less parameters. We resort to Matrix Factorization to reduce the complexity of the DNN models resulting into lightweight DNNmodels that require less computational power, without much loss in the accuracy. We have tested LightLayers on MNIST, Fashion MNIST, CI-FAR 10, and CIFAR 100 datasets. Promising results are obtained for MNIST, Fashion MNIST, CIFAR-10 datasets whereas CIFAR 100 shows acceptable performance by using fewer parameters.

This paper presents an overview of the 2020 ImageCLEF lab that will be organized as part of the Conference and Labs of the Evaluation Forum—CLEF Labs 2020 in Thessaloniki, Greece. ImageCLEF is an ongoing evaluation initiative (run since 2003) that promotes the evaluation of technologies for annotation, indexing and retrieval of visual data with the aim of providing information access to large collections of images in various usage scenarios and domains. In 2020, the 18th edition of ImageCLEF will organize four main tasks: (i) a Lifelog task (videos, images and other sources) about daily activity understanding, retrieval and summarization, (ii) a Medical task that groups three previous tasks (caption analysis, tuberculosis prediction, and medical visual question answering) with new data and adapted tasks, (iii) a Coral task about segmenting and labeling collections of coral images for 3D modeling, and a new (iv) Web user interface task addressing the problems of detecting and recognizing hand drawn website UIs (User Interfaces) for generating automatic code. The strong participation, with over 235 research groups registering and 63 submitting over 359 runs for the tasks in 2019 shows an important interest in this benchmarking campaign. We expect the new tasks to attract at least as many researchers for 2020.

Segmentation of findings in the gastrointestinal tract is a challenging but also an important task which is an important building stone for sufficient automatic decision support systems. In this work, we present our solution for the Medico 2020 task, which focused on the problem of colon polyp segmentation. We present our simple but efficient idea of using an augmentation method that uses grids in a pyramid-like manner (large to small) for segmentation. Our results show that the proposed methods work as indented and can also lead to comparable results when competing with other methods.

Recent technological advances are adapted in sports to improve performance, avoid injuries, and make advantageous decisions. In this paper, we describe our ongoing efforts to develop and deploy PMSys, our smartphone-based athlete monitoring and reporting system. We describe our first attempts to gain insight into some of the data we have collected. Experiences so far are promising, both on the technical side and for athlete performance development. Our initial application of artificial-intelligence methods for prediction is encouraging and indicative.