Semi-supervised Ensemble Learning for Automatic Interpretation of Lung Ultrasound Videos.

Bárbara Malainho, João Freitas, Catarina Rodrigues, Ana Claudia Tonelli, André Santanchè, Marco A Carvalho-Filho, Jaime C Fonseca, Sandro Queirós
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Abstract

Point-of-care ultrasound (POCUS) stands as a safe, portable, and cost-effective imaging modality for swift bedside patient examinations. Specifically, lung ultrasonography (LUS) has proven useful in evaluating both acute and chronic pulmonary conditions. Despite its clinical value, automatic LUS interpretation remains relatively unexplored, particularly in multi-label contexts. This work proposes a novel deep learning (DL) framework tailored for interpreting lung POCUS videos, whose outputs are the finding(s) present in these videos (such as A-lines, B-lines, or consolidations). The pipeline, based on a residual (2+1)D architecture, initiates with a pre-processing routine for video masking and standardisation, and employs a semi-supervised approach to harness available unlabeled data. Additionally, we introduce an ensemble modeling strategy that aggregates outputs from models trained to predict distinct label sets, thereby leveraging the hierarchical nature of LUS findings. The proposed framework and its building blocks were evaluated through extensive experiments with both multi-class and multi-label models, highlighting its versatility. In a held-out test set, the categorical proposal, suited for expedite triage, achieved an average F1-score of 92.4%, while the multi-label proposal, helpful for patient management and referral, achieved an average F1-score of 70.5% across five relevant LUS findings. Overall, the semi-supervised methodology contributed significantly to improved performance, while the proposed hierarchy-aware ensemble provided moderate additional gains.

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用于肺超声视频自动解释的半监督集成学习。
即时超声(POCUS)是一种安全、便携、成本效益高的快速床边患者检查成像方式。具体而言,肺超声检查(LUS)已被证明在评估急性和慢性肺部疾病有用。尽管具有临床价值,但自动LUS解释仍然相对未被探索,特别是在多标签背景下。这项工作提出了一种专门用于解释肺部POCUS视频的新型深度学习(DL)框架,其输出是这些视频中存在的发现(如a线、b线或合并)。该管道基于残差(2+1)D架构,从视频屏蔽和标准化的预处理例程开始,并采用半监督方法来利用可用的未标记数据。此外,我们引入了一种集成建模策略,该策略聚合了经过训练的模型的输出,以预测不同的标签集,从而利用了LUS发现的层次性。通过多类别和多标签模型的大量实验,对所提出的框架及其构建模块进行了评估,突出了其通用性。在一组测试中,适合快速分诊的分类方案平均f1得分为92.4%,而有助于患者管理和转诊的多标签方案在5个相关LUS结果中平均f1得分为70.5%。总体而言,半监督方法显著提高了性能,而提出的层次感知集成提供了适度的额外收益。
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