RAMON ALFREDO MORENO

Índice h a partir de 2011
4
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
LIM/65, Hospital das Clínicas, Faculdade de Medicina

Resultados de Busca

Agora exibindo 1 - 4 de 4
  • conferenceObject
    Automated radiographic bone suppression with deep convolutional neural networks
    (2021) CARDENAS, Diego Armando Cardona; FERREIRA JUNIOR, Jose Raniery; MORENO, Ramon Alfredo; REBELO, Marina de Fatima de Sa; KRIEGER, Jose Eduardo; GUTIERREZ, Marco Antonio
    Dual-energy subtraction (DES) is a technique that separates soft tissue from bones in a chest radiograph (CR). As DES requires specialized equipment, we propose an automatic method based on convolutional neural networks (CNNs) to generate virtual soft tissue images. A dataset comprising 35 pairs of CR and its soft-tissue version split in training (28 image pairs) and testing (7 image pairs) sets were used with data augmentation. We tested two types of images: the lung region's cropped image and the segmented lung image. The ribs suppression was treated as a local problem, so each image was divided into 784 patches. The U-Net architecture was used to perform bone suppression. We tested two types of loss functions: mean squared error (L-mse) and L-sm, which combines L-mse with the structural similarity index measure (SSIM). Due to the patches overlapping, it was necessary to interpolate the gray levels on the reconstructed image from the predicted patches. Evaluations were based on SSIM and root mean square error (RMSE) over the reconstructed lung area. The combination that presented the best results used the loss L-sm and the segmented lung image as input to the U-Net (SSIM of 0.858 and RMSE of 0.033). We observed that the U-Net has poor performance when trained with cropped images containing all information from the chest cavity and how the loss using local information can improve CR rib bone suppression. Our results suggest that it is possible removing the rib bones accurately in CR using CNN and a patch-based approach.y
  • article 16 Citação(ões) na Scopus
    Novel Chest Radiographic Biomarkers for COVID-19 Using Radiomic Features Associated with Diagnostics and Outcomes
    (2021) FERREIRA JUNIOR, Jose Raniery; CARDENAS, Diego Armando Cardona; MORENO, Ramon Alfredo; REBELO, Marina de Fatima de Sa; KRIEGER, Jose Eduardo; GUTIERREZ, Marco Antonio
    COVID-19 is a highly contagious disease that can cause severe pneumonia. Patients with pneumonia undergo chest X-rays (XR) to assess infiltrates that identify the infection. However, the radiographic characteristics of COVID-19 are similar to the other acute respiratory syndromes, hindering the imaging diagnosis. In this work, we proposed identifying quantitative/radiomic biomarkers for COVID-19 to support XR assessment of acute respiratory diseases. This retrospective study used different cohorts of 227 patients diagnosed with pneumonia; 49 of them had COVID-19. Automatically segmented images were characterized by 558 quantitative features, including gray-level histogram and matrices of co-occurrence, run-length, size zone, dependence, and neighboring gray-tone difference. Higher-order features were also calculated after applying square and wavelet transforms. Mann-Whitney U test assessed the diagnostic performance of the features, and the log-rank test assessed the prognostic value to predict Kaplan-Meier curves of overall and deterioration-free survival. Statistical analysis identified 51 independently validated radiomic features associated with COVID-19. Most of them were wavelet-transformed features; the highest performance was the small dependence matrix feature of ""low gray-level emphasis"" (area under the curve of 0.87, sensitivity of 0.85, p<0.001). Six features presented short-term prognostic value to predict overall and deterioration-free survival. The features of histogram ""mean absolute deviation"" and size zone matrix ""non-uniformity"" yielded the highest differences on Kaplan-Meier curves with a hazard ratio of 3.20 (p<0.05). The radiomic markers showed potential as quantitative measures correlated with the etiologic agent of acute infectious diseases and to stratify short-term risk of COVID-19 patients.
  • conferenceObject
    Multi-View Ensemble Convolutional Neural Network to Improve Classification of Pneumonia in Low Contrast Chest X-Ray Images
    (2020) FERREIRA JUNIOR, Jose Raniery; CARDENAS, Diego Armando Cardona; MORENO, Ramon Alfredo; REBELO, Marina de Fatima de Sa; KRIEGER, Jose Eduardo; GUTIERREZ, Marco Antonio
    Pneumonia is one of the leading causes of childhood mortality worldwide. Chest x-ray (CXR) can aid the diagnosis of pneumonia, but in the case of low contrast images, it is important to include computational tools to aid specialists. Deep learning is an alternative because it can identify patterns automatically, even in low-resolution images. We propose herein a convolutional neural network (CNN) architecture with different training strategies towards detecting pneumonia on CXRs and distinguishing its subforms of bacteria and virus. We also evaluated different image pre-processing methods to improve the classification. This study used CXRs from pediatric patients from a public pneumonia CXR dataset. The pre-processing methods evaluated were image cropping and histogram equalization. To classify the images, we adopted the VGG16 CNN and replaced its fully-connected layers with a customized multilayer perceptron. With this architecture, we proposed and evaluated four different training strategies: original CXR image (baseline), chest-cavity-cropped image (A), and histogram-equalized segmented image (B). The last strategy method (C) implemented is based on ensemble between strategies A and B. The performance was assessed by the area under the ROC curve (AUC) with 95% confidence interval (CI), accuracy, sensitivity, specificity, and F1-score. The ensemble model C yielded the highest performances: AUC of 0.97 (CI: 0.96-0.99) to classify pneumonia vs. normal, and AUC of 0.91 (CI: 0.88-0.94) to classify bacterial vs. viral cases. All models that used pre-processed images showed higher AUC than baseline, which used the original CXR image. Image cropping and histogram equalization reduced irrelevant information from the exam, enhanced contrast, and was able to identify fine CXR texture details. The proposed ensemble model increased the representation of inflammatory patterns from bacteria and viruses with few epochs to train the deep CNNs.
  • conferenceObject
    A general fully automated deep-learning method to detect cardiomegaly in chest x-rays
    (2021) FERREIRA-JUNIOR, Jose Raniery; CARDENAS, Diego Armando Cardona; MORENO, Ramon Alfredo; REBELO, Marina de Fdtima de Sa; KRIEGER, Jose Eduardo; GUTIERREZ, Marco Antonio
    Cardiomegaly is a medical condition that leads to an increase in cardiac size. It can be manually assessed using the cardiothoracic ratio from chest x-rays (CXRs). However, as that task can be challenging in such limited examinations, we propose the fully automated cardiomegaly detection in CXR. For this, we first trained convolutional networks (ConvNets) to classify the CXR as positive or negative to cardiomegaly and then evaluated the generalization potential of the trained ConvNets on independent cohorts. This work used frontal CXR images from a public dataset for training/testing and another public and one private dataset to test the models' generalization externally. Training and testing were performed using images cropped with a previously developed U-Net model. Experiments were performed with five topologically different ConvNets, data augmentation techniques, and a 50-50 class-weighing strategy to improve performance and reduce the possibility of bias to the majority class. The receiver operating characteristic curve assessed the performance of the models. DenseNet yielded the highest area under the curve (AUC) on testing (0.818) and external validation (0.809) datasets. Moreover, DenseNet obtained the highest sensitivity overall, yielding up to 0.971 on the private dataset with patients from our hospital. Therefore, DenseNet had a statistically higher potential to identify cardiomegaly. The proposed models, especially those trained with DenseNet convolutional core, automatically detected cardiomegaly with high sensitivity. To the best of our knowledge, this was the first work to design a novel general model for classifying specific deep-learning patterns of cardiomegaly in CXRs.