scholarly journals Weakly Supervised Ternary Stream Data Augmentation Fine-Grained Classification Network for Identifying Acute Lymphoblastic Leukemia

Diagnostics ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 16
Author(s):  
Yunfei Liu ◽  
Pu Chen ◽  
Junran Zhang ◽  
Nian Liu ◽  
Yan Liu

Due to the high incidence of acute lymphoblastic leukemia (ALL) worldwide as well as its rapid and fatal progression, timely microscopy screening of peripheral blood smears is essential for the rapid diagnosis of ALL. However, screening manually is time-consuming and tedious and may lead to missed or misdiagnosis due to subjective bias; on the other hand, artificially intelligent diagnostic algorithms are constrained by the limited sample size of the data and are prone to overfitting, resulting in limited applications. Conventional data augmentation is commonly adopted to expand the amount of training data, avoid overfitting, and improve the performance of deep models. However, in practical applications, random data augmentation, such as random image cropping or erasing, is difficult to realistically occur in specific tasks and may instead introduce tremendous background noises that modify actual distribution of data, thereby degrading model performance. In this paper, to assist in the early and accurate diagnosis of acute lymphoblastic leukemia, we present a ternary stream-driven weakly supervised data augmentation classification network (WT-DFN) to identify lymphoblasts in a fine-grained scale using microscopic images of peripheral blood smears. Concretely, for each training image, we first generate attention maps to represent the distinguishable part of the target by weakly supervised learning. Then, guided by these attention maps, we produce the other two streams via attention cropping and attention erasing to obtain the fine-grained distinctive features. The proposed WT-DFN improves the classification accuracy of the model from two aspects: (1) in the images can be seen details since cropping attention regions provide the accurate location of the object, which ensures our model looks at the object closer and discovers certain detailed features; (2) images can be seen more since erasing attention mechanism forces the model to extract more discriminative parts’ features. Validation suggests that the proposed method is capable of addressing the high intraclass variances located in lymphocyte classes, as well as the low interclass variances between lymphoblasts and other normal or reactive lymphocytes. The proposed method yields the best performance on the public dataset and the real clinical dataset among competitive methods.

Author(s):  
Hidayat . ◽  
Nina Susana Dewi ◽  
Nadjwa Zamalek Dalimoenthe

Normoblast is an immature form of erythrocyte in erythropoietin system. Normally, normoblast can be found in peripheral blood healthy neonates. The existence of normoblast in peripheral blood might be the sign of pathologic conditions such as hemolytic anemia,acute blood loss, and ischemia and bone marrows abnormalities like malignancy or leukemia. In acute leukemia (Acute MyeloblasticLeukemia and Acute Lymphoblastic Leukemia), normoblast existence in peripheral blood may due to erythropoietin system suppression.The aim of this study is to compare normoblast count between AML and ALL, and also to find out the correlation between leukocyte andnormoblast count in AML and ALL. The subject of this study were patient diagnosed as AML (30) and ALL (30) in Hematology Divisionof Clinical Pathology Department at Dr.Hasan Sadikin Hospital Bandung in July 2006–August 2008. In this study we examined 30peripheral blood smears from AML and 30 peripheral blood smears from ALL. Leukocyte count result was derived from CBC performedwith Sysmex KX-21. The mean value of normoblast count from AML blood smear patients is 1930.60 (3.60/100 WBC) while ALL bloodsmear patients is 309.60 (0.43/100 WBC). Statistically this difference is significant (p < 0.001). There are strong correlation betweenleukocyte count and normoblast count within both group (r = 0.851, r = 0.948; p < 0.001).


2021 ◽  
Author(s):  
Kokou S. Dogbevi ◽  
Paul Gordon ◽  
Kimberly L. Branan ◽  
Bryan Khai D. Ngo ◽  
Kevin B. Kiefer ◽  
...  

Effective staining of peripheral blood smears which enhances the contrast of intracellular components and biomarkers is essential for the accurate characterization, diagnosis, and monitoring of various diseases such as malaria.


2002 ◽  
Vol 116 (3) ◽  
pp. 503-503 ◽  
Author(s):  
Glen A. Kennedy ◽  
Jennifer L. Curnow ◽  
Julie Gooch ◽  
Bronwyn Williams ◽  
Peter Wood ◽  
...  

2021 ◽  
pp. jclinpath-2021-207863
Author(s):  
Lisa N van der Vorm ◽  
Henriët A Hendriks ◽  
Simone M Smits

AimsRecently, a new automated digital cell imaging analyser (Sysmex CellaVision DC-1), intended for use in low-volume and small satellite laboratories, has become available. The purpose of this study was to compare the performance of the DC-1 with the Sysmex DI-60 system and the gold standard, manual microscopy.MethodsWhite blood cell (WBC) differential counts in 100 normal and 100 abnormal peripheral blood smears were compared between the DC-1, the DI-60 and manual microscopy to establish accuracy, within-run imprecision, clinical sensitivity and specificity. Moreover, the agreement between precharacterisation and postcharacterisation of red blood cell (RBC) morphological abnormalities was determined for the DC-1.ResultsWBC preclassification and postclassification results of the DC-1 showed good correlation compared with DI-60 results and manual microscopy. In addition, the within-run SD of the DC-1 was below 1 for all five major WBC classes, indicating good reproducibility. Clinical sensitivity and specificity were, respectively, 96.7%/95.9% compared with the DI-60% and 96.6%/95.3% compared with manual microscopy. The overall agreement on RBC morphology between the precharacterisation and postcharacterisation results ranged from 49% (poikilocytosis) to 100% (hypochromasia, microcytosis and macrocytosis).ConclusionsThe DC-1 has proven to be an accurate digital cell imaging system for differential counting and morphological classification of WBCs and RBCs in peripheral blood smears. It is a compact and easily operated instrument that can offer low-volume and small satellite laboratories the possibilities of readily available blood cell analysis that can be stored and retrieved for consultation with remote locations.


2021 ◽  
pp. 72-74
Author(s):  
Sarat Das ◽  
Prasanta Kr. Baruah ◽  
Sandeep Khakhlari ◽  
Gautam Boro

Introduction: Leukemias are neoplastic proliferations of haematopoietic stem cells and form a major proportion of haematopoietic neoplasms that are diagnosed worldwide. Typing of leukemia is essential for effective therapy because prognosis and survival rate are different for each type and sub-type Aims: this study was carried out to determine the frequency of acute and chronic leukemias and to evaluate their clinicopathological features. Methods: It was a hospital based cross sectional study of 60 patients carried out in the department of Pathology, JMCH, Assam over a period of one year between February 2018 and January 2019. Diagnosis was based on peripheral blood count, peripheral blood smear and bone marrow examination (as on when available marrow sample) for morphology along with cytochemical study whenever possible. Results: In the present study, commonest leukemia was Acute myeloid leukemia (AML, 50%) followed by Acute lymphoblastic leukemia (ALL 26.6%), chronic myeloid leukemia (CML, 16.7%) and chronic lymphocytic leukemia (CLL, 6.7%). Out of total 60 cases, 36 were male and 24 were female with Male:Female ratio of 1.5:1. Acute lymphoblastic leukemia was the most common type of leukemia in the children and adolescents. Acute Myeloid leukemia was more prevalent in adults. Peripheral blood smear and bone Conclusion: marrow aspiration study still remains the important tool along with cytochemistry, immunophenotyping and cytogenetic study in the diagnosis and management of leukemia.


PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254054
Author(s):  
Gaihua Wang ◽  
Lei Cheng ◽  
Jinheng Lin ◽  
Yingying Dai ◽  
Tianlun Zhang

The large intra-class variance and small inter-class variance are the key factor affecting fine-grained image classification. Recently, some algorithms have been more accurate and efficient. However, these methods ignore the multi-scale information of the network, resulting in insufficient ability to capture subtle changes. To solve this problem, a weakly supervised fine-grained classification network based on multi-scale pyramid is proposed in this paper. It uses pyramid convolution kernel to replace ordinary convolution kernel in residual network, which can expand the receptive field of the convolution kernel and use complementary information of different scales. Meanwhile, the weakly supervised data augmentation network (WS-DAN) is used to prevent over fitting and improve the performance of the model. In addition, a new attention module, which includes spatial attention and channel attention, is introduced to pay more attention to the object part in the image. The comprehensive experiments are carried out on three public benchmarks. It shows that the proposed method can extract subtle feature and achieve classification effectively.


2018 ◽  
Vol 52 (3) ◽  
pp. 296-306 ◽  
Author(s):  
Vladimir Gasic ◽  
Branka Zukic ◽  
Biljana Stankovic ◽  
Dragana Janic ◽  
Lidija Dokmanovic ◽  
...  

AbstractBackgroundResponse to glucocorticoid (GC) monotherapy in the initial phase of remission induction treatment in childhood acute lymphoblastic leukemia (ALL) represents important biomarker of prognosis and outcome. We aimed to study variants in several pharmacogenes (NR3C1,GSTsandABCB1) that could contribute to improvement of GC response through personalization of GC therapy.MethodsRetrospective study enrolling 122 ALL patients was carried out to analyze variants ofNR3C1(rs33389, rs33388 and rs6198),GSTT1(null genotype),GSTM1(null genotype),GSTP1(rs1695 and rs1138272) andABCB1(rs1128503, rs2032582 and rs1045642) genes using PCR-based methodology. The marker of GC response was blast count per microliter of peripheral blood on treatment day 8. We carried out analysis in which cut-off value for GC response was 1000 (according to Berlin-Frankfurt-Munster [BFM] protocol), as well as 100 or 0 blasts per microliter.ResultsCarriers of rareNR3C1rs6198 GG genotype were more likely to have blast count over 1000, than the non-carriers (p = 0.030).NR3C1CAA (rs33389-rs33388-rs6198) haplotype was associated with blast number below 1000 (p = 0.030).GSTP1GC haplotype carriers were more likely to have blast number below 1000 (p = 0.036), below 100 (p = 0.028) and to be blast negative (p = 0.054), whileGSTP1GT haplotype and rs1138272 T allele carriers were more likely to be blasts positive (p = 0.034 and p = 0.024, respectively).ABCB1CGT (rs1128503-rs2032582-rs1045642) haplotype carriers were more likely to be blast positive (p = 0.018).ConclusionsOur results have shown thatNR3C1rs6198 variant andGSTP1rs1695-rs1138272 haplotype are the most promising pharmacogenomic markers of GC response in ALL patients.


Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 45-46
Author(s):  
Christian Pohlkamp ◽  
Kapil Jhalani ◽  
Niroshan Nadarajah ◽  
Inseok Heo ◽  
William Wetton ◽  
...  

Background: Cytomorphology is the gold standard for quick assessment of peripheral blood and bone marrow samples in hematological neoplasms. It is a broadly-accepted method for orchestrating more specific diagnostics including immunophenotyping or genetics. Inter-/intra-observer-reproducibility of single cell classification is only 75 to 90%. Only a limited number of cells (100 - 500 cells/smear) is read in a time-consuming procedure. Machine learning (ML) is more reliable where human skills are limited, i.e. in handling large amounts of data or images. We here tested ML to differentiate peripheral blood leukocytes in a high throughput hematology laboratory. Aim: To establish an ML-based cell classifier capable of identifying healthy and pathologic cells in digitalized peripheral blood smear scans at an accuracy competitive with or outperforming human expert level. Methods: We selected &gt;2,600 smears out of our unique archive of &gt; 250,000 peripheral blood smears from hematological neoplasms. Depending on quality, we scanned up to 1,000 single cell images per smear. For image acquisition, a Metafer Scanning System (Zeiss Axio Imager.Z2 microscope, automatic slide feeder and automatic oiling device) from MetaSystems (Altlussheim, GER) was used. Areas of interest were defined by pre-scan in 10x magnification followed by high resolution scan in 40x to generate cell images for analysis. Average capture times for 300/500 cells were 3:43/4:37 min We set up a supervised ML-learning model using colour images (144x144 pixels) as input, outputting predicted probabilities of 21 predefined classes. We used ImageNet-pretrained Xception as our base model. We trained, evaluated and deployed the model using Amazon SageMaker on a subset of 82,974 images randomly selected from 514,183 cells captured and labelled for this study. 20 different cell types and one garbage class were classified. We included cell type categories referring to the critical importance of detecting rare leukemia subtypes (e.g. APL). Numbers of images from respective 21 classes ranged from 1,830 to 14,909 (median: 2,945). Minority classes were up-sampledto handle imbalances. Each picture was labelled by highly skilled technicians (median years practicing in this laboratory: 5) and two independent hematologists (median years at microscope: 20). Results: On a separate test set of 8,297 cells, our classifier was able to predict any of the five cell types occurring in the peripheral blood of healthy individuals (PMN, lymphocytes, monocytes, eosinophils, basophils) at very high median accuracy (97.0%) Median prediction accuracy of 15 rare or pathological cell types was 91.3%. For six critical pathological cell forms (myeloblasts, atypical/bilobulated promyelocytes in APL/APLv, hairy cells, lymphoma cells,plasma cells), median accuracy was 93.4% (sensitivity 93.8%). We saw a very high "T98 accuracy" for these cell types (98.5%) which is the accuracy of cell type predictions with prediction probability &gt;0.98 (achieved in 2231/2417 cases), implicating that critical cells predicted with probability &lt;0.98 should be flagged for human expert validation with priority. For all 21 classes median accuracy was 91.7%. Accuracy was lower for cells representing consecutive steps of maturation, e.g. promyelo-/myelo-/metamyelocytes, reproducing inconsistencies from the human-built phenotypic classification system (s.Fig.). Conclusions: We demonstrate an automated workflow using automatic microscopic cell capturing and ML-driven cell differentiation in samples of hematologic patients. Reproducibility, accuracy, sensitivity and specificity are above 90%, for many cell types above 98%. By flagging suspicious cells for humanvalidation, this tool can support even experienced hematology professionals, especially in detecting rare cell types. Given an appropriate scanning speed, it clearly outperforms human investigators in terms of examination time and number of differentiated cells. An ML-based intelligence can make its skills accessible to hematology laboratories on site or after upload of scanned cell images, independent of time/location. A cloud-based infrastructure is available. A prospective head to head challenge between ML-based classifier and human experts comparing sensitivity and accuracy for detection of all cell classes in peripheral blood will be tested to proof suitability for routine use (NCT 4466059). Figure Disclosures Heo: AWS: Current Employment. Wetton:AWS: Current Employment. Drescher:MetaSystems: Current Employment. Hänselmann:MetaSystems: Current Employment. Lörch:MetaSystems: Current equity holder in private company.


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