Improving medical diagnostic accuracy of ultrasound Doppler signals by combining neural network models

There are a number of different quantitative models that can be used in a medical diagnostic decision support system including parametric methods (linear discriminant analysis or logistic regression), nonparametric models (k nearest neighbor or kernel density) and several neural network models. The complexity of the diagnostic task is thought to be one of the prime determinants of model selection. Unfortunately, there is no theory available to guide model selection. This paper illustrates the use of combined neural network models to guide model selection for diagnosis of ophthalmic and internal carotid arterial disorders. The ophthalmic and internal carotid arterial Doppler signals were decomposed into time-frequency representations using discrete wavelet transform and statistical features were calculated to depict their distribution. The first-level networks were implemented for the diagnosis of ophthalmic and internal carotid arterial disorders using the statistical features as inputs. To improve diagnostic accuracy, the second-level networks were trained using the outputs of the first-level networks as input data. The combined neural network models achieved accuracy rates which were higher than that of the stand-alone neural network models.     

Statistics over features for internal carotid arterial disorders detection

The objective of the present study is to extract the representative features of the internal carotid arterial (ICA) Doppler ultrasound signals and to present the accurate classification model. This paper presented the usage of statistics over the set of the extracted features (Lyapunov exponents and the power levels of the power spectral density estimates obtained by the eigenvector methods) in order to reduce the dimensionality of the extracted feature vectors. Since classification is more accurate when the pattern is simplified through representation by important features, feature extraction and selection play an important role in classifying systems such as neural networks. Mixture of experts (ME) and modified mixture of experts (MME) architectures were formulated and used as basis for detection of arterial disorders. Three types of ICA Doppler signals (Doppler signals recorded from healthy subjects, subjects having stenosis, and subjects having occlusion) were classified. The classification results confirmed that the proposed ME and MME has potential in detecting the arterial disorders.     

A mixture of experts network structure for modelling Doppler ultrasound blood flow signals

Mixture of experts (ME) is a modular neural network architecture for supervised learning. This paper illustrates the use of ME network structure to guide modelling Doppler ultrasound blood flow signals. Expectation-Maximization (EM) algorithm was used for training the ME so that the learning process is decoupled in a manner that fits well with the modular structure. The ophthalmic and internal carotid arterial Doppler signals were decomposed into time-frequency representations using discrete wavelet transform and statistical features were calculated to depict their distribution. The ME network structures were implemented for diagnosis of ophthalmic and internal carotid arterial disorders using the statistical features as inputs. To improve diagnostic accuracy, the outputs of expert networks were combined by a gating network simultaneously trained in order to stochastically select the expert that is performing the best at solving the problem. The ME network structure achieved accuracy rates which were higher than that of the stand-alone neural network models.     

Classification of carotid artery Doppler signals in the early phase of atherosclerosis using complex-valued artificial neural network

In this study, carotid arterial Doppler ultrasound signals were acquired from left carotid arteries of 38 patients and 40 healthy volunteers. The patient group had an established diagnosis of the early phase of atherosclerosis through coronary or aortofemoropopliteal angiographies. Results were classified using complex-valued artificial neural network (CVANN). Principal component analysis (PCA) and fuzzy c-means clustering (FCM) algorithm were used to make a CVANN system more effective. For this aim, before classifying with CVANN, PCA method was used for feature extraction in PCA-CVANN architecture and FCM algorithm was used for data set reduction in FCM-CVANN architecture. Training and test data were selected randomly using 10-fold cross validation. PCA-CVANN and FCM-CVANN architectures classified healthy and unhealthy subjects for training and test data with about 100% correct classification rate. These results shown that PCA-CVANN and FCM-CVANN classified Doppler signals successfully.     

Comparison of eigenvector methods with classical and model-based methods in analysis of internal carotid arterial Doppler signals

Doppler ultrasound is known as a reliable technique, which demonstrates the flow characteristics and resistance of arteries in various vascular disease. In this study, internal carotid arterial Doppler signals recorded from 105 subjects were processed by PC-computer using classical, model-based, and eigenvector methods. The classical method (fast Fourier transform), two model-based methods (Burg autoregressive, least-squares modified Yule-Walker autoregressive moving average methods), and three eigenvector methods (Pisarenko, multiple signal classification, and Minimum-Norm methods) were selected for processing internal carotid arterial Doppler signals. Doppler power spectra of internal carotid arterial Doppler signals were obtained using these spectrum analysis techniques. The variations in the shape of the Doppler power spectra were examined in order to obtain medical information. These power spectra were then used to compare the applied methods in terms of their frequency resolution and the effects in determination of stenosis and occlusion in internal carotid arteries.     

Adaptive neuro-fuzzy inference systems for analysis of internal carotid arterial Doppler signals

In this study, a new approach based on adaptive neuro-fuzzy inference system (ANFIS) was presented for detection of internal carotid artery stenosis and occlusion. The internal carotid arterial Doppler signals were recorded from 130 subjects that 45 of them suffered from internal carotid artery stenosis, 44 of them suffered from internal carotid artery occlusion and the rest of them were healthy subjects. The three ANFIS classifiers were used to detect internal carotid artery conditions (normal, stenosis and occlusion) when two features, resistivity and pulsatility indices, defining changes of internal carotid arterial Doppler waveforms were used as inputs. To improve diagnostic accuracy, the fourth ANFIS classifier (combining ANFIS) was trained using the outputs of the three ANFIS classifiers as input data. The proposed ANFIS model combined the neural network adaptive capabilities and the fuzzy logic qualitative approach. Some conclusions concerning the impacts of features on the detection of internal carotid artery stenosis and occlusion were obtained through analysis of the ANFIS. The performance of the ANFIS model was evaluated in terms of classification accuracies and the results confirmed that the proposed ANFIS classifiers have some potential in detecting the internal carotid artery stenosis and occlusion. The ANFIS model achieved accuracy rates which were higher than that of the stand-alone neural network model.     

Usage of eigenvector methods to improve reliable classifier for Doppler ultrasound signals

A new approach based on the implementation of the automated diagnostic systems for Doppler ultrasound signals classification with the features extracted by eigenvector methods is presented. In practical applications of pattern recognition, there are often diverse features extracted from raw data which needs recognizing. Because of the importance of making the right decision, the present work is carried out for searching better classification procedures for the Doppler ultrasound signals. Decision making was performed in two stages: feature extraction by the eigenvector methods and classification using the classifiers trained on the extracted features. The aim of the study is classification of the Doppler ultrasound signals by the combination of eigenvector methods and the classifiers. The present research demonstrated that the power levels of the power spectral density (PSD) estimates obtained by the eigenvector methods are the features which well represent the Doppler ultrasound signals and the probabilistic neural networks (PNNs), recurrent neural networks (RNNs) trained on these features achieved high classification accuracies.     

Classification of carotid artery stenosis of patients with diabetes by neural network and logistic regression

The blood flow hemodynamics of carotid arteries were obtained from carotid arteries of 168 individuals with diabetes using the 7.5 MHz ultrasound Doppler M-unit. Fast Fourier Transform (FFT) methods were used for feature extraction from the Doppler signals on the time-frequency domain. The parameters, obtained from the Doppler sonograms, were applied to the mathematical models that were constituted to analyze the effect of diabetes on internal carotid artery (ICA) stenosis. In this study, two different mathematical models such as the traditional statistical method based on logistic regression and a Multi-Layer Perceptron (MLP) neural network were used to classify the Doppler parameters. The correct classification of these data was performed by an expert radiologist using angiograpy before they were executed by logistic regression and MLP neural networks. We classified the carotid artery stenosis into two categories such as non-stenosis and stenosis and we achieved similar results (correctly classified (CC) = 92.8%) in both mathematical models. But, as the degree of stenosis had been increased to 4 (0-39%, 40-59%, 60-79% and 80-99% diameter stenosis), it was found that the neural network (CC = 73.9%) became more efficient than the logistic regression analysis (CC = 67.7%). These outcomes indicate that the Doppler sonograms taken from the carotid arteries may be classified successfully by neural network.     

Detection of ophthalmic arterial doppler signals with Behcet disease using multilayer perceptron neural network

Doppler ultrasound is known as a reliable technique, which demonstrates the flow characteristics and resistance of ophthalmic arteries. In this study, ophthalmic arterial Doppler signals were obtained from 106 subjects, 54 of whom suffered from ocular Behcet disease while the rest were healthy subjects. Multilayer perceptron neural network (MLPNN) employing delta-bar-delta training algorithm was used to detect the presence of ocular Behcet disease. Spectral analysis of the ophthalmic arterial Doppler signals was performed by least squares (LS) autoregressive (AR) method for determining the MLPNN inputs. The MLPNN was trained with training set, cross validated with cross validation set and tested with testing set. All these data sets were obtained from ophthalmic arteries of healthy subjects and subjects suffering from ocular Behcet disease. Performance indicators and statistical measures were used for evaluating the MLPNN. The correct classification rate was 96.43% for healthy subjects and 93.75% for unhealthy subjects suffering from ocular Behcet disease. The classification results showed that the MLPNN employing delta-bar-delta training algorithm was effective to detect the ophthalmic arterial Doppler signals with Behcet disease.     

Spectral analysis of internal carotid arterial Doppler signals using FFT, AR, MA, and ARMA methods

In this study, Doppler signals recorded from internal carotid artery of 45 subjects were processed by PC-computer using classical (fast Fourier transform) and model-based (autoregressive, moving average, autoregressive moving average (ARMA) methods) methods. Power spectral density estimates of internal carotid arterial Doppler signals were obtained using these spectral analysis methods. The variations in the shape of the Doppler power spectra as a function of time were presented in the form of sonograms in order to determine the degree of internal carotid artery stenosis. These Doppler power spectra and sonograms were then used to compare the applied methods in terms of their frequency resolution and the impact on determining stenosis in internal carotid arteries. Based on the results, performance characteristics of the autoregressive and ARMA methods were found extremely valuable for spectral analysis of internal carotid arterial Doppler signals obtained from healthy subjects and unhealthy subjects having artery stenosis.     

Detecting variability of internal carotid arterial Doppler signals by Lyapunov exponents

The new method presented in this study was directly based on the consideration that internal carotid arterial Doppler signals are chaotic signals. This consideration was tested successfully using the nonlinear dynamics tools, like the computation of Lyapunov exponents. Multilayer perceptron neural network (MLPNN) architecture was formulated and used as a basis for detecting variabilities such as stenosis and occlusion in the physical state of internal carotid arterial Doppler signals. The computed Lyapunov exponents of the internal carotid arterial Doppler signals were used as inputs of the MLPNN. Receiver operating characteristic (ROC) curve was used to assess the performance of the detection process. The internal carotid arterial Doppler signals were classified with the accuracy varying from 94.87% to 97.44%. The results confirmed that the proposed MLPNN trained with Levenberg-Marquardt algorithm has potential in detecting stenosis and occlusion in internal carotid arteries.     

Determining variability of ophthalmic arterial Doppler signals using Lyapunov exponents

The new method presented in this study was directly based on the consideration that ophthalmic arterial Doppler signals are chaotic signals. This consideration was tested successfully using the nonlinear dynamics tools, like the computation of Lyapunov exponents. Multilayer perceptron neural network (MLPNN) architecture was formulated and used as a basis for determining variabilities such as stenosis, ocular Behcet disease, and uveitis disease in the physical state of ophthalmic arterial Doppler signals. The computed Lyapunov exponents of the ophthalmic arterial Doppler signals were used as inputs of the MLPNN. Receiver operating characteristic (ROC) curve was used to assess the performance of the detection process. The ophthalmic arterial Doppler signals were classified with the accuracy varying from 93.75% to 97.06%. The results confirmed that the proposed MLPNN trained with Levenberg-Marquardt algorithm has potential in detecting stenosis, Behcet disease and uveitis disease in ophthalmic arteries.     

Application of complex discrete wavelet transform in classification of Doppler signals using complex-valued artificial neural network

OBJECTIVE: In biomedical signal classification, due to the huge amount of data, to compress the biomedical waveform data is vital. This paper presents two different structures formed using feature extraction algorithms to decrease size of feature set in training and test data. MATERIALS AND METHODS: The proposed structures, named as wavelet transform-complex-valued artificial neural network (WT-CVANN) and complex wavelet transform-complex-valued artificial neural network (CWT-CVANN), use real and complex discrete wavelet transform for feature extraction. The aim of using wavelet transform is to compress data and to reduce training time of network without decreasing accuracy rate. In this study, the presented structures were applied to the problem of classification in carotid arterial Doppler ultrasound signals. Carotid arterial Doppler ultrasound signals were acquired from left carotid arteries of 38 patients and 40 healthy volunteers. The patient group included 22 males and 16 females with an established diagnosis of the early phase of atherosclerosis through coronary or aortofemoropopliteal (lower extremity) angiographies (mean age, 59 years; range, 48-72 years). Healthy volunteers were young non-smokers who seem to not bear any risk of atherosclerosis, including 28 males and 12 females (mean age, 23 years; range, 19-27 years). RESULTS AND CONCLUSION: Sensitivity, specificity and average detection rate were calculated for comparison, after training and test phases of all structures finished. These parameters have demonstrated that training times of CVANN and real-valued artificial neural network (RVANN) were reduced using feature extraction algorithms without decreasing accuracy rate in accordance to our aim.     

Wavelet-based neural network analysis of ophthalmic artery Doppler signals

In this study, ophthalmic artery Doppler signals were recorded from 115 subjects, 52 of whom had ophthalmic artery stenosis while the rest were healthy controls. Results were classified using a wavelet-based neural network. The wavelet-based neural network model, employing the multilayer perceptron, was used for analysis of ophthalmic artery Doppler signals. A multilayer perceptron neural network (MLPNN) trained with the Levenberg-Marquardt algorithm was used to detect stenosis in ophthalmic arteries. In order to determine the MLPNN inputs, spectral analysis of ophthalmic artery Doppler signals was performed using wavelet transform. The MLPNN was trained, cross validated, and tested with training, cross validation, and testing sets, respectively. All data sets were obtained from ophthalmic arteries of healthy subjects and subjects suffering from ophthalmic artery stenosis. The correct classification rate was 97.22% for healthy subjects, and 96.77% for subjects having ophthalmic artery stenosis. The classification results showed that the MLPNN trained with the Levenberg-Marquardt algorithm was effective to detect ophthalmic artery stenosis.     

Application of classical and model-based spectral methods to ophthalmic arterial Doppler signals with uveitis disease

In this study, Doppler signals recorded from ophthalmic artery of 75 subjects were processed by PC-computer using classical and model-based methods. The classical method (fast Fourier transform) and three model-based methods (Burg autoregressive, moving average, least-squares modified Yule–Walker autoregressive moving average methods) were selected for processing ophthalmic arterial Doppler signals with uveitis disease. Doppler power spectra of ophthalmic arterial Doppler signals were obtained by using these spectrum analysis techniques. The variations in the shape of the Doppler spectra as a function of time were presented in the form of sonograms in order to obtain medical information. These Doppler spectra and sonograms were then used to compare the applied methods in terms of their frequency resolution and the effects in determination of uveitis disease.     

Recurrent neural networks with composite features for detection of electrocardiographic changes in partial epileptic patients

The aim of this study is to evaluate the diagnostic accuracy of the recurrent neural networks (RNNs) with composite features (wavelet coefficients and Lyapunov exponents) on the electrocardiogram (ECG) signals. Two types of ECG beats (normal and partial epilepsy) were obtained from the MIT-BIH database. The multilayer perceptron neural networks (MLPNNs) were also tested and benchmarked for their performance on the classification of the ECG signals. Decision making was performed in two stages: computing composite features which were then input into the classifiers and classification using the classifiers trained with the Levenberg-Marquardt algorithm. The research demonstrated that the wavelet coefficients and the Lyapunov exponents are the features which well represent the ECG signals and the RNN trained on these features achieved high classification accuracies.     

基于交叉对比神经网络的心音分类

目的:通过交叉对比神经网络（CCNN）实现心音信号的自动分类,从而对心血管疾病进行早期诊断。方法:实验基于PhysioNet/Cinc 2016心音数据库。训练集和测试集数据来自互斥的健康受试者/病理患者,并以4:1的比例进行划分,输入CCNN。CCNN利用深度卷积神经网络进行特征提取,结合基于信息的相似度度量理论（IBS）,对特征向量间的相似性进行度量并分类。结果:实验结果得出灵敏度为0.834 6,特异性为0.962 3,最终大赛综合得分为0.898 5。结论:CCNN使用交叉对比的输入模式扩充数据量,引入信号间的对比信息,同时在神经网络的训练过程中应用统计学思想,使网络具备良好的泛化性,更加适应医学数据量较少的场景,在心音分类中取得较好的结果。     

Effects of window types on classification of carotid artery Doppler signals in the early phase of atherosclerosis using complex-valued artificial neural network

In this study, carotid artery Doppler ultrasound signals were acquired from left carotid arteries of 38 patients and 40 healthy volunteers. The patient group had an established diagnosis of the early phase of atherosclerosis through coronary or aortofemoropopliteal angiographies. Doppler signals were processed using fast Fourier transform (FFT) with different window types, Hilbert transform and Welch methods. After these processes, Doppler signals were classified using complex-valued artificial neural network (CVANN). Effects of window types in classification were interpreted. Results for three methods and five window types (Bartlett, Blackman, Boxcar, Hamming, Hanning) were presented as comparatively. CVANN is a new technique for solving classification problems in Doppler signals. Furthermore, examining the effects of window types in addition to CVANN in this classification problem is also the first study in literature related with this subject. Results showed that CVANN, whose input data were processed by Welch method for each window types stated above, had classified all training and test patterns, which consist of 36 healthy, 34 unhealthy and four healthy, four unhealthy subjects, respectively, with 100% classification accuracy for both training and test phases.     

Detection of arterial disorders by spectral analysis techniques

This paper intends to an integrated view of the spectral analysis techniques in the detection of arterial disorders. The paper includes illustrative information about feature extraction from signals recorded from arteries. Short-time Fourier transform (STFT) and wavelet transform (WT) were used for spectral analysis of ophthalmic arterial (OA) Doppler signals. Using these spectral analysis methods, the variations in the shape of the Doppler spectra as a function of time were presented in the form of sonograms in order to obtain medical information. These sonograms were then used to compare the applied methods in terms of their frequency resolution and the effects in determination of OA stenosis. The author suggest that the content of the paper will assist to the people in gaining a better understanding of the STFT and WT in the detection of arterial disorders.     

An intelligent system for diagnosis of the heart valve diseases with wavelet packet neural networks

In this paper, an intelligent system is presented for interpretation of the Doppler signals of the heart valve diseases based on the pattern recognition. This paper especially deals with combination of the feature extraction and classification from measured Doppler signal waveforms at the heart valve using the Doppler Ultrasound. Because of this, a wavelet packet neural network model developed by us is used. The model consists of two layers: wavelet and multi-layer perceptron. The wavelet layer is used for adaptive feature extraction in the time-frequency domain and is composed of wavelet packet decomposition and wavelet packet entropy. The multi-layer perceptron used for classification is a feed-forward neural network. The performance of the developed system has been evaluated in 215 samples. The test results showed that this system was effective in detecting Doppler heart sounds. The correct classification rate was about 94% for abnormal and normal subjects.