OBJECTIVE: This paper introduces an encoder-decoder-based attentional decoder network to recognize small-size lesions in chest X-ray images. In the encoder-only network, small-size lesions disappear during the down-sampling steps or are indistinguishable in the low-resolution feature maps. To address these issues, the proposed network processes images in the encoder-decoder architecture similar to U-Net families and classifies lesions by globally pooling high-resolution feature maps. However, two challenging obstacles prohibit U-Net families from being extended to classification: (1) the up-sampling procedure consumes considerable resources, and (2) there needs to be an effective pooling approach for the high-resolution feature maps.
METHODS: Therefore, the proposed network employs a lightweight attentional decoder and harmonic magnitude transform. The attentional decoder up-samples the given features with the low-resolution features as the key and value while the high-resolution features as the query. Since multi-scaled features interact, up-sampled features embody global context at a high resolution, maintaining pathological locality. In addition, harmonic magnitude transform is devised for pooling high-resolution feature maps in the frequency domain. We borrow the shift theorem of the Fourier transform to preserve the translation invariant property and further reduce the parameters of the pooling layer by an efficient embedding strategy.
RESULTS: The proposed network achieves state-of-the-art classification performance on the three public chest X-ray datasets, such as NIH, CheXpert, and MIMIC-CXR.
CONCLUSIONS: In conclusion, the proposed efficient encoder-decoder network recognizes small-size lesions well in chest X-ray images by efficiently up-sampling feature maps through an attentional decoder and processing high-resolution feature maps with harmonic magnitude transform. We open-source our implementation at https://github.com/Lab-LVM/ADNet.

BACKGROUND: In the last decade, long-tail learning has become a popular research focus in deep learning applications in medicine. However, no scientometric reports have provided a systematic overview of this scientific field. We utilized bibliometric techniques to identify and analyze the literature on long-tailed learning in deep learning applications in medicine and investigate research trends, core authors, and core journals. We expanded our understanding of the primary components and principal methodologies of long-tail learning research in the medical field.
METHODS: Web of Science was utilized to collect all articles on long-tailed learning in medicine published until December 2023. The suitability of all retrieved titles and abstracts was evaluated. For bibliometric analysis, all numerical data were extracted. CiteSpace was used to create clustered and visual knowledge graphs based on keywords.
RESULTS: A total of 579 articles met the evaluation criteria. Over the last decade, the annual number of publications and citation frequency both showed significant growth, following a power-law and exponential trend, respectively. Noteworthy contributors to this field include Husanbir Singh Pannu, Fadi Thabtah, and Talha Mahboob Alam, while leading journals such as IEEE ACCESS, COMPUTERS IN BIOLOGY AND MEDICINE, IEEE TRANSACTIONS ON MEDICAL IMAGING, and COMPUTERIZED MEDICAL IMAGING AND GRAPHICS have emerged as pivotal platforms for disseminating research in this area. The core of long-tailed learning research within the medical domain is encapsulated in six principal themes: deep learning for imbalanced data, model optimization, neural networks in image analysis, data imbalance in health records, CNN in diagnostics and risk assessment, and genetic information in disease mechanisms.
CONCLUSIONS: This study summarizes recent advancements in applying long-tail learning to deep learning in medicine through bibliometric analysis and visual knowledge graphs. It explains new trends, sources, core authors, journals, and research hotspots. Although this field has shown great promise in medical deep learning research, our findings will provide pertinent and valuable insights for future research and clinical practice.

The third artificial intelligence (AI) boom is coming, and there is an inkling that the speed of its evolution is quickly increasing. In games like chess, shogi, and go, AI has already defeated human champions, and the fact that it is able to achieve autonomous driving is also being realized. Under these circumstances, AI has evolved and diversified at a remarkable pace in medical diagnosis, especially in diagnostic imaging. Therefore, this commentary focuses on AI in medical diagnostic imaging and explains the recent development trends and practical applications of computer-aided detection/diagnosis using artificial intelligence, especially deep learning technology, as well as some topics surrounding it.