Tuberculosis Chest X-Ray Image Retrieval System Using Deep Learning Based Biomarker Predictions

The world health organization's global tuberculosis (TB) report for 2022 identifies TB, with an estimated 1.6 million, as a leading cause of death. The number of new cases has risen since 2020, particularly the number of new drug-resistant cases, estimated at 450,000 in 2021. This is concerning, as treatment of patients with drug resistant TB is complex and may not always be successful. The NIAID TB Portals program is an international consortium with a primary focus on patient centric data collection and analysis for drug resistant TB. The data includes images, their associated radiological findings, clinical records, and socioeconomic information. This work describes a TB Portals' Chest X-ray based image retrieval system which enables precision medicine. An input image is used to retrieve similar images and the associated patient specific information, thus facilitating inspection of outcomes and treatment regimens from comparable patients. Image similarity is defined using clinically relevant biomarkers: gender, age, body mass index (BMI), and the percentage of lung affected per sextant. The biomarkers are predicted using variations of the DenseNet169 convolutional neural network. A multi-task approach is used to predict gender, age and BMI incorporating transfer learning from an initial training on the NIH Clinical Center CXR dataset to the TB portals dataset. The resulting gender AUC, age and BMI mean absolute errors were 0.9854, 4.03years and $1.67\frac{kg}{m^2}$. For the percentage of sextant affected by lesions the mean absolute errors ranged between 7% to 12% with higher error values in the middle and upper sextants which exhibit more variability than the lower sextants. The retrieval system is currently available from https://rap.tbportals.niaid.nih.gov/find_similar_cxr.