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AI System Quickly and Automatically Evaluates Chest X-Rays for TB

By MedImaging International staff writers
Posted on 07 Sep 2022

Image: An AI-based system has shown promise in tuberculosis detection (Photo courtesy of Pexels)

Tuberculosis (TB) is an infectious disease of the lungs that kills more than a million people worldwide every year. The COVID-19 pandemic has exacerbated the problem, with recent reports indicating that 21% fewer people received care for TB in 2020 than in 2019. Almost 90% of the active TB infections occur in about 30 countries, many with scarce resources needed to address this public health problem. Cost-effective TB screening using chest X-rays and artificial intelligence (AI) has the potential to improve access to healthcare, particularly in difficult-to-reach populations. Now, an AI system that detects TB in chest X-rays at a level comparable to radiologists may be able to aid screening in areas with limited radiologist resources.

Scientists at Google Health AI (Mountain View, CA, USA) have developed and assessed an AI system that can quickly and automatically evaluate chest X-rays for TB. The system uses deep learning, a type of AI that can be applied to teach the computer to recognize and predict medical conditions. The researchers developed the system using data from nine countries. They then tested it on data from five countries, covering multiple high-TB-burden countries, various clinical settings and a wide range of races and ethnicities. Over 165,000 images from more than 22,000 patients were used for model development and testing.

Analysis with 14 international radiologists showed that the deep-learning method was comparable to radiologists for the determination of active TB on chest X-rays. Trends were similar across different patient subgroups, including a test set from gold miners in South Africa, a group with a high prevalence of TB, compared to the general public. If additional research supports the results, the deep-learning system could be used to automatically screen chest X-ray results for TB. People who test positive would then receive a sputum test or nucleic acid amplification testing (NAAT). These tests are relatively expensive, but if AI could filter the patients who need the test, the benefits would be extensive. Simulations using the deep-learning system to identify likely TB positive chest X-rays for NAAT confirmation reduced the cost by 40% to 80% per positive TB patient detected.

“We wanted to see if this system predicts TB on par with radiologists, and that’s what the study is showing,” said study co-author Rory Pilgrim, B.Eng., a product manager at Google Health AI. “AI performed really well with a variety of patients.”

“What’s especially promising in this study is that we looked at a range of different datasets that reflected the breadth of TB presentation, different equipment and different clinical workflows,” said first author Sahar Kazemzadeh, B.S., software engineer at Google Health. “We found that this deep-learning system performs really well with all of them with a single operating point that was pre-selected based on a development dataset, something that other medical imaging AI systems have found challenging.”

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69 (396.9669342041): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=211 ORDER BY `ordering`

70 (!!!!! 5101.9191741943): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294794499 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (!!!!! 7503.9863586426): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294794499 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (!!!!! 7930.9940338135): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (89.883804321289): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (37.193298339844): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (107.0499420166): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294794499 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (46.014785766602): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294794499 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (46.014785766602): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (55.074691772461): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (51.975250244141): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (87.02278137207): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (72.956085205078): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (422.95455932617): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (!!!!! 1574.9931335449): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 5527.0195007324): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794499 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794499 AND published='1' LIMIT 1

105 (334.9781036377): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794499 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794499 AND published='1' LIMIT 1

106 (351.90582275391): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294794499 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (617.02728271484): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294794499 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 7397.1748352051): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794499 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794499 AND published='1' LIMIT 1

109 (73.19450378418): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794499 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794499 AND published='1' LIMIT 1

110 (72.002410888672): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294794499 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (533.8191986084): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294794499 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (!!!!! 4884.0045928955): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (!!!!! 4796.9818115234): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (!!!!! 3132.8201293945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794499 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794499 AND published='1' LIMIT 1

115 (!!!!! 6340.0268554688): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794499 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794499 AND published='1' LIMIT 1

116 (430.82237243652): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794499 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794499 AND published='1' LIMIT 1

117 (191.92695617676): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794499 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794499 AND published='1' LIMIT 1

118 (714.06364440918): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794499 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794499 AND published='1' LIMIT 1

119 (48.160552978516): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794499 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794499 AND published='1' LIMIT 1

120 (368.11828613281): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 104740.858078): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

122 (!!!!! 7651.8058776855): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794499 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794499 AND published='1' LIMIT 1

123 (!!!!! 7957.2200775146): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794499 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794499 AND published='1' LIMIT 1

124 (!!!!! 2621.8891143799): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294794499 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294794499 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 1341833.114624): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (87.976455688477): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (313.04359436035): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (63.896179199219): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (216.00723266602): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (85.830688476562): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (399.11270141602): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (92.983245849609): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (365.01884460449): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794499 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (421.04721069336): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794499 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (418.90144348145): SELECT name FROM jos_deeppockets WHERE id=211

136 (212.9077911377): SELECT name FROM jos_deeppockets WHERE id=211

137 (607.96737670898): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (!!!!! 1642.9424285889): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (396.0132598877): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794499 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794499 AND published='1' LIMIT 1

140 (312.80517578125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794499 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794499 AND published='1' LIMIT 1

141 (!!!!! 7456.0642242432): TRUNCATE TABLE jos_trademed_module

142 (!!!!! 1056.9095611572): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294794499 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (!!!!! 3600.8358001709): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294794499 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (!!!!! 3119.945526123): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794499 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794499 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794499 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794499 AND published='1' LIMIT 1

147 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794499 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794499 AND published='1' LIMIT 1

148 (!!!!! 1449.1081237793): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

149 (225.06713867188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794499 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794499 AND published='1' LIMIT 1

150 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794499 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794499 AND published='1' LIMIT 1

151 (312.08992004395): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294794499 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294794499 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (55.074691772461): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

153 (35.04753112793): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

154 (283.95652770996): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (!!!!! 5324.8405456543): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794499 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794499 AND published='1' LIMIT 1

156 (!!!!! 2474.0695953369): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794499 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794499 AND published='1' LIMIT 1

157 (65.088272094727): select jos_twitters.link from jos_twitters where cat=10

158 (30.040740966797): select jos_facebook.link from jos_facebook where cat=10

159 (28.848648071289): select jos_google_plus.link from jos_google_plus where cat=10

160 (29.802322387695): select jos_linkedin.link from jos_linkedin where cat=10

161 (289.9169921875): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 1957.893371582): insert into jos_banners_delta values (14615,'2025-04-30 14:16:38','3.144.87.133','view'),(14202,'2025-04-30 14:16:38','3.144.87.133','view'),(14203,'2025-04-30 14:16:38','3.144.87.133','view')

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