An explorative childhood pneumonia analysis based on ultrasonic imaging texture features

According to World Health Organization, pneumonia is the respiratory disease with the highest pediatric mortality rate accounting for 15% of all deaths of children under 5 years old worldwide. The diagnosis of pneumonia is commonly made by clinical criteria with support from ancillary studies and also laboratory findings. Chest imaging is commonly done with chest X-rays and occasionally with a chest CT scan. Lung ultrasound is a promising alternative for chest imaging; however, interpretation is subjective and requires adequate training. In the present work, a two-class classification algorithm based on four Gray-level co-occurrence matrix texture features (i.e., Contrast, Correlation, Energy and Homogeneity) extracted from lung ultrasound images from children aged between six months and five years is presented. Ultrasound data was collected using a L14-5/38 linear transducer. The data consisted of 22 positive- and 68 negative-diagnosed B-mode cine-loops selected by a medical expert and captured in the facilities of the Instituto Nacional de Salud del Nino (Lima, Peru), for a total number of 90 videos obtained from twelve children diagnosed with pneumonia. The classification capacity of each feature was explored independently and the optimal threshold was selected by a receiver operator characteristic (ROC) curve analysis. In addition, a principal component analysis was performed to evaluate the combined performance of all the features. Contrast and correlation resulted the two more significant features. The classification performance of these two features by principal components was evaluated. The results revealed 82% sensitivity, 76% specificity, 78% accuracy and 0.85 area under the ROC.