TB-Net: A Tailored, Self-Attention Deep Convolutional Neural Network Design for Detection of Tuberculosis Cases from Chest X-ray Images

TL;DR

TB-Net is a specialized deep learning model with self-attention mechanisms designed for accurate tuberculosis detection from chest X-ray images, demonstrating near-perfect performance in a multi-national cohort.

Contribution

The paper introduces TB-Net, a novel self-attention deep CNN architecture optimized for TB screening, developed through machine-driven design exploration and validated with explainability techniques.

Findings

Achieved 99.86% accuracy, 100% sensitivity, 99.71% specificity.

Validated decision-making with radiologists, showing high interpretability.

Open-sourced TB-Net to aid global TB screening efforts.

Abstract

Tuberculosis (TB) remains a global health problem, and is the leading cause of death from an infectious disease. A crucial step in the treatment of tuberculosis is screening high risk populations and the early detection of the disease, with chest x-ray (CXR) imaging being the most widely-used imaging modality. As such, there has been significant recent interest in artificial intelligence-based TB screening solutions for use in resource-limited scenarios where there is a lack of trained healthcare workers with expertise in CXR interpretation. Motivated by this pressing need and the recent recommendation by the World Health Organization (WHO) for the use of computer-aided diagnosis of TB, we introduce TB-Net, a self-attention deep convolutional neural network tailored for TB case screening. More specifically, we leveraged machine-driven design exploration to build a highly customized deep neural network architecture with attention condensers. We conducted an explainability-driven performance validation process to validate TB-Net's decision-making behaviour. Experiments on CXR data from a multi-national patient cohort showed that the proposed TB-Net is able to achieve accuracy/sensitivity/specificity of 99.86%/100.0%/99.71%. Radiologist validation was conducted on select cases by two board-certified radiologists with over 10 and 19 years of experience, respectively, and showed consistency between radiologist interpretation and critical factors leveraged by TB-Net for TB case detection for the case where radiologists identified anomalies. While not a production-ready solution, we hope that the open-source release of TB-Net as part of the COVID-Net initiative will support researchers, clinicians, and citizen data scientists in advancing this field in the fight against this global public health crisis.