Automatic Representative Frame Selection and Intrathoracic Lymph Node Diagnosis With Endobronchial Ultrasound Elastography Videos.

Endobronchial ultrasound (EBUS) elastography videos have shown great potential to supplement intrathoracic lymph node diagnosis. However, it is laborious and subjective for the specialists to select the representative frames from the tedious videos and make a diagnosis, and there lacks a framework for automatic representative frame selection and diagnosis. To this end, we propose a novel deep learning framework that achieves reliable diagnosis by explicitly selecting sparse representative frames and guaranteeing the invariance of diagnostic results to the permutations of video frames. Specifically, we develop a differentiable sparse graph attention mechanism that jointly considers frame-level features and the interactions across frames to select sparse representative frames and exclude disturbed frames. Furthermore, instead of adopting deep learning-based frame-level features, we introduce the normalized color histogram that considers the domain knowledge of EBUS elastography images and achieves superior performance. To our best knowledge, the proposed framework is the first to simultaneously achieve automatic representative frame selection and diagnosis with EBUS elastography videos. Experimental results demonstrate that it achieves an average accuracy of 81.29% and area under the receiver operating characteristic curve (AUC) of 0.8749 on the collected dataset of 727 EBUS elastography videos, which is comparable to the performance of the expert-based clinical methods based on manually-selected representative frames.