Deep learning-based classification of lymphedema and other lower limb edema diseases using clinical images.

Journal: Scientific reports
PMID:

Abstract

Lymphedema is a chronic condition characterized by lymphatic fluid accumulation, primarily affecting the limbs. Its diagnosis is challenging due to symptom overlap with conditions like chronic venous insufficiency (CVI), deep vein thrombosis (DVT), and systemic diseases, often leading to diagnostic delays that can extend up to ten years. These delays negatively impact patient outcomes and burden healthcare systems. Conventional diagnostic methods rely heavily on clinical expertise, which may fail to distinguish subtle variations between these conditions. This study investigates the application of artificial intelligence (AI), specifically deep learning, to improve diagnostic accuracy for lower limb edema. A dataset of 1622 clinical images was used to train sixteen convolutional neural networks (CNNs) and transformer-based models, including EfficientNetV2, which achieved the highest accuracy of 78.6%. Grad-CAM analyses enhanced model interpretability, highlighting clinically relevant features such as swelling and hyperpigmentation. The AI system consistently outperformed human evaluators, whose diagnostic accuracy plateaued at 62.7%. The findings underscore the transformative potential of AI as a diagnostic tool, particularly in distinguishing conditions with overlapping clinical presentations. By integrating AI with clinical workflows, healthcare systems can reduce diagnostic delays, enhance accuracy, and alleviate the burden on medical professionals. While promising, the study acknowledges limitations, such as dataset diversity and the controlled evaluation environment, which necessitate further validation in real-world settings. This research highlights the potential of AI-driven diagnostics to revolutionize lymphedema care, bridging gaps in conventional methods and supporting healthcare professionals in delivering more precise and timely interventions. Future work should focus on external validation and hybrid systems integrating AI and clinical expertise for comprehensive diagnostic solutions.

Authors

  • Thanat Lewsirirat
    Division of Plastic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand.
  • Taravichet Titijaroonroj
    School of Information Technology, King Mongkut's Institute of Technology Ladkrabang, Bangkok, 10520, Thailand.
  • Sirin Apichonbancha
    Division of Plastic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand.
  • Ason Uthatham
    School of Information Technology, King Mongkut's Institute of Technology Ladkrabang, Bangkok, 10520, Thailand.
  • Veera Suwanruangsri
    Division of Vascular Surgery, Department of Surgery, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, 30000, Thailand.
  • Nirut Suwan
    Division of Nephrology, Department of Medicine, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, 30000, Thailand.
  • Surakiat Bokerd
    Division of Vascular Surgery, Department of Surgery, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, 30000, Thailand.
  • Tossapol Prapassaro
    Division of Vascular Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand.
  • Wanchai Chinchalongporn
    Division of Vascular Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand.
  • Nutcha Yodrabum
    Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand.