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  <front>
    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>3D-CNN and SVM for Multi-Drug Resistance Detection</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Imane Allaouzi</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Badr Benamrou</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Mohamed Benamrou</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Mohamed Ben Ahmed</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>Abdelmalek Essaâdi University Faculty of Sciences and Techniques</institution>
          ,
          <addr-line>Tangier</addr-line>
          ,
          <country country="MA">Morocco</country>
        </aff>
      </contrib-group>
      <abstract>
        <p>Recently, deep Convolutional neural networks (CNN) have obtained significant results in volumetric medical image classification task. However, a number of studies have claimed that replacing the trainable classifier (the conventional softmax function) of a CNN model with an SVM classifier can improve the classification performance. In this paper, we investigate the use of a hybrid approach which combines 3D CNN and a linear SVM to tackle the task of Multi-Drug Resistant detection.</p>
      </abstract>
      <kwd-group>
        <kwd>3D-CNN</kwd>
        <kwd>Deep Neural Networks</kwd>
        <kwd>SVM classifier</kwd>
        <kwd>3D CT medical imaging</kwd>
        <kwd>binary classification</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>Introduction</title>
      <p>
        Tuberculosis (TB) is a serious infectious disease usually caused by the
Mycobacterium tuberculosis (MTB) [
        <xref ref-type="bibr" rid="ref1">1</xref>
        ].It is one of the top 10 causes of morbidity and mortality
worldwide, killing 1.7 million people in 2016. The greatest problem that can happen
to a patient with tuberculosis (TB) is that the organisms become resistant to two or
more of the standard drugs, which is a formidable obstacle to effective TB care and
prevention globally.
      </p>
      <p>
        The motivation of ImageCLEFtuberculosis 2018 task [
        <xref ref-type="bibr" rid="ref2 ref3">2,3</xref>
        ] is to explore the use of
tuberculosis CT (Computed Tomography) scans in order to help in early detection of
the drug resistance (DR) status which in turn has a great importance for effective
treatment. In this paper, we describe our contribution to the task of Multi-Drug
Resistant (MDR) detection, which aims to assess the probability of a TB patient having
resistant form of tuberculosis.
      </p>
      <p>
        Recently, deep Convolutional neural networks (CNNs) have obtained significant
results in volumetric medical image classification task [
        <xref ref-type="bibr" rid="ref4 ref5 ref6">4,5,6</xref>
        ]. However, a number of
studies have claimed that replacing the trainable classifier (the conventional softmax
function) of a CNN model with the Support Vector Machine (SVM) classifier can
improve the classification performance [
        <xref ref-type="bibr" rid="ref7">7</xref>
        ]. In this regard, we investigate the use of a
hybrid approach that combines 3D CNN and a linear SVM classifier to tackle the task
of MDR detection.
      </p>
      <p>The remainder of this paper is organized as follows: the dataset is described in
Section 2, the proposed methodology is described in Section 3, results are presented and
discussed in Section 4, and finally Section 5 draws some conclusions and future work.</p>
    </sec>
    <sec id="sec-2">
      <title>Dataset:</title>
      <p>• MDR detection dataset:
MDR detection is a Binary classification task, where the goal is to predict the
probability for each of the two classes: Drug Sensitive (DS) and Multi-Drug Resistant
(MDR). As shown in the table below a dataset of 3D CT images is used with 259 of
training examples, and 236 of test cases.
This section elaborates on the details our proposed approach to address the MDR
detection task from ImageCLEFtuberculosis 2018. As shown in the fig.1, our system
is designed to (1) automatically extract prominent features from 3D CT scans using a
3D CNN, and then (2) classify them into predefined categories with the Linear SVM
classifier.
The input 3D CT scans are stored in Niftii file format, where the number of slices is
around 50- 400, and the image size per slice of 512x512 pixels. However, slices
variations can be problematic for automatic analysis using CNN. For that we have
standardized the size of input images to 100x100x50.</p>
      <p> 3D CNN as features Extractor:
Generally, CNN architecture consist of three main types of layers (convolutional
layers, pooling layers and fully connected layers) that are stacked on top of each other to
form a full CNN model.
1) Convolutional layer: the convolutional layer is always the first layer of CNN, it
serves as features extractor, and it consists of several features maps. Each neuron
in a feature map is connected to a small region, called the local receptive field,
through a set of shared weights and a single shared bias.</p>
      <p>
        Two main advantages of using Convolutional layer instead of fully connected
layer. The first one is parameters sharing; where sharing weights and bias are
equal for all neurons in a feature map, which greatly reduces the number of
parameters that in turn will result in faster training, and, ultimately, will help to build
deep networks [
        <xref ref-type="bibr" rid="ref8">8</xref>
        ].The second advantage is sparsity of connections since in each
layer, each output value depends only on a small number of inputs.
2) Pooling layer: The pooling layer is usually applied after convolutional layer with
the aim of reducing the spatial resolution of the feature maps, speeding the
computation and extracting prominent features. The most used technique for pooling is
Max-pooling, where each pooling unit is equal to the largest element in a receptive
field.
3) Fully connected (FC) layer: The fully connected layer input must be a vector, so
we must first flatten the output features from the convolutional and pooling layers.
Then, we may pass them to the output layer, where we usually use a softmax
classifier or sigmoid to predict the input class label.
      </p>
      <p>
        CNNs are mainly developed for 2D images, however in the medical domain most
images are 3D tensors. The traditional way to solve this problem is to convert 3D
image into 2D representation, but this method leads to a loss of information, which in
turn limits the performance of the overall system [
        <xref ref-type="bibr" rid="ref4">4</xref>
        ]. For that, we propose a 3D CNN
model with the following architecture.
      </p>
      <p>Name
Data
Conv3D_1
Max pool3D_1
Conv3D_2
Max Pool3D_1
FC1
FC2
As shown in the table above, our 3D CNN has about 130 million parameters. It
consists of two convolutional layers with the same padding and 64 filters with a kernel
size of 5x5x5; each Convolutional layer is followed by a max-pooling layer with
overlapping 3 × 3 × 3 windows, and two fully connected layers with 1024, and 2
neurons respectively.</p>
      <p>
        At the first fully connected layer and in each convolutional layer, we have chosen
to use a Rectified Linear Unit (ReLU)[
        <xref ref-type="bibr" rid="ref9">9</xref>
        ] as an activation function since some recent
work on image recognition, has found considerable benefit in using rectified linear
units through much of the network. In addition, we have adopted dropout technique
with a rate of 0.5 to the first fully connected layer; this prevents hidden units from
complex co-adaptations that might ultimately lead to overfitting.
      </p>
      <p>
        Our 3D CNN was trained on the training set, with “Categorical Cross-entropy” as
loss function and Adam [
        <xref ref-type="bibr" rid="ref10">10</xref>
        ] as optimizer. We have used a mini-batch size of 5
samples, and a number of epochs up to 10, where the best model was selected based on
the validation loss.
      </p>
      <p>However, this trained model is used only as features extractor. Therefore, we have
replaced the fully connected layers (FC1 and FC2) with the SVM classifier, which
takes the flattened output from the rest layers as a new feature vector.</p>
      <p>
         Support Vector Machine (SVM) classifier:
The SVM [
        <xref ref-type="bibr" rid="ref11">11</xref>
        ] is one of the most powerful and adopted algorithm for the
classification task. Its main idea is to find the optimal hyper-plane that maximizes the margin
between two classes in a given dataset.
      </p>
      <p>To predict the probability of a TB patient having resistant form of tuberculosis, we
have used the SVM classifier with a linear kernel. This classifier takes as input the
extracted features from the pre-trained 3D CNN (with a size of 127050), and trained
on the whole training set.</p>
    </sec>
    <sec id="sec-3">
      <title>Results :</title>
      <p>
        In this section, we present the performance results of our model on the test set:
 Multi-Drug Resistant (MDR) Detection:
MDR detection task consists on assigning the probability of each patient having
MDR. For that, two metrics was used to evaluate model performance: Accuracy and
Area Under the Curve (AUC) obtained from the ROC-curves produced with the
submitted probabilities. The following table provides the results obtained by our model
and the best run for the task of MDR detection.
Our model gives good results on MDR detection task with an AUC of 0.5029 and an
accuracy of 0.4576. However, the best model has achieved an accuracy of 0.6144 and
AUC of 0.6178. For that we aim to improve the performance of our model by using
the provided masks[
        <xref ref-type="bibr" rid="ref12">12</xref>
        ] to reduce the size of 3D volumes before resampling them.
With this we can focus on the lung tissue and we can reduce the noise from the rest of
the body.
5
      </p>
    </sec>
    <sec id="sec-4">
      <title>Conclusion:</title>
      <p>In this paper, we investigate the use of a combination of 3D-CNN and SVM classifier
to tackle the problem of MDR detection. Where, the 3D-CNN is used to extract
relevant features from patients CT scans, while the SVM is used for the classification
step. However, the test results of our submitted run are not satisfactory comparatively
with the results obtained by the best model. Therefore, we aim to improve the
performance of our model by adding more training data using the provided masks to reduce
the size of 3D volumes before resampling them. With this we can focus on the lung
tissue and we can reduce the noise from the rest of the body.</p>
    </sec>
  </body>
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