Automated Computer-Assisted Diagnosis of Pleural Effusion in Chest X-Rays via Deep Learning.

Background/Objectives: Pleural effusion is a common pulmonary condition that, if left untreated, may lead to respiratory distress and severe complications. Chest X-ray (CXR) imaging is routinely used by physicians to identify signs of pleural effusion. However, manually examining large volumes of CXR images on a daily basis can require substantial time and effort. To address this issue, this study proposes an automated pleural effusion detection system for CXR images. Methods: The proposed system integrates image cropping, image enhancement, and the EfficientNet-B0 deep learning model to assist in detecting pleural effusion, a task that is often challenging due to subtle symptom presentation. Image cropping was applied to extract the region from the heart to the costophrenic angle as the target area. Subsequently, image enhancement techniques were employed to emphasize pleural effusion features, thereby improving the model's learning efficiency. Finally, EfficientNet-B0 was used to train and classify pleural effusion cases based on processed images. Results: In the experimental results, the proposed image enhancement approach improved the model's recognition accuracy by approximately 4.33% compared with the non-enhanced method, confirming that enhancement effectively supports subsequent model learning. Ultimately, the proposed system achieved an accuracy of 93.27%, representing a substantial improvement of 21.30% over the 77.00% reported in previous studies, highlighting its significant advancement in pleural effusion detection. Conclusions: This system can serve as an assistive diagnostic tool for physicians, providing standardized detection results, reducing the workload associated with manual interpretation, and improving the overall efficiency of pulmonary care.