Deep Learning for Diagonal Earlobe Crease Detection Sara L. Almonacid-Uribe a Oliverio J. Santana

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Deep Learning for Diagonal Earlobe Crease Detection
Sara L. Almonacid-Uribe a, Oliverio J. Santana b,
Daniel Hern´
andez-Sosa c, and David Freire-Obreg´
on d
SIANI, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
david.freire@ulpgc.es
Keywords: Computer vision, diagonal earlobe crease, DELC, Frank’s Sign, cardiovascular disease, coronary artery
disease, deep learning.
Abstract: An article published on Medical News Today in June 2022 presented a fundamental question in its title: Can an
earlobe crease predict heart attacks? The author explained that end arteries supply the heart and ears. In other
words, if they lose blood supply, no other arteries can take over, resulting in tissue damage. Consequently,
some earlobes have a diagonal crease, line, or deep fold that resembles a wrinkle. In this paper, we take a
step toward detecting this specific marker, commonly known as DELC or Frank’s Sign. For this reason, we
have made the first DELC dataset available to the public. In addition, we have investigated the performance of
numerous cutting-edge backbones on annotated photos. Experimentally, we demonstrate that it is possible to
solve this challenge by combining pre-trained encoders with a customized classifier to achieve 97.7% accuracy.
Moreover, we have analyzed the backbone trade-off between performance and size, estimating MobileNet as
the most promising encoder.
1 Introduction
According to the Centers for Disease Control and Pre-
vention (CDC), heart disease is the leading cause of
death for men, women, and the majority of racial
and ethnic groups in the United States (CDC, 2022).
Overall, cardiovascular disease is responsible for one
death every 34 seconds in the United States. Further-
more, one in five heart attacks are silent; the dam-
age is done, but the individual is unaware (Tsao et al.,
2022). Early detection is essential for providing treat-
ment to alleviate symptoms, reduce mortality, and en-
hance the quality of life (Boudoulas et al., 2016).
As a standard practice, clinicians are taught to di-
agnose coronary artery disease (CAD) based on the
medical history, biomarkers, raw scores, and phys-
ical examinations of individual patients, which they
interpret based on their clinical experience. However,
this approach has evolved due to technological ad-
vances. In the past decade, deep learning (DL) has
demonstrated a promising ability to detect abnormal-
ities in computed tomography (CT) images (Ardila
et al., 2019). Several DL techniques have been pro-
ahttps://orcid.org/0000-0001-6660-0867
bhttps://orcid.org/0000-0001-7511-5783
chttps://orcid.org/0000-0003-3022-7698
dhttps://orcid.org/0000-0003-2378-4277
Figure 1: Celebrities exhibiting a DELC marker. In 1987,
the former CNN interviewer Larry King suffered a heart at-
tack and underwent bypass surgery (photo by Eva Rinaldi,
Wikimedia Commons, CC-BY-SA 2.0). In 2009, the for-
mer comedian and actor Robin Williams underwent aortic
valve replacement surgery (photo by Angela George, Wiki-
media Commons, CC-BY 3.0). The ear is highlighted in
both pictures.
posed to automatically estimate CAD markers from
CT images. The majority of these models predict clin-
ically relevant image features from cardiac CT, such
as coronary artery calcification scoring (Isgum et al.,
2012; Wolterink et al., 2015; Zeleznik et al., 2021),
non-calcified atherosclerotic plaque localization (Ya-
arXiv:2210.11582v4 [cs.CV] 7 Feb 2023
mak et al., 2014; Zhao et al., 2019), and stenosis from
cardiac CT (Lee et al., 2019; Zreik et al., 2019).
Even though the development of DL on CT im-
ages is promising, CT equipment is expensive and
cardiac illnesses are hard to find unless the patient
has symptoms and goes to the hospital for a cardiac
checkup. In this context, the diagonal earlobe crease
(DELC) can be a helpful guide to identify cardiac
problems. This crease extends diagonally from the
tragus to the earlobe’s border (see Figure 1). It is
also known as Frank’s Sign because it was first de-
scribed by Frank in a case series of CAD patients
(Frank, 1973). Since then, numerous reports have
been published concerning its association primarily
with atherosclerosis, particularly CAD (Wieckowski,
2021). While not as well known as more traditional
approaches, DELC examinations are painless, non-
invasive, and simple to interpret. If its diagnostic ac-
curacy is sufficient for decision-making, it could be
utilized in primary care or emergency departments.
In this work, we have created a DELC detector
using state-of-the-art (SOTA) backbones and ear col-
lections as benchmarks for the models. First, we have
gathered DELC ear images available on the Internet.
Then, we developed multiple DL models consider-
ing pre-trained encoders, also known as backbones,
to predict whether or not an ear displays a DELC. In
addition, we analyzed the performance of the consid-
ered backbones by varying the classifier parameters
and found no correlation between the number of pa-
rameters and the best model.
Our proposal was evaluated using a mixed-source
dataset. As previously stated, we gathered 342 pos-
itive DELC images by collecting publicly available
images from the Internet and cropping off the ears.
Negative samples were obtained from a publicly ac-
cessible ear database, namely AWE (Emerˇ
siˇ
c et al.,
2017). All images are collected from natural settings,
including lighting, pose, and shape variations. Con-
sidering the number of samples, data augmentation
techniques were considered during training. The out-
comes are remarkable (predictions up to 97.7% accu-
rate) and have yielded intriguing insights.
Even though the earlobe is a relatively small
part of the ear (see Figure 2), the classifier’s perfor-
mance is noteworthy. Unlike other diseases, such as
melanoma, which can be found anywhere in the hu-
man body, the DELC is located in a specific area,
facilitating the detection task. The usability of the
trained models reveals an additional insightful rev-
elation. Light-weight convolutional neural networks
such as MobileNet provide high accuracy, balancing
the precision of complex neural network structures
with the performance constraints of mobile runtimes.
Helix
Tragus
Lobule
Anti-Helix
Concha
Figure 2: Outer ear scheme. The human earlobe (lobulus
auriculae) is composed of areolar and adipose connective
tissues that lack rigidity. Due to the absence of cartilage in
the earlobe, it has an abundant blood flow and may aid in
warming the ears (Steinberg and Rosner, 2003).
Hence, ubiquitous applications could take advantage
of this proposal, making it possible to detect DELC by
just using a smartphone anywhere and anytime. Our
contributions can be summarized as follows:
We propose a novel dataset with DELC ear im-
ages in the wild with 342 samples. All samples
have been gathered from the Internet. The dataset
is publicly available.
We experimentally demonstrate that it is possible
to tackle this problem by combining pre-trained
backbones with a new classifier.
In this experiment, eleven different backbones are
compared to one another regarding their DELC
detection performance. Moreover, the models’
size-performance trade-off analysis demonstrates
that the problem can be effectively addressed by
employing light-weight encoders. As aforemen-
tioned, this opens the door for the broad imple-
mentation of this technology.
The remainder of this paper is organized as fol-
lows. Section 2 discusses previous related work. Sec-
tion 3 describes the proposed pipeline. Section 4 re-
ports the experimental setup and the experimental re-
sults. Finally, conclusions are drawn in Section 5.
2 Related work
The state of the art can be studied from both phys-
iological and technological viewpoints. The former
aims to find support for the relationship between CAD
and DELC by examining related studies, while the lat-
ter intends to evaluate the Computer Vision Commu-
nity proposals.
摘要:

DeepLearningforDiagonalEarlobeCreaseDetectionSaraL.Almonacid-Uribea,OliverioJ.Santanab,DanielHern´andez-Sosac,andDavidFreire-Obreg´ondSIANI,UniversidaddeLasPalmasdeGranCanaria,LasPalmasdeGranCanaria,Spaindavid.freire@ulpgc.esKeywords:Computervision,diagonalearlobecrease,DELC,Frank'sSign,cardiovascul...

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