Neural Machine Registration for Motion Correction in Breast DCE-MRI

Federica Aprea, Stefano Marrone, Carlo Sansone

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Auto-TLDR; A Neural Registration Network for Dynamic Contrast Enhanced-Magnetic Resonance Imaging

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Cancer is one of the leading causes of death in the western world, with medical imaging playing a key role for early diagnosis. Focusing on breast cancer, one of the emerging imaging methodologies is Dynamic Contrast Enhanced-Magnetic Resonance Imaging (DCE-MRI). The flip side of using DCE-MRI is in its long acquisition times, often causing the patient to move, resulting in motion artefacts, namely distortions in the acquired image that can affect DCE-MRI analysis. A possible solution consists in the use of Motion Correction Techniques (MCTs), i.e. procedures intended to re-align the post-contrast image to the corresponding pre-contrast (reference) one. This task is particularly critic in DCE-MRI, due to brightness variations introduced in post-contrast images by the contrast-agent flowing. To face this problem, in this work we introduce a new MCT for breast DCE-MRI leveraging Physiologically Based PharmacoKinetic (PBPK) modelling and Artificial Neural Networks (ANN) to determine the most suitable physiologically-compliant transformation. To this aim, we propose a Neural Registration Network relying on a very task-specific loss function explicitly designed to take into account the contrast agent flowing while enforcing a correct re-alignment. We compared the obtained results against some conventional motion correction techniques, evaluating the performance on a patient-by-patient basis. Results clearly show the effectiveness of the proposed approach, resulting as the best performing even when compares against other techniques designed to take into account for brightness variations.

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A Novel Computer-Aided Diagnostic System for Early Assessment of Hepatocellular Carcinoma

Ahmed Alksas, Mohamed Shehata, Gehad Saleh, Ahmed Shaffie, Ahmed Soliman, Mohammed Ghazal, Hadil Abukhalifeh, Abdel Razek Ahmed, Ayman El-Baz

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Auto-TLDR; Classification of Liver Tumor Lesions from CE-MRI Using Structured Structural Features and Functional Features

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Early assessment of liver cancer patients with hepatocellular carcinoma (HCC) is of immense importance to provide the proper treatment plan. In this paper, we have developed a two-stage classification computer-aided diagnostic (CAD) system that has the ability to detect and grade the liver observations from multiphase contrast enhanced magnetic resonance imaging (CE-MRI). The proposed approach consists of three main steps. First, a pre-processing is applied to the CE-MRI scans to delineate the tumor lesions that will be used as an ROI across the four different phases of the CE-MRI, (namely, the pre-contrast, late-arterial, portal-venous, and delayed-contrast). Second, a group of three features are modeled to provide a quantitative discrimination between the tumor lesions; namely: i) the tumor appearance that is modeled using a set of texture features, (namely; the first-order histogram, second-order gray-level co-occurrence matrix, and second-order gray-level run-length matrix), to capture any discrimination that may appear in the lesion texture, ii) the spherical harmonics (SH) based shape features that have the ability to describe the shape complexity of the liver tumors, and iii) the functional features that are based on the calculation of the wash-in/wash-out through that evaluate the intensity changes across the post-contrast phases. Finally, the aforementioned individual features were then integrated together to obtain the combined features to be fed to a machine learning classifier towards getting the final diagnostic decision. The proposed CAD system has been tested using hepatic observations that was obtained from 85 participating patients, 34 patients with benign tumors, 34 patients with intermediate tumors and 34 with malignant tumors. Using a random forests based classifier with a leave-one-subject-out (LOSO) cross-validation, the developed CAD system achieved an 87.1% accuracy in distinguishing the malignant, intermediate and benign tumors. The classification performance is then evaluated using k-fold (5/10-fold) cross-validation approach to examine the robustness of the system. The LR-1 lesions were classified from LR-2 benign lesions with 91.2% accuracy, while 85.3% accuracy was achieved differentiating between LR-4 and LR-5 malignant tumors. The obtained results hold a promise of the proposed framework to be reliably used as a noninvasive diagnostic tool for the early detection and grading of liver cancer tumors.

Planar 3D Transfer Learning for End to End Unimodal MRI Unbalanced Data Segmentation

Martin Kolarik, Radim Burget, Carlos M. Travieso-Gonzalez, Jan Kocica

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Auto-TLDR; Planar 3D Res-U-Net Network for Unbalanced 3D Image Segmentation using Fluid Attenuation Inversion Recover

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We present a novel approach of 2D to 3D transfer learning based on mapping pre-trained 2D convolutional neural network weights into planar 3D kernels. The method is validated by proposed planar 3D res-u-net network with encoder transferred from the 2D VGG-16 which is applied for a single-stage unbalanced 3D image data segmentation. In particular, we evaluate the method on the MICCAI 2016 MS lesion segmentation challenge dataset utilizing solely Fluid Attenuation Inversion Recover (FLAIR) sequence without brain extraction for training and inference to simulate real medical praxis. The planar 3D res-u-net network performed the best both in sensitivity and Dice score amongst end to end methods processing raw MRI scans and achieved comparable Dice score to a state-of-the-art unimodal not end to end approach. Complete source code was released under the open-source license and this paper is in compliance with the Machine learning Reproducibility Checklist. By implementing practical transfer learning for 3D data representation we were able to successfully segment heavily unbalanced data without selective sampling and achieved more reliable results using less training data in single modality. From medical perspective, the unimodal approach gives an advantage in real praxis as it does not require co-registration nor additional scanning time during examination. Although modern medical imaging methods capture high resolution 3D anatomy scans suitable for computer aided detection system processing, deployment of automatic systems for interpretation of radiology imaging is still rather theoretical in many medical areas. Our work aims to bridge the gap offering solution for partial research questions.

Automatic Semantic Segmentation of Structural Elements related to the Spinal Cord in the Lumbar Region by Using Convolutional Neural Networks

Jhon Jairo Sáenz Gamboa, Maria De La Iglesia-Vaya, Jon Ander Gómez

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Auto-TLDR; Semantic Segmentation of Lumbar Spine Using Convolutional Neural Networks

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This work addresses the problem of automatically segmenting the MR images corresponding to the lumbar spine. The purpose is to detect and delimit the different structural elements like vertebrae, intervertebral discs, nerves, blood vessels, etc. This task is known as semantic segmentation. The approach proposed in this work is based on convolutional neural networks whose output is a mask where each pixel from the input image is classified into one of the possible classes. Classes were defined by radiologists and correspond to structural elements and tissues. The proposed network architectures are variants of the U-Net. Several complementary blocks were used to define the variants: spatial attention models, deep supervision and multi-kernels at input, this last block type is based on the idea of inception. Those architectures which got the best results are described in this paper, and their results are discussed. Two of the proposed architectures outperform the standard U-Net used as baseline.

Segmentation of Axillary and Supraclavicular Tumoral Lymph Nodes in PET/CT: A Hybrid CNN/Component-Tree Approach

Diana Lucia Farfan Cabrera, Nicolas Gogin, David Morland, Benoît Naegel, Dimitri Papathanassiou, Nicolas Passat

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Auto-TLDR; Coupling Convolutional Neural Networks and Component-Trees for Lymph node Segmentation from PET/CT Images

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The analysis of axillary and supraclavicular lymph nodes is a primary prognostic factor for the staging of breast cancer. However, due to the size of lymph nodes and the low resolution of PET data, their segmentation is challenging. We investigate the relevance of considering axillary and supraclavicular lymph node segmentation from PET/CT images by coupling Convolutional Neural Networks (CNNs) and Component-Trees (C-Trees). Building upon the U-Net architecture, we propose a framework that couples a multi-modal U-Net fed with PET and CT, coupled with a hierarchical model obtained from the PET that provides additional high-level region-based features as input channels. Our working hypotheses are twofold. First, we take advantage of both anatomical information from CT for detecting the nodes, and from functional information from PET for detecting the pathological ones. Second, we consider region-based attributes extracted from C-Tree analysis of 3D PET/CT images to improve the CNN segmentation. We carried out experiments on a dataset of 240 pathological lymph nodes from 52 patients scans, and compared our outputs with human expert-defined ground-truth, leading to promising results.

A Comparison of Neural Network Approaches for Melanoma Classification

Maria Frasca, Michele Nappi, Michele Risi, Genoveffa Tortora, Alessia Auriemma Citarella

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Auto-TLDR; Classification of Melanoma Using Deep Neural Network Methodologies

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Melanoma is the deadliest form of skin cancer and it is diagnosed mainly visually, starting from initial clinical screening and followed by dermoscopic analysis, biopsy and histopathological examination. A dermatologist’s recognition of melanoma may be subject to errors and may take some time to diagnose it. In this regard, deep learning can be useful in the study and classification of skin cancer. In particular, by classifying images with Deep Neural Network methodologies, it is possible to obtain comparable or even superior results compared to those of dermatologists. In this paper, we propose a methodology for the classification of melanoma by adopting different deep learning techniques applied to a common dataset, composed of images from the ISIC dataset and consisting of different types of skin diseases, including melanoma on which we applied a specific pre-processing phase. In particular, a comparison of the results is performed in order to select the best effective neural network to be applied to the problem of recognition and classification of melanoma. Moreover, we also evaluate the impact of the pre- processing phase on the final classification. Different metrics such as accuracy, sensitivity, and specificity have been selected to assess the goodness of the adopted neural networks and compare them also with the manual classification of dermatologists.

A Deep Learning Approach for the Segmentation of Myocardial Diseases

Khawala Brahim, Abdull Qayyum, Alain Lalande, Arnaud Boucher, Anis Sakly, Fabrice Meriaudeau

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Auto-TLDR; Segmentation of Myocardium Infarction Using Late GADEMRI and SegU-Net

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Cardiac left ventricular (LV) segmentation is of paramount essential step for both diagnosis and treatment of cardiac pathologies such as ischemia, myocardial infarction, arrhythmia and myocarditis. However, this segmentation is challenging due to high variability across patients and the potential lack of contrast between structures. In this work, we propose and evaluate a (2.5D) SegU-Net model based on the fusion of two deep learning techniques (U-Net and Seg-Net) for automated LGEMRI (Late gadolinium enhanced magnetic resonance imaging) myocardial disease (infarct core and no reflow region) quantification in a new multifield expert annotated dataset. Given that the scar tissue represents a small part of the whole MRI slices, we focused on myocardium area. Segmentation results show that this preprocessing step facilitate the learning procedure. In order to solve the class imbalance problem, we propose to apply the Jaccard loss and the Focal Loss as optimization loss function and to integrate a class weights strategy into the objective function. Late combination has been used to merge the output of the best trained models on a different set of hyperparameters. The final network segmentation performances will be useful for future comparison of new method to the current related work for this task. A total number of 2237 of slices (320 cases) were used for training/validation and 210 slices (35 cases) were used for testing. Experiments over our proposed dataset, using several evaluation metrics such Jaccard distance (IOU), Accuracy and Dice similarity coefficient (DSC), demonstrate efficiency performance in quantifying different zones of myocardium infarction across various patients. As compared to the second intra-observer study, our testing results showed that the SegUNet prediction model leads to these average dice coefficients over all segmented tissue classes, respectively : 'Background': 0.99999, 'Myocardium': 0.99434, 'Infarctus': 0.95587, 'Noreflow': 0.78187.

A New Geodesic-Based Feature for Characterization of 3D Shapes: Application to Soft Tissue Organ Temporal Deformations

Karim Makki, Amine Bohi, Augustin Ogier, Marc-Emmanuel Bellemare

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Auto-TLDR; Spatio-Temporal Feature Descriptors for 3D Shape Characterization from Point Clouds

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Spatio-temporal feature descriptors are of great importance for characterizing the local changes of 3D deformable shapes. In this study, we propose a method for characterizing 3D shapes from point clouds and we show a direct application on a study of organ temporal deformations. As an example, we characterize the behavior of the bladder during forced respiratory motion with a reduced number of 3D surface points: first, a set of equidistant points representing the vertices of quadrilateral mesh for the organ surface are tracked throughout a long dynamic MRI sequence using a large deformation diffeomorphic metric mapping (LDDMM) framework. Second, a novel 3D shape descriptor invariant to translation, scale and rotation is proposed for characterizing the temporal organ deformations by employing an Eulerian Partial Differential Equations (PDEs) methodology. We demonstrate the robustness of our feature on both synthetic 3D shapes and realistic dynamic Magnetic Resonance Imaging (MRI) data sequences portraying the bladder deformation during a forced breathing exercise. Promising results are obtained, showing that the proposed feature may be useful for several computer vision applications such as medical imaging, aerodynamics and robotics.

A Benchmark Dataset for Segmenting Liver, Vasculature and Lesions from Large-Scale Computed Tomography Data

Bo Wang, Zhengqing Xu, Wei Xu, Qingsen Yan, Liang Zhang, Zheng You

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Auto-TLDR; The Biggest Treatment-Oriented Liver Cancer Dataset for Segmentation

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How to build a high-performance liver-related computer assisted diagnosis system is an open question of great interest. However, the performance of the state-of-art algorithm is always limited by the amount of data and quality of the label. To address this problem, we propose the biggest treatment-oriented liver cancer dataset for liver surgery and treatment planning. This dataset provides 216 cases (totally about 268K frames) scanned images in contrast-enhanced computed tomography (CT). We labeled all the CT images with the liver, liver vasculature and liver tumor segmentation ground truth for train and tune segmentation algorithms in advance. Based on that, we evaluate several recent and state-of-the-art segmentation algorithms, including 7 deep learning methods, on CT sequences. All results are compared to reference segmentations five error metrics that highlight different aspects of segmentation accuracy. In general, compared with previous datasets, our dataset is really a challenging dataset. To our knowledge, the proposed dataset and benchmark allow for the first time systematic exploration of such issues, and will be made available to allow for further research in this field.

FOANet: A Focus of Attention Network with Application to Myocardium Segmentation

Zhou Zhao, Elodie Puybareau, Nicolas Boutry, Thierry Geraud

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Auto-TLDR; FOANet: A Hybrid Loss Function for Myocardium Segmentation of Cardiac Magnetic Resonance Images

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In myocardium segmentation of cardiac magnetic resonance images, ambiguities often appear near the boundaries of the target domains due to tissue similarities. To address this issue, we propose a new architecture, called FOANet, which can be decomposed in three main steps: a localization step, a Gaussian-based contrast enhancement step, and a segmentation step. This architecture is supplied with a hybrid loss function that guides the FOANet to study the transformation relationship between the input image and the corresponding label in a threelevel hierarchy (pixel-, patch- and map-level), which is helpful to improve segmentation and recovery of the boundaries. We demonstrate the efficiency of our approach on two public datasets in terms of regional and boundary segmentations.

A Systematic Investigation on Deep Architectures for Automatic Skin Lesions Classification

Pierluigi Carcagni, Marco Leo, Andrea Cuna, Giuseppe Celeste, Cosimo Distante

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Auto-TLDR; RegNet: Deep Investigation of Convolutional Neural Networks for Automatic Classification of Skin Lesions

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Computer vision-based techniques are more and more employed in healthcare and medical fields nowadays in order, principally, to be as a support to the experienced medical staff to help them to make a quick and correct diagnosis. One of the hot topics in this arena concerns the automatic classification of skin lesions. Several promising works exist about it, mainly leveraging Convolutional Neural Networks (CNN), but proposed pipeline mainly rely on complex data preprocessing and there is no systematic investigation about how available deep models can actually reach the accuracy needed for real applications. In order to overcome these drawbacks, in this work, an end-to-end pipeline is introduced and some of the most recent Convolutional Neural Networks (CNNs) architectures are included in it and compared on the largest common benchmark dataset recently introduced. To this aim, for the first time in this application context, a new network design paradigm, namely RegNet, has been exploited to get the best models among a population of configurations. The paper introduces a threefold level of contribution and novelty with respect the previous literature: the deep investigation of several CNN architectures driving to a consistent improvement of the lesions recognition accuracy, the exploitation of a new network design paradigm able to study the behavior of populations of models and a deep discussion about pro and cons of each analyzed method paving the path towards new research lines.

3D Medical Multi-Modal Segmentation Network Guided by Multi-Source Correlation Constraint

Tongxue Zhou, Stéphane Canu, Pierre Vera, Su Ruan

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Auto-TLDR; Multi-modality Segmentation with Correlation Constrained Network

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In the field of multimodal segmentation, the correlation between different modalities can be considered for improving the segmentation results. In this paper, we propose a multi-modality segmentation network with a correlation constraint. Our network includes N model-independent encoding paths with N image sources, a correlation constrain block, a feature fusion block, and a decoding path. The model-independent encoding path can capture modality-specific features from the N modalities. Since there exists a strong correlation between different modalities, we first propose a linear correlation block to learn the correlation between modalities, then a loss function is used to guide the network to learn the correlated features based on the correlation representation block. This block forces the network to learn the latent correlated features which are more relevant for segmentation. Considering that not all the features extracted from the encoders are useful for segmentation, we propose to use dual attention based fusion block to recalibrate the features along the modality and spatial paths, which can suppress less informative features and emphasize the useful ones. The fused feature representation is finally projected by the decoder to obtain the segmentation result. Our experiment results tested on BraTS-2018 dataset for brain tumor segmentation demonstrate the effectiveness of our proposed method.

One Step Clustering Based on A-Contrario Framework for Detection of Alterations in Historical Violins

Alireza Rezaei, Sylvie Le Hégarat-Mascle, Emanuel Aldea, Piercarlo Dondi, Marco Malagodi

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Auto-TLDR; A-Contrario Clustering for the Detection of Altered Violins using UVIFL Images

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Preventive conservation is an important practice in Cultural Heritage. The constant monitoring of the state of conservation of an artwork helps us reduce the risk of damage and number of interventions necessary. In this work, we propose a probabilistic approach for the detection of alterations on the surface of historical violins based on an a-contrario framework. Our method is a one step NFA clustering solution which considers grey-level and spatial density information in one background model. The proposed method is robust to noise and avoids parameter tuning and any assumption about the quantity of the worn out areas. We have used as input UV induced fluorescence (UVIFL) images for considering details not perceivable with visible light. Tests were conducted on image sequences included in the ``Violins UVIFL imagery'' dataset. Results illustrate the ability of the algorithm to distinguish the worn area from the surrounding regions. Comparisons with the state of the art clustering methods shows improved overall precision and recall.

MedZip: 3D Medical Images Lossless Compressor Using Recurrent Neural Network (LSTM)

Omniah Nagoor, Joss Whittle, Jingjing Deng, Benjamin Mora, Mark W. Jones

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Auto-TLDR; Recurrent Neural Network for Lossless Medical Image Compression using Long Short-Term Memory

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As scanners produce higher-resolution and more densely sampled images, this raises the challenge of data storage, transmission and communication within healthcare systems. Since the quality of medical images plays a crucial role in diagnosis accuracy, medical imaging compression techniques are desired to reduce scan bitrate while guaranteeing lossless reconstruction. This paper presents a lossless compression method that integrates a Recurrent Neural Network (RNN) as a 3D sequence prediction model. The aim is to learn the long dependencies of the voxel's neighbourhood in 3D using Long Short-Term Memory (LSTM) network then compress the residual error using arithmetic coding. Experiential results reveal that our method obtains a higher compression ratio achieving 15% saving compared to the state-of-the-art lossless compression standards, including JPEG-LS, JPEG2000, JP3D, HEVC, and PPMd. Our evaluation demonstrates that the proposed method generalizes well to unseen modalities CT and MRI for the lossless compression scheme. To the best of our knowledge, this is the first lossless compression method that uses LSTM neural network for 16-bit volumetric medical image compression.

Deep Learning-Based Type Identification of Volumetric MRI Sequences

Jean Pablo De Mello, Thiago Paixão, Rodrigo Berriel, Mauricio Reyes, Alberto F. De Souza, Claudine Badue, Thiago Oliveira-Santos

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Auto-TLDR; Deep Learning for Brain MRI Sequences Identification Using Convolutional Neural Network

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The analysis of Magnetic Resonance Imaging (MRI) sequences enables clinical professionals to monitor the progression of a brain tumor. As the interest for automatizing brain volume MRI analysis increases, it becomes convenient to have each sequence well identified. However, the unstandardized naming of MRI sequences make their identification difficult for automated systems, as well as make it difficult for researches to generate or use datasets for machine learning research. In face of that, we propose a system for identifying types of brain MRI sequences based on deep learning. By training a Convolutional Neural Network (CNN) based on 18-layer ResNet architecture, our system is able to classify a volumetric brain MRI as a T1, T1c, T2 or FLAIR sequence, or whether it does not belong to any of these classes. The network was trained with both pre-processed (BraTS dataset) and non-pre-processed (TCGA-GBM dataset) images with diverse acquisition protocols, requiring only a few layers of the volume for training. Our system is able to classify among sequence types with an accuracy of 96.27%.

Vesselness Filters: A Survey with Benchmarks Applied to Liver Imaging

Jonas Lamy, Odyssée Merveille, Bertrand Kerautret, Nicolas Passat, Antoine Vacavant

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Auto-TLDR; Comparison of Vessel Enhancement Filters for Liver Vascular Network Segmentation

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The accurate knowledge of vascular network geometry is crucial for many clinical applications such as cardiovascular disease diagnosis and surgery planning. Vessel enhancement algorithms are often a key step to improve the robustness of vessel segmentation. A wide variety of enhancement filters exists in the literature, but they are often difficult to compare as the applications and datasets differ from a paper to another and the code is rarely available. In this article, we compare seven vessel enhancement filters covering the last twenty years literature in a unique common framework. We focus our study on the liver vascular network which is under-represented in the literature. The evaluation is made from three points of view: in the whole liver, in the vessel neighborhood and near the bifurcations. The study is performed on two publicly available datasets: the Ircad dataset (CT images) and the VascuSynth dataset adapted for MRI simulation. We discuss the strengths and weaknesses of each method in the hepatic context. In addition, the benchmark framework including a C++ implementation of each compared method is provided. An online demonstration ensures the reproducibility of the results without requiring any additional software.

A Heuristic-Based Decision Tree for Connected Components Labeling of 3D Volumes

Maximilian Söchting, Stefano Allegretti, Federico Bolelli, Costantino Grana

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Auto-TLDR; Entropy Partitioning Decision Tree for Connected Components Labeling

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Connected Components Labeling represents a fundamental step for many Computer Vision and Image Processing pipelines. Since the first appearance of the task in the sixties, many algorithmic solutions to optimize the computational load needed to label an image have been proposed. Among them, block-based scan approaches and decision trees revealed to be some of the most valuable strategies. However, due to the cost of the manual construction of optimal decision trees and the computational limitations of automatic strategies employed in the past, the application of blocks and decision trees has been restricted to small masks, and thus to 2D algorithms. With this paper we present a novel heuristic algorithm based on decision tree learning methodology, called Entropy Partitioning Decision Tree (EPDT). It allows to compute near-optimal decision trees for large scan masks. Experimental results demonstrate that algorithms based on the generated decision trees outperform state-of-the-art competitors.

A Joint Super-Resolution and Deformable Registration Network for 3D Brain Images

Sheng Lan, Zhenhua Guo

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Auto-TLDR; Joint Super-Resolution and Deformable Image Registration with Super-resolution

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In this paper, we propose a joint network for 3D brain images registration with super-resolution to reduce deformable image registration errors caused by low resolution. Basically, the task of deformable image registration is to find the displacement field between the reference image and the moving image. Many research works have been done for deformable image registration, under the assumption that the image resolution is high enough. However, due to the limited level of current acquisition instruments, the resolution of images is not high enough usually. As low resolution images might cause large registration errors, this paper presents a new approach that performs joint super-resolution and deformable image registration. Experiments with 3D brain images show that the joint network does help to reduce the registration errors significantly.

A Multi-Task Contextual Atrous Residual Network for Brain Tumor Detection & Segmentation

Ngan Le, Kashu Yamazaki, Quach Kha Gia, Thanh-Dat Truong, Marios Savvides

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Auto-TLDR; Contextual Brain Tumor Segmentation Using 3D atrous Residual Networks and Cascaded Structures

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In recent years, deep neural networks have achieved state-of-the-art performance in a variety of recognition and segmentation tasks in medical imaging including brain tumor segmentation. We investigate that segmenting brain tumor is facing to the imbalanced data problem where the number of pixels belonging to background class (non tumor pixel) is much larger than the number of pixels belonging to foreground class (tumor pixel). To address this problem, we propose a multi-task network which is formed as a cascaded structure and designed to share the feature maps. Our model consists of two targets, i.e., (i) effectively differentiating brain tumor regions and (ii) estimating brain tumor masks. The first task is performed by our proposed contextual brain tumor detection network, which plays the role of an attention gate and focuses on the region around brain tumor only while ignore the background (non tumor area). Instead of processing every pixel, our contextual brain tumor detection network only processes contextual regions around ground-truth instances and this strategy helps to produce meaningful regions proposals. The second task is built upon a 3D atrous residual network and under an encode-decode network in order to effectively segment both large and small objects (brain tumor). Our 3D atrous residual network is designed with a skip connection to enables the gradient from the deep layers to be directly propagated to shallow layers, thus, features of different depths are preserved and used for refining each other. In order to incorporate larger contextual information in volume MRI data, our network is designed by 3D atrous convolution with various kernel sizes, which enlarges the receptive field of filters. Our proposed network has been evaluated on various datasets including BRATS2015, BRATS2017 and BRATS2018 datasets with both validation set and testing set. Our performance has been benchmarked by both region-based metrics and surface-based metrics. We also have conducted comparisons against state-of-the-art approaches.

A Transformer-Based Network for Anisotropic 3D Medical Image Segmentation

Guo Danfeng, Demetri Terzopoulos

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Auto-TLDR; A transformer-based model to tackle the anisotropy problem in 3D medical image analysis

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A critical challenge of applying neural networks to 3D medical image analysis is to deal with the anisotropy problem. The inter-slice contextual information contained in medical images is important, especially when the structural information of lesions is needed. However, such information often varies with cases because of variable slice spacing. Image anisotropy downgrades model performance especially when slice spacing varies significantly among training and testing datasets. ExsiWe proposed a transformer-based model to tackle the anisotropy problem. It is adaptable to different levels of anisotropy and is computationally efficient. Experiments are conducted on 3D lung cancer segmentation task. Our model achieves an average Dice score of approximately 0.87, which generally outperforms baseline models.

Tensor Factorization of Brain Structural Graph for Unsupervised Classification in Multiple Sclerosis

Berardino Barile, Marzullo Aldo, Claudio Stamile, Françoise Durand-Dubief, Dominique Sappey-Marinier

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Auto-TLDR; A Fully Automated Tensor-based Algorithm for Multiple Sclerosis Classification based on Structural Connectivity Graph of the White Matter Network

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Analysis of longitudinal changes in brain diseases is essential for a better characterization of pathological processes and evaluation of the prognosis. This is particularly important in Multiple Sclerosis (MS) which is the first traumatic disease in young adults, with unknown etiology and characterized by complex inflammatory and degenerative processes leading to different clinical courses. In this work, we propose a fully automated tensor-based algorithm for the classification of MS clinical forms based on the structural connectivity graph of the white matter (WM) network. Using non-negative tensor factorization (NTF), we first focused on the detection of pathological patterns of the brain WM network affected by significant longitudinal variations. Second, we performed unsupervised classification of different MS phenotypes based on these longitudinal patterns, and finally, we used the latent factors obtained by the factorization algorithm to identify the most affected brain regions.

A Riemannian Framework for Detecting Stimulus-Relevant Fiber Pathways

Jingyong Su, Linlin Tang, Zhipeng Yang, Mengmeng Guo

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Auto-TLDR; Clustering Task-Specific Fiber Pathways in Functional MRI using BOLD Signals

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Functional MRI based on blood oxygenation level-dependent (BOLD) contrast is well established as a neuro-imaging technique for detecting neural activity in the cortex of the human brain. Recent studies have shown that variations of BOLD signals in white matter are also related to neural activities both in resting state and under functional loading. We develop a comprehensive framework of detecting task-specific fiber pathways. We not only study fiber tracts as open curves with different physical features (shape, scale, orientation and position), but also incorporate the BOLD signals transmitted along them to find stimulus-relevant pathways. Specifically, we propose a novel Riemannian metric, which is a weighted sum of distances in product space of shapes and functions. This metric provides both a cost function for registration and a proper distance for comparison. Experimental results on real data have shown that we can cluster fiber pathways correctly by evaluating correlations between BOLD signals and stimuli, temporal variations and power spectra of them. The proposed framework can also be easily generalized to various applications where multi-modality data exist.

Deep Recurrent-Convolutional Model for AutomatedSegmentation of Craniomaxillofacial CT Scans

Francesca Murabito, Simone Palazzo, Federica Salanitri Proietto, Francesco Rundo, Ulas Bagci, Daniela Giordano, Rosalia Leonardi, Concetto Spampinato

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Auto-TLDR; Automated Segmentation of Anatomical Structures in Craniomaxillofacial CT Scans using Fully Convolutional Deep Networks

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In this paper we define a deep learning architecture for automated segmentation of anatomical structures in Craniomaxillofacial (CMF) CT scans that leverages the recent success of encoder-decoder models for semantic segmentation of natural images. In particular, we propose a fully convolutional deep network that combines the advantages of recent fully convolutional models, such as Tiramisu, with squeeze-and-excitation blocks for feature recalibration, integrated with convolutional LSTMs to model spatio-temporal correlations between consecutive slices. The proposed segmentation network shows superior performance and generalization capabilities (to different structures and imaging modalities) than state of the art methods on automated segmentation of CMF structures (e.g., mandibles and airways) in several standard benchmarks (e.g., MICCAI datasets) and on new datasets proposed herein, effectively facing shape variability.

NephCNN: A Deep-Learning Framework for Vessel Segmentation in Nephrectomy Laparoscopic Videos

Alessandro Casella, Sara Moccia, Chiara Carlini, Emanuele Frontoni, Elena De Momi, Leonardo Mattos

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Auto-TLDR; Adversarial Fully Convolutional Neural Networks for kidney vessel segmentation from nephrectomy laparoscopic videos

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Objective: In the last years, Robot-assisted partial nephrectomy (RAPN) is establishing as elected treatment for renal cell carcinoma (RCC). Reduced field of view, field occlusions by surgical tools, and reduced maneuverability may potentially cause accidents, such as unwanted vessel resection with consequent bleeding. Surgical Data Science (SDS) can provide effective context-aware tools for supporting surgeons. However, currently no tools have been exploited for automatic vessels segmentation from nephrectomy laparoscopic videos. Herein, we propose a new approach based on adversarial Fully Convolutional Neural Networks (FCNNs) to kidney vessel segmentation from nephrectomy laparoscopic vision. Methods: The proposed approach enhances existing segmentation framework by (i) encoding 3D kernels for spatio-temporal features extraction to enforce pixel connectivity in time, and (ii) perform training in adversarial fashion, which constrains vessels shape. Results: We performed a preliminary study using 8 different RAPN videos (1871 frames), the first in the field, achieving a median Dice Similarity Coefficient of 71.76%. Conclusions: Results showed that the proposed approach could be a valuable solution with a view to assist surgeon during RAPN.

Supporting Skin Lesion Diagnosis with Content-Based Image Retrieval

Stefano Allegretti, Federico Bolelli, Federico Pollastri, Sabrina Longhitano, Giovanni Pellacani, Costantino Grana

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Auto-TLDR; Skin Images Retrieval Using Convolutional Neural Networks for Skin Lesion Classification and Segmentation

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Given the relevance of skin cancer, many attempts have been dedicated to the creation of automated devices that could assist both expert and beginner dermatologists towards fast and early diagnosis of skin lesions. In recent years, tasks such as skin lesion classification and segmentation have been extensively addressed with deep learning algorithms, which in some cases reach a diagnostic accuracy comparable to that of expert physicians. However, the general lack of interpretability and reliability severely hinders the ability of those approaches to actually support dermatologists in the diagnosis process. In this paper a novel skin images retrieval system is presented, which exploits features extracted by Convolutional Neural Networks to gather similar images from a publicly available dataset, in order to assist the diagnosis process of both expert and novice practitioners. In the proposed framework, Resnet-50 is initially trained for the classification of dermoscopic images; then, the feature extraction part is isolated, and an embedding network is build on top of it. The embedding learns an alternative representation, which allows to check image similarity by means of a distance measure. Experimental results reveal that the proposed method is able to select meaningful images, which can effectively boost the classification accuracy of human dermatologists.

Trainable Spectrally Initializable Matrix Transformations in Convolutional Neural Networks

Michele Alberti, Angela Botros, Schuetz Narayan, Rolf Ingold, Marcus Liwicki, Mathias Seuret

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Auto-TLDR; Trainable and Spectrally Initializable Matrix Transformations for Neural Networks

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In this work, we introduce a new architectural component to Neural Networks (NN), i.e., trainable and spectrally initializable matrix transformations on feature maps. While previous literature has already demonstrated the possibility of adding static spectral transformations as feature processors, our focus is on more general trainable transforms. We study the transforms in various architectural configurations on four datasets of different nature: from medical (ColorectalHist, HAM10000) and natural (Flowers) images to historical documents (CB55). With rigorous experiments that control for the number of parameters and randomness, we show that networks utilizing the introduced matrix transformations outperform vanilla neural networks. The observed accuracy increases appreciably across all datasets. In addition, we show that the benefit of spectral initialization leads to significantly faster convergence, as opposed to randomly initialized matrix transformations. The transformations are implemented as auto-differentiable PyTorch modules that can be incorporated into any neural network architecture. The entire code base is open-source.

Weakly Supervised Geodesic Segmentation of Egyptian Mummy CT Scans

Avik Hati, Matteo Bustreo, Diego Sona, Vittorio Murino, Alessio Del Bue

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Auto-TLDR; A Weakly Supervised and Efficient Interactive Segmentation of Ancient Egyptian Mummies CT Scans Using Geodesic Distance Measure and GrabCut

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In this paper, we tackle the task of automatically analyzing 3D volumetric scans obtained from computed tomography (CT) devices. In particular, we address a particular task for which data is very limited: the segmentation of ancient Egyptian mummies CT scans. We aim at digitally unwrapping the mummy and identify different segments such as body, bandages and jewelry. The problem is complex because of the lack of annotated data for the different semantic regions to segment, thus discouraging the use of strongly supervised approaches. We, therefore, propose a weakly supervised and efficient interactive segmentation method to solve this challenging problem. After segmenting the wrapped mummy from its exterior region using histogram analysis and template matching, we first design a voxel distance measure to find an approximate solution for the body and bandage segments. Here, we use geodesic distances since voxel features as well as spatial relationship among voxels is incorporated in this measure. Next, we refine the solution using a GrabCut based segmentation together with a tracking method on the slices of the scan that assigns labels to different regions in the volume, using limited supervision in the form of scribbles drawn by the user. The efficiency of the proposed method is demonstrated using visualizations and validated through quantitative measures and qualitative unwrapping of the mummy.

A Bayesian Deep CNN Framework for Reconstructing K-T-Undersampled Resting-fMRI

Karan Taneja, Prachi Kulkarni, Shabbir Merchant, Suyash Awate

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Auto-TLDR; K-t undersampled R-fMRI Reconstruction using Deep Convolutional Neural Networks

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Undersampled reconstruction in resting functional magnetic resonance imaging (R-fMRI) holds the potential to enable higher spatial resolution in brain R-fMRI without increasing scan duration. We propose a novel framework to reconstruct k-t undersampled R-fMRI relying on a deep convolutional neural network (CNN) framework that leverages the insight that R-fMRI measurements are in k-space (frequency domain) and explicitly models the Fourier transformation from the frequency domain to the spatial domain. The architecture of our CNN framework comprises a multi-stage scheme that jointly learns two multilayer CNN components for (i)~filling in missing k-space data using acquired data in frequency-temporal neighborhoods and (ii)~image quality enhancement in the spatiotemporal domain. We propose four methods within our framework, including a Bayesian CNN that produces uncertainty maps indicating the per-voxel (and per-timepoint) confidence in the blood oxygenation level dependent (BOLD) time-series reconstruction. Results on brain R-fMRI show that our CNN framework improves over the state of the art, quantitatively and qualitatively, in terms of the connectivity maps for three cerebral functional networks.

Inferring Functional Properties from Fluid Dynamics Features

Andrea Schillaci, Maurizio Quadrio, Carlotta Pipolo, Marcello Restelli, Giacomo Boracchi

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Auto-TLDR; Exploiting Convective Properties of Computational Fluid Dynamics for Medical Diagnosis

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In a wide range of applied problems involving fluid flows, Computational Fluid Dynamics (CFD) provides detailed quantitative information on the flow field, at various levels of fidelity and computational cost. However, CFD alone cannot predict high-level functional properties of the system that are not easily obtained from the equations of fluid motion. In this work, we present a data-driven framework to extract additional information, such as medical diagnostic output, from CFD solutions. The task is made difficult by the huge data dimensionality of CFD, together with the limited amount of training data implied by its high computational cost. By pursuing a traditional ML pipeline of pre-processing, feature extraction, and model training, we demonstrate that informative features can be extracted from CFD data. Two experiments, pertaining to different application domains, support the claim that the convective properties implicit into a CFD solution can be leveraged to retrieve functional information for which an analytical definition is missing. Despite the preliminary nature of our study and the relative simplicity of both the geometrical and CFD models, for the first time we demonstrate that the combination of ML and CFD can diagnose a complex system in terms of high-level functional information.

A Lumen Segmentation Method in Ureteroscopy Images Based on a Deep Residual U-Net Architecture

Jorge Lazo, Marzullo Aldo, Sara Moccia, Michele Catellani, Benoit Rosa, Elena De Momi, Michel De Mathelin, Francesco Calimeri

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Auto-TLDR; A Deep Neural Network for Ureteroscopy with Residual Units

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Ureteroscopy is becoming the first surgical treatment option for the majority of urinary affections. This procedure is carried out using an endoscope which provides the surgeon with the visual and spatial information necessary to navigate inside the urinary tract. Having in mind the development of surgical assistance systems, that could enhance the performance of surgeon, the task of lumen segmentation is a fundamental part since this is the visual reference which marks the path that the endoscope should follow. This is something that has not been analyzed in ureteroscopy data before. However, this task presents several challenges given the image quality and the conditions itself of ureteroscopy procedures. In this paper, we study the implementation of a Deep Neural Network which exploits the advantage of residual units in an architecture based on U-Net. For the training of these networks, we analyze the use of two different color spaces: gray-scale and RGB data images. We found that training on gray-scale images gives the best results obtaining mean values of Dice Score, Precision, and Recall of 0.73, 0.58, and 0.92 respectively. The results obtained show that the use of residual U-Net could be a suitable model for further development for a computer-aided system for navigation and guidance through the urinary system.

Multi-focus Image Fusion for Confocal Microscopy Using U-Net Regression Map

Md Maruf Hossain Shuvo, Yasmin M. Kassim, Filiz Bunyak, Olga V. Glinskii, Leike Xie, Vladislav V Glinsky, Virginia H. Huxley, Kannappan Palaniappan

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Auto-TLDR; Independent Single Channel U-Net Fusion for Multi-focus Microscopy Images

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Multi-focus image fusion plays an important role to better visualize the detailed information and anatomical structures of microscopy images. We propose a new approach to fuse all single-focus microscopy images in each Z-stack. As the structures are different in different channels, input images are separated into red and green channels. Red for blood vessels, and green for lymphatics like structures . Taking the maximum likelihood of U-Net regression likelihood map along Z, we obtain the focus selection map for each channel. We named this approach as Independent Single Channel U-Net (ISCU) fusion. We combined each channel fusion result to get the final dual channel composite RGB image. The dataset used is extremely challenging with complex microscopy images of mice dura mater attached to bone. We compared our results with one of the popular and widely used derivative based fusion method [7] using multiscale Hessian. We found that multiscale Hessian-based approach produces banding effects with nonhomogeneous background lacking detailed anatomical structures. So, we took the advantages of Convolutional Neural Network (CNN), and used the U-Net regression likelihood map to fuse the images. Perception based no-reference image quality assessment parameters like PIQUE, NIQE, and BRISQUE confirms the effectiveness of the proposed method.

Confidence Calibration for Deep Renal Biopsy Immunofluorescence Image Classification

Federico Pollastri, Juan Maroñas, Federico Bolelli, Giulia Ligabue, Roberto Paredes, Riccardo Magistroni, Costantino Grana

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Auto-TLDR; A Probabilistic Convolutional Neural Network for Immunofluorescence Classification in Renal Biopsy

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With this work we tackle immunofluorescence classification in renal biopsy, employing state-of-the-art Convolutional Neural Networks. In this setting, the aim of the probabilistic model is to assist an expert practitioner towards identifying the location pattern of antibody deposits within a glomerulus. Since modern neural networks often provide overconfident outputs, we stress the importance of having a reliable prediction, demonstrating that Temperature Scaling, a recently introduced re-calibration technique, can be successfully applied to immunofluorescence classification in renal biopsy. Experimental results demonstrate that the designed model yields good accuracy on the specific task, and that Temperature Scaling is able to provide reliable probabilities, which are highly valuable for such a task given the low inter-rater agreement.

Semantic Segmentation of Breast Ultrasound Image with Pyramid Fuzzy Uncertainty Reduction and Direction Connectedness Feature

Kuan Huang, Yingtao Zhang, Heng-Da Cheng, Ping Xing, Boyu Zhang

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Auto-TLDR; Uncertainty-Based Deep Learning for Breast Ultrasound Image Segmentation

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Deep learning approaches have achieved impressive results in breast ultrasound (BUS) image segmentation. However, these methods did not solve uncertainty and noise in BUS images well. To address this issue, we present a novel deep learning structure for BUS image semantic segmentation by analyzing the uncertainty using a pyramid fuzzy block and generating a novel feature based on connectedness. Firstly, feature maps in the proposed network are down-sampled to different resolutions. Fuzzy transformation and uncertainty representation are applied to each resolution to obtain the uncertainty degree on different scales. Meanwhile, the BUS images contain layer structures. From top to bottom, there are skin layer, fat layer, mammary layer, muscle layer, and background area. A spatial recurrent neural network (RNN) is utilized to calculate the connectedness between each pixel and the pixels on the four boundaries in horizontal and vertical lines. The spatial-wise context feature can introduce the characteristic of layer structure to deep neural network. Finally, the original convolutional features are combined with connectedness feature according to the uncertainty degrees. The proposed methods are applied to two datasets: a BUS image benchmark with two categories (background and tumor) and a five-category BUS image dataset with fat layer, mammary layer, muscle layer, background, and tumor. The proposed method achieves the best results on both datasets compared with eight state-of-the-art deep learning-based approaches.

MTGAN: Mask and Texture-Driven Generative Adversarial Network for Lung Nodule Segmentation

Wei Chen, Qiuli Wang, Kun Wang, Dan Yang, Xiaohong Zhang, Chen Liu, Yucong Li

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Auto-TLDR; Mask and Texture-driven Generative Adversarial Network for Lung Nodule Segmentation

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Accurate segmentation for lung nodules in lung computed tomography (CT) scans plays a key role in the early diagnosis of lung cancer. Many existing methods, especially UNet, have made significant progress in lung nodule segmentation. However, due to the complex shapes of lung nodules and the similarity of visual characteristics between nodules and lung tissues, an accurate segmentation with few false positives of lung nodules is still a challenging problem. Considering the fact that both boundary and texture information of lung nodules are important for obtaining an accurate segmentation result, we propose a novel Mask and Texture-driven Generative Adversarial Network (MTGAN) with a joint multi-scale L1 loss for lung nodule segmentation, which takes full advantages of U-Net and adversarial training. The proposed MTGAN leverages adversarial learning strategy guided by the boundary and texture information of lung nodules to generate more accurate segmentation results with lesser false positives. We validate our model with the LIDC–IDRI dataset, and experimental results show that our method achieves excellent segmentation results for a variety of lung nodules, especially for juxtapleural nodules and low-dense nodules. Without any bells and whistles, the proposed MTGAN achieves significant segmentation performance with the Dice similarity coefficient (DSC) of 85.24% on the LIDC–IDRI dataset.

DA-RefineNet: Dual-Inputs Attention RefineNet for Whole Slide Image Segmentation

Ziqiang Li, Rentuo Tao, Qianrun Wu, Bin Li

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Auto-TLDR; DA-RefineNet: A dual-inputs attention network for whole slide image segmentation

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Automatic medical image segmentation techniques have wide applications for disease diagnosing, however, its much more challenging than natural optical image segmentation tasks due to the high-resolution of medical images and the corresponding huge computation cost. Sliding window was a commonly used technique for whole slide image (WSI) segmentation, however, for these methods that based on sliding window, the main drawback was lacking of global contextual information for supervision. In this paper, we proposed a dual-inputs attention network (denoted as DA-RefineNet) for WSI segmentation, where both local fine-grained information and global coarse information can be efficiently utilized. Sufficient comparative experiments were conducted to evaluate the effectiveness of the proposed method, the results proved that the proposed method can achieve better performance on WSI segmentation tasks compared to methods rely on single-input.

Leveraging Unlabeled Data for Glioma Molecular Subtype and Survival Prediction

Nicholas Nuechterlein, Beibin Li, Mehmet Saygin Seyfioglu, Sachin Mehta, Patrick Cimino, Linda Shapiro

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Auto-TLDR; Multimodal Brain Tumor Segmentation Using Unlabeled MR Data and Genomic Data for Cancer Prediction

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In this paper, we address two long-standing challenges in neuro-oncology: (1) how to leverage large amounts of unlabeled magnetic resonance (MR) imaging data for radiogenomic tasks and (2) how to unite glioma MR imaging with genomic data. We examine multi-parametric MR data from 542 patients in the combined training, validation, and testing sets of the 2018 Multimodal Brain Tumor Segmentation Challenge and somatic copy number alteration (SCNA) data from 1090 patients in The Cancer Genome Archive's (TCGA) lower-grade glioma and glioblastoma projects. We propose a novel application of multi-task learning (MTL) that leverages unlabeled MR data by jointly learning tumor segmentation masks with glioma molecular subtype markers and allows for SCNA input when available. There are 235 patients in the intersection of these MR and SCNA datasets, which we divide into an unlabeled training set, a labeled training set, and a validation set. Our MTL model significantly outperforms comparable classification models trained only on labeled MR data for both IDH1/2 mutation and 1p/19q co-deletion glioma subtype marker prediction tasks. We also observe that models trained on genomic and imaging data improve survival prediction results achieved by models trained on either alone. We will release our source code for future research.

Offset Curves Loss for Imbalanced Problem in Medical Segmentation

Ngan Le, Duc Toan Bui, Khoa Luu, Marios Savvides

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Auto-TLDR; Offset Curves Loss for Medical Image Segmentation

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Medical image segmentation has played an important role in medical analysis and widely developed for many clinical applications. Deep learning-based approaches have achieved high performance in semantic segmentation but they are limited to pixel-wise setting and imbalanced classes data problem. In this paper, we tackle those limitations by developing a new deep learning-based model which takes into account both higher feature level i.e. region inside contour, intermediate feature level i.e. offset curves around the contour and lower feature level i.e. contour. Our proposed Offset Curves (OsC) loss consists of three main fitting terms. The first fitting term focuses on pixel-wise level segmentation whereas the second fitting term acts as attention model which pays attention to the area around the boundaries (offset curves). The third terms plays a role as regularization term which takes the length of boundaries into account. We evaluate our proposed OsC loss on both 2D network and 3D network. Two common medical datasets, i.e. retina DRIVE and brain tumor BRATS 2018 datasets are used to benchmark our proposed loss performance. The experiments have showed that our proposed OsC loss function outperforms other mainstream loss functions such as Cross-Entropy, Dice, Focal on the most common segmentation networks Unet, FCN.

One-Stage Multi-Task Detector for 3D Cardiac MR Imaging

Weizeng Lu, Xi Jia, Wei Chen, Nicolò Savioli, Antonio De Marvao, Linlin Shen, Declan O'Regan, Jinming Duan

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Auto-TLDR; Multi-task Learning for Real-Time, simultaneous landmark location and bounding box detection in 3D space

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Fast and accurate landmark location and bounding box detection are important steps in 3D medical imaging. In this paper, we propose a novel multi-task learning framework, for real-time, simultaneous landmark location and bounding box detection in 3D space. Our method extends the famous single-shot multibox detector (SSD) from single-task learning to multi-task learning and from 2D to 3D. Furthermore, we propose a post-processing approach to refine the network landmark output, by averaging the candidate landmarks. Owing to these settings, the proposed framework is fast and accurate. For 3D cardiac magnetic resonance (MR) images with size 224 × 224 × 64, our framework runs about 128 volumes per second (VPS) on GPU and achieves 6.75mm average point-to-point distance error for landmark location, which outperforms both state-of-the-art and baseline methods. We also show that segmenting the 3D image cropped with the bounding box results in both improved performance and efficiency.

Cross-View Relation Networks for Mammogram Mass Detection

Ma Jiechao, Xiang Li, Hongwei Li, Ruixuan Wang, Bjoern Menze, Wei-Shi Zheng

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Auto-TLDR; Multi-view Modeling for Mass Detection in Mammogram

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In medical image analysis, multi-view modeling is crucial for pathology detection when the target lesion is presented in different views, e.g. mass lesions in breast. Currently mammogram is the most effective imaging modality for mass lesion detection of breast cancer at the early stage. The pathological information from the two paired views (i.e., medio-lateral oblique and cranio-caudal) are highly relational and complementary, which is crucial for diagnosis in clinical practice. Existing mass detection methods do not consider learning synergistic features from the two relational views. For the first time, we propose a novel mass detection framework to capture the latent relation information from the two paired views of a same mass in mammogram. We evaluate our model on a public mammogram dataset and a large-scale private dataset, demonstrating that the proposed method outperforms existing feature fusion approaches and state-of-the-art mass detection methods. We further analyze the performance gains from the relation modeling. Our quantitative and qualitative results suggest that jointly learning cross-view features boosts the detection performance of existing models, which is a promising avenue for mass detection task in mammogram.

Prediction of Obstructive Coronary Artery Disease from Myocardial Perfusion Scintigraphy using Deep Neural Networks

Ida Arvidsson, Niels Christian Overgaard, Miguel Ochoa Figueroa, Jeronimo Rose, Anette Davidsson, Kalle Åström, Anders Heyden

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Auto-TLDR; A Deep Learning Algorithm for Multi-label Classification of Myocardial Perfusion Scintigraphy for Stable Ischemic Heart Disease

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For diagnosis and risk assessment in patients with stable ischemic heart disease, myocardial perfusion scintigraphy is one of the most common cardiological examinations performed today. There are however many motivations for why an artificial intelligence algorithm would provide useful input to this task. For example to reduce the subjectiveness and save time for the nuclear medicine physicians working with this time consuming task. In this work we have developed a deep learning algorithm for multi-label classification based on a modified convolutional neural network to estimate probability of obstructive coronary artery disease in the left anterior artery, left circumflex artery and right coronary artery. The prediction is based on data from myocardial perfusion scintigraphy studies conducted in a dedicated Cadmium-Zinc-Telluride cardio camera (D-SPECT Spectrum Dynamics). Data from 588 patients was available, with stress images in both upright and supine position, as well as a number of auxiliary parameters such as angina symptoms and BMI. The data was used to train and evaluate the algorithm using 5-fold cross-validation. We achieve state-of-the-art results for this task with an area under the receiver operating characteristics curve of 0.89 as average on per-vessel level and 0.94 on per-patient level.

Segmentation of Intracranial Aneurysm Remnant in MRA Using Dual-Attention Atrous Net

Subhashis Banerjee, Ashis Kumar Dhara, Johan Wikström, Robin Strand

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Auto-TLDR; Dual-Attention Atrous Net for Segmentation of Intracranial Aneurysm Remnant from MRA Images

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Due to the advancement of non-invasive medical imaging modalities like Magnetic Resonance Angiography (MRA), an increasing number of Intracranial Aneurysm (IA) cases are being reported in recent years. The IAs are typically treated by so-called endovascular coiling, where blood flow in the IA is prevented by embolization with a platinum coil. Accurate quantification of the IA Remnant (IAR), i.e. the volume with blood flow present post treatment is the utmost important factor in choosing the right treatment planning. This is typically done by manually segmenting the aneurysm remnant from the MRA volume. Since manual segmentation of volumetric images is a labour-intensive and error-prone process, development of an automatic volumetric segmentation method is required. Segmentation of small structures such as IA, that may largely vary in size, shape, and location is considered extremely difficult. Similar intensity distribution of IAs and surrounding blood vessels makes it more challenging and susceptible to false positive. In this paper we propose a novel 3D CNN architecture called Dual-Attention Atrous Net (DAtt-ANet), which can efficiently segment IAR volumes from MRA images by reconciling features at different scales using the proposed Parallel Atrous Unit (PAU) along with the use of self-attention mechanism for extracting fine-grained features and intra-class correlation. The proposed DAtt-ANet model is trained and evaluated on a clinical MRA image dataset (prospective research project, approved by the local ethical committee) of IAR consisting of 46 subjects, annotated by an expert radiologist from our group. We compared the proposed DAtt-ANet with five state-of-the-art CNN models based on their segmentation performance. The proposed DAtt-ANet outperformed all other methods and was able to achieve a five-fold cross-validation DICE score of $0.73\pm0.06$.

Deep Multi-Stage Model for Automated Landmarking of Craniomaxillofacial CT Scans

Simone Palazzo, Giovanni Bellitto, Luca Prezzavento, Francesco Rundo, Ulas Bagci, Daniela Giordano, Rosalia Leonardi, Concetto Spampinato

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Auto-TLDR; Automated Landmarking of Craniomaxillofacial CT Images Using Deep Multi-Stage Architecture

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In this paper we define a deep multi-stage architecture for automated landmarking of craniomaxillofacial (CMF) CT images. Our model is composed of three subnetworks that first localize, on reduced-resolution images, areas where land-marks may be found and then refine the search, at full-resolution scale, through a hierarchical structure aiming at increasing the granularity of the investigated region. The multi-stage pipeline is designed to deal with full resolution data and does not require any additional pre-processing step to reduce search space, as opposed to existing methods that can be only adopted for searching landmarks located in well-defined anatomical structures (e.g.,mandibles). The automated landmarking system is tested on identifying landmarks located in several CMF regions, achieving an average error of 0.8 mm, significantly lower than expert readings. The proposed model also outperforms baselines and is on par with existing models that employ additional upstream segmentation, on state-of-the-art benchmarks.

Learn to Segment Retinal Lesions and Beyond

Qijie Wei, Xirong Li, Weihong Yu, Xiao Zhang, Yongpeng Zhang, Bojie Hu, Bin Mo, Di Gong, Ning Chen, Dayong Ding, Youxin Chen

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Auto-TLDR; Multi-task Lesion Segmentation and Disease Classification for Diabetic Retinopathy Grading

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Towards automated retinal screening, this paper makes an endeavor to simultaneously achieve pixel-level retinal lesion segmentation and image-level disease classification. Such a multi-task approach is crucial for accurate and clinically interpretable disease diagnosis. Prior art is insufficient due to three challenges, i.e., lesions lacking objective boundaries, clinical importance of lesions irrelevant to their size, and the lack of one-to-one correspondence between lesion and disease classes. This paper attacks the three challenges in the context of diabetic retinopathy (DR) grading. We propose Lesion-Net, a new variant of fully convolutional networks, with its expansive path re- designed to tackle the first challenge. A dual Dice loss that leverages both semantic segmentation and image classification losses is introduced to resolve the second challenge. Lastly, we build a multi-task network that employs Lesion-Net as a side- attention branch for both DR grading and result interpretation. A set of 12K fundus images is manually segmented by 45 ophthalmologists for 8 DR-related lesions, resulting in 290K manual segments in total. Extensive experiments on this large- scale dataset show that our proposed approach surpasses the prior art for multiple tasks including lesion segmentation, lesion classification and DR grading.

Deep Learning in the Ultrasound Evaluation of Neonatal Respiratory Status

Michela Gravina, Diego Gragnaniello, Giovanni Poggi, Luisa Verdoliva, Carlo Sansone, Iuri Corsini, Carlo Dani, Fabio Meneghin, Gianluca Lista, Salvatore Aversa, Migliaro Migliaro, Raimondi Francesco

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Auto-TLDR; Lung Ultrasound Imaging with Deep Learning Networks and Training Strategies: An Analysis and Adaptation

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Lung ultrasound imaging is reaching growing interest from the scientific community. On one side, thanks to its harmlessness and high descriptive power, this kind of diagnostic imaging became largely adopted in sensitive applications, like the diagnosis and follow-up of preterm newborns in neonatal intensive care units. At the same time, novel image analysis and pattern recognition approaches can fully exploit the rich information contained in this data, making them attractive for the research community. In this work, we present a thorough analysis of recent deep learning networks and training strategies conducted on a vast and challenging multicenter dataset comprising 87 patients with different diseases and gestational ages. These approaches are firstly discussed in the context of lung respiratory status assessing through ultrasound imaging and then evaluated against a reference marker. The conducted analysis shed some light on this problem, by relating the criticisms that can mislead the training procedure and proposing some adaptations to the specific problem. The achieved results sensibly outperform that obtained by previous work, based on textural features, and narrow the gap with the visual score predicted by the human experts.

Do Not Treat Boundaries and Regions Differently: An Example on Heart Left Atrial Segmentation

Zhou Zhao, Elodie Puybareau, Nicolas Boutry, Thierry Geraud

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Auto-TLDR; Attention Full Convolutional Network for Atrial Segmentation using ResNet-101 Architecture

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Atrial fibrillation is the most common heart rhythm disease. Due to a lack of understanding in matter of underlying atrial structures, current treatments are still not satisfying. Recently, with the popularity of deep learning, many segmentation methods based on fully convolutional networks have been proposed to analyze atrial structures, especially from late gadolinium-enhanced magnetic resonance imaging. However, two problems still occur: 1) segmentation results include the atrial-like background; 2) boundaries are very hard to segment. Most segmentation approaches design a specific network that mainly focuses on the regions, to the detriment of the boundaries. Therefore, this paper proposes an attention full convolutional network framework based on the ResNet-101 architecture, which focuses on boundaries as much as on regions. The additional attention module is added to have the network pay more attention on regions and then to reduce the impact of the misleading similarity of neighboring tissues. We also use a hybrid loss composed of a region loss and a boundary loss to treat boundaries and regions at the same time. We demonstrate the efficiency of the proposed approach on the MICCAI 2018 Atrial Segmentation Challenge public dataset.

Recovery of 2D and 3D Layout Information through an Advanced Image Stitching Algorithm Using Scanning Electron Microscope Images

Aayush Singla, Bernhard Lippmann, Helmut Graeb

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Auto-TLDR; Image Stitching for True Geometrical Layout Recovery in Nanoscale Dimension

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Image stitching describes the process of reconstruction of a high resolution image from combining multiple images. Using a scanning electron microscope as the image source, individual images will show patterns in a nm dimension whereas the combined image may cover an area of several mm2. The recovery of the physical layout of modern semiconductor products manufactured in advanced technologies nodes down to 22 nm requires a perfect stitching process with no deviation with respect to the original design data, as any stitching error will result in failures during the reconstruction of the electrical design. In addition, the recovery of the complete design requires the acquisition of all individual layers of a semiconductor device which represent a 3D structure with interconnections defining error limits on the stitching error for each individual scanned image mosaic. An advanced stitching and alignment process is presented enabling a true geometrical layout recovery in nanoscale dimensions which is also applied and evaluated on other use cases from biological applications.

Bridging the Gap between Natural and Medical Images through Deep Colorization

Lia Morra, Luca Piano, Fabrizio Lamberti, Tatiana Tommasi

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Auto-TLDR; Transfer Learning for Diagnosis on X-ray Images Using Color Adaptation

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Deep learning has thrived by training on large-scale datasets. However, in many applications, as for medical image diagnosis, getting massive amount of data is still prohibitive due to privacy, lack of acquisition homogeneity and annotation cost. In this scenario transfer learning from natural image collections is a standard practice that attempts to tackle shape, texture and color discrepancy all at once through pretrained model fine-tuning. In this work we propose to disentangle those challenges and design a dedicated network module that focuses on color adaptation. We combine learning from scratch of the color module with transfer learning of different classification backbones obtaining an end-to-end, easy-to-train architecture for diagnostic image recognition on X-ray images. Extensive experiments show how our approach is particularly efficient in case of data scarcity and provides a new path for further transferring the learned color information across multiple medical datasets.

SAGE: Sequential Attribute Generator for Analyzing Glioblastomas Using Limited Dataset

Padmaja Jonnalagedda, Brent Weinberg, Jason Allen, Taejin Min, Shiv Bhanu, Bir Bhanu

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Auto-TLDR; SAGE: Generative Adversarial Networks for Imaging Biomarker Detection and Prediction

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While deep learning approaches have shown remarkable performance in many imaging tasks, most of these methods rely on availability of large quantities of data. Medical image data, however, is scarce and fragmented. Generative Adversarial Networks (GANs) have recently been very effective in handling such datasets by generating more data. If the datasets are very small, however, GANs cannot learn the data distribution properly, resulting in less diverse or low-quality results. One such limited dataset is that for the concurrent gain of 19/20 chromosomes (19/20 co-gain), a mutation with positive prognostic value in Glioblastomas (GBM). In this paper, we detect imaging biomarkers for the mutation to streamline the extensive and invasive prognosis pipeline. Since this mutation is relatively rare, i.e. small dataset, we propose a novel generative framework – the Sequential Attribute GEnerator (SAGE), that generates detailed tumor imaging features while learning from a limited dataset. Experiments show that not only does SAGE generate high quality tumors when compared to standard Deep Convolutional GAN (DC-GAN) and Wasserstein GAN with Gradient Penalty (WGAN-GP), it also captures the imaging biomarkers accurately.

Unsupervised Detection of Pulmonary Opacities for Computer-Aided Diagnosis of COVID-19 on CT Images

Rui Xu, Xiao Cao, Yufeng Wang, Yen-Wei Chen, Xinchen Ye, Lin Lin, Wenchao Zhu, Chao Chen, Fangyi Xu, Yong Zhou, Hongjie Hu, Shoji Kido, Noriyuki Tomiyama

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Auto-TLDR; A computer-aided diagnosis of COVID-19 from CT images using unsupervised pulmonary opacity detection

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COVID-19 emerged towards the end of 2019 which was identified as a global pandemic by the world heath organization (WHO). With the rapid spread of COVID-19, the number of infected and suspected patients has increased dramatically. Chest computed tomography (CT) has been recognized as an efficient tool for the diagnosis of COVID-19. However, the huge CT data make it difficult for radiologist to fully exploit them on the diagnosis. In this paper, we propose a computer-aided diagnosis system that can automatically analyze CT images to distinguish the COVID-19 against to community-acquired pneumonia (CAP). The proposed system is based on an unsupervised pulmonary opacity detection method that locates opacity regions by a detector unsupervisedly trained from CT images with normal lung tissues. Radiomics based features are extracted insides the opacity regions, and fed into classifiers for classification. We evaluate the proposed CAD system by using 200 CT images collected from different patients in several hospitals. The accuracy, precision, recall, f1-score and AUC achieved are 95.5%, 100%, 91%, 95.1% and 95.9% respectively, exhibiting the promising capacity on the differential diagnosis of COVID-19 from CT images.