No Arabic abstract
Purpose: To develop and evaluate the accuracy of a multi-view deep learning approach to the analysis of high-resolution synthetic mammograms from digital breast tomosynthesis screening cases, and to assess the effect on accuracy of image resolution and training set size. Materials and Methods: In a retrospective study, 21,264 screening digital breast tomosynthesis (DBT) exams obtained at our institution were collected along with associated radiology reports. The 2D synthetic mammographic images from these exams, with varying resolutions and data set sizes, were used to train a multi-view deep convolutional neural network (MV-CNN) to classify screening images into BI-RADS classes (BI-RADS 0, 1 and 2) before evaluation on a held-out set of exams. Results: Area under the receiver operating characteristic curve (AUC) for BI-RADS 0 vs non-BI-RADS 0 class was 0.912 for the MV-CNN trained on the full dataset. The model obtained accuracy of 84.8%, recall of 95.9% and precision of 95.0%. This AUC value decreased when the same model was trained with 50% and 25% of images (AUC = 0.877, P=0.010 and 0.834, P=0.009 respectively). Also, the performance dropped when the same model was trained using images that were under-sampled by 1/2 and 1/4 (AUC = 0.870, P=0.011 and 0.813, P=0.009 respectively). Conclusion: This deep learning model classified high-resolution synthetic mammography scans into normal vs needing further workup using tens of thousands of high-resolution images. Smaller training data sets and lower resolution images both caused significant decrease in performance.
The purpose of this study was to develop a fully-automated segmentation algorithm, robust to various density enhancing lung abnormalities, to facilitate rapid quantitative analysis of computed tomography images. A polymorphic training approach is proposed, in which both specifically labeled left and right lungs of humans with COPD, and nonspecifically labeled lungs of animals with acute lung injury, were incorporated into training a single neural network. The resulting network is intended for predicting left and right lung regions in humans with or without diffuse opacification and consolidation. Performance of the proposed lung segmentation algorithm was extensively evaluated on CT scans of subjects with COPD, confirmed COVID-19, lung cancer, and IPF, despite no labeled training data of the latter three diseases. Lobar segmentations were obtained using the left and right lung segmentation as input to the LobeNet algorithm. Regional lobar analysis was performed using hierarchical clustering to identify radiographic subtypes of COVID-19. The proposed lung segmentation algorithm was quantitatively evaluated using semi-automated and manually-corrected segmentations in 87 COVID-19 CT images, achieving an average symmetric surface distance of $0.495 pm 0.309$ mm and Dice coefficient of $0.985 pm 0.011$. Hierarchical clustering identified four radiographical phenotypes of COVID-19 based on lobar fractions of consolidated and poorly aerated tissue. Lower left and lower right lobes were consistently more afflicted with poor aeration and consolidation. However, the most severe cases demonstrated involvement of all lobes. The polymorphic training approach was able to accurately segment COVID-19 cases with diffuse consolidation without requiring COVID-19 cases for training.
Spatial attention has been introduced to convolutional neural networks (CNNs) for improving both their performance and interpretability in visual tasks including image classification. The essence of the spatial attention is to learn a weight map which represents the relative importance of activations within the same layer or channel. All existing attention mechanisms are local attentions in the sense that weight maps are image-specific. However, in the medical field, there are cases that all the images should share the same weight map because the set of images record the same kind of symptom related to the same object and thereby share the same structural content. In this paper, we thus propose a novel global spatial attention mechanism in CNNs mainly for medical image classification. The global weight map is instantiated by a decision boundary between important pixels and unimportant pixels. And we propose to realize the decision boundary by a binary classifier in which the intensities of all images at a pixel are the features of the pixel. The binary classification is integrated into an image classification CNN and is to be optimized together with the CNN. Experiments on two medical image datasets and one facial expression dataset showed that with the proposed attention, not only the performance of four powerful CNNs which are GoogleNet, VGG, ResNet, and DenseNet can be improved, but also meaningful attended regions can be obtained, which is beneficial for understanding the content of images of a domain.
Thoracic disease detection from chest radiographs using deep learning methods has been an active area of research in the last decade. Most previous methods attempt to focus on the diseased organs of the image by identifying spatial regions responsible for significant contributions to the models prediction. In contrast, expert radiologists first locate the prominent anatomical structures before determining if those regions are anomalous. Therefore, integrating anatomical knowledge within deep learning models could bring substantial improvement in automatic disease classification. This work proposes an anatomy-aware attention-based architecture named Anatomy X-Net, that prioritizes the spatial features guided by the pre-identified anatomy regions. We leverage a semi-supervised learning method using the JSRT dataset containing organ-level annotation to obtain the anatomical segmentation masks (for lungs and heart) for the NIH and CheXpert datasets. The proposed Anatomy X-Net uses the pre-trained DenseNet-121 as the backbone network with two corresponding structured modules, the Anatomy Aware Attention (AAA) and Probabilistic Weighted Average Pooling (PWAP), in a cohesive framework for anatomical attention learning. Our proposed method sets new state-of-the-art performance on the official NIH test set with an AUC score of 0.8439, proving the efficacy of utilizing the anatomy segmentation knowledge to improve the thoracic disease classification. Furthermore, the Anatomy X-Net yields an averaged AUC of 0.9020 on the Stanford CheXpert dataset, improving on existing methods that demonstrate the generalizability of the proposed framework.
Breast cancer is the most common invasive cancer in women, and the second main cause of death. Breast cancer screening is an efficient method to detect indeterminate breast lesions early. The common approaches of screening for women are tomosynthesis and mammography images. However, the traditional manual diagnosis requires an intense workload by pathologists, who are prone to diagnostic errors. Thus, the aim of this study is to build a deep convolutional neural network method for automatic detection, segmentation, and classification of breast lesions in mammography images. Based on deep learning the Mask-CNN (RoIAlign) method was developed to features selection and extraction; and the classification was carried out by DenseNet architecture. Finally, the precision and accuracy of the model is evaluated by cross validation matrix and AUC curve. To summarize, the findings of this study may provide a helpful to improve the diagnosis and efficiency in the automatic tumor localization through the medical image classification.
A novel coronavirus disease 2019 (COVID-19) was detected and has spread rapidly across various countries around the world since the end of the year 2019, Computed Tomography (CT) images have been used as a crucial alternative to the time-consuming RT-PCR test. However, pure manual segmentation of CT images faces a serious challenge with the increase of suspected cases, resulting in urgent requirements for accurate and automatic segmentation of COVID-19 infections. Unfortunately, since the imaging characteristics of the COVID-19 infection are diverse and similar to the backgrounds, existing medical image segmentation methods cannot achieve satisfactory performance. In this work, we try to establish a new deep convolutional neural network tailored for segmenting the chest CT images with COVID-19 infections. We firstly maintain a large and new chest CT image dataset consisting of 165,667 annotated chest CT images from 861 patients with confirmed COVID-19. Inspired by the observation that the boundary of the infected lung can be enhanced by adjusting the global intensity, in the proposed deep CNN, we introduce a feature variation block which adaptively adjusts the global properties of the features for segmenting COVID-19 infection. The proposed FV block can enhance the capability of feature representation effectively and adaptively for diverse cases. We fuse features at different scales by proposing Progressive Atrous Spatial Pyramid Pooling to handle the sophisticated infection areas with diverse appearance and shapes. We conducted experiments on the data collected in China and Germany and show that the proposed deep CNN can produce impressive performance effectively.