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Deep learning for detection and segmentation of artefact and disease instances in gastrointestinal endoscopy

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 Added by Sharib Ali Dr.
 Publication date 2020
and research's language is English




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The Endoscopy Computer Vision Challenge (EndoCV) is a crowd-sourcing initiative to address eminent problems in developing reliable computer aided detection and diagnosis endoscopy systems and suggest a pathway for clinical translation of technologies. Whilst endoscopy is a widely used diagnostic and treatment tool for hollow-organs, there are several core challenges often faced by endoscopists, mainly: 1) presence of multi-class artefacts that hinder their visual interpretation, and 2) difficulty in identifying subtle precancerous precursors and cancer abnormalities. Artefacts often affect the robustness of deep learning methods applied to the gastrointestinal tract organs as they can be confused with tissue of interest. EndoCV2020 challenges are designed to address research questions in these remits. In this paper, we present a summary of methods developed by the top 17 teams and provide an objective comparison of state-of-the-art methods and methods designed by the participants for two sub-challenges: i) artefact detection and segmentation (EAD2020), and ii) disease detection and segmentation (EDD2020). Multi-center, multi-organ, multi-class, and multi-modal clinical endoscopy datasets were compiled for both EAD2020 and EDD2020 sub-challenges. The out-of-sample generalization ability of detection algorithms was also evaluated. Whilst most teams focused on accuracy improvements, only a few methods hold credibility for clinical usability. The best performing teams provided solutions to tackle class imbalance, and variabilities in size, origin, modality and occurrences by exploring data augmentation, data fusion, and optimal class thresholding techniques.



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Gastrointestinal (GI) pathologies are periodically screened, biopsied, and resected using surgical tools. Usually the procedures and the treated or resected areas are not specifically tracked or analysed during or after colonoscopies. Information regarding disease borders, development and amount and size of the resected area get lost. This can lead to poor follow-up and bothersome reassessment difficulties post-treatment. To improve the current standard and also to foster more research on the topic we have released the ``Kvasir-Instrument dataset which consists of $590$ annotated frames containing GI procedure tools such as snares, balloons and biopsy forceps, etc. Beside of the images, the dataset includes ground truth masks and bounding boxes and has been verified by two expert GI endoscopists. Additionally, we provide a baseline for the segmentation of the GI tools to promote research and algorithm development. We obtained a dice coefficient score of 0.9158 and a Jaccard index of 0.8578 using a classical U-Net architecture. A similar dice coefficient score was observed for DoubleUNet. The qualitative results showed that the model did not work for the images with specularity and the frames with multiple instruments, while the best result for both methods was observed on all other types of images. Both, qualitative and quantitative results show that the model performs reasonably good, but there is a large potential for further improvements. Benchmarking using the dataset provides an opportunity for researchers to contribute to the field of automatic endoscopic diagnostic and therapeutic tool segmentation for GI endoscopy.
We systematically evaluate the performance of deep learning models in the presence of diseases not labeled for or present during training. First, we evaluate whether deep learning models trained on a subset of diseases (seen diseases) can detect the presence of any one of a larger set of diseases. We find that models tend to falsely classify diseases outside of the subset (unseen diseases) as no disease. Second, we evaluate whether models trained on seen diseases can detect seen diseases when co-occurring with diseases outside the subset (unseen diseases). We find that models are still able to detect seen diseases even when co-occurring with unseen diseases. Third, we evaluate whether feature representations learned by models may be used to detect the presence of unseen diseases given a small labeled set of unseen diseases. We find that the penultimate layer of the deep neural network provides useful features for unseen disease detection. Our results can inform the safe clinical deployment of deep learning models trained on a non-exhaustive set of disease classes.
Whilst many technologies are built around endoscopy, there is a need to have a comprehensive dataset collected from multiple centers to address the generalization issues with most deep learning frameworks. What could be more important than disease detection and localization? Through our extensive network of clinical and computational experts, we have collected, curated and annotated gastrointestinal endoscopy video frames. We have released this dataset and have launched disease detection and segmentation challenge EDD2020 https://edd2020.grand-challenge.org to address the limitations and explore new directions. EDD2020 is a crowd sourcing initiative to test the feasibility of recent deep learning methods and to promote research for building robust technologies. In this paper, we provide an overview of the EDD2020 dataset, challenge tasks, evaluation strategies and a short summary of results on test data. A detailed paper will be drafted after the challenge workshop with more detailed analysis of the results.
Endoscopy is a routine imaging technique used for both diagnosis and minimally invasive surgical treatment. Artifacts such as motion blur, bubbles, specular reflections, floating objects and pixel saturation impede the visual interpretation and the automated analysis of endoscopy videos. Given the widespread use of endoscopy in different clinical applications, we contend that the robust and reliable identification of such artifacts and the automated restoration of corrupted video frames is a fundamental medical imaging problem. Existing state-of-the-art methods only deal with the detection and restoration of selected artifacts. However, typically endoscopy videos contain numerous artifacts which motivates to establish a comprehensive solution. We propose a fully automatic framework that can: 1) detect and classify six different primary artifacts, 2) provide a quality score for each frame and 3) restore mildly corrupted frames. To detect different artifacts our framework exploits fast multi-scale, single stage convolutional neural network detector. We introduce a quality metric to assess frame quality and predict image restoration success. Generative adversarial networks with carefully chosen regularization are finally used to restore corrupted frames. Our detector yields the highest mean average precision (mAP at 5% threshold) of 49.0 and the lowest computational time of 88 ms allowing for accurate real-time processing. Our restoration models for blind deblurring, saturation correction and inpainting demonstrate significant improvements over previous methods. On a set of 10 test videos we show that our approach preserves an average of 68.7% which is 25% more frames than that retained from the raw videos.
Endoscopic artifacts are a core challenge in facilitating the diagnosis and treatment of diseases in hollow organs. Precise detection of specific artifacts like pixel saturations, motion blur, specular reflections, bubbles and debris is essential for high-quality frame restoration and is crucial for realizing reliable computer-assisted tools for improved patient care. At present most videos in endoscopy are currently not analyzed due to the abundant presence of multi-class artifacts in video frames. Through the endoscopic artifact detection (EAD 2019) challenge, we address this key bottleneck problem by solving the accurate identification and localization of endoscopic frame artifacts to enable further key quantitative analysis of unusable video frames such as mosaicking and 3D reconstruction which is crucial for delivering improved patient care. This paper summarizes the challenge tasks and describes the dataset and evaluation criteria established in the EAD 2019 challenge.

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