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Register a new userFully-Automated Liver Tumor Localization and Characterization from Multi-Phase MR Volumes Using Key-Slice ROI Parsing: A Physician-Inspired Approach
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Added by
Bolin Lai
Publication date
2020
fields
Informatics Engineering
and research's language is
English
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Using radiological scans to identify liver tumors is crucial for proper patient treatment. This is highly challenging, as top radiologists only achieve F1 scores of roughly 80% (hepatocellular carcinoma (HCC) vs. others) with only moderate inter-rater agreement, even when using multi-phase magnetic resonance (MR) imagery. Thus, there is great impetus for computer-aided diagnosis (CAD) solutions. A critical challenge is to robustly parse a 3D MR volume to localize diagnosable regions of interest (ROI), especially for edge cases. In this paper, we break down this problem using a key-slice parser (KSP), which emulates physician workflows by first identifying key slices and then localizing their corresponding key ROIs. To achieve robustness, the KSP also uses curve-parsing and detection confidence re-weighting. We evaluate our approach on the largest multi-phase MR liver lesion test dataset to date (430 biopsy-confirmed patients). Experiments demonstrate that our KSP can localize diagnosable ROIs with high reliability: 87% patients have an average 3D overlap of >= 40% with the ground truth compared to only 79% using the best tested detector. When coupled with a classifier, we achieve an HCC vs. others F1 score of 0.801, providing a fully-automated CAD performance comparable to top human physicians.
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Automatic segmentation of the liver and hepatic lesions is an important step towards deriving quantitative biomarkers for accurate clinical diagnosis and computer-aided decision support systems. This paper presents a method to automatically segment liver and lesions in CT and MRI abdomen images using cascaded fully convolutional neural networks (CFCNs) enabling the segmentation of a large-scale medical trial or quantitative image analysis. We train and cascade two FCNs for a combined segmentation of the liver and its lesions. In the first step, we train a FCN to segment the liver as ROI input for a second FCN. The second FCN solely segments lesions within the predicted liver ROIs of step 1. CFCN models were trained on an abdominal CT dataset comprising 100 hepatic tumor volumes. Validations on further datasets show that CFCN-based semantic liver and lesion segmentation achieves Dice scores over 94% for liver with computation times below 100s per volume. We further experimentally demonstrate the robustness of the proposed method on an 38 MRI liver tumor volumes and the public 3DIRCAD dataset.
Accurate automatic liver and tumor segmentation plays a vital role in treatment planning and disease monitoring. Recently, deep convolutional neural network (DCNNs) has obtained tremendous success in 2D and 3D medical image segmentation. However, 2D DCNNs cannot fully leverage the inter-slice information, while 3D DCNNs are computationally expensive and memory intensive. To address these issues, we first propose a novel dense-sparse training flow from a data perspective, in which, densely adjacent slices and sparsely adjacent slices are extracted as inputs for regularizing DCNNs, thereby improving the model performance. Moreover, we design a 2.5D light-weight nnU-Net from a network perspective, in which, depthwise separable convolutions are adopted to improve the efficiency. Extensive experiments on the LiTS dataset have demonstrated the superiority of the proposed method.
In the clinical routine, short axis (SA) cine cardiac MR (CMR) image stacks are acquired during multiple subsequent breath-holds. If the patient cannot consistently hold the breath at the same position, the acquired image stack will be affected by inter-slice respiratory motion and will not correctly represent the cardiac volume, introducing potential errors in the following analyses and visualisations. We propose an approach to automatically correct inter-slice respiratory motion in SA CMR image stacks. Our approach makes use of probabilistic segmentation maps (PSMs) of the left ventricular (LV) cavity generated with decision forests. PSMs are generated for each slice of the SA stack and rigidly registered in-plane to a target PSM. If long axis (LA) images are available, PSMs are generated for them and combined to create the target PSM; if not, the target PSM is produced from the same stack using a 3D model trained from motion-free stacks. The proposed approach was tested on a dataset of SA stacks acquired from 24 healthy subjects (for which anatomical 3D cardiac images were also available as reference) and compared to two techniques which use LA intensity images and LA segmentations as targets, respectively. The results show the accuracy and robustness of the proposed approach in motion compensation.
In this paper, we propose a phase attention residual network (PA-ResSeg) to model multi-phase features for accurate liver tumor segmentation, in which a phase attention (PA) is newly proposed to additionally exploit the images of arterial (ART) phase to facilitate the segmentation of portal venous (PV) phase. The PA block consists of an intra-phase attention (Intra-PA) module and an inter-phase attention (Inter-PA) module to capture channel-wise self-dependencies and cross-phase interdependencies, respectively. Thus it enables the network to learn more representative multi-phase features by refining the PV features according to the channel dependencies and recalibrating the ART features based on the learned interdependencies between phases. We propose a PA-based multi-scale fusion (MSF) architecture to embed the PA blocks in the network at multiple levels along the encoding path to fuse multi-scale features from multi-phase images. Moreover, a 3D boundary-enhanced loss (BE-loss) is proposed for training to make the network more sensitive to boundaries. To evaluate the performance of our proposed PA-ResSeg, we conducted experiments on a multi-phase CT dataset of focal liver lesions (MPCT-FLLs). Experimental results show the effectiveness of the proposed method by achieving a dice per case (DPC) of 0.77.87, a dice global (DG) of 0.8682, a volumetric overlap error (VOE) of 0.3328 and a relative volume difference (RVD) of 0.0443 on the MPCT-FLLs. Furthermore, to validate the effectiveness and robustness of PA-ResSeg, we conducted extra experiments on another multi-phase liver tumor dataset and obtained a DPC of 0.8290, a DG of 0.9132, a VOE of 0.2637 and a RVD of 0.0163. The proposed method shows its robustness and generalization capability in different datasets and different backbones.
Multi-phase computed tomography (CT) images provide crucial complementary information for accurate liver tumor segmentation (LiTS). State-of-the-art multi-phase LiTS methods usually fused cross-phase features through phase-weighted summation or channel-attention based concatenation. However, these methods ignored the spatial (pixel-wise) relationships between different phases, hence leading to insufficient feature integration. In addition, the performance of existing methods remains subject to the uncertainty in segmentation, which is particularly acute in tumor boundary regions. In this work, we propose a novel LiTS method to adequately aggregate multi-phase information and refine uncertain region segmentation. To this end, we introduce a spatial aggregation module (SAM), which encourages per-pixel interactions between different phases, to make full use of cross-phase information. Moreover, we devise an uncertain region inpainting module (URIM) to refine uncertain pixels using neighboring discriminative features. Experiments on an in-house multi-phase CT dataset of focal liver lesions (MPCT-FLLs) demonstrate that our method achieves promising liver tumor segmentation and outperforms state-of-the-arts.
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