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Register a new userDetection, growth quantification and malignancy prediction of pulmonary nodules using deep convolutional networks in follow-up CT scans
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Authors
Xavier Rafael-Palou
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We address the problem of supporting radiologists in the longitudinal management of lung cancer. Therefore, we proposed a deep learning pipeline, composed of four stages that completely automatized from the detection of nodules to the classification of cancer, through the detection of growth in the nodules. In addition, the pipeline integrated a novel approach for nodule growth detection, which relied on a recent hierarchical probabilistic U-Net adapted to report uncertainty estimates. Also, a second novel method was introduced for lung cancer nodule classification, integrating into a two stream 3D-CNN network the estimated nodule malignancy probabilities derived from a pretrained nodule malignancy network. The pipeline was evaluated in a longitudinal cohort and reported comparable performances to the state of art.
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Follow-up serves an important role in the management of pulmonary nodules for lung cancer. Imaging diagnostic guidelines with expert consensus have been made to help radiologists make clinical decision for each patient. However, tumor growth is such a complicated process that it is difficult to stratify high-risk nodules from low-risk ones based on morphologic characteristics. On the other hand, recent deep learning studies using convolutional neural networks (CNNs) to predict the malignancy score of nodules, only provides clinicians with black-box predictions. To this end, we propose a unified framework, named Nodule Follow-Up Prediction Network (NoFoNet), which predicts the growth of pulmonary nodules with high-quality visual appearances and accurate quantitative results, given any time interval from baseline observations. It is achieved by predicting future displacement field of each voxel with a WarpNet. A TextureNet is further developed to refine textural details of WarpNet outputs. We also introduce techniques including Temporal Encoding Module and Warp Segmentation Loss to encourage time-aware and shape-aware representation learning. We build an in-house follow-up dataset from two medical centers to validate the effectiveness of the proposed method. NoFoNet significantly outperforms direct prediction by a U-Net in terms of visual quality; more importantly, it demonstrates accurate differentiating performance between high- and low-risk nodules. Our promising results suggest the potentials in computer aided intervention for lung nodule management.
Diagnosis and treatment of multiple pulmonary nodules are clinically important but challenging. Prior studies on nodule characterization use solitary-nodule approaches on multiple nodular patients, which ignores the relations between nodules. In this study, we propose a multiple instance learning (MIL) approach and empirically prove the benefit to learn the relations between multiple nodules. By treating the multiple nodules from a same patient as a whole, critical relational information between solitary-nodule voxels is extracted. To our knowledge, it is the first study to learn the relations between multiple pulmonary nodules. Inspired by recent advances in natural language processing (NLP) domain, we introduce a self-attention transformer equipped with 3D CNN, named {NoduleSAT}, to replace typical pooling-based aggregation in multiple instance learning. Extensive experiments on lung nodule false positive reduction on LUNA16 database, and malignancy classification on LIDC-IDRI database, validate the effectiveness of the proposed method.
The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has rapidly spread into a global pandemic. A form of pneumonia, presenting as opacities with in a patients lungs, is the most common presentation associated with this virus, and great attention has gone into how these changes relate to patient morbidity and mortality. In this work we provide open source models for the segmentation of patterns of pulmonary opacification on chest Computed Tomography (CT) scans which have been correlated with various stages and severities of infection. We have collected 663 chest CT scans of COVID-19 patients from healthcare centers around the world, and created pixel wise segmentation labels for nearly 25,000 slices that segment 6 different patterns of pulmonary opacification. We provide open source implementations and pre-trained weights for multiple segmentation models trained on our dataset. Our best model achieves an opacity Intersection-Over-Union score of 0.76 on our test set, demonstrates successful domain adaptation, and predicts the volume of opacification within 1.7% of expert radiologists. Additionally, we present an analysis of the inter-observer variability inherent to this task, and propose methods for appropriate probabilistic approaches.
Idiopathic pulmonary fibrosis (IPF) is a restrictive interstitial lung disease that causes lung function decline by lung tissue scarring. Although lung function decline is assessed by the forced vital capacity (FVC), determining the accurate progression of IPF remains a challenge. To address this challenge, we proposed Fibro-CoSANet, a novel end-to-end multi-modal learning-based approach, to predict the FVC decline. Fibro-CoSANet utilized CT images and demographic information in convolutional neural network frameworks with a stacked attention layer. Extensive experiments on the OSIC Pulmonary Fibrosis Progression Dataset demonstrated the superiority of our proposed Fibro-CoSANet by achieving the new state-of-the-art modified Laplace Log-Likelihood score of -6.68. This network may benefit research areas concerned with designing networks to improve the prognostic accuracy of IPF. The source-code for Fibro-CoSANet is available at: url{https://github.com/zabir-nabil/Fibro-CoSANet}.
Accurate pulmonary nodule detection is a crucial step in lung cancer screening. Computer-aided detection (CAD) systems are not routinely used by radiologists for pulmonary nodule detection in clinical practice despite their potential benefits. Maximum intensity projection (MIP) images improve the detection of pulmonary nodules in radiological evaluation with computed tomography (CT) scans. Inspired by the clinical methodology of radiologists, we aim to explore the feasibility of applying MIP images to improve the effectiveness of automatic lung nodule detection using convolutional neural networks (CNNs). We propose a CNN-based approach that takes MIP images of different slab thicknesses (5 mm, 10 mm, 15 mm) and 1 mm axial section slices as input. Such an approach augments the two-dimensional (2-D) CT slice images with more representative spatial information that helps discriminate nodules from vessels through their morphologies. Our proposed method achieves sensitivity of 92.67% with 1 false positive per scan and sensitivity of 94.19% with 2 false positives per scan for lung nodule detection on 888 scans in the LIDC-IDRI dataset. The use of thick MIP images helps the detection of small pulmonary nodules (3 mm-10 mm) and results in fewer false positives. Experimental results show that utilizing MIP images can increase the sensitivity and lower the number of false positives, which demonstrates the effectiveness and significance of the proposed MIP-based CNNs framework for automatic pulmonary nodule detection in CT scans. The proposed method also shows the potential that CNNs could gain benefits for nodule detection by combining the clinical procedure.
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