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Register a new userSelf-learning for weakly supervised Gleason grading of local patterns
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Prostate cancer is one of the main diseases affecting men worldwide. The gold standard for diagnosis and prognosis is the Gleason grading system. In this process, pathologists manually analyze prostate histology slides under microscope, in a high time-consuming and subjective task. In the last years, computer-aided-diagnosis (CAD) systems have emerged as a promising tool that could support pathologists in the daily clinical practice. Nevertheless, these systems are usually trained using tedious and prone-to-error pixel-level annotations of Gleason grades in the tissue. To alleviate the need of manual pixel-wise labeling, just a handful of works have been presented in the literature. Motivated by this, we propose a novel weakly-supervised deep-learning model, based on self-learning CNNs, that leverages only the global Gleason score of gigapixel whole slide images during training to accurately perform both, grading of patch-level patterns and biopsy-level scoring. To evaluate the performance of the proposed method, we perform extensive experiments on three different external datasets for the patch-level Gleason grading, and on two different test sets for global Grade Group prediction. We empirically demonstrate that our approach outperforms its supervised counterpart on patch-level Gleason grading by a large margin, as well as state-of-the-art methods on global biopsy-level scoring. Particularly, the proposed model brings an average improvement on the Cohens quadratic kappa (k) score of nearly 18% compared to full-supervision for the patch-level Gleason grading task.
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The Gleason score is the most important prognostic marker for prostate cancer patients but suffers from significant inter-observer variability. We developed a fully automated deep learning system to grade prostate biopsies. The system was developed using 5834 biopsies from 1243 patients. A semi-automatic labeling technique was used to circumvent the need for full manual annotation by pathologists. The developed system achieved a high agreement with the reference standard. In a separate observer experiment, the deep learning system outperformed 10 out of 15 pathologists. The system has the potential to improve prostate cancer prognostics by acting as a first or second reader.
Deep learning (DL) has emerged as a powerful tool for accelerated MRI reconstruction, but these methods often necessitate a database of fully-sampled measurements for training. Recent self-supervised and unsupervised learning approaches enable training without fully-sampled data. However, a database of undersampled measurements may not be available in many scenarios, especially for scans involving contrast or recently developed translational acquisitions. Moreover, database-trained models may not generalize well when the unseen measurements differ in terms of sampling pattern, acceleration rate, SNR, image contrast, and anatomy. Such challenges necessitate a new methodology that can enable scan-specific DL MRI reconstruction without any external training datasets. In this work, we propose a zero-shot self-supervised learning approach to perform scan-specific accelerated MRI reconstruction to tackle these issues. The proposed approach splits available measurements for each scan into three disjoint sets. Two of these sets are used to enforce data consistency and define loss during training, while the last set is used to establish an early stopping criterion. In the presence of models pre-trained on a database with different image characteristics, we show that the proposed approach can be combined with transfer learning to further improve reconstruction quality.
Resective surgery may be curative for drug-resistant focal epilepsy, but only 40% to 70% of patients achieve seizure freedom after surgery. Retrospective quantitative analysis could elucidate patterns in resected structures and patient outcomes to improve resective surgery. However, the resection cavity must first be segmented on the postoperative MR image. Convolutional neural networks (CNNs) are the state-of-the-art image segmentation technique, but require large amounts of annotated data for training. Annotation of medical images is a time-consuming process requiring highly-trained raters, and often suffering from high inter-rater variability. Self-supervised learning can be used to generate training instances from unlabeled data. We developed an algorithm to simulate resections on preoperative MR images. We curated a new dataset, EPISURG, comprising 431 postoperative and 269 preoperative MR images from 431 patients who underwent resective surgery. In addition to EPISURG, we used three public datasets comprising 1813 preoperative MR images for training. We trained a 3D CNN on artificially resected images created on the fly during training, using images from 1) EPISURG, 2) public datasets and 3) both. To evaluate trained models, we calculate Dice score (DSC) between model segmentations and 200 manual annotations performed by three human raters. The model trained on data with manual annotations obtained a median (interquartile range) DSC of 65.3 (30.6). The DSC of our best-performing model, trained with no manual annotations, is 81.7 (14.2). For comparison, inter-rater agreement between human annotators was 84.0 (9.9). We demonstrate a training method for CNNs using simulated resection cavities that can accurately segment real resection cavities, without manual annotations.
The status of retinal arteriovenous crossing is of great significance for clinical evaluation of arteriolosclerosis and systemic hypertension. As an ophthalmology diagnostic criteria, Scheies classification has been used to grade the severity of arteriolosclerosis. In this paper, we propose a deep learning approach to support the diagnosis process, which, to the best of our knowledge, is one of the earliest attempts in medical imaging. The proposed pipeline is three-fold. First, we adopt segmentation and classification models to automatically obtain vessels in a retinal image with the corresponding artery/vein labels and find candidate arteriovenous crossing points. Second, we use a classification model to validate the true crossing point. At last, the grade of severity for the vessel crossings is classified. To better address the problem of label ambiguity and imbalanced label distribution, we propose a new model, named multi-diagnosis team network (MDTNet), in which the sub-models with different structures or different loss functions provide different decisions. MDTNet unifies these diverse theories to give the final decision with high accuracy. Our severity grading method was able to validate crossing points with precision and recall of 96.3% and 96.3%, respectively. Among correctly detected crossing points, the kappa value for the agreement between the grading by a retina specialist and the estimated score was 0.85, with an accuracy of 0.92. The numerical results demonstrate that our method can achieve a good performance in both arteriovenous crossing validation and severity grading tasks. By the proposed models, we could build a pipeline reproducing retina specialists subjective grading without feature extractions. The code is available for reproducibility.
Supervised learning method requires a large volume of annotated datasets. Collecting such datasets is time-consuming and expensive. Until now, very few annotated COVID-19 imaging datasets are available. Although self-supervised learning enables us to bootstrap the training by exploiting unlabeled data, the generic self-supervised methods for natural images do not sufficiently incorporate the context. For medical images, a desirable method should be sensitive enough to detect deviation from normal-appearing tissue of each anatomical region; here, anatomy is the context. We introduce a novel approach with two levels of self-supervised representation learning objectives: one on the regional anatomical level and another on the patient-level. We use graph neural networks to incorporate the relationship between different anatomical regions. The structure of the graph is informed by anatomical correspondences between each patient and an anatomical atlas. In addition, the graph representation has the advantage of handling any arbitrarily sized image in full resolution. Experiments on large-scale Computer Tomography (CT) datasets of lung images show that our approach compares favorably to baseline methods that do not account for the context. We use the learnt embedding to quantify the clinical progression of COVID-19 and show that our method generalizes well to COVID-19 patients from different hospitals. Qualitative results suggest that our model can identify clinically relevant regions in the images.
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