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Register a new userLung Cancer Risk Estimation with Incomplete Data: A Joint Missing Imputation Perspective
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Data from multi-modality provide complementary information in clinical prediction, but missing data in clinical cohorts limits the number of subjects in multi-modal learning context. Multi-modal missing imputation is challenging with existing methods when 1) the missing data span across heterogeneous modalities (e.g., image vs. non-image); or 2) one modality is largely missing. In this paper, we address imputation of missing data by modeling the joint distribution of multi-modal data. Motivated by partial bidirectional generative adversarial net (PBiGAN), we propose a new Conditional PBiGAN (C-PBiGAN) method that imputes one modality combining the conditional knowledge from another modality. Specifically, C-PBiGAN introduces a conditional latent space in a missing imputation framework that jointly encodes the available multi-modal data, along with a class regularization loss on imputed data to recover discriminative information. To our knowledge, it is the first generative adversarial model that addresses multi-modal missing imputation by modeling the joint distribution of image and non-image data. We validate our model with both the national lung screening trial (NLST) dataset and an external clinical validation cohort. The proposed C-PBiGAN achieves significant improvements in lung cancer risk estimation compared with representative imputation methods (e.g., AUC values increase in both NLST (+2.9%) and in-house dataset (+4.3%) compared with PBiGAN, p$<$0.05).
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Clinical data elements (CDEs) (e.g., age, smoking history), blood markers and chest computed tomography (CT) structural features have been regarded as effective means for assessing lung cancer risk. These independent variables can provide complementary information and we hypothesize that combining them will improve the prediction accuracy. In practice, not all patients have all these variables available. In this paper, we propose a new network design, termed as multi-path multi-modal missing network (M3Net), to integrate the multi-modal data (i.e., CDEs, biomarker and CT image) considering missing modality with multiple paths neural network. Each path learns discriminative features of one modality, and different modalities are fused in a second stage for an integrated prediction. The network can be trained end-to-end with both medical image features and CDEs/biomarkers, or make a prediction with single modality. We evaluate M3Net with datasets including three sites from the Consortium for Molecular and Cellular Characterization of Screen-Detected Lesions (MCL) project. Our method is cross validated within a cohort of 1291 subjects (383 subjects with complete CDEs/biomarkers and CT images), and externally validated with a cohort of 99 subjects (99 with complete CDEs/biomarkers and CT images). Both cross-validation and external-validation results show that combining multiple modality significantly improves the predicting performance of single modality. The results suggest that integrating subjects with missing either CDEs/biomarker or CT imaging features can contribute to the discriminatory power of our model (p < 0.05, bootstrap two-tailed test). In summary, the proposed M3Net framework provides an effective way to integrate image and non-image data in the context of missing information.
Background and Objective: Early detection of lung cancer is crucial as it has high mortality rate with patients commonly present with the disease at stage 3 and above. There are only relatively few methods that simultaneously detect and classify nodules from computed tomography (CT) scans. Furthermore, very few studies have used semi-supervised learning for lung cancer prediction. This study presents a complete end-to-end scheme to detect and classify lung nodules using the state-of-the-art Self-training with Noisy Student method on a comprehensive CT lung screening dataset of around 4,000 CT scans. Methods: We used three datasets, namely LUNA16, LIDC and NLST, for this study. We first utilise a three-dimensional deep convolutional neural network model to detect lung nodules in the detection stage. The classification model known as Maxout Local-Global Network uses non-local networks to detect global features including shape features, residual blocks to detect local features including nodule texture, and a Maxout layer to detect nodule variations. We trained the first Self-training with Noisy Student model to predict lung cancer on the unlabelled NLST datasets. Then, we performed Mixup regularization to enhance our scheme and provide robustness to erroneous labels. Results and Conclusions: Our new Mixup Maxout Local-Global network achieves an AUC of 0.87 on 2,005 completely independent testing scans from the NLST dataset. Our new scheme significantly outperformed the next highest performing method at the 5% significance level using DeLongs test (p = 0.0001). This study presents a new complete end-to-end scheme to predict lung cancer using Self-training with Noisy Student combined with Mixup regularization. On a completely independent dataset of 2,005 scans, we achieved state-of-the-art performance even with more images as compared to other methods.
Background and Objective:Computer-aided diagnosis (CAD) systems promote diagnosis effectiveness and alleviate pressure of radiologists. A CAD system for lung cancer diagnosis includes nodule candidate detection and nodule malignancy evaluation. Recently, deep learning-based pulmonary nodule detection has reached satisfactory performance ready for clinical application. However, deep learning-based nodule malignancy evaluation depends on heuristic inference from low-dose computed tomography volume to malignant probability, which lacks clinical cognition. Methods:In this paper, we propose a joint radiology analysis and malignancy evaluation network (R2MNet) to evaluate the pulmonary nodule malignancy via radiology characteristics analysis. Radiological features are extracted as channel descriptor to highlight specific regions of the input volume that are critical for nodule malignancy evaluation. In addition, for model explanations, we propose channel-dependent activation mapping to visualize the features and shed light on the decision process of deep neural network. Results:Experimental results on the LIDC-IDRI dataset demonstrate that the proposed method achieved area under curve of 96.27% on nodule radiology analysis and AUC of 97.52% on nodule malignancy evaluation. In addition, explanations of CDAM features proved that the shape and density of nodule regions were two critical factors that influence a nodule to be inferred as malignant, which conforms with the diagnosis cognition of experienced radiologists. Conclusion:Incorporating radiology analysis with nodule malignant evaluation, the network inference process conforms to the diagnostic procedure of radiologists and increases the confidence of evaluation results. Besides, model interpretation with CDAM features shed light on the regions which DNNs focus on when they estimate nodule malignancy probabilities.
Lung cancer begins in the lungs and leading to the reason of cancer demise amid population in the creation. According to the American Cancer Society, which estimates about 27% of the deaths because of cancer. In the early phase of its evolution, lung cancer does not cause any symptoms usually. Many of the patients have been diagnosed in a developed phase where symptoms become more prominent, that results in poor curative treatment and high mortality rate. Computer Aided Detection systems are used to achieve greater accuracies for the lung cancer diagnosis. In this research exertion, we proposed a novel methodology for lung Segmentation on the basis of Fuzzy C-Means Clustering, Adaptive Thresholding, and Segmentation of Active Contour Model. The experimental results are analysed and presented.
Breast density is an important risk factor for breast cancer that also affects the specificity and sensitivity of screening mammography. Current federal legislation mandates reporting of breast density for all women undergoing breast screening. Clinically, breast density is assessed visually using the American College of Radiology Breast Imaging Reporting And Data System (BI-RADS) scale. Here, we introduce an artificial intelligence (AI) method to estimate breast percentage density (PD) from digital mammograms. Our method leverages deep learning (DL) using two convolutional neural network architectures to accurately segment the breast area. A machine-learning algorithm combining superpixel generation, texture feature analysis, and support vector machine is then applied to differentiate dense from non-dense tissue regions, from which PD is estimated. Our method has been trained and validated on a multi-ethnic, multi-institutional dataset of 15,661 images (4,437 women), and then tested on an independent dataset of 6,368 digital mammograms (1,702 women; cases=414) for both PD estimation and discrimination of breast cancer. On the independent dataset, PD estimates from Deep-LIBRA and an expert reader were strongly correlated (Spearman correlation coefficient = 0.90). Moreover, Deep-LIBRA yielded a higher breast cancer discrimination performance (area under the ROC curve, AUC = 0.611 [95% confidence interval (CI): 0.583, 0.639]) compared to four other widely-used research and commercial PD assessment methods (AUCs = 0.528 to 0.588). Our results suggest a strong agreement of PD estimates between Deep-LIBRA and gold-standard assessment by an expert reader, as well as improved performance in breast cancer risk assessment over state-of-the-art open-source and commercial methods.
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