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Colorectal Polyp Classification from White-light Colonoscopy Images via Domain Alignment

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 Added by Qin Wang
 Publication date 2021
and research's language is English




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Differentiation of colorectal polyps is an important clinical examination. A computer-aided diagnosis system is required to assist accurate diagnosis from colonoscopy images. Most previous studies at-tempt to develop models for polyp differentiation using Narrow-Band Imaging (NBI) or other enhanced images. However, the wide range of these models applications for clinical work has been limited by the lagging of imaging techniques. Thus, we propose a novel framework based on a teacher-student architecture for the accurate colorectal polyp classification (CPC) through directly using white-light (WL) colonoscopy images in the examination. In practice, during training, the auxiliary NBI images are utilized to train a teacher network and guide the student network to acquire richer feature representation from WL images. The feature transfer is realized by domain alignment and contrastive learning. Eventually the final student network has the ability to extract aligned features from only WL images to facilitate the CPC task. Besides, we release the first public-available paired CPC dataset containing WL-NBI pairs for the alignment training. Quantitative and qualitative evaluation indicates that the proposed method outperforms the previous methods in CPC, improving the accuracy by 5.6%with very fast speed.

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The performance of imaging techniques has an important influence on the clinical diagnostic strategy of colorectal cancer. Linked color imaging (LCI) by laser endoscopy is a recently developed techniques, and its advantage in improving the analysis accuracy of colorectal polyps over white-light (WL) endoscopy has been demonstrated in previous clinical studies. However, there are no objective criteria to evaluate and compare the aforementioned endoscopy methods. This paper presents a new criterion, namely entropy of color gradients image (ECGI), which is based on color gradients distribution and provides a comprehensive and objective evaluating indicator of the performance of colorectal images. Our method extracts the color gradient image pairs of 143 colonoscopy polyps in the LCI-PairedColon database, which are generated with WL and LCI conditions, respectively. Then, we apply the morphological method to fix the deviation of light-reflecting regions, and the ECGI scores of sample pairs are calculated. Experimental results show that the average ECGI scores of LCI images (5.7071) were significantly higher than that of WL (4.6093). This observation is consistent with the clinical studies. Therefore, the effectiveness of the proposed criterion is demonstrated.
Automatic colorectal polyp detection in colonoscopy video is a fundamental task, which has received a lot of attention. Manually annotating polyp region in a large scale video dataset is time-consuming and expensive, which limits the development of deep learning techniques. A compromise is to train the target model by using labeled images and infer on colonoscopy videos. However, there are several issues between the image-based training and video-based inference, including domain differences, lack of positive samples, and temporal smoothness. To address these issues, we propose an Image-video-joint polyp detection network (Ivy-Net) to address the domain gap between colonoscopy images from historical medical reports and real-time videos. In our Ivy-Net, a modified mixup is utilized to generate training data by combining the positive images and negative video frames at the pixel level, which could learn the domain adaptive representations and augment the positive samples. Simultaneously, a temporal coherence regularization (TCR) is proposed to introduce the smooth constraint on feature-level in adjacent frames and improve polyp detection by unlabeled colonoscopy videos. For evaluation, a new large colonoscopy polyp dataset is collected, which contains 3056 images from historical medical reports of 889 positive patients and 7.5-hour videos of 69 patients (28 positive). The experiments on the collected dataset demonstrate that our Ivy-Net achieves the state-of-the-art result on colonoscopy video.
Anomaly detection methods generally target the learning of a normal image distribution (i.e., inliers showing healthy cases) and during testing, samples relatively far from the learned distribution are classified as anomalies (i.e., outliers showing disease cases). These approaches tend to be sensitive to outliers that lie relatively close to inliers (e.g., a colonoscopy image with a small polyp). In this paper, we address the inappropriate sensitivity to outliers by also learning from inliers. We propose a new few-shot anomaly detection method based on an encoder trained to maximise the mutual information between feature embeddings and normal images, followed by a few-shot score inference network, trained with a large set of inliers and a substantially smaller set of outliers. We evaluate our proposed method on the clinical problem of detecting frames containing polyps from colonoscopy video sequences, where the training set has 13350 normal images (i.e., without polyps) and less than 100 abnormal images (i.e., with polyps). The results of our proposed model on this data set reveal a state-of-the-art detection result, while the performance based on different number of anomaly samples is relatively stable after approximately 40 abnormal training images.
Colorectal polyps are abnormal tissues growing on the intima of the colon or rectum with a high risk of developing into colorectal cancer, the third leading cause of cancer death worldwide. Early detection and removal of colon polyps via colonoscopy have proved to be an effective approach to prevent colorectal cancer. Recently, various CNN-based computer-aided systems have been developed to help physicians detect polyps. However, these systems do not perform well in real-world colonoscopy operations due to the significant difference between images in a real colonoscopy and those in the public datasets. Unlike the well-chosen clear images with obvious polyps in the public datasets, images from a colonoscopy are often blurry and contain various artifacts such as fluid, debris, bubbles, reflection, specularity, contrast, saturation, and medical instruments, with a wide variety of polyps of different sizes, shapes, and textures. All these factors pose a significant challenge to effective polyp detection in a colonoscopy. To this end, we collect a private dataset that contains 7,313 images from 224 complete colonoscopy procedures. This dataset represents realistic operation scenarios and thus can be used to better train the models and evaluate a systems performance in practice. We propose an integrated system architecture to address the unique challenges for polyp detection. Extensive experiments results show that our system can effectively detect polyps in a colonoscopy with excellent performance in real time.
Colorectal cancer (CRC) is a common and lethal disease. Globally, CRC is the third most commonly diagnosed cancer in males and the second in females. For colorectal cancer, the best screening test available is the colonoscopy. During a colonoscopic procedure, a tiny camera at the tip of the endoscope generates a video of the internal mucosa of the colon. The video data are displayed on a monitor for the physician to examine the lining of the entire colon and check for colorectal polyps. Detection and removal of colorectal polyps are associated with a reduction in mortality from colorectal cancer. However, the miss rate of polyp detection during colonoscopy procedure is often high even for very experienced physicians. The reason lies in the high variation of polyp in terms of shape, size, textural, color and illumination. Though challenging, with the great advances in object detection techniques, automated polyp detection still demonstrates a great potential in reducing the false negative rate while maintaining a high precision. In this paper, we propose a novel anchor free polyp detector that can localize polyps without using predefined anchor boxes. To further strengthen the model, we leverage a Context Enhancement Module and Cosine Ground truth Projection. Our approach can respond in real time while achieving state-of-the-art performance with 99.36% precision and 96.44% recall.
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