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Register a new userA Computer-Aided Diagnosis System for Breast Pathology: A Deep Learning Approach with Model Interpretability from Pathological Perspective
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Objective: We develop a computer-aided diagnosis (CAD) system using deep learning approaches for lesion detection and classification on whole-slide images (WSIs) with breast cancer. The deep features being distinguishing in classification from the convolutional neural networks (CNN) are demonstrated in this study to provide comprehensive interpretability for the proposed CAD system using pathological knowledge. Methods: In the experiment, a total of 186 slides of WSIs were collected and classified into three categories: Non-Carcinoma, Ductal Carcinoma in Situ (DCIS), and Invasive Ductal Carcinoma (IDC). Instead of conducting pixel-wise classification into three classes directly, we designed a hierarchical framework with the multi-view scheme that performs lesion detection for region proposal at higher magnification first and then conducts lesion classification at lower magnification for each detected lesion. Results: The slide-level accuracy rate for three-category classification reaches 90.8% (99/109) through 5-fold cross-validation and achieves 94.8% (73/77) on the testing set. The experimental results show that the morphological characteristics and co-occurrence properties learned by the deep learning models for lesion classification are accordant with the clinical rules in diagnosis. Conclusion: The pathological interpretability of the deep features not only enhances the reliability of the proposed CAD system to gain acceptance from medical specialists, but also facilitates the development of deep learning frameworks for various tasks in pathology. Significance: This paper presents a CAD system for pathological image analysis, which fills the clinical requirements and can be accepted by medical specialists with providing its interpretability from the pathological perspective.
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Magnetic Resonance Imaging (MRI) is widely used for screening and staging prostate cancer. However, many prostate cancers have subtle features which are not easily identifiable on MRI, resulting in missed diagnoses and alarming variability in radiologist interpretation. Machine learning models have been developed in an effort to improve cancer identification, but current models localize cancer using MRI-derived features, while failing to consider the disease pathology characteristics observed on resected tissue. In this paper, we propose CorrSigNet, an automated two-step model that localizes prostate cancer on MRI by capturing the pathology features of cancer. First, the model learns MRI signatures of cancer that are correlated with corresponding histopathology features using Common Representation Learning. Second, the model uses the learned correlated MRI features to train a Convolutional Neural Network to localize prostate cancer. The histopathology images are used only in the first step to learn the correlated features. Once learned, these correlated features can be extracted from MRI of new patients (without histopathology or surgery) to localize cancer. We trained and validated our framework on a unique dataset of 75 patients with 806 slices who underwent MRI followed by prostatectomy surgery. We tested our method on an independent test set of 20 prostatectomy patients (139 slices, 24 cancerous lesions, 1.12M pixels) and achieved a per-pixel sensitivity of 0.81, specificity of 0.71, AUC of 0.86 and a per-lesion AUC of $0.96 pm 0.07$, outperforming the current state-of-the-art accuracy in predicting prostate cancer using MRI.
Mammography remains the most prevalent imaging tool for early breast cancer screening. The language used to describe abnormalities in mammographic reports is based on the breast Imaging Reporting and Data System (BI-RADS). Assigning a correct BI-RADS category to each examined mammogram is a strenuous and challenging task for even experts. This paper proposes a new and effective computer-aided diagnosis (CAD) system to classify mammographic masses into four assessment categories in BI-RADS. The mass regions are first enhanced by means of histogram equalization and then semiautomatically segmented based on the region growing technique. A total of 130 handcrafted BI-RADS features are then extrcated from the shape, margin, and density of each mass, together with the mass size and the patients age, as mentioned in BI-RADS mammography. Then, a modified feature selection method based on the genetic algorithm (GA) is proposed to select the most clinically significant BI-RADS features. Finally, a back-propagation neural network (BPN) is employed for classification, and its accuracy is used as the fitness in GA. A set of 500 mammogram images from the digital database of screening mammography (DDSM) is used for evaluation. Our system achieves classification accuracy, positive predictive value, negative predictive value, and Matthews correlation coefficient of 84.5%, 84.4%, 94.8%, and 79.3%, respectively. To our best knowledge, this is the best current result for BI-RADS classification of breast masses in mammography, which makes the proposed system promising to support radiologists for deciding proper patient management based on the automatically assigned BI-RADS categories.
Current Computer-Aided Diagnosis (CAD) methods mainly depend on medical images. The clinical information, which usually needs to be considered in practical clinical diagnosis, has not been fully employed in CAD. In this paper, we propose a novel deep learning-based method for fusing Magnetic Resonance Imaging (MRI)/Computed Tomography (CT) images and clinical information for diagnostic tasks. Two paths of neural layers are performed to extract image features and clinical features, respectively, and at the same time clinical features are employed as the attention to guide the extraction of image features. Finally, these two modalities of features are concatenated to make decisions. We evaluate the proposed method on its applications to Alzheimers disease diagnosis, mild cognitive impairment converter prediction and hepatic microvascular invasion diagnosis. The encouraging experimental results prove the values of the image feature extraction guided by clinical features and the concatenation of two modalities of features for classification, which improve the performance of diagnosis effectively and stably.
Skin conditions affect an estimated 1.9 billion people worldwide. A shortage of dermatologists causes long wait times and leads patients to seek dermatologic care from general practitioners. However, the diagnostic accuracy of general practitioners has been reported to be only 0.24-0.70 (compared to 0.77-0.96 for dermatologists), resulting in referral errors, delays in care, and errors in diagnosis and treatment. In this paper, we developed a deep learning system (DLS) to provide a differential diagnosis of skin conditions for clinical cases (skin photographs and associated medical histories). The DLS distinguishes between 26 skin conditions that represent roughly 80% of the volume of skin conditions seen in primary care. The DLS was developed and validated using de-identified cases from a teledermatology practice serving 17 clinical sites via a temporal split: the first 14,021 cases for development and the last 3,756 cases for validation. On the validation set, where a panel of three board-certified dermatologists defined the reference standard for every case, the DLS achieved 0.71 and 0.93 top-1 and top-3 accuracies respectively. For a random subset of the validation set (n=963 cases), 18 clinicians reviewed the cases for comparison. On this subset, the DLS achieved a 0.67 top-1 accuracy, non-inferior to board-certified dermatologists (0.63, p<0.001), and higher than primary care physicians (PCPs, 0.45) and nurse practitioners (NPs, 0.41). The top-3 accuracy showed a similar trend: 0.90 DLS, 0.75 dermatologists, 0.60 PCPs, and 0.55 NPs. These results highlight the potential of the DLS to augment general practitioners to accurately diagnose skin conditions by suggesting differential diagnoses that may not have been considered. Future work will be needed to prospectively assess the clinical impact of using this tool in actual clinical workflows.
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.
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