No Arabic abstract
The scarcity of high quality medical image annotations hinders the implementation of accurate clinical applications for detecting and segmenting abnormal lesions. To mitigate this issue, the scientific community is working on the development of unsupervised anomaly detection (UAD) systems that learn from a training set containing only normal (i.e., healthy) images, where abnormal samples (i.e., unhealthy) are detected and segmented based on how much they deviate from the learned distribution of normal samples. One significant challenge faced by UAD methods is how to learn effective low-dimensional image representations that are sensitive enough to detect and segment abnormal lesions of varying size, appearance and shape. To address this challenge, we propose a novel self-supervised UAD pre-training algorithm, named Multi-centred Strong Augmentation via Contrastive Learning (MSACL). MSACL learns representations by separating several types of strong and weak augmentations of normal image samples, where the weak augmentations represent normal images and strong augmentations denote synthetic abnormal images. To produce such strong augmentations, we introduce MedMix, a novel data augmentation strategy that creates new training images with realistic looking lesions (i.e., anomalies) in normal images. The pre-trained representations from MSACL are generic and can be used to improve the efficacy of different types of off-the-shelf state-of-the-art (SOTA) UAD models. Comprehensive experimental results show that the use of MSACL largely improves these SOTA UAD models on four medical imaging datasets from diverse organs, namely colonoscopy, fundus screening and covid-19 chest-ray datasets.
Brain lesion segmentation provides a valuable tool for clinical diagnosis, and convolutional neural networks (CNNs) have achieved unprecedented success in the task. Data augmentation is a widely used strategy that improves the training of CNNs, and the design of the augmentation method for brain lesion segmentation is still an open problem. In this work, we propose a simple data augmentation approach, dubbed as CarveMix, for CNN-based brain lesion segmentation. Like other mix-based methods, such as Mixup and CutMix, CarveMix stochastically combines two existing labeled images to generate new labeled samples. Yet, unlike these augmentation strategies based on image combination, CarveMix is lesion-aware, where the combination is performed with an attention on the lesions and a proper annotation is created for the generated image. Specifically, from one labeled image we carve a region of interest (ROI) according to the lesion location and geometry, and the size of the ROI is sampled from a probability distribution. The carved ROI then replaces the corresponding voxels in a second labeled image, and the annotation of the second image is replaced accordingly as well. In this way, we generate new labeled images for network training and the lesion information is preserved. To evaluate the proposed method, experiments were performed on two brain lesion datasets. The results show that our method improves the segmentation accuracy compared with other simple data augmentation approaches.
There are many clinical contexts which require accurate detection and segmentation of all focal pathologies (e.g. lesions, tumours) in patient images. In cases where there are a mix of small and large lesions, standard binary cross entropy loss will result in better segmentation of large lesions at the expense of missing small ones. Adjusting the operating point to accurately detect all lesions generally leads to oversegmentation of large lesions. In this work, we propose a novel reweighing strategy to eliminate this performance gap, increasing small pathology detection performance while maintaining segmentation accuracy. We show that our reweighing strategy vastly outperforms competing strategies based on experiments on a large scale, multi-scanner, multi-center dataset of Multiple Sclerosis patient images.
Despite tremendous efforts, it is very challenging to generate a robust model to assist in the accurate quantification assessment of COVID-19 on chest CT images. Due to the nature of blurred boundaries, the supervised segmentation methods usually suffer from annotation biases. To support unbiased lesion localisation and to minimise the labeling costs, we propose a data-driven framework supervised by only image-level labels. The framework can explicitly separate potential lesions from original images, with the help of a generative adversarial network and a lesion-specific decoder. Experiments on two COVID-19 datasets demonstrate the effectiveness of the proposed framework and its superior performance to several existing methods.
Previous studies on computer aided detection/diagnosis (CAD) in 4D breast magnetic resonance imaging (MRI) regard lesion detection, segmentation and characterization as separate tasks, and typically require users to manually select 2D MRI slices or regions of interest as the input. In this work, we present a breast MRI CAD system that can handle 4D multimodal breast MRI data, and integrate lesion detection, segmentation and characterization with no user intervention. The proposed CAD system consists of three major stages: region candidate generation, feature extraction and region candidate classification. Breast lesions are firstly extracted as region candidates using the novel 3D multiscale morphological sifting (MMS). The 3D MMS, which uses linear structuring elements to extract lesion-like patterns, can segment lesions from breast images accurately and efficiently. Analytical features are then extracted from all available 4D multimodal breast MRI sequences, including T1-, T2-weighted and DCE sequences, to represent the signal intensity, texture, morphological and enhancement kinetic characteristics of the region candidates. The region candidates are lastly classified as lesion or normal tissue by the random under-sampling boost (RUSboost), and as malignant or benign lesion by the random forest. Evaluated on a breast MRI dataset which contains a total of 117 cases with 95 malignant and 46 benign lesions, the proposed system achieves a true positive rate (TPR) of 0.90 at 3.19 false positives per patient (FPP) for lesion detection and a TPR of 0.91 at a FPP of 2.95 for identifying malignant lesions without any user intervention. The average dice similarity index (DSI) is 0.72 for lesion segmentation. Compared with previously proposed systems evaluated on the same breast MRI dataset, the proposed CAD system achieves a favourable performance in breast lesion detection and characterization.
Predicting the final ischaemic stroke lesion provides crucial information regarding the volume of salvageable hypoperfused tissue, which helps physicians in the difficult decision-making process of treatment planning and intervention. Treatment selection is influenced by clinical diagnosis, which requires delineating the stroke lesion, as well as characterising cerebral blood flow dynamics using neuroimaging acquisitions. Nonetheless, predicting the final stroke lesion is an intricate task, due to the variability in lesion size, shape, location and the underlying cerebral haemodynamic processes that occur after the ischaemic stroke takes place. Moreover, since elapsed time between stroke and treatment is related to the loss of brain tissue, assessing and predicting the final stroke lesion needs to be performed in a short period of time, which makes the task even more complex. Therefore, there is a need for automatic methods that predict the final stroke lesion and support physicians in the treatment decision process. We propose a fully automatic deep learning method based on unsupervised and supervised learning to predict the final stroke lesion after 90 days. Our aim is to predict the final stroke lesion location and extent, taking into account the underlying cerebral blood flow dynamics that can influence the prediction. To achieve this, we propose a two-branch Restricted Boltzmann Machine, which provides specialized data-driven features from different sets of standard parametric Magnetic Resonance Imaging maps. These data-driven feature maps are then combined with the parametric Magnetic Resonance Imaging maps, and fed to a Convolutional and Recurrent Neural Network architecture. We evaluated our proposal on the publicly available ISLES 2017 testing dataset, reaching a Dice score of 0.38, Hausdorff Distance of 29.21 mm, and Average Symmetric Surface Distance of 5.52 mm.