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Register a new userLung Cancer Detection using Co-learning from Chest CT Images and Clinical Demographics
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Added by
Riqiang Gao
Publication date
2019
fields
Informatics Engineering
and research's language is
English
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Early detection of lung cancer is essential in reducing mortality. Recent studies have demonstrated the clinical utility of low-dose computed tomography (CT) to detect lung cancer among individuals selected based on very limited clinical information. However, this strategy yields high false positive rates, which can lead to unnecessary and potentially harmful procedures. To address such challenges, we established a pipeline that co-learns from detailed clinical demographics and 3D CT images. Toward this end, we leveraged data from the Consortium for Molecular and Cellular Characterization of Screen-Detected Lesions (MCL), which focuses on early detection of lung cancer. A 3D attention-based deep convolutional neural net (DCNN) is proposed to identify lung cancer from the chest CT scan without prior anatomical location of the suspicious nodule. To improve upon the non-invasive discrimination between benign and malignant, we applied a random forest classifier to a dataset integrating clinical information to imaging data. The results show that the AUC obtained from clinical demographics alone was 0.635 while the attention network alone reached an accuracy of 0.687. In contrast when applying our proposed pipeline integrating clinical and imaging variables, we reached an AUC of 0.787 on the testing dataset. The proposed network both efficiently captures anatomical information for classification and also generates attention maps that explain the features that drive performance.
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The analysis of multi-modality positron emission tomography and computed tomography (PET-CT) images for computer aided diagnosis applications requires combining the sensitivity of PET to detect abnormal regions with anatomical localization from CT. Current methods for PET-CT image analysis either process the modalities separately or fuse information from each modality based on knowledge about the image analysis task. These methods generally do not consider the spatially varying visual characteristics that encode different information across the different modalities, which have different priorities at different locations. For example, a high abnormal PET uptake in the lungs is more meaningful for tumor detection than physiological PET uptake in the heart. Our aim is to improve fusion of the complementary information in multi-modality PET-CT with a new supervised convolutional neural network (CNN) that learns to fuse complementary information for multi-modality medical image analysis. Our CNN first encodes modality-specific features and then uses them to derive a spatially varying fusion map that quantifies the relative importance of each modalitys features across different spatial locations. These fusion maps are then multiplied with the modality-specific feature maps to obtain a representation of the complementary multi-modality information at different locations, which can then be used for image analysis. We evaluated the ability of our CNN to detect and segment multiple regions with different fusion requirements using a dataset of PET-CT images of lung cancer. We compared our method to baseline techniques for multi-modality image fusion and segmentation. Our findings show that our CNN had a significantly higher foreground detection accuracy (99.29%, p < 0.05) than the fusion baselines and a significantly higher Dice score (63.85%) than recent PET-CT tumor segmentation methods.
This paper proposes a novel and efficient method to build a Computer-Aided Diagnoses (CAD) system for lung nodule detection based on Computed Tomography (CT). This task was treated as an Object Detection on Video (VID) problem by imitating how a radiologist reads CT scans. A lung nodule detector was trained to automatically learn nodule features from still images to detect lung nodule candidates with both high recall and accuracy. Unlike previous work which used 3-dimensional information around the nodule to reduce false positives, we propose two simple but efficient methods, Multi-slice propagation (MSP) and Motionless-guide suppression (MLGS), which analyze sequence information of CT scans to reduce false negatives and suppress false positives. We evaluated our method in open-source LUNA16 dataset which contains 888 CT scans, and obtained state-of-the-art result (Free-Response Receiver Operating Characteristic score of 0.892) with detection speed (end to end within 20 seconds per patient on a single NVidia GTX 1080) much higher than existing methods.
Importance: Lung cancer is the leading cause of cancer mortality in the US, responsible for more deaths than breast, prostate, colon and pancreas cancer combined and it has been recently demonstrated that low-dose computed tomography (CT) screening of the chest can significantly reduce this death rate. Objective: To compare the performance of a deep learning model to state-of-the-art automated algorithms and radiologists as well as assessing the robustness of the algorithm in heterogeneous datasets. Design, Setting, and Participants: Three low-dose CT lung cancer screening datasets from heterogeneous sources were used, including National Lung Screening Trial (NLST, n=3410), Lahey Hospital and Medical Center (LHMC, n=3174) data, Kaggle competition data (from both stages, n=1595+505) and the University of Chicago data (UCM, a subset of NLST, annotated by radiologists, n=197). Relevant works on automated methods for Lung Cancer malignancy estimation have used significantly less data in size and diversity. At the first stage, our framework employs a nodule detector; while in the second stage, we use both the image area around the nodules and nodule features as inputs to a neural network that estimates the malignancy risk for the entire CT scan. We trained our two-stage algorithm on a part of the NLST dataset, and validated it on the other datasets. Results, Conclusions, and Relevance: The proposed deep learning model: (a) generalizes well across all three data sets, achieving AUC between 86% to 94%; (b) has better performance than the widely accepted PanCan Risk Model, achieving 11% better AUC score; (c) has improved performance compared to the state-of-the-art represented by the winners of the Kaggle Data Science Bowl 2017 competition on lung cancer screening; (d) has comparable performance to radiologists in estimating cancer risk at a patient level.
Annual low dose computed tomography (CT) lung screening is currently advised for individuals at high risk of lung cancer (e.g., heavy smokers between 55 and 80 years old). The recommended screening practice significantly reduces all-cause mortality, but the vast majority of screening results are negative for cancer. If patients at very low risk could be identified based on individualized, image-based biomarkers, the health care resources could be more efficiently allocated to higher risk patients and reduce overall exposure to ionizing radiation. In this work, we propose a multi-task (diagnosis and prognosis) deep convolutional neural network to improve the diagnostic accuracy over a baseline model while simultaneously estimating a personalized cancer-free progression time (CFPT). A novel Censored Regression Loss (CRL) is proposed to perform weakly supervised regression so that even single negative screening scans can provide small incremental value. Herein, we study 2287 scans from 1433 de-identified patients from the Vanderbilt Lung Screening Program (VLSP) and Molecular Characterization Laboratories (MCL) cohorts. Using five-fold cross-validation, we train a 3D attention-based network under two scenarios: (1) single-task learning with only classification, and (2) multi-task learning with both classification and regression. The single-task learning leads to a higher AUC compared with the Kaggle challenge winner pre-trained model (0.878 v. 0.856), and multi-task learning significantly improves the single-task one (AUC 0.895, p<0.01, McNemar test). In summary, the image-based predicted CFPT can be used in follow-up year lung cancer prediction and data assessment.
CT imaging is crucial for diagnosis, assessment and staging COVID-19 infection. Follow-up scans every 3-5 days are often recommended for disease progression. It has been reported that bilateral and peripheral ground glass opacification (GGO) with or without consolidation are predominant CT findings in COVID-19 patients. However, due to lack of computerized quantification tools, only qualitative impression and rough description of infected areas are currently used in radiological reports. In this paper, a deep learning (DL)-based segmentation system is developed to automatically quantify infection regions of interest (ROIs) and their volumetric ratios w.r.t. the lung. The performance of the system was evaluated by comparing the automatically segmented infection regions with the manually-delineated ones on 300 chest CT scans of 300 COVID-19 patients. For fast manual delineation of training samples and possible manual intervention of automatic results, a human-in-the-loop (HITL) strategy has been adopted to assist radiologists for infection region segmentation, which dramatically reduced the total segmentation time to 4 minutes after 3 iterations of model updating. The average Dice simiarility coefficient showed 91.6% agreement between automatic and manual infaction segmentations, and the mean estimation error of percentage of infection (POI) was 0.3% for the whole lung. Finally, possible applications, including but not limited to analysis of follow-up CT scans and infection distributions in the lobes and segments correlated with clinical findings, were discussed.
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