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A computer-aided detection (CAD) system for the identification of pulmonary nodules in low-dose multi-detector helical CT images with 1.25 mm slice thickness is being developed in the framework of the INFN-supported MAGIC-5 Italian project. The basic modules of our lung-CAD system, a dot enhancement filter for nodule candidate selection and a voxel-based neural classifier for false-positive finding reduction, are described. Preliminary results obtained on the so-far collected database of lung CT scans are discussed.
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A computer-aided detection (CAD) system for the identification of pulmonary nodules in low-dose multi-detector computed-tomography (CT) images has been developed in the framework of the MAGIC-5 Italian project. One of the main goals of this project is to build a distributed database of lung CT scans in order to enable automated image analysis through a data and cpu GRID infrastructure. The basic modules of our lung-CAD system, consisting in a 3D dot-enhancement filter for nodule detection and a neural classifier for false-positive finding reduction, are described. The system was designed and tested for both internal and sub-pleural nodules. The database used in this study consists of 17 low-dose CT scans reconstructed with thin slice thickness (~300 slices/scan). The preliminary results are shown in terms of the FROC analysis reporting a good sensitivity (85% range) for both internal and sub-pleural nodules at an acceptable level of false positive findings (1-9 FP/scan); the sensitivity value remains very high (75% range) even at 1-6 FP/scan
Rationale: Computer aided detection (CAD) algorithms for Pulmonary Embolism (PE) algorithms have been shown to increase radiologists sensitivity with a small increase in specificity. However, CAD for PE has not been adopted into clinical practice, likely because of the high number of false positives current CAD software produces. Objective: To generate a database of annotated computed tomography pulmonary angiographies, use it to compare the sensitivity and false positive rate of current algorithms and to develop new methods that improve such metrics. Methods: 91 Computed tomography pulmonary angiography scans were annotated by at least one radiologist by segmenting all pulmonary emboli visible on the study. 20 annotated CTPAs were open to the public in the form of a medical image analysis challenge. 20 more were kept for evaluation purposes. 51 were made available post-challenge. 8 submissions, 6 of them novel, were evaluated on the 20 evaluation CTPAs. Performance was measured as per embolus sensitivity vs. false positives per scan curve. Results: The best algorithms achieved a per-embolus sensitivity of 75% at 2 false positives per scan (fps) or of 70% at 1 fps, outperforming the state of the art. Deep learning approaches outperformed traditional machine learning ones, and their performance improved with the number of training cases. Significance: Through this work and challenge we have improved the state-of-the art of computer aided detection algorithms for pulmonary embolism. An open database and an evaluation benchmark for such algorithms have been generated, easing the development of further improvements. Implications on clinical practice will need further research.
We present a fully automated method for top-down segmentation of the pulmonary arterial tree in low-dose thoracic CT images. The main basal pulmonary arteries are identified near the lung hilum by searching for candidate vessels adjacent to known airways, identified by our previously reported airway segmentation method. Model cylinders are iteratively fit to the vessels to track them into the lungs. Vessel bifurcations are detected by measuring the rate of change of vessel radii, and child vessels are segmented by initiating new trackers at bifurcation points. Validation is accomplished using our novel sparse surface (SS) evaluation metric. The SS metric was designed to quantify the magnitude of the segmentation error per vessel while significantly decreasing the manual marking burden for the human user. A total of 210 arteries and 205 veins were manually marked across seven test cases. 134/210 arteries were correctly segmented, with a specificity for arteries of 90%, and average segmentation error of 0.15 mm. This fully-automated segmentation is a promising method for improving lung nodule detection in low-dose CT screening scans, by separating vessels from surrounding iso-intensity objects.
X-ray Computed Tomography (CT) is an important tool in medical imaging to obtain a direct visualization of patient anatomy. However, the x-ray radiation exposure leads to the concern of lifetime cancer risk. Low-dose CT scan can reduce the radiation exposure to patient while the image quality is usually degraded due to the appearance of noise and artifacts. Numerous studies have been conducted to regularize CT image for better image quality. Yet, exploring the underlying manifold where real CT images residing on is still an open problem. In this paper, we propose a fully data-driven manifold learning approach by incorporating the emerging deep-learning technology. An encoder-decoder convolutional neural network has been established to map a CT image to the inherent low-dimensional manifold, as well as to restore the CT image from its corresponding manifold representation. A novel reconstruction algorithm assisted by the leant manifold prior has been developed to achieve high quality low-dose CT reconstruction. In order to demonstrate the effectiveness of the proposed framework, network training, testing, and comprehensive simulation study have been performed using patient abdomen CT images. The trained encoder-decoder CNN is capable of restoring high-quality CT images with average error of ~20 HU. Furthermore, the proposed manifold prior assisted reconstruction scheme achieves high-quality low-dose CT reconstruction, with average reconstruction error of < 30 HU, more than five times and two times lower than that of filtered back projection method and total-variation based iterative reconstruction method, respectively.
Pulmonary embolism (PE) represents a thrombus (blood clot), usually originating from a lower extremity vein, that travels to the blood vessels in the lung, causing vascular obstruction and in some patients, death. This disorder is commonly diagnosed using CT pulmonary angiography (CTPA). Deep learning holds great promise for the computer-aided CTPA diagnosis (CAD) of PE. However, numerous competing methods for a given task in the deep learning literature exist, causing great confusion regarding the development of a CAD PE system. To address this confusion, we present a comprehensive analysis of competing deep learning methods applicable to PE diagnosis using CTPA at the both image and exam levels. At the image level, we compare convolutional neural networks (CNNs) with vision transformers, and contrast self-supervised learning (SSL) with supervised learning, followed by an evaluation of transfer learning compared with training from scratch. At the exam level, we focus on comparing conventional classification (CC) with multiple instance learning (MIL). Our extensive experiments consistently show: (1) transfer learning consistently boosts performance despite differences between natural images and CT scans, (2) transfer learning with SSL surpasses its supervised counterparts; (3) CNNs outperform vision transformers, which otherwise show satisfactory performance; and (4) CC is, surprisingly, superior to MIL. Compared with the state of the art, our optimal approach provides an AUC gain of 0.2% and 1.05% for image-level and exam-level, respectively.
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