Self-supervised Depth Estimation to Regularise Semantic Segmentation in Knee Arthroscopy

Intra-operative automatic semantic segmentation of knee joint structures can assist surgeons during knee arthroscopy in terms of situational awareness. However, due to poor imaging conditions (e.g., low texture, overexposure, etc.), automatic semantic segmentation is a challenging scenario, which justifies the scarce literature on this topic. In this paper, we propose a novel self-supervised monocular depth estimation to regularise the training of the semantic segmentation in knee arthroscopy. To further regularise the depth estimation, we propose the use of clean training images captured by the stereo arthroscope of routine objects (presenting none of the poor imaging conditions and with rich texture information) to pre-train the model. We fine-tune such model to produce both the semantic segmentation and self-supervised monocular depth using stereo arthroscopic images taken from inside the knee. Using a data set containing 3868 arthroscopic images captured during cadaveric knee arthroscopy with semantic segmentation annotations, 2000 stereo image pairs of cadaveric knee arthroscopy, and 2150 stereo image pairs of routine objects, we show that our semantic segmentation regularised by self-supervised depth estimation produces a more accurate segmentation than a state-of-the-art semantic segmentation approach modeled exclusively with semantic segmentation annotation.

Few-Shot Anomaly Detection for Polyp Frames from Colonoscopy

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.

Unsupervised Dual Adversarial Learning for Anomaly Detection in Colonoscopy Video Frames

The automatic detection of frames containing polyps from a colonoscopy video sequence is an important first step for a fully automated colonoscopy analysis tool. Typically, such detection system is built using a large annotated data set of frames with and without polyps, which is expensive to be obtained. In this paper, we introduce a new system that detects frames containing polyps as anomalies from a distribution of frames from exams that do not contain any polyps. The system is trained using a one-class training set consisting of colonoscopy frames without polyps -- such training set is considerably less expensive to obtain, compared to the 2-class data set mentioned above. During inference, the system is only able to reconstruct frames without polyps, and when it tries to reconstruct a frame with polyp, it automatically removes (i.e., photoshop) it from the frame -- the difference between the input and reconstructed frames is used to detect frames with polyps. We name our proposed model as anomaly detection generative adversarial network (ADGAN), comprising a dual GAN with two generators and two discriminators. We show that our proposed approach achieves the state-of-the-art result on this data set, compared with recently proposed anomaly detection systems.

End-to-End Diagnosis and Segmentation Learning from Cardiac Magnetic Resonance Imaging

Cardiac magnetic resonance (CMR) is used extensively in the diagnosis and management of cardiovascular disease. Deep learning methods have proven to deliver segmentation results comparable to human experts in CMR imaging, but there have been no convincing results for the problem of end-to-end segmentation and diagnosis from CMR. This is in part due to a lack of sufficiently large datasets required to train robust diagnosis models. In this paper, we propose a learning method to train diagnosis models, where our approach is designed to work with relatively small datasets. In particular, the optimisation loss is based on multi-task learning that jointly trains for the tasks of segmentation and diagnosis classification. We hypothesize that segmentation has a regularizing effect on the learning of features relevant for diagnosis. Using the 100 training and 50 testing samples available from the Automated Cardiac Diagnosis Challenge (ACDC) dataset, which has a balanced distribution of 5 cardiac diagnoses, we observe a reduction of the classification error from 32% to 22%, and a faster convergence compared to a baseline without segmentation. To the best of our knowledge, this is the best diagnosis results from CMR using an end-to-end diagnosis and segmentation learning method.

Pre and Post-hoc Diagnosis and Interpretation of Malignancy from Breast DCE-MRI

We propose a new method for breast cancer screening from DCE-MRI based on a post-hoc approach that is trained using weakly annotated data (i.e., labels are available only at the image level without any lesion delineation). Our proposed post-hoc method automatically diagnosis the whole volume and, for positive cases, it localizes the malignant lesions that led to such diagnosis. Conversely, traditional approaches follow a pre-hoc approach that initially localises suspicious areas that are subsequently classified to establish the breast malignancy -- this approach is trained using strongly annotated data (i.e., it needs a delineation and classification of all lesions in an image). Another goal of this paper is to establish the advantages and disadvantages of both approaches when applied to breast screening from DCE-MRI. Relying on experiments on a breast DCE-MRI dataset that contains scans of 117 patients, our results show that the post-hoc method is more accurate for diagnosing the whole volume per patient, achieving an AUC of 0.91, while the pre-hoc method achieves an AUC of 0.81. However, the performance for localising the malignant lesions remains challenging for the post-hoc method due to the weakly labelled dataset employed during training.

Model Agnostic Saliency for Weakly Supervised Lesion Detection from Breast DCE-MRI

There is a heated debate on how to interpret the decisions provided by deep learning models (DLM), where the main approaches rely on the visualization of salient regions to interpret the DLM classification process. However, these approaches generally fail to satisfy three conditions for the problem of lesion detection from medical images: 1) for images with lesions, all salient regions should represent lesions, 2) for images containing no lesions, no salient region should be produced,and 3) lesions are generally small with relatively smooth borders. We propose a new model-agnostic paradigm to interpret DLM classification decisions supported by a novel definition of saliency that incorporates the conditions above. Our model-agnostic 1-class saliency detector (MASD) is tested on weakly supervised breast lesion detection from DCE-MRI, achieving state-of-the-art detection accuracy when compared to current visualization methods.

Training Medical Image Analysis Systems like Radiologists

The training of medical image analysis systems using machine learning approaches follows a common script: collect and annotate a large dataset, train the classifier on the training set, and test it on a hold-out test set. This process bears no direct resemblance with radiologist training, which is based on solving a series of tasks of increasing difficulty, where each task involves the use of significantly smaller datasets than those used in machine learning. In this paper, we propose a novel training approach inspired by how radiologists are trained. In particular, we explore the use of meta-training that models a classifier based on a series of tasks. Tasks are selected using teacher-student curriculum learning, where each task consists of simple classification problems containing small training sets. We hypothesize that our proposed meta-training approach can be used to pre-train medical image analysis models. This hypothesis is tested on the automatic breast screening classification from DCE-MRI trained with weakly labeled datasets. The classification performance achieved by our approach is shown to be the best in the field for that application, compared to state of art baseline approaches: DenseNet, multiple instance learning and multi-task learning.