The Multimodal Brain Tumor Image Segmentation Benchmark (BRATS)

In this paper we report the set-up and results of the Multimodal Brain Tumor Image Segmentation Benchmark (BRATS) organized in conjunction with the MICCAI 2012 and 2013 conferences. Twenty state-of-the-art tumor segmentation algorithms were applied to a set of 65 multi-contrast MR scans of low-and high-grade glioma patients-manually annotated by up to four raters-and to 65 comparable scans generated using tumor image simulation software. Quantitative evaluations revealed considerable disagreement between the human raters in segmenting various tumor sub-regions (Dice scores in the range 74%-85%), illustrating the difficulty of this task. We found that different algorithms worked best for different sub-regions (reaching performance comparable to human inter-rater variability), but that no single algorithm ranked in the top for all sub-regions simultaneously. Fusing several good algorithms using a hierarchical majority vote yielded segmentations that consistently ranked above all individual algorithms, indicating remaining opportunities for further methodological improvements. The BRATS image data and manual annotations continue to be publicly available through an online evaluation system as an ongoing benchmarking resource

Segmentierung medizinischer Bilddaten und bildgestützte intraoperative Navigation

Die Entwicklung von Algorithmen zur automatischen oder semi-automatischen Verarbeitung von medizinischen Bilddaten hat in den letzten Jahren mehr und mehr an Bedeutung gewonnen. Das liegt zum einen an den immer besser werdenden medizinischen Aufnahmemodalitäten, die den menschlichen Körper immer feiner virtuell abbilden können. Zum anderen liegt dies an der verbesserten Computerhardware, die eine algorithmische Verarbeitung der teilweise im Gigabyte-Bereich liegenden Datenmengen in einer vernünftigen Zeit erlaubt. Das Ziel dieser Habilitationsschrift ist die Entwicklung und Evaluation von Algorithmen für die medizinische Bildverarbeitung. Insgesamt besteht die Habilitationsschrift aus einer Reihe von Publikationen, die in drei übergreifende Themenbereiche gegliedert sind: -Segmentierung medizinischer Bilddaten anhand von vorlagenbasierten Algorithmen -Experimentelle Evaluation quelloffener Segmentierungsmethoden unter medizinischen Einsatzbedingungen -Navigation zur Unterstützung intraoperativer Therapien Im Bereich Segmentierung medizinischer Bilddaten anhand von vorlagenbasierten Algorithmen wurden verschiedene graphbasierte Algorithmen in 2D und 3D entwickelt, die einen gerichteten Graphen mittels einer Vorlage aufbauen. Dazu gehört die Bildung eines Algorithmus zur Segmentierung von Wirbeln in 2D und 3D. In 2D wird eine rechteckige und in 3D eine würfelförmige Vorlage genutzt, um den Graphen aufzubauen und das Segmentierungsergebnis zu berechnen. Außerdem wird eine graphbasierte Segmentierung von Prostatadrüsen durch eine Kugelvorlage zur automatischen Bestimmung der Grenzen zwischen Prostatadrüsen und umliegenden Organen vorgestellt. Auf den vorlagenbasierten Algorithmen aufbauend, wurde ein interaktiver Segmentierungsalgorithmus, der einem Benutzer in Echtzeit das Segmentierungsergebnis anzeigt, konzipiert und implementiert. Der Algorithmus nutzt zur Segmentierung die verschiedenen Vorlagen, benötigt allerdings nur einen Saatpunkt des Benutzers. In einem weiteren Ansatz kann der Benutzer die Segmentierung interaktiv durch zusätzliche Saatpunkte verfeinern. Dadurch wird es möglich, eine semi-automatische Segmentierung auch in schwierigen Fällen zu einem zufriedenstellenden Ergebnis zu führen. Im Bereich Evaluation quelloffener Segmentierungsmethoden unter medizinischen Einsatzbedingungen wurden verschiedene frei verfügbare Segmentierungsalgorithmen anhand von Patientendaten aus der klinischen Routine getestet. Dazu gehörte die Evaluierung der semi-automatischen Segmentierung von Hirntumoren, zum Beispiel Hypophysenadenomen und Glioblastomen, mit der frei verfügbaren Open Source-Plattform 3D Slicer. Dadurch konnte gezeigt werden, wie eine rein manuelle Schicht-für-Schicht-Vermessung des Tumorvolumens in der Praxis unterstützt und beschleunigt werden kann. Weiterhin wurde die Segmentierung von Sprachbahnen in medizinischen Aufnahmen von Hirntumorpatienten auf verschiedenen Plattformen evaluiert. Im Bereich Navigation zur Unterstützung intraoperativer Therapien wurden Softwaremodule zum Begleiten von intra-operativen Eingriffen in verschiedenen Phasen einer Behandlung (Therapieplanung, Durchführung, Kontrolle) entwickelt. Dazu gehört die erstmalige Integration des OpenIGTLink-Netzwerkprotokolls in die medizinische Prototyping-Plattform MeVisLab, die anhand eines NDI-Navigationssystems evaluiert wurde. Außerdem wurde hier ebenfalls zum ersten Mal die Konzeption und Implementierung eines medizinischen Software-Prototypen zur Unterstützung der intraoperativen gynäkologischen Brachytherapie vorgestellt. Der Software-Prototyp enthielt auch ein Modul zur erweiterten Visualisierung bei der MR-gestützten interstitiellen gynäkologischen Brachytherapie, welches unter anderem die Registrierung eines gynäkologischen Brachytherapie-Instruments in einen intraoperativen Datensatz einer Patientin ermöglichte. Die einzelnen Module führten zur Vorstellung eines umfassenden bildgestützten Systems für die gynäkologische Brachytherapie in einem multimodalen Operationssaal. Dieses System deckt die prä-, intra- und postoperative Behandlungsphase bei einer interstitiellen gynäkologischen Brachytherapie ab

Image similarity in medical images

Recent experiments have indicated a strong influence of the substrate grain orientation on the self-ordering in anodic porous alumina. Anodic porous alumina with straight pore channels grown in a stable, self-ordered manner is formed on (001) oriented Al grain, while disordered porous pattern is formed on (101) oriented Al grain with tilted pore channels growing in an unstable manner. In this work, numerical simulation of the pore growth process is carried out to understand this phenomenon. The rate-determining step of the oxide growth is assumed to be the Cabrera-Mott barrier at the oxide/electrolyte (o/e) interface, while the substrate is assumed to determine the ratio β between the ionization and oxidation reactions at the metal/oxide (m/o) interface. By numerically solving the electric field inside a growing porous alumina during anodization, the migration rates of the ions and hence the evolution of the o/e and m/o interfaces are computed. The simulated results show that pore growth is more stable when β is higher. A higher β corresponds to more Al ionized and migrating away from the m/o interface rather than being oxidized, and hence a higher retained O:Al ratio in the oxide. Experimentally measured oxygen content in the self-ordered porous alumina on (001) Al is indeed found to be about 3% higher than that in the disordered alumina on (101) Al, in agreement with the theoretical prediction. The results, therefore, suggest that ionization on (001) Al substrate is relatively easier than on (101) Al, and this leads to the more stable growth of the pore channels on (001) Al

The Convergence of Human and Artificial Intelligence on Clinical Care - Part I

This edited book contains twelve studies, large and pilots, in five main categories: (i) adaptive imputation to increase the density of clinical data for improving downstream modeling; (ii) machine-learning-empowered diagnosis models; (iii) machine learning models for outcome prediction; (iv) innovative use of AI to improve our understanding of the public view; and (v) understanding of the attitude of providers in trusting insights from AI for complex cases. This collection is an excellent example of how technology can add value in healthcare settings and hints at some of the pressing challenges in the field. Artificial intelligence is gradually becoming a go-to technology in clinical care; therefore, it is important to work collaboratively and to shift from performance-driven outcomes to risk-sensitive model optimization, improved transparency, and better patient representation, to ensure more equitable healthcare for all

OFSET_mine:an integrated framework for cardiovascular diseases risk prediction based on retinal vascular function

As cardiovascular disease (CVD) represents a spectrum of disorders that often manifestfor the first time through an acute life-threatening event, early identification of seemingly healthy subjects with various degrees of risk is a priority.More recently, traditional scores used for early identification of CVD risk are slowly being replaced by more sensitive biomarkers that assess individual, rather than population risks for CVD. Among these, retinal vascular function, as assessed by the retinal vessel analysis method (RVA), has been proven as an accurate reflection of subclinical CVD in groups of participants without overt disease but with certain inherited or acquired risk factors. Furthermore, in order to correctly detect individual risk at an early stage, specialized machine learning methods and featureselection techniques that can cope with the characteristics of the data need to bedevised.The main contribution of this thesis is an integrated framework, OFSET_mine, that combinesnovel machine learning methods to produce a bespoke solution for Cardiovascular Risk Prediction based on RVA data that is also applicable to other medical datasets with similar characteristics. The three identified essential characteristics are 1) imbalanced dataset,2) high dimensionality and 3) overlapping feature ranges with the possibility of acquiring new samples. The thesis proposes FiltADASYN as an oversampling method that deals with imbalance, DD_Rank as a feature selection method that handles high dimensionality, and GCO_mine as a method for individual-based classification, all three integrated within the OFSET_mine framework.The new oversampling method FiltADASYN extends Adaptive Synthetic Oversampling(ADASYN) with an additional step to filter the generated samples and improve the reliability of the resultant sample set. The feature selection method DD_Rank is based on Restricted Boltzmann Machine (RBM) and ranks features according to their stability and discrimination power. GCO_mine is a lazy learning method based on Graph Cut Optimization (GCO), which considers both the local arrangements and the global structure of the data.OFSET_mine compares favourably to well established composite techniques. Itex hibits high classification performance when applied to a wide range of benchmark medical datasets with variable sample size, dimensionality and imbalance ratios.When applying OFSET _mine on our RVA data, an accuracy of 99.52% is achieved. In addition, using OFSET, the hybrid solution of FiltADASYN and DD_Rank, with Random Forest on our RVA data produces risk group classifications with accuracy 99.68%. This not only reflects the success of the framework but also establishes RVAas a valuable cardiovascular risk predicto

Impact of epigallocatechin-3-gallate (EGCG), a broad-spectrum anti-inflammatory, in controlling intestinal factors contributing to inflammatory bowel disease.

This dissertation explores the role of epigallocatechin-3-gallate (EGCG), as a potential treatment for patients with inflammatory bowel disease (IBD). IBD is a common disorder that causes a great deal of suffering. Our understanding of the etiologies, pathogenic mechanisms, and treatment targets continues to evolve. Many new therapeutic targets are making their way through the pharmaceutical pipelines. However, not all patients benefit from these therapies. EGCG has long been studied as an anti-cancer agent. Most of our understanding of this compound comes from the oncologic literature. As the pathways of oncology and inflammation converge, new lessons can be taken from the cross discipline. EGCG’s effects on intracellular signaling bridges cancer to inflammation. Many of the same cytokines, chemokines, and molecular signals influencing cancer cells to grow also stimulate immune cells. Chapter 3 first explores the role of EGCG as both a preventative as well as a therapeutic agent and its effect on the dextran sulfate sodium (DSS) mouse model of colitis. The influence of EGCG on immune cell function is then explored in chapter 4. One novel approach in chapter 4 has to do with a focus on intestinal epithelial cells as agents of an immune response, and how EGCG impacts their function in that role. Chapter 5 explores the impact of EGCG on bolstering barrier function, as this is an important aspect of inflammatory bowel disease that is often neglected when considering new approaches to treating IBD. Finally, chapter 6 ends this dissertation with the first clinical trial in the world’s literature to evaluate EGCG as a therapeutic for IBD

The State of the Art of Spatial Interfaces for 3D Visualization

International audienceWe survey the state of the art of spatial interfaces for 3D visualization. Interaction techniques are crucial to data visualization processes and the visualization research community has been calling for more research on interaction for years. Yet, research papers focusing on interaction techniques, in particular for 3D visualization purposes, are not always published in visualization venues, sometimes making it challenging to synthesize the latest interaction and visualization results. We therefore introduce a taxonomy of interaction technique for 3D visualization. The taxonomy is organized along two axes: the primary source of input on the one hand and the visualization task they support on the other hand. Surveying the state of the art allows us to highlight specific challenges and missed opportunities for research in 3D visualization. In particular, we call for additional research in: (1) controlling 3D visualization widgets to help scientists better understand their data, (2) 3D interaction techniques for dissemination, which are under-explored yet show great promise for helping museum and science centers in their mission to share recent knowledge, and (3) developing new measures that move beyond traditional time and errors metrics for evaluating visualizations that include spatial interaction

Machine Learning Approaches and Web-Based System to the Application of Disease Modifying Therapy for Sickle Cell

Sickle cell disease (SCD) is a common serious genetic disease, which has a severe impact due to red blood cell (RBCs) abnormality. According to the World Health Organisation, 7 million newborn babies each year suffer either from the congenital anomaly or from an inherited disease, primarily from thalassemia and sickle cell disease. In the case of SCD, recent research has shown the beneficial effects of a drug called hydroxyurea/hydroxycarbamide in modifying the disease phenotype. The clinical management of this disease-modifying therapy is difficult and time consuming for clinical staff. This includes finding an optimal classifier that can help to solve the issues with missing values, multi-class datasets, and features selection. For the classification and discriminant analysis of SCD datasets, 7 classifiers based on machine learning models are selected representing linear and non-linear methods. After running these classifiers with a single model, the results revealed that a single classifier has provided us with effective outcomes in terms of the classification performance evaluation metric. In order to produce such an optimal outcome, this research proposed and designed combined classifiers (ensemble classifiers) among the neural network’s models, the random forest classifier, and the K-nearest neighbour classifier. In this aspect, combining the levenberg-marquardt algorithm, the voted perceptron classifier, the radial basis neural classifier, and random forest classifier obtain the highest rate of performance and accuracy. This ensemble classifier receives better results during the training set and testing set process. Recent technology advances based on smart devices have improved the medical facilities and become increasingly popular in association with real-time health monitoring and remote/personal health-care. The web-based system developed under the supervision of the haematology specialist at the Alder Hey Children’s Hospital in order to produce such an effective and useful system for both patients and clinicians. To sum up, the simulation experiment concludes that using machine learning and the web-based system platforms represents an alternative procedure that could assist healthcare professionals, particularly for the specialist nurse and junior doctor to improve the quality of care with sickle cell disorder