Towards automatic pulmonary nodule management in lung cancer screening with deep learning

The introduction of lung cancer screening programs will produce an unprecedented amount of chest CT scans in the near future, which radiologists will have to read in order to decide on a patient follow-up strategy. According to the current guidelines, the workup of screen-detected nodules strongly relies on nodule size and nodule type. In this paper, we present a deep learning system based on multi-stream multi-scale convolutional networks, which automatically classifies all nodule types relevant for nodule workup. The system processes raw CT data containing a nodule without the need for any additional information such as nodule segmentation or nodule size and learns a representation of 3D data by analyzing an arbitrary number of 2D views of a given nodule. The deep learning system was trained with data from the Italian MILD screening trial and validated on an independent set of data from the Danish DLCST screening trial. We analyze the advantage of processing nodules at multiple scales with a multi-stream convolutional network architecture, and we show that the proposed deep learning system achieves performance at classifying nodule type that surpasses the one of classical machine learning approaches and is within the inter-observer variability among four experienced human observers.Comment: Published on Scientific Report

Time series kernel similarities for predicting Paroxysmal Atrial Fibrillation from ECGs

We tackle the problem of classifying Electrocardiography (ECG) signals with the aim of predicting the onset of Paroxysmal Atrial Fibrillation (PAF). Atrial fibrillation is the most common type of arrhythmia, but in many cases PAF episodes are asymptomatic. Therefore, in order to help diagnosing PAF, it is important to design procedures for detecting and, more importantly, predicting PAF episodes. We propose a method for predicting PAF events whose first step consists of a feature extraction procedure that represents each ECG as a multi-variate time series. Successively, we design a classification framework based on kernel similarities for multi-variate time series, capable of handling missing data. We consider different approaches to perform classification in the original space of the multi-variate time series and in an embedding space, defined by the kernel similarity measure. We achieve a classification accuracy comparable with state of the art methods, with the additional advantage of detecting the PAF onset up to 15 minutes in advance

Prediction of progression in idiopathic pulmonary fibrosis using CT scans atbaseline: A quantum particle swarm optimization - Random forest approach

Idiopathic pulmonary fibrosis (IPF) is a fatal lung disease characterized by an unpredictable progressive declinein lung function. Natural history of IPF is unknown and the prediction of disease progression at the time ofdiagnosis is notoriously difficult. High resolution computed tomography (HRCT) has been used for the diagnosisof IPF, but not generally for monitoring purpose. The objective of this work is to develop a novel predictivemodel for the radiological progression pattern at voxel-wise level using only baseline HRCT scans. Mainly, thereare two challenges: (a) obtaining a data set of features for region of interest (ROI) on baseline HRCT scans andtheir follow-up status; and (b) simultaneously selecting important features from high-dimensional space, andoptimizing the prediction performance. We resolved the first challenge by implementing a study design andhaving an expert radiologist contour ROIs at baseline scans, depending on its progression status in follow-upvisits. For the second challenge, we integrated the feature selection with prediction by developing an algorithmusing a wrapper method that combines quantum particle swarm optimization to select a small number of featureswith random forest to classify early patterns of progression. We applied our proposed algorithm to analyzeanonymized HRCT images from 50 IPF subjects from a multi-center clinical trial. We showed that it yields aparsimonious model with 81.8% sensitivity, 82.2% specificity and an overall accuracy rate of 82.1% at the ROIlevel. These results are superior to other popular feature selections and classification methods, in that ourmethod produces higher accuracy in prediction of progression and more balanced sensitivity and specificity witha smaller number of selected features. Our work is the first approach to show that it is possible to use onlybaseline HRCT scans to predict progressive ROIs at 6 months to 1year follow-ups using artificial intelligence

Automation of motor dexterity assessment

Motor dexterity assessment is regularly performed in rehabilitation wards to establish patient status and automatization for such routinary task is sought. A system for automatizing the assessment of motor dexterity based on the Fugl-Meyer scale and with loose restrictions on sensing technologies is presented. The system consists of two main elements: 1) A data representation that abstracts the low level information obtained from a variety of sensors, into a highly separable low dimensionality encoding employing t-distributed Stochastic Neighbourhood Embedding, and, 2) central to this communication, a multi-label classifier that boosts classification rates by exploiting the fact that the classes corresponding to the individual exercises are naturally organized as a network. Depending on the targeted therapeutic movement class labels i.e. exercises scores, are highly correlated-patients who perform well in one, tends to perform well in related exercises-; and critically no node can be used as proxy of others - an exercise does not encode the information of other exercises. Over data from a cohort of 20 patients, the novel classifier outperforms classical Naive Bayes, random forest and variants of support vector machines (ANOVA: p <; 0.001). The novel multi-label classification strategy fulfills an automatic system for motor dexterity assessment, with implications for lessening therapist's workloads, reducing healthcare costs and providing support for home-based virtual rehabilitation and telerehabilitation alternatives