A Dempster-Shafer approach to trustworthy AI with application to fetal brain MRI segmentation

Deep learning models for medical image segmentation can fail unexpectedly and spectacularly for pathological cases and images acquired at different centers than training images, with labeling errors that violate expert knowledge. Such errors undermine the trustworthiness of deep learning models for medical image segmentation. Mechanisms for detecting and correcting such failures are essential for safely translating this technology into clinics and are likely to be a requirement of future regulations on artificial intelligence (AI). In this work, we propose a trustworthy AI theoretical framework and a practical system that can augment any backbone AI system using a fallback method and a fail-safe mechanism based on Dempster-Shafer theory. Our approach relies on an actionable definition of trustworthy AI. Our method automatically discards the voxel-level labeling predicted by the backbone AI that violate expert knowledge and relies on a fallback for those voxels. We demonstrate the effectiveness of the proposed trustworthy AI approach on the largest reported annotated dataset of fetal MRI consisting of 540 manually annotated fetal brain 3D T2w MRIs from 13 centers. Our trustworthy AI method improves the robustness of a state-of-the-art backbone AI for fetal brain MRIs acquired across various centers and for fetuses with various brain abnormalities

A Dempster-Shafer approach to trustworthy AI with application to fetal brain MRI segmentation

Deep learning models for medical image segmentation can fail unexpectedly and spectacularly for pathological cases and images acquired at different centers than training images, with labeling errors that violate expert knowledge. Such errors undermine the trustworthiness of deep learning models for medical image segmentation. Mechanisms for detecting and correcting such failures are essential for safely translating this technology into clinics and are likely to be a requirement of future regulations on artificial intelligence (AI). In this work, we propose a trustworthy AI theoretical framework and a practical system that can augment any backbone AI system using a fallback method and a fail-safe mechanism based on Dempster-Shafer theory. Our approach relies on an actionable definition of trustworthy AI. Our method automatically discards the voxel-level labeling predicted by the backbone AI that violate expert knowledge and relies on a fallback for those voxels. We demonstrate the effectiveness of the proposed trustworthy AI approach on the largest reported annotated dataset of fetal MRI consisting of 540 manually annotated fetal brain 3D T2w MRIs from 13 centers. Our trustworthy AI method improves the robustness of a state-of-the-art backbone AI for fetal brain MRIs acquired across various centers and for fetuses with various brain abnormalities

Brain Tumor Diagnosis Support System: A decision Fusion Framework

An important factor in providing effective and efficient therapy for brain tumors is early and accurate detection, which can increase survival rates. Current image-based tumor detection and diagnosis techniques are heavily dependent on interpretation by neuro-specialists and/or radiologists, making the evaluation process time-consuming and prone to human error and subjectivity. Besides, widespread use of MR spectroscopy requires specialized processing and assessment of the data and obvious and fast show of the results as photos or maps for routine medical interpretative of an exam. Automatic brain tumor detection and classification have the potential to offer greater efficiency and predictions that are more accurate. However, the performance accuracy of automatic detection and classification techniques tends to be dependent on the specific image modality and is well known to vary from technique to technique. For this reason, it would be prudent to examine the variations in the execution of these methods to obtain consistently high levels of achievement accuracy. Designing, implementing, and evaluating categorization software is the goal of the suggested framework for discerning various brain tumor types on magnetic resonance imaging (MRI) using textural features. This thesis introduces a brain tumor detection support system that involves the use of a variety of tumor classifiers. The system is designed as a decision fusion framework that enables these multi-classifier to analyze medical images, such as those obtained from magnetic resonance imaging (MRI). The fusion procedure is ground on the Dempster-Shafer evidence fusion theory. Numerous experimental scenarios have been implemented to validate the efficiency of the proposed framework. Compared with alternative approaches, the outcomes show that the methodology developed in this thesis demonstrates higher accuracy and higher computational efficiency

Decision fusion in healthcare and medicine : a narrative review

Objective: To provide an overview of the decision fusion (DF) technique and describe the applications of the technique in healthcare and medicine at prevention, diagnosis, treatment and administrative levels. Background: The rapid development of technology over the past 20 years has led to an explosion in data growth in various industries, like healthcare. Big data analysis within the healthcare systems is essential for arriving to a value-based decision over a period of time. Diversity and uncertainty in big data analytics have made it impossible to analyze data by using conventional data mining techniques and thus alternative solutions are required. DF is a form of data fusion techniques that could increase the accuracy of diagnosis and facilitate interpretation, summarization and sharing of information. Methods: We conducted a review of articles published between January 1980 and December 2020 from various databases such as Google Scholar, IEEE, PubMed, Science Direct, Scopus and web of science using the keywords decision fusion (DF), information fusion, healthcare, medicine and big data. A total of 141 articles were included in this narrative review. Conclusions: Given the importance of big data analysis in reducing costs and improving the quality of healthcare; along with the potential role of DF in big data analysis, it is recommended to know the full potential of this technique including the advantages, challenges and applications of the technique before its use. Future studies should focus on describing the methodology and types of data used for its applications within the healthcare sector

Informational Paradigm, management of uncertainty and theoretical formalisms in the clustering framework: A review

Fifty years have gone by since the publication of the first paper on clustering based on fuzzy sets theory. In 1965, L.A. Zadeh had published “Fuzzy Sets” [335]. After only one year, the first effects of this seminal paper began to emerge, with the pioneering paper on clustering by Bellman, Kalaba, Zadeh [33], in which they proposed a prototypal of clustering algorithm based on the fuzzy sets theory

A fuzzy approach for feature extraction of brain tissues in Non-Contrast CT

In neuroimaging, brain tissue segmentation is a fundamental part of the techniques that seek to automate the detection of pathologies, the quantification of tissues or the evaluation of the progress of a treatment. Because of its wide availability, lower cost than other imaging techniques, fast execution and proven efficacy, Non-contrast Cerebral Computerized Tomography (NCCT) is the most used technique in emergency room for neuroradiology examination, however, most research on brain segmentation focuses on MRI due to the inherent difficulty of brain tissue segmentation in NCCT. In this work, three brain tissues were characterized: white matter, gray matter and cerebrospinal fluid in NCCT images. Feature extraction of these structures was made based on the radiological attenuation index denoted by the Hounsfield Units using fuzzy logic techniques. We evaluated the classification of each tissue in NCCT images and quantified the feature extraction technique in images from real tissues with a sensitivity of 92% and a specificity of 96% for images from cases with slice thickness of 1 mm, and 96% and 98% respectively for those of 1.5 mm, demonstrating the ability of the method as feature extractor of brain tissues.Postprint (published version

Automated detection of parenchymal changes of ischemic stroke in non-contrast computer tomography: a fuzzy approach

The detection of ischemic changes is a primary task in the interpretation of brain Computer Tomography (CT) of patients suffering from neurological disorders. Although CT can easily show these lesions, their interpretation may be difficult when the lesion is not easily recognizable. The gold standard for the detection of acute stroke is highly variable and depends on the experience of physicians. This research proposes a new method of automatic detection of parenchymal changes of ischemic stroke in Non-Contrast CT. The method identifies non-pathological cases (94 cases, 40 training, 54 test) based on the analysis of cerebral symmetry. Parenchymal changes in cases with abnormalities (20 cases) are detected by means of a contralateral analysis of brain regions. In order to facilitate the evaluation of abnormal regions, non-pathological tissues in Hounsfield Units were characterized using fuzzy logic techniques. Cases of non-pathological and stroke patients were used to discard/confirm abnormality with a sensitivity (TPR) of 91% and specificity (SPC) of 100%. Abnormal regions were evaluated and the presence of parenchymal changes was detected with a TPR of 96% and SPC of 100%. The presence of parenchymal changes of ischemic stroke was detected by the identification of tissues using fuzzy logic techniques. Because of abnormal regions are identified, the expert can prioritize the examination to a previously delimited region, decreasing the diagnostic time. The identification of tissues allows a better visualization of the region to be evaluated, helping to discard or confirm a stroke.Peer ReviewedPostprint (author's final draft

Challenges in Brain Magnetic Resonance Image Segmentation

Over the past several decades, the application of magnetic resonance imaging (MRI) has been rapidly expanding in the areas of brain research studies and clinical diagnosis. One of the most important steps in brain MRI data preparation is the removal of unwanted brain regions, which is followed by segmentation of the brain into three main regions – white matter (WM), grey matter (GM) and cerebrospinal fluid (CSF) – or into subregions. In brain MRI analysis, image segmentation is commonly used for measuring and visualizing the brain’s anatomical structures, analyzing brain changes, delineating pathological regions, and surgical planning and image-guided interventions. Brain segmentation allows clinicians and researchers to concentrate on a specific region in the brain in their analyses. However, brain segmentation is a difficult task due to high similarities and correlations of image intensity among brain regions. In this review, image segmentation algorithms used for dividing the brain into different sectors were discussed in detail. The potential for using the fuzzy c-means (FCM) unsupervised clustering algorithm and certain hybrid (combined) methods to segment brain MR images was demonstrated. Additionally, certain validation techniques that are required to demonstrate the performance of segmentation methods in terms of accuracy rates were described.