Introduction of a combination vector to optimise the interpolation of numerical phantoms

International audiencePhantoms are 3-dimensional (3D) numerical representations of the contours of organs in the human body. The quality of the dosimetric reports established when accidental overexposures to radiation occur is highly dependent on the phantom's reliability with respect to the subject. EquiVox is a Case-Based Reasoning platform which proposes an interpolation of the 3D Lung Contours (3DLC) of subjects during its adaptation phase. This interpolation is conducted by an Artificial Neural Network (ANN) trained to learn how to interpolate the 3DLC of a Learning Set (LS). ANN is a well-suited tool when known results are numerous. Since the cardinality of our learning set is restrained, the imperfections of each 3DLC have a great impact on interpolations. Thus, we explored the possibility of ignoring some of the 3DLC of LS via implementation of a new learning algorithm which associated Combination Vectors (CV) to LS. The results proved that this method could optimise interpolation accuracy. Furthermore, this study highlights the fact that some of the 3DLC were harmful for some interpolations whereas they increased the accuracy of others

EQUIVOX: an example of adaptation using an artificial neural network on a case-based reasoning platform

International audienceIn case of a radiological emergency situation involving accidental human exposure, a dosimetry evaluation must be established as soon as possible. In most cases, this evaluation is based on numerical representations and models of victims. Unfortunately, personalised and realistic human representations are often unavailable for the exposed subjects. However, accuracy of treatment depends on the similarity of the phantom to the victim. The EquiVox platform (Research of Equivalent Voxel phantom) developed in this study uses Case-Based Reasoning (CBR) principles to retrieve and adapt, from among a set of existing phantoms, the one to represent the victim. This paper introduces the EquiVox platform and the Artificial Neural Network (ANN) developed to interpolate the victim's 3D lung contours. The results obtained for the choice and construction of the contours are presented and discussed

Advanced machine learning methods for oncological image analysis

Cancer is a major public health problem, accounting for an estimated 10 million deaths worldwide in 2020 alone. Rapid advances in the field of image acquisition and hardware development over the past three decades have resulted in the development of modern medical imaging modalities that can capture high-resolution anatomical, physiological, functional, and metabolic quantitative information from cancerous organs. Therefore, the applications of medical imaging have become increasingly crucial in the clinical routines of oncology, providing screening, diagnosis, treatment monitoring, and non/minimally- invasive evaluation of disease prognosis. The essential need for medical images, however, has resulted in the acquisition of a tremendous number of imaging scans. Considering the growing role of medical imaging data on one side and the challenges of manually examining such an abundance of data on the other side, the development of computerized tools to automatically or semi-automatically examine the image data has attracted considerable interest. Hence, a variety of machine learning tools have been developed for oncological image analysis, aiming to assist clinicians with repetitive tasks in their workflow. This thesis aims to contribute to the field of oncological image analysis by proposing new ways of quantifying tumor characteristics from medical image data. Specifically, this thesis consists of six studies, the first two of which focus on introducing novel methods for tumor segmentation. The last four studies aim to develop quantitative imaging biomarkers for cancer diagnosis and prognosis. The main objective of Study I is to develop a deep learning pipeline capable of capturing the appearance of lung pathologies, including lung tumors, and integrating this pipeline into the segmentation networks to leverage the segmentation accuracy. The proposed pipeline was tested on several comprehensive datasets, and the numerical quantifications show the superiority of the proposed prior-aware DL framework compared to the state of the art. Study II aims to address a crucial challenge faced by supervised segmentation models: dependency on the large-scale labeled dataset. In this study, an unsupervised segmentation approach is proposed based on the concept of image inpainting to segment lung and head- neck tumors in images from single and multiple modalities. The proposed autoinpainting pipeline shows great potential in synthesizing high-quality tumor-free images and outperforms a family of well-established unsupervised models in terms of segmentation accuracy. Studies III and IV aim to automatically discriminate the benign from the malignant pulmonary nodules by analyzing the low-dose computed tomography (LDCT) scans. In Study III, a dual-pathway deep classification framework is proposed to simultaneously take into account the local intra-nodule heterogeneities and the global contextual information. Study IV seeks to compare the discriminative power of a series of carefully selected conventional radiomics methods, end-to-end Deep Learning (DL) models, and deep features-based radiomics analysis on the same dataset. The numerical analyses show the potential of fusing the learned deep features into radiomic features for boosting the classification power. Study V focuses on the early assessment of lung tumor response to the applied treatments by proposing a novel feature set that can be interpreted physiologically. This feature set was employed to quantify the changes in the tumor characteristics from longitudinal PET-CT scans in order to predict the overall survival status of the patients two years after the last session of treatments. The discriminative power of the introduced imaging biomarkers was compared against the conventional radiomics, and the quantitative evaluations verified the superiority of the proposed feature set. Whereas Study V focuses on a binary survival prediction task, Study VI addresses the prediction of survival rate in patients diagnosed with lung and head-neck cancer by investigating the potential of spherical convolutional neural networks and comparing their performance against other types of features, including radiomics. While comparable results were achieved in intra- dataset analyses, the proposed spherical-based features show more predictive power in inter-dataset analyses. In summary, the six studies incorporate different imaging modalities and a wide range of image processing and machine-learning techniques in the methods developed for the quantitative assessment of tumor characteristics and contribute to the essential procedures of cancer diagnosis and prognosis

Towards autonomous diagnostic systems with medical imaging

Democratizing access to high quality healthcare has highlighted the need for autonomous diagnostic systems that a non-expert can use. Remote communities, first responders and even deep space explorers will come to rely on medical imaging systems that will provide them with Point of Care diagnostic capabilities. This thesis introduces the building blocks that would enable the creation of such a system. Firstly, we present a case study in order to further motivate the need and requirements of autonomous diagnostic systems. This case study primarily concerns deep space exploration where astronauts cannot rely on communication with earth-bound doctors to help them through diagnosis, nor can they make the trip back to earth for treatment. Requirements and possible solutions about the major challenges faced with such an application are discussed. Moreover, this work describes how a system can explore its perceived environment by developing a Multi Agent Reinforcement Learning method that allows for implicit communication between the agents. Under this regime agents can share the knowledge that benefits them all in achieving their individual tasks. Furthermore, we explore how systems can understand the 3D properties of 2D depicted objects in a probabilistic way. In Part II, this work explores how to reason about the extracted information in a causally enabled manner. A critical view on the applications of causality in medical imaging, and its potential uses is provided. It is then narrowed down to estimating possible future outcomes and reasoning about counterfactual outcomes by embedding data on a pseudo-Riemannian manifold and constraining the latent space by using the relativistic concept of light cones. By formalizing an approach to estimating counterfactuals, a computationally lighter alternative to the abduction-action-prediction paradigm is presented through the introduction of Deep Twin Networks. Appropriate partial identifiability constraints for categorical variables are derived and the method is applied in a series of medical tasks involving structured data, images and videos. All methods are evaluated in a wide array of synthetic and real life tasks that showcase their abilities, often achieving state-of-the-art performance or matching the existing best performance while requiring a fraction of the computational cost.Open Acces

Computer-Aided Assessment of Tuberculosis with Radiological Imaging: From rule-based methods to Deep Learning

Mención Internacional en el título de doctorTuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis (Mtb.) that produces pulmonary damage due to its airborne nature. This fact facilitates the disease fast-spreading, which, according to the World Health Organization (WHO), in 2021 caused 1.2 million deaths and 9.9 million new cases. Traditionally, TB has been considered a binary disease (latent/active) due to the limited specificity of the traditional diagnostic tests. Such a simple model causes difficulties in the longitudinal assessment of pulmonary affectation needed for the development of novel drugs and to control the spread of the disease. Fortunately, X-Ray Computed Tomography (CT) images enable capturing specific manifestations of TB that are undetectable using regular diagnostic tests, which suffer from limited specificity. In conventional workflows, expert radiologists inspect the CT images. However, this procedure is unfeasible to process the thousands of volume images belonging to the different TB animal models and humans required for a suitable (pre-)clinical trial. To achieve suitable results, automatization of different image analysis processes is a must to quantify TB. It is also advisable to measure the uncertainty associated with this process and model causal relationships between the specific mechanisms that characterize each animal model and its level of damage. Thus, in this thesis, we introduce a set of novel methods based on the state of the art Artificial Intelligence (AI) and Computer Vision (CV). Initially, we present an algorithm to assess Pathological Lung Segmentation (PLS) employing an unsupervised rule-based model which was traditionally considered a needed step before biomarker extraction. This procedure allows robust segmentation in a Mtb. infection model (Dice Similarity Coefficient, DSC, 94%±4%, Hausdorff Distance, HD, 8.64mm±7.36mm) of damaged lungs with lesions attached to the parenchyma and affected by respiratory movement artefacts. Next, a Gaussian Mixture Model ruled by an Expectation-Maximization (EM) algorithm is employed to automatically quantify the burden of Mtb.using biomarkers extracted from the segmented CT images. This approach achieves a strong correlation (R2 ≈ 0.8) between our automatic method and manual extraction. Consequently, Chapter 3 introduces a model to automate the identification of TB lesions and the characterization of disease progression. To this aim, the method employs the Statistical Region Merging algorithm to detect lesions subsequently characterized by texture features that feed a Random Forest (RF) estimator. The proposed procedure enables a selection of a simple but powerful model able to classify abnormal tissue. The latest works base their methodology on Deep Learning (DL). Chapter 4 extends the classification of TB lesions. Namely, we introduce a computational model to infer TB manifestations present in each lung lobe of CT scans by employing the associated radiologist reports as ground truth. We do so instead of using the classical manually delimited segmentation masks. The model adjusts the three-dimensional architecture, V-Net, to a multitask classification context in which loss function is weighted by homoscedastic uncertainty. Besides, the method employs Self-Normalizing Neural Networks (SNNs) for regularization. Our results are promising with a Root Mean Square Error of 1.14 in the number of nodules and F1-scores above 0.85 for the most prevalent TB lesions (i.e., conglomerations, cavitations, consolidations, trees in bud) when considering the whole lung. In Chapter 5, we present a DL model capable of extracting disentangled information from images of different animal models, as well as information of the mechanisms that generate the CT volumes. The method provides the segmentation mask of axial slices from three animal models of different species employing a single trained architecture. It also infers the level of TB damage and generates counterfactual images. So, with this methodology, we offer an alternative to promote generalization and explainable AI models. To sum up, the thesis presents a collection of valuable tools to automate the quantification of pathological lungs and moreover extend the methodology to provide more explainable results which are vital for drug development purposes. Chapter 6 elaborates on these conclusions.Programa de Doctorado en Multimedia y Comunicaciones por la Universidad Carlos III de Madrid y la Universidad Rey Juan CarlosPresidenta: María Jesús Ledesma Carbayo.- Secretario: David Expósito Singh.- Vocal: Clarisa Sánchez Gutiérre

An Evolutionary Approach to Adaptive Image Analysis for Retrieving and Long-term Monitoring Historical Land Use from Spatiotemporally Heterogeneous Map Sources

Land use changes have become a major contributor to the anthropogenic global change. The ongoing dispersion and concentration of the human species, being at their orders unprecedented, have indisputably altered Earth’s surface and atmosphere. The effects are so salient and irreversible that a new geological epoch, following the interglacial Holocene, has been announced: the Anthropocene. While its onset is by some scholars dated back to the Neolithic revolution, it is commonly referred to the late 18th century. The rapid development since the industrial revolution and its implications gave rise to an increasing awareness of the extensive anthropogenic land change and led to an urgent need for sustainable strategies for land use and land management. By preserving of landscape and settlement patterns at discrete points in time, archival geospatial data sources such as remote sensing imagery and historical geotopographic maps, in particular, could give evidence of the dynamic land use change during this crucial period. In this context, this thesis set out to explore the potentials of retrospective geoinformation for monitoring, communicating, modeling and eventually understanding the complex and gradually evolving processes of land cover and land use change. Currently, large amounts of geospatial data sources such as archival maps are being worldwide made online accessible by libraries and national mapping agencies. Despite their abundance and relevance, the usage of historical land use and land cover information in research is still often hindered by the laborious visual interpretation, limiting the temporal and spatial coverage of studies. Thus, the core of the thesis is dedicated to the computational acquisition of geoinformation from archival map sources by means of digital image analysis. Based on a comprehensive review of literature as well as the data and proposed algorithms, two major challenges for long-term retrospective information acquisition and change detection were identified: first, the diversity of geographical entity representations over space and time, and second, the uncertainty inherent to both the data source itself and its utilization for land change detection. To address the former challenge, image segmentation is considered a global non-linear optimization problem. The segmentation methods and parameters are adjusted using a metaheuristic, evolutionary approach. For preserving adaptability in high level image analysis, a hybrid model- and data-driven strategy, combining a knowledge-based and a neural net classifier, is recommended. To address the second challenge, a probabilistic object- and field-based change detection approach for modeling the positional, thematic, and temporal uncertainty adherent to both data and processing, is developed. Experimental results indicate the suitability of the methodology in support of land change monitoring. In conclusion, potentials of application and directions for further research are given

Generalizable deep learning based medical image segmentation

Deep learning is revolutionizing medical image analysis and interpretation. However, its real-world deployment is often hindered by the poor generalization to unseen domains (new imaging modalities and protocols). This lack of generalization ability is further exacerbated by the scarcity of labeled datasets for training: Data collection and annotation can be prohibitively expensive in terms of labor and costs because label quality heavily dependents on the expertise of radiologists. Additionally, unreliable predictions caused by poor model generalization pose safety risks to clinical downstream applications. To mitigate labeling requirements, we investigate and develop a series of techniques to strengthen the generalization ability and the data efficiency of deep medical image computing models. We further improve model accountability and identify unreliable predictions made on out-of-domain data, by designing probability calibration techniques. In the first and the second part of thesis, we discuss two types of problems for handling unexpected domains: unsupervised domain adaptation and single-source domain generalization. For domain adaptation we present a data-efficient technique that adapts a segmentation model trained on a labeled source domain (e.g., MRI) to an unlabeled target domain (e.g., CT), using a small number of unlabeled training images from the target domain. For domain generalization, we focus on both image reconstruction and segmentation. For image reconstruction, we design a simple and effective domain generalization technique for cross-domain MRI reconstruction, by reusing image representations learned from natural image datasets. For image segmentation, we perform causal analysis of the challenging cross-domain image segmentation problem. Guided by this causal analysis we propose an effective data-augmentation-based generalization technique for single-source domains. The proposed method outperforms existing approaches on a large variety of cross-domain image segmentation scenarios. In the third part of the thesis, we present a novel self-supervised method for learning generic image representations that can be used to analyze unexpected objects of interest. The proposed method is designed together with a novel few-shot image segmentation framework that can segment unseen objects of interest by taking only a few labeled examples as references. Superior flexibility over conventional fully-supervised models is demonstrated by our few-shot framework: it does not require any fine-tuning on novel objects of interest. We further build a publicly available comprehensive evaluation environment for few-shot medical image segmentation. In the fourth part of the thesis, we present a novel probability calibration model. To ensure safety in clinical settings, a deep model is expected to be able to alert human radiologists if it has low confidence, especially when confronted with out-of-domain data. To this end we present a plug-and-play model to calibrate prediction probabilities on out-of-domain data. It aligns the prediction probability in line with the actual accuracy on the test data. We evaluate our method on both artifact-corrupted images and images from an unforeseen MRI scanning protocol. Our method demonstrates improved calibration accuracy compared with the state-of-the-art method. Finally, we summarize the major contributions and limitations of our works. We also suggest future research directions that will benefit from the works in this thesis.Open Acces

Deep Learning in Medical Image Analysis

The accelerating power of deep learning in diagnosing diseases will empower physicians and speed up decision making in clinical environments. Applications of modern medical instruments and digitalization of medical care have generated enormous amounts of medical images in recent years. In this big data arena, new deep learning methods and computational models for efficient data processing, analysis, and modeling of the generated data are crucially important for clinical applications and understanding the underlying biological process. This book presents and highlights novel algorithms, architectures, techniques, and applications of deep learning for medical image analysis