Thinking Twice: Clinical-Inspired Thyroid Ultrasound Lesion Detection Based on Feature Feedback

Accurate detection of thyroid lesions is a critical aspect of computer-aided diagnosis. However, most existing detection methods perform only one feature extraction process and then fuse multi-scale features, which can be affected by noise and blurred features in ultrasound images. In this study, we propose a novel detection network based on a feature feedback mechanism inspired by clinical diagnosis. The mechanism involves first roughly observing the overall picture and then focusing on the details of interest. It comprises two parts: a feedback feature selection module and a feature feedback pyramid. The feedback feature selection module efficiently selects the features extracted in the first phase in both space and channel dimensions to generate high semantic prior knowledge, which is similar to coarse observation. The feature feedback pyramid then uses this high semantic prior knowledge to enhance feature extraction in the second phase and adaptively fuses the two features, similar to fine observation. Additionally, since radiologists often focus on the shape and size of lesions for diagnosis, we propose an adaptive detection head strategy to aggregate multi-scale features. Our proposed method achieves an AP of 70.3% and AP50 of 99.0% on the thyroid ultrasound dataset and meets the real-time requirement. The code is available at https://github.com/HIT-wanglingtao/Thinking-Twice.Comment: 20 pages, 11 figures, released code for https://github.com/HIT-wanglingtao/Thinking-Twic

Recent Advances in Machine Learning Applied to Ultrasound Imaging

Machine learning (ML) methods are pervading an increasing number of fields of application because of their capacity to effectively solve a wide variety of challenging problems. The employment of ML techniques in ultrasound imaging applications started several years ago but the scientific interest in this issue has increased exponentially in the last few years. The present work reviews the most recent (2019 onwards) implementations of machine learning techniques for two of the most popular ultrasound imaging fields, medical diagnostics and non-destructive evaluation. The former, which covers the major part of the review, was analyzed by classifying studies according to the human organ investigated and the methodology (e.g., detection, segmentation, and/or classification) adopted, while for the latter, some solutions to the detection/classification of material defects or particular patterns are reported. Finally, the main merits of machine learning that emerged from the study analysis are summarized and discussed. © 2022 by the authors. Licensee MDPI, Basel, Switzerland

Studies on Category Prediction of Ovarian Cancers Based on Magnetic Resonance Images

Ovarian cancer is the gynecological malignant tumor with low early diagnosis rate and high mortality. Ovarian epithelial cancer (OEC) is the most common subtype of ovarian cancer. Pathologically, OEC is divided into two subtypes: Type I and Type II. These two subtypes of OEC have different biological characteristics and treatment response. Therefore, it is important to accurately categorize these two groups of patients and provide the reference for clinicians in designing treatment plans. In the current magnetic resonance (MR) examination, the diagnoses given by the radiologists are largely based on individual judgment and not sufficiently accurate. Because of the low accuracy of the results and the risk of suffering Type II OEC, most patients will undertake the fine-needle aspiration, which may cause harm to patients’ bodies. Therefore, there is need for the method for OEC subtype classification based on MR images. This thesis proposes the automatic diagnosis system of ovarian cancer based on the combination of deep learning and radiomics. The method utilizes four common useful sequences for ovarian cancer diagnosis: sagittal fat-suppressed T2WI (Sag-fs-T2WI), coronal T2WI (Cor-T2WI), axial T1WI (Axi-T1WI), and apparent diffusion coefficient map (ADC) to establish a multi-sequence diagnostic model. The system starts with the segmentation of the ovarian tumors, and then obtains the radiomic features from lesion parts together with the network features. Selected Features are used to build model to predict the malignancy of ovarian cancers, the subtype of OEC and the survival condition. Bi-atten-ResUnet is proposed in this thesis as the segmentation model. The network is established on the basis of U-Net with adopting Residual block and non-local attention module. It preserves the classic encoder/decoder architecture in the U-Net network. The encoder part is reconstructed by the pretrained ResNet to make use of transfer learning knowledge, and bi-non-local attention modules are added to the decoder part on each level. The application of these techniques enhances the network’s performance in segmentation tasks. The model achieves 0.918, 0.905, 0.831, and 0.820 Dice coefficient respectively in segmenting on four MR sequences. After the segmentation work, the thesis proposes a diagnostic model with three steps: quantitative description feature extraction, feature selection, and establishment of prediction models. First, radiomic features and network features are obtained. Then iterative sparse representation (ISR) method is adopted as the feature selection to reduce the redundancy and correlation. The selected features are used to establish a predictive model, and support vector machine (SVM) is used as the classifier. The model achieves an AUC of 0.967 in distinguishing between benign and malignant ovarian tumors. For discriminating Type I and Type II OEC, the model yields an AUC of 0.823. In the survival prediction, patients categorized in high risk group are more likely to have poor prognosis with hazard ratio 4.169

Risk Stratification of Thyroid Nodule: From Ultrasound Features to TIRADS

Since the 1990s, ultrasound (US) has played a major role in the assessment of thyroid nodules and their risk of malignancy. Over the last decade, the most eminent international societies have published US-based systems for the risk stratification of thyroid lesions, namely, Thyroid Imaging Reporting And Data Systems (TIRADSs). The introduction of TIRADSs into clinical practice has significantly increased the diagnostic power of US to a level approaching that of fine-needle aspiration cytology (FNAC). At present, we are probably approaching a new era in which US could be the primary tool to diagnose thyroid cancer. However, before using US in this new dominant role, we need further proof. This Special Issue, which includes reviews and original articles, aims to pave the way for the future in the field of thyroid US. Highly experienced thyroidologists focused on US are asked to contribute to achieve this goal

Microscopy and Analysis

Microscopes represent tools of the utmost importance for a wide range of disciplines. Without them, it would have been impossible to stand where we stand today in terms of understanding the structure and functions of organelles and cells, tissue composition and metabolism, or the causes behind various pathologies and their progression. Our knowledge on basic and advanced materials is also intimately intertwined to the realm of microscopy, and progress in key fields of micro- and nanotechnologies critically depends on high-resolution imaging systems. This volume includes a series of chapters that address highly significant scientific subjects from diverse areas of microscopy and analysis. Authoritative voices in their fields present in this volume their work or review recent trends, concepts, and applications, in a manner that is accessible to a broad readership audience from both within and outside their specialist area

Automated Strategies in Multimodal and Multidimensional Ultrasound Image-based Diagnosis

Medical ultrasonography is an effective technique in traditional anatomical and functional diagnosis. However, it requires the visual examination by experienced clinicians, which is a laborious, time consuming and highly subjective procedure. Computer-aided diagnosis (CADx) have been extensively used in clinical practice to support the interpretation of images; nevertheless, current ultrasound CADx still entails a substantial user-dependency and are unable to extract image data for prediction modelling. The aim of this thesis is to propose a set of fully automated strategies to overcome the limitations of ultrasound CADx. These strategies are addressed to multiple modalities (B-Mode, Contrast-Enhanced Ultrasound-CEUS, Power Doppler-PDUS and Acoustic Angiography-AA) and dimensions (2-D and 3-D imaging). The enabling techniques presented in this work are designed, developed and quantitively validated to efficiently improve the overall patients’ diagnosis. This work is subdivided in 2 macro-sections: in the first part, two fully automated algorithms for the reliable quantification of 2-D B-Mode ultrasound skeletal muscle architecture and morphology are proposed. In the second part, two fully automated algorithms for the objective assessment and characterization of tumors’ vasculature in 3-D CEUS and PDUS thyroid tumors and preclinical AA cancer growth are presented. In the first part, the MUSA (Muscle UltraSound Analysis) algorithm is designed to measure the muscle thickness, the fascicles length and the pennation angle; the TRAMA (TRAnsversal Muscle Analysis) algorithm is proposed to extract and analyze the Visible Cross-Sectional Area (VCSA). MUSA and TRAMA algorithms have been validated on two datasets of 200 images; automatic measurements have been compared with expert operators’ manual measurements. A preliminary statistical analysis was performed to prove the ability of texture analysis on automatic VCSA in the distinction between healthy and pathological muscles. In the second part, quantitative assessment on tumor vasculature is proposed in two automated algorithms for the objective characterization of 3-D CEUS/Power Doppler thyroid nodules and the evolution study of fibrosarcoma invasion in preclinical 3-D AA imaging. Vasculature analysis relies on the quantification of architecture and vessels tortuosity. Vascular features obtained from CEUS and PDUS images of 20 thyroid nodules (10 benign, 10 malignant) have been used in a multivariate statistical analysis supported by histopathological results. Vasculature parametric maps of implanted fibrosarcoma are extracted from 8 rats investigated with 3-D AA along four time points (TPs), in control and tumors areas; results have been compared with manual previous findings in a longitudinal tumor growth study. Performance of MUSA and TRAMA algorithms results in 100% segmentation success rate. Absolute difference between manual and automatic measurements is below 2% for the muscle thickness and 4% for the VCSA (values between 5-10% are acceptable in clinical practice), suggesting that automatic and manual measurements can be used interchangeably. The texture features extraction on the automatic VCSAs reveals that texture descriptors can distinguish healthy from pathological muscles with a 100% success rate for all the four muscles. Vascular features extracted of 20 thyroid nodules in 3-D CEUS and PDUS volumes can be used to distinguish benign from malignant tumors with 100% success rate for both ultrasound techniques. Malignant tumors present higher values of architecture and tortuosity descriptors; 3-D CEUS and PDUS imaging present the same accuracy in the differentiation between benign and malignant nodules. Vascular parametric maps extracted from the 8 rats along the 4 TPs in 3-D AA imaging show that parameters extracted from the control area are statistically different compared to the ones within the tumor volume. Tumor angiogenetic vessels present a smaller diameter and higher tortuosity. Tumor evolution is characterized by the significant vascular trees growth and a constant value of vessel diameter along the four TPs, confirming the previous findings. In conclusion, the proposed automated strategies are highly performant in segmentation, features extraction, muscle disease detection and tumor vascular characterization. These techniques can be extended in the investigation of other organs, diseases and embedded in ultrasound CADx, providing a user-independent reliable diagnosis

Advanced Sensing and Image Processing Techniques for Healthcare Applications

This Special Issue aims to attract the latest research and findings in the design, development and experimentation of healthcare-related technologies. This includes, but is not limited to, using novel sensing, imaging, data processing, machine learning, and artificially intelligent devices and algorithms to assist/monitor the elderly, patients, and the disabled population

New Statistical Algorithms for the Analysis of Mass Spectrometry Time-Of-Flight Mass Data with Applications in Clinical Diagnostics

Mass spectrometry (MS) based techniques have emerged as a standard forlarge-scale protein analysis. The ongoing progress in terms of more sensitive machines and improved data analysis algorithms led to a constant expansion of its fields of applications. Recently, MS was introduced into clinical proteomics with the prospect of early disease detection using proteomic pattern matching. Analyzing biological samples (e.g. blood) by mass spectrometry generates mass spectra that represent the components (molecules) contained in a sample as masses and their respective relative concentrations. In this work, we are interested in those components that are constant within a group of individuals but differ much between individuals of two distinct groups. These distinguishing components that dependent on a particular medical condition are generally called biomarkers. Since not all biomarkers found by the algorithms are of equal (discriminating) quality we are only interested in a small biomarker subset that - as a combination - can be used as a fingerprint for a disease. Once a fingerprint for a particular disease (or medical condition) is identified, it can be used in clinical diagnostics to classify unknown spectra. In this thesis we have developed new algorithms for automatic extraction of disease specific fingerprints from mass spectrometry data. Special emphasis has been put on designing highly sensitive methods with respect to signal detection. Thanks to our statistically based approach our methods are able to detect signals even below the noise level inherent in data acquired by common MS machines, such as hormones. To provide access to these new classes of algorithms to collaborating groups we have created a web-based analysis platform that provides all necessary interfaces for data transfer, data analysis and result inspection. To prove the platform's practical relevance it has been utilized in several clinical studies two of which are presented in this thesis. In these studies it could be shown that our platform is superior to commercial systems with respect to fingerprint identification. As an outcome of these studies several fingerprints for different cancer types (bladder, kidney, testicle, pancreas, colon and thyroid) have been detected and validated. The clinical partners in fact emphasize that these results would be impossible with a less sensitive analysis tool (such as the currently available systems). In addition to the issue of reliably finding and handling signals in noise we faced the problem to handle very large amounts of data, since an average dataset of an individual is about 2.5 Gigabytes in size and we have data of hundreds to thousands of persons. To cope with these large datasets, we developed a new framework for a heterogeneous (quasi) ad-hoc Grid - an infrastructure that allows to integrate thousands of computing resources (e.g. Desktop Computers, Computing Clusters or specialized hardware, such as IBM's Cell Processor in a Playstation 3)