Machine learning approaches for lung cancer diagnosis.

The enormity of changes and development in the field of medical imaging technology is hard to fathom, as it does not just represent the technique and process of constructing visual representations of the body from inside for medical analysis and to reveal the internal structure of different organs under the skin, but also it provides a noninvasive way for diagnosis of various disease and suggest an efficient ways to treat them. While data surrounding all of our lives are stored and collected to be ready for analysis by data scientists, medical images are considered a rich source that could provide us with a huge amount of data, that could not be read easily by physicians and radiologists, with valuable information that could be used in smart ways to discover new knowledge from these vast quantities of data. Therefore, the design of computer-aided diagnostic (CAD) system, that can be approved for use in clinical practice that aid radiologists in diagnosis and detecting potential abnormalities, is of a great importance. This dissertation deals with the development of a CAD system for lung cancer diagnosis, which is the second most common cancer in men after prostate cancer and in women after breast cancer. Moreover, lung cancer is considered the leading cause of cancer death among both genders in USA. Recently, the number of lung cancer patients has increased dramatically worldwide and its early detection doubles a patient’s chance of survival. Histological examination through biopsies is considered the gold standard for final diagnosis of pulmonary nodules. Even though resection of pulmonary nodules is the ideal and most reliable way for diagnosis, there is still a lot of different methods often used just to eliminate the risks associated with the surgical procedure. Lung nodules are approximately spherical regions of primarily high density tissue that are visible in computed tomography (CT) images of the lung. A pulmonary nodule is the first indication to start diagnosing lung cancer. Lung nodules can be benign (normal subjects) or malignant (cancerous subjects). Large (generally defined as greater than 2 cm in diameter) malignant nodules can be easily detected with traditional CT scanning techniques. However, the diagnostic options for small indeterminate nodules are limited due to problems associated with accessing small tumors. Therefore, additional diagnostic and imaging techniques which depends on the nodules’ shape and appearance are needed. The ultimate goal of this dissertation is to develop a fast noninvasive diagnostic system that can enhance the accuracy measures of early lung cancer diagnosis based on the well-known hypotheses that malignant nodules have different shape and appearance than benign nodules, because of the high growth rate of the malignant nodules. The proposed methodologies introduces new shape and appearance features which can distinguish between benign and malignant nodules. To achieve this goal a CAD system is implemented and validated using different datasets. This CAD system uses two different types of features integrated together to be able to give a full description to the pulmonary nodule. These two types are appearance features and shape features. For the appearance features different texture appearance descriptors are developed, namely the 3D histogram of oriented gradient, 3D spherical sector isosurface histogram of oriented gradient, 3D adjusted local binary pattern, 3D resolved ambiguity local binary pattern, multi-view analytical local binary pattern, and Markov Gibbs random field. Each one of these descriptors gives a good description for the nodule texture and the level of its signal homogeneity which is a distinguishable feature between benign and malignant nodules. For the shape features multi-view peripheral sum curvature scale space, spherical harmonics expansions, and different group of fundamental geometric features are utilized to describe the nodule shape complexity. Finally, the fusion of different combinations of these features, which is based on two stages is introduced. The first stage generates a primary estimation for every descriptor. Followed by the second stage that consists of an autoencoder with a single layer augmented with a softmax classifier to provide us with the ultimate classification of the nodule. These different combinations of descriptors are combined into different frameworks that are evaluated using different datasets. The first dataset is the Lung Image Database Consortium which is a benchmark publicly available dataset for lung nodule detection and diagnosis. The second dataset is our local acquired computed tomography imaging data that has been collected from the University of Louisville hospital and the research protocol was approved by the Institutional Review Board at the University of Louisville (IRB number 10.0642). These frameworks accuracy was about 94%, which make the proposed frameworks demonstrate promise to be valuable tool for the detection of lung cancer

Development, Implementation and Pre-clinical Evaluation of Medical Image Computing Tools in Support of Computer-aided Diagnosis: Respiratory, Orthopedic and Cardiac Applications

Over the last decade, image processing tools have become crucial components of all clinical and research efforts involving medical imaging and associated applications. The imaging data available to the radiologists continue to increase their workload, raising the need for efficient identification and visualization of the required image data necessary for clinical assessment. Computer-aided diagnosis (CAD) in medical imaging has evolved in response to the need for techniques that can assist the radiologists to increase throughput while reducing human error and bias without compromising the outcome of the screening, diagnosis or disease assessment. More intelligent, but simple, consistent and less time-consuming methods will become more widespread, reducing user variability, while also revealing information in a more clear, visual way. Several routine image processing approaches, including localization, segmentation, registration, and fusion, are critical for enhancing and enabling the development of CAD techniques. However, changes in clinical workflow require significant adjustments and re-training and, despite the efforts of the academic research community to develop state-of-the-art algorithms and high-performance techniques, their footprint often hampers their clinical use. Currently, the main challenge seems to not be the lack of tools and techniques for medical image processing, analysis, and computing, but rather the lack of clinically feasible solutions that leverage the already developed and existing tools and techniques, as well as a demonstration of the potential clinical impact of such tools. Recently, more and more efforts have been dedicated to devising new algorithms for localization, segmentation or registration, while their potential and much intended clinical use and their actual utility is dwarfed by the scientific, algorithmic and developmental novelty that only result in incremental improvements over already algorithms. In this thesis, we propose and demonstrate the implementation and evaluation of several different methodological guidelines that ensure the development of image processing tools --- localization, segmentation and registration --- and illustrate their use across several medical imaging modalities --- X-ray, computed tomography, ultrasound and magnetic resonance imaging --- and several clinical applications: Lung CT image registration in support for assessment of pulmonary nodule growth rate and disease progression from thoracic CT images. Automated reconstruction of standing X-ray panoramas from multi-sector X-ray images for assessment of long limb mechanical axis and knee misalignment. Left and right ventricle localization, segmentation, reconstruction, ejection fraction measurement from cine cardiac MRI or multi-plane trans-esophageal ultrasound images for cardiac function assessment. When devising and evaluating our developed tools, we use clinical patient data to illustrate the inherent clinical challenges associated with highly variable imaging data that need to be addressed before potential pre-clinical validation and implementation. In an effort to provide plausible solutions to the selected applications, the proposed methodological guidelines ensure the development of image processing tools that help achieve sufficiently reliable solutions that not only have the potential to address the clinical needs, but are sufficiently streamlined to be potentially translated into eventual clinical tools provided proper implementation. G1: Reducing the number of degrees of freedom (DOF) of the designed tool, with a plausible example being avoiding the use of inefficient non-rigid image registration methods. This guideline addresses the risk of artificial deformation during registration and it clearly aims at reducing complexity and the number of degrees of freedom. G2: The use of shape-based features to most efficiently represent the image content, either by using edges instead of or in addition to intensities and motion, where useful. Edges capture the most useful information in the image and can be used to identify the most important image features. As a result, this guideline ensures a more robust performance when key image information is missing. G3: Efficient method of implementation. This guideline focuses on efficiency in terms of the minimum number of steps required and avoiding the recalculation of terms that only need to be calculated once in an iterative process. An efficient implementation leads to reduced computational effort and improved performance. G4: Commence the workflow by establishing an optimized initialization and gradually converge toward the final acceptable result. This guideline aims to ensure reasonable outcomes in consistent ways and it avoids convergence to local minima, while gradually ensuring convergence to the global minimum solution. These guidelines lead to the development of interactive, semi-automated or fully-automated approaches that still enable the clinicians to perform final refinements, while they reduce the overall inter- and intra-observer variability, reduce ambiguity, increase accuracy and precision, and have the potential to yield mechanisms that will aid with providing an overall more consistent diagnosis in a timely fashion

Deep Learning Based Medical Image Analysis with Limited Data

Deep Learning Methods have shown its great effort in the area of Computer Vision. However, when solving the problems of medical imaging, deep learning’s power is confined by limited data available. We present a series of novel methodologies for solving medical imaging analysis problems with limited Computed tomography (CT) scans available. Our method, based on deep learning, with different strategies, including using Generative Adversar- ial Networks, two-stage training, infusing the expert knowledge, voting based or converting to other space, solves the data set limitation issue for the cur- rent medical imaging problems, specifically cancer detection and diagnosis, and shows very good performance and outperforms the state-of-art results in the literature. With the self-learned features, deep learning based techniques start to be applied to the biomedical imaging problems and various structures have been designed. In spite of its simplity and anticipated good performance, the deep learning based techniques can not perform to its best extent due to the limited size of data sets for the medical imaging problems. On the other side, the traditional hand-engineered features based methods have been studied in the past decades and a lot of useful features have been found by these research for the task of detecting and diagnosing the pulmonary nod- ules on CT scans, but these methods are usually performed through a series of complicated procedures with manually empirical parameter adjustments. Our method significantly reduces the complications of the traditional proce- dures for pulmonary nodules detection, while retaining and even outperforming the state-of-art accuracy. Besides, we make contribution on how to convert low-dose CT image to full-dose CT so as to adapting current models on the newly-emerged low-dose CT data

A Survey of Deep Learning for Lung Disease Detection on Medical Images: State-of-the-Art, Taxonomy, Issues and Future Directions

The recent developments of deep learning support the identification and classification of lung diseases in medical images. Hence, numerous work on the detection of lung disease using deep learning can be found in the literature. This paper presents a survey of deep learning for lung disease detection in medical images. There has only been one survey paper published in the last five years regarding deep learning directed at lung diseases detection. However, their survey is lacking in the presentation of taxonomy and analysis of the trend of recent work. The objectives of this paper are to present a taxonomy of the state-of-the-art deep learning based lung disease detection systems, visualise the trends of recent work on the domain and identify the remaining issues and potential future directions in this domain. Ninety-eight articles published from 2016 to 2020 were considered in this survey. The taxonomy consists of seven attributes that are common in the surveyed articles: image types, features, data augmentation, types of deep learning algorithms, transfer learning, the ensemble of classifiers and types of lung diseases. The presented taxonomy could be used by other researchers to plan their research contributions and activities. The potential future direction suggested could further improve the efficiency and increase the number of deep learning aided lung disease detection applications

Automatic Chest X-rays Analysis using Statistical Machine Learning Strategies

Tuberculosis (TB) is a disease responsible for the deaths of more than one million people worldwide every year. Even though it is preventable and curable, it remains a major threat to humanity that needs to be taken care of. It is often diagnosed in developed countries using approaches such as sputum smear microscopy and culture methods. However, since these approaches are rather expensive, they are not commonly used in poor regions of the globe such as India, Africa, and Bangladesh. Instead, the well known and affordable chest x-ray (CXR) interpretation by radiologists is the technique employed in those places. Nevertheless, if this method is obsolete in other parts of the world nowadays it is because of its many flaws including: i) it is a tedious task that requires experienced medical personnel --which is scarce given the high demand for it--, ii) it is manual and difficult when executed for a large population, and iii) it is prone to human error depending on the proficiency and aptitude of the interpreter. Researchers have thus been trying to overcome these challenges over the years by proposing software solutions that mainly involve computer vision, artificial intelligence, and machine learning. The problems with these existing solutions are that they are either complex or not reliable enough. The need for better solutions in this specific domain as well as my desire to bring my contribution to something meaningful are what led us to investigate in this direction. In this manuscript, I propose a simple fully automatic software solution that uses only machine learning and image processing to analyze and detect anomalies related to TB in CXR scans. My system starts by extracting the region of interest from the incoming images, then performs a computationally inexpensive yet efficient feature extraction that involves edge detection using Laplacian of Gaussian and positional information retention. The extracted features are then fed to a regular random forest classifier for discrimination. I tested the system on two benchmark data collections --Montgomery and Shenzhen-- and obtained state-of-the-art results that reach up to 97% classification accuracy

Chest X-Ray Image Classification on Common Thorax Diseases using GLCM and AlexNet Deep Features

Image processing has been progressing far in medical as it is one of the main techniques used in the development of medical imaging diagnosis system. Some of the medical imaging modalities are the Magnetic Resonance Imaging (MRI), Computed Tomography (CT) Scan, X-Ray and Ultrasound. The output from all of these modalities would later be reviewed by the expert for an accurate result. Ensemble methods in machine learning are able to provide an automatic detection that can be used in the development of computer aided diagnosis system which can aid the experts in making their diagnosis. This paper presents the investigation on the classification of fourteen thorax diseases using chest x-ray image from ChestX-Ray8 database using Grey Level Co-occurrence Matrix (GLCM) and AlexNet feature extraction which are process using supervised classifiers: Zero R, k-NN, Naïve Bayes, PART, and J48 Tree. The classification accuracy result indicates that k-NN classifier gave the highest accuracy compare to the other classifiers with 47.51% accuracy for GLCM feature extraction method and 47.18% for AlexNet feature extraction method. The result shows that number of data by class and multilabelled data will influence the classifcation method. Data using GLCM feature extraction method has higher classification accuracy compared to AlexNet and required less processing step

Deep Functional Mapping For Predicting Cancer Outcome

The effective understanding of the biological behavior and prognosis of cancer subtypes is becoming very important in-patient administration. Cancer is a diverse disorder in which a significant medical progression and diagnosis for each subtype can be observed and characterized. Computer-aided diagnosis for early detection and diagnosis of many kinds of diseases has evolved in the last decade. In this research, we address challenges associated with multi-organ disease diagnosis and recommend numerous models for enhanced analysis. We concentrate on evaluating the Magnetic Resonance Imaging (MRI), Computed Tomography (CT), and Positron Emission Tomography (PET) for brain, lung, and breast scans to detect, segment, and classify types of cancer from biomedical images. Moreover, histopathological, and genomic classification of cancer prognosis has been considered for multi-organ disease diagnosis and biomarker recommendation. We considered multi-modal, multi-class classification during this study. We are proposing implementing deep learning techniques based on Convolutional Neural Network and Generative Adversarial Network. In our proposed research we plan to demonstrate ways to increase the performance of the disease diagnosis by focusing on a combined diagnosis of histology, image processing, and genomics. It has been observed that the combination of medical imaging and gene expression can effectively handle the cancer detection situation with a higher diagnostic rate rather than considering the individual disease diagnosis. This research puts forward a blockchain-based system that facilitates interpretations and enhancements pertaining to automated biomedical systems. In this scheme, a secured sharing of the biomedical images and gene expression has been established. To maintain the secured sharing of the biomedical contents in a distributed system or among the hospitals, a blockchain-based algorithm is considered that generates a secure sequence to identity a hash key. This adaptive feature enables the algorithm to use multiple data types and combines various biomedical images and text records. All data related to patients, including identity, pathological records are encrypted using private key cryptography based on blockchain architecture to maintain data privacy and secure sharing of the biomedical contents