Machine Learning towards General Medical Image Segmentation

The quality of patient care associated with diagnostic radiology is proportionate to a physician\u27s workload. Segmentation is a fundamental limiting precursor to diagnostic and therapeutic procedures. Advances in machine learning aims to increase diagnostic efficiency to replace single applications with generalized algorithms. We approached segmentation as a multitask shape regression problem, simultaneously predicting coordinates on an object\u27s contour while jointly capturing global shape information. Shape regression models inherent point correlations to recover ambiguous boundaries not supported by clear edges and region homogeneity. Its capabilities was investigated using multi-output support vector regression (MSVR) on head and neck (HaN) CT images. Subsequently, we incorporated multiplane and multimodality spinal images and presented the first deep learning multiapplication framework for shape regression, the holistic multitask regression network (HMR-Net). MSVR and HMR-Net\u27s performance were comparable or superior to state-of-the-art algorithms. Multiapplication frameworks bridges any technical knowledge gaps and increases workflow efficiency

Deformable Multisurface Segmentation of the Spine for Orthopedic Surgery Planning and Simulation

Purpose: We describe a shape-aware multisurface simplex deformable model for the segmentation of healthy as well as pathological lumbar spine in medical image data. Approach: This model provides an accurate and robust segmentation scheme for the identification of intervertebral disc pathologies to enable the minimally supervised planning and patient-specific simulation of spine surgery, in a manner that combines multisurface and shape statistics-based variants of the deformable simplex model. Statistical shape variation within the dataset has been captured by application of principal component analysis and incorporated during the segmentation process to refine results. In the case where shape statistics hinder detection of the pathological region, user assistance is allowed to disable the prior shape influence during deformation. Results: Results demonstrate validation against user-assisted expert segmentation, showing excellent boundary agreement and prevention of spatial overlap between neighboring surfaces. This section also plots the characteristics of the statistical shape model, such as compactness, generalizability and specificity, as a function of the number of modes used to represent the family of shapes. Final results demonstrate a proof-of-concept deformation application based on the open-source surgery simulation Simulation Open Framework Architecture toolkit. Conclusions: To summarize, we present a deformable multisurface model that embeds a shape statistics force, with applications to surgery planning and simulation

A Machine Learning and Computer Assisted Methodology for Diagnosing Chronic Lower Back Pain on Lumbar Spine Magnetic Resonance Images

Chronic Lower Back Pain (CLBP) is one of the major types of pain that affects many people around the world. It is estimated that 28.1% of US adults suffer from this illness and 2.5 million of the UK population experience this type of pain every day. Most CLBP cases do not happen overnight and it is usually developed from a less serious but acute variant of lower back pain. An acute type of lower back pain can develop into a chronic one if the underlying cause is serious and left untreated. The longer a person is disabled by back pain, the less chance he or she returns to work and the more health care cost he or she will require. It is therefore important to identify the cause of back pains as early as possible in order to improve the chance of patient rehabilitation. The speediness of early diagnosis can depend on many factors including referral time from a general practitioner to the hospital, waiting time for a specialist appointment, time for a Magnetic Resonance Imaging (MRI) scan and time for the analysis result to come out. Currently diagnosing the lower back pain is done by visual observation and analysis of the lumbar spine MRI images by radiologists and clinicians and this process could take up much of their time and effort. This, therefore, rationalizes the need for a new method to increase the efficiency and effectiveness of the imaging diagnostic process. This thesis details a novel methodology to automatically aid clinicians in performing diagnosis of CLBP on lumbar spine MRI images. The methodology is based on the current accepted medical practice of manual inspection of the MRI scans of the patient’s lumbar spine as advised by several practitioners in this field. The main methodology is divided into three sub-methods the first sub-method is disc herniation detection using disc segmentation and centroid distance function. While the second sub-method is lumbar spinal stenosis detection via segmentation of area between anterior and posterior (AAP) Elements. Whereas, the last sub-method is the use of deep learning to perform semantic segmentation to identify regions in the MRI images that are relevant to the diagnosis process. The method then performs boundary delineation between these regions, identifies key points along the boundaries and measures distances between these points that can be used as an indication to the health of the lumbar spine. Due to a limitation in the size and suitability of the currently existing open-access lumbar spine dataset necessary to train and test any good classification algorithms, a dataset consisting of 48,345 MRI slices from a complete clinical lumbar MRI study of 515 symptomatic back pain patients from several specialty hospitals around the world has been created. Each MRI study is annotated by expert radiologists with notes regarding the observed characteristics, condition of the lumbar spine, or presence of diseases. The ground-truth dataset containing manually labelled segmented images has also been developed. To complement this ground-truth dataset, a novel method of constructing and evaluating the suitability of ground truth data for lumbar spine MRI image segmentation has been developed. A subset of the dataset, which includes the data for 101 patients, is used in a set of experiments that have been conducted using a variety of algorithms to conclude with using SegNet as the image segmentation algorithm. The network consists of VGG16 layers pre-trained using a subset of non-medical images from the ImageNet database and fine-tuned using the training portion of the ground-truth dataset. The results of these experiments show the accurate delineation of important boundaries of regions in lumbar spine MRI. The experiments also show very close agreement between the expert radiologists’ notes on the condition of a lumbar spine and the conclusion of the system about the lumbar spine in the majority of cases

Evaluating Cranial Nonmetric Traits in Mummies from Pachacamac, Peru: The Utility of Semi-Automated Image Segmentation in Paleoradiology

Anthropologists employ biodistance analysis to understand past population interactions and relatedness. The objectives of this thesis are twofold: to determine whether a sample of five mummies from the pilgrimage centre, Pachacamac, on the Central Coast of Peru comprised local or non-local individuals through an analysis of cranial nonmetric traits using comparative samples from the North and Central Coasts of Peru and Chile; and to test the utility of machine-learning-based image segmentation in the image analysis software, Dragonfly, to automatically segment CT scans of the mummies such that the cranial nonmetric traits are visible. Results show that while fully automated segmentation was not achieved, a semi-automated procedure was adequate for visualizing and scoring the skulls and saved time over manual segmentation methods. The sample from Pachacamac was too small to make significant inter-site comparisons, but a broader regional analysis suggests there are significant biological differences between geographical regions along the coast

Proceedings, MSVSCC 2018

Proceedings of the 12th Annual Modeling, Simulation & Visualization Student Capstone Conference held on April 19, 2018 at VMASC in Suffolk, Virginia. 155 pp

Semi-automatic GUI platform to characterize brain development in preterm children using ultrasound images

The third trimester of pregnancy is the most critical period for human brain development, during which significant changes occur in the morphology of the brain. The development of sulci and gyri allows for a considerable increase in the brain surface. In preterm newborns, these changes occur in an extrauterine environment that may cause a disruption of the normal brain maturation process. We hypothesize that a normalized atlas of brain maturation with cerebral ultrasound images from birth to term equivalent age will help clinicians assess these changes. This work proposes a semi-automatic Graphical User Interface (GUI) platform for segmenting the main cerebral sulci in the clinical setting from ultrasound images. This platform has been obtained from images of a cerebral ultrasound neonatal database images provided by two clinical researchers from the Hospital Sant Joan de Déu in Barcelona, Spain. The primary objective is to provide a user-friendly design platform for clinicians for running and visualizing an atlas of images validated by medical experts. This GUI offers different segmentation approaches and pre-processing tools and is user-friendly and designed for running, visualizing images, and segmenting the principal sulci. The presented results are discussed in detail in this paper, providing an exhaustive analysis of the proposed approach’s effectiveness.Peer ReviewedPostprint (published version

Multimodal MRI analysis using deep learning methods

Magnetic resonance imaging (MRI) has been widely used in scientific and clinical research. It is a non-invasive medical imaging technique that reveals anatomical structures and provides useful information for investigators to explore aging and pathological processes. Different MR modalities offer different useful properties. Automatic MRI analysis algorithms have been developed to address problems in many applications such as classification, segmentation, and disease diagnosis. Segmentation and labeling algorithms applied to brain MRIs enable evaluations of the volumetric changes of specific structures in neurodegenerative diseases. Reconstruction of fiber orientations using diffusion MRI is beneficial to obtain better understanding of the underlying structures. In this thesis, we focused on development of deep learning methods for MRI analysis using different image modalities. Specifically, we applied deep learning techniques on different applications, including segmentation of brain structures and reconstruction of tongue muscle fiber orientations. For segmentation of brain structures, we developed an end-to-end deep learning algorithm for ventricle parcellation of brains with ventriculomegaly using T1-w MR images. The deep network provides robust and accurate segmentation results in subjects with high variability in ventricle shapes and sizes. We developed another deep learning method to automatically parcellate the thalamus into a set of thalamic nuclei using T1-w MRI and features from diffusion MRI. The algorithm incorporates a harmonization step to make the network adapt to input images with different contrasts. We also studied the strains associated with tongue muscles during speech production using multiple MRI modalities. To enable this study, we first developed a deep network to reconstruct crossing tongue muscle fiber orientations using diffusion MRI. The network was specifically designed for the human tongue and accounted for the orthogonality property of the tongue muscles. Next, we proposed a comprehensive pipeline to analyze the strains associated with tongue muscle fiber orientations during speech using diffusion MRI, and tagged and cine MRI. The proposed pipeline provides a solution to analyze the cooperation between muscle groups during speech production

The structural neurobiology of social anxiety disorder : a clinical neuroimaging study

Includes bibliographical referencesWhile a number of studies have explored the functional neuroanatomy of social anxiety disorder (SAD), comparatively few studies have investigated the structural underpinnings in SAD. 18 psychopharmacologically and psychotherapeutically naïve adult patients with a primary Axis I diagnosis of generalized social anxiety disorder and 18 demographically (age, gender and education) matched healthy controls underwent 3T structural magnetic resonance imaging. A manual tracing protocol was specifically developed to compute the volume of the most prominent subcortical gray matter structures implicated in SAD by previous functional research. Cortical thickness was estimated using an automated algorithm and whole brain analyses of white matter structure were performed using FSL's tract - based spatial statistics comparing fractional anisotropy (FA), mean diffusivity (MD) in individuals with SAD. Manual tracing demonstrated that compared to controls, SAD patients showed an enlarged right globus pallidus. Cortical thickness analyses demonstrated significant cortical thinning in the left isthmus of the cingulate gyrus, the left temporal pole, and the left superior temporal gyrus. Analyses of white matter tractographic data demonstrated reduced FA in in the genu, splenium and tapetum of the corpus callosum. Additionally reduced FA was noticed in the fornix and the right cingulum. Reduced FA was also noted in bilateral corticospinal tracts and the right corona radiata. The results demonstrate structural alterations in limbic circuitry as well as involvement of the basal glanglia and their cortical projections and input pathways