A Survey on Deep Learning in Medical Image Analysis

Deep learning algorithms, in particular convolutional networks, have rapidly become a methodology of choice for analyzing medical images. This paper reviews the major deep learning concepts pertinent to medical image analysis and summarizes over 300 contributions to the field, most of which appeared in the last year. We survey the use of deep learning for image classification, object detection, segmentation, registration, and other tasks and provide concise overviews of studies per application area. Open challenges and directions for future research are discussed.Comment: Revised survey includes expanded discussion section and reworked introductory section on common deep architectures. Added missed papers from before Feb 1st 201

Bayesian inference for structured additive regression models for large-scale problems with applications to medical imaging

In der angewandten Statistik können Regressionsmodelle mit hochdimensionalen Koeffizienten auftreten, die sich nicht mit gewöhnlichen Computersystemen schätzen lassen. Dies betrifft unter anderem die Analyse digitaler Bilder unter Berücksichtigung räumlich-zeitlicher Abhängigkeiten, wie sie innerhalb der medizinisch-biologischen Forschung häufig vorkommen. In der vorliegenden Arbeit wird ein Verfahren formuliert, das in der Lage ist, Regressionsmodelle mit hochdimensionalen Koeffizienten und nicht-normalverteilten Zielgrößen unter moderaten Anforderungen an die benötigte Hardware zu schätzen. Hierzu wird zunächst im Rahmen strukturiert additiver Regressionsmodelle aufgezeigt, worin die Limitationen aktueller Inferenzansätze bei der Anwendung auf hochdimensionale Problemstellungen liegen, sowie Möglichkeiten diskutiert, diese zu umgehen. Darauf basierend wird ein Algorithmus formuliert, dessen Stärken und Schwächen anhand von Simulationsstudien analysiert werden. Darüber hinaus findet das Verfahren Anwendung in drei verschiedenen Bereichen der medizinisch-biologischen Bildgebung und zeigt dadurch, dass es ein vielversprechender Kandidat für die Beantwortung hochdimensionaler Fragestellungen ist.In applied statistics regression models with high-dimensional coefficients can occur which cannot be estimated using ordinary computers. Amongst others, this applies to the analysis of digital images taking spatio-temporal dependencies into account as they commonly occur within bio-medical research. In this thesis a procedure is formulated which allows to fit regression models with high-dimensional coefficients and non-normal response values requiring only moderate computational equipment. To this end, limitations of different inference strategies for structured additive regression models are demonstrated when applied to high-dimensional problems and possible solutions are discussed. Based thereon an algorithm is formulated whose strengths and weaknesses are subsequently analyzed using simulation studies. Furthermore, the procedure is applied to three different fields of bio-medical imaging from which can be concluded that the algorithm is a promising candidate for answering high-dimensional problems

Deep learning for fast and robust medical image reconstruction and analysis

Medical imaging is an indispensable component of modern medical research as well as clinical practice. Nevertheless, imaging techniques such as magnetic resonance imaging (MRI) and computational tomography (CT) are costly and are less accessible to the majority of the world. To make medical devices more accessible, affordable and efficient, it is crucial to re-calibrate our current imaging paradigm for smarter imaging. In particular, as medical imaging techniques have highly structured forms in the way they acquire data, they provide us with an opportunity to optimise the imaging techniques holistically by leveraging data. The central theme of this thesis is to explore different opportunities where we can exploit data and deep learning to improve the way we extract information for better, faster and smarter imaging. This thesis explores three distinct problems. The first problem is the time-consuming nature of dynamic MR data acquisition and reconstruction. We propose deep learning methods for accelerated dynamic MR image reconstruction, resulting in up to 10-fold reduction in imaging time. The second problem is the redundancy in our current imaging pipeline. Traditionally, imaging pipeline treated acquisition, reconstruction and analysis as separate steps. However, we argue that one can approach them holistically and optimise the entire pipeline jointly for a specific target goal. To this end, we propose deep learning approaches for obtaining high fidelity cardiac MR segmentation directly from significantly undersampled data, greatly exceeding the undersampling limit for image reconstruction. The final part of this thesis tackles the problem of interpretability of the deep learning algorithms. We propose attention-models that can implicitly focus on salient regions in an image to improve accuracy for ultrasound scan plane detection and CT segmentation. More crucially, these models can provide explainability, which is a crucial stepping stone for the harmonisation of smart imaging and current clinical practice.Open Acces

Sparse reduced-rank regression for imaging genetics studies: models and applications

We present a novel statistical technique; the sparse reduced rank regression (sRRR) model which is a strategy for multivariate modelling of high-dimensional imaging responses and genetic predictors. By adopting penalisation techniques, the model is able to enforce sparsity in the regression coefficients, identifying subsets of genetic markers that best explain the variability observed in subsets of the phenotypes. To properly exploit the rich structure present in each of the imaging and genetics domains, we additionally propose the use of several structured penalties within the sRRR model. Using simulation procedures that accurately reflect realistic imaging genetics data, we present detailed evaluations of the sRRR method in comparison with the more traditional univariate linear modelling approach. In all settings considered, we show that sRRR possesses better power to detect the deleterious genetic variants. Moreover, using a simple genetic model, we demonstrate the potential benefits, in terms of statistical power, of carrying out voxel-wise searches as opposed to extracting averages over regions of interest in the brain. Since this entails the use of phenotypic vectors of enormous dimensionality, we suggest the use of a sparse classification model as a de-noising step, prior to the imaging genetics study. Finally, we present the application of a data re-sampling technique within the sRRR model for model selection. Using this approach we are able to rank the genetic markers in order of importance of association to the phenotypes, and similarly rank the phenotypes in order of importance to the genetic markers. In the very end, we illustrate the application perspective of the proposed statistical models in three real imaging genetics datasets and highlight some potential associations

Low-Rank Atlas Image Analyses in the Presence of Pathologies

We present a common framework, for registering images to an atlas and for forming an unbiased atlas, that tolerates the presence of pathologies such as tumors and traumatic brain injury lesions. This common framework is particularly useful when a sufficient number of protocol-matched scans from healthy subjects cannot be easily acquired for atlas formation and when the pathologies in a patient cause large appearance changes

Multimodal Data Fusion and Quantitative Analysis for Medical Applications

Medical big data is not only enormous in its size, but also heterogeneous and complex in its data structure, which makes conventional systems or algorithms difficult to process. These heterogeneous medical data include imaging data (e.g., Positron Emission Tomography (PET), Computerized Tomography (CT), Magnetic Resonance Imaging (MRI)), and non-imaging data (e.g., laboratory biomarkers, electronic medical records, and hand-written doctor notes). Multimodal data fusion is an emerging vital field to address this urgent challenge, aiming to process and analyze the complex, diverse and heterogeneous multimodal data. The fusion algorithms bring great potential in medical data analysis, by 1) taking advantage of complementary information from different sources (such as functional-structural complementarity of PET/CT images) and 2) exploiting consensus information that reflects the intrinsic essence (such as the genetic essence underlying medical imaging and clinical symptoms). Thus, multimodal data fusion benefits a wide range of quantitative medical applications, including personalized patient care, more optimal medical operation plan, and preventive public health. Though there has been extensive research on computational approaches for multimodal fusion, there are three major challenges of multimodal data fusion in quantitative medical applications, which are summarized as feature-level fusion, information-level fusion and knowledge-level fusion: • Feature-level fusion. The first challenge is to mine multimodal biomarkers from high-dimensional small-sample multimodal medical datasets, which hinders the effective discovery of informative multimodal biomarkers. Specifically, efficient dimension reduction algorithms are required to alleviate "curse of dimensionality" problem and address the criteria for discovering interpretable, relevant, non-redundant and generalizable multimodal biomarkers. • Information-level fusion. The second challenge is to exploit and interpret inter-modal and intra-modal information for precise clinical decisions. Although radiomics and multi-branch deep learning have been used for implicit information fusion guided with supervision of the labels, there is a lack of methods to explicitly explore inter-modal relationships in medical applications. Unsupervised multimodal learning is able to mine inter-modal relationship as well as reduce the usage of labor-intensive data and explore potential undiscovered biomarkers; however, mining discriminative information without label supervision is an upcoming challenge. Furthermore, the interpretation of complex non-linear cross-modal associations, especially in deep multimodal learning, is another critical challenge in information-level fusion, which hinders the exploration of multimodal interaction in disease mechanism. • Knowledge-level fusion. The third challenge is quantitative knowledge distillation from multi-focus regions on medical imaging. Although characterizing imaging features from single lesions using either feature engineering or deep learning methods have been investigated in recent years, both methods neglect the importance of inter-region spatial relationships. Thus, a topological profiling tool for multi-focus regions is in high demand, which is yet missing in current feature engineering and deep learning methods. Furthermore, incorporating domain knowledge with distilled knowledge from multi-focus regions is another challenge in knowledge-level fusion. To address the three challenges in multimodal data fusion, this thesis provides a multi-level fusion framework for multimodal biomarker mining, multimodal deep learning, and knowledge distillation from multi-focus regions. Specifically, our major contributions in this thesis include: • To address the challenges in feature-level fusion, we propose an Integrative Multimodal Biomarker Mining framework to select interpretable, relevant, non-redundant and generalizable multimodal biomarkers from high-dimensional small-sample imaging and non-imaging data for diagnostic and prognostic applications. The feature selection criteria including representativeness, robustness, discriminability, and non-redundancy are exploited by consensus clustering, Wilcoxon filter, sequential forward selection, and correlation analysis, respectively. SHapley Additive exPlanations (SHAP) method and nomogram are employed to further enhance feature interpretability in machine learning models. • To address the challenges in information-level fusion, we propose an Interpretable Deep Correlational Fusion framework, based on canonical correlation analysis (CCA) for 1) cohesive multimodal fusion of medical imaging and non-imaging data, and 2) interpretation of complex non-linear cross-modal associations. Specifically, two novel loss functions are proposed to optimize the discovery of informative multimodal representations in both supervised and unsupervised deep learning, by jointly learning inter-modal consensus and intra-modal discriminative information. An interpretation module is proposed to decipher the complex non-linear cross-modal association by leveraging interpretation methods in both deep learning and multimodal consensus learning. • To address the challenges in knowledge-level fusion, we proposed a Dynamic Topological Analysis framework, based on persistent homology, for knowledge distillation from inter-connected multi-focus regions in medical imaging and incorporation of domain knowledge. Different from conventional feature engineering and deep learning, our DTA framework is able to explicitly quantify inter-region topological relationships, including global-level geometric structure and community-level clusters. K-simplex Community Graph is proposed to construct the dynamic community graph for representing community-level multi-scale graph structure. The constructed dynamic graph is subsequently tracked with a novel Decomposed Persistence algorithm. Domain knowledge is incorporated into the Adaptive Community Profile, summarizing the tracked multi-scale community topology with additional customizable clinically important factors