Trustworthy Deep Learning for Medical Image Segmentation

Despite the recent success of deep learning methods at achieving new state-of-the-art accuracy for medical image segmentation, some major limitations are still restricting their deployment into clinics. One major limitation of deep learning-based segmentation methods is their lack of robustness to variability in the image acquisition protocol and in the imaged anatomy that were not represented or were underrepresented in the training dataset. This suggests adding new manually segmented images to the training dataset to better cover the image variability. However, in most cases, the manual segmentation of medical images requires highly skilled raters and is time-consuming, making this solution prohibitively expensive. Even when manually segmented images from different sources are available, they are rarely annotated for exactly the same regions of interest. This poses an additional challenge for current state-of-the-art deep learning segmentation methods that rely on supervised learning and therefore require all the regions of interest to be segmented for all the images to be used for training. This thesis introduces new mathematical and optimization methods to mitigate those limitations.Comment: PhD thesis successfully defended on 1st July 2022. Examiners: Prof Sotirios Tsaftaris and Dr Wenjia Ba

Multi-Atlas Segmentation of Biomedical Images: A Survey

Abstract Multi-atlas segmentation (MAS), first introduced and popularized by the pioneering work of Rohlfing

Deep learning of brain asymmetry digital biomarkers to support early diagnosis of cognitive decline and dementia

Early identification of degenerative processes in the human brain is essential for proper care and treatment. This may involve different instrumental diagnostic methods, including the most popular computer tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) scans. These technologies provide detailed information about the shape, size, and function of the human brain. Structural and functional cerebral changes can be detected by computational algorithms and used to diagnose dementia and its stages (amnestic early mild cognitive impairment - EMCI, Alzheimer’s Disease - AD). They can help monitor the progress of the disease. Transformation shifts in the degree of asymmetry between the left and right hemispheres illustrate the initialization or development of a pathological process in the brain. In this vein, this study proposes a new digital biomarker for the diagnosis of early dementia based on the detection of image asymmetries and crosssectional comparison of NC (normal cognitively), EMCI and AD subjects. Features of brain asymmetries extracted from MRI of the ADNI and OASIS databases are used to analyze structural brain changes and machine learning classification of the pathology. The experimental part of the study includes results of supervised machine learning algorithms and transfer learning architectures of convolutional neural networks for distinguishing between cognitively normal subjects and patients with early or progressive dementia. The proposed pipeline offers a low-cost imaging biomarker for the classification of dementia. It can be potentially helpful to other brain degenerative disorders accompanied by changes in brain asymmetries

Application of Deep Learning to Brain Connectivity Classification in Large MRI Datasets

The use of machine learning for whole-brain classification of magnetic resonance imaging (MRI) data is of clear interest, both for understanding phenotypic differences in brain structure and function and for diagnostic applications. Developments of deep learning models in the past decade have revolutionized photographic image and speech recognition, bringing promise to do the same to other fields of science. However, there are many practical and theoretical challenges in the translation of such methods to the unique context of MRIs of the brain. This thesis presents a theoretical underpinning for whole-brain classification of extremely large datasets of multi-site MRIs, including machine learning model architecture, dataset curation methods, machine learning visualization methods, encoding of MRI data, and feature extraction. To replicate large sample sizes typically applied to deep learning models, a dataset of over 50,000 functional and structural MRIs was amassed from nine different databases, and the undertaken analyses were conducted on three covariates commonly found across these collections: sex, resting state/task, and autism spectrum disorder. I find that deep learning is not only a method that has promise for clinical application in the future, but also a powerful statistical tool for analyzing complex, nonlinear relationships in brain data where conventional statistics may fail. However, results are also dependent on factors such as dataset imbalances, confounding factors such as motion and head size, selected methods of encoding MRI data, variability of machine learning models and selected methods of visualizing the machine learning results. In this thesis, I present the following methodological innovations: (1) a method of balancing datasets as a means of regressing out measurable confounding factors; (2) a means of removing spatial biases from deep learning visualization methods; (3) methods of encoding functional and structural datasets as connectivity matrices; (4) the use of ensemble models and convolutional neural network architectures to improve classification accuracy and consistency; (5) adaptation of deep learning visualization methods to study brain connections utilized in the classification process. Additionally, I discuss interpretations, limitations, and future directions of this research.Gates Cambridge Scholarshi

Learning from Complex Neuroimaging Datasets

Advancements in Magnetic Resonance Imaging (MRI) allowed for the early diagnosis of neurodevelopmental disorders and neurodegenerative diseases. Neuroanatomical abnormalities in the cerebral cortex are often investigated by examining group-level differences of brain morphometric measures extracted from highly-sampled cortical surfaces. However, group-level differences do not allow for individual-level outcome prediction critical for the application to clinical practice. Despite the success of MRI-based deep learning frameworks, critical issues have been identified: (1) extracting accurate and reliable local features from the cortical surface, (2) determining a parsimonious subset of cortical features for correct disease diagnosis, (3) learning directly from a non-Euclidean high-dimensional feature space, (4) improving the robustness of multi-task multi-modal models, and (5) identifying anomalies in imbalanced and heterogeneous settings. This dissertation describes novel methodological contributions to tackle the challenges above. First, I introduce a Laplacian-based method for quantifying local Extra-Axial Cerebrospinal Fluid (EA-CSF) from structural MRI. Next, I describe a deep learning approach for combining local EA-CSF with other morphometric cortical measures for early disease detection. Then, I propose a data-driven approach for extending convolutional learning to non-Euclidean manifolds such as cortical surfaces. I also present a unified framework for robust multi-task learning from imaging and non-imaging information. Finally, I propose a semi-supervised generative approach for the detection of samples from untrained classes in imbalanced and heterogeneous developmental datasets. The proposed methodological contributions are evaluated by applying them to the early detection of Autism Spectrum Disorder (ASD) in the first year of the infant’s life. Also, the aging human brain is examined in the context of studying different stages of Alzheimer’s Disease (AD).Doctor of Philosoph