Ensemble Methods for Multi-Organ Segmentation in CT Series

In the medical images field, semantic segmentation is one of the most important, yet difficult and time-consuming tasks to be performed by physicians. Thanks to the recent advancement in the Deep Learning models regarding Computer Vision, the promise to automate this kind of task is getting more and more realistic. However, many problems are still to be solved, like the scarce availability of data and the difficulty to extend the efficiency of highly specialised models to general scenarios. Organs at risk segmentation for radiotherapy treatment planning falls in this category, as the limited data available negatively affects the possibility to develop general-purpose models; in this work, we focus on the possibility to solve this problem by presenting three types of ensembles of single-organ models able to produce multi-organ masks exploiting the different specialisations of their components. The results obtained are promising and prove that this is a possible solution to finding efficient multi-organ segmentation methods

How molecular imaging will enable robotic precision surgery: the role of artificial intelligence, augmented reality, and navigation

Molecular imaging is one of the pillars of precision surgery. Its applications range from early diagnostics to therapy planning, execution, and the accurate assessment of outcomes. In particular, molecular imaging solutions are in high demand in minimally invasive surgical strategies, such as the substantially increasing field of robotic surgery. This review aims at connecting the molecular imaging and nuclear medicine community to the rapidly expanding armory of surgical medical devices. Such devices entail technologies ranging from artificial intelligence and computer-aided visualization technologies (software) to innovative molecular imaging modalities and surgical navigation (hardware). We discuss technologies based on their role at different steps of the surgical workflow, i.e., from surgical decision and planning, over to target localization and excision guidance, all the way to (back table) surgical verification. This provides a glimpse of how innovations from the technology fields can realize an exciting future for the molecular imaging and surgery communities.Imaging- and therapeutic targets in neoplastic and musculoskeletal inflammatory diseas

MEDICAL MACHINE INTELLIGENCE: DATA-EFFICIENCY AND KNOWLEDGE-AWARENESS

Traditional clinician diagnosis requires massive manual labor from experienced doctors, which is time-consuming and costly. Computer-aided systems are therefore proposed to reduce doctors’ efforts by using machines to automatically make diagnosis and treatment recommendations. The recent success in deep learning has largely advanced the field of computer-aided diagnosis by offering an avenue to deliver automated medical image analysis. Despite such progress, there remain several challenges towards medical machine intelligence, such as unsatisfactory performance regarding challenging small targets, insufficient training data, high annotation cost, the lack of domain-specific knowledge, etc. These challenges cultivate the need for developing data-efficient and knowledge-aware deep learning techniques which can generalize to different medical tasks without requiring intensive manual labeling efforts, and incorporate domain-specific knowledge in the learning process. In this thesis, we rethink the current progress of deep learning in medical image analysis, with a focus on the aforementioned challenges, and present different data-efficient and knowledge-aware deep learning approaches to address them accordingly. Firstly, we introduce coarse-to-fine mechanisms which use the prediction from the first (coarse) stage to shrink the input region for the second (fine) stage, to enhance the model performance especially for segmenting small challenging structures, such as the pancreas which occupies only a very small fraction (e.g., < 0.5%) of the entire CT volume. The method achieved the state-of-the-art result on the NIH pancreas segmentation dataset. Further extensions also demonstrated effectiveness for segmenting neoplasms such as pancreatic cysts or multiple organs. Secondly, we present a semi-supervised learning framework for medical image segmentation by leveraging both limited labeled data and abundant unlabeled data. Our learning method encourages the segmentation output to be consistent for the same input under different viewing conditions. More importantly, the outputs from different viewing directions are fused altogether to improve the quality of the target, which further enhances the overall performance. The comparison with fully-supervised methods on multi-organ segmentation confirms the effectiveness of this method. Thirdly, we discuss how to incorporate knowledge priors for multi-organ segmentation. Noticing that the abdominal organ sizes exhibit similar distributions across different cohorts, we propose to explicitly incorporate anatomical priors on abdominal organ sizes, guiding the training process with domain-specific knowledge. The approach achieves 84.97% on the MICCAI 2015 challenge “Multi-Atlas Labeling Beyond the Cranial Vault”, which significantly outperforms previous state-of-the-art even using fewer annotations. Lastly, by rethinking how radiologists interpret medical images, we identify one limitation for existing deep-learning-based works on detecting pancreatic ductal adenocarcinoma is the lack of knowledge integration from multi-phase images. Thereby, we introduce a dual-path network where different paths are connected for multi-phase information exchange, and an additional loss is added for removing view divergence. By effectively incorporating multi-phase information, the presented method shows superior performance than prior arts on this matter