Developing Ultrasound-Based Computer-Aided Diagnostic Systems Through Statistical Pattern Recognition

Computer-aided diagnosis (CAD) is the use of a computer software to help physicians having a better interpretation of medical images. CAD systems can be viewed as pattern recognition algorithms that identify suspicious signs on a medical image and complement physicians' judgments, by reducing inter-/intra-observer variability and subjectivity. The proposed CAD systems in this thesis have been designed based on the statistical approach to pattern recognition as the most successfully used technique in practice. The main focus of this thesis has been on designing (new) feature extraction and classification algorithms for ultrasound-based CAD purposes. Ultrasound imaging has a broad range of usage in medical applications because it is a safe device which does not use harmful ionizing radiations, it provides clinicians with real-time images, it is portable and relatively cheap. The thesis was concerned with developing new ultrasound-based systems for the diagnosis of prostate cancer (PCa) and myocardial infarction (MI) where these issues have been addressed in two separate parts. In the first part, 1) a new CAD system was designed for prostate cancer biopsy by focusing on handling uncertainties in labels of the ground truth data, 2) the appropriateness of the independent component analysis (ICA) method for learning features from radiofrequency (RF) signals, backscattered from prostate tissues, was examined and, 3) a new ensemble scheme for learning ICA dictionaries from RF signals, backscattered from a tissue mimicking phantom, was proposed. In the second part, 1) principal component analysis (PCA) was used for the statistical modeling of the temporal deformation patterns of the left ventricle (LV) to detect abnormalities in its regional function, 2) a spatio-temporal representation of LV function based on PCA parameters was proposed to detect MI and, 3) a local-to-global statistical shape model based on PCA was presented to detect MI

Prospects for Theranostics in Neurosurgical Imaging: Empowering Confocal Laser Endomicroscopy Diagnostics via Deep Learning

Confocal laser endomicroscopy (CLE) is an advanced optical fluorescence imaging technology that has the potential to increase intraoperative precision, extend resection, and tailor surgery for malignant invasive brain tumors because of its subcellular dimension resolution. Despite its promising diagnostic potential, interpreting the gray tone fluorescence images can be difficult for untrained users. In this review, we provide a detailed description of bioinformatical analysis methodology of CLE images that begins to assist the neurosurgeon and pathologist to rapidly connect on-the-fly intraoperative imaging, pathology, and surgical observation into a conclusionary system within the concept of theranostics. We present an overview and discuss deep learning models for automatic detection of the diagnostic CLE images and discuss various training regimes and ensemble modeling effect on the power of deep learning predictive models. Two major approaches reviewed in this paper include the models that can automatically classify CLE images into diagnostic/nondiagnostic, glioma/nonglioma, tumor/injury/normal categories and models that can localize histological features on the CLE images using weakly supervised methods. We also briefly review advances in the deep learning approaches used for CLE image analysis in other organs. Significant advances in speed and precision of automated diagnostic frame selection would augment the diagnostic potential of CLE, improve operative workflow and integration into brain tumor surgery. Such technology and bioinformatics analytics lend themselves to improved precision, personalization, and theranostics in brain tumor treatment.Comment: See the final version published in Frontiers in Oncology here: https://www.frontiersin.org/articles/10.3389/fonc.2018.00240/ful

Pattern recognition systems design on parallel GPU architectures for breast lesions characterisation employing multimodality images

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University London.The aim of this research was to address the computational complexity in designing multimodality Computer-Aided Diagnosis (CAD) systems for characterising breast lesions, by harnessing the general purpose computational potential of consumer-level Graphics Processing Units (GPUs) through parallel programming methods. The complexity in designing such systems lies on the increased dimensionality of the problem, due to the multiple imaging modalities involved, on the inherent complexity of optimal design methods for securing high precision, and on assessing the performance of the design prior to deployment in a clinical environment, employing unbiased system evaluation methods. For the purposes of this research, a Pattern Recognition (PR)-system was designed to provide highest possible precision by programming in parallel the multiprocessors of the NVIDIA’s GPU-cards, GeForce 8800GT or 580GTX, and using the CUDA programming framework and C++. The PR-system was built around the Probabilistic Neural Network classifier and its performance was evaluated by a re-substitution method, for estimating the system’s highest accuracy, and by the external cross validation method, for assessing the PR-system’s unbiased accuracy to new, “unseen” by the system, data. Data comprised images of patients with histologically verified (benign or malignant) breast lesions, who underwent both ultrasound (US) and digital mammography (DM). Lesions were outlined on the images by an experienced radiologist, and textural features were calculated. Regarding breast lesion classification, the accuracies for discriminating malignant from benign lesions were, 85.5% using US-features alone, 82.3% employing DM-features alone, and 93.5% combining US and DM features. Mean accuracy to new “unseen” data for the combined US and DM features was 81%. Those classification accuracies were about 10% higher than accuracies achieved on a single CPU, using sequential programming methods, and 150-fold faster. In addition, benign lesions were found smoother, more homogeneous, and containing larger structures. Additionally, the PR-system design was adapted for tackling other medical problems, as a proof of its generalisation. These included classification of rare brain tumours, (achieving 78.6% for overall accuracy (OA) and 73.8% for estimated generalisation accuracy (GA), and accelerating system design 267 times), discrimination of patients with micro-ischemic and multiple sclerosis lesions (90.2% OA and 80% GA with 32-fold design acceleration), classification of normal and pathological knee cartilages (93.2% OA and 89% GA with 257-fold design acceleration), and separation of low from high grade laryngeal cancer cases (93.2% OA and 89% GA, with 130-fold design acceleration). The proposed PR-system improves breast-lesion discrimination accuracy, it may be redesigned on site when new verified data are incorporated in its depository, and it may serve as a second opinion tool in a clinical environment

A non-invasive diagnostic system for early assessment of acute renal transplant rejection.

Early diagnosis of acute renal transplant rejection (ARTR) is of immense importance for appropriate therapeutic treatment administration. Although the current diagnostic technique is based on renal biopsy, it is not preferred due to its invasiveness, recovery time (1-2 weeks), and potential for complications, e.g., bleeding and/or infection. In this thesis, a computer-aided diagnostic (CAD) system for early detection of ARTR from 4D (3D + b-value) diffusion-weighted (DW) MRI data is developed. The CAD process starts from a 3D B-spline-based data alignment (to handle local deviations due to breathing and heart beat) and kidney tissue segmentation with an evolving geometric (level-set-based) deformable model. The latter is guided by a voxel-wise stochastic speed function, which follows from a joint kidney-background Markov-Gibbs random field model accounting for an adaptive kidney shape prior and for on-going visual kidney-background appearances. A cumulative empirical distribution of apparent diffusion coefficient (ADC) at different b-values of the segmented DW-MRI is considered a discriminatory transplant status feature. Finally, a classifier based on deep learning of a non-negative constrained stacked auto-encoder is employed to distinguish between rejected and non-rejected renal transplants. In the “leave-one-subject-out” experiments on 53 subjects, 98% of the subjects were correctly classified (namely, 36 out of 37 rejected transplants and 16 out of 16 nonrejected ones). Additionally, a four-fold cross-validation experiment was performed, and an average accuracy of 96% was obtained. These experimental results hold promise of the proposed CAD system as a reliable non-invasive diagnostic tool

Diffusion-weighted magnetic resonance imaging in diagnosing graft dysfunction : a non-invasive alternative to renal biopsy.

The thesis is divided into three parts. The first part focuses on background information including how the kidney functions, diseases, and available kidney disease treatment strategies. In addition, the thesis provides information on imaging instruments and how they can be used to diagnose renal graft dysfunction. The second part focuses on elucidating the parameters linked with highly accurate diagnosis of rejection. Four parameters categories were tested: clinical biomarkers alone, individual mean apparent diffusion coefficient (ADC) at 11-different b- values, mean ADCs of certain groups of b-value, and fusion of clinical biomarkers and all b-values. The most accurate model was found to be when the b-value of b=100 s/mm2 and b=700 s/mm2 were fused. The third part of this thesis focuses on a study that uses Diffusion-Weighted MRI to diagnose and differentiate two types of renal rejection. The system was found to correctly differentiate the two types of rejection with a 98% accuracy. The last part of this thesis concludes the work that has been done and states the possible trends and future avenues