Deep learning for image-based liver analysis — A comprehensive review focusing on malignant lesions

Deep learning-based methods, in particular, convolutional neural networks and fully convolutional networks are now widely used in the medical image analysis domain. The scope of this review focuses on the analysis using deep learning of focal liver lesions, with a special interest in hepatocellular carcinoma and metastatic cancer; and structures like the parenchyma or the vascular system. Here, we address several neural network architectures used for analyzing the anatomical structures and lesions in the liver from various imaging modalities such as computed tomography, magnetic resonance imaging and ultrasound. Image analysis tasks like segmentation, object detection and classification for the liver, liver vessels and liver lesions are discussed. Based on the qualitative search, 91 papers were filtered out for the survey, including journal publications and conference proceedings. The papers reviewed in this work are grouped into eight categories based on the methodologies used. By comparing the evaluation metrics, hybrid models performed better for both the liver and the lesion segmentation tasks, ensemble classifiers performed better for the vessel segmentation tasks and combined approach performed better for both the lesion classification and detection tasks. The performance was measured based on the Dice score for the segmentation, and accuracy for the classification and detection tasks, which are the most commonly used metrics.publishedVersio

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