Computer-aided detection of lung nodules: A review

We present an in-depth review and analysis of salient methods for computer-aided detection of lung nodules. We evaluate the current methods for detecting lung nodules using literature searches with selection criteria based on validation dataset types, nodule sizes, numbers of cases, types of nodules, extracted features in traditional feature-based classifiers, sensitivity, and false positives (FP)/scans. Our review shows that current detection systems are often optimized for particular datasets and can detect only one or two types of nodules. We conclude that, in addition to achieving high sensitivity and reduced FP/scans, strategies for detecting lung nodules must detect a variety of nodules with high precision to improve the performances of the radiologists. To the best of our knowledge, ours is the first review of the effectiveness of feature extraction using traditional feature-based classifiers. Moreover, we discuss deep-learning methods in detail and conclude that features must be appropriately selected to improve the overall accuracy of the system. We present an analysis of current schemes and highlight constraints and future research areas

Cancer diagnosis using deep learning: A bibliographic review

In this paper, we first describe the basics of the field of cancer diagnosis, which includes steps of cancer diagnosis followed by the typical classification methods used by doctors, providing a historical idea of cancer classification techniques to the readers. These methods include Asymmetry, Border, Color and Diameter (ABCD) method, seven-point detection method, Menzies method, and pattern analysis. They are used regularly by doctors for cancer diagnosis, although they are not considered very efficient for obtaining better performance. Moreover, considering all types of audience, the basic evaluation criteria are also discussed. The criteria include the receiver operating characteristic curve (ROC curve), Area under the ROC curve (AUC), F1 score, accuracy, specificity, sensitivity, precision, dice-coefficient, average accuracy, and Jaccard index. Previously used methods are considered inefficient, asking for better and smarter methods for cancer diagnosis. Artificial intelligence and cancer diagnosis are gaining attention as a way to define better diagnostic tools. In particular, deep neural networks can be successfully used for intelligent image analysis. The basic framework of how this machine learning works on medical imaging is provided in this study, i.e., pre-processing, image segmentation and post-processing. The second part of this manuscript describes the different deep learning techniques, such as convolutional neural networks (CNNs), generative adversarial models (GANs), deep autoencoders (DANs), restricted Boltzmann’s machine (RBM), stacked autoencoders (SAE), convolutional autoencoders (CAE), recurrent neural networks (RNNs), long short-term memory (LTSM), multi-scale convolutional neural network (M-CNN), multi-instance learning convolutional neural network (MIL-CNN). For each technique, we provide Python codes, to allow interested readers to experiment with the cited algorithms on their own diagnostic problems. The third part of this manuscript compiles the successfully applied deep learning models for different types of cancers. Considering the length of the manuscript, we restrict ourselves to the discussion of breast cancer, lung cancer, brain cancer, and skin cancer. The purpose of this bibliographic review is to provide researchers opting to work in implementing deep learning and artificial neural networks for cancer diagnosis a knowledge from scratch of the state-of-the-art achievements

Computational methods for the analysis of functional 4D-CT chest images.

Medical imaging is an important emerging technology that has been intensively used in the last few decades for disease diagnosis and monitoring as well as for the assessment of treatment effectiveness. Medical images provide a very large amount of valuable information that is too huge to be exploited by radiologists and physicians. Therefore, the design of computer-aided diagnostic (CAD) system, which can be used as an assistive tool for the medical community, is of a great importance. This dissertation deals with the development of a complete CAD system for lung cancer patients, which remains the leading cause of cancer-related death in the USA. In 2014, there were approximately 224,210 new cases of lung cancer and 159,260 related deaths. The process begins with the detection of lung cancer which is detected through the diagnosis of lung nodules (a manifestation of lung cancer). These nodules are approximately spherical regions of primarily high density tissue that are visible in computed tomography (CT) images of the lung. The treatment of these lung cancer nodules is complex, nearly 70% of lung cancer patients require radiation therapy as part of their treatment. Radiation-induced lung injury is a limiting toxicity that may decrease cure rates and increase morbidity and mortality treatment. By finding ways to accurately detect, at early stage, and hence prevent lung injury, it will have significant positive consequences for lung cancer patients. The ultimate goal of this dissertation is to develop a clinically usable CAD system that can improve the sensitivity and specificity of early detection of radiation-induced lung injury based on the hypotheses that radiated lung tissues may get affected and suffer decrease of their functionality as a side effect of radiation therapy treatment. These hypotheses have been validated by demonstrating that automatic segmentation of the lung regions and registration of consecutive respiratory phases to estimate their elasticity, ventilation, and texture features to provide discriminatory descriptors that can be used for early detection of radiation-induced lung injury. The proposed methodologies will lead to novel indexes for distinguishing normal/healthy and injured lung tissues in clinical decision-making. To achieve this goal, a CAD system for accurate detection of radiation-induced lung injury that requires three basic components has been developed. These components are the lung fields segmentation, lung registration, and features extraction and tissue classification. This dissertation starts with an exploration of the available medical imaging modalities to present the importance of medical imaging in today’s clinical applications. Secondly, the methodologies, challenges, and limitations of recent CAD systems for lung cancer detection are covered. This is followed by introducing an accurate segmentation methodology of the lung parenchyma with the focus of pathological lungs to extract the volume of interest (VOI) to be analyzed for potential existence of lung injuries stemmed from the radiation therapy. After the segmentation of the VOI, a lung registration framework is introduced to perform a crucial and important step that ensures the co-alignment of the intra-patient scans. This step eliminates the effects of orientation differences, motion, breathing, heart beats, and differences in scanning parameters to be able to accurately extract the functionality features for the lung fields. The developed registration framework also helps in the evaluation and gated control of the radiotherapy through the motion estimation analysis before and after the therapy dose. Finally, the radiation-induced lung injury is introduced, which combines the previous two medical image processing and analysis steps with the features estimation and classification step. This framework estimates and combines both texture and functional features. The texture features are modeled using the novel 7th-order Markov Gibbs random field (MGRF) model that has the ability to accurately models the texture of healthy and injured lung tissues through simultaneously accounting for both vertical and horizontal relative dependencies between voxel-wise signals. While the functionality features calculations are based on the calculated deformation fields, obtained from the 4D-CT lung registration, that maps lung voxels between successive CT scans in the respiratory cycle. These functionality features describe the ventilation, the air flow rate, of the lung tissues using the Jacobian of the deformation field and the tissues’ elasticity using the strain components calculated from the gradient of the deformation field. Finally, these features are combined in the classification model to detect the injured parts of the lung at an early stage and enables an earlier intervention

Automatic 3D pulmonary nodule detection in CT images: a survey

This work presents a systematic review of techniques for the 3D automatic detection of pulmonary nodules in computerized-tomography (CT) images. Its main goals are to analyze the latest technology being used for the development of computational diagnostic tools to assist in the acquisition, storage and, mainly, processing and analysis of the biomedical data. Also, this work identifies the progress made, so far, evaluates the challenges to be overcome and provides an analysis of future prospects. As far as the authors know, this is the first time that a review is devoted exclusively to automated 3D techniques for the detection of pulmonary nodules from lung CT images, which makes this work of noteworthy value. The research covered the published works in the Web of Science, PubMed, Science Direct and IEEEXplore up to December 2014. Each work found that referred to automated 3D segmentation of the lungs was individually analyzed to identify its objective, methodology and results. Based on the analysis of the selected works, several studies were seen to be useful for the construction of medical diagnostic aid tools. However, there are certain aspects that still require attention such as increasing algorithm sensitivity, reducing the number of false positives, improving and optimizing the algorithm detection of different kinds of nodules with different sizes and shapes and, finally, the ability to integrate with the Electronic Medical Record Systems and Picture Archiving and Communication Systems. Based on this analysis, we can say that further research is needed to develop current techniques and that new algorithms are needed to overcome the identified drawbacks

Automated classification of pulmonary nodules through a retrospective analysis of conventional CT and two-phase PET images in patients undergoing biopsy

Objective(s): Positron emission tomography/computed tomography (PET/CT) examination is commonly used for the evaluation of pulmonary nodules since it provides both anatomical and functional information. However, given the dependence of this evaluation on physician’s subjective judgment, the results could be variable. The purpose of this study was to develop an automated scheme for the classification of pulmonary nodules using early and delayed phase PET/ CT and conventional CT images.Methods: We analysed 36 early and delayed phase PET/CT images in patients who underwent both PET/CT scan and lung biopsy, following bronchoscopy. In addition, conventional CT images at maximal inspiration were analysed. The images consisted of 18 malignant and 18 benign nodules. For the classification scheme, 25 types of shape and functional features were first calculated from the images. The random forest algorithm, which is a machine learning technique, was used for classification.Results: The evaluation of the characteristic features and classification accuracy was accomplished using collected images. There was a significant difference between the characteristic features of benign and malignant nodules with regard to standardised uptake value and texture. In terms of classification performance, 94.4% of the malignant nodules were identified correctly assuming that 72.2% of the benign nodules were diagnosed accurately. The accuracy rate of benign nodule detection by means of CT plus two-phase PET images was 44.4% and 11.1% higher than those obtained by CT images alone and CT plus early phase PET images, respectively.Conclusion: Based on the findings, the proposed method may be useful to improve the accuracy of malignancy analysis

Machine Intelligence for Advanced Medical Data Analysis: Manifold Learning Approach

In the current work, linear and non-linear manifold learning techniques, specifically Principle Component Analysis (PCA) and Laplacian Eigenmaps, are studied in detail. Their applications in medical image and shape analysis are investigated. In the first contribution, a manifold learning-based multi-modal image registration technique is developed, which results in a unified intensity system through intensity transformation between the reference and sensed images. The transformation eliminates intensity variations in multi-modal medical scans and hence facilitates employing well-studied mono-modal registration techniques. The method can be used for registering multi-modal images with full and partial data. Next, a manifold learning-based scale invariant global shape descriptor is introduced. The proposed descriptor benefits from the capability of Laplacian Eigenmap in dealing with high dimensional data by introducing an exponential weighting scheme. It eliminates the limitations tied to the well-known cotangent weighting scheme, namely dependency on triangular mesh representation and high intra-class quality of 3D models. In the end, a novel descriptive model for diagnostic classification of pulmonary nodules is presented. The descriptive model benefits from structural differences between benign and malignant nodules for automatic and accurate prediction of a candidate nodule. It extracts concise and discriminative features automatically from the 3D surface structure of a nodule using spectral features studied in the previous work combined with a point cloud-based deep learning network. Extensive experiments have been conducted and have shown that the proposed algorithms based on manifold learning outperform several state-of-the-art methods. Advanced computational techniques with a combination of manifold learning and deep networks can play a vital role in effective healthcare delivery by providing a framework for several fundamental tasks in image and shape processing, namely, registration, classification, and detection of features of interest

Lung nodule modeling and detection for computerized image analysis of low dose CT imaging of the chest.

From a computerized image analysis prospective, early diagnosis of lung cancer involves detection of doubtful nodules and classification into different pathologies. The detection stage involves a detection approach, usually by template matching, and an authentication step to reduce false positives, usually conducted by a classifier of one form or another; statistical, fuzzy logic, support vector machines approaches have been tried. The classification stage matches, according to a particular approach, the characteristics (e.g., shape, texture and spatial distribution) of the detected nodules to common characteristics (again, shape, texture and spatial distribution) of nodules with known pathologies (confirmed by biopsies). This thesis focuses on the first step; i.e., nodule detection. Specifically, the thesis addresses three issues: a) understanding the CT data of typical low dose CT (LDCT) scanning of the chest, and devising an image processing approach to reduce the inherent artifacts in the scans; b) devising an image segmentation approach to isolate the lung tissues from the rest of the chest and thoracic regions in the CT scans; and c) devising a nodule modeling methodology to enhance the detection rate and lend benefits for the ultimate step in computerized image analysis of LDCT of the lungs, namely associating a pathology to the detected nodule. The methodology for reducing the noise artifacts is based on noise analysis and examination of typical LDCT scans that may be gathered on a repetitive fashion; since, a reduction in the resolution is inevitable to avoid excessive radiation. Two optimal filtering methods are tested on samples of the ELCAP screening data; the Weiner and the Anisotropic Diffusion Filters. Preference is given to the Anisotropic Diffusion Filter, which can be implemented on 7x7 blocks/windows of the CT data. The methodology for lung segmentation is based on the inherent characteristics of the LDCT scans, shown as distinct bi-modal gray scale histogram. A linear model is used to describe the histogram (the joint probability density function of the lungs and non-lungs tissues) by a linear combination of weighted kernels. The Gaussian kernels were chosen, and the classic Expectation-Maximization (EM) algorithm was employed to estimate the marginal probability densities of the lungs and non-lungs tissues, and select an optimal segmentation threshold. The segmentation is further enhanced using standard shape analysis based on mathematical morphology, which improves the continuity of the outer and inner borders of the lung tissues. This approach (a preliminary version of it appeared in [14]) is found to be adequate for lung segmentation as compared to more sophisticated approaches developed at the CVIP Lab (e.g., [15][16]) and elsewhere. The methodology developed for nodule modeling is based on understanding the physical characteristics of the nodules in LDCT scans, as identified by human experts. An empirical model is introduced for the probability density of the image intensity (or Hounsfield units) versus the radial distance measured from the centroid – center of mass - of typical nodules. This probability density showed that the nodule spatial support is within a circle/square of size 10 pixels; i.e., limited to 5 mm in length; which is within the range that the radiologist specify to be of concern. This probability density is used to fill in the intensity (or Hounsfield units) of parametric nodule models. For these models (e.g., circles or semi-circles), given a certain radius, we calculate the intensity (or Hounsfield units) using an exponential expression for the radial distance with parameters specified from the histogram of an ensemble of typical nodules. This work is similar in spirit to the earlier work of Farag et al., 2004 and 2005 [18][19], except that the empirical density of the radial distance and the histogram of typical nodules provide a data-driven guide for estimating the intensity (or Hounsfield units) of the nodule models. We examined the sensitivity and specificity of parametric nodules in a template-matching framework for nodule detection. We show that false positives are inevitable problems with typical machine learning methods of automatic lung nodule detection, which invites further efforts and perhaps fresh thinking into automatic nodule detection. A new approach for nodule modeling is introduced in Chapter 5 of this thesis, which brings high promise in both the detection, and the classification of nodules. Using the ELCAP study, we created an ensemble of four types of nodules and generated a nodule model for each type based on optimal data reduction methods. The resulting nodule model, for each type, has lead to drastic improvements in the sensitivity and specificity of nodule detection. This approach may be used as well for classification. In conclusion, the methodologies in this thesis are based on understanding the LDCT scans and what is to be expected in terms of image quality. Noise reduction and image segmentation are standard. The thesis illustrates that proper nodule models are possible and indeed a computerized approach for image analysis to detect and classify lung nodules is feasible. Extensions to the results in this thesis are immediate and the CVIP Lab has devised plans to pursue subsequent steps using clinical data

A lung cancer detection approach based on shape index and curvedness superpixel candidate selection

Orientador : Lucas Ferrari de OliveiraDissertação (mestrado) - Universidade Federal do Paraná, Setor de Tecnologia, Programa de Pós-Graduação em Engenharia Elétrica. Defesa: Curitiba, 29/08/2016Inclui referências : f. 72-76Área de concentração: Sistemas eletrônicosResumo: Câncer é uma das causas com mais mortalidade mundialmente. Câncer de pulmão é o tipo de câncer mais comum (excluíndo câncer de pele não-melanoma). Seus sintomas aparecem em estágios mais avançados, o que dificulta o seu tratamento. Para diagnosticar o paciente, a tomografia computadorizada é utilizada. Ela é composta de diversos cortes, que mapeiam uma região 3D de interesse. Apesar de fornecer muitos detalhes, por serem gerados vários cortes, a análise de exames de tomografia computadorizada se torna exaustiva, o que pode influenciar negativamente no diagnóstico feito pelo especialista. O objetivo deste trabalho é o desenvolvimento de métodos para a segmentação do pulmão e a detecção de nódulos em imagens de tomografia computadorizada do tórax. As imagens são segmentadas para separar o pulmão das outras estruturas e após, detecção de nódulos utilizando a técnicas de superpixeis são aplicadas. A técnica de Rótulamento dos Eixos teve uma média de preservação de nódulos de 93,53% e a técnica Monotone Chain Convex Hull apresentou melhores resultados com uma taxa de 97,78%. Para a detecção dos nódulos, as técnicas Felzenszwalb e SLIC são empregadas para o agrupamento de regiões de nódulos em superpixeis. Uma seleção de candidatos à nódulos baseada em shape index e curvedness é aplicada para redução do número de superpixeis. Para a classificação desses candidatos, foi utilizada a técnica de Florestas Aleatórias. A base de imagens utilizada foi a LIDC, que foi dividida em duas sub-bases: uma de desenvolvimento, composta pelos pacientes 0001 a 0600, e uma de validação, composta pelos pacientes 0601 a 1012. Na base de validação, a técnica Felzenszwalb obteve uma sensibilidade de 60,61% e 7,2 FP/exame. Palavras-chaves: Câncer de pulmão. Detecção de nódulos. Superpixel. Shape index.Abstract: Cancer is one of the causes with more mortality worldwide. Lung cancer is the most common type (excluding non-melanoma skin cancer). Its symptoms appear mostly in advanced stages, which difficult its treatment. For patient diagnostic, computer tomography (CT) is used. CT is composed of many slices, which maps a 3D region of interest. Although it provides many details, its analysis is very exhaustive, which may has negatively influence in the specialist's diagnostic. The objective of this work is the development of lung segmentation and nodule detection methods in chest CT images. These images are segmented to separate the lung region from other parts and, after that, nodule detection using superpixel methods is applied. The Axes' Labeling had a mean of nodule preservation of 93.53% and the Monotone Chain Convex Hull method presented better results, with a mean of 97.78%. For nodule detection, the Felzenszwalb and SLIC methods are employed to group nodule regions. A nodule candidate selection based on shape index and curvedness is applied for superpixel reduction. Then, classification of these candidates is realized by the Random Forest. The LIDC database was divided into two data sets: a development data set composed of the CT scans of patients 0001 to 0600, and a untouched, validation data set, composed of patients 0601 to 1012. For the validation data set, the Felzenszwalb method had a sensitivity of 60.61% and 7.2 FP/scan. Key-words: Lung cancer. Nodule detection. Superpixel. Shape index