A non-invasive image based system for early diagnosis of prostate cancer.

Prostate cancer is the second most fatal cancer experienced by American males. The average American male has a 16.15% chance of developing prostate cancer, which is 8.38% higher than lung cancer, the second most likely cancer. The current in-vitro techniques that are based on analyzing a patients blood and urine have several limitations concerning their accuracy. In addition, the prostate Specific Antigen (PSA) blood-based test, has a high chance of false positive diagnosis, ranging from 28%-58%. Yet, biopsy remains the gold standard for the assessment of prostate cancer, but only as the last resort because of its invasive nature, high cost, and potential morbidity rates. The major limitation of the relatively small needle biopsy samples is the higher possibility of producing false positive diagnosis. Moreover, the visual inspection system (e.g., Gleason grading system) is not quantitative technique and different observers may classify a sample differently, leading to discrepancies in the diagnosis. As reported in the literature that the early detection of prostate cancer is a crucial step for decreasing prostate cancer related deaths. Thus, there is an urgent need for developing objective, non-invasive image based technology for early detection of prostate cancer. The objective of this dissertation is to develop a computer vision methodology, later translated into a clinically usable software tool, which can improve sensitivity and specificity of early prostate cancer diagnosis based on the well-known hypothesis that malignant tumors are will connected with the blood vessels than the benign tumors. Therefore, using either Diffusion Weighted Magnetic Resonance imaging (DW-MRI) or Dynamic Contrast Enhanced Magnetic Resonance Imaging (DCE-MRI), we will be able to interrelate the amount of blood in the detected prostate tumors by estimating either the Apparent Diffusion Coefficient (ADC) in the prostate with the malignancy of the prostate tumor or perfusion parameters. We intend to validate this hypothesis by demonstrating that automatic segmentation of the prostate from either DW-MRI or DCE-MRI after handling its local motion, provides discriminatory features for early prostate cancer diagnosis. The proposed CAD system consists of three majors components, the first two of which constitute new research contributions to a challenging computer vision problem. The three main components are: (1) A novel Shape-based segmentation approach to segment the prostate from either low contrast DW-MRI or DCE-MRI data; (2) A novel iso-contours-based non-rigid registration approach to ensure that we have voxel-on-voxel matches of all data which may be more difficult due to gross patient motion, transmitted respiratory effects, and intrinsic and transmitted pulsatile effects; and (3) Probabilistic models for the estimated diffusion and perfusion features for both malignant and benign tumors. Our results showed a 98% classification accuracy using Leave-One-Subject-Out (LOSO) approach based on the estimated ADC for 30 patients (12 patients diagnosed as malignant; 18 diagnosed as benign). These results show the promise of the proposed image-based diagnostic technique as a supplement to current technologies for diagnosing prostate cancer

A Survey on Deep Learning in Medical Image Analysis

Deep learning algorithms, in particular convolutional networks, have rapidly become a methodology of choice for analyzing medical images. This paper reviews the major deep learning concepts pertinent to medical image analysis and summarizes over 300 contributions to the field, most of which appeared in the last year. We survey the use of deep learning for image classification, object detection, segmentation, registration, and other tasks and provide concise overviews of studies per application area. Open challenges and directions for future research are discussed.Comment: Revised survey includes expanded discussion section and reworked introductory section on common deep architectures. Added missed papers from before Feb 1st 201

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

Analysis of contrast-enhanced medical images.

Early detection of human organ diseases is of great importance for the accurate diagnosis and institution of appropriate therapies. This can potentially prevent progression to end-stage disease by detecting precursors that evaluate organ functionality. In addition, it also assists the clinicians for therapy evaluation, tracking diseases progression, and surgery operations. Advances in functional and contrast-enhanced (CE) medical images enabled accurate noninvasive evaluation of organ functionality due to their ability to provide superior anatomical and functional information about the tissue-of-interest. The main objective of this dissertation is to develop a computer-aided diagnostic (CAD) system for analyzing complex data from CE magnetic resonance imaging (MRI). The developed CAD system has been tested in three case studies: (i) early detection of acute renal transplant rejection, (ii) evaluation of myocardial perfusion in patients with ischemic heart disease after heart attack; and (iii), early detection of prostate cancer. However, developing a noninvasive CAD system for the analysis of CE medical images is subject to multiple challenges, including, but are not limited to, image noise and inhomogeneity, nonlinear signal intensity changes of the images over the time course of data acquisition, appearances and shape changes (deformations) of the organ-of-interest during data acquisition, determination of the best features (indexes) that describe the perfusion of a contrast agent (CA) into the tissue. To address these challenges, this dissertation focuses on building new mathematical models and learning techniques that facilitate accurate analysis of CAs perfusion in living organs and include: (i) accurate mathematical models for the segmentation of the object-of-interest, which integrate object shape and appearance features in terms of pixel/voxel-wise image intensities and their spatial interactions; (ii) motion correction techniques that combine both global and local models, which exploit geometric features, rather than image intensities to avoid problems associated with nonlinear intensity variations of the CE images; (iii) fusion of multiple features using the genetic algorithm. The proposed techniques have been integrated into CAD systems that have been tested in, but not limited to, three clinical studies. First, a noninvasive CAD system is proposed for the early and accurate diagnosis of acute renal transplant rejection using dynamic contrast-enhanced MRI (DCE-MRI). Acute rejection–the immunological response of the human immune system to a foreign kidney–is the most sever cause of renal dysfunction among other diagnostic possibilities, including acute tubular necrosis and immune drug toxicity. In the U.S., approximately 17,736 renal transplants are performed annually, and given the limited number of donors, transplanted kidney salvage is an important medical concern. Thus far, biopsy remains the gold standard for the assessment of renal transplant dysfunction, but only as the last resort because of its invasive nature, high cost, and potential morbidity rates. The diagnostic results of the proposed CAD system, based on the analysis of 50 independent in-vivo cases were 96% with a 95% confidence interval. These results clearly demonstrate the promise of the proposed image-based diagnostic CAD system as a supplement to the current technologies, such as nuclear imaging and ultrasonography, to determine the type of kidney dysfunction. Second, a comprehensive CAD system is developed for the characterization of myocardial perfusion and clinical status in heart failure and novel myoregeneration therapy using cardiac first-pass MRI (FP-MRI). Heart failure is considered the most important cause of morbidity and mortality in cardiovascular disease, which affects approximately 6 million U.S. patients annually. Ischemic heart disease is considered the most common underlying cause of heart failure. Therefore, the detection of the heart failure in its earliest forms is essential to prevent its relentless progression to premature death. While current medical studies focus on detecting pathological tissue and assessing contractile function of the diseased heart, this dissertation address the key issue of the effects of the myoregeneration therapy on the associated blood nutrient supply. Quantitative and qualitative assessment in a cohort of 24 perfusion data sets demonstrated the ability of the proposed framework to reveal regional perfusion improvements with therapy, and transmural perfusion differences across the myocardial wall; thus, it can aid in follow-up on treatment for patients undergoing the myoregeneration therapy. Finally, an image-based CAD system for early detection of prostate cancer using DCE-MRI is introduced. Prostate cancer is the most frequently diagnosed malignancy among men and remains the second leading cause of cancer-related death in the USA with more than 238,000 new cases and a mortality rate of about 30,000 in 2013. Therefore, early diagnosis of prostate cancer can improve the effectiveness of treatment and increase the patient’s chance of survival. Currently, needle biopsy is the gold standard for the diagnosis of prostate cancer. However, it is an invasive procedure with high costs and potential morbidity rates. Additionally, it has a higher possibility of producing false positive diagnosis due to relatively small needle biopsy samples. Application of the proposed CAD yield promising results in a cohort of 30 patients that would, in the near future, represent a supplement of the current technologies to determine prostate cancer type. The developed techniques have been compared to the state-of-the-art methods and demonstrated higher accuracy as shown in this dissertation. The proposed models (higher-order spatial interaction models, shape models, motion correction models, and perfusion analysis models) can be used in many of today’s CAD applications for early detection of a variety of diseases and medical conditions, and are expected to notably amplify the accuracy of CAD decisions based on the automated analysis of CE images

Prostate Segmentation and Regions of Interest Detection in Transrectal Ultrasound Images

The early detection of prostate cancer plays a significant role in the success of treatment and outcome. To detect prostate cancer, imaging modalities such as TransRectal UltraSound (TRUS) and Magnetic Resonance Imaging (MRI) are relied on. MRI images are more comprehensible than TRUS images which are corrupted by noise such as speckles and shadowing. However, MRI screening is costly, often unavailable in many community hospitals, time consuming, and requires more patient preparation time. Therefore, TRUS is more popular for screening and biopsy guidance for prostate cancer. For these reasons, TRUS images are chosen in this research. Radiologists first segment the prostate image from ultrasound image and then identify the hypoechoic regions which are more likely to exhibit cancer and should be considered for biopsy. In this thesis, the focus is on prostate segmentation and on Regions of Interest (ROI)segmentation. First, the extraneous tissues surrounding the prostate gland are eliminated. Consequently, the process of detecting the cancerous regions is focused on the prostate gland only. Thus, the diagnosing process is significantly shortened. Also, segmentation techniques such as thresholding, region growing, classification, clustering, Markov random field models, artificial neural networks (ANNs), atlas-guided, and deformable models are investigated. In this dissertation, the deformable model technique is selected because it is capable of segmenting difficult images such as ultrasound images. Deformable models are classified as either parametric or geometric deformable models. For the prostate segmentation, one of the parametric deformable models, Gradient Vector Flow (GVF) deformable contour, is adopted because it is capable of segmenting the prostate gland, even if the initial contour is not close to the prostate boundary. The manual segmentation of ultrasound images not only consumes much time and effort, but also leads to operator-dependent results. Therefore, a fully automatic prostate segmentation algorithm is proposed based on knowledge-based rules. The new algorithm results are evaluated with respect to their manual outlining by using distance-based and area-based metrics. Also, the novel technique is compared with two well-known semi-automatic algorithms to illustrate its superiority. With hypothesis testing, the proposed algorithm is statistically superior to the other two algorithms. The newly developed algorithm is operator-independent and capable of accurately segmenting a prostate gland with any shape and orientation from the ultrasound image. The focus of the second part of the research is to locate the regions which are more prone to cancer. Although the parametric dynamic contour technique can readily segment a single region, it is not conducive for segmenting multiple regions, as required in the regions of interest (ROI) segmentation part. Since the number of regions is not known beforehand, the problem is stated as 3D one by using level set approach to handle the topology changes such as splitting and merging the contours. For the proposed ROI segmentation algorithm, one of the geometric deformable models, active contours without edges, is used. This technique is capable of segmenting the regions with either weak edges, or even, no edges at all. The results of the proposed ROI segmentation algorithm are compared with those of the two experts' manual marking. The results are also compared with the common regions manually marked by both experts and with the total regions marked by either expert. The proposed ROI segmentation algorithm is also evaluated by using region-based and pixel-based strategies. The evaluation results indicate that the proposed algorithm produces similar results to those of the experts' manual markings, but with the added advantages of being fast and reliable. This novel algorithm also detects some regions that have been missed by one expert but confirmed by the other. In conclusion, the two newly devised algorithms can assist experts in segmenting the prostate image and detecting the suspicious abnormal regions that should be considered for biopsy. This leads to the reduction the number of biopsies, early detection of the diseased regions, proper management, and possible reduction of death related to prostate cancer

Deep Networks Based Energy Models for Object Recognition from Multimodality Images

Object recognition has been extensively investigated in computer vision area, since it is a fundamental and essential technique in many important applications, such as robotics, auto-driving, automated manufacturing, and security surveillance. According to the selection criteria, object recognition mechanisms can be broadly categorized into object proposal and classification, eye fixation prediction and saliency object detection. Object proposal tends to capture all potential objects from natural images, and then classify them into predefined groups for image description and interpretation. For a given natural image, human perception is normally attracted to the most visually important regions/objects. Therefore, eye fixation prediction attempts to localize some interesting points or small regions according to human visual system (HVS). Based on these interesting points and small regions, saliency object detection algorithms propagate the important extracted information to achieve a refined segmentation of the whole salient objects. In addition to natural images, object recognition also plays a critical role in clinical practice. The informative insights of anatomy and function of human body obtained from multimodality biomedical images such as magnetic resonance imaging (MRI), transrectal ultrasound (TRUS), computed tomography (CT) and positron emission tomography (PET) facilitate the precision medicine. Automated object recognition from biomedical images empowers the non-invasive diagnosis and treatments via automated tissue segmentation, tumor detection and cancer staging. The conventional recognition methods normally utilize handcrafted features (such as oriented gradients, curvature, Haar features, Haralick texture features, Laws energy features, etc.) depending on the image modalities and object characteristics. It is challenging to have a general model for object recognition. Superior to handcrafted features, deep neural networks (DNN) can extract self-adaptive features corresponding with specific task, hence can be employed for general object recognition models. These DNN-features are adjusted semantically and cognitively by over tens of millions parameters corresponding to the mechanism of human brain, therefore leads to more accurate and robust results. Motivated by it, in this thesis, we proposed DNN-based energy models to recognize object on multimodality images. For the aim of object recognition, the major contributions of this thesis can be summarized below: 1. We firstly proposed a new comprehensive autoencoder model to recognize the position and shape of prostate from magnetic resonance images. Different from the most autoencoder-based methods, we focused on positive samples to train the model in which the extracted features all come from prostate. After that, an image energy minimization scheme was applied to further improve the recognition accuracy. The proposed model was compared with three classic classifiers (i.e. support vector machine with radial basis function kernel, random forest, and naive Bayes), and demonstrated significant superiority for prostate recognition on magnetic resonance images. We further extended the proposed autoencoder model for saliency object detection on natural images, and the experimental validation proved the accurate and robust saliency object detection results of our model. 2. A general multi-contexts combined deep neural networks (MCDN) model was then proposed for object recognition from natural images and biomedical images. Under one uniform framework, our model was performed in multi-scale manner. Our model was applied for saliency object detection from natural images as well as prostate recognition from magnetic resonance images. Our experimental validation demonstrated that the proposed model was competitive to current state-of-the-art methods. 3. We designed a novel saliency image energy to finely segment salient objects on basis of our MCDN model. The region priors were taken into account in the energy function to avoid trivial errors. Our method outperformed state-of-the-art algorithms on five benchmarking datasets. In the experiments, we also demonstrated that our proposed saliency image energy can boost the results of other conventional saliency detection methods