Development of computer-based algorithms for unsupervised assessment of radiotherapy contouring

INTRODUCTION: Despite the advances in radiotherapy treatment delivery, target volume delineation remains one of the greatest sources of error in the radiotherapy delivery process, which can lead to poor tumour control probability and impact clinical outcome. Contouring assessments are performed to ensure high quality of target volume definition in clinical trials but this can be subjective and labour-intensive. This project addresses the hypothesis that computational segmentation techniques, with a given prior, can be used to develop an image-based tumour delineation process for contour assessments. This thesis focuses on the exploration of the segmentation techniques to develop an automated method for generating reference delineations in the setting of advanced lung cancer. The novelty of this project is in the use of the initial clinician outline as a prior for image segmentation. METHODS: Automated segmentation processes were developed for stage II and III non-small cell lung cancer using the IDEAL-CRT clinical trial dataset. Marker-controlled watershed segmentation, two active contour approaches (edge- and region-based) and graph-cut applied on superpixels were explored. k-nearest neighbour (k-NN) classification of tumour from normal tissues based on texture features was also investigated. RESULTS: 63 cases were used for development and training. Segmentation and classification performance were evaluated on an independent test set of 16 cases. Edge-based active contour segmentation achieved highest Dice similarity coefficient of 0.80 ± 0.06, followed by graphcut at 0.76 ± 0.06, watershed at 0.72 ± 0.08 and region-based active contour at 0.71 ± 0.07, with mean computational times of 192 ± 102 sec, 834 ± 438 sec, 21 ± 5 sec and 45 ± 18 sec per case respectively. Errors in accuracy of irregularly shaped lesions and segmentation leakages at the mediastinum were observed. In the distinction of tumour and non-tumour regions, misclassification errors of 14.5% and 15.5% were achieved using 16- and 8-pixel regions of interest (ROIs) respectively. Higher misclassification errors of 24.7% and 26.9% for 16- and 8-pixel ROIs were obtained in the analysis of the tumour boundary. CONCLUSIONS: Conventional image-based segmentation techniques with the application of priors are useful in automatic segmentation of tumours, although further developments are required to improve their performance. Texture classification can be useful in distinguishing tumour from non-tumour tissue, but the segmentation task at the tumour boundary is more difficult. Future work with deep-learning segmentation approaches need to be explored.Funded by National Radiotherapy Trials Quality Assurance (RTTQA) grou

Rich probabilistic models for semantic labeling

Das Ziel dieser Monographie ist es die Methoden und Anwendungen des semantischen Labelings zu erforschen. Unsere Beiträge zu diesem sich rasch entwickelten Thema sind bestimmte Aspekte der Modellierung und der Inferenz in probabilistischen Modellen und ihre Anwendungen in den interdisziplinären Bereichen der Computer Vision sowie medizinischer Bildverarbeitung und Fernerkundung

Uma abordagem de agrupamento baseada na técnica de divisão e conquista e floresta de caminhos ótimos

Orientador: Alexandre Xavier FalcãoDissertação (mestrado) - Universidade Estadual de Campinas, Instituto de ComputaçãoResumo: O agrupamento de dados é um dos principais desafios em problemas de Ciência de Dados. Apesar do seu progresso científico em quase um século de existência, algoritmos de agrupamento ainda falham na identificação de grupos (clusters) naturalmente relacionados com a semântica do problema. Ademais, os avanços das tecnologias de aquisição, comunicação, e armazenamento de dados acrescentam desafios cruciais com o aumento considerável de dados, os quais não são tratados pela maioria das técnicas. Essas questões são endereçadas neste trabalho através da proposta de uma abordagem de divisão e conquista para uma técnica de agrupamento única em encontrar um grupo por domo da função de densidade de probabilidade dos dados --- o algoritmo de agrupamento por floresta de caminhos ótimos (OPF - Optimum-Path Forest). Nesta técnica, amostras são interpretadas como nós de um grafo cujos arcos conectam os $k$-vizinhos mais próximos no espaço de características. Os nós são ponderados pela sua densidade de probabilidade e um mapa de conexidade é maximizado de modo que cada máximo da função densidade de probabilidade se torna a raiz de uma árvore de caminhos ótimos (grupo). O melhor valor de $k$ é estimado por otimização em um intervalo de valores dependente da aplicação. O problema com este método é que um número alto de amostras torna o algoritmo inviável, devido ao espaço de memória necessário para armazenar o grafo e o tempo computacional para encontrar o melhor valor de $k$. Visto que as soluções existentes levam a resultados ineficazes, este trabalho revisita o problema através da proposta de uma abordagem de divisão e conquista com dois níveis. No primeiro nível, o conjunto de dados é dividido em subconjuntos (blocos) menores e as amostras pertencentes a cada bloco são agrupadas pelo algoritmo OPF. Em seguida, as amostras representativas de cada grupo (mais especificamente as raízes da floresta de caminhos ótimos) são levadas ao segundo nível, onde elas são agrupadas novamente. Finalmente, os rótulos de grupo obtidos no segundo nível são transferidos para todas as amostras do conjunto de dados através de seus representantes do primeiro nível. Nesta abordagem, todas as amostras, ou pelo menos muitas delas, podem ser usadas no processo de aprendizado não supervisionado, sem afetar a eficácia do agrupamento e, portanto, o procedimento é menos susceptível a perda de informação relevante ao agrupamento. Os resultados mostram agrupamentos satisfatórios em dois cenários, segmentação de imagem e agrupamento de dados arbitrários, tendo como base a comparação com abordagens populares. No primeiro cenário, a abordagem proposta atinge os melhores resultados em todas as bases de imagem testadas. No segundo cenário, os resultados são similares aos obtidos por uma versão otimizada do método original de agrupamento por floresta de caminhos ótimosAbstract: Data clustering is one of the main challenges when solving Data Science problems. Despite its progress over almost one century of research, clustering algorithms still fail in identifying groups naturally related to the semantics of the problem. Moreover, the advances in data acquisition, communication, and storage technologies add crucial challenges with a considerable data increase, which are not handled by most techniques. We address these issues by proposing a divide-and-conquer approach to a clustering technique, which is unique in finding one group per dome of the probability density function of the data --- the Optimum-Path Forest (OPF) clustering algorithm. In the OPF-clustering technique, samples are taken as nodes of a graph whose arcs connect the $k$-nearest neighbors in the feature space. The nodes are weighted by their probability density values and a connectivity map is maximized such that each maximum of the probability density function becomes the root of an optimum-path tree (cluster). The best value of $k$ is estimated by optimization within an application-specific interval of values. The problem with this method is that a high number of samples makes the algorithm prohibitive, due to the required memory space to store the graph and the computational time to obtain the clusters for the best value of $k$. Since the existing solutions lead to ineffective results, we decided to revisit the problem by proposing a two-level divide-and-conquer approach. At the first level, the dataset is divided into smaller subsets (blocks) and the samples belonging to each block are grouped by the OPF algorithm. Then, the representative samples (more specifically the roots of the optimum-path forest) are taken to a second level where they are clustered again. Finally, the group labels obtained in the second level are transferred to all samples of the dataset through their representatives of the first level. With this approach, we can use all samples, or at least many samples, in the unsupervised learning process without affecting the grouping performance and, therefore, the procedure is less likely to lose relevant grouping information. We show that our proposal can obtain satisfactory results in two scenarios, image segmentation and the general data clustering problem, in comparison with some popular baselines. In the first scenario, our technique achieves better results than the others in all tested image databases. In the second scenario, it obtains outcomes similar to an optimized version of the traditional OPF-clustering algorithmMestradoCiência da ComputaçãoMestre em Ciência da ComputaçãoCAPE

복부 CT에서 간과 혈관 분할 기법

학위논문(박사)--서울대학교 대학원 :공과대학 컴퓨터공학부,2020. 2. 신영길.복부 전산화 단층 촬영 (CT) 영상에서 정확한 간 및 혈관 분할은 체적 측정, 치료 계획 수립 및 추가적인 증강 현실 기반 수술 가이드와 같은 컴퓨터 진단 보조 시스템을 구축하는데 필수적인 요소이다. 최근 들어 컨볼루셔널 인공 신경망 (CNN) 형태의 딥 러닝이 많이 적용되면서 의료 영상 분할의 성능이 향상되고 있지만, 실제 임상에 적용할 수 있는 높은 일반화 성능을 제공하기는 여전히 어렵다. 또한 물체의 경계는 전통적으로 영상 분할에서 매우 중요한 요소로 이용되었지만, CT 영상에서 간의 불분명한 경계를 추출하기가 어렵기 때문에 현대 CNN에서는 이를 사용하지 않고 있다. 간 혈관 분할 작업의 경우, 복잡한 혈관 영상으로부터 학습 데이터를 만들기 어렵기 때문에 딥 러닝을 적용하기가 어렵다. 또한 얇은 혈관 부분의 영상 밝기 대비가 약하여 원본 영상에서 식별하기가 매우 어렵다. 본 논문에서는 위 언급한 문제들을 해결하기 위해 일반화 성능이 향상된 CNN과 얇은 혈관을 포함하는 복잡한 간 혈관을 정확하게 분할하는 알고리즘을 제안한다. 간 분할 작업에서 우수한 일반화 성능을 갖는 CNN을 구축하기 위해, 내부적으로 간 모양을 추정하는 부분이 포함된 자동 컨텍스트 알고리즘을 제안한다. 또한, CNN을 사용한 학습에 경계선의 개념이 새롭게 제안된다. 모호한 경계부가 포함되어 있어 전체 경계 영역을 CNN에 훈련하는 것은 매우 어렵기 때문에 반복되는 학습 과정에서 인공 신경망이 스스로 예측한 확률에서 부정확하게 추정된 부분적 경계만을 사용하여 인공 신경망을 학습한다. 실험적 결과를 통해 제안된 CNN이 다른 최신 기법들보다 정확도가 우수하다는 것을 보인다. 또한, 제안된 CNN의 일반화 성능을 검증하기 위해 다양한 실험을 수행한다. 간 혈관 분할에서는 간 내부의 관심 영역을 지정하기 위해 앞서 획득한 간 영역을 활용한다. 정확한 간 혈관 분할을 위해 혈관 후보 점들을 추출하여 사용하는 알고리즘을 제안한다. 확실한 후보 점들을 얻기 위해, 삼차원 영상의 차원을 먼저 최대 강도 투영 기법을 통해 이차원으로 낮춘다. 이차원 영상에서는 복잡한 혈관의 구조가 보다 단순화될 수 있다. 이어서, 이차원 영상에서 혈관 분할을 수행하고 혈관 픽셀들은 원래의 삼차원 공간상으로 역 투영된다. 마지막으로, 전체 혈관의 분할을 위해 원본 영상과 혈관 후보 점들을 모두 사용하는 새로운 레벨 셋 기반 알고리즘을 제안한다. 제안된 알고리즘은 복잡한 구조가 단순화되고 얇은 혈관이 더 잘 보이는 이차원 영상에서 얻은 후보 점들을 사용하기 때문에 얇은 혈관 분할에서 높은 정확도를 보인다. 실험적 결과에 의하면 제안된 알고리즘은 잘못된 영역의 추출 없이 다른 레벨 셋 기반 알고리즘들보다 우수한 성능을 보인다. 제안된 알고리즘은 간과 혈관을 분할하는 새로운 방법을 제시한다. 제안된 자동 컨텍스트 구조는 사람이 디자인한 학습 과정이 일반화 성능을 크게 향상할 수 있다는 것을 보인다. 그리고 제안된 경계선 학습 기법으로 CNN을 사용한 영상 분할의 성능을 향상할 수 있음을 내포한다. 간 혈관의 분할은 이차원 최대 강도 투영 기반 이미지로부터 획득된 혈관 후보 점들을 통해 얇은 혈관들이 성공적으로 분할될 수 있음을 보인다. 본 논문에서 제안된 알고리즘은 간의 해부학적 분석과 자동화된 컴퓨터 진단 보조 시스템을 구축하는 데 매우 중요한 기술이다.Accurate liver and its vessel segmentation on abdominal computed tomography (CT) images is one of the most important prerequisites for computer-aided diagnosis (CAD) systems such as volumetric measurement, treatment planning, and further augmented reality-based surgical guide. In recent years, the application of deep learning in the form of convolutional neural network (CNN) has improved the performance of medical image segmentation, but it is difficult to provide high generalization performance for the actual clinical practice. Furthermore, although the contour features are an important factor in the image segmentation problem, they are hard to be employed on CNN due to many unclear boundaries on the image. In case of a liver vessel segmentation, a deep learning approach is impractical because it is difficult to obtain training data from complex vessel images. Furthermore, thin vessels are hard to be identified in the original image due to weak intensity contrasts and noise. In this dissertation, a CNN with high generalization performance and a contour learning scheme is first proposed for liver segmentation. Secondly, a liver vessel segmentation algorithm is presented that accurately segments even thin vessels. To build a CNN with high generalization performance, the auto-context algorithm is employed. The auto-context algorithm goes through two pipelines: the first predicts the overall area of a liver and the second predicts the final liver using the first prediction as a prior. This process improves generalization performance because the network internally estimates shape-prior. In addition to the auto-context, a contour learning method is proposed that uses only sparse contours rather than the entire contour. Sparse contours are obtained and trained by using only the mispredicted part of the network's final prediction. Experimental studies show that the proposed network is superior in accuracy to other modern networks. Multiple N-fold tests are also performed to verify the generalization performance. An algorithm for accurate liver vessel segmentation is also proposed by introducing vessel candidate points. To obtain confident vessel candidates, the 3D image is first reduced to 2D through maximum intensity projection. Subsequently, vessel segmentation is performed from the 2D images and the segmented pixels are back-projected into the original 3D space. Finally, a new level set function is proposed that utilizes both the original image and vessel candidate points. The proposed algorithm can segment thin vessels with high accuracy by mainly using vessel candidate points. The reliability of the points can be higher through robust segmentation in the projected 2D images where complex structures are simplified and thin vessels are more visible. Experimental results show that the proposed algorithm is superior to other active contour models. The proposed algorithms present a new method of segmenting the liver and its vessels. The auto-context algorithm shows that a human-designed curriculum (i.e., shape-prior learning) can improve generalization performance. The proposed contour learning technique can increase the accuracy of a CNN for image segmentation by focusing on its failures, represented by sparse contours. The vessel segmentation shows that minor vessel branches can be successfully segmented through vessel candidate points obtained by reducing the image dimension. The algorithms presented in this dissertation can be employed for later analysis of liver anatomy that requires accurate segmentation techniques.Chapter 1 Introduction 1 1.1 Background and motivation 1 1.2 Problem statement 3 1.3 Main contributions 6 1.4 Contents and organization 9 Chapter 2 Related Works 10 2.1 Overview 10 2.2 Convolutional neural networks 11 2.2.1 Architectures of convolutional neural networks 11 2.2.2 Convolutional neural networks in medical image segmentation 21 2.3 Liver and vessel segmentation 37 2.3.1 Classical methods for liver segmentation 37 2.3.2 Vascular image segmentation 40 2.3.3 Active contour models 46 2.3.4 Vessel topology-based active contour model 54 2.4 Motivation 60 Chapter 3 Liver Segmentation via Auto-Context Neural Network with Self-Supervised Contour Attention 62 3.1 Overview 62 3.2 Single-pass auto-context neural network 65 3.2.1 Skip-attention module 66 3.2.2 V-transition module 69 3.2.3 Liver-prior inference and auto-context 70 3.2.4 Understanding the network 74 3.3 Self-supervising contour attention 75 3.4 Learning the network 81 3.4.1 Overall loss function 81 3.4.2 Data augmentation 81 3.5 Experimental Results 83 3.5.1 Overview 83 3.5.2 Data configurations and target of comparison 84 3.5.3 Evaluation metric 85 3.5.4 Accuracy evaluation 87 3.5.5 Ablation study 93 3.5.6 Performance of generalization 110 3.5.7 Results from ground-truth variations 114 3.6 Discussion 116 Chapter 4 Liver Vessel Segmentation via Active Contour Model with Dense Vessel Candidates 119 4.1 Overview 119 4.2 Dense vessel candidates 124 4.2.1 Maximum intensity slab images 125 4.2.2 Segmentation of 2D vessel candidates and back-projection 130 4.3 Clustering of dense vessel candidates 135 4.3.1 Virtual gradient-assisted regional ACM 136 4.3.2 Localized regional ACM 142 4.4 Experimental results 145 4.4.1 Overview 145 4.4.2 Data configurations and environment 146 4.4.3 2D segmentation 146 4.4.4 ACM comparisons 149 4.4.5 Evaluation of bifurcation points 154 4.4.6 Computational performance 159 4.4.7 Ablation study 160 4.4.8 Parameter study 162 4.5 Application to portal vein analysis 164 4.6 Discussion 168 Chapter 5 Conclusion and Future Works 170 Bibliography 172 초록 197Docto

Computational Methods for Segmentation of Multi-Modal Multi-Dimensional Cardiac Images

Segmentation of the heart structures helps compute the cardiac contractile function quantified via the systolic and diastolic volumes, ejection fraction, and myocardial mass, representing a reliable diagnostic value. Similarly, quantification of the myocardial mechanics throughout the cardiac cycle, analysis of the activation patterns in the heart via electrocardiography (ECG) signals, serve as good cardiac diagnosis indicators. Furthermore, high quality anatomical models of the heart can be used in planning and guidance of minimally invasive interventions under the assistance of image guidance. The most crucial step for the above mentioned applications is to segment the ventricles and myocardium from the acquired cardiac image data. Although the manual delineation of the heart structures is deemed as the gold-standard approach, it requires significant time and effort, and is highly susceptible to inter- and intra-observer variability. These limitations suggest a need for fast, robust, and accurate semi- or fully-automatic segmentation algorithms. However, the complex motion and anatomy of the heart, indistinct borders due to blood flow, the presence of trabeculations, intensity inhomogeneity, and various other imaging artifacts, makes the segmentation task challenging. In this work, we present and evaluate segmentation algorithms for multi-modal, multi-dimensional cardiac image datasets. Firstly, we segment the left ventricle (LV) blood-pool from a tri-plane 2D+time trans-esophageal (TEE) ultrasound acquisition using local phase based filtering and graph-cut technique, propagate the segmentation throughout the cardiac cycle using non-rigid registration-based motion extraction, and reconstruct the 3D LV geometry. Secondly, we segment the LV blood-pool and myocardium from an open-source 4D cardiac cine Magnetic Resonance Imaging (MRI) dataset by incorporating average atlas based shape constraint into the graph-cut framework and iterative segmentation refinement. The developed fast and robust framework is further extended to perform right ventricle (RV) blood-pool segmentation from a different open-source 4D cardiac cine MRI dataset. Next, we employ convolutional neural network based multi-task learning framework to segment the myocardium and regress its area, simultaneously, and show that segmentation based computation of the myocardial area is significantly better than that regressed directly from the network, while also being more interpretable. Finally, we impose a weak shape constraint via multi-task learning framework in a fully convolutional network and show improved segmentation performance for LV, RV and myocardium across healthy and pathological cases, as well as, in the challenging apical and basal slices in two open-source 4D cardiac cine MRI datasets. We demonstrate the accuracy and robustness of the proposed segmentation methods by comparing the obtained results against the provided gold-standard manual segmentations, as well as with other competing segmentation methods

User-centered design and evaluation of interactive segmentation methods for medical images

Segmentation of medical images is a challenging task that aims to identify a particular structure present on the image. Among the existing methods involving the user at different levels, from a fully-manual to a fully-automated task, interactive segmentation methods provide assistance to the user during the task to reduce the variability in the results and allow occasional corrections of segmentation failures. Therefore, they offer a compromise between the segmentation efficiency and the accuracy of the results. It is the user who judges whether the results are satisfactory and how to correct them during the segmentation, making the process subject to human factors. Despite the strong influence of the user on the outcomes of a segmentation task, the impact of such factors has received little attention, with the literature focusing the assessment of segmentation processes on computational performance. Yet, involving the user performance in the analysis is more representative of a realistic scenario. Our goal is to explore the user behaviour in order to improve the efficiency of interactive image segmentation processes. This is achieved through three contributions. First, we developed a method which is based on a new user interaction mechanism to provide hints as to where to concentrate the computations. This significantly improves the computation efficiency without sacrificing the quality of the segmentation. The benefits of using such hints are twofold: (i) because our contribution is based on user interaction, it generalizes to a wide range of segmentation methods, and (ii) it gives comprehensive indications about where to focus the segmentation search. The latter advantage is used to achieve the second contribution. We developed an automated method based on a multi-scale strategy to: (i) reduce the user’s workload and, (ii) improve the computational time up to tenfold, allowing real-time segmentation feedback. Third, we have investigated the effects of such improvements in computations on the user’s performance. We report an experiment that manipulates the delay induced by the computation time while performing an interactive segmentation task. Results reveal that the influence of this delay can be significantly reduced with an appropriate interaction mechanism design. In conclusion, this project provides an effective image segmentation solution that has been developed in compliance with user performance requirements. We validated our approach through multiple user studies that provided a step forward into understanding the user behaviour during interactive image segmentation