DEVELOPING NOVEL COMPUTER-AIDED DETECTION AND DIAGNOSIS SYSTEMS OF MEDICAL IMAGES

Reading medical images to detect and diagnose diseases is often difficult and has large inter-reader variability. To address this issue, developing computer-aided detection and diagnosis (CAD) schemes or systems of medical images has attracted broad research interest in the last several decades. Despite great effort and significant progress in previous studies, only limited CAD schemes have been used in clinical practice. Thus, developing new CAD schemes is still a hot research topic in medical imaging informatics field. In this dissertation, I investigate the feasibility of developing several new innovative CAD schemes for different application purposes. First, to predict breast tumor response to neoadjuvant chemotherapy and reduce unnecessary aggressive surgery, I developed two CAD schemes of breast magnetic resonance imaging (MRI) to generate quantitative image markers based on quantitative analysis of global kinetic features. Using the image marker computed from breast MRI acquired pre-chemotherapy, CAD scheme enables to predict radiographic complete response (CR) of breast tumors to neoadjuvant chemotherapy, while using the imaging marker based on the fusion of kinetic and texture features extracted from breast MRI performed after neoadjuvant chemotherapy, CAD scheme can better predict the pathologic complete response (pCR) of the patients. Second, to more accurately predict prognosis of stroke patients, quantifying brain hemorrhage and ventricular cerebrospinal fluid depicting on brain CT images can play an important role. For this purpose, I developed a new interactive CAD tool to segment hemorrhage regions and extract radiological imaging marker to quantitatively determine the severity of aneurysmal subarachnoid hemorrhage at presentation and correlate the estimation with various homeostatic/metabolic derangements and predict clinical outcome. Third, to improve the efficiency of primary antibody screening processes in new cancer drug development, I developed a CAD scheme to automatically identify the non-negative tissue slides, which indicate reactive antibodies in digital pathology images. Last, to improve operation efficiency and reliability of storing digital pathology image data, I developed a CAD scheme using optical character recognition algorithm to automatically extract metadata from tissue slide label images and reduce manual entry for slide tracking and archiving in the tissue pathology laboratories. In summary, in these studies, we developed and tested several innovative approaches to identify quantitative imaging markers with high discriminatory power. In all CAD schemes, the graphic user interface-based visual aid tools were also developed and implemented. Study results demonstrated feasibility of applying CAD technology to several new application fields, which has potential to assist radiologists, oncologists and pathologists improving accuracy and consistency in disease diagnosis and prognosis assessment of using medical image

PathLDM: Text conditioned Latent Diffusion Model for Histopathology

To achieve high-quality results, diffusion models must be trained on large datasets. This can be notably prohibitive for models in specialized domains, such as computational pathology. Conditioning on labeled data is known to help in data-efficient model training. Therefore, histopathology reports, which are rich in valuable clinical information, are an ideal choice as guidance for a histopathology generative model. In this paper, we introduce PathLDM, the first text-conditioned Latent Diffusion Model tailored for generating high-quality histopathology images. Leveraging the rich contextual information provided by pathology text reports, our approach fuses image and textual data to enhance the generation process. By utilizing GPT's capabilities to distill and summarize complex text reports, we establish an effective conditioning mechanism. Through strategic conditioning and necessary architectural enhancements, we achieved a SoTA FID score of 7.64 for text-to-image generation on the TCGA-BRCA dataset, significantly outperforming the closest text-conditioned competitor with FID 30.1

Machine Learning Models to automate Radiotherapy Structure Name Standardization

Structure name standardization is a critical problem in Radiotherapy planning systems to correctly identify the various Organs-at-Risk, Planning Target Volumes and `Other\u27 organs for monitoring present and future medications. Physicians often label anatomical structure sets in Digital Imaging and Communications in Medicine (DICOM) images with nonstandard random names. Hence, the standardization of these names for the Organs at Risk (OARs), Planning Target Volumes (PTVs), and `Other\u27 organs is a vital problem. Prior works considered traditional machine learning approaches on structure sets with moderate success. We compare both traditional methods and deep neural network-based approaches on the multimodal vision-language prostate cancer patient data, compiled from the radiotherapy centers of the US Veterans Health Administration (VHA) and Virginia Commonwealth University (VCU) for structure name standardization. These de-identified data comprise 16,290 prostate structures. Our method integrates the multimodal textual and imaging data with Convolutional Neural Network (CNN)-based deep learning approaches such as CNN, Visual Geometry Group (VGG) network, and Residual Network (ResNet) and shows improved results in prostate radiotherapy structure name standardization. Our proposed deep neural network-based approach on the multimodal vision-language prostate cancer patient data provides state-of-the-art results for structure name standardization. Evaluation with macro-averaged F1 score shows that our CNN model with single-modal textual data usually performs better than previous studies. We also experimented with various combinations of multimodal data (masked images, masked dose) besides textual data. The models perform well on textual data alone, while the addition of imaging data shows that deep neural networks achieve better performance using information present in other modalities. Our pipeline can successfully standardize the Organs-at-Risk and the Planning Target Volumes, which are of utmost interest to the clinicians and simultaneously, performs very well on the `Other\u27 organs. We performed comprehensive experiments by varying input data modalities to show that using masked images and masked dose data with text outperforms the combination of other input modalities. We also undersampled the majority class, i.e., the `Other\u27 class, at different degrees and conducted extensive experiments to demonstrate that a small amount of majority class undersampling is essential for superior performance. Overall, our proposed integrated, deep neural network-based architecture for prostate structure name standardization can solve several challenges associated with multimodal data. The VGG network on the masked image-dose data combined with CNNs on the text data performs the best and presents the state-of-the-art in this domain