Novel Computer-Aided Diagnosis Schemes for Radiological Image Analysis

The computer-aided diagnosis (CAD) scheme is a powerful tool in assisting clinicians (e.g., radiologists) to interpret medical images more accurately and efficiently. In developing high-performing CAD schemes, classic machine learning (ML) and deep learning (DL) algorithms play an essential role because of their advantages in capturing meaningful patterns that are important for disease (e.g., cancer) diagnosis and prognosis from complex datasets. This dissertation, organized into four studies, investigates the feasibility of developing several novel ML-based and DL-based CAD schemes for different cancer research purposes. The first study aims to develop and test a unique radiomics-based CT image marker that can be used to detect lymph node (LN) metastasis for cervical cancer patients. A total of 1,763 radiomics features were first computed from the segmented primary cervical tumor depicted on one CT image with the maximal tumor region. Next, a principal component analysis algorithm was applied on the initial feature pool to determine an optimal feature cluster. Then, based on this optimal cluster, machine learning models (e.g., support vector machine (SVM)) were trained and optimized to generate an image marker to detect LN metastasis. The SVM based imaging marker achieved an AUC (area under the ROC curve) value of 0.841 ± 0.035. This study initially verifies the feasibility of combining CT images and the radiomics technology to develop a low-cost image marker for LN metastasis detection among cervical cancer patients. In the second study, the purpose is to develop and evaluate a unique global mammographic image feature analysis scheme to identify case malignancy for breast cancer. From the entire breast area depicted on the mammograms, 59 features were initially computed to characterize the breast tissue properties in both the spatial and frequency domain. Given that each case consists of two cranio-caudal and two medio-lateral oblique view images of left and right breasts, two feature pools were built, which contain the computed features from either two positive images of one breast or all the four images of two breasts. For each feature pool, a particle swarm optimization (PSO) method was applied to determine the optimal feature cluster followed by training an SVM classifier to generate a final score for predicting likelihood of the case being malignant. The classification performances measured by AUC were 0.79±0.07 and 0.75±0.08 when applying the SVM classifiers trained using image features computed from two-view and four-view images, respectively. This study demonstrates the potential of developing a global mammographic image feature analysis-based scheme to predict case malignancy without including an arduous segmentation of breast lesions. In the third study, given that the performance of DL-based models in the medical imaging field is generally bottlenecked by a lack of sufficient labeled images, we specifically investigate the effectiveness of applying the latest transferring generative adversarial networks (GAN) technology to augment limited data for performance boost in the task of breast mass classification. This transferring GAN model was first pre-trained on a dataset of 25,000 mammogram patches (without labels). Then its generator and the discriminator were fine-tuned on a much smaller dataset containing 1024 labeled breast mass images. A supervised loss was integrated with the discriminator, such that it can be used to directly classify the benign/malignant masses. Our proposed approach improved the classification accuracy by 6.002%, when compared with the classifiers trained without traditional data augmentation. This investigation may provide a new perspective for researchers to effectively train the GAN models on a medical imaging task with only limited datasets. Like the third study, our last study also aims to alleviate DL models’ reliance on large amounts of annotations but uses a totally different approach. We propose employing a semi-supervised method, i.e., virtual adversarial training (VAT), to learn and leverage useful information underlying in unlabeled data for better classification of breast masses. Accordingly, our VAT-based models have two types of losses, namely supervised and virtual adversarial losses. The former loss acts as in supervised classification, while the latter loss works towards enhancing the model’s robustness against virtual adversarial perturbation, thus improving model generalizability. A large CNN and a small CNN were used in this investigation, and both were trained with and without the adversarial loss. When the labeled ratios were 40% and 80%, VAT-based CNNs delivered the highest classification accuracy of 0.740±0.015 and 0.760±0.015, respectively. The experimental results suggest that the VAT-based CAD scheme can effectively utilize meaningful knowledge from unlabeled data to better classify mammographic breast mass images. In summary, several innovative approaches have been investigated and evaluated in this dissertation to develop ML-based and DL-based CAD schemes for the diagnosis of cervical cancer and breast cancer. The promising results demonstrate the potential of these CAD schemes in assisting radiologists to achieve a more accurate interpretation of radiological images

Object Detection in medical imaging

A thesis submitted in partial fulfillment of the requirements for the degree of Doctor in Information Management, specialization in Information and Decision SystemsArtificial Intelligence, assisted by deep learning, has emerged in various fields of our society. These systems allow the automation and the improvement of several tasks, even surpassing, in some cases, human capability. Object detection methods are used nowadays in several areas, including medical imaging analysis. However, these methods are susceptible to errors, and there is a lack of a universally accepted method that can be applied across all types of applications with the needed precision in the medical field. Additionally, the application of object detectors in medical imaging analysis has yet to be thoroughly analyzed to achieve a richer understanding of the state of the art. To tackle these shortcomings, we present three studies with distinct goals. First, a quantitative and qualitative analysis of academic research was conducted to gather a perception of which object detectors are employed, the modality of medical imaging used, and the particular body parts under investigation. Secondly, we propose an optimized version of a widely used algorithm to overcome limitations commonly addressed in medical imaging by fine-tuning several hyperparameters. Thirdly, we develop a novel stacking approach to augment the precision of detections on medical imaging analysis. The findings show that despite the late arrival of object detection in medical imaging analysis, the number of publications has increased in recent years, demonstrating the significant potential for growth. Additionally, we establish that it is possible to address some constraints on the data through an exhaustive optimization of the algorithm. Finally, our last study highlights that there is still room for improvement in these advanced techniques, using, as an example, stacking approaches. The contributions of this dissertation are several, as it puts forward a deeper overview of the state-of-the-art applications of object detection algorithms in the medical field and presents strategies for addressing typical constraints in this area.A Inteligência Artificial, auxiliada pelo deep learning, tem emergido em diversas áreas da nossa sociedade. Estes sistemas permitem a automatização e a melhoria de diversas tarefas, superando mesmo, em alguns casos, a capacidade humana. Os métodos de detecção de objetos são utilizados atualmente em diversas áreas, inclusive na análise de imagens médicas. No entanto, esses métodos são suscetíveis a erros e falta um método universalmente aceite que possa ser aplicado em todos os tipos de aplicações com a precisão necessária na área médica. Além disso, a aplicação de detectores de objetos na análise de imagens médicas ainda precisa ser analisada minuciosamente para alcançar uma compreensão mais rica do estado da arte. Para enfrentar essas limitações, apresentamos três estudos com objetivos distintos. Inicialmente, uma análise quantitativa e qualitativa da pesquisa acadêmica foi realizada para obter uma percepção de quais detectores de objetos são empregues, a modalidade de imagem médica usada e as partes específicas do corpo sob investigação. Num segundo estudo, propomos uma versão otimizada de um algoritmo amplamente utilizado para superar limitações comumente abordadas em imagens médicas por meio do ajuste fino de vários hiperparâmetros. Em terceiro lugar, desenvolvemos uma nova abordagem de stacking para aumentar a precisão das detecções na análise de imagens médicas. Os resultados demostram que, apesar da chegada tardia da detecção de objetos na análise de imagens médicas, o número de publicações aumentou nos últimos anos, evidenciando o significativo potencial de crescimento. Adicionalmente, estabelecemos que é possível resolver algumas restrições nos dados por meio de uma otimização exaustiva do algoritmo. Finalmente, o nosso último estudo destaca que ainda há espaço para melhorias nessas técnicas avançadas, usando, como exemplo, abordagens de stacking. As contribuições desta dissertação são várias, apresentando uma visão geral em maior detalhe das aplicações de ponta dos algoritmos de detecção de objetos na área médica e apresenta estratégias para lidar com restrições típicas nesta área

A Bottom-Up Review of Image Analysis Methods for Suspicious Region Detection in Mammograms.

Breast cancer is one of the most common death causes amongst women all over the world. Early detection of breast cancer plays a critical role in increasing the survival rate. Various imaging modalities, such as mammography, breast MRI, ultrasound and thermography, are used to detect breast cancer. Though there is a considerable success with mammography in biomedical imaging, detecting suspicious areas remains a challenge because, due to the manual examination and variations in shape, size, other mass morphological features, mammography accuracy changes with the density of the breast. Furthermore, going through the analysis of many mammograms per day can be a tedious task for radiologists and practitioners. One of the main objectives of biomedical imaging is to provide radiologists and practitioners with tools to help them identify all suspicious regions in a given image. Computer-aided mass detection in mammograms can serve as a second opinion tool to help radiologists avoid running into oversight errors. The scientific community has made much progress in this topic, and several approaches have been proposed along the way. Following a bottom-up narrative, this paper surveys different scientific methodologies and techniques to detect suspicious regions in mammograms spanning from methods based on low-level image features to the most recent novelties in AI-based approaches. Both theoretical and practical grounds are provided across the paper sections to highlight the pros and cons of different methodologies. The paper's main scope is to let readers embark on a journey through a fully comprehensive description of techniques, strategies and datasets on the topic

DEVELOPING MEDICAL IMAGE SEGMENTATION AND COMPUTER-AIDED DIAGNOSIS SYSTEMS USING DEEP NEURAL NETWORKS

Diagnostic medical imaging is an important non-invasive tool in medicine. It provides doctors (i.e., radiologists) with rich diagnostic information in clinical practice. Computer-aided diagnosis (CAD) schemes aim to provide a tool to assist the doctors for reading and interpreting medical images. Traditional CAD schemes are based on hand-crafted features and shallow supervised learning algorithms. They are greatly limited by the difficulties of accurate region segmentation and effective feature extraction. In this dissertation, our motivation is to apply deep learning techniques to address these challenges. We comprehensively investigated the feasibilities of applying deep learning technique to develop medical image segmentation and computer-aided diagnosis schemes for different imaging modalities and different tasks. First, we applied a two-step convolutional neural network architecture for selection of abdomen part and segmentation of subtypes of adipose tissue from abdominal CT images. We demonstrated high agreement between the segmentation generated by human and by our proposed deep learning models. Second, we explored to combine transfer learning technique with traditional hand-crafted features to improve the accuracy of breast mass classification from digital mammograms. Our results show that the ensemble of hand-crafted features and transferred features yields improvement of prediction performances. Third, we proposed a 3D fully convolutional network architecture with a novel coarse-to-fine residual module for prostate segmentation from MRI. State-of-art segmentation accuracy was obtained by using this model. We also investigated the feasibilities of applying fully convolutional network for prostate cancer detection based on multi-parametric MRI and obtained promising detection accuracy. Last, we proposed a novel cascaded neural network architecture with post-processing steps for nuclear segmentation from histology images. Superiority of the model was demonstrated by experiments. In summary, these study results demonstrated that deep learning is a very promising technology to help significantly improve efficacy of developing computer-aided diagnosis schemes of medical images and achieve higher performance