Deep Learning in Medical Image Analysis

The computer-assisted analysis for better interpreting images have been longstanding issues in the medical imaging field. On the image-understanding front, recent advances in machine learning, especially, in the way of deep learning, have made a big leap to help identify, classify, and quantify patterns in medical images. Specifically, exploiting hierarchical feature representations learned solely from data, instead of handcrafted features mostly designed based on domain-specific knowledge, lies at the core of the advances. In that way, deep learning is rapidly proving to be the state-of-the-art foundation, achieving enhanced performances in various medical applications. In this article, we introduce the fundamentals of deep learning methods; review their successes to image registration, anatomical/cell structures detection, tissue segmentation, computer-aided disease diagnosis or prognosis, and so on. We conclude by raising research issues and suggesting future directions for further improvements

Fast catheter segmentation and tracking based on x-ray fluoroscopic and echocardiographic modalities for catheter-based cardiac minimally invasive interventions

X-ray fluoroscopy and echocardiography imaging (ultrasound, US) are two imaging modalities that are widely used in cardiac catheterization. For these modalities, a fast, accurate and stable algorithm for the detection and tracking of catheters is required to allow clinicians to observe the catheter location in real-time. Currently X-ray fluoroscopy is routinely used as the standard modality in catheter ablation interventions. However, it lacks the ability to visualize soft tissue and uses harmful radiation. US does not have these limitations but often contains acoustic artifacts and has a small field of view. These make the detection and tracking of the catheter in US very challenging. The first contribution in this thesis is a framework which combines Kalman filter and discrete optimization for multiple catheter segmentation and tracking in X-ray images. Kalman filter is used to identify the whole catheter from a single point detected on the catheter in the first frame of a sequence of x-ray images. An energy-based formulation is developed that can be used to track the catheters in the following frames. We also propose a discrete optimization for minimizing the energy function in each frame of the X-ray image sequence. Our approach is robust to tangential motion of the catheter and combines the tubular and salient feature measurements into a single robust and efficient framework. The second contribution is an algorithm for catheter extraction in 3D ultrasound images based on (a) the registration between the X-ray and ultrasound images and (b) the segmentation of the catheter in X-ray images. The search space for the catheter extraction in the ultrasound images is constrained to lie on or close to a curved surface in the ultrasound volume. The curved surface corresponds to the back-projection of the extracted catheter from the X-ray image to the ultrasound volume. Blob-like features are detected in the US images and organized in a graphical model. The extracted catheter is modelled as the optimal path in this graphical model. Both contributions allow the use of ultrasound imaging for the improved visualization of soft tissue. However, X-ray imaging is still required for each ultrasound frame and the amount of X-ray exposure has not been reduced. The final contribution in this thesis is a system that can track the catheter in ultrasound volumes automatically without the need for X-ray imaging during the tracking. Instead X-ray imaging is only required for the system initialization and for recovery from tracking failures. This allows a significant reduction in the amount of X-ray exposure for patient and clinicians.Open Acces

Object detection and segmentation using discriminative learning

Object detection and segmentation algorithms need to use prior knowledge of objects' shape and appearance to guide solutions to correct ones. A promising way of obtaining prior knowledge is to learn it directly from expert annotations by using machine learning techniques. Previous approaches commonly use generative learning approaches to achieve this goal. In this dissertation, I propose a series of discriminative learning algorithms based on boosting principles to learn prior knowledge from image databases with expert annotations. The learned knowledge improves the performance of detection and segmentation, leading to fast and accurate solutions. For object detection, I present a learning procedure called a Probabilistic Boosting Network (PBN) suitable for real-time object detection and pose estimation. Based on the law of total probability, PBN integrates evidence from two building blocks, namely a multiclass classifier for pose estimation and a detection cascade for object detection. Both the classifier and detection cascade employ boosting. By inferring the pose parameter, I avoid the exhaustive scan over pose parameters, which hampers real-time detection. I implement PBN using a graph-structured network that alternates the two tasks of object detection and pose estimation in an effort to reject negative cases as quickly as possible. Compared with previous approaches, PBN has higher accuracy in object localization and pose estimation with noticeable reduced computation. For object segmentation, I cast deformable object segmentation as optimizing the conditional probability density function p(C|I), where I is an image and C is a vector of model parameters describing the object shape. I propose a regression approach to learn the density p(C|I) discriminatively based on boosting principles. The learned density p(C|I) possesses a desired unimodal, smooth shape, which can be used by optimization algorithms to efficiently estimate a solution. To handle the high-dimensional learning challenges, I propose a multi-level approach and a gradient-based sampling strategy to learn regression functions efficiently. I show that the regression approach consistently outperforms state-of-the-art methods on a variety of testing datasets. Finally, I present a comparative study on how to apply three discriminative learning approaches - classification, regression, and ranking - to deformable shape segmentation. I discuss how to extend the idea of the regression approach to build discriminative models using classification and ranking. I propose sampling strategies to collect training examples from a high-dimensional model space for the classification and the ranking approach. I also propose a ranking algorithm based on Rankboost to learn a discriminative model for segmentation. Experimental results on left ventricle and left atrium segmentation from ultrasound images and facial feature localization demonstrate that the discriminative models outperform generative models and energy minimization methods by a large margin

Symbiotic deep learning for medical image analysis with applications in real-time diagnosis for fetal ultrasound screening

The last hundred years have seen a monumental rise in the power and capability of machines to perform intelligent tasks in the stead of previously human operators. This rise is not expected to slow down any time soon and what this means for society and humanity as a whole remains to be seen. The overwhelming notion is that with the right goals in mind, the growing influence of machines on our every day tasks will enable humanity to give more attention to the truly groundbreaking challenges that we all face together. This will usher in a new age of human machine collaboration in which humans and machines may work side by side to achieve greater heights for all of humanity. Intelligent systems are useful in isolation, but the true benefits of intelligent systems come to the fore in complex systems where the interaction between humans and machines can be made seamless, and it is this goal of symbiosis between human and machine that may democratise complex knowledge, which motivates this thesis. In the recent past, datadriven methods have come to the fore and now represent the state-of-the-art in many different fields. Alongside the shift from rule-based towards data-driven methods we have also seen a shift in how humans interact with these technologies. Human computer interaction is changing in response to data-driven methods and new techniques must be developed to enable the same symbiosis between man and machine for data-driven methods as for previous formula-driven technology. We address five key challenges which need to be overcome for data-driven human-in-the-loop computing to reach maturity. These are (1) the ’Categorisation Challenge’ where we examine existing work and form a taxonomy of the different methods being utilised for data-driven human-in-the-loop computing; (2) the ’Confidence Challenge’, where data-driven methods must communicate interpretable beliefs in how confident their predictions are; (3) the ’Complexity Challenge’ where the aim of reasoned communication becomes increasingly important as the complexity of tasks and methods to solve also increases; (4) the ’Classification Challenge’ in which we look at how complex methods can be separated in order to provide greater reasoning in complex classification tasks; and finally (5) the ’Curation Challenge’ where we challenge the assumptions around bottleneck creation for the development of supervised learning methods.Open Acces

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

Deep Learning With Attention Mechanisms in Breast Ultrasound Image Segmentation and Classification

Breast cancer is a great threat to women’s health. Breast ultrasound (BUS) imaging is commonly used in the early detection of breast cancer as a portable, valuable, and widely available diagnosis tool. Automated BUS image analysis can assist radiologists in making accurate and fast decisions. Generally, automated BUS image analysis includes BUS image segmentation and classification. BUS image segmentation automatically extracts tumor regions from a BUS image. BUS image classification automatically classifies breast tumors into benign or malignant categories. Multi-task learning accomplishes segmentation and classification simultaneously, which makes it more appealing and practical than an either individual task. Deep neural networks have recently been employed to achieve better image segmentation and classification results than conventional approaches. In addition, attention mechanisms are applied to deep neural networks to make them focus on the important parts of the input to improve the segmentation and classification performance. However, BUS image segmentation and classification are still challenging due to the lack of public training data and the high variability of tumors in shape, size, and location. In this dissertation, we introduce three different deep learning architectures with attention mechanisms, each of which aims to address the drawbacks of their peers and evaluate their performance in terms of segmentation and classification accuracy on two public BUS datasets. First, we propose a Multi-Scale Self-Attention Network (MSSA-Net) for BUS image segmentation that can be trained on small BUS image datasets. We design a multi-scale attention mechanism to explore relationships between pixels to improve the feature representation and achieve better segmentation accuracy. Second, we propose a Multi-Task Learning Network with Context-Oriented Self-Attention (MTL-COSA) to segment tumors and classify them as benign or malignant automatically and simultaneously. We design a COSA attention mechanism that utilizes segmentation outputs to estimate the tumor boundary, which is treated as prior medical knowledge, to guide the network to learn contextual relationships for better feature representations to improve both segmentation and classification accuracy. Third, we propose a Regional-Attentive Multi-Task Learning framework (RMTL-Net) for simultaneous BUS image segmentation and classification. We design a regional attention mechanism that employs the segmentation output to guide the classifier to learn important category-sensitive information in three regions of BUS images and fuse them to achieve better classification accuracy. We conduct experiments on two public BUS image datasets to show the superiority of the proposed three methods to several state-of-the-art methods for BUS image segmentation, classification, and Multi-task learning

Activity profiling for minimally invasive surgery

Imperial Users onl