Deep learning for clinical decision support in oncology

In den letzten Jahrzehnten sind medizinische Bildgebungsverfahren wie die Computertomographie (CT) zu einem unersetzbaren Werkzeug moderner Medizin geworden, welche eine zeitnahe, nicht-invasive Begutachtung von Organen und Geweben ermöglichen. Die Menge an anfallenden Daten ist dabei rapide gestiegen, allein innerhalb der letzten Jahre um den Faktor 15, und aktuell verantwortlich für 30 % des weltweiten Datenvolumens. Die Anzahl ausgebildeter Radiologen ist weitestgehend stabil, wodurch die medizinische Bildanalyse, angesiedelt zwischen Medizin und Ingenieurwissenschaften, zu einem schnell wachsenden Feld geworden ist. Eine erfolgreiche Anwendung verspricht Zeitersparnisse, und kann zu einer höheren diagnostischen Qualität beitragen. Viele Arbeiten fokussieren sich auf „Radiomics“, die Extraktion und Analyse von manuell konstruierten Features. Diese sind jedoch anfällig gegenüber externen Faktoren wie dem Bildgebungsprotokoll, woraus Implikationen für Reproduzierbarkeit und klinische Anwendbarkeit resultieren. In jüngster Zeit sind Methoden des „Deep Learning“ zu einer häufig verwendeten Lösung algorithmischer Problemstellungen geworden. Durch Anwendungen in Bereichen wie Robotik, Physik, Mathematik und Wirtschaft, wurde die Forschung im Bereich maschinellen Lernens wesentlich verändert. Ein Kriterium für den Erfolg stellt die Verfügbarkeit großer Datenmengen dar. Diese sind im medizinischen Bereich rar, da die Bilddaten strengen Anforderungen bezüglich Datenschutz und Datensicherheit unterliegen, und oft heterogene Qualität, sowie ungleichmäßige oder fehlerhafte Annotationen aufweisen, wodurch ein bedeutender Teil der Methoden keine Anwendung finden kann. Angesiedelt im Bereich onkologischer Bildgebung zeigt diese Arbeit Wege zur erfolgreichen Nutzung von Deep Learning für medizinische Bilddaten auf. Mittels neuer Methoden für klinisch relevante Anwendungen wie die Schätzung von Läsionswachtum, Überleben, und Entscheidungkonfidenz, sowie Meta-Learning, Klassifikator-Ensembling, und Entscheidungsvisualisierung, werden Wege zur Verbesserungen gegenüber State-of-the-Art-Algorithmen aufgezeigt, welche ein breites Anwendungsfeld haben. Hierdurch leistet die Arbeit einen wesentlichen Beitrag in Richtung einer klinischen Anwendung von Deep Learning, zielt auf eine verbesserte Diagnose, und damit letztlich eine verbesserte Gesundheitsversorgung insgesamt.Over the last decades, medical imaging methods, such as computed tomography (CT), have become an indispensable tool of modern medicine, allowing for a fast, non-invasive inspection of organs and tissue. Thus, the amount of acquired healthcare data has rapidly grown, increased 15-fold within the last years, and accounts for more than 30 % of the world's generated data volume. In contrast, the number of trained radiologists remains largely stable. Thus, medical image analysis, settled between medicine and engineering, has become a rapidly growing research field. Its successful application may result in remarkable time savings and lead to a significantly improved diagnostic performance. Many of the work within medical image analysis focuses on radiomics, i. e. the extraction and analysis of hand-crafted imaging features. Radiomics, however, has been shown to be highly sensitive to external factors, such as the acquisition protocol, having major implications for reproducibility and clinical applicability. Lately, deep learning has become one of the most employed methods for solving computational problems. With successful applications in diverse fields, such as robotics, physics, mathematics, and economy, deep learning has revolutionized the process of machine learning research. Having large amounts of training data is a key criterion for its successful application. These data, however, are rare within medicine, as medical imaging is subject to a variety of data security and data privacy regulations. Moreover, medical imaging data often suffer from heterogeneous quality, label imbalance, and label noise, rendering a considerable fraction of deep learning-based algorithms inapplicable. Settled in the field of CT oncology, this work addresses these issues, showing up ways to successfully handle medical imaging data using deep learning. It proposes novel methods for clinically relevant tasks, such as lesion growth and patient survival prediction, confidence estimation, meta-learning and classifier ensembling, and finally deep decision explanation, yielding superior performance in comparison to state-of-the-art approaches, and being applicable to a wide variety of applications. With this, the work contributes towards a clinical translation of deep learning-based algorithms, aiming for an improved diagnosis, and ultimately overall improved patient healthcare

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

LoMAE: Low-level Vision Masked Autoencoders for Low-dose CT Denoising

Low-dose computed tomography (LDCT) offers reduced X-ray radiation exposure but at the cost of compromised image quality, characterized by increased noise and artifacts. Recently, transformer models emerged as a promising avenue to enhance LDCT image quality. However, the success of such models relies on a large amount of paired noisy and clean images, which are often scarce in clinical settings. In the fields of computer vision and natural language processing, masked autoencoders (MAE) have been recognized as an effective label-free self-pretraining method for transformers, due to their exceptional feature representation ability. However, the original pretraining and fine-tuning design fails to work in low-level vision tasks like denoising. In response to this challenge, we redesign the classical encoder-decoder learning model and facilitate a simple yet effective low-level vision MAE, referred to as LoMAE, tailored to address the LDCT denoising problem. Moreover, we introduce an MAE-GradCAM method to shed light on the latent learning mechanisms of the MAE/LoMAE. Additionally, we explore the LoMAE's robustness and generability across a variety of noise levels. Experiments results show that the proposed LoMAE can enhance the transformer's denoising performance and greatly relieve the dependence on the ground truth clean data. It also demonstrates remarkable robustness and generalizability over a spectrum of noise levels

U-Capkidnets++-: A Novel Hybrid Capsule Networks with Optimized Deep Feed Forward Networks for an Effective Classification of Kidney Tumours Using CT Kidney Images

Chronic Kidney Diseases (CKD) has become one among the world wide health crisis and needs the associated efforts to prevent the complete organ damage. A considerable research effort has been put forward onto the effective seperation and classification of kidney tumors from the kidney CT Images. Emerging machine learning along with deep learning algorithms have waved the novel paths of tumor detections. But these methods are proved to be laborious and its success rate is purely depends on the previous experiences. To achieve the better classification and segmentation of tumors, this paper proposes the hybrid ensemble of visual capsule networks in U-NET deep learning architecture and w deep feed-forward extreme learning machines. The proposed framework incorporates the data-preprocessing powerful data augmentation, saliency tumor segmentation (STS) followed by the classification phase. Furthermore, classification levels are constructed based upon the feed forward extreme learning machines (FFELM) to enhance the effectiveness of the suggested model .The extensive experimentation has been conducted to evaluate the efficacy of the recommended structure and matched with the other prevailing hybrid deep learning model. Experimentation demonstrates that the suggested model has showed the superior predominance over the other models and exhibited DICE co-efficient of kidney tumors as high as 0.96 and accuracy of 97.5 %respectively

Deep learning in medical imaging and radiation therapy

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146980/1/mp13264_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146980/2/mp13264.pd

Exploring variability in medical imaging

Although recent successes of deep learning and novel machine learning techniques improved the perfor- mance of classification and (anomaly) detection in computer vision problems, the application of these methods in medical imaging pipeline remains a very challenging task. One of the main reasons for this is the amount of variability that is encountered and encapsulated in human anatomy and subsequently reflected in medical images. This fundamental factor impacts most stages in modern medical imaging processing pipelines. Variability of human anatomy makes it virtually impossible to build large datasets for each disease with labels and annotation for fully supervised machine learning. An efficient way to cope with this is to try and learn only from normal samples. Such data is much easier to collect. A case study of such an automatic anomaly detection system based on normative learning is presented in this work. We present a framework for detecting fetal cardiac anomalies during ultrasound screening using generative models, which are trained only utilising normal/healthy subjects. However, despite the significant improvement in automatic abnormality detection systems, clinical routine continues to rely exclusively on the contribution of overburdened medical experts to diagnosis and localise abnormalities. Integrating human expert knowledge into the medical imaging processing pipeline entails uncertainty which is mainly correlated with inter-observer variability. From the per- spective of building an automated medical imaging system, it is still an open issue, to what extent this kind of variability and the resulting uncertainty are introduced during the training of a model and how it affects the final performance of the task. Consequently, it is very important to explore the effect of inter-observer variability both, on the reliable estimation of model’s uncertainty, as well as on the model’s performance in a specific machine learning task. A thorough investigation of this issue is presented in this work by leveraging automated estimates for machine learning model uncertainty, inter-observer variability and segmentation task performance in lung CT scan images. Finally, a presentation of an overview of the existing anomaly detection methods in medical imaging was attempted. This state-of-the-art survey includes both conventional pattern recognition methods and deep learning based methods. It is one of the first literature surveys attempted in the specific research area.Open Acces

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

Deep Learning in Cardiology

The medical field is creating large amount of data that physicians are unable to decipher and use efficiently. Moreover, rule-based expert systems are inefficient in solving complicated medical tasks or for creating insights using big data. Deep learning has emerged as a more accurate and effective technology in a wide range of medical problems such as diagnosis, prediction and intervention. Deep learning is a representation learning method that consists of layers that transform the data non-linearly, thus, revealing hierarchical relationships and structures. In this review we survey deep learning application papers that use structured data, signal and imaging modalities from cardiology. We discuss the advantages and limitations of applying deep learning in cardiology that also apply in medicine in general, while proposing certain directions as the most viable for clinical use.Comment: 27 pages, 2 figures, 10 table