Review on the methods of automatic liver segmentation from abdominal images

Automatic liver segmentation from abdominal images is challenging on the aspects of segmentation accuracy, automation and robustness. There exist many methods of liver segmentation and ways of categorisingthem. In this paper, we present a new way of summarizing the latest achievements in automatic liver segmentation.We categorise a segmentation method according to the image feature it works on, therefore better summarising the performance of each category and leading to finding an optimal solution for a particular segmentation task. All the methods of liver segmentation are categorized into three main classes including gray level based method, structure based method and texture based method. In each class, the latest advance is reviewed with summary comments on the advantages and drawbacks of each discussed approach. Performance comparisons among the classes are given along with the remarks on the problems existed and possible solutions. In conclusion, we point out that liver segmentation is still an open issue and the tendency is that multiple methods will be employed to-gether to achieve better segmentation performance

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

Computer-Aided Assessment of Tuberculosis with Radiological Imaging: From rule-based methods to Deep Learning

Mención Internacional en el título de doctorTuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis (Mtb.) that produces pulmonary damage due to its airborne nature. This fact facilitates the disease fast-spreading, which, according to the World Health Organization (WHO), in 2021 caused 1.2 million deaths and 9.9 million new cases. Traditionally, TB has been considered a binary disease (latent/active) due to the limited specificity of the traditional diagnostic tests. Such a simple model causes difficulties in the longitudinal assessment of pulmonary affectation needed for the development of novel drugs and to control the spread of the disease. Fortunately, X-Ray Computed Tomography (CT) images enable capturing specific manifestations of TB that are undetectable using regular diagnostic tests, which suffer from limited specificity. In conventional workflows, expert radiologists inspect the CT images. However, this procedure is unfeasible to process the thousands of volume images belonging to the different TB animal models and humans required for a suitable (pre-)clinical trial. To achieve suitable results, automatization of different image analysis processes is a must to quantify TB. It is also advisable to measure the uncertainty associated with this process and model causal relationships between the specific mechanisms that characterize each animal model and its level of damage. Thus, in this thesis, we introduce a set of novel methods based on the state of the art Artificial Intelligence (AI) and Computer Vision (CV). Initially, we present an algorithm to assess Pathological Lung Segmentation (PLS) employing an unsupervised rule-based model which was traditionally considered a needed step before biomarker extraction. This procedure allows robust segmentation in a Mtb. infection model (Dice Similarity Coefficient, DSC, 94%±4%, Hausdorff Distance, HD, 8.64mm±7.36mm) of damaged lungs with lesions attached to the parenchyma and affected by respiratory movement artefacts. Next, a Gaussian Mixture Model ruled by an Expectation-Maximization (EM) algorithm is employed to automatically quantify the burden of Mtb.using biomarkers extracted from the segmented CT images. This approach achieves a strong correlation (R2 ≈ 0.8) between our automatic method and manual extraction. Consequently, Chapter 3 introduces a model to automate the identification of TB lesions and the characterization of disease progression. To this aim, the method employs the Statistical Region Merging algorithm to detect lesions subsequently characterized by texture features that feed a Random Forest (RF) estimator. The proposed procedure enables a selection of a simple but powerful model able to classify abnormal tissue. The latest works base their methodology on Deep Learning (DL). Chapter 4 extends the classification of TB lesions. Namely, we introduce a computational model to infer TB manifestations present in each lung lobe of CT scans by employing the associated radiologist reports as ground truth. We do so instead of using the classical manually delimited segmentation masks. The model adjusts the three-dimensional architecture, V-Net, to a multitask classification context in which loss function is weighted by homoscedastic uncertainty. Besides, the method employs Self-Normalizing Neural Networks (SNNs) for regularization. Our results are promising with a Root Mean Square Error of 1.14 in the number of nodules and F1-scores above 0.85 for the most prevalent TB lesions (i.e., conglomerations, cavitations, consolidations, trees in bud) when considering the whole lung. In Chapter 5, we present a DL model capable of extracting disentangled information from images of different animal models, as well as information of the mechanisms that generate the CT volumes. The method provides the segmentation mask of axial slices from three animal models of different species employing a single trained architecture. It also infers the level of TB damage and generates counterfactual images. So, with this methodology, we offer an alternative to promote generalization and explainable AI models. To sum up, the thesis presents a collection of valuable tools to automate the quantification of pathological lungs and moreover extend the methodology to provide more explainable results which are vital for drug development purposes. Chapter 6 elaborates on these conclusions.Programa de Doctorado en Multimedia y Comunicaciones por la Universidad Carlos III de Madrid y la Universidad Rey Juan CarlosPresidenta: María Jesús Ledesma Carbayo.- Secretario: David Expósito Singh.- Vocal: Clarisa Sánchez Gutiérre

image analysis and processing with applications in proteomics and medicine

This thesis introduces unsupervised image analysis algorithms for the segmentation of several types of images, with an emphasis on proteomics and medical images. Τhe presented algorithms are tailored upon the principles of deformable models and more specific region-based active contours. Two different objectives are pursued. The first is the core issue of unsupervised parameterization in image segmentation, whereas the second is the formulation of a complete model for the segmentation of proteomics images, which is the first to exploit the appealing attributes of active contours. The first major contribution of this thesis is a novel framework for the automated parameterization of region-based active contours. The presented framework aims to endow segmentation results with objectivity and robustness as well as to set domain users free from the cumbersome and time-consuming process of empirical adjustment. It is applicable on various medical imaging modalities and remains insensitive on alterations in the settings of the acquisition devices. The experimental results demonstrate that the presented framework maintains a segmentation quality which is comparable to the one obtained with empirical parameterization. The second major contribution of this thesis is an unsupervised active contour-based model for the segmentation of proteomics images. The presented model copes with crucial issues in 2D-GE image analysis including streaks, artifacts, faint and overlapping spots. In addition, it provides an alternate to the laborious, error-prone process of manual editing, which is required in state-of-the-art 2D-GE image analysis software packages. The experimental results demonstrate that the presented model outperforms 2D-GE image analysis software packages in terms of detection and segmentation quantity metrics

Computational methods for the analysis of functional 4D-CT chest images.

Medical imaging is an important emerging technology that has been intensively used in the last few decades for disease diagnosis and monitoring as well as for the assessment of treatment effectiveness. Medical images provide a very large amount of valuable information that is too huge to be exploited by radiologists and physicians. Therefore, the design of computer-aided diagnostic (CAD) system, which can be used as an assistive tool for the medical community, is of a great importance. This dissertation deals with the development of a complete CAD system for lung cancer patients, which remains the leading cause of cancer-related death in the USA. In 2014, there were approximately 224,210 new cases of lung cancer and 159,260 related deaths. The process begins with the detection of lung cancer which is detected through the diagnosis of lung nodules (a manifestation of lung cancer). These nodules are approximately spherical regions of primarily high density tissue that are visible in computed tomography (CT) images of the lung. The treatment of these lung cancer nodules is complex, nearly 70% of lung cancer patients require radiation therapy as part of their treatment. Radiation-induced lung injury is a limiting toxicity that may decrease cure rates and increase morbidity and mortality treatment. By finding ways to accurately detect, at early stage, and hence prevent lung injury, it will have significant positive consequences for lung cancer patients. The ultimate goal of this dissertation is to develop a clinically usable CAD system that can improve the sensitivity and specificity of early detection of radiation-induced lung injury based on the hypotheses that radiated lung tissues may get affected and suffer decrease of their functionality as a side effect of radiation therapy treatment. These hypotheses have been validated by demonstrating that automatic segmentation of the lung regions and registration of consecutive respiratory phases to estimate their elasticity, ventilation, and texture features to provide discriminatory descriptors that can be used for early detection of radiation-induced lung injury. The proposed methodologies will lead to novel indexes for distinguishing normal/healthy and injured lung tissues in clinical decision-making. To achieve this goal, a CAD system for accurate detection of radiation-induced lung injury that requires three basic components has been developed. These components are the lung fields segmentation, lung registration, and features extraction and tissue classification. This dissertation starts with an exploration of the available medical imaging modalities to present the importance of medical imaging in today’s clinical applications. Secondly, the methodologies, challenges, and limitations of recent CAD systems for lung cancer detection are covered. This is followed by introducing an accurate segmentation methodology of the lung parenchyma with the focus of pathological lungs to extract the volume of interest (VOI) to be analyzed for potential existence of lung injuries stemmed from the radiation therapy. After the segmentation of the VOI, a lung registration framework is introduced to perform a crucial and important step that ensures the co-alignment of the intra-patient scans. This step eliminates the effects of orientation differences, motion, breathing, heart beats, and differences in scanning parameters to be able to accurately extract the functionality features for the lung fields. The developed registration framework also helps in the evaluation and gated control of the radiotherapy through the motion estimation analysis before and after the therapy dose. Finally, the radiation-induced lung injury is introduced, which combines the previous two medical image processing and analysis steps with the features estimation and classification step. This framework estimates and combines both texture and functional features. The texture features are modeled using the novel 7th-order Markov Gibbs random field (MGRF) model that has the ability to accurately models the texture of healthy and injured lung tissues through simultaneously accounting for both vertical and horizontal relative dependencies between voxel-wise signals. While the functionality features calculations are based on the calculated deformation fields, obtained from the 4D-CT lung registration, that maps lung voxels between successive CT scans in the respiratory cycle. These functionality features describe the ventilation, the air flow rate, of the lung tissues using the Jacobian of the deformation field and the tissues’ elasticity using the strain components calculated from the gradient of the deformation field. Finally, these features are combined in the classification model to detect the injured parts of the lung at an early stage and enables an earlier intervention

Image Analysis and Processing With Applications in Proteomics and Medicine

Στην παρούσα διατριβή παρουσιάζονται αυτόματοι αλγόριθμοι ανάλυσης εικόνας για την κατάτμηση διαφόρων τύπων εικόνων, με έμφαση στις εικόνες πρωτεομικής και στις ιατρικές εικόνες. Οι προτεινόμενοι αλγόριθμοι βασίζονται στις αρχές των παραμορφώσιμων μοντέλων. Η διατριβή εστιάζει σε δύο κυρίως στόχους: 1) στην επίλυση του σημαντικού προβλήματος της αυτόματης παραμετροποίησης στην κατάτμηση εικόνας, 2) στην διατύπωση ενός ολοκληρωμένου μοντέλου κατάτμησης εικόνων πρωτεομικής. Η πρώτη συνεισφορά είναι ένα πρωτότυπο πλαίσιο αυτόματης παραμετροποίησης των ενεργών περιγραμμάτων περιοχής. Το πλαίσιο εμπλουτίζει τα αποτελέσματα με αντικειμενικότητα και απελευθερώνει τους τελικούς χρήστες από την επίπονη διαδικασία της εμπειρικής ρύθμισης. Εφαρμόζεται σε διάφορους τύπους ιατρικών εικόνων και παραμένει ανεπηρέαστο στις τροποποιήσεις των ρυθμίσεων των συσκευών λήψης των εικόνων αυτών. Τα πειραματικά αποτελέσματα καταδεικνύουν ότι το προτεινόμενο πλαίσιο διατηρεί υψηλή την ποιότητα κατάτμησης, συγκρίσιμη με εκείνη που επιτυγχάνεται με εμπειρική παραμετροποίηση. Η δεύτερη συνεισφορά είναι ένα αυτόματο μοντέλο βασιζόμενο στα ενεργά περιγράμματα για την κατάτμηση εικόνων πρωτεομικής. Το μοντέλο αντιμετωπίζει σημαντικά προβλήματα συμπεριλαμβανομένων των γραμμών, τεχνουργημάτων, αχνών και επικαλυπτομένων κηλίδων. Ακόμη, παρέχει εναλλακτική λύση στην επιρρεπή σε σφάλματα διαδικασία της χειρωνακτικής επεξεργασίας που απαιτείται στα υπάρχοντα πακέτα λογισμικού. Τα πειραματικά αποτελέσματα καταδεικνύουν ότι το προτεινόμενο μοντέλο υπερτερεί των υπαρχόντων πακέτων λογισμικού σε ποσοτικές μετρικές εντοπισμού και κατάτμησης.This thesis introduces unsupervised image analysis algorithms for the segmentation of several types of images, with an emphasis on proteomics and medical images. Τhe presented algorithms are tailored upon the principles of deformable models. Two objectives are pursued: 1) the core issue of unsupervised parameterization in image segmentation, 2) the formulation of a complete model for the segmentation of proteomics images. The first contribution is a novel framework for automated parameterization of region-based active contours. The presented framework endows segmentation results with objectivity and sets domain users free from the cumbersome process of empirical adjustment. It is applicable on various medical imaging modalities and remains insensitive on alterations in the settings of acquisition devices. The experimental results demonstrate that the presented framework maintains a high segmentation quality, comparable to the one obtained with empirical parameterization. The second contribution is an unsupervised active contour-based model for the segmentation of proteomics images. The presented model copes with crucial issues including streaks, artifacts, faint and overlapping spots. Moreover, it provides an alternate to the error-prone process of manual editing, required in state-of-the-art software packages. The experimental results demonstrate that the proposed model outperforms software packages in terms of detection and segmentation quantity metrics