Automated detection of parenchymal changes of ischemic stroke in non-contrast computer tomography: a fuzzy approach

The detection of ischemic changes is a primary task in the interpretation of brain Computer Tomography (CT) of patients suffering from neurological disorders. Although CT can easily show these lesions, their interpretation may be difficult when the lesion is not easily recognizable. The gold standard for the detection of acute stroke is highly variable and depends on the experience of physicians. This research proposes a new method of automatic detection of parenchymal changes of ischemic stroke in Non-Contrast CT. The method identifies non-pathological cases (94 cases, 40 training, 54 test) based on the analysis of cerebral symmetry. Parenchymal changes in cases with abnormalities (20 cases) are detected by means of a contralateral analysis of brain regions. In order to facilitate the evaluation of abnormal regions, non-pathological tissues in Hounsfield Units were characterized using fuzzy logic techniques. Cases of non-pathological and stroke patients were used to discard/confirm abnormality with a sensitivity (TPR) of 91% and specificity (SPC) of 100%. Abnormal regions were evaluated and the presence of parenchymal changes was detected with a TPR of 96% and SPC of 100%. The presence of parenchymal changes of ischemic stroke was detected by the identification of tissues using fuzzy logic techniques. Because of abnormal regions are identified, the expert can prioritize the examination to a previously delimited region, decreasing the diagnostic time. The identification of tissues allows a better visualization of the region to be evaluated, helping to discard or confirm a stroke.Peer ReviewedPostprint (author's final draft

Acute ischemic stroke lesion segmentation in non-contrast CT images using 3D convolutional neural networks

In this paper, an automatic algorithm aimed at volumetric segmentation of acute ischemic stroke lesion in non-contrast computed tomography brain 3D images is proposed. Our deep-learning approach is based on the popular 3D U-Net convolutional neural network architecture, which was modified by adding the squeeze-and-excitation blocks and residual connections. Robust pre-processing methods were implemented to improve the segmentation accuracy. Moreover, a specific patches sampling strategy was used to address the large size of medical images, to smooth out the effect of the class imbalance problem and to stabilize neural network training. All experiments were performed using five-fold cross-validation on the dataset containing non-contrast computed tomography volumetric brain scans of 81 patients diagnosed with acute ischemic stroke. Two radiology experts manually segmented images independently and then verified the labeling results for inconsistencies. The quantitative results of the proposed algorithm and obtained segmentation were measured by the Dice similarity coefficient, sensitivity, specificity and precision metrics. Our proposed model achieves an average Dice of $0.628\pm0.033$, sensitivity of $0.699\pm0.039$, specificity of $0.9965\pm0.0016$ and precision of $0.619\pm0.036$, showing promising segmentation results.Comment: 18 pages, 4 figures, 2 table

A Review on Computer Aided Diagnosis of Acute Brain Stroke.

Amongst the most common causes of death globally, stroke is one of top three affecting over 100 million people worldwide annually. There are two classes of stroke, namely ischemic stroke (due to impairment of blood supply, accounting for ~70% of all strokes) and hemorrhagic stroke (due to bleeding), both of which can result, if untreated, in permanently damaged brain tissue. The discovery that the affected brain tissue (i.e., 'ischemic penumbra') can be salvaged from permanent damage and the bourgeoning growth in computer aided diagnosis has led to major advances in stroke management. Abiding to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines, we have surveyed a total of 177 research papers published between 2010 and 2021 to highlight the current status and challenges faced by computer aided diagnosis (CAD), machine learning (ML) and deep learning (DL) based techniques for CT and MRI as prime modalities for stroke detection and lesion region segmentation. This work concludes by showcasing the current requirement of this domain, the preferred modality, and prospective research areas

Fast and robust hybrid framework for infant brain classification from structural MRI : a case study for early diagnosis of autism.

The ultimate goal of this work is to develop a computer-aided diagnosis (CAD) system for early autism diagnosis from infant structural magnetic resonance imaging (MRI). The vital step to achieve this goal is to get accurate segmentation of the different brain structures: whitematter, graymatter, and cerebrospinal fluid, which will be the main focus of this thesis. The proposed brain classification approach consists of two major steps. First, the brain is extracted based on the integration of a stochastic model that serves to learn the visual appearance of the brain texture, and a geometric model that preserves the brain geometry during the extraction process. Secondly, the brain tissues are segmented based on shape priors, built using a subset of co-aligned training images, that is adapted during the segmentation process using first- and second-order visual appearance features of infant MRIs. The accuracy of the presented segmentation approach has been tested on 300 infant subjects and evaluated blindly on 15 adult subjects. The experimental results have been evaluated by the MICCAI MR Brain Image Segmentation (MRBrainS13) challenge organizers using three metrics: Dice coefficient, 95-percentile Hausdorff distance, and absolute volume difference. The proposed method has been ranked the first in terms of performance and speed

Automated infaction core delineation

Tato práce se zabývá návrhem metody, která by mohla lékařům poskytnout dodatečné informace při rozhodování o nejvhodnější léčbě pro pacienty s ischemickou cévní mozkovou příhodou. Navrhovaná metoda je automatická a dokáže označit nekrotickou tkáň na snímcích, které vznikly kombinací angiografického a nekontrastního vyšetření počítačovou tomografií. Tato kombinace dokáže pokrýt oblast celého mozku. Objem nekrotické tkáně je kritickým faktorem pro aplikaci trombolytické léčby. Takový parametr nemají lékaři v současné době k dispozici. Lidem, kteří přesáhnou určitou hodnotu objemu nekrotické tkáně, by neměla být aplikována trombolytická léčba, neboť je vysoké riziko dalšího krvácení.Katedra informatiky a výpočetní technikyObhájenoThis thesis deals with methods that could provide additional information for physicians when deciding about the most appropriate treatment for patients with ischemic strokes. The thesis proposes a method for automated infarction core delineation based on combination of angiography and non contract computed tomography examinations. Such perfused blood volume mapping has advantage in whole brain coverage. The volume of the infarction core area is the crucial factor for thrombolytic treatment indication. Such information is not yet available for physicians. Patients who exceed certain level of the infarction core volume should not be indicated for thrombolytic treatment because of high risk of further bleeding

Computational Modeling for Abnormal Brain Tissue Segmentation, Brain Tumor Tracking, and Grading

This dissertation proposes novel texture feature-based computational models for quantitative analysis of abnormal tissues in two neurological disorders: brain tumor and stroke. Brain tumors are the cells with uncontrolled growth in the brain tissues and one of the major causes of death due to cancer. On the other hand, brain strokes occur due to the sudden interruption of the blood supply which damages the normal brain tissues and frequently causes death or persistent disability. Clinical management of these brain tumors and stroke lesions critically depends on robust quantitative analysis using different imaging modalities including Magnetic Resonance (MR) and Digital Pathology (DP) images. Due to uncontrolled growth and infiltration into the surrounding tissues, the tumor regions appear with a significant texture variation in the static MRI volume and also in the longitudinal imaging study. Consequently, this study developed computational models using novel texture features to segment abnormal brain tissues (tumor, and stroke lesions), tracking the change of tumor volume in longitudinal images, and tumor grading in MR images. Manual delineation and analysis of these abnormal tissues in large scale is tedious, error-prone, and often suffers from inter-observer variability. Therefore, efficient computational models for robust segmentation of different abnormal tissues is required to support the diagnosis and analysis processes. In this study, brain tissues are characterized with novel computational modeling of multi-fractal texture features for multi-class brain tumor tissue segmentation (BTS) and extend the method for ischemic stroke lesions in MRI. The robustness of the proposed segmentation methods is evaluated using a huge amount of private and public domain clinical data that offers competitive performance when compared with that of the state-of-the-art methods. Further, I analyze the dynamic texture behavior of tumor volume in longitudinal imaging and develop post-processing frame-work using three-dimensional (3D) texture features. These post-processing methods are shown to reduce the false positives in the BTS results and improve the overall segmentation result in longitudinal imaging. Furthermore, using this improved segmentation results the change of tumor volume has been quantified in three types such as stable, progress, and shrinkage as observed by the volumetric changes of different tumor tissues in longitudinal images. This study also investigates a novel non-invasive glioma grading, for the first time in literature, that uses structural MRI only. Such non-invasive glioma grading may be useful before an invasive biopsy is recommended. This study further developed an automatic glioma grading scheme using the invasive cell nuclei morphology in DP images for cross-validation with the same patients. In summary, the texture-based computational models proposed in this study are expected to facilitate the clinical management of patients with the brain tumors and strokes by automating large scale imaging data analysis, reducing human error, inter-observer variability, and producing repeatable brain tumor quantitation and grading

Advanced Computational Methods for Oncological Image Analysis

[Cancer is the second most common cause of death worldwide and encompasses highly variable clinical and biological scenarios. Some of the current clinical challenges are (i) early diagnosis of the disease and (ii) precision medicine, which allows for treatments targeted to specific clinical cases. The ultimate goal is to optimize the clinical workflow by combining accurate diagnosis with the most suitable therapies. Toward this, large-scale machine learning research can define associations among clinical, imaging, and multi-omics studies, making it possible to provide reliable diagnostic and prognostic biomarkers for precision oncology. Such reliable computer-assisted methods (i.e., artificial intelligence) together with clinicians’ unique knowledge can be used to properly handle typical issues in evaluation/quantification procedures (i.e., operator dependence and time-consuming tasks). These technical advances can significantly improve result repeatability in disease diagnosis and guide toward appropriate cancer care. Indeed, the need to apply machine learning and computational intelligence techniques has steadily increased to effectively perform image processing operations—such as segmentation, co-registration, classification, and dimensionality reduction—and multi-omics data integration.