Intelligent computing applications to assist perceptual training in medical imaging

The research presented in this thesis represents a body of work which addresses issues in medical imaging, primarily as it applies to breast cancer screening and laparoscopic surgery. The concern here is how computer based methods can aid medical practitioners in these tasks. Thus, research is presented which develops both new techniques of analysing radiologists performance data and also new approaches of examining surgeons visual behaviour when they are undertaking laparoscopic training. Initially a new chest X-Ray self-assessment application is described which has been developed to assess and improve radiologists performance in detecting lung cancer. Then, in breast cancer screening, a method of identifying potential poor performance outliers at an early stage in a national self-assessment scheme is demonstrated. Additionally, a method is presented to optimize whether a radiologist, in using this scheme, has correctly localised and identified an abnormality or made an error. One issue in appropriately measuring radiological performance in breast screening is that both the size of clinical monitors used and the difficulty in linking the medical image to the observer s line of sight hinders suitable eye tracking. Consequently, a new method is presented which links these two items. Laparoscopic surgeons have similar issues to radiologists in interpreting a medical display but with the added complications of hand-eye co-ordination. Work is presented which examines whether visual search feedback of surgeons operations can be useful training aids

Lesion detection in epilepsy surgery: Lessons from a prospective evaluation of a machine learning algorithm

AIM: To evaluate a lesion detection algorithm designed to detect focal cortical dysplasia (FCD) in children undergoing stereoelectroencephalography (SEEG) as part of their presurgical evaluation for drug-resistant epilepsy. METHOD: This was a prospective, single-arm, interventional study (Idea, Development, Exploration, Assessment, and Long-Term Follow-Up phase 1/2a). After routine SEEG planning, structural magnetic resonance imaging sequences were run through an FCD lesion detection algorithm to identify putative clusters. If the top three clusters were not already sampled, up to three additional SEEG electrodes were added. The primary outcome measure was the proportion of patients who had additional electrode contacts in the SEEG-defined seizure-onset zone (SOZ). RESULTS: Twenty patients (median age 12 years, range 4-18 years) were enrolled, one of whom did not undergo SEEG. Additional electrode contacts were part of the SOZ in 1 out of 19 patients while 3 out of 19 patients had clusters that were part of the SOZ but they were already implanted. A total of 16 additional electrodes were implanted in nine patients and there were no adverse events from the additional electrodes. INTERPRETATION: We demonstrate early-stage prospective clinical validation of a machine learning lesion detection algorithm used to aid the identification of the SOZ in children undergoing SEEG. We share key lessons learnt from this evaluation and emphasize the importance of robust prospective evaluation before routine clinical adoption of such algorithms

Subspace discovery for video anomaly detection

PhDIn automated video surveillance anomaly detection is a challenging task. We address this task as a novelty detection problem where pattern description is limited and labelling information is available only for a small sample of normal instances. Classification under these conditions is prone to over-fitting. The contribution of this work is to propose a novel video abnormality detection method that does not need object detection and tracking. The method is based on subspace learning to discover a subspace where abnormality detection is easier to perform, without the need of detailed annotation and description of these patterns. The problem is formulated as one-class classification utilising a low dimensional subspace, where a novelty classifier is used to learn normal actions automatically and then to detect abnormal actions from low-level features extracted from a region of interest. The subspace is discovered (using both labelled and unlabelled data) by a locality preserving graph-based algorithm that utilises the Graph Laplacian of a specially designed parameter-less nearest neighbour graph. The methodology compares favourably with alternative subspace learning algorithms (both linear and non-linear) and direct one-class classification schemes commonly used for off-line abnormality detection in synthetic and real data. Based on these findings, the framework is extended to on-line abnormality detection in video sequences, utilising multiple independent detectors deployed over the image frame to learn the local normal patterns and infer abnormality for the complete scene. The method is compared with an alternative linear method to establish advantages and limitations in on-line abnormality detection scenarios. Analysis shows that the alternative approach is better suited for cases where the subspace learning is restricted on the labelled samples, while in the presence of additional unlabelled data the proposed approach using graph-based subspace learning is more appropriate

Examining the clinical utility of the modified Alarm Distress Baby Scale (m-ADBB) for the detection of early signs of Autism Spectrum Disorder

Background / Aim Signs of Autism Spectrum Disorder (ASD) can be observed in the first two years of life. However early detection of ASD remains challenging, partly because no reliable and easy to use routine screening instrument for infants and toddlers is currently available to clinicians. Some early ASD related deficits in social communication and interaction are also typical of sustained social withdrawal in infants and toddlers. The current study aims to test whether a brief observational screening instrument for social withdrawal in infants, the modified Alarm Distress Baby Scale (m-ADBB), may be clinically useful for detection of ASD in the first two years of life. It is hypothesised, that children with ASD will score higher on the m-ADBB than typically developing (TD) children, indicating more symptoms of social withdrawal. Method Home-video recordings of children with ASD and of TD children from approximately age 12 month and 24 month were analysed using the m-ADBB. Results Home-videos of 10 children with ASD and 10 TD children were available at each age. Children with a diagnosis of ASD scored statistically significantly higher on the m-ADBB than TD children at 12 month (Z=-2.54; p=0.023; r=-0.57) and at 24 month (Z=-2.40; p=0.023; r=-0.54). Five of ten children with ASD met the m-ADBB criterion for social withdrawal in their 12 month videos, and four out of ten in their 24 month videos. Using a lower cut-off score increased detection rates (7 at 12 month; 8 at 24 month). False positive rates were low at both ages and for both cut-off scores (range 1 to 3 out of 10). Conclusion Observing only five social withdrawal behaviours as operationalized by the m-ADBB appears to be useful in flagging possible presence of ASD during the first two years of life. The scale’s sensitivity and specificity for ASD detection needs to be established in a larger sample

Video Event Recognition and Anomaly Detection by Combining Gaussian Process and Hierarchical Dirichlet Process Models

In this paper, we present an unsupervised learning framework for analyzing activities and interactions in surveillance videos. In our framework, three levels of video events are connected by Hierarchical Dirichlet Process (HDP) model: low-level visual features, simple atomic activities, and multi-agent interactions. Atomic activities are represented as distribution of low-level features, while complicated interactions are represented as distribution of atomic activities. This learning process is unsupervised. Given a training video sequence, low-level visual features are extracted based on optic flow and then clustered into different atomic activities and video clips are clustered into different interactions. The HDP model automatically decide the number of clusters, i.e. the categories of atomic activities and interactions. Based on the learned atomic activities and interactions, a training dataset is generated to train the Gaussian Process (GP) classifier. Then the trained GP models work in newly captured video to classify interactions and detect abnormal events in real time. Furthermore, the temporal dependencies between video events learned by HDP-Hidden Markov Models (HMM) are effectively integrated into GP classifier to enhance the accuracy of the classification in newly captured videos. Our framework couples the benefits of the generative model (HDP) with the discriminant model (GP). We provide detailed experiments showing that our framework enjoys favorable performance in video event classification in real-time in a crowded traffic scene