Prototypes for Content-Based Image Retrieval in Clinical Practice

Content-based image retrieval (CBIR) has been proposed as key technology for computer-aided diagnostics (CAD). This paper reviews the state of the art and future challenges in CBIR for CAD applied to clinical practice

Computer-Aided Cancer Diagnosis and Grading via Sparse Directional Image Representations

Prostate cancer and breast cancer are the second cause of death among cancers in males and females, respectively. If not diagnosed, prostate and breast cancers can spread and metastasize to other organs and bones and make it impossible for treatment. Hence, early diagnosis of cancer is vital for patient survival. Histopathological evaluation of the tissue is used for cancer diagnosis. The tissue is taken during biopsies and stained using hematoxylin and eosin (H&E) stain. Then a pathologist looks for abnormal changes in the tissue to diagnose and grade the cancer. This process can be time-consuming and subjective. A reliable and repetitive automatic cancer diagnosis method can greatly reduce the time while producing more reliable results. The scope of this dissertation is developing computer vision and machine learning algorithms for automatic cancer diagnosis and grading methods with accuracy acceptable by the expert pathologists. Automatic image classification relies on feature representation methods. In this dissertation we developed methods utilizing sparse directional multiscale transforms - specifically shearlet transform - for medical image analysis. We particularly designed theses computer visions-based algorithms and methods to work with H&E images and MRI images. Traditional signal processing methods (e.g. Fourier transform, wavelet transform, etc.) are not suitable for detecting carcinoma cells due to their lack of directional sensitivity. However, shearlet transform has inherent directional sensitivity and multiscale framework that enables it to detect different edges in the tissue images. We developed techniques for extracting holistic and local texture features from the histological and MRI images using histogram and co-occurrence of shearlet coefficients, respectively. Then we combined these features with the color and morphological features using multiple kernel learning (MKL) algorithm and employed support vector machines (SVM) with MKL to classify the medical images. We further investigated the impact of deep neural networks in representing the medical images for cancer detection. The aforementioned engineered features have a few limitations. They lack generalizability due to being tailored to the specific texture and structure of the tissues. They are time-consuming and expensive and need prepossessing and sometimes it is difficult to extract discriminative features from the images. On the other hand, feature learning techniques use multiple processing layers and learn feature representations directly from the data. To address these issues, we have developed a deep neural network containing multiple layers of convolution, max-pooling, and fully connected layers, trained on the Red, Green, and Blue (RGB) images along with the magnitude and phase of shearlet coefficients. Then we developed a weighted decision fusion deep neural network that assigns weights on the output probabilities and update those weights via backpropagation. The final decision was a weighted sum of the decisions from the RGB, and the magnitude and the phase of shearlet networks. We used the trained networks for classification of benign and malignant H&E images and Gleason grading. Our experimental results show that our proposed methods based on feature engineering and feature learning outperform the state-of-the-art and are even near perfect (100%) for some databases in terms of classification accuracy, sensitivity, specificity, F1 score, and area under the curve (AUC) and hence are promising computer-based methods for cancer diagnosis and grading using images

Quantification of tumour heterogenity in MRI

Cancer is the leading cause of death that touches us all, either directly or indirectly. It is estimated that the number of newly diagnosed cases in the Netherlands will increase to 123,000 by the year 2020. General Dutch statistics are similar to those in the UK, i.e. over the last ten years, the age-standardised incidence rate1 has stabilised at around 355 females and 415 males per 100,000. Figure 1 shows the cancer incidence per gender. In the UK, the rise in lifetime risk of cancer is more than one in three and depends on many factors, including age, lifestyle and genetic makeup

Advancing combined radiological and optical scanning for breast-conserving surgery margin guidance

Breast cancer is one of the most common types of cancer worldwide, and standard-of-care for early-stage disease typically involves a lumpectomy or breast-conserving surgery (BCS). BCS involves the local resection of cancerous tissue, while sparring as much healthy tissue as possible. State-of-the-art methods for intraoperatively evaluating BCS margins are limited. Approximately 20% of BCS cases result in a tissue resection with cancer at or near the resection surface (i.e., a positive margin). A two-fold increase in ipsilateral breast cancer recurrence is associated with the presence of one or more positive margins. Consequently, positive margins often necessitate costly re-excision procedures to achieve a curative outcome. X-ray micro-computed tomography (CT) is emerging as a powerful ex vivo specimen imaging technology, as it provides robust three-dimensional sensing of tumor morphology rapidly. However, X-ray attenuation lacks contrast between soft tissues that are important for surgical decision making during BCS. Optical structured light imaging, including spatial frequency domain imaging and active line scan imaging, can act as adjuvant tools to complement micro-CT, providing wide field-of-view, non-contact sensing of relevant breast tissue subtypes on resection margins that cannot be differentiated by micro-CT alone. This thesis is dedicated to multimodal imaging of BCS tissues to ultimately improve intraoperative BCS margin assessment, reducing the number of positive margins after initial surgeries and thereby reducing the need for costly follow-up procedures. Volumetric sensing of micro-CT is combined with surface-weighted, sub-diffuse optical reflectance derived from high spatial frequency structured light imaging. Sub-diffuse reflectance plays the key role of providing enhanced contrast to a suite of normal, abnormal benign, and malignant breast tissue subtypes. This finding is corroborated through clinical studies imaging BCS specimen slices post-operatively and is further investigated through an observational clinical trial focused on combined, intraoperative micro-CT and optical imaging of whole, freshly resected BCS tumors. The central thesis of this work is that combining volumetric X-ray imaging and sub-diffuse optical scanning provides a synergistic multimodal imaging solution to margin assessment, one that can be readily implemented or retrofitted in X-ray specimen imaging systems and that could meaningfully improve surgical guidance during initial BCS procedures

Data-driven Representation Learning from Histopathology Image Databases to Support Digital Pathology Analysis

Cancer research is a major public health priority in the world due to its high incidence, diversity and mortality. Despite great advances in this area during recent decades, the high incidence and lack of specialists have proven that one of the major challenges is to achieve early diagnosis. Improved early diagnosis, especially in developing countries, plays a crucial role in timely treatment and patient survival. Recent advances in scanner technology for the digitization of pathology slides and the growth of global initiatives to build databases for cancer research have enabled the emergence of digital pathology as a new approach to support pathology workflows. This has led to the development of many computational methods for automatic histopathology image analysis, which in turn has raised new computational challenges due to the high visual variability of histopathology slides, the difficulty in assessing the effectiveness of methods (considering the lack of annotated data from different pathologists and institutions), and the need of interpretable, efficient and feasible methods for practical use. On the other hand, machine learning techniques have focused on exploiting large databases to automatically extract and induce information and knowledge, in the form of patterns and rules, that allow to connect low-level content with its high-level meaning. Several approaches have emerged as opposed to traditional schemes based on handcrafted features for data representation, which nowadays are known as representation learning. The objective of this thesis is the exploration, development and validation of precise, interpretable and efficient computational machine learning methods for automatic representation learning from histopathology image databases to support diagnosis tasks of different types of cancer. The validation of the proposed methods during the thesis development allowed to corroborate their capability in several histopathology image analysis tasks of different types of cancer. These methods achieve good results in terms of accuracy, robustness, reproducibility, interpretability and feasibility suggesting their potential practical application towards translational and personalized medicine.Resumen. La investigación en cáncer es una de las principales prioridades de salud pública en el mundo debido a su alta incidencia, diversidad y mortalidad. A pesar de los grandes avances en el área en las últimas décadas, la alta incidencia y la falta de especialistas ha llevado a que una de las principales problemáticas sea lograr su detección temprana, en especial en países en vías de desarrollo, como quiera a que de ello depende las posibilidades de un tratamiento oportuno y las oportunidades de supervivencia de los pacientes. Los recientes avances en tecnología de escáneres para digitalización de láminas de patología y el crecimiento de iniciativas mundiales para la construcción de bases de datos para la investigación en cáncer, han permitido el surgimiento de la patología digital como un nuevo enfoque para soportar los flujos de trabajo en patología. Esto ha llevado al desarrollo de una gran variedad de métodos computacionales para el análisis automático de imágenes de histopatología, lo cual ha planteado nuevos desafíos computacionales debido a la alta variabilidad visual de las láminas de histopatología; la dificultad para evaluar la efectividad de los métodos por la falta de datos de diferentes instituciones que cuenten con anotaciones por parte de los patólogos, y la necesidad de métodos interpretables, eficientes y factibles para su uso práctico. Por otro lado, el aprendizaje de máquina se ha enfocado en explotar las grandes bases de datos para extraer e inducir de manera automática información y conocimiento, en forma de patrones y reglas, que permita conectar el contenido de bajo nivel con su significado. Diferentes técnicas han surgido en contraposición a los esquemas tradicionales basados en diseño manual de la representación de los datos, en lo que se conoce como aprendizaje de la representación. El propósito de esta tesis fue la exploración, desarrollo y validación de métodos computacionales de aprendizaje de máquina precisos, interpretables y eficientes a partir de bases de datos de imágenes de histopatología para el aprendizaje automático de la representación en tareas de apoyo al diagnóstico de distintos tipos de cáncer. La validación de los distintos métodos propuestos durante el desarrollo de la tesis permitieron corroborar la capacidad de cada uno de ellos en distintivas tareas de análisis de imágenes de histopatología, en diferentes tipos de cáncer, con buenos resultados en términos de exactitud, robustez, reproducibilidad, interpretabilidad y factibilidad, lo cual sugiere su potencial aplicación práctica hacia la medicina traslacional y personalizada.Doctorad