Automatic Pulmonary Nodule Detection in CT Scans Using Convolutional Neural Networks Based on Maximum Intensity Projection

Accurate pulmonary nodule detection is a crucial step in lung cancer screening. Computer-aided detection (CAD) systems are not routinely used by radiologists for pulmonary nodule detection in clinical practice despite their potential benefits. Maximum intensity projection (MIP) images improve the detection of pulmonary nodules in radiological evaluation with computed tomography (CT) scans. Inspired by the clinical methodology of radiologists, we aim to explore the feasibility of applying MIP images to improve the effectiveness of automatic lung nodule detection using convolutional neural networks (CNNs). We propose a CNN-based approach that takes MIP images of different slab thicknesses (5 mm, 10 mm, 15 mm) and 1 mm axial section slices as input. Such an approach augments the two-dimensional (2-D) CT slice images with more representative spatial information that helps discriminate nodules from vessels through their morphologies. Our proposed method achieves sensitivity of 92.67% with 1 false positive per scan and sensitivity of 94.19% with 2 false positives per scan for lung nodule detection on 888 scans in the LIDC-IDRI dataset. The use of thick MIP images helps the detection of small pulmonary nodules (3 mm-10 mm) and results in fewer false positives. Experimental results show that utilizing MIP images can increase the sensitivity and lower the number of false positives, which demonstrates the effectiveness and significance of the proposed MIP-based CNNs framework for automatic pulmonary nodule detection in CT scans. The proposed method also shows the potential that CNNs could gain benefits for nodule detection by combining the clinical procedure.Comment: Submitted to IEEE TM

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

S4ND: Single-Shot Single-Scale Lung Nodule Detection

The state of the art lung nodule detection studies rely on computationally expensive multi-stage frameworks to detect nodules from CT scans. To address this computational challenge and provide better performance, in this paper we propose S4ND, a new deep learning based method for lung nodule detection. Our approach uses a single feed forward pass of a single network for detection and provides better performance when compared to the current literature. The whole detection pipeline is designed as a single $3D$ Convolutional Neural Network (CNN) with dense connections, trained in an end-to-end manner. S4ND does not require any further post-processing or user guidance to refine detection results. Experimentally, we compared our network with the current state-of-the-art object detection network (SSD) in computer vision as well as the state-of-the-art published method for lung nodule detection (3D DCNN). We used publically available $888$ CT scans from LUNA challenge dataset and showed that the proposed method outperforms the current literature both in terms of efficiency and accuracy by achieving an average FROC-score of $0.897$. We also provide an in-depth analysis of our proposed network to shed light on the unclear paradigms of tiny object detection.Comment: Accepted for publication at MICCAI 2018 (21st International Conference on Medical Image Computing and Computer Assisted Intervention

Localisation in 3D Images Using Cross-features Correlation Learning

Object detection and segmentation have evolved drastically over the past two decades thanks to the continuous advancement in the field of deep learning. Substantial research efforts have been dedicated towards integrating object detection techniques into a wide range of real-world prob-lems. Most existing methods take advantage of the successful application and representational ability of convolutional neural networks (CNNs). Generally, these methods target mainstream applications that are typically based on 2D imaging scenarios. Additionally, driven by the strong correlation between the quality of the feature embedding and the performance in CNNs, most works focus on design characteristics of CNNs, e.g., depth and width, to enhance their modelling capacity and discriminative ability. Limited research was directed towards exploiting feature-level dependencies, which can be feasibly used to enhance the performance of CNNs. More-over, directly adopting such approaches into more complex imaging domains that target data of higher dimensions (e.g., 3D multi-modal and volumetric images) is not straightforwardly appli-cable due to the different nature and complexity of the problem. In this thesis, we explore the possibility of incorporating feature-level correspondence and correlations into object detection and segmentation contexts that target the localisation of 3D objects from 3D multi-modal and volumetric image data. Accordingly, we first explore the detection problem of 3D solar active regions in multi-spectral solar imagery where different imaging bands correspond to different 2D layers (altitudes) in the 3D solar atmosphere.We propose a joint analysis approach in which information from different imaging bands is first individually analysed using band-specific network branches to extract inter-band features that are then dynamically cross-integrated and jointly analysed to investigate spatial correspon-dence and co-dependencies between the different bands. The aggregated embeddings are further analysed using band-specific detection network branches to predict separate sets of results (one for each band). Throughout our study, we evaluate different types of feature fusion, using convo-lutional embeddings of different semantic levels, as well as the impact of using different numbers of image bands inputs to perform the joint analysis. We test the proposed approach over different multi-modal datasets (multi-modal solar images and brain MRI) and applications. The proposed joint analysis based framework consistently improves the CNN’s performance when detecting target regions in contrast to single band based baseline methods.We then generalise our cross-band joint analysis detection scheme into the 3D segmentation problem using multi-modal images. We adopt the joint analysis principles into a segmentation framework where cross-band information is dynamically analysed and cross-integrated at vari-ous semantic levels. The proposed segmentation network also takes advantage of band-specific skip connections to maximise the inter-band information and assist the network in capturing fine details using embeddings of different spatial scales. Furthermore, a recursive training strat-egy, based on weak labels (e.g., bounding boxes), is proposed to overcome the difficulty of producing dense labels to train the segmentation network. We evaluate the proposed segmen-tation approach using different feature fusion approaches, over different datasets (multi-modal solar images, brain MRI, and cloud satellite imagery), and using different levels of supervisions. Promising results were achieved and demonstrate an improved performance in contrast to single band based analysis and state-of-the-art segmentation methods.Additionally, we investigate the possibility of explicitly modelling objective driven feature-level correlations, in a localised manner, within 3D medical imaging scenarios (3D CT pul-monary imaging) to enhance the effectiveness of the feature extraction process in CNNs and subsequently the detection performance. Particularly, we present a framework to perform the 3D detection of pulmonary nodules as an ensemble of two stages, candidate proposal and a false positive reduction. We propose a 3D channel attention block in which cross-channel informa-tion is incorporated to infer channel-wise feature importance with respect to the target objective. Unlike common attention approaches that rely on heavy dimensionality reduction and computa-tionally expensive multi-layer perceptron networks, the proposed approach utilises fully convo-lutional networks to allow directly exploiting rich 3D descriptors and performing the attention in an efficient manner. We also propose a fully convolutional 3D spatial attention approach that elevates cross-sectional information to infer spatial attention. We demonstrate the effectiveness of the proposed attention approaches against a number of popular channel and spatial attention mechanisms. Furthermore, for the False positive reduction stage, in addition to attention, we adopt a joint analysis based approach that takes into account the variable nodule morphology by aggregating spatial information from different contextual levels. We also propose a Zoom-in convolutional path that incorporates semantic information of different spatial scales to assist the network in capturing fine details. The proposed detection approach demonstrates considerable gains in performance in contrast to state-of-the-art lung nodule detection methods.We further explore the possibility of incorporating long-range dependencies between arbi-trary positions in the input features using Transformer networks to infer self-attention, in the context of 3D pulmonary nodule detection, in contrast to localised (convolutional based) atten-tion . We present a hybrid 3D detection approach that takes advantage of both, the Transformers ability in modelling global context and correlations and the spatial representational characteris-tics of convolutional neural networks, providing complementary information and subsequently improving the discriminative ability of the detection model. We propose two hybrid Transformer CNN variants where we investigate the impact of exploiting a deeper Transformer design –in which more Transformer layers and trainable parameters are incorporated– is used along with high-level convolutional feature inputs of a single spatial resolution, in contrast to a shallower Transformer design –of less Transformer layers and trainable parameters– while exploiting con-volutional embeddings of different semantic levels and relatively higher resolution.Extensive quantitative and qualitative analyses are presented for the proposed methods in this thesis and demonstrate the feasibility of exploiting feature-level relations, either implicitly or explicitly, in different detection and segmentation problems

Machine learning approaches for lung cancer diagnosis.

The enormity of changes and development in the field of medical imaging technology is hard to fathom, as it does not just represent the technique and process of constructing visual representations of the body from inside for medical analysis and to reveal the internal structure of different organs under the skin, but also it provides a noninvasive way for diagnosis of various disease and suggest an efficient ways to treat them. While data surrounding all of our lives are stored and collected to be ready for analysis by data scientists, medical images are considered a rich source that could provide us with a huge amount of data, that could not be read easily by physicians and radiologists, with valuable information that could be used in smart ways to discover new knowledge from these vast quantities of data. Therefore, the design of computer-aided diagnostic (CAD) system, that can be approved for use in clinical practice that aid radiologists in diagnosis and detecting potential abnormalities, is of a great importance. This dissertation deals with the development of a CAD system for lung cancer diagnosis, which is the second most common cancer in men after prostate cancer and in women after breast cancer. Moreover, lung cancer is considered the leading cause of cancer death among both genders in USA. Recently, the number of lung cancer patients has increased dramatically worldwide and its early detection doubles a patient’s chance of survival. Histological examination through biopsies is considered the gold standard for final diagnosis of pulmonary nodules. Even though resection of pulmonary nodules is the ideal and most reliable way for diagnosis, there is still a lot of different methods often used just to eliminate the risks associated with the surgical procedure. Lung nodules are approximately spherical regions of primarily high density tissue that are visible in computed tomography (CT) images of the lung. A pulmonary nodule is the first indication to start diagnosing lung cancer. Lung nodules can be benign (normal subjects) or malignant (cancerous subjects). Large (generally defined as greater than 2 cm in diameter) malignant nodules can be easily detected with traditional CT scanning techniques. However, the diagnostic options for small indeterminate nodules are limited due to problems associated with accessing small tumors. Therefore, additional diagnostic and imaging techniques which depends on the nodules’ shape and appearance are needed. The ultimate goal of this dissertation is to develop a fast noninvasive diagnostic system that can enhance the accuracy measures of early lung cancer diagnosis based on the well-known hypotheses that malignant nodules have different shape and appearance than benign nodules, because of the high growth rate of the malignant nodules. The proposed methodologies introduces new shape and appearance features which can distinguish between benign and malignant nodules. To achieve this goal a CAD system is implemented and validated using different datasets. This CAD system uses two different types of features integrated together to be able to give a full description to the pulmonary nodule. These two types are appearance features and shape features. For the appearance features different texture appearance descriptors are developed, namely the 3D histogram of oriented gradient, 3D spherical sector isosurface histogram of oriented gradient, 3D adjusted local binary pattern, 3D resolved ambiguity local binary pattern, multi-view analytical local binary pattern, and Markov Gibbs random field. Each one of these descriptors gives a good description for the nodule texture and the level of its signal homogeneity which is a distinguishable feature between benign and malignant nodules. For the shape features multi-view peripheral sum curvature scale space, spherical harmonics expansions, and different group of fundamental geometric features are utilized to describe the nodule shape complexity. Finally, the fusion of different combinations of these features, which is based on two stages is introduced. The first stage generates a primary estimation for every descriptor. Followed by the second stage that consists of an autoencoder with a single layer augmented with a softmax classifier to provide us with the ultimate classification of the nodule. These different combinations of descriptors are combined into different frameworks that are evaluated using different datasets. The first dataset is the Lung Image Database Consortium which is a benchmark publicly available dataset for lung nodule detection and diagnosis. The second dataset is our local acquired computed tomography imaging data that has been collected from the University of Louisville hospital and the research protocol was approved by the Institutional Review Board at the University of Louisville (IRB number 10.0642). These frameworks accuracy was about 94%, which make the proposed frameworks demonstrate promise to be valuable tool for the detection of lung cancer