Automated Segmentation of Pulmonary Lobes using Coordination-Guided Deep Neural Networks

The identification of pulmonary lobes is of great importance in disease diagnosis and treatment. A few lung diseases have regional disorders at lobar level. Thus, an accurate segmentation of pulmonary lobes is necessary. In this work, we propose an automated segmentation of pulmonary lobes using coordination-guided deep neural networks from chest CT images. We first employ an automated lung segmentation to extract the lung area from CT image, then exploit volumetric convolutional neural network (V-net) for segmenting the pulmonary lobes. To reduce the misclassification of different lobes, we therefore adopt coordination-guided convolutional layers (CoordConvs) that generate additional feature maps of the positional information of pulmonary lobes. The proposed model is trained and evaluated on a few publicly available datasets and has achieved the state-of-the-art accuracy with a mean Dice coefficient index of 0.947 $\pm$ 0.044.Comment: ISBI 2019 (Oral

Persistent mucus plugs in proximal airways are consequential for airflow limitation in asthma

BACKGROUNDInformation about the size, airway location, and longitudinal behavior of mucus plugs in asthma is needed to understand their role in mechanisms of airflow obstruction and to rationally design muco-active treatments.METHODSCT lung scans from 57 patients with asthma were analyzed to quantify mucus plug size and airway location, and paired CT scans obtained 3 years apart were analyzed to determine plug behavior over time. Radiologist annotations of mucus plugs were incorporated in an image-processing pipeline to generate size and location information that was related to measures of airflow.RESULTSThe length distribution of 778 annotated mucus plugs was multimodal, and a 12 mm length defined short ( stubby , ≤12 mm) and long ( stringy , \u3e12 mm) plug phenotypes. High mucus plug burden was disproportionately attributable to stringy mucus plugs. Mucus plugs localized predominantly to airway generations 6-9, and 47% of plugs in baseline scans persisted in the same airway for 3 years and fluctuated in length and volume. Mucus plugs in larger proximal generations had greater effects on spirometry measures than plugs in smaller distal generations, and a model of airflow that estimates the increased airway resistance attributable to plugs predicted a greater effect for proximal generations and more numerous mucus plugs.CONCLUSIONPersistent mucus plugs in proximal airway generations occur in asthma and demonstrate a stochastic process of formation and resolution over time. Proximal airway mucus plugs are consequential for airflow and are in locations amenable to treatment by inhaled muco-active drugs or bronchoscopy.TRIAL REGISTRATIONClinicaltrials.gov; NCT01718197, NCT01606826, NCT01750411, NCT01761058, NCT01761630, NCT01716494, and NCT01760915.FUNDINGAstraZeneca, Boehringer-Ingelheim, Genentech, GlaxoSmithKline, Sanofi-Genzyme-Regeneron, and TEVA provided financial support for study activities at the Coordinating and Clinical Centers beyond the third year of patient follow-up. These companies had no role in study design or data analysis, and the only restriction on the funds was that they be used to support the SARP initiative

An analysis of the regional heterogeneity in tissue elasticity in lung cancer patients with COPD

PurposeRecent advancements in obtaining image-based biomarkers from CT images have enabled lung function characterization, which could aid in lung interventional planning. However, the regional heterogeneity in these biomarkers has not been well documented, yet it is critical to several procedures for lung cancer and COPD. The purpose of this paper is to analyze the interlobar and intralobar heterogeneity of tissue elasticity and study their relationship with COPD severity.MethodsWe retrospectively analyzed a set of 23 lung cancer patients for this study, 14 of whom had COPD. For each patient, we employed a 5DCT scanning protocol to obtain end-exhalation and end-inhalation images and semi-automatically segmented the lobes. We calculated tissue elasticity using a biomechanical property estimation model. To obtain a measure of lobar elasticity, we calculated the mean of the voxel-wise elasticity values within each lobe. To analyze interlobar heterogeneity, we defined an index that represented the properties of the least elastic lobe as compared to the rest of the lobes, termed the Elasticity Heterogeneity Index (EHI). An index of 0 indicated total homogeneity, and higher indices indicated higher heterogeneity. Additionally, we measured intralobar heterogeneity by calculating the coefficient of variation of elasticity within each lobe.ResultsThe mean EHI was 0.223 ± 0.183. The mean coefficient of variation of the elasticity distributions was 51.1% ± 16.6%. For mild COPD patients, the interlobar heterogeneity was low compared to the other categories. For moderate-to-severe COPD patients, the interlobar and intralobar heterogeneities were highest, showing significant differences from the other groups.ConclusionWe observed a high level of lung tissue heterogeneity to occur between and within the lobes in all COPD severity cases, especially in moderate-to-severe cases. Heterogeneity results demonstrate the value of a regional, function-guided approach like elasticity for procedures such as surgical decision making and treatment planning

Pulmonary lobe segmentation from CT images using fissureness‚ airways‚ vessels and multilevel B−splines.

Lobe detection from CT images is a challenging segmentation problem with important respiratory health care applications, including surgical planning and regional image analysis. We present a fully automated method for segmenting the pulmonary lobes. We first build a lobar approximation by applying a watershed transform to a vesselness density filter, using seed points generated from segmentation and analysis of the bronchial tree. We then apply a fissureness filter, which combines Hessian-based detection of planar structures with suppression of locally fissure-like points on the boundaries of the pulmonary vasculature. Finally, we fit a smooth multi-level B-spline curve through the fissureness maxima and extrapolate to the lung boundaries. Our method addresses several limitations of similar work, namely it is robust to incomplete fissures and vessels crossing the lobar boundaries, and it is computationally efficient and does not require training. We provide validation using fissure landmarks manually placed on 10 lung cancer datasets by a pulmonary clinician. © 2012 IEEE

Deep Learning of Unified Region, Edge, and Contour Models for Automated Image Segmentation

Image segmentation is a fundamental and challenging problem in computer vision with applications spanning multiple areas, such as medical imaging, remote sensing, and autonomous vehicles. Recently, convolutional neural networks (CNNs) have gained traction in the design of automated segmentation pipelines. Although CNN-based models are adept at learning abstract features from raw image data, their performance is dependent on the availability and size of suitable training datasets. Additionally, these models are often unable to capture the details of object boundaries and generalize poorly to unseen classes. In this thesis, we devise novel methodologies that address these issues and establish robust representation learning frameworks for fully-automatic semantic segmentation in medical imaging and mainstream computer vision. In particular, our contributions include (1) state-of-the-art 2D and 3D image segmentation networks for computer vision and medical image analysis, (2) an end-to-end trainable image segmentation framework that unifies CNNs and active contour models with learnable parameters for fast and robust object delineation, (3) a novel approach for disentangling edge and texture processing in segmentation networks, and (4) a novel few-shot learning model in both supervised settings and semi-supervised settings where synergies between latent and image spaces are leveraged to learn to segment images given limited training data.Comment: PhD dissertation, UCLA, 202

From Fully-Supervised, Single-Task to Scarcely-Supervised, Multi-Task Deep Learning for Medical Image Analysis

Image analysis based on machine learning has gained prominence with the advent of deep learning, particularly in medical imaging. To be effective in addressing challenging image analysis tasks, however, conventional deep neural networks require large corpora of annotated training data, which are unfortunately scarce in the medical domain, thus often rendering fully-supervised learning strategies ineffective.This thesis devises for use in a variety of medical image analysis applications a series of novel deep learning methods, ranging from fully-supervised, single-task learning to scarcely-supervised, multi-task learning that makes efficient use of annotated training data. Specifically, its main contributions include (1) fully-supervised, single-task learning for the segmentation of pulmonary lobes from chest CT scans and the analysis of scoliosis from spine X-ray images; (2) supervised, single-task, domain-generalized pulmonary segmentation in chest X-ray images and retinal vasculature segmentation in fundoscopic images; (3) largely-unsupervised, multiple-task learning via deep generative modeling for the joint synthesis and classification of medical image data; and (4) partly-supervised, multiple-task learning for the combined segmentation and classification of chest and spine X-ray images

Quantitative lung CT analysis for the study and diagnosis of Chronic Obstructive Pulmonary Disease

The importance of medical imaging in the research of Chronic Obstructive Pulmonary Dis- ease (COPD) has risen over the last decades. COPD affects the pulmonary system through two competing mechanisms; emphysema and small airways disease. The relative contribu- tion of each component varies widely across patients whilst they can also evolve regionally in the lung. Patients can also be susceptible to exacerbations, which can dramatically ac- celerate lung function decline. Diagnosis of COPD is based on lung function tests, which measure airflow limitation. There is a growing consensus that this is inadequate in view of the complexities of COPD. Computed Tomography (CT) facilitates direct quantification of the pathological changes that lead to airflow limitation and can add to our understanding of the disease progression of COPD. There is a need to better capture lung pathophysiology whilst understanding regional aspects of disease progression. This has motivated the work presented in this thesis. Two novel methods are proposed to quantify the severity of COPD from CT by analysing the global distribution of features sampled locally in the lung. They can be exploited in the classification of lung CT images or to uncover potential trajectories of disease progression. A novel lobe segmentation algorithm is presented that is based on a probabilistic segmen- tation of the fissures whilst also constructing a groupwise fissure prior. In combination with the local sampling methods, a pipeline of analysis was developed that permits a re- gional analysis of lung disease. This was applied to study exacerbation susceptible COPD. Lastly, the applicability of performing disease progression modelling to study COPD has been shown. Two main subgroups of COPD were found, which are consistent with current clinical knowledge of COPD subtypes. This research may facilitate precise phenotypic characterisation of COPD from CT, which will increase our understanding of its natural history and associated heterogeneities. This will be instrumental in the precision medicine of COPD

RF Coil Design, Imaging Methods and Measurement of Ventilation with 19F C3F8 MRI

This thesis attempts to address the challenge of low signal in fluorinated gas ventilation imaging and optimize imaging methods considering the particular MR parameters of C3F8 by the following approaches: (i) Exploration of coil designs capable of imaging both proton (1H – 63.8 MHz at 1.5T) and fluorine (19F – 60.1 MHz at 1.5T) nuclei involved: 1. The novel use of microelectromechanical systems to switch a single transceive vest coil between the two nuclei was compared to hard-wired or PIN diode switching. 2. The design of an 8 element transceive array with an additional 6 receive only coils for 19F imaging. MEMs was utilized for broadband transmit-receive switching. 3. The amalgamation of a ladder resonator coil with a 6-element transceive array to reduce SAR and improve transmit homogeneity when compared to standard vest coil designs. (ii) Development of imaging methods involved: 1. The optimization and comparison of steady-state free precession and spoiled gradient 19F imaging with C3F8 at 1.5T and 3T. Simulation of the optimal SNR was verified through comprehensive phantom and in-vivo imaging experiments. 2. The investigation of compressed sensing via incoherent sparse k-space sampling to maximize the resolution in 19F ventilation imaging under the constraint of low SNR. Retrospective simulation with hyperpolarized gas images were corroborated by prospective 19F imaging of a 3D printed lung phantom and in-vivo measurements of the lungs. (iii) In-vivo ventilation metrics obtained by 19F ventilation imaging were explored by: 1. The in-vivo mapping of T1 at 1.5T and 3T and mapping of FV and T2* at 3 T. The apparent diffusion coefficient (1.5T) and the evaluation of ventilated volume (1.5T and 3T) was also compared to imaging performed with 129Xe (1.5T). 2. The optimization of imaging for the evaluation of percent ventilated volume with 19F at 3T with a commercial birdcage coil