Deep Learning in Cardiology

The medical field is creating large amount of data that physicians are unable to decipher and use efficiently. Moreover, rule-based expert systems are inefficient in solving complicated medical tasks or for creating insights using big data. Deep learning has emerged as a more accurate and effective technology in a wide range of medical problems such as diagnosis, prediction and intervention. Deep learning is a representation learning method that consists of layers that transform the data non-linearly, thus, revealing hierarchical relationships and structures. In this review we survey deep learning application papers that use structured data, signal and imaging modalities from cardiology. We discuss the advantages and limitations of applying deep learning in cardiology that also apply in medicine in general, while proposing certain directions as the most viable for clinical use.Comment: 27 pages, 2 figures, 10 table

Image registration and visualization of in situ gene expression images.

In the age of high-throughput molecular biology techniques, scientists have incorporated the methodology of in-situ hybridization to map spatial patterns of gene expression. In order to compare expression patterns within a common tissue structure, these images need to be registered or organized into a common coordinate system for alignment to a reference or atlas images. We use three different image registration methodologies (manual; correlation based; mutual information based) to determine the common coordinate system for the reference and in-situ hybridization images. All three methodologies are incorporated into a Matlab tool to visualize the results in a user friendly way and save them for future work. Our results suggest that the user-defined landmark method is best when considering images from different modalities; automated landmark detection is best when the images are expected to have a high degree of consistency; and the mutual information methodology is useful when the images are from the same modality

Medical image registration using unsupervised deep neural network: A scoping literature review

In medicine, image registration is vital in image-guided interventions and other clinical applications. However, it is a difficult subject to be addressed which by the advent of machine learning, there have been considerable progress in algorithmic performance has recently been achieved for medical image registration in this area. The implementation of deep neural networks provides an opportunity for some medical applications such as conducting image registration in less time with high accuracy, playing a key role in countering tumors during the operation. The current study presents a comprehensive scoping review on the state-of-the-art literature of medical image registration studies based on unsupervised deep neural networks is conducted, encompassing all the related studies published in this field to this date. Here, we have tried to summarize the latest developments and applications of unsupervised deep learning-based registration methods in the medical field. Fundamental and main concepts, techniques, statistical analysis from different viewpoints, novelties, and future directions are elaborately discussed and conveyed in the current comprehensive scoping review. Besides, this review hopes to help those active readers, who are riveted by this field, achieve deep insight into this exciting field

Deep Learning Techniques for Automated Analysis and Processing of High Resolution Medical Imaging

Programa Oficial de Doutoramento en Computación . 5009V01[Abstract] Medical imaging plays a prominent role in modern clinical practice for numerous medical specialties. For instance, in ophthalmology, different imaging techniques are commonly used to visualize and study the eye fundus. In this context, automated image analysis methods are key towards facilitating the early diagnosis and adequate treatment of several diseases. Nowadays, deep learning algorithms have already demonstrated a remarkable performance for different image analysis tasks. However, these approaches typically require large amounts of annotated data for the training of deep neural networks. This complicates the adoption of deep learning approaches, especially in areas where large scale annotated datasets are harder to obtain, such as in medical imaging. This thesis aims to explore novel approaches for the automated analysis of medical images, particularly in ophthalmology. In this regard, the main focus is on the development of novel deep learning-based approaches that do not require large amounts of annotated training data and can be applied to high resolution images. For that purpose, we have presented a novel paradigm that allows to take advantage of unlabeled complementary image modalities for the training of deep neural networks. Additionally, we have also developed novel approaches for the detailed analysis of eye fundus images. In that regard, this thesis explores the analysis of relevant retinal structures as well as the diagnosis of different retinal diseases. In general, the developed algorithms provide satisfactory results for the analysis of the eye fundus, even when limited annotated training data is available.[Resumen] Las técnicas de imagen tienen un papel destacado en la práctica clínica moderna de numerosas especialidades médicas. Por ejemplo, en oftalmología es común el uso de diferentes técnicas de imagen para visualizar y estudiar el fondo de ojo. En este contexto, los métodos automáticos de análisis de imagen son clave para facilitar el diagnóstico precoz y el tratamiento adecuado de diversas enfermedades. En la actualidad, los algoritmos de aprendizaje profundo ya han demostrado un notable rendimiento en diferentes tareas de análisis de imagen. Sin embargo, estos métodos suelen necesitar grandes cantidades de datos etiquetados para el entrenamiento de las redes neuronales profundas. Esto complica la adopción de los métodos de aprendizaje profundo, especialmente en áreas donde los conjuntos masivos de datos etiquetados son más difíciles de obtener, como es el caso de la imagen médica. Esta tesis tiene como objetivo explorar nuevos métodos para el análisis automático de imagen médica, concretamente en oftalmología. En este sentido, el foco principal es el desarrollo de nuevos métodos basados en aprendizaje profundo que no requieran grandes cantidades de datos etiquetados para el entrenamiento y puedan aplicarse a imágenes de alta resolución. Para ello, hemos presentado un nuevo paradigma que permite aprovechar modalidades de imagen complementarias no etiquetadas para el entrenamiento de redes neuronales profundas. Además, también hemos desarrollado nuevos métodos para el análisis en detalle de las imágenes del fondo de ojo. En este sentido, esta tesis explora el análisis de estructuras retinianas relevantes, así como el diagnóstico de diferentes enfermedades de la retina. En general, los algoritmos desarrollados proporcionan resultados satisfactorios para el análisis de las imágenes de fondo de ojo, incluso cuando la disponibilidad de datos de entrenamiento etiquetados es limitada.[Resumo] As técnicas de imaxe teñen un papel destacado na práctica clínica moderna de numerosas especialidades médicas. Por exemplo, en oftalmoloxía é común o uso de diferentes técnicas de imaxe para visualizar e estudar o fondo de ollo. Neste contexto, os métodos automáticos de análises de imaxe son clave para facilitar o diagn ostico precoz e o tratamento adecuado de diversas enfermidades. Na actualidade, os algoritmos de aprendizaxe profunda xa demostraron un notable rendemento en diferentes tarefas de análises de imaxe. Con todo, estes métodos adoitan necesitar grandes cantidades de datos etiquetos para o adestramento das redes neuronais profundas. Isto complica a adopción dos métodos de aprendizaxe profunda, especialmente en áreas onde os conxuntos masivos de datos etiquetados son máis difíciles de obter, como é o caso da imaxe médica. Esta tese ten como obxectivo explorar novos métodos para a análise automática de imaxe médica, concretamente en oftalmoloxía. Neste sentido, o foco principal é o desenvolvemento de novos métodos baseados en aprendizaxe profunda que non requiran grandes cantidades de datos etiquetados para o adestramento e poidan aplicarse a imaxes de alta resolución. Para iso, presentamos un novo paradigma que permite aproveitar modalidades de imaxe complementarias non etiquetadas para o adestramento de redes neuronais profundas. Ademais, tamén desenvolvemos novos métodos para a análise en detalle das imaxes do fondo de ollo. Neste sentido, esta tese explora a análise de estruturas retinianas relevantes, así como o diagnóstico de diferentes enfermidades da retina. En xeral, os algoritmos desenvolvidos proporcionan resultados satisfactorios para a análise das imaxes de fondo de ollo, mesmo cando a dispoñibilidade de datos de adestramento etiquetados é limitada

In Vivo Retinal Pigment Epithelium Imaging using Transscleral Optical Imaging in Healthy Eyes.

To image healthy retinal pigment epithelial (RPE) cells in vivo using Transscleral OPtical Imaging (TOPI) and to analyze statistics of RPE cell features as a function of age, axial length (AL), and eccentricity. Single-center, exploratory, prospective, and descriptive clinical study. Forty-nine eyes (AL: 24.03 ± 0.93 mm; range: 21.9-26.7 mm) from 29 participants aged 21 to 70 years (37.1 ± 13.3 years; 19 men, 10 women). Retinal images, including fundus photography and spectral-domain OCT, AL, and refractive error measurements were collected at baseline. For each eye, 6 high-resolution RPE images were acquired using TOPI at different locations, one of them being imaged 5 times to evaluate the repeatability of the method. Follow-up ophthalmic examination was repeated 1 to 3 weeks after TOPI to assess safety. Retinal pigment epithelial images were analyzed with a custom automated software to extract cell parameters. Statistical analysis of the selected high-contrast images included calculation of coefficient of variation (CoV) for each feature at each repetition and Spearman and Mann-Whitney tests to investigate the relationship between cell features and eye and subject characteristics. Retinal pigment epithelial cell features: density, area, center-to-center spacing, number of neighbors, circularity, elongation, solidity, and border distance CoV. Macular RPE cell features were extracted from TOPI images at an eccentricity of 1.6° to 16.3° from the fovea. For each feature, the mean CoV was < 4%. Spearman test showed correlation within RPE cell features. In the perifovea, the region in which images were selected for all participants, longer AL significantly correlated with decreased RPE cell density (R Spearman, Rs = -0.746; P < 0.0001) and increased cell area (Rs = 0.668; P < 0.0001), without morphologic changes. Aging was also significantly correlated with decreased RPE density (Rs = -0.391; P = 0.036) and increased cell area (Rs = 0.454; P = 0.013). Lower circular, less symmetric, more elongated, and larger cells were observed in those > 50 years. The TOPI technology imaged RPE cells in vivo with a repeatability of < 4% for the CoV and was used to analyze the influence of physiologic factors on RPE cell morphometry in the perifovea of healthy volunteers. Proprietary or commercial disclosure may be found after the references

A Hybrid Similarity Measure Framework for Multimodal Medical Image Registration

Medical imaging is widely used today to facilitate both disease diagnosis and treatment planning practice, with a key prerequisite being the systematic process of medical image registration (MIR) to align either mono or multimodal images of different anatomical parts of the human body. MIR utilises a similarity measure (SM) to quantify the level of spatial alignment and is particularly demanding due to the presence of inherent modality characteristics like intensity non-uniformities (INU) in magnetic resonance images and large homogeneous non-vascular regions in retinal images. While various intensity and feature-based SMs exist for MIR, mutual information (MI) has become established because of its computational efficiency and ability to register multimodal images. It is however, very sensitive to interpolation artefacts in the presence of INU with noise and can be compromised when overlapping areas are small. Recently MI-based hybrid variants which combine regional features with intensity have emerged, though these incur high dimensionality and large computational overheads. To address these challenges and secure accurate, efficient and robust registration of images containing high INU, noise and large homogeneous regions, this thesis presents a new hybrid SM framework for 2D multimodal rigid MIR. The framework consistently provides superior quantitative and qualitative performance, while offering a uniquely flexible design trade-off between registration accuracy and computational time. It makes three significant technical contributions to the field: i) An expectation maximisation-based principal component analysis with mutual information (EMPCA-MI) framework incorporating neighbourhood feature information; ii) Two innovative enhancements to reduce information redundancy and improve MI computational efficiency; and iii) an adaptive algorithm to select the most significant principal components for feature selection. The thesis findings conclusively confirm the hybrid SM framework offers an accurate and robust 2D registration solution for challenging multimodal medical imaging datasets, while its inherent flexibility means it can also be extended to the 3D registration domain

Detection and Mosaicing through Deep Learning Models for Low-Quality Retinal Images

Glaucoma is a severe eye disease that is asymptomatic in the initial stages and can lead to blindness, due to its degenerative characteristic. There isn’t any available cure for it, and it is the second most common cause of blindness in the world. Most of the people affected by it only discovers the disease when it is already too late. Regular visits to the ophthalmologist are the best way to prevent or contain it, with a precise diagnosis performed with professional equipment. From another perspective, for some individuals or populations, this task can be difficult to accomplish, due to several restrictions, such as low incoming resources, geographical adversities, and travelling restrictions (distance, lack of means of transportation, etc.). Also, logistically, due to its dimensions, relocating the professional equipment can be expensive, thus becoming not viable to bring them to remote areas. In the market, low-cost products like the D-Eye lens offer an alternative to meet this need. The D-Eye lens can be attached to a smartphone to capture fundus images, but it presents a major drawback in terms of lower-quality imaging when compared to professional equipment. This work presents and evaluates methods for eye reading with D-Eye recordings. This involves exposing the retina in two steps: object detection and summarization via object mosaicing. Deep learning methods, such as the YOLO family architecture, were used for retina registration as an object detector. The summarization methods presented and inferred in this work mosaiced the best retina images together to produce a more detailed resultant image. After selecting the best workflow from these methods, a final inference was performed and visually evaluated, the results were not rich enough to serve as a pre-screening medical assessment, determining that improvements in the actual algorithm and technology are needed to retrieve better imaging

A novel automated approach of multi-modality retinal image registration and fusion

Biomedical image registration and fusion are usually scene dependent, and require intensive computational effort. A novel automated approach of feature-based control point detection and area-based registration and fusion of retinal images has been successfully designed and developed. The new algorithm, which is reliable and time-efficient, has an automatic adaptation from frame to frame with few tunable threshold parameters. The reference and the to-be-registered images are from two different modalities, i.e. angiogram grayscale images and fundus color images. The relative study of retinal images enhances the information on the fundus image by superimposing information contained in the angiogram image. Through the thesis research, two new contributions have been made to the biomedical image registration and fusion area. The first contribution is the automatic control point detection at the global direction change pixels using adaptive exploratory algorithm. Shape similarity criteria are employed to match the control points. The second contribution is the heuristic optimization algorithm that maximizes Mutual-Pixel-Count (MPC) objective function. The initially selected control points are adjusted during the optimization at the sub-pixel level. A global maxima equivalent result is achieved by calculating MPC local maxima with an efficient computation cost. The iteration stops either when MPC reaches the maximum value, or when the maximum allowable loop count is reached. To our knowledge, it is the first time that the MPC concept has been introduced into biomedical image fusion area as the measurement criteria for fusion accuracy. The fusion image is generated based on the current control point coordinates when the iteration stops. The comparative study of the presented automatic registration and fusion scheme against Centerline Control Point Detection Algorithm, Genetic Algorithm, RMSE objective function, and other existing data fusion approaches has shown the advantage of the new approach in terms of accuracy, efficiency, and novelty