Machine Learning towards General Medical Image Segmentation

The quality of patient care associated with diagnostic radiology is proportionate to a physician\u27s workload. Segmentation is a fundamental limiting precursor to diagnostic and therapeutic procedures. Advances in machine learning aims to increase diagnostic efficiency to replace single applications with generalized algorithms. We approached segmentation as a multitask shape regression problem, simultaneously predicting coordinates on an object\u27s contour while jointly capturing global shape information. Shape regression models inherent point correlations to recover ambiguous boundaries not supported by clear edges and region homogeneity. Its capabilities was investigated using multi-output support vector regression (MSVR) on head and neck (HaN) CT images. Subsequently, we incorporated multiplane and multimodality spinal images and presented the first deep learning multiapplication framework for shape regression, the holistic multitask regression network (HMR-Net). MSVR and HMR-Net\u27s performance were comparable or superior to state-of-the-art algorithms. Multiapplication frameworks bridges any technical knowledge gaps and increases workflow efficiency

Automatic Segmentation of Mandible from Conventional Methods to Deep Learning-A Review

Medical imaging techniques, such as (cone beam) computed tomography and magnetic resonance imaging, have proven to be a valuable component for oral and maxillofacial surgery (OMFS). Accurate segmentation of the mandible from head and neck (H&N) scans is an important step in order to build a personalized 3D digital mandible model for 3D printing and treatment planning of OMFS. Segmented mandible structures are used to effectively visualize the mandible volumes and to evaluate particular mandible properties quantitatively. However, mandible segmentation is always challenging for both clinicians and researchers, due to complex structures and higher attenuation materials, such as teeth (filling) or metal implants that easily lead to high noise and strong artifacts during scanning. Moreover, the size and shape of the mandible vary to a large extent between individuals. Therefore, mandible segmentation is a tedious and time-consuming task and requires adequate training to be performed properly. With the advancement of computer vision approaches, researchers have developed several algorithms to automatically segment the mandible during the last two decades. The objective of this review was to present the available fully (semi)automatic segmentation methods of the mandible published in different scientific articles. This review provides a vivid description of the scientific advancements to clinicians and researchers in this field to help develop novel automatic methods for clinical applications

FAS-UNet: A Novel FAS-driven Unet to Learn Variational Image Segmentation

Solving variational image segmentation problems with hidden physics is often expensive and requires different algorithms and manually tunes model parameter. The deep learning methods based on the U-Net structure have obtained outstanding performances in many different medical image segmentation tasks, but designing such networks requires a lot of parameters and training data, not always available for practical problems. In this paper, inspired by traditional multi-phase convexity Mumford-Shah variational model and full approximation scheme (FAS) solving the nonlinear systems, we propose a novel variational-model-informed network (denoted as FAS-Unet) that exploits the model and algorithm priors to extract the multi-scale features. The proposed model-informed network integrates image data and mathematical models, and implements them through learning a few convolution kernels. Based on the variational theory and FAS algorithm, we first design a feature extraction sub-network (FAS-Solution module) to solve the model-driven nonlinear systems, where a skip-connection is employed to fuse the multi-scale features. Secondly, we further design a convolution block to fuse the extracted features from the previous stage, resulting in the final segmentation possibility. Experimental results on three different medical image segmentation tasks show that the proposed FAS-Unet is very competitive with other state-of-the-art methods in qualitative, quantitative and model complexity evaluations. Moreover, it may also be possible to train specialized network architectures that automatically satisfy some of the mathematical and physical laws in other image problems for better accuracy, faster training and improved generalization.The code is available at \url{https://github.com/zhuhui100/FASUNet}.Comment: 18 page

SegRap2023: A Benchmark of Organs-at-Risk and Gross Tumor Volume Segmentation for Radiotherapy Planning of Nasopharyngeal Carcinoma

Radiation therapy is a primary and effective NasoPharyngeal Carcinoma (NPC) treatment strategy. The precise delineation of Gross Tumor Volumes (GTVs) and Organs-At-Risk (OARs) is crucial in radiation treatment, directly impacting patient prognosis. Previously, the delineation of GTVs and OARs was performed by experienced radiation oncologists. Recently, deep learning has achieved promising results in many medical image segmentation tasks. However, for NPC OARs and GTVs segmentation, few public datasets are available for model development and evaluation. To alleviate this problem, the SegRap2023 challenge was organized in conjunction with MICCAI2023 and presented a large-scale benchmark for OAR and GTV segmentation with 400 Computed Tomography (CT) scans from 200 NPC patients, each with a pair of pre-aligned non-contrast and contrast-enhanced CT scans. The challenge's goal was to segment 45 OARs and 2 GTVs from the paired CT scans. In this paper, we detail the challenge and analyze the solutions of all participants. The average Dice similarity coefficient scores for all submissions ranged from 76.68\% to 86.70\%, and 70.42\% to 73.44\% for OARs and GTVs, respectively. We conclude that the segmentation of large-size OARs is well-addressed, and more efforts are needed for GTVs and small-size or thin-structure OARs. The benchmark will remain publicly available here: https://segrap2023.grand-challenge.orgComment: A challenge report of SegRap2023 (organized in conjunction with MICCAI2023

Deep learning in medical imaging and radiation therapy

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146980/1/mp13264_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146980/2/mp13264.pd

Automatic Segmentation of the Mandible for Three-Dimensional Virtual Surgical Planning

Three-dimensional (3D) medical imaging techniques have a fundamental role in the field of oral and maxillofacial surgery (OMFS). 3D images are used to guide diagnosis, assess the severity of disease, for pre-operative planning, per-operative guidance and virtual surgical planning (VSP). In the field of oral cancer, where surgical resection requiring the partial removal of the mandible is a common treatment, resection surgery is often based on 3D VSP to accurately design a resection plan around tumor margins. In orthognathic surgery and dental implant surgery, 3D VSP is also extensively used to precisely guide mandibular surgery. Image segmentation from the radiography images of the head and neck, which is a process to create a 3D volume of the target tissue, is a useful tool to visualize the mandible and quantify geometric parameters. Studies have shown that 3D VSP requires accurate segmentation of the mandible, which is currently performed by medical technicians. Mandible segmentation was usually done manually, which is a time-consuming and poorly reproducible process. This thesis presents four algorithms for mandible segmentation from CT and CBCT and contributes to some novel ideas for the development of automatic mandible segmentation for 3D VSP. We implement the segmentation approaches on head and neck CT/CBCT datasets and then evaluate the performance. Experimental results show that our proposed approaches for mandible segmentation in CT/CBCT datasets exhibit high accuracy

This is not a real image:Generative artificial intelligence to enhance radiology education

Radiologists fulfill a critical role in our healthcare system, but their workload has increased substantially over time. Although algorithmic tools have been proposed to support the diagnostic process, the workload is not efficiently decreased in this manner. However, another possibility is to decrease workload in a different area. The main topic of this thesis is concerned with investigating how simulation training can be realized to aid in the image interpretation skills training of the radiology resident. To realize simulated training it is necessary to know (1) how we can create realistic artificial medical images, subsequently (2) How we can control their variety and (3) how we can adjust their difficulty.Firstly, it is shown that artificial medical images can blend in with original ones. For this purpose a GAN model is used to create 2-dimensional artificial medical images. The created artificial images are assessed both quantitatively and qualitatively in terms of their realism. Secondly, to better control the variety of the artificial medical images a diffusion model is used to guide both coarse- and fine-features. The results show that the model was able to adjust fine-feature characteristics of the pathology type according to the feedback of the independent classifier. Thirdly, a method is presented to describe the detection difficulty of an (artificial) medical image using quantitative pathology and image characteristics. Results show that it is possible to describe almost two thirds of the variation in difficulty using these quantitative characteristics and as such describe images as having lower or higher detection difficulty. Finally, the responsible implementation of the medical image simulator to assist in image interpretation skills is investigated. Combining the results of this thesis resulted in a prototype of a 'medical image simulator'. This simulator can take over part of the workload of the supervising radiologists, by providing a means for independent repetitive practice for the resident. The realistic artificial medical images can be varied in terms of their content and their difficulty. This can enable a personalized experience that can enhance training of image interpretation skills and make it more efficient