A Computationally Efficient U-Net Architecture for Lung Segmentation in Chest Radiographs

Lung segmentation plays a crucial role in computer-aided diagnosis using Chest Radiographs (CRs). We implement a U-Net architecture for lung segmentation in CRs across multiple publicly available datasets. We utilize a private dataset with 160 CRs provided by the Riverain Medical Group for training purposes. A publicly available dataset provided by the Japanese Radiological Scientific Technology (JRST) is used for testing. The active shape model-based results would serve as the ground truth for both these datasets. In addition, we also study the performance of our algorithm on a publicly available Shenzhen dataset which contains 566 CRs with manually segmented lungs (ground truth). Our overall performance in terms of pixel-based classification is about 98.3% and 95.6% for a set of 100 CRs in Shenzhen dataset and 140 CRs in JRST dataset. We also achieve an intersection over union value of 0.95 at a computation time of 8 seconds for the entire suite of Shenzhen testing cases

Computational methods for the analysis of functional 4D-CT chest images.

Medical imaging is an important emerging technology that has been intensively used in the last few decades for disease diagnosis and monitoring as well as for the assessment of treatment effectiveness. Medical images provide a very large amount of valuable information that is too huge to be exploited by radiologists and physicians. Therefore, the design of computer-aided diagnostic (CAD) system, which can be used as an assistive tool for the medical community, is of a great importance. This dissertation deals with the development of a complete CAD system for lung cancer patients, which remains the leading cause of cancer-related death in the USA. In 2014, there were approximately 224,210 new cases of lung cancer and 159,260 related deaths. The process begins with the detection of lung cancer which is detected through the diagnosis of lung nodules (a manifestation of lung cancer). These nodules are approximately spherical regions of primarily high density tissue that are visible in computed tomography (CT) images of the lung. The treatment of these lung cancer nodules is complex, nearly 70% of lung cancer patients require radiation therapy as part of their treatment. Radiation-induced lung injury is a limiting toxicity that may decrease cure rates and increase morbidity and mortality treatment. By finding ways to accurately detect, at early stage, and hence prevent lung injury, it will have significant positive consequences for lung cancer patients. The ultimate goal of this dissertation is to develop a clinically usable CAD system that can improve the sensitivity and specificity of early detection of radiation-induced lung injury based on the hypotheses that radiated lung tissues may get affected and suffer decrease of their functionality as a side effect of radiation therapy treatment. These hypotheses have been validated by demonstrating that automatic segmentation of the lung regions and registration of consecutive respiratory phases to estimate their elasticity, ventilation, and texture features to provide discriminatory descriptors that can be used for early detection of radiation-induced lung injury. The proposed methodologies will lead to novel indexes for distinguishing normal/healthy and injured lung tissues in clinical decision-making. To achieve this goal, a CAD system for accurate detection of radiation-induced lung injury that requires three basic components has been developed. These components are the lung fields segmentation, lung registration, and features extraction and tissue classification. This dissertation starts with an exploration of the available medical imaging modalities to present the importance of medical imaging in today’s clinical applications. Secondly, the methodologies, challenges, and limitations of recent CAD systems for lung cancer detection are covered. This is followed by introducing an accurate segmentation methodology of the lung parenchyma with the focus of pathological lungs to extract the volume of interest (VOI) to be analyzed for potential existence of lung injuries stemmed from the radiation therapy. After the segmentation of the VOI, a lung registration framework is introduced to perform a crucial and important step that ensures the co-alignment of the intra-patient scans. This step eliminates the effects of orientation differences, motion, breathing, heart beats, and differences in scanning parameters to be able to accurately extract the functionality features for the lung fields. The developed registration framework also helps in the evaluation and gated control of the radiotherapy through the motion estimation analysis before and after the therapy dose. Finally, the radiation-induced lung injury is introduced, which combines the previous two medical image processing and analysis steps with the features estimation and classification step. This framework estimates and combines both texture and functional features. The texture features are modeled using the novel 7th-order Markov Gibbs random field (MGRF) model that has the ability to accurately models the texture of healthy and injured lung tissues through simultaneously accounting for both vertical and horizontal relative dependencies between voxel-wise signals. While the functionality features calculations are based on the calculated deformation fields, obtained from the 4D-CT lung registration, that maps lung voxels between successive CT scans in the respiratory cycle. These functionality features describe the ventilation, the air flow rate, of the lung tissues using the Jacobian of the deformation field and the tissues’ elasticity using the strain components calculated from the gradient of the deformation field. Finally, these features are combined in the classification model to detect the injured parts of the lung at an early stage and enables an earlier intervention

Medical Image Segmentation by Deep Convolutional Neural Networks

Medical image segmentation is a fundamental and critical step for medical image analysis. Due to the complexity and diversity of medical images, the segmentation of medical images continues to be a challenging problem. Recently, deep learning techniques, especially Convolution Neural Networks (CNNs) have received extensive research and achieve great success in many vision tasks. Specifically, with the advent of Fully Convolutional Networks (FCNs), automatic medical image segmentation based on FCNs is a promising research field. This thesis focuses on two medical image segmentation tasks: lung segmentation in chest X-ray images and nuclei segmentation in histopathological images. For the lung segmentation task, we investigate several FCNs that have been successful in semantic and medical image segmentation. We evaluate the performance of these different FCNs on three publicly available chest X-ray image datasets. For the nuclei segmentation task, since the challenges of this task are difficulty in segmenting the small, overlapping and touching nuclei, and limited ability of generalization to nuclei in different organs and tissue types, we propose a novel nuclei segmentation approach based on a two-stage learning framework and Deep Layer Aggregation (DLA). We convert the original binary segmentation task into a two-step task by adding nuclei-boundary prediction (3-classes) as an intermediate step. To solve our two-step task, we design a two-stage learning framework by stacking two U-Nets. The first stage estimates nuclei and their coarse boundaries while the second stage outputs the final fine-grained segmentation map. Furthermore, we also extend the U-Nets with DLA by iteratively merging features across different levels. We evaluate our proposed method on two public diverse nuclei datasets. The experimental results show that our proposed approach outperforms many standard segmentation architectures and recently proposed nuclei segmentation methods, and can be easily generalized across different cell types in various organs

Automated lung segmentation in digital chest tomosynthesis: Lung segmentation in tomosynthesis

Purpose: The purpose of this study was to develop an automated lung segmentation method for computerized detection of lung nodules in digital chest tomosynthesis

Quantification of pulmonary tuberculosis characteristics from digital chest x-rays using radiomics

Thesis (PhD (Nuclear Medical Sciences))--University of Pretoria, 2023.Pulmonary tuberculosis (PTB) is internationally one of the leading causes of death from a single infectious agent, and South Africa remains in the top 8 countries globally with the highest number of new infections. A chest x-ray (CXR) is still the most common radiological imaging procedure for PTB screening, diagnosis and monitoring, but it cannot be used as a standalone diagnostic tool due to the subjectivity associated with reporting. This can be addressed by quantifying digital CXR with tools such as radiomic feature extraction. In this thesis a unique sliding window segmentation method was developed to eliminate the difficult and time-consuming task of accurate PTB disease segmentation from planar images. It was applied as a secondary segmentation, superimposed on a primary automatic lung segmentation, that divided the entire lung region into uniform windows that overlapped while sliding over the CXR in both image dimensions. When radiomic features were extracted from each sliding window, it allowed the distribution of the features across the lung region to be evaluated. Three different outcomes were achieved when radiomic feature extraction was applied to chest x-rays using the sliding window segmentation. Firstly a model was developed that can automatically differentiate normal CXR from CXR with PTB cavities, which could improve the accuracy of CXR reporting currently regaining prominence as a high-volume screening tool. Secondly, signature parameter maps that showed a strong correlation to the lung pathology were constructed. This might be valuable as a quantitative supplementary indicator in the management of PTB disease and further increase the acceptance of CXR as a tool for assessing the TB response in medical research and clinical practice. Finally, a radiomics score was constructed that was able to quantify the change in the disease characteristics as seen from digital CXR of patients diagnosed with PTB. This radiomic score analysis of serial x-rays taken while patients receive TB therapy has the potential to be a quantitative monitoring tool of response to therapy. Radiomics was therefore successfully applied in this study to quantify the characteristics of PTB from chest x-rays.Nuclear MedicinePhD (Nuclear Medical Sciences)UnrestrictedFaculty of Health SciencesSDG-03: Good health and well-bein

Image similarity in medical images

Recent experiments have indicated a strong influence of the substrate grain orientation on the self-ordering in anodic porous alumina. Anodic porous alumina with straight pore channels grown in a stable, self-ordered manner is formed on (001) oriented Al grain, while disordered porous pattern is formed on (101) oriented Al grain with tilted pore channels growing in an unstable manner. In this work, numerical simulation of the pore growth process is carried out to understand this phenomenon. The rate-determining step of the oxide growth is assumed to be the Cabrera-Mott barrier at the oxide/electrolyte (o/e) interface, while the substrate is assumed to determine the ratio β between the ionization and oxidation reactions at the metal/oxide (m/o) interface. By numerically solving the electric field inside a growing porous alumina during anodization, the migration rates of the ions and hence the evolution of the o/e and m/o interfaces are computed. The simulated results show that pore growth is more stable when β is higher. A higher β corresponds to more Al ionized and migrating away from the m/o interface rather than being oxidized, and hence a higher retained O:Al ratio in the oxide. Experimentally measured oxygen content in the self-ordered porous alumina on (001) Al is indeed found to be about 3% higher than that in the disordered alumina on (101) Al, in agreement with the theoretical prediction. The results, therefore, suggest that ionization on (001) Al substrate is relatively easier than on (101) Al, and this leads to the more stable growth of the pore channels on (001) Al

Tuberculosis diagnosis from pulmonary chest x-ray using deep learning.

Doctoral Degree. University of KwaZulu-Natal, Durban.Tuberculosis (TB) remains a life-threatening disease, and it is one of the leading causes of mortality in developing countries. This is due to poverty and inadequate medical resources. While treatment for TB is possible, it requires an accurate diagnosis first. Several screening tools are available, and the most reliable is Chest X-Ray (CXR), but the radiological expertise for accurately interpreting the CXR images is often lacking. Over the years, CXR has been manually examined; this process results in delayed diagnosis, is time-consuming, expensive, and is prone to misdiagnosis, which could further spread the disease among individuals. Consequently, an algorithm could increase diagnosis efficiency, improve performance, reduce the cost of manual screening and ultimately result in early/timely diagnosis. Several algorithms have been implemented to diagnose TB automatically. However, these algorithms are characterized by low accuracy and sensitivity leading to misdiagnosis. In recent years, Convolutional Neural Networks (CNN), a class of Deep Learning, has demonstrated tremendous success in object detection and image classification task. Hence, this thesis proposed an efficient Computer-Aided Diagnosis (CAD) system with high accuracy and sensitivity for TB detection and classification. The proposed model is based firstly on novel end-to-end CNN architecture, then a pre-trained Deep CNN model that is fine-tuned and employed as a features extractor from CXR. Finally, Ensemble Learning was explored to develop an Ensemble model for TB classification. The Ensemble model achieved a new stateof- the-art diagnosis accuracy of 97.44% with a 99.18% sensitivity, 96.21% specificity and 0.96% AUC. These results are comparable with state-of-the-art techniques and outperform existing TB classification models.Author's Publications listed on page iii

Computer-aided detection of lung nodules: A review

We present an in-depth review and analysis of salient methods for computer-aided detection of lung nodules. We evaluate the current methods for detecting lung nodules using literature searches with selection criteria based on validation dataset types, nodule sizes, numbers of cases, types of nodules, extracted features in traditional feature-based classifiers, sensitivity, and false positives (FP)/scans. Our review shows that current detection systems are often optimized for particular datasets and can detect only one or two types of nodules. We conclude that, in addition to achieving high sensitivity and reduced FP/scans, strategies for detecting lung nodules must detect a variety of nodules with high precision to improve the performances of the radiologists. To the best of our knowledge, ours is the first review of the effectiveness of feature extraction using traditional feature-based classifiers. Moreover, we discuss deep-learning methods in detail and conclude that features must be appropriately selected to improve the overall accuracy of the system. We present an analysis of current schemes and highlight constraints and future research areas