The impact of pre- and post-image processing techniques on deep learning frameworks: A comprehensive review for digital pathology image analysis

Recently, deep learning frameworks have rapidly become the main methodology for analyzing medical images. Due to their powerful learning ability and advantages in dealing with complex patterns, deep learning algorithms are ideal for image analysis challenges, particularly in the field of digital pathology. The variety of image analysis tasks in the context of deep learning includes classification (e.g., healthy vs. cancerous tissue), detection (e.g., lymphocytes and mitosis counting), and segmentation (e.g., nuclei and glands segmentation). The majority of recent machine learning methods in digital pathology have a pre- and/or post-processing stage which is integrated with a deep neural network. These stages, based on traditional image processing methods, are employed to make the subsequent classification, detection, or segmentation problem easier to solve. Several studies have shown how the integration of pre- and post-processing methods within a deep learning pipeline can further increase the model's performance when compared to the network by itself. The aim of this review is to provide an overview on the types of methods that are used within deep learning frameworks either to optimally prepare the input (pre-processing) or to improve the results of the network output (post-processing), focusing on digital pathology image analysis. Many of the techniques presented here, especially the post-processing methods, are not limited to digital pathology but can be extended to almost any image analysis field

Deep learning for unsupervised domain adaptation in medical imaging: Recent advancements and future perspectives

Deep learning has demonstrated remarkable performance across various tasks in medical imaging. However, these approaches primarily focus on supervised learning, assuming that the training and testing data are drawn from the same distribution. Unfortunately, this assumption may not always hold true in practice. To address these issues, unsupervised domain adaptation (UDA) techniques have been developed to transfer knowledge from a labeled domain to a related but unlabeled domain. In recent years, significant advancements have been made in UDA, resulting in a wide range of methodologies, including feature alignment, image translation, self-supervision, and disentangled representation methods, among others. In this paper, we provide a comprehensive literature review of recent deep UDA approaches in medical imaging from a technical perspective. Specifically, we categorize current UDA research in medical imaging into six groups and further divide them into finer subcategories based on the different tasks they perform. We also discuss the respective datasets used in the studies to assess the divergence between the different domains. Finally, we discuss emerging areas and provide insights and discussions on future research directions to conclude this survey.Comment: Under Revie

Applications of Deep Learning in Medical Image Analysis : Grading of Prostate Cancer and Detection of Coronary Artery Disease

A wide range of medical examinations are using analysis of images from different types of equipment. Using artificial intelligence, the assessments could be done automatically. This can have multiple benefits for the healthcare; reduce workload for medical doctors, decrease variations in diagnoses and cut waiting times for the patient as well as improve the performance. The aim of this thesis has been to develop such solutions for two common diseases: prostate cancer and coronary artery disease. The methods used are mainly based on deep learning, where the model teaches itself by training on large datasets.Prostate cancer is one of the most common cancer diagnoses among men. The diagnosis is most commonly determined by visual assessment of prostate biopsies in a light microscope according to the Gleason scale. Deep learning methods to automatically detect and grade the cancer areas are presented in this thesis. The methods have been adapted to improve the generalisation performance on images from different hospitals, images which have inevitable variations in e.g.\ stain appearance. The methods include the usage of digital stain normalisation, training with extensive augmentation or using models such as a domain-adversarial neural network. One Gleason grading algorithm was evaluated on a small cohort with biopsies annotated in detail by two pathologists, to compare the performance with pathologists' inter-observer variability. Another cancer detection algorithm was evaluated on a large active surveillance cohort, containing patients with small areas of low-grade cancer. The results are promising towards a future tool to facilitate grading of prostate cancer.Cardiovascular disease is the leading cause of death world-wide, whereof coronary artery disease is one of the most common diseases. One way to diagnose coronary artery disease is by using myocardial perfusion imaging, where disease in the three main arteries supplying the heart with blood can be detected. Methods based on deep learning to perform the detection automatically are presented in this thesis. Furthermore, an algorithm developed to predict the degree of coronary artery stenosis from myocardial perfusion imaging, by means of quantitative coronary angiography, has also been developed. This assessment is normally done using invasive coronary angiography. Making the prediction automatically from myocardial perfusion imaging could save suffering for patients and free resources within the healthcare system

Deep learning-based improvement for the outcomes of glaucoma clinical trials

Glaucoma is the leading cause of irreversible blindness worldwide. It is a progressive optic neuropathy in which retinal ganglion cell (RGC) axon loss, probably as a consequence of damage at the optic disc, causes a loss of vision, predominantly affecting the mid-peripheral visual field (VF). Glaucoma results in a decrease in vision-related quality of life and, therefore, early detection and evaluation of disease progression rates is crucial in order to assess the risk of functional impairment and to establish sound treatment strategies. The aim of my research is to improve glaucoma diagnosis by enhancing state of the art analyses of glaucoma clinical trial outcomes using advanced analytical methods. This knowledge would also help better design and analyse clinical trials, providing evidence for re-evaluating existing medications, facilitating diagnosis and suggesting novel disease management. To facilitate my objective methodology, this thesis provides the following contributions: (i) I developed deep learning-based super-resolution (SR) techniques for optical coherence tomography (OCT) image enhancement and demonstrated that using super-resolved images improves the statistical power of clinical trials, (ii) I developed a deep learning algorithm for segmentation of retinal OCT images, showing that the methodology consistently produces more accurate segmentations than state-of-the-art networks, (iii) I developed a deep learning framework for refining the relationship between structural and functional measurements and demonstrated that the mapping is significantly improved over previous techniques, iv) I developed a probabilistic method and demonstrated that glaucomatous disc haemorrhages are influenced by a possible systemic factor that makes both eyes bleed simultaneously. v) I recalculated VF slopes, using the retinal never fiber layer thickness (RNFLT) from the super-resolved OCT as a Bayesian prior and demonstrated that use of VF rates with the Bayesian prior as the outcome measure leads to a reduction in the sample size required to distinguish treatment arms in a clinical trial