A Survey on Deep Learning in Medical Image Analysis

Deep learning algorithms, in particular convolutional networks, have rapidly become a methodology of choice for analyzing medical images. This paper reviews the major deep learning concepts pertinent to medical image analysis and summarizes over 300 contributions to the field, most of which appeared in the last year. We survey the use of deep learning for image classification, object detection, segmentation, registration, and other tasks and provide concise overviews of studies per application area. Open challenges and directions for future research are discussed.Comment: Revised survey includes expanded discussion section and reworked introductory section on common deep architectures. Added missed papers from before Feb 1st 201

Cancer diagnosis using deep learning: A bibliographic review

In this paper, we first describe the basics of the field of cancer diagnosis, which includes steps of cancer diagnosis followed by the typical classification methods used by doctors, providing a historical idea of cancer classification techniques to the readers. These methods include Asymmetry, Border, Color and Diameter (ABCD) method, seven-point detection method, Menzies method, and pattern analysis. They are used regularly by doctors for cancer diagnosis, although they are not considered very efficient for obtaining better performance. Moreover, considering all types of audience, the basic evaluation criteria are also discussed. The criteria include the receiver operating characteristic curve (ROC curve), Area under the ROC curve (AUC), F1 score, accuracy, specificity, sensitivity, precision, dice-coefficient, average accuracy, and Jaccard index. Previously used methods are considered inefficient, asking for better and smarter methods for cancer diagnosis. Artificial intelligence and cancer diagnosis are gaining attention as a way to define better diagnostic tools. In particular, deep neural networks can be successfully used for intelligent image analysis. The basic framework of how this machine learning works on medical imaging is provided in this study, i.e., pre-processing, image segmentation and post-processing. The second part of this manuscript describes the different deep learning techniques, such as convolutional neural networks (CNNs), generative adversarial models (GANs), deep autoencoders (DANs), restricted Boltzmann’s machine (RBM), stacked autoencoders (SAE), convolutional autoencoders (CAE), recurrent neural networks (RNNs), long short-term memory (LTSM), multi-scale convolutional neural network (M-CNN), multi-instance learning convolutional neural network (MIL-CNN). For each technique, we provide Python codes, to allow interested readers to experiment with the cited algorithms on their own diagnostic problems. The third part of this manuscript compiles the successfully applied deep learning models for different types of cancers. Considering the length of the manuscript, we restrict ourselves to the discussion of breast cancer, lung cancer, brain cancer, and skin cancer. The purpose of this bibliographic review is to provide researchers opting to work in implementing deep learning and artificial neural networks for cancer diagnosis a knowledge from scratch of the state-of-the-art achievements

Deep-Learning-Based Computer- Aided Systems for Breast Cancer Imaging: A Critical Review

[EN] This paper provides a critical review of the literature on deep learning applications in breast tumor diagnosis using ultrasound and mammography images. It also summarizes recent advances in computer-aided diagnosis/detection (CAD) systems, which make use of new deep learning methods to automatically recognize breast images and improve the accuracy of diagnoses made by radiologists. This review is based upon published literature in the past decade (January 2010-January 2020), where we obtained around 250 research articles, and after an eligibility process, 59 articles were presented in more detail. The main findings in the classification process revealed that new DL-CAD methods are useful and effective screening tools for breast cancer, thus reducing the need for manual feature extraction. The breast tumor research community can utilize this survey as a basis for their current and future studies.This project has been co-financed by the Spanish Government Grant PID2019-107790RB-C22, "Software development for a continuous PET crystal systems applied to breast cancer".Jiménez-Gaona, Y.; Rodríguez Álvarez, MJ.; Lakshminarayanan, V. (2020). Deep-Learning-Based Computer- Aided Systems for Breast Cancer Imaging: A Critical Review. Applied Sciences. 10(22):1-29. https://doi.org/10.3390/app10228298S1291022Jemal, A., Bray, F., Center, M. M., Ferlay, J., Ward, E., & Forman, D. (2011). Global cancer statistics. CA: A Cancer Journal for Clinicians, 61(2), 69-90. doi:10.3322/caac.20107Gao, F., Chia, K.-S., Ng, F.-C., Ng, E.-H., & Machin, D. (2002). Interval cancers following breast cancer screening in Singaporean women. International Journal of Cancer, 101(5), 475-479. doi:10.1002/ijc.10636Munir, K., Elahi, H., Ayub, A., Frezza, F., & Rizzi, A. (2019). Cancer Diagnosis Using Deep Learning: A Bibliographic Review. Cancers, 11(9), 1235. doi:10.3390/cancers11091235Nahid, A.-A., & Kong, Y. (2017). Involvement of Machine Learning for Breast Cancer Image Classification: A Survey. Computational and Mathematical Methods in Medicine, 2017, 1-29. doi:10.1155/2017/3781951Ramadan, S. Z. (2020). Methods Used in Computer-Aided Diagnosis for Breast Cancer Detection Using Mammograms: A Review. Journal of Healthcare Engineering, 2020, 1-21. doi:10.1155/2020/9162464CHAN, H.-P., DOI, K., VYBRONY, C. J., SCHMIDT, R. A., METZ, C. E., LAM, K. L., … MACMAHON, H. (1990). Improvement in Radiologists?? Detection of Clustered Microcalcifications on Mammograms. Investigative Radiology, 25(10), 1102-1110. doi:10.1097/00004424-199010000-00006Olsen, O., & Gøtzsche, P. C. (2001). Cochrane review on screening for breast cancer with mammography. The Lancet, 358(9290), 1340-1342. doi:10.1016/s0140-6736(01)06449-2Mann, R. M., Kuhl, C. K., Kinkel, K., & Boetes, C. (2008). Breast MRI: guidelines from the European Society of Breast Imaging. European Radiology, 18(7), 1307-1318. doi:10.1007/s00330-008-0863-7Jalalian, A., Mashohor, S. B. T., Mahmud, H. R., Saripan, M. I. B., Ramli, A. R. B., & Karasfi, B. (2013). Computer-aided detection/diagnosis of breast cancer in mammography and ultrasound: a review. Clinical Imaging, 37(3), 420-426. doi:10.1016/j.clinimag.2012.09.024Sarno, A., Mettivier, G., & Russo, P. (2015). Dedicated breast computed tomography: Basic aspects. Medical Physics, 42(6Part1), 2786-2804. doi:10.1118/1.4919441Njor, S., Nyström, L., Moss, S., Paci, E., Broeders, M., Segnan, N., & Lynge, E. (2012). Breast Cancer Mortality in Mammographic Screening in Europe: A Review of Incidence-Based Mortality Studies. Journal of Medical Screening, 19(1_suppl), 33-41. doi:10.1258/jms.2012.012080Morrell, S., Taylor, R., Roder, D., & Dobson, A. (2012). Mammography screening and breast cancer mortality in Australia: an aggregate cohort study. Journal of Medical Screening, 19(1), 26-34. doi:10.1258/jms.2012.011127Marmot, M. G., Altman, D. G., Cameron, D. A., Dewar, J. A., Thompson, S. G., & Wilcox, M. (2013). The benefits and harms of breast cancer screening: an independent review. British Journal of Cancer, 108(11), 2205-2240. doi:10.1038/bjc.2013.177Pisano, E. D., Gatsonis, C., Hendrick, E., Yaffe, M., Baum, J. K., Acharyya, S., … Rebner, M. (2005). Diagnostic Performance of Digital versus Film Mammography for Breast-Cancer Screening. New England Journal of Medicine, 353(17), 1773-1783. doi:10.1056/nejmoa052911Carney, P. A., Miglioretti, D. L., Yankaskas, B. C., Kerlikowske, K., Rosenberg, R., Rutter, C. M., … Ballard-Barbash, R. (2003). Individual and Combined Effects of Age, Breast Density, and Hormone Replacement Therapy Use on the Accuracy of Screening Mammography. Annals of Internal Medicine, 138(3), 168. doi:10.7326/0003-4819-138-3-200302040-00008Woodard, D. B., Gelfand, A. E., Barlow, W. E., & Elmore, J. G. (2007). Performance assessment for radiologists interpreting screening mammography. Statistics in Medicine, 26(7), 1532-1551. doi:10.1002/sim.2633Cole, E. B., Pisano, E. D., Kistner, E. O., Muller, K. E., Brown, M. E., Feig, S. A., … Braeuning, M. P. (2003). Diagnostic Accuracy of Digital Mammography in Patients with Dense Breasts Who Underwent Problem-solving Mammography: Effects of Image Processing and Lesion Type. Radiology, 226(1), 153-160. doi:10.1148/radiol.2261012024Boyd, N. F., Guo, H., Martin, L. J., Sun, L., Stone, J., Fishell, E., … Yaffe, M. J. (2007). Mammographic Density and the Risk and Detection of Breast Cancer. New England Journal of Medicine, 356(3), 227-236. doi:10.1056/nejmoa062790Bird, R. E., Wallace, T. W., & Yankaskas, B. C. (1992). Analysis of cancers missed at screening mammography. Radiology, 184(3), 613-617. doi:10.1148/radiology.184.3.1509041Kerlikowske, K. (2000). 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Ultrasound in Medicine & Biology, 42(4), 980-988. doi:10.1016/j.ultrasmedbio.2015.11.016Zhang, Q., Xiao, Y., Dai, W., Suo, J., Wang, C., Shi, J., & Zheng, H. (2016). Deep learning based classification of breast tumors with shear-wave elastography. Ultrasonics, 72, 150-157. doi:10.1016/j.ultras.2016.08.004Cheng, J.-Z., Ni, D., Chou, Y.-H., Qin, J., Tiu, C.-M., Chang, Y.-C., … Chen, C.-M. (2016). Computer-Aided Diagnosis with Deep Learning Architecture: Applications to Breast Lesions in US Images and Pulmonary Nodules in CT Scans. Scientific Reports, 6(1). doi:10.1038/srep24454Shin, S. Y., Lee, S., Yun, I. D., Kim, S. M., & Lee, K. M. (2019). Joint Weakly and Semi-Supervised Deep Learning for Localization and Classification of Masses in Breast Ultrasound Images. IEEE Transactions on Medical Imaging, 38(3), 762-774. doi:10.1109/tmi.2018.2872031Wang, J., Ding, H., Bidgoli, F. A., Zhou, B., Iribarren, C., Molloi, S., & Baldi, P. (2017). Detecting Cardiovascular Disease from Mammograms With Deep Learning. IEEE Transactions on Medical Imaging, 36(5), 1172-1181. doi:10.1109/tmi.2017.2655486Kooi, T., Litjens, G., van Ginneken, B., Gubern-Mérida, A., Sánchez, C. I., Mann, R., … Karssemeijer, N. (2017). Large scale deep learning for computer aided detection of mammographic lesions. Medical Image Analysis, 35, 303-312. doi:10.1016/j.media.2016.07.007Debelee, T. G., Schwenker, F., Ibenthal, A., & Yohannes, D. (2019). Survey of deep learning in breast cancer image analysis. Evolving Systems, 11(1), 143-163. doi:10.1007/s12530-019-09297-2Keen, J. D., Keen, J. M., & Keen, J. E. (2018). Utilization of Computer-Aided Detection for Digital Screening Mammography in the United States, 2008 to 2016. Journal of the American College of Radiology, 15(1), 44-48. doi:10.1016/j.jacr.2017.08.033Henriksen, E. L., Carlsen, J. F., Vejborg, I. M., Nielsen, M. B., & Lauridsen, C. A. (2018). The efficacy of using computer-aided detection (CAD) for detection of breast cancer in mammography screening: a systematic review. Acta Radiologica, 60(1), 13-18. doi:10.1177/0284185118770917Gao, Y., Geras, K. J., Lewin, A. A., & Moy, L. (2019). New Frontiers: An Update on Computer-Aided Diagnosis for Breast Imaging in the Age of Artificial Intelligence. American Journal of Roentgenology, 212(2), 300-307. doi:10.2214/ajr.18.20392Pacilè, S., Lopez, J., Chone, P., Bertinotti, T., Grouin, J. M., & Fillard, P. (2020). Improving Breast Cancer Detection Accuracy of Mammography with the Concurrent Use of an Artificial Intelligence Tool. Radiology: Artificial Intelligence, 2(6), e190208. doi:10.1148/ryai.2020190208Huynh, B. Q., Li, H., & Giger, M. L. (2016). Digital mammographic tumor classification using transfer learning from deep convolutional neural networks. Journal of Medical Imaging, 3(3), 034501. doi:10.1117/1.jmi.3.3.034501Yap, M. 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Deep Convolutional Neural Networks for Computer-Aided Detection: CNN Architectures, Dataset Characteristics and Transfer Learning. IEEE Transactions on Medical Imaging, 35(5), 1285-1298. doi:10.1109/tmi.2016.2528162Lee, J.-G., Jun, S., Cho, Y.-W., Lee, H., Kim, G. B., Seo, J. B., & Kim, N. (2017). Deep Learning in Medical Imaging: General Overview. Korean Journal of Radiology, 18(4), 570. doi:10.3348/kjr.2017.18.4.570Suzuki, K. (2017). Overview of deep learning in medical imaging. Radiological Physics and Technology, 10(3), 257-273. doi:10.1007/s12194-017-0406-5Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2010). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. International Journal of Surgery, 8(5), 336-341. doi:10.1016/j.ijsu.2010.02.007Khan, K. S., Kunz, R., Kleijnen, J., & Antes, G. (2003). Five Steps to Conducting a Systematic Review. 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Confocal Laser Endomicroscopy Image Analysis with Deep Convolutional Neural Networks

abstract: Rapid intraoperative diagnosis of brain tumors is of great importance for planning treatment and guiding the surgeon about the extent of resection. Currently, the standard for the preliminary intraoperative tissue analysis is frozen section biopsy that has major limitations such as tissue freezing and cutting artifacts, sampling errors, lack of immediate interaction between the pathologist and the surgeon, and time consuming. Handheld, portable confocal laser endomicroscopy (CLE) is being explored in neurosurgery for its ability to image histopathological features of tissue at cellular resolution in real time during brain tumor surgery. Over the course of examination of the surgical tumor resection, hundreds to thousands of images may be collected. The high number of images requires significant time and storage load for subsequent reviewing, which motivated several research groups to employ deep convolutional neural networks (DCNNs) to improve its utility during surgery. DCNNs have proven to be useful in natural and medical image analysis tasks such as classification, object detection, and image segmentation. This thesis proposes using DCNNs for analyzing CLE images of brain tumors. Particularly, it explores the practicality of DCNNs in three main tasks. First, off-the shelf DCNNs were used to classify images into diagnostic and non-diagnostic. Further experiments showed that both ensemble modeling and transfer learning improved the classifier’s accuracy in evaluating the diagnostic quality of new images at test stage. Second, a weakly-supervised learning pipeline was developed for localizing key features of diagnostic CLE images from gliomas. Third, image style transfer was used to improve the diagnostic quality of CLE images from glioma tumors by transforming the histology patterns in CLE images of fluorescein sodium-stained tissue into the ones in conventional hematoxylin and eosin-stained tissue slides. These studies suggest that DCNNs are opted for analysis of CLE images. They may assist surgeons in sorting out the non-diagnostic images, highlighting the key regions and enhancing their appearance through pattern transformation in real time. With recent advances in deep learning such as generative adversarial networks and semi-supervised learning, new research directions need to be followed to discover more promises of DCNNs in CLE image analysis.Dissertation/ThesisDoctoral Dissertation Neuroscience 201