Learning under Distributed Weak Supervision

The availability of training data for supervision is a frequently encountered bottleneck of medical image analysis methods. While typically established by a clinical expert rater, the increase in acquired imaging data renders traditional pixel-wise segmentations less feasible. In this paper, we examine the use of a crowdsourcing platform for the distribution of super-pixel weak annotation tasks and collect such annotations from a crowd of non-expert raters. The crowd annotations are subsequently used for training a fully convolutional neural network to address the problem of fetal brain segmentation in T2-weighted MR images. Using this approach we report encouraging results compared to highly targeted, fully supervised methods and potentially address a frequent problem impeding image analysis research

Should We Resect and Discard Low Risk Diminutive Colon Polyps

Diminutive colorectal polyps <5 mm are very common and almost universally benign. The current strategy of resection with histological confirmation of all colorectal polyps is costly and may increase the risk of colonoscopy. Accurate, optical diagnosis without histology can be achieved with currently available endoscopic technologies. The American Society of Gastrointestinal Endoscopy Preservation and Incorporation of Valuable endoscopic Innovations supports strategies for optical diagnosis of small non neoplastic polyps as long as two criteria are met. For hyperplastic appearing polyps <5 mm in recto-sigmoid colon, the negative predictive value should be at least 90%. For diminutive low grade adenomatous appearing polyps, a resect and discard strategy should be sufficiently accurate such that post-polypectomy surveillance recommendations based on the optical diagnosis, agree with a histologically diagnosis at least 90% of the time. Although the resect and discard as well as diagnose and leave behind approach has major benefits with regard to both safety and cost, it has yet to be used widely in practice. To fully implement such as strategy, there is a need for better-quality training, quality assurance, and patient acceptance. In the article, we will review the current state of the science on optical diagnose of colorectal polyps and its implications for colonoscopy practice

Agreement Between Experts and an Untrained Crowd for Identifying Dermoscopic Features Using a Gamified App: Reader Feasibility Study

Background Dermoscopy is commonly used for the evaluation of pigmented lesions, but agreement between experts for identification of dermoscopic structures is known to be relatively poor. Expert labeling of medical data is a bottleneck in the development of machine learning (ML) tools, and crowdsourcing has been demonstrated as a cost- and time-efficient method for the annotation of medical images. Objective The aim of this study is to demonstrate that crowdsourcing can be used to label basic dermoscopic structures from images of pigmented lesions with similar reliability to a group of experts. Methods First, we obtained labels of 248 images of melanocytic lesions with 31 dermoscopic “subfeatures” labeled by 20 dermoscopy experts. These were then collapsed into 6 dermoscopic “superfeatures” based on structural similarity, due to low interrater reliability (IRR): dots, globules, lines, network structures, regression structures, and vessels. These images were then used as the gold standard for the crowd study. The commercial platform DiagnosUs was used to obtain annotations from a nonexpert crowd for the presence or absence of the 6 superfeatures in each of the 248 images. We replicated this methodology with a group of 7 dermatologists to allow direct comparison with the nonexpert crowd. The Cohen κ value was used to measure agreement across raters. Results In total, we obtained 139,731 ratings of the 6 dermoscopic superfeatures from the crowd. There was relatively lower agreement for the identification of dots and globules (the median κ values were 0.526 and 0.395, respectively), whereas network structures and vessels showed the highest agreement (the median κ values were 0.581 and 0.798, respectively). This pattern was also seen among the expert raters, who had median κ values of 0.483 and 0.517 for dots and globules, respectively, and 0.758 and 0.790 for network structures and vessels. The median κ values between nonexperts and thresholded average–expert readers were 0.709 for dots, 0.719 for globules, 0.714 for lines, 0.838 for network structures, 0.818 for regression structures, and 0.728 for vessels. Conclusions This study confirmed that IRR for different dermoscopic features varied among a group of experts; a similar pattern was observed in a nonexpert crowd. There was good or excellent agreement for each of the 6 superfeatures between the crowd and the experts, highlighting the similar reliability of the crowd for labeling dermoscopic images. This confirms the feasibility and dependability of using crowdsourcing as a scalable solution to annotate large sets of dermoscopic images, with several potential clinical and educational applications, including the development of novel, explainable ML tools

Geodesic tractography segmentation for directional medical image analysis

Acknowledgements page removed per author's request, 01/06/2014.Geodesic Tractography Segmentation is the two component approach presented in this thesis for the analysis of imagery in oriented domains, with emphasis on the application to diffusion-weighted magnetic resonance imagery (DW-MRI). The computeraided analysis of DW-MRI data presents a new set of problems and opportunities for the application of mathematical and computer vision techniques. The goal is to develop a set of tools that enable clinicians to better understand DW-MRI data and ultimately shed new light on biological processes. This thesis presents a few techniques and tools which may be used to automatically find and segment major neural fiber bundles from DW-MRI data. For each technique, we provide a brief overview of the advantages and limitations of our approach relative to other available approaches.Ph.D.Committee Chair: Tannenbaum, Allen; Committee Member: Barnes, Christopher F.; Committee Member: Niethammer, Marc; Committee Member: Shamma, Jeff; Committee Member: Vela, Patrici