Strengthening deep-learning models for intracranial hemorrhage detection: strongly annotated computed tomography images and model ensembles

Background and purposeMultiple attempts at intracranial hemorrhage (ICH) detection using deep-learning techniques have been plagued by clinical failures. We aimed to compare the performance of a deep-learning algorithm for ICH detection trained on strongly and weakly annotated datasets, and to assess whether a weighted ensemble model that integrates separate models trained using datasets with different ICH improves performance.MethodsWe used brain CT scans from the Radiological Society of North America (27,861 CT scans, 3,528 ICHs) and AI-Hub (53,045 CT scans, 7,013 ICHs) for training. DenseNet121, InceptionResNetV2, MobileNetV2, and VGG19 were trained on strongly and weakly annotated datasets and compared using independent external test datasets. We then developed a weighted ensemble model combining separate models trained on all ICH, subdural hemorrhage (SDH), subarachnoid hemorrhage (SAH), and small-lesion ICH cases. The final weighted ensemble model was compared to four well-known deep-learning models. After external testing, six neurologists reviewed 91 ICH cases difficult for AI and humans.ResultsInceptionResNetV2, MobileNetV2, and VGG19 models outperformed when trained on strongly annotated datasets. A weighted ensemble model combining models trained on SDH, SAH, and small-lesion ICH had a higher AUC, compared with a model trained on all ICH cases only. This model outperformed four deep-learning models (AUC [95% C.I.]: Ensemble model, 0.953[0.938–0.965]; InceptionResNetV2, 0.852[0.828–0.873]; DenseNet121, 0.875[0.852–0.895]; VGG19, 0.796[0.770–0.821]; MobileNetV2, 0.650[0.620–0.680]; p < 0.0001). In addition, the case review showed that a better understanding and management of difficult cases may facilitate clinical use of ICH detection algorithms.ConclusionWe propose a weighted ensemble model for ICH detection, trained on large-scale, strongly annotated CT scans, as no model can capture all aspects of complex tasks

Artificial Intelligence with Light Supervision: Application to Neuroimaging

Recent developments in artificial intelligence research have resulted in tremendous success in computer vision, natural language processing and medical imaging tasks, often reaching human or superhuman performance. In this thesis, I further developed artificial intelligence methods based on convolutional neural networks with a special focus on the automated analysis of brain magnetic resonance imaging scans (MRI). I showed that efficient artificial intelligence systems can be created using only minimal supervision, by reducing the quantity and quality of annotations used for training. I applied those methods to the automated assessment of the burden of enlarged perivascular spaces, brain structural changes that may be related to dementia, stroke, mult

Explainable artificial intelligence (XAI) in deep learning-based medical image analysis

With an increase in deep learning-based methods, the call for explainability of such methods grows, especially in high-stakes decision making areas such as medical image analysis. This survey presents an overview of eXplainable Artificial Intelligence (XAI) used in deep learning-based medical image analysis. A framework of XAI criteria is introduced to classify deep learning-based medical image analysis methods. Papers on XAI techniques in medical image analysis are then surveyed and categorized according to the framework and according to anatomical location. The paper concludes with an outlook of future opportunities for XAI in medical image analysis.Comment: Submitted for publication. Comments welcome by email to first autho

Apprentissage faiblement supervisé appliqué à la segmentation d'images de protéines neuronales

Titre de l'écran-titre (visionné le 9 juillet 2020)Thèse ou mémoire avec insertion d'articlesTableau d'honneur de la Faculté des études supérieures et postdoctorales, 2020-2021En biologie cellulaire, la microscopie optique est couramment utilisée pour visualiser et caractériser la présence et la morphologie des structures biologiques. Suite à l’acquisition, un expert devra effectuer l’annotation des structures pour quantification. Cette tâche est ardue, requiert de nombreuses heures de travail, parfois répétitif, qui peut résulter en erreurs d’annotations causées par la fatigue d’étiquetage. L’apprentissage machine promet l’automatisation de tâches complexes à partir d’un grand lot de données exemples annotés. Mon projet de maîtrise propose d’utiliser des techniques faiblement supervisées, où les annotations requises pour l’entraînement sont réduites et/ou moins précises, pour la segmentation de structures neuronales. J’ai d’abord testé l’utilisation de polygones délimitant la structure d’intérêt pour la tâche complexe de segmentation de la protéine neuronale F-actine dans des images de microscopie à super-résolution. La complexité de la tâche est supportée par la morphologie hétérogène des neurones, le nombre élevé d’instances à segmenter dans une image et la présence de nombreux distracteurs. Malgré ces difficultés, l’utilisation d’annotations faibles a permis de quantifier un changement novateur de la conformation de la protéine F-actine en fonction de l’activité neuronale. J’ai simplifié davantage la tâche d’annotation en requérant seulement des étiquettes binaires renseignant sur la présence des structures dans l’image réduisant d’un facteur 30 le temps d’annotation. De cette façon, l’algorithme est entraîné à prédire le contenu d’une image et extrait ensuite les caractéristiques sémantiques importantes pour la reconnaissance de la structure d’intérêt à l’aide de mécanismes d’attention. La précision de segmentation obtenue sur les images de F-actine est supérieure à celle des annotations polygonales et équivalente à celle des annotations précises d’un expert. Cette nouvelle approche devrait faciliter la quantification des changements dynamiques qui se produisent sous le microscope dans des cellules vivantes et réduire les erreurs causées par l’inattention ou le biais de sélection des régions d’intérêt dans les images de microscopie.In cell biology, optical microscopy is commonly used to visualize and characterize the presenceand morphology of biological structures. Following the acquisition, an expert will have toannotate the structures for quantification. This is a difficult task, requiring many hours ofwork, sometimes repetitive, which can result in annotation errors caused by labelling fatigue.Machine learning promises to automate complex tasks from a large set of annotated sampledata. My master’s project consists of using weakly supervised techniques, where the anno-tations required for training are reduced and/or less precise, for the segmentation of neuralstructures.I first tested the use of polygons delimiting the structure of interest for the complex taskof segmentation of the neuronal protein F-actin in super-resolution microscopy images. Thecomplexity of the task is supported by the heterogeneous morphology of neurons, the highnumber of instances to segment in an image and the presence of many distractors. Despitethese difficulties, the use of weak annotations has made it possible to quantify an innovativechange in the conformation of the F-actin protein as a function of neuronal activity. I furthersimplified the annotation task by requiring only binary labels that indicate the presence ofstructures in the image, reducing annotation time by a factor of 30. In this way, the algorithmis trained to predict the content of an image and then extract the semantic characteristicsimportant for recognizing the structure of interest using attention mechanisms. The segmen-tation accuracy obtained on F-actin images is higher than that of polygonal annotations andequivalent to that of an expert’s precise annotations. This new approach should facilitate thequantification of dynamic changes that occur under the microscope in living cells and reduceerrors caused by inattention or bias in the selection of regions of interest in microscopy images

Weakly supervised object detection with 2D and 3D regression neural networks

Finding automatically multiple lesions in large images is a common problem in medical image analysis. Solving this problem can be challenging if, during

Weakly supervised object detection with 2D and 3D regression neural networks

Finding automatically multiple lesions in large images is a common problem in medical image analysis. Solving this problem can be challenging if, during optimization, the automated method cannot access information about the location of the lesions nor is given single examples of the lesions. We propose a new weakly supervised detection method using neural networks, that computes attention maps revealing the locations of brain lesions. These attention maps are computed using the last feature maps of a segmentation network optimized only with global image-level labels. The proposed method can generate attention maps at full input resolution without need for interpolation during preprocessing, which allows small lesions to appear in attention maps. For comparison, we modify state-of-the-art methods to compute attention maps for weakly supervised object detection, by using a global regression objective instead of the more conventional classification objective. This regression objective optimizes the number of occurrences of the target object in an image, e.g. the number of brain lesions in a scan, or the number of digits in an image. We study the behavior of the proposed method in MNIST-based detection datasets, and evaluate it for the challenging detection of enlarged perivascular spaces – a type of brain lesion – in a dataset of 2202 3D scans with point-wise annotations in the center of all lesions in four brain regions. In MNIST-based datasets, the proposed method outperforms the other methods. In the brain dataset, the weakly supervised detection methods come close to the human intrarater agreement in each region. The proposed method reaches the best area under the curve in two out of four regions, and has the lowest number of false positive detections in all regions, while its average sensitivity over all regions is similar to that of the other best methods. The proposed method can facilitate epidemiological and clinical studies of enlarged perivascular spaces and help advance research in the etiology of enlarged perivascular spaces and in their relationship with cerebrovascular diseases.</p

Weakly supervised object detection with 2D and 3D regression neural networks

Finding automatically multiple lesions in large images is a common problem in medical image analysis. Solving this problem can be challenging if, during optimization, the automated method cannot access information about the location of the lesions nor is given single examples of the lesions. We propose a new weakly supervised detection method using neural networks, that computes attention maps revealing the locations of brain lesions. These attention maps are computed using the last feature maps of a segmentation network optimized only with global image-level labels. The proposed method can generate attention maps at full input resolution without need for interpolation during preprocessing, which allows small lesions to appear in attention maps. For comparison, we modify state-of-the-art methods to compute attention maps for weakly supervised object detection, by using a global regression objective instead of the more conventional classification objective. This regression objective optimizes the number of occurrences of the target object in an image, e.g. the number of brain lesions in a scan, or the number of digits in an image. We study the behavior of the proposed method in MNIST-based detection datasets, and evaluate it for the challenging detection of enlarged perivascular spaces – a type of brain lesion – in a dataset of 2202 3D scans with point-wise annotations in the center of all lesions in four brain regions. In MNIST-based datasets, the proposed method outperforms the other methods. In the brain dataset, the weakly supervised detection methods come close to the human intrarater agreement in each region. The proposed method reaches the best area under the curve in two out of four regions, and has the lowest number of false positive detections in all regions, while its average sensitivity over all regions is similar to that of the other best methods. The proposed method can facilitate epidemiological and clinical studies of enlarged perivascular spaces and help advance research in the etiology of enlarged perivascular spaces and in their relationship with cerebrovascular diseases.ImPhys/Medical ImagingImPhys/Computational Imagin