Segmentation of Pathology Images: A Deep Learning Strategy with Annotated Data

Cancer has significantly threatened human life and health for many years. In the clinic, histopathology image segmentation is the golden stand for evaluating the prediction of patient prognosis and treatment outcome. Generally, manually labelling tumour regions in hundreds of high-resolution histopathological images is time-consuming and expensive for pathologists. Recently, the advancements in hardware and computer vision have allowed deep-learning-based methods to become mainstream to segment tumours automatically, significantly reducing the workload of pathologists. However, most current methods rely on large-scale labelled histopathological images. Therefore, this research studies label-effective tumour segmentation methods using deep-learning paradigms to relieve the annotation limitations. Chapter 3 proposes an ensemble framework for fully-supervised tumour segmentation. Usually, the performance of an individual-trained network is limited by significant morphological variances in histopathological images. We propose a fully-supervised learning ensemble fusion model that uses both shallow and deep U-Nets, trained with images of different resolutions and subsets of images, for robust predictions of tumour regions. Noise elimination is achieved with Convolutional Conditional Random Fields. Two open datasets are used to evaluate the proposed method: the ACDC@LungHP challenge at ISBI2019 and the DigestPath challenge at MICCAI2019. With a dice coefficient of 79.7 %, the proposed method takes third place in ACDC@LungHP. In DigestPath 2019, the proposed method achieves a dice coefficient 77.3 %. Well-annotated images are an indispensable part of training fully-supervised segmentation strategies. However, large-scale histopathology images are hardly annotated finely in clinical practice. It is common for labels to be of poor quality or for only a few images to be manually marked by experts. Consequently, fully-supervised methods cannot perform well in these cases. Chapter 4 proposes a self-supervised contrast learning for tumour segmentation. A self-supervised cancer segmentation framework is proposed to reduce label dependency. An innovative contrastive learning scheme is developed to represent tumour features based on unlabelled images. Unlike a normal U-Net, the backbone is a patch-based segmentation network. Additionally, data augmentation and contrastive losses are applied to improve the discriminability of tumour features. A convolutional Conditional Random Field is used to smooth and eliminate noise. Three labelled, and fourteen unlabelled images are collected from a private skin cancer dataset called BSS. Experimental results show that the proposed method achieves better tumour segmentation performance than other popular self-supervised methods. However, by evaluated on the same public dataset as chapter 3, the proposed self-supervised method is hard to handle fine-grained segmentation around tumour boundaries compared to the supervised method we proposed. Chapter 5 proposes a sketch-based weakly-supervised tumour segmentation method. To segment tumour regions precisely with coarse annotations, a sketch-supervised method is proposed, containing a dual CNN-Transformer network and a global normalised class activation map. CNN-Transformer networks simultaneously model global and local tumour features. With the global normalised class activation map, a gradient-based tumour representation can be obtained from the dual network predictions. We invited experts to mark fine and coarse annotations in the private BSS and the public PAIP2019 datasets to facilitate reproducible performance comparisons. Using the BSS dataset, the proposed method achieves 76.686 % IOU and 86.6 % Dice scores, outperforming state-of-the-art methods. Additionally, the proposed method achieves a Dice gain of 8.372 % compared with U-Net on the PAIP2019 dataset. The thesis presents three approaches to segmenting cancers from histology images: fully-supervised, unsupervised, and weakly supervised methods. This research effectively segments tumour regions based on histopathological annotations and well-designed modules. Our studies comprehensively demonstrate label-effective automatic histopathological image segmentation. Experimental results prove that our works achieve state-of-the-art segmentation performances on private and public datasets. In the future, we plan to integrate more tumour feature representation technologies with other medical modalities and apply them to clinical research

Machine Learning Models for Deciphering Regulatory Mechanisms and Morphological Variations in Cancer

The exponential growth of multi-omics biological datasets is resulting in an emerging paradigm shift in fundamental biological research. In recent years, imaging and transcriptomics datasets are increasingly incorporated into biological studies, pushing biology further into the domain of data-intensive-sciences. New approaches and tools from statistics, computer science, and data engineering are profoundly influencing biological research. Harnessing this ever-growing deluge of multi-omics biological data requires the development of novel and creative computational approaches. In parallel, fundamental research in data sciences and Artificial Intelligence (AI) has advanced tremendously, allowing the scientific community to generate a massive amount of knowledge from data. Advances in Deep Learning (DL), in particular, are transforming many branches of engineering, science, and technology. Several of these methodologies have already been adapted for harnessing biological datasets; however, there is still a need to further adapt and tailor these techniques to new and emerging technologies. In this dissertation, we present computational algorithms and tools that we have developed to study gene-regulation and cellular morphology in cancer. The models and platforms that we have developed are general and widely applicable to several problems relating to dysregulation of gene expression in diseases. Our pipelines and software packages are disseminated in public repositories for larger scientific community use. This dissertation is organized in three main projects. In the first project, we present Causal Inference Engine (CIE), an integrated platform for the identification and interpretation of active regulators of transcriptional response. The platform offers visualization tools and pathway enrichment analysis to map predicted regulators to Reactome pathways. We provide a parallelized R-package for fast and flexible directional enrichment analysis to run the inference on custom regulatory networks. Next, we designed and developed MODEX, a fully automated text-mining system to extract and annotate causal regulatory interaction between Transcription Factors (TFs) and genes from the biomedical literature. MODEX uses putative TF-gene interactions derived from high-throughput ChIP-Seq or other experiments and seeks to collect evidence and meta-data in the biomedical literature to validate and annotate the interactions. MODEX is a complementary platform to CIE that provides auxiliary information on CIE inferred interactions by mining the literature. In the second project, we present a Convolutional Neural Network (CNN) classifier to perform a pan-cancer analysis of tumor morphology, and predict mutations in key genes. The main challenges were to determine morphological features underlying a genetic status and assess whether these features were common in other cancer types. We trained an Inception-v3 based model to predict TP53 mutation in five cancer types with the highest rate of TP53 mutations. We also performed a cross-classification analysis to assess shared morphological features across multiple cancer types. Further, we applied a similar methodology to classify HER2 status in breast cancer and predict response to treatment in HER2 positive samples. For this study, our training slides were manually annotated by expert pathologists to highlight Regions of Interest (ROIs) associated with HER2+/- tumor microenvironment. Our results indicated that there are strong morphological features associated with each tumor type. Moreover, our predictions highly agree with manual annotations in the test set, indicating the feasibility of our approach in devising an image-based diagnostic tool for HER2 status and treatment response prediction. We have validated our model using samples from an independent cohort, which demonstrates the generalizability of our approach. Finally, in the third project, we present an approach to use spatial transcriptomics data to predict spatially-resolved active gene regulatory mechanisms in tissues. Using spatial transcriptomics, we identified tissue regions with differentially expressed genes and applied our CIE methodology to predict active TFs that can potentially regulate the marker genes in the region. This project bridged the gap between inference of active regulators using molecular data and morphological studies using images. The results demonstrate a significant local pattern in TF activity across the tissue, indicating differential spatial-regulation in tissues. The results suggest that the integrative analysis of spatial transcriptomics data with CIE can capture discriminant features and identify localized TF-target links in the tissue

Discriminative Representations for Heterogeneous Images and Multimodal Data

Histology images of tumor tissue are an important diagnostic and prognostic tool for pathologists. Recently developed molecular methods group tumors into subtypes to further guide treatment decisions, but they are not routinely performed on all patients. A lower cost and repeatable method to predict tumor subtypes from histology could bring benefits to more cancer patients. Further, combining imaging and genomic data types provides a more complete view of the tumor and may improve prognostication and treatment decisions. While molecular and genomic methods capture the state of a small sample of tumor, histological image analysis provides a spatial view and can identify multiple subtypes in a single tumor. This intra-tumor heterogeneity has yet to be fully understood and its quantification may lead to future insights into tumor progression. In this work, I develop methods to learn appropriate features directly from images using dictionary learning or deep learning. I use multiple instance learning to account for intra-tumor variations in subtype during training, improving subtype predictions and providing insights into tumor heterogeneity. I also integrate image and genomic features to learn a projection to a shared space that is also discriminative. This method can be used for cross-modal classification or to improve predictions from images by also learning from genomic data during training, even if only image data is available at test time.Doctor of Philosoph

A deep-learning approach to aid in diagnosing Barrett’s oesophagus related dysplasia

Barrett's oesophagus is the only known precursor to oesophagus carcinoma. Histologically, it is defined as a condition of columnar cells replacing the standard squamous lining. Those altered cells are prone to cytological and architectural abnormalities, known as dysplasia. The dysplastic degree varies from low to high grade and can evolve into invasive carcinoma or adenocarcinoma. Thus, detecting high-grade and intramucosal carcinoma during the surveillance of Barrett's oesophagus patients is vital so they can be treated by surgical resection. Unfortunately, the achieved interobserver agreement for grading dysplasia among pathologists is only fair to moderate. Nowadays, grading Barrett's dysplasia is limited to visual examination by pathologists for glass or virtual slides. This work aims to diagnose different grades of dysplasia in Barrett’s oesophagus, particularly high-grade dysplasia, from virtual histopathological slides of oesophagus tissue. In the first approach, virtual slides were analysed at a low magnification to detect regions of interest and predict the grade of dysplasia based on the analysis of the virtual slides at 10X magnification. Transfer learning was employed to partially fine-tune two deep-learning networks using healthy and Barrett’s oesophagus tissue. Then, the two networks were connected. The proposed model achieved 0.57 sensitivity, 0.79 specificity and moderate agreement with a pathologist. On the contrary, the second approach processed the slides at a higher magnification (40X magnification). It adapted novelty detection and local outlier factor alongside transfer learning to solve the multiple instances learning problem. It increased the performance of the diagnosis to 0.84 sensitivity and 0.92 specificity, and the interobserver agreement reached a substantial level. Finally, the last approach mimics the pathologists’ procedure to diagnose dysplasia, relying on both magnifications. Thus, their behaviours during the assessment were analysed. As a result, it was found that employing a multi-scale approach to detect dysplastic tissue using a low magnification level (10X magnification) and grade dysplasia at a higher level (40X magnification). The proposed computer-aided diagnosis system was built using networks from the first two approaches. It scored 0.90 sensitivity, 0.94 specificity and a substantial agreement with the pathologist and a moderate agreement with the other expert