Robust Resolution-Enhanced Prostate Segmentation in Magnetic Resonance and Ultrasound Images through Convolutional Neural Networks

[EN] Prostate segmentations are required for an ever-increasing number of medical applications, such as image-based lesion detection, fusion-guided biopsy and focal therapies. However, obtaining accurate segmentations is laborious, requires expertise and, even then, the inter-observer variability remains high. In this paper, a robust, accurate and generalizable model for Magnetic Resonance (MR) and three-dimensional (3D) Ultrasound (US) prostate image segmentation is proposed. It uses a densenet-resnet-based Convolutional Neural Network (CNN) combined with techniques such as deep supervision, checkpoint ensembling and Neural Resolution Enhancement. The MR prostate segmentation model was trained with five challenging and heterogeneous MR prostate datasets (and two US datasets), with segmentations from many different experts with varying segmentation criteria. The model achieves a consistently strong performance in all datasets independently (mean Dice Similarity Coefficient -DSC- above 0.91 for all datasets except for one), outperforming the inter-expert variability significantly in MR (mean DSC of 0.9099 vs. 0.8794). When evaluated on the publicly available Promise12 challenge dataset, it attains a similar performance to the best entries. In summary, the model has the potential of having a significant impact on current prostate procedures, undercutting, and even eliminating, the need of manual segmentations through improvements in terms of robustness, generalizability and output resolutionThis work has been partially supported by a doctoral grant of the Spanish Ministry of Innovation and Science, with reference FPU17/01993Pellicer-Valero, OJ.; González-Pérez, V.; Casanova Ramón-Borja, JL.; Martín García, I.; Barrios Benito, M.; Pelechano Gómez, P.; Rubio-Briones, J.... (2021). Robust Resolution-Enhanced Prostate Segmentation in Magnetic Resonance and Ultrasound Images through Convolutional Neural Networks. Applied Sciences. 11(2):1-17. https://doi.org/10.3390/app11020844S117112Marra, G., Ploussard, G., Futterer, J., & Valerio, M. (2019). Controversies in MR targeted biopsy: alone or combined, cognitive versus software-based fusion, transrectal versus transperineal approach? World Journal of Urology, 37(2), 277-287. doi:10.1007/s00345-018-02622-5Ahdoot, M., Lebastchi, A. H., Turkbey, B., Wood, B., & Pinto, P. A. (2019). Contemporary treatments in prostate cancer focal therapy. Current Opinion in Oncology, 31(3), 200-206. doi:10.1097/cco.0000000000000515Krizhevsky, A., Sutskever, I., & Hinton, G. E. (2017). ImageNet classification with deep convolutional neural networks. Communications of the ACM, 60(6), 84-90. doi:10.1145/3065386Allen, P. D., Graham, J., Williamson, D. C., & Hutchinson, C. E. (s. f.). Differential Segmentation of the Prostate in MR Images Using Combined 3D Shape Modelling and Voxel Classification. 3rd IEEE International Symposium on Biomedical Imaging: Macro to Nano, 2006. doi:10.1109/isbi.2006.1624940Freedman, D., Radke, R. J., Tao Zhang, Yongwon Jeong, Lovelock, D. M., & Chen, G. T. Y. (2005). Model-based segmentation of medical imagery by matching distributions. IEEE Transactions on Medical Imaging, 24(3), 281-292. doi:10.1109/tmi.2004.841228Klein, S., van der Heide, U. A., Lips, I. M., van Vulpen, M., Staring, M., & Pluim, J. P. W. (2008). Automatic segmentation of the prostate in 3D MR images by atlas matching using localized mutual information. Medical Physics, 35(4), 1407-1417. doi:10.1118/1.2842076Ronneberger, O., Fischer, P., & Brox, T. (2015). U-Net: Convolutional Networks for Biomedical Image Segmentation. Medical Image Computing and Computer-Assisted Intervention – MICCAI 2015, 234-241. doi:10.1007/978-3-319-24574-4_28He, K., Gkioxari, G., Dollar, P., & Girshick, R. (2017). Mask R-CNN. 2017 IEEE International Conference on Computer Vision (ICCV). doi:10.1109/iccv.2017.322Shelhamer, E., Long, J., & Darrell, T. (2017). Fully Convolutional Networks for Semantic Segmentation. IEEE Transactions on Pattern Analysis and Machine Intelligence, 39(4), 640-651. doi:10.1109/tpami.2016.2572683He, K., Zhang, X., Ren, S., & Sun, J. (2016). Deep Residual Learning for Image Recognition. 2016 IEEE Conference on Computer Vision and Pattern Recognition (CVPR). doi:10.1109/cvpr.2016.90Milletari, F., Navab, N., & Ahmadi, S.-A. (2016). V-Net: Fully Convolutional Neural Networks for Volumetric Medical Image Segmentation. 2016 Fourth International Conference on 3D Vision (3DV). doi:10.1109/3dv.2016.79Zhu, Q., Du, B., Turkbey, B., Choyke, P. L., & Yan, P. (2017). Deeply-supervised CNN for prostate segmentation. 2017 International Joint Conference on Neural Networks (IJCNN). doi:10.1109/ijcnn.2017.7965852To, M. N. N., Vu, D. Q., Turkbey, B., Choyke, P. L., & Kwak, J. T. (2018). Deep dense multi-path neural network for prostate segmentation in magnetic resonance imaging. International Journal of Computer Assisted Radiology and Surgery, 13(11), 1687-1696. doi:10.1007/s11548-018-1841-4Huang, G., Liu, Z., Van Der Maaten, L., & Weinberger, K. Q. (2017). Densely Connected Convolutional Networks. 2017 IEEE Conference on Computer Vision and Pattern Recognition (CVPR). doi:10.1109/cvpr.2017.243Zhu, Y., Wei, R., Gao, G., Ding, L., Zhang, X., Wang, X., & Zhang, J. (2018). Fully automatic segmentation on prostate MR images based on cascaded fully convolution network. Journal of Magnetic Resonance Imaging, 49(4), 1149-1156. doi:10.1002/jmri.26337Wang, Y., Ni, D., Dou, H., Hu, X., Zhu, L., Yang, X., … Wang, T. (2019). Deep Attentive Features for Prostate Segmentation in 3D Transrectal Ultrasound. IEEE Transactions on Medical Imaging, 38(12), 2768-2778. doi:10.1109/tmi.2019.2913184Lemaître, G., Martí, R., Freixenet, J., Vilanova, J. C., Walker, P. M., & Meriaudeau, F. (2015). Computer-Aided Detection and diagnosis for prostate cancer based on mono and multi-parametric MRI: A review. Computers in Biology and Medicine, 60, 8-31. doi:10.1016/j.compbiomed.2015.02.009Litjens, G., Toth, R., van de Ven, W., Hoeks, C., Kerkstra, S., van Ginneken, B., … Madabhushi, A. (2014). Evaluation of prostate segmentation algorithms for MRI: The PROMISE12 challenge. Medical Image Analysis, 18(2), 359-373. doi:10.1016/j.media.2013.12.002Zhu, Q., Du, B., & Yan, P. (2020). Boundary-Weighted Domain Adaptive Neural Network for Prostate MR Image Segmentation. IEEE Transactions on Medical Imaging, 39(3), 753-763. doi:10.1109/tmi.2019.2935018He, K., Zhang, X., Ren, S., & Sun, J. (2015). Delving Deep into Rectifiers: Surpassing Human-Level Performance on ImageNet Classification. 2015 IEEE International Conference on Computer Vision (ICCV). doi:10.1109/iccv.2015.123Pan, S. J., & Yang, Q. (2010). A Survey on Transfer Learning. IEEE Transactions on Knowledge and Data Engineering, 22(10), 1345-1359. doi:10.1109/tkde.2009.191Smith, L. N. (2017). Cyclical Learning Rates for Training Neural Networks. 2017 IEEE Winter Conference on Applications of Computer Vision (WACV). doi:10.1109/wacv.2017.58Abraham, N., & Khan, N. M. (2019). A Novel Focal Tversky Loss Function With Improved Attention U-Net for Lesion Segmentation. 2019 IEEE 16th International Symposium on Biomedical Imaging (ISBI 2019). doi:10.1109/isbi.2019.8759329Lei, Y., Tian, S., He, X., Wang, T., Wang, B., Patel, P., … Yang, X. (2019). Ultrasound prostate segmentation based on multidirectional deeply supervised V‐Net. Medical Physics, 46(7), 3194-3206. doi:10.1002/mp.13577Orlando, N., Gillies, D. J., Gyacskov, I., Romagnoli, C., D’Souza, D., & Fenster, A. (2020). Automatic prostate segmentation using deep learning on clinically diverse 3D transrectal ultrasound images. Medical Physics, 47(6), 2413-2426. doi:10.1002/mp.14134Karimi, D., Zeng, Q., Mathur, P., Avinash, A., Mahdavi, S., Spadinger, I., … Salcudean, S. E. (2019). Accurate and robust deep learning-based segmentation of the prostate clinical target volume in ultrasound images. Medical Image Analysis, 57, 186-196. doi:10.1016/j.media.2019.07.005PROMISE12 Resultshttps://promise12.grand-challenge.org/Isensee, F., Jaeger, P. F., Kohl, S. A. A., Petersen, J., & Maier-Hein, K. H. (2020). nnU-Net: a self-configuring method for deep learning-based biomedical image segmentation. Nature Methods, 18(2), 203-211. doi:10.1038/s41592-020-01008-

CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative

Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research

Caídas en ancianos válidos institucionalizados, prevalencia y factores asociados

OBJETIVO: Estimar la prevalencia de caídas en ancianos válidos institucionalizados. MÉTODO: Estudio descriptivo trasversal, mediante muestreo aleatorio simple. Escalas utilizadas: MEC-35 1979 y Cuestionario de caídas OMS (1989). Dictamen favorable del CEICA. A todas las personas del centro se les informó y entregó consentimiento informado. La recogida de datos fue entre octubre de 2012 hasta febrero de 2013. Las entrevistas se realizaron preservando la intimidad de los participantes. RESULTADOS: Los participantes del estudio fueron 51 residentes. Se produjeron 21 caídas, lo que implica una prevalencia de caídas del 41,17%. 8 caídas se produjeron en varones (38,09%) y 13 en mujeres (61,91%). El 72,54% de los ancianos/as padecían enfermedades cardiovasculares. El 52,9% de los participantes tomaban fármacos sedantes. De las 21 caídas producidas, se observó que 16 ancianos que se cayeron tomaban fármacos sedantes, mientras que 5 ancianos no los tomaban y sufrieron una caída. Mediante Chi-Cuadrado y un Test de Fisher, se obtuvo que la probabilidad de caídas tomando sedantes era del 84,19%. Tras Anova se obtuvieron diferencias significativas del 5% entre fármacos y caídas. Por tanto, a mayor número de fármacos mayor número de caídas. CONCUSIONES: El registro de caídas ha permitido conocer la prevalencia y los factores asociados. Se hace necesario valorar los patrones de sueño de nuestros ancianos para conocer la necesidad o no de ingesta de fármacos sedantes, ya que es un factor muy relacionado. Con una efectiva valoración y prevención se mejorará la calidad de vida de nuestros mayores, y además, disminuir el gasto sociosanitario. Abstract: OBJECTIVE: To estimate the prevalence of falls in elderly institutionalized valid. METHOD: A cross by simple random sampling. Scales used: MEC-35 Questionnaire fall 1979 and WHO (1989). Assent of CEICA. To all the people downtown were informed and gave informed consent. Data collection was from October 2012 to February 2013. Interviews were conducted preserving the privacy of the participants. RESULTS: Study participants were 51 residents. Were 21 falls, implying falls prevalence 41,17%. Falls occurred 8 males (38,09%) and 13 females (61.91%). The 72,54% of the elderly / as suffering from cardiovascular diseases. 52,9% of participants were taking sedative drugs. Of the 21 falls produced, it was observed that 16 elders fell taking sedative drugs, while not taking 5 seniors and suffered a fall. By Chi-square and Fisher test, we found that the likelihood of falls was taking sedatives of 84,19%. After Anova significant difference of 5% between drugs and falls were obtained. Therefore, a greater number of drugs more falls. CONCLUSIONS: Fall Registration has shown the prevalence and associated factors. It is necessary to assess the sleep patterns of our seniors to know whether or not the intake of sedative drugs, as it is a closely related factor. With effective prevention assessment and quality of life of our seniors will be improved, and also decrease the socio spending. Palabra Clave: Ancianos; Caídas; Prevalencia; Factores de riesgo; Consecuencias. Key Words: Elderly; Falls; Prevalence; Risk factors; Consequences

Anchuelo. Propuestas bioclimáticas en el espacio público

Anchuelo. Propuestas bioclimáticas en el espacio público. Publicación digital de los trabajos elaborados por los estudiantes del curso 2021/22 de la asignatura La Ciudad y el Medio de la Escuela Técnica Superior de Arquitectura de Madrid de la Universidad Politécnica de Madrid. Muestra una serie de propuestas elaboradas en la asignatura para mejorar bioclimáticamente diferentes espacios públicos municipales en el marco del acuerdo realizado entre el Departamento de Urbanística y Ordenación del Territorio y el Excmo. Ayuntamiento de Anchuelo (Madrid)