Learning Algorithms for Fat Quantification and Tumor Characterization

Obesity is one of the most prevalent health conditions. About 30% of the world\u27s and over 70% of the United States\u27 adult populations are either overweight or obese, causing an increased risk for cardiovascular diseases, diabetes, and certain types of cancer. Among all cancers, lung cancer is the leading cause of death, whereas pancreatic cancer has the poorest prognosis among all major cancers. Early diagnosis of these cancers can save lives. This dissertation contributes towards the development of computer-aided diagnosis tools in order to aid clinicians in establishing the quantitative relationship between obesity and cancers. With respect to obesity and metabolism, in the first part of the dissertation, we specifically focus on the segmentation and quantification of white and brown adipose tissue. For cancer diagnosis, we perform analysis on two important cases: lung cancer and Intraductal Papillary Mucinous Neoplasm (IPMN), a precursor to pancreatic cancer. This dissertation proposes an automatic body region detection method trained with only a single example. Then a new fat quantification approach is proposed which is based on geometric and appearance characteristics. For the segmentation of brown fat, a PET-guided CT co-segmentation method is presented. With different variants of Convolutional Neural Networks (CNN), supervised learning strategies are proposed for the automatic diagnosis of lung nodules and IPMN. In order to address the unavailability of a large number of labeled examples required for training, unsupervised learning approaches for cancer diagnosis without explicit labeling are proposed. We evaluate our proposed approaches (both supervised and unsupervised) on two different tumor diagnosis challenges: lung and pancreas with 1018 CT and 171 MRI scans respectively. The proposed segmentation, quantification and diagnosis approaches explore the important adiposity-cancer association and help pave the way towards improved diagnostic decision making in routine clinical practice

Deep Multi-Modal Classification of Intraductal Papillary Mucinous Neoplasms (IPMN) with Canonical Correlation Analysis

Pancreatic cancer has the poorest prognosis among all cancer types. Intraductal Papillary Mucinous Neoplasms (IPMNs) are radiographically identifiable precursors to pancreatic cancer; hence, early detection and precise risk assessment of IPMN are vital. In this work, we propose a Convolutional Neural Network (CNN) based computer aided diagnosis (CAD) system to perform IPMN diagnosis and risk assessment by utilizing multi-modal MRI. In our proposed approach, we use minimum and maximum intensity projections to ease the annotation variations among different slices and type of MRIs. Then, we present a CNN to obtain deep feature representation corresponding to each MRI modality (T1-weighted and T2-weighted). At the final step, we employ canonical correlation analysis (CCA) to perform a fusion operation at the feature level, leading to discriminative canonical correlation features. Extracted features are used for classification. Our results indicate significant improvements over other potential approaches to solve this important problem. The proposed approach doesn't require explicit sample balancing in cases of imbalance between positive and negative examples. To the best of our knowledge, our study is the first to automatically diagnose IPMN using multi-modal MRI.Comment: Accepted for publication in IEEE International Symposium on Biomedical Imaging (ISBI) 201

Automated Segmentation and Recurrence Risk Prediction of Surgically Resected Lung Tumors with Adaptive Convolutional Neural Networks

Lung cancer is the leading cause of cancer related mortality by a significant margin. While new technologies, such as image segmentation, have been paramount to improved detection and earlier diagnoses, there are still significant challenges in treating the disease. In particular, despite an increased number of curative resections, many postoperative patients still develop recurrent lesions. Consequently, there is a significant need for prognostic tools that can more accurately predict a patient's risk for recurrence. In this paper, we explore the use of convolutional neural networks (CNNs) for the segmentation and recurrence risk prediction of lung tumors that are present in preoperative computed tomography (CT) images. First, expanding upon recent progress in medical image segmentation, a residual U-Net is used to localize and characterize each nodule. Then, the identified tumors are passed to a second CNN for recurrence risk prediction. The system's final results are produced with a random forest classifier that synthesizes the predictions of the second network with clinical attributes. The segmentation stage uses the LIDC-IDRI dataset and achieves a dice score of 70.3%. The recurrence risk stage uses the NLST dataset from the National Cancer institute and achieves an AUC of 73.0%. Our proposed framework demonstrates that first, automated nodule segmentation methods can generalize to enable pipelines for a wide range of multitask systems and second, that deep learning and image processing have the potential to improve current prognostic tools. To the best of our knowledge, it is the first fully automated segmentation and recurrence risk prediction system.Comment: 9 pages, 5 figure

How To Fool Radiologists With Generative Adversarial Networks? A Visual Turing Test For Lung Cancer Diagnosis

Discriminating lung nodules as malignant or benign is still an underlying challenge. To address this challenge, radiologists need computer aided diagnosis (CAD) systems which can assist in learning discriminative imaging features corresponding to malignant and benign nodules. However, learning highly discriminative imaging features is an open problem. In this paper, our aim is to learn the most discriminative features pertaining to lung nodules by using an adversarial learning methodology. Specifically, we propose to use un-supervised learning with Deep Convolutional-Generative Adversarial Networks (DC-GANs) to generate lung nodule samples realistically. We hypothesize that imaging features of lung nodules will be discriminative if it is hard to differentiate them (fake) from real (true) nodules. To test this hypothesis, we present Visual Turing tests to two radiologists in order to evaluate the quality of the generated (fake) nodules. Extensive comparisons are performed in discerning real, generated, benign, and malignant nodules. This experimental set up allows us to validate the overall quality of the generated nodules, which can then be used to (1) improve diagnostic decisions by mining highly discriminative imaging features, (2) train radiologists for educational purposes, and (3) generate realistic samples to train deep networks with big data

Context Region Discovery For Automatic Motion Compensation In Fluoroscopy

Purpose: Image-based tracking for motion compensation is an important topic in image-guided interventions, as it enables physicians to operate in a less complex space. In this paper, we propose an automatic motion compensation scheme to boost image guidence power in transcatheter aortic valve implantation (TAVI). Methods: The proposed tracking algorithm automatically discovers reliable regions that correlate strongly with the target. These discovered regions can assist to estimate target motion under severe occlusion, even if target tracker fails. Results: We evaluate the proposed method for pigtail tracking during TAVI. We obtain significant improvement (12 %) over the baseline in a clinical dataset. Calcification regions are automatically discovered during tracking, which would aid TAVI processes. Conclusion: In this work, we open a new paradigm to provide dynamic real-time guidance for TAVI without user interventions, specially in case of severe occlusion where conventional tracking methods are challenged

Tumornet: Lung Nodule Characterization Using Multi-View Convolutional Neural Network With Gaussian Process

Characterization of lung nodules as benign or malignant is one of the most important tasks in lung cancer diagnosis, staging and treatment planning. While the variation in the appearance of the nodules remains large, there is a need for a fast and robust computer aided system. In this work, we propose an end-to-end trainable multi-view deep Convolutional Neural Network (CNN) for nodule characterization. First, we use median intensity projection to obtain a 2D patch corresponding to each dimension. The three images are then concatenated to form a tensor, where the images serve as different channels of the input image. In order to increase the number of training samples, we perform data augmentation by scaling, rotating and adding noise to the input image. The trained network is used to extract features from the input image followed by a Gaussian Process (GP) regression to obtain the malignancy score. We also empirically establish the significance of different high level nodule attributes such as calcification, sphericity and others for malignancy determination. These attributes are found to be complementary to the deep multi-view CNN features and a significant improvement over other methods is obtained

Automatic Segmentation And Quantification Of White And Brown Adipose Tissues From Pet/Ct Scans

In this paper, we investigate the automatic detection of white and brown adipose tissues using Positron Emission Tomography/Computed Tomography (PET/CT) scans, and develop methods for the quantification of these tissues at the whole-body and body-region levels. We propose a patient-specific automatic adiposity analysis system with two modules. In the first module, we detect white adipose tissue (WAT) and its two sub-types from CT scans: Visceral Adipose Tissue (VAT) and Subcutaneous Adipose Tissue (SAT). This process relies conventionally on manual or semi-automated segmentation, leading to inefficient solutions. Our novel framework addresses this challenge by proposing an unsupervised learning method to separate VAT from SAT in the abdominal region for the clinical quantification of central obesity. This step is followed by a context driven label fusion algorithm through sparse 3D Conditional Random Fields (CRF) for volumetric adiposity analysis. In the second module, we automatically detect, segment, and quantify brown adipose tissue (BAT) using PET scans because unlike WAT, BAT is metabolically active. After identifying BAT regions using PET, we perform a co-segmentation procedure utilizing asymmetric complementary information from PET and CT. Finally, we present a new probabilistic distance metric for differentiating BAT from non-BAT regions. Both modules are integrated via an automatic body-region detection unit based on one-shot learning. Experimental evaluations conducted on 151 PET/CT scans achieve state-of-the-art performances in both central obesity as well as brown adiposity quantification