Class Activation Mapping and Uncertainty Estimation in Multi-Organ Segmentation

Deep learning (DL)-based medical imaging and image segmentation algorithms achieve impressive performance on many benchmarks. Yet the efficacy of deep learning methods for future clinical applications may become questionable due to the lack of ability to reason with uncertainty and interpret probable areas of failures in prediction decisions. Therefore, it is desired that such a deep learning model for segmentation classification is able to reliably predict its confidence measure and map back to the original imaging cases to interpret the prediction decisions. In this work, uncertainty estimation for multiorgan segmentation task is evaluated to interpret the predictive modeling in DL solutions. We use the state-of-the-art nnU-Net to perform segmentation of 15 abdominal organs (spleen, right kidney, left kidney, gallbladder, esophagus, liver, stomach, aorta, inferior vena cava, pancreas, right adrenal gland, left adrenal gland, duodenum, bladder, prostate/uterus) using 200 patient cases for the Multimodality Abdominal Multi-Organ Segmentation Challenge 2022. Further, the softmax probabilities from different variants of nnU-Net are used to compute the knowledge uncertainty in the deep learning framework. Knowledge uncertainty from ensemble of DL models is utilized to quantify and visualize class activation map for two example segmented organs. The preliminary result of our model shows that class activation maps may be used to interpret the prediction decision made by the DL model used in this study

Prediction of Rapid Early Progression and Survival Risk with Pre-Radiation MRI in WHO Grade 4 Glioma Patients

Recent clinical research describes a subset of glioblastoma patients that exhibit REP prior to start of radiation therapy. Current literature has thus far described this population using clinicopathologic features. To our knowledge, this study is the first to investigate the potential of conventional ra-diomics, sophisticated multi-resolution fractal texture features, and different molecular features (MGMT, IDH mutations) as a diagnostic and prognostic tool for prediction of REP from non-REP cases using computational and statistical modeling methods. Radiation-planning T1 post-contrast (T1C) MRI sequences of 70 patients are analyzed. Ensemble method with 5-fold cross validation over 1000 iterations offers AUC of 0.793 with standard deviation of 0.082 for REP and non-REP classification. In addition, copula-based modeling under dependent censoring (where a subset of the patients may not be followed up until death) identifies significant features (p-value <0.05) for survival probability and prognostic grouping of patient cases. The prediction of survival for the patients cohort produces precision of 0.881 with standard deviation of 0.056. The prognostic index (PI) calculated using the fused features suggests that 84.62% of REP cases fall under the bad prognostic group, suggesting potentiality of fused features to predict a higher percentage of REP cases. The experimental result further shows that mul-ti-resolution fractal texture features perform better than conventional radiomics features for REP and survival outcomes

Prediction of Rapid Early Progression and Survival Risk with Pre-Radiation MRI in WHO Grade 4 Glioma Patients

Recent clinical research describes a subset of glioblastoma patients that exhibit REP prior to the start of radiation therapy. Current literature has thus far described this population using clinicopathologic features. To our knowledge, this study is the first to investigate the potential of conventional radiomics, sophisticated multi-resolution fractal texture features, and different molecular features (MGMT, IDH mutations) as a diagnostic and prognostic tool for prediction of REP from non-REP cases using computational and statistical modeling methods. The radiation-planning T1 post-contrast (T1C) MRI sequences of 70 patients are analyzed. An ensemble method with 5-fold cross-validation over 1000 iterations offers an AUC of 0.793 ± 0.082 for REP versus non-REP classification. In addition, copula-based modeling under dependent censoring (where a subset of the patients may not be followed up with until death) identifies significant features (p-value < 0.05) for survival probability and prognostic grouping of patient cases. The prediction of survival for the patients’ cohort produces a precision of 0.881 ± 0.056. The prognostic index (PI) calculated using the fused features shows that 84.62% of REP cases fall under the bad prognostic group, suggesting the potential of fused features for predicting a higher percentage of REP cases. The experimental results further show that multi-resolution fractal texture features perform better than conventional radiomics features for prediction of REP and survival outcomes