Model Agnostic Saliency for Weakly Supervised Lesion Detection from Breast DCE-MRI

There is a heated debate on how to interpret the decisions provided by deep learning models (DLM), where the main approaches rely on the visualization of salient regions to interpret the DLM classification process. However, these approaches generally fail to satisfy three conditions for the problem of lesion detection from medical images: 1) for images with lesions, all salient regions should represent lesions, 2) for images containing no lesions, no salient region should be produced,and 3) lesions are generally small with relatively smooth borders. We propose a new model-agnostic paradigm to interpret DLM classification decisions supported by a novel definition of saliency that incorporates the conditions above. Our model-agnostic 1-class saliency detector (MASD) is tested on weakly supervised breast lesion detection from DCE-MRI, achieving state-of-the-art detection accuracy when compared to current visualization methods

Pre and Post-hoc Diagnosis and Interpretation of Malignancy from Breast DCE-MRI

We propose a new method for breast cancer screening from DCE-MRI based on a post-hoc approach that is trained using weakly annotated data (i.e., labels are available only at the image level without any lesion delineation). Our proposed post-hoc method automatically diagnosis the whole volume and, for positive cases, it localizes the malignant lesions that led to such diagnosis. Conversely, traditional approaches follow a pre-hoc approach that initially localises suspicious areas that are subsequently classified to establish the breast malignancy -- this approach is trained using strongly annotated data (i.e., it needs a delineation and classification of all lesions in an image). Another goal of this paper is to establish the advantages and disadvantages of both approaches when applied to breast screening from DCE-MRI. Relying on experiments on a breast DCE-MRI dataset that contains scans of 117 patients, our results show that the post-hoc method is more accurate for diagnosing the whole volume per patient, achieving an AUC of 0.91, while the pre-hoc method achieves an AUC of 0.81. However, the performance for localising the malignant lesions remains challenging for the post-hoc method due to the weakly labelled dataset employed during training.Comment: Submitted to Medical Image Analysi

Training Medical Image Analysis Systems like Radiologists

The training of medical image analysis systems using machine learning approaches follows a common script: collect and annotate a large dataset, train the classifier on the training set, and test it on a hold-out test set. This process bears no direct resemblance with radiologist training, which is based on solving a series of tasks of increasing difficulty, where each task involves the use of significantly smaller datasets than those used in machine learning. In this paper, we propose a novel training approach inspired by how radiologists are trained. In particular, we explore the use of meta-training that models a classifier based on a series of tasks. Tasks are selected using teacher-student curriculum learning, where each task consists of simple classification problems containing small training sets. We hypothesize that our proposed meta-training approach can be used to pre-train medical image analysis models. This hypothesis is tested on the automatic breast screening classification from DCE-MRI trained with weakly labeled datasets. The classification performance achieved by our approach is shown to be the best in the field for that application, compared to state of art baseline approaches: DenseNet, multiple instance learning and multi-task learning.Comment: Oral Presentation at MICCAI 201

Few-Shot Anomaly Detection for Polyp Frames from Colonoscopy

Anomaly detection methods generally target the learning of a normal image distribution (i.e., inliers showing healthy cases) and during testing, samples relatively far from the learned distribution are classified as anomalies (i.e., outliers showing disease cases). These approaches tend to be sensitive to outliers that lie relatively close to inliers (e.g., a colonoscopy image with a small polyp). In this paper, we address the inappropriate sensitivity to outliers by also learning from inliers. We propose a new few-shot anomaly detection method based on an encoder trained to maximise the mutual information between feature embeddings and normal images, followed by a few-shot score inference network, trained with a large set of inliers and a substantially smaller set of outliers. We evaluate our proposed method on the clinical problem of detecting frames containing polyps from colonoscopy video sequences, where the training set has 13350 normal images (i.e., without polyps) and less than 100 abnormal images (i.e., with polyps). The results of our proposed model on this data set reveal a state-of-the-art detection result, while the performance based on different number of anomaly samples is relatively stable after approximately 40 abnormal training images.Comment: Accept at MICCAI 202

BreastScreening: On the Use of Multi-Modality in Medical Imaging Diagnosis

This paper describes the field research, design and comparative deployment of a multimodal medical imaging user interface for breast screening. The main contributions described here are threefold: 1) The design of an advanced visual interface for multimodal diagnosis of breast cancer (BreastScreening); 2) Insights from the field comparison of single vs multimodality screening of breast cancer diagnosis with 31 clinicians and 566 images, and 3) The visualization of the two main types of breast lesions in the following image modalities: (i) MammoGraphy (MG) in both Craniocaudal (CC) and Mediolateral oblique (MLO) views; (ii) UltraSound (US); and (iii) Magnetic Resonance Imaging (MRI). We summarize our work with recommendations from the radiologists for guiding the future design of medical imaging interfaces.Comment: AVI 2020 Short Papers, 5 pages, 2 figures, for associated files, see https://github.com/MIMBCD-UI/avi-2020-short-pape