Automated detection of lupus white matter lesions in MRI

Brain magnetic resonance imaging provides detailed information which can be used to detect and segment white matter lesions (WML). In this work we propose an approach to automatically segment WML in Lupus patients by using T1w and fluid-attenuated inversion recovery (FLAIR) images. Lupus WML appear as small focal abnormal tissue observed as hyperintensities in the FLAIR images. The quantification of these WML is a key factor for the stratification of lupus patients and therefore both lesion detection and segmentation play an important role. In our approach, the T1w image is first used to classify the three main tissues of the brain, white matter (WM), gray matter (GM), and cerebrospinal fluid (CSF), while the FLAIR image is then used to detect focal WML as outliers of its GM intensity distribution. A set of post-processing steps based on lesion size, tissue neighborhood, and location are used to refine the lesion candidates. The proposal is evaluated on 20 patients, presenting qualitative, and quantitative results in terms of precision and sensitivity of lesion detection [True Positive Rate (62%) and Positive Prediction Value (80%), respectively] as well as segmentation accuracy [Dice Similarity Coefficient (72%)]. Obtained results illustrate the validity of the approach to automatically detect and segment lupus lesions. Besides, our approach is publicly available as a SPM8/12 toolbox extension with a simple parameter configuration

A protocol for annotation of total body photography for machine learning to analyze skin phenotype and lesion classification

IntroductionArtificial Intelligence (AI) has proven effective in classifying skin cancers using dermoscopy images. In experimental settings, algorithms have outperformed expert dermatologists in classifying melanoma and keratinocyte cancers. However, clinical application is limited when algorithms are presented with ‘untrained’ or out-of-distribution lesion categories, often misclassifying benign lesions as malignant, or misclassifying malignant lesions as benign. Another limitation often raised is the lack of clinical context (e.g., medical history) used as input for the AI decision process. The increasing use of Total Body Photography (TBP) in clinical examinations presents new opportunities for AI to perform holistic analysis of the whole patient, rather than a single lesion. Currently there is a lack of existing literature or standards for image annotation of TBP, or on preserving patient privacy during the machine learning process.MethodsThis protocol describes the methods for the acquisition of patient data, including TBP, medical history, and genetic risk factors, to create a comprehensive dataset for machine learning. 500 patients of various risk profiles will be recruited from two clinical sites (Australia and Spain), to undergo temporal total body imaging, complete surveys on sun behaviors and medical history, and provide a DNA sample. This patient-level metadata is applied to image datasets using DICOM labels. Anonymization and masking methods are applied to preserve patient privacy. A two-step annotation process is followed to label skin images for lesion detection and classification using deep learning models. Skin phenotype characteristics are extracted from images, including innate and facultative skin color, nevi distribution, and UV damage. Several algorithms will be developed relating to skin lesion detection, segmentation and classification, 3D mapping, change detection, and risk profiling. Simultaneously, explainable AI (XAI) methods will be incorporated to foster clinician and patient trust. Additionally, a publicly released dataset of anonymized annotated TBP images will be released for an international challenge to advance the development of new algorithms using this type of data.ConclusionThe anticipated results from this protocol are validated AI-based tools to provide holistic risk assessment for individual lesions, and risk stratification of patients to assist clinicians in monitoring for skin cancer

Automated brain structure segmentation in magnetic resonance images of multiple sclerosis patients

This thesis is focused on the automated segmentation of the brain structures in magnetic resonance images, applied to multiple sclerosis patients. This disease is characterized by the presence of lesions, which affect the segmentation result of commonly used automatic methods. We propose a new correspondence search model able to minimize this problem and extend the theory of two remarkable label fusion strategies of the literature, i.e. Non-local Spatial STAPLE and Joint Label Fusion, in order to integrate this model into their corresponding estimation algorithms. Furthermore, with the aim of providing fully automated algorithms, a whole automated pipeline is presented. Finally, a second extension of the theory to enable the integration of manual and automatic edits into the segmentation estimation of both strategies is also proposed. The analysis of the results obtained points out a performance improvement on the lesion areas, which is also reflected on the whole brain segmentation performanceAquesta tesi se centra en la segmentació automàtica de les estructures cerebrals en imatges de ressonància magnètica, aplicada a pacients d’esclerosi múltiple. Aquesta malaltia es caracteritza per la presència de lesions, que afecten els resultats de segmentació dels mètodes automàtics tradicionals. Per aquest motiu proposem un nou model de cerca de correspondències capaç de minimitzar aquest problema i estenem la teoria de dues estratègies notables de la literatura, Non-local Spatial STAPLE i Joint Label Fusion, per integrar aquest model en els seus corresponents algoritmes d’estimació. Amb l’objectiu de proporcionar algoritmes totalment automatitzats, es presenta una pipeline completa. Finalment, també es proposa una segona extensió de la teoria per permetre la integració d’anotacions manuals i automàtiques en les dues estratègies. L’anàlisi dels resultats obtinguts demostra una millora en el rendiment dels algorismes de segmentació en les àrees de lesió, que també es veu reflectida en la segmentació de tot el cervel

Automated brain structure segmentation in magnetic resonance images of multiple sclerosis patients

This thesis is focused on the automated segmentation of the brain structures in magnetic resonance images, applied to multiple sclerosis patients. This disease is characterized by the presence of lesions, which affect the segmentation result of commonly used automatic methods. We propose a new correspondence search model able to minimize this problem and extend the theory of two remarkable label fusion strategies of the literature, i.e. Non-local Spatial STAPLE and Joint Label Fusion, in order to integrate this model into their corresponding estimation algorithms. Furthermore, with the aim of providing fully automated algorithms, a whole automated pipeline is presented. Finally, a second extension of the theory to enable the integration of manual and automatic edits into the segmentation estimation of both strategies is also proposed. The analysis of the results obtained points out a performance improvement on the lesion areas, which is also reflected on the whole brain segmentation performanceAquesta tesi se centra en la segmentació automàtica de les estructures cerebrals en imatges de ressonància magnètica, aplicada a pacients d’esclerosi múltiple. Aquesta malaltia es caracteritza per la presència de lesions, que afecten els resultats de segmentació dels mètodes automàtics tradicionals. Per aquest motiu proposem un nou model de cerca de correspondències capaç de minimitzar aquest problema i estenem la teoria de dues estratègies notables de la literatura, Non-local Spatial STAPLE i Joint Label Fusion, per integrar aquest model en els seus corresponents algoritmes d’estimació. Amb l’objectiu de proporcionar algoritmes totalment automatitzats, es presenta una pipeline completa. Finalment, també es proposa una segona extensió de la teoria per permetre la integració d’anotacions manuals i automàtiques en les dues estratègies. L’anàlisi dels resultats obtinguts demostra una millora en el rendiment dels algorismes de segmentació en les àrees de lesió, que també es veu reflectida en la segmentació de tot el cervel

Brain structure segmentation in the presence of multiple sclerosis lesions

Intensity-based multi-atlas segmentation strategies have shown to be particularly successful in segmenting brain images of healthy subjects. However, in the same way as most of the methods in the state of the art, their performance tends to be affected by the presence of MRI visible lesions, such as those found in multiple sclerosis (MS) patients. Here, we present an approach to minimize the effect of the abnormal lesion intensities on multi-atlas segmentation. We propose a new voxel/patch correspondence model for intensity-based multi-atlas label fusion strategies that leads to more accurate similarity measures, having a key role in the final brain segmentation. We present the theory of this model and integrate it into two well-known fusion strategies: Non-local Spatial STAPLE (NLSS) and Joint Label Fusion (JLF). The experiments performed show that our proposal improves the segmentation performance of the lesion areas. The results indicate a mean Dice Similarity Coefficient (DSC) improvement of 1.96% for NLSS (3.29% inside and 0.79% around the lesion masks) and, an improvement of 2.06% for JLF (2.31% inside and 1.42% around lesions). Furthermore, we show that, with the proposed strategy, the well-established preprocessing step of lesion filling can be disregarded, obtaining similar or even more accurate segmentation results. Keywords: Brain structures, Parcellation, Multiple sclerosis lesions, Segmentation, MRI, Multi-atlas, Label fusio

Automated detection of Lupus white matter lesions in MRI

Brain magnetic resonance imaging provides detailed information which can be used to detect and segment white matter lesions (WML). In this work we propose an approach to automatically segment WML in Lupus patients by using T1w and fluid-attenuated inversion recovery (FLAIR) images. Lupus WML appear as small focal abnormal tissue observed as hyperintensities in the FLAIR images. The quantification of these WML is a key factor for the stratification of lupus patients and therefore both lesion detection and segmentation play an important role. In our approach, the T1w image is first used to classify the three main tissues of the brain, white matter (WM), gray matter (GM) and cerebrospinal fluid (CSF), while the FLAIR image is then used to detect focal WML as outliers of its GM intensity distribution. A set of post-processing steps based on lesion size, tissue neighborhood, and location are used to refine the lesion candidates. The proposal is evaluated on 20 patients, presenting qualitative and quantitative results in terms of precision and sensitivity of lesion detection (True Positive Rate (62%) and Positive Prediction Value (80%) respectively) as well as segmentation accuracy (Dice Similarity Coefficient (72%)). Obtained results illustrate the validity of the approach to automatically detect and segment lupus lesions. Besides, our approach is publicly available as a SPM8/12 toolbox extension with a simple parameter configuration

Evaluating the effect of multiple sclerosis lesions on automatic brain structure segmentation

In recent years, many automatic brain structure segmentation methods have been proposed. However, these methods are commonly tested with non-lesioned brains and the effect of lesions on their performance has not been evaluated. Here, we analyze the effect of multiple sclerosis (MS) lesions on three well-known automatic brain structure segmentation methods, namely, FreeSurfer, FIRST and multi-atlas fused by majority voting, which use learning-based, deformable and atlas-based strategies, respectively. To perform a quantitative analysis, 100 synthetic images of MS patients with a total of 2174 lesions are simulated on two public databases with available brain structure ground truth information (IBSR18 and MICCAI’12). The Dice similarity coefficient (DSC) differences and the volume differences between the healthy and the simulated images are calculated for the subcortical structures and the brainstem. We observe that the three strategies are affected when lesions are present. However, the effects of the lesions do not follow the same pattern; the lesions either make the segmentation method underperform or surprisingly augment the segmentation accuracy. The obtained results show that FreeSurfer is the method most affected by the presence of lesions, with DSC differences (generated − healthy) ranging from −0.11±0.54 to 9.65±9.87, whereas FIRST tends to be the most robust method when lesions are present (−2.40±5.54 to 0.44±0.94). Lesion location is not important for global strategies such as FreeSurfer or majority voting, where structure segmentation is affected wherever the lesions exist. On the other hand, FIRST is more affected when the lesions are overlaid or close to the structure of analysis. The most affected structure by the presence of lesions is the nucleus accumbens (from −1.12±2.53 to 1.32±4.00 for the left hemisphere and from −2.40±5.54 to 9.65±9.87 for the right hemisphere), whereas the structures that show less variation include the thalamus (from 0.03±0.35 to 0.74±0.89 and from −0.48±1.08 to −0.04±0.22) and the brainstem (from −0.20±0.38 to 1.03±1.31). The three segmentation approaches are affected by the presence of MS lesions, which demonstrates that there exists a problem in the automatic segmentation methods of the deep gray matter (DGM) structures that has to be taken into account when using them as a tool to measure the disease progression. Keywords: Brain structures, Multiple sclerosis lesions, Segmentation, Magnetic resonance imagin

Automated Detection of Lupus White Matter Lesions in MRI

Brain magnetic resonance imaging provides detailed information which can be used to detectand segment white matter lesions (WML). In this work we propose an approach to automatically segment WML in Lupus patients by using T1 wandfluid-attenuated inversion recovery (FLAIR) images. Lupus WML appear as small fo calabnormal tissue observed as hyperintensities in the FLAIR images. The quantification of these WML is a key factor for the stratification of lupus patients and therefore both lesion detection and segmentation play an important role. In our approach, the T1 wimage is first used to classify the three maint issues of the brain , white matter (WM), graymatter (GM) ,and cerebro spinal fluid (CSF), while the FLAIR image is then used to detect focal WM La soutliers of its GMintensity distribution. Aset of post-processing steps based on lesionsize, tissue neighborhood, and location are used to refine the lesion candidates. The propos alise valuated on 20 patients, presenting qualitative, and quantitative results in terms of precision and sensitivity of lesion detection [True Positive Rate (62%) and Positive Prediction Value (80%), respectively] as well as segmentation accuracy [Dice Similarity Coefficient (72%)]. Obtained results illustrate the validity of the aproach to automatically detectand segment lupus lesions. Besides,our approach is publicly available as a SPM8/12 tool box extension with a simple parameter configurationER holds a BR-UdG2013 Ph.D. grant. SV holds a FI-DGR2013 Ph.D.grant. This work has been supported by“L aFundació la Marató de TV3”,by Retos de Investigación TIN2014-55710-R, and by MP CUdG2016/022gran