Coronary Artery Plaque Characterization from CCTA Scans using Deep Learning and Radiomics

Assessing coronary artery plaque segments in coronary CT angiography scans is an important task to improve patient management and clinical outcomes, as it can help to decide whether invasive investigation and treatment are necessary. In this work, we present three machine learning approaches capable of performing this task. The first approach is based on radiomics, where a plaque segmentation is used to calculate various shape-, intensity- and texture-based features under different image transformations. A second approach is based on deep learning and relies on centerline extraction as sole prerequisite. In the third approach, we fuse the deep learning approach with radiomic features. On our data the methods reached similar scores as simulated fractional flow reserve (FFR) measurements, which - in contrast to our methods - requires an exact segmentation of the whole coronary tree and often time-consuming manual interaction. In literature, the performance of simulated FFR reaches an AUC between 0.79-0.93 predicting an abnormal invasive FFR that demands revascularization. The radiomics approach achieves an AUC of 0.86, the deep learning approach 0.84 and the combined method 0.88 for predicting the revascularization decision directly. While all three proposed methods can be determined within seconds, the FFR simulation typically takes several minutes. Provided representative training data in sufficient quantities, we believe that the presented methods can be used to create systems for fully automatic non-invasive risk assessment for a variety of adverse cardiac events.

Deep Learning Algorithms for Coronary Artery Plaque Characterisation from CCTA Scans

Analysing coronary artery plaque segments with respect to their functional significance and therefore their influence to patient management in a non-invasive setup is an important subject of current research. In this work we compare and improve three deep learning algorithms for this task: A 3D recurrent convolutional neural network (RCNN), a 2D multi-view ensemble approach based on texture analysis, and a newly proposed 2.5D approach. Current state of the art methods utilising fluid dynamics based fractional flow reserve (FFR) simulation reach an AUC of up to 0.93 for the task of predicting an abnormal invasive FFR value. For the comparable task of predicting revascularisation decision, we are able to improve the performance in terms of AUC of both existing approaches with the proposed modifications, specifically from 0.80 to 0.90 for the 3D-RCNN, and from 0.85 to 0.90 for the multi-view texture-based ensemble. The newly proposed 2.5D approach achieves comparable results with an AUC of 0.90.

Epoch-wise label attacks for robustness against label noise

The current accessibility to large medical datasets for training convolutional neural networks is tremendously high. The associated dataset labels are always considered to be the real "ground truth". However, the labeling procedures often seem to be inaccurate and many wrong labels are integrated. This may have fatal consequences on the performance of both training and evaluation. In this paper, we show the impact of label noise in the training set on a specific medical problem based on chest X-ray images. With a simple one-class problem, the classification of tuberculosis, we measure the performance on a clean evaluation set when training with label-corrupt data. We develop a method to compete with incorrectly labeled data during training by randomly attacking labels on individual epochs. The network tends to be robust when flipping correct labels for a single epoch and initiates a good step to the optimal minimum on the error surface when flipping noisy labels. On a baseline with an AUC (Area under Curve) score of 0.924, the performance drops to 0.809 when 30% of our training data is misclassified. With our approach the baseline performance could almost be maintained, the performance raised to 0.918.

Deep Learning-based Denoising of Mammographic Images using Physics-driven Data Augmentation

Mammography is using low-energy X-rays to screen the human breast and is utilized by radiologists to detect breast cancer. Typically radiologists require a mammogram with impeccable image quality for an accurate diagnosis. In this study, we propose a deep learning method based on Convolutional Neural Networks (CNNs) for mammogram denoising to improve the image quality. We first enhance the noise level and employ Anscombe Transformation (AT) to transform Poisson noise to white Gaussian noise. With this data augmentation, a deep residual network is trained to learn the noise map of the noisy images. We show, that the proposed method can remove not only simulated but also real noise. Furthermore, we also compare our results with state-of-the-art denoising methods, such as BM3D and DNCNN. In an early investigation, we achieved qualitatively better mammogram denoising results.

Field of View Extension in Computed Tomography Using Deep Learning Prior

In computed tomography (CT), data truncation is a common problem. Images reconstructed by the standard filtered back-projection algorithm from truncated data suffer from cupping artifacts inside the field-of-view (FOV), while anatomical structures are severely distorted or missing outside the FOV. Deep learning, particularly the U-Net, has been applied to extend the FOV as a post-processing method. Since image-to-image prediction neglects the data fidelity to measured projection data, incorrect structures, even inside the FOV, might be reconstructed by such an approach. Therefore, generating reconstructed images directly from a post-processing neural network is inadequate. In this work, we propose a data consistent reconstruction method, which utilizes deep learning reconstruction as prior for extrapolating truncated projections and a conventional iterative reconstruction to constrain the reconstruction consistent to measured raw data. Its efficacy is demonstrated in our study, achieving small average root-mean-square error of 24 HU inside the FOV and a high structure similarity index of 0.993 for the whole body area on a test patient's CT data.

ICDAR 2019 Competition on Image Retrieval for Historical Handwritten Documents

This competition investigates the performance of large-scale retrieval of historical document images based on writing style. Based on large image data sets provided by cultural heritage institutions and digital libraries, providing a total of 20 000 document images representing about 10 000 writers, divided in three types: writers of (i) manuscript books, (ii) letters, (iii) charters and legal documents. We focus on the task of automatic image retrieval to simulate common scenarios of humanities research, such as writer retrieval. The most teams submitted traditional methods not using deep learning techniques. The competition results show that a combination of methods is outperforming single methods. Furthermore, letters are much more difficult to retrieve than manuscripts.

Deep autofocus with cone-beam CT consistency constraint

High quality reconstruction with interventional C-arm cone-beam computed tomography (CBCT) requires exact geometry information. If the geometry information is corrupted, e. g., by unexpected patient or system movement, the measured signal is misplaced in the backprojection operation. With prolonged acquisition times of interventional C-arm CBCT the likelihood of rigid patient motion increases. To adapt the backprojection operation accordingly, a motion estimation strategy is necessary. Recently, a novel learning-based approach was proposed, capable of compensating motions within the acquisition plane. We extend this method by a CBCT consistency constraint, which was proven to be efficient for motions perpendicular to the acquisition plane. By the synergistic combination of these two measures, in and out-plane motion is well detectable, achieving an average artifact suppression of 93 [percent]. This outperforms the entropy-based state-of-the-art autofocus measure which achieves on average an artifact suppression of 54 [percent].

Multi-Channel Volumetric Neural Network for Knee Cartilage Segmentation in Cone-beam CT

Analyzing knee cartilage thickness and strain under load can help to further the understanding of the effects of diseases like Osteoarthritis. A precise segmentation of the cartilage is a necessary prerequisite for this analysis. This segmentation task has mainly been addressed in Magnetic Resonance Imaging, and was rarely investigated on contrast-enhanced Computed Tomography, where contrast agent visualizes the border between femoral and tibial cartilage. To overcome the main drawback of manual segmentation, namely its high time investment, we propose to use a 3D Convolutional Neural Network for this task. The presented architecture consists of a V-Net with SeLu activation, and a Tversky loss function. Due to the high imbalance between very few cartilage pixels and many background pixels, a high false positive rate is to be expected. To reduce this rate, the two largest segmented point clouds are extracted using a connected component analysis, since they most likely represent the medial and lateral tibial cartilage surfaces. The resulting segmentations are compared to manual segmentations, and achieve on average a recall of 0.69, which confirms the feasibility of this approach.

Learning New Tricks from Old Dogs -- Inter-Species, Inter-Tissue Domain Adaptation for Mitotic Figure Assessment

For histopathological tumor assessment, the count of mitotic figures per area is an important part of prognostication. Algorithmic approaches - such as for mitotic figure identification - have significantly improved in recent times, potentially allowing for computer-augmented or fully automatic screening systems in the future. This trend is further supported by whole slide scanning microscopes becoming available in many pathology labs and could soon become a standard imaging tool. For an application in broader fields of such algorithms, the availability of mitotic figure data sets of sufficient size for the respective tissue type and species is an important precondition, that is, however, rarely met. While algorithmic performance climbed steadily for e.g. human mammary carcinoma, thanks to several challenges held in the field, for most tumor types, data sets are not available. In this work, we assess domain transfer of mitotic figure recognition using domain adversarial training on four data sets, two from dogs and two from humans. We were able to show that domain adversarial training considerably improves accuracy when applying mitotic figure classification learned from the canine on the human data sets (up to +12.8% in accuracy) and is thus a helpful method to transfer knowledge from existing data sets to new tissue types and species.

Projection-to-Projection Translation for Hybrid X-ray and Magnetic Resonance Imaging

Hybrid X-ray and magnetic resonance (MR) imaging promises large potential in interventional medical imaging applications due to the broad variety of contrast of MRI combined with fast imaging of X-ray-based modalities. To fully utilize the potential of the vast amount of existing image enhancement techniques, the corresponding information from both modalities must be present in the same domain. For image-guided interventional procedures, X-ray fluoroscopy has proven to be the modality of choice. Synthesizing one modality from another in this case is an ill-posed problem due to ambiguous signal and overlapping structures in projective geometry. To take on these challenges, we present a learning-based solution to MR to X-ray projection-to-projection translation. We propose an image generator network that focuses on high representation capacity in higher resolution layers to allow for accurate synthesis of fine details in the projection images. Additionally, a weighting scheme in the loss computation that favors high-frequency structures is proposed to focus on the important details and contours in projection imaging. The proposed extensions prove valuable in generating X-ray projection images with natural appearance. Our approach achieves a deviation from the ground truth of only $6$% and structural similarity measure of $0.913\,\pm\,0.005$. In particular the high frequency weighting assists in generating projection images with sharp appearance and reduces erroneously synthesized fine details.