A Mixed Focal Loss Function for Handling Class Imbalanced Medical Image Segmentation

Automatic segmentation methods are an important advancement in medical imaging analysis. Machine learning techniques, and deep neural networks in particular, are the state-of-the-art for most automated medical image segmentation tasks, ranging from the subcellular to the level of organ systems. Issues with class imbalance pose a significant challenge irrespective of scale, with organs, and especially with tumours, often occupying a considerably smaller volume relative to the background. Loss functions used in the training of segmentation algorithms differ in their robustness to class imbalance, with cross entropy-based losses being more affected than Dice-based losses. In this work, we first experiment with seven different Dice-based and cross entropy-based loss functions on the publicly available Kidney Tumour Segmentation 2019 (KiTS19) Computed Tomography dataset, and then further evaluate the top three performing loss functions on the Brain Tumour Segmentation 2020 (BraTS20) Magnetic Resonance Imaging dataset. Motivated by the results of our study, we propose a Mixed Focal loss function, a new compound loss function derived from modified variants of the Focal loss and Focal Dice loss functions. We demonstrate that our proposed loss function is associated with a better recall-precision balance, significantly outperforming the other loss functions in both binary and multi-class image segmentation. Importantly, the proposed Mixed Focal loss function is robust to significant class imbalance. Furthermore, we showed the benefit of using compound losses over their component losses, and the improvement provided by the focal variants over other variants.

Expectation-Maximization Regularized Deep Learning for Weakly Supervised Tumor Segmentation for Glioblastoma

We present an Expectation-Maximization (EM) Regularized Deep Learning (EMReDL) model for the weakly supervised tumor segmentation. The proposed framework was tailored to glioblastoma, a type of malignant tumor characterized by its diffuse infiltration into the surrounding brain tissue, which poses significant challenge to treatment target and tumor burden estimation based on conventional structural MRI. Although physiological MRI can provide more specific information regarding tumor infiltration, the relatively low resolution hinders a precise full annotation. This has motivated us to develop a weakly supervised deep learning solution that exploits the partial labelled tumor regions. EMReDL contains two components: a physiological prior prediction model and EM-regularized segmentation model. The physiological prior prediction model exploits the physiological MRI by training a classifier to generate a physiological prior map. This map was passed to the segmentation model for regularization using the EM algorithm. We evaluated the model on a glioblastoma dataset with the available pre-operative multiparametric MRI and recurrence MRI. EMReDL was shown to effectively segment the infiltrated tumor from the partially labelled region of potential infiltration. The segmented core and infiltrated tumor showed high consistency with the tumor burden labelled by experts. The performance comparison showed that EMReDL achieved higher accuracy than published state-of-the-art models. On MR spectroscopy, the segmented region showed more aggressive features than other partial labelled region. The proposed model can be generalized to other segmentation tasks with partial labels, with the CNN architecture flexible in the framework.

Beyond Fine-tuning: Classifying High Resolution Mammograms using Function-Preserving Transformations

The task of classifying mammograms is very challenging because the lesion is usually small in the high resolution image. The current state-of-the-art approaches for medical image classification rely on using the de-facto method for ConvNets - fine-tuning. However, there are fundamental differences between natural images and medical images, which based on existing evidence from the literature, limits the overall performance gain when designed with algorithmic approaches. In this paper, we propose to go beyond fine-tuning by introducing a novel framework called MorphHR, in which we highlight a new transfer learning scheme. The idea behind the proposed framework is to integrate function-preserving transformations, for any continuous non-linear activation neurons, to internally regularise the network for improving mammograms classification. The proposed solution offers two major advantages over the existing techniques. Firstly and unlike fine-tuning, the proposed approach allows for modifying not only the last few layers but also several of the first ones on a deep ConvNet. By doing this, we can design the network front to be suitable for learning domain specific features. Secondly, the proposed scheme is scalable to hardware. Therefore, one can fit high resolution images on standard GPU memory. We show that by using high resolution images, one prevents losing relevant information. We demonstrate, through numerical and visual experiments, that the proposed approach yields to a significant improvement in the classification performance over state-of-the-art techniques, and is indeed on a par with radiology experts. Moreover and for generalisation purposes, we show the effectiveness of the proposed learning scheme on another large dataset, the ChestX-ray14, surpassing current state-of-the-art techniques.

TFPnP: Tuning-free Plug-and-Play Proximal Algorithm with Applications to Inverse Imaging Problems

Plug-and-Play (PnP) is a non-convex framework that combines proximal algorithms, for example alternating direction method of multipliers (ADMM), with advanced denoiser priors. Over the past few years, great empirical success has been obtained by PnP algorithms, especially for the ones integrated with deep learning-based denoisers. However, a crucial issue of PnP approaches is the need of manual parameter tweaking. As it is essential to obtain high-quality results across the high discrepancy in terms of imaging conditions and varying scene content. In this work, we present a tuning-free PnP proximal algorithm, which can automatically determine the internal parameters including the penalty parameter, the denoising strength and the termination time. A core part of our approach is to develop a policy network for automatic search of parameters, which can be effectively learned via mixed model-free and model-based deep reinforcement learning. We demonstrate, through a set of numerical and visual experiments, that the learned policy can customize different parameters for different states, and often more efficient and effective than existing handcrafted criteria. Moreover, we discuss the practical considerations of the plugged denoisers, which together with our learned policy yield to state-of-the-art results. This is prevalent on both linear and nonlinear exemplary inverse imaging problems, and in particular, we show promising results on compressed sensing MRI, sparse-view CT and phase retrieval.

Bayesian optimization assisted unsupervised learning for efficient intra-tumor partitioning in MRI and survival prediction for glioblastoma patients

Glioblastoma is profoundly heterogeneous in microstructure and vasculature, which may lead to tumor regional diversity and distinct treatment response. Although successful in tumor sub-region segmentation and survival prediction, radiomics based on machine learning algorithms, is challenged by its robustness, due to the vague intermediate process and track changes. Also, the weak interpretability of the model poses challenges to clinical application. Here we proposed a machine learning framework to semi-automatically fine-tune the clustering algorithms and quantitatively identify stable sub-regions for reliable clinical survival prediction. Hyper-parameters are automatically determined by the global minimum of the trained Gaussian Process (GP) surrogate model through Bayesian optimization(BO) to alleviate the difficulty of tuning parameters for clinical researchers. To enhance the interpretability of the survival prediction model, we incorporated the prior knowledge of intra-tumoral heterogeneity, by segmenting tumor sub-regions and extracting sub-regional features. The results demonstrated that the global minimum of the trained GP surrogate can be used as sub-optimal hyper-parameter solutions for efficient. The sub-regions segmented based on physiological MRI can be applied to predict patient survival, which could enhance the clinical interpretability for the machine learning model.

A Three-Stage Self-Training Framework for Semi-Supervised Semantic Segmentation

Semantic segmentation has been widely investigated in the community, in which the state of the art techniques are based on supervised models. Those models have reported unprecedented performance at the cost of requiring a large set of high quality segmentation masks. To obtain such annotations is highly expensive and time consuming, in particular, in semantic segmentation where pixel-level annotations are required. In this work, we address this problem by proposing a holistic solution framed as a three-stage self-training framework for semi-supervised semantic segmentation. The key idea of our technique is the extraction of the pseudo-masks statistical information to decrease uncertainty in the predicted probability whilst enforcing segmentation consistency in a multi-task fashion. We achieve this through a three-stage solution. Firstly, we train a segmentation network to produce rough pseudo-masks which predicted probability is highly uncertain. Secondly, we then decrease the uncertainty of the pseudo-masks using a multi-task model that enforces consistency whilst exploiting the rich statistical information of the data. We compare our approach with existing methods for semi-supervised semantic segmentation and demonstrate its state-of-the-art performance with extensive experiments.

Contrastive Registration for Unsupervised Medical Image Segmentation

Medical image segmentation is a relevant task as it serves as the first step for several diagnosis processes, thus it is indispensable in clinical usage. Whilst major success has been reported using supervised techniques, they assume a large and well-representative labelled set. This is a strong assumption in the medical domain where annotations are expensive, time-consuming, and inherent to human bias. To address this problem, unsupervised techniques have been proposed in the literature yet it is still an open problem due to the difficulty of learning any transformation pattern. In this work, we present a novel optimisation model framed into a new CNN-based contrastive registration architecture for unsupervised medical image segmentation. The core of our approach is to exploit image-level registration and feature-level from a contrastive learning mechanism, to perform registration-based segmentation. Firstly, we propose an architecture to capture the image-to-image transformation pattern via registration for unsupervised medical image segmentation. Secondly, we embed a contrastive learning mechanism into the registration architecture to enhance the discriminating capacity of the network in the feature-level. We show that our proposed technique mitigates the major drawbacks of existing unsupervised techniques. We demonstrate, through numerical and visual experiments, that our technique substantially outperforms the current state-of-the-art unsupervised segmentation methods on two major medical image datasets.

Regularized Compression of MRI Data: Modular Optimization of Joint Reconstruction and Coding

The Magnetic Resonance Imaging (MRI) processing chain starts with a critical acquisition stage that provides raw data for reconstruction of images for medical diagnosis. This flow usually includes a near-lossless data compression stage that enables digital storage and/or transmission in binary formats. In this work we propose a framework for joint optimization of the MRI reconstruction and lossy compression, producing compressed representations of medical images that achieve improved trade-offs between quality and bit-rate. Moreover, we demonstrate that lossy compression can even improve the reconstruction quality compared to settings based on lossless compression. Our method has a modular optimization structure, implemented using the alternating direction method of multipliers (ADMM) technique and the state-of-the-art image compression technique (BPG) as a black-box module iteratively applied. This establishes a medical data compression approach compatible with a lossy compression standard of choice. A main novelty of the proposed algorithm is in the total-variation regularization added to the modular compression process, leading to decompressed images of higher quality without any additional processing at/after the decompression stage. Our experiments show that our regularization-based approach for joint MRI reconstruction and compression often achieves significant PSNR gains between 4 to 9 dB at high bit-rates compared to non-regularized solutions of the joint task. Compared to regularization-based solutions, our optimization method provides PSNR gains between 0.5 to 1 dB at high bit-rates, which is the range of interest for medical image compression.

GraphXCOVID: Explainable Deep Graph Diffusion Pseudo-Labelling for Identifying COVID-19 on Chest X-rays

Can one learn to diagnose COVID-19 under extreme minimal supervision? Since the outbreak of the novel COVID-19 there has been a rush for developing Artificial Intelligence techniques for expert-level disease identification on Chest X-ray data. In particular, the use of deep supervised learning has become the go-to paradigm. However, the performance of such models is heavily dependent on the availability of a large and representative labelled dataset. The creation of which is a heavily expensive and time consuming task, and especially imposes a great challenge for a novel disease. Semi-supervised learning has shown the ability to match the incredible performance of supervised models whilst requiring a small fraction of the labelled examples. This makes the semi-supervised paradigm an attractive option for identifying COVID-19. In this work, we introduce a graph based deep semi-supervised framework for classifying COVID-19 from chest X-rays. Our framework introduces an optimisation model for graph diffusion that reinforces the natural relation among the tiny labelled set and the vast unlabelled data. We then connect the diffusion prediction output as pseudo-labels that are used in an iterative scheme in a deep net. We demonstrate, through our experiments, that our model is able to outperform the current leading supervised model with a tiny fraction of the labelled examples. Finally, we provide attention maps to accommodate the radiologist's mental model, better fitting their perceptual and cognitive abilities. These visualisation aims to assist the radiologist in judging whether the diagnostic is correct or not, and in consequence to accelerate the decision.

A Linear Transportation $\mathrm{L}^p$ Distance for Pattern Recognition

The transportation $\mathrm{L}^p$ distance, denoted $\mathrm{TL}^p$, has been proposed as a generalisation of Wasserstein $\mathrm{W}^p$ distances motivated by the property that it can be applied directly to colour or multi-channelled images, as well as multivariate time-series without normalisation or mass constraints. These distances, as with $\mathrm{W}^p$, are powerful tools in modelling data with spatial or temporal perturbations. However, their computational cost can make them infeasible to apply to even moderate pattern recognition tasks. We propose linear versions of these distances and show that the linear $\mathrm{TL}^p$ distance significantly improves over the linear $\mathrm{W}^p$ distance on signal processing tasks, whilst being several orders of magnitude faster to compute than the $\mathrm{TL}^p$ distance.