Ensembled ResUnet for Anatomical Brain Barriers Segmentation

Accuracy segmentation of brain structures could be helpful for glioma and radiotherapy planning. However, due to the visual and anatomical differences between different modalities, the accurate segmentation of brain structures becomes challenging. To address this problem, we first construct a residual block based U-shape network with a deep encoder and shallow decoder, which can trade off the framework performance and efficiency. Then, we introduce the Tversky loss to address the issue of the class imbalance between different foreground and the background classes. Finally, a model ensemble strategy is utilized to remove outliers and further boost performance.

TR-GAN: Topology Ranking GAN with Triplet Loss for Retinal Artery/Vein Classification

Retinal artery/vein (A/V) classification lays the foundation for the quantitative analysis of retinal vessels, which is associated with potential risks of various cardiovascular and cerebral diseases. The topological connection relationship, which has been proved effective in improving the A/V classification performance for the conventional graph based method, has not been exploited by the deep learning based method. In this paper, we propose a Topology Ranking Generative Adversarial Network (TR-GAN) to improve the topology connectivity of the segmented arteries and veins, and further to boost the A/V classification performance. A topology ranking discriminator based on ordinal regression is proposed to rank the topological connectivity level of the ground-truth, the generated A/V mask and the intentionally shuffled mask. The ranking loss is further back-propagated to the generator to generate better connected A/V masks. In addition, a topology preserving module with triplet loss is also proposed to extract the high-level topological features and further to narrow the feature distance between the predicted A/V mask and the ground-truth. The proposed framework effectively increases the topological connectivity of the predicted A/V masks and achieves state-of-the-art A/V classification performance on the publicly available AV-DRIVE dataset.

Difficulty-aware Glaucoma Classification with Multi-Rater Consensus Modeling

Medical images are generally labeled by multiple experts before the final ground-truth labels are determined. Consensus or disagreement among experts regarding individual images reflects the gradeability and difficulty levels of the image. However, when being used for model training, only the final ground-truth label is utilized, while the critical information contained in the raw multi-rater gradings regarding the image being an easy/hard case is discarded. In this paper, we aim to take advantage of the raw multi-rater gradings to improve the deep learning model performance for the glaucoma classification task. Specifically, a multi-branch model structure is proposed to predict the most sensitive, most specifical and a balanced fused result for the input images. In order to encourage the sensitivity branch and specificity branch to generate consistent results for consensus labels and opposite results for disagreement labels, a consensus loss is proposed to constrain the output of the two branches. Meanwhile, the consistency/inconsistency between the prediction results of the two branches implies the image being an easy/hard case, which is further utilized to encourage the balanced fusion branch to concentrate more on the hard cases. Compared with models trained only with the final ground-truth labels, the proposed method using multi-rater consensus information has achieved superior performance, and it is also able to estimate the difficulty levels of individual input images when making the prediction.

Comparing to Learn: Surpassing ImageNet Pretraining on Radiographs By Comparing Image Representations

In deep learning era, pretrained models play an important role in medical image analysis, in which ImageNet pretraining has been widely adopted as the best way. However, it is undeniable that there exists an obvious domain gap between natural images and medical images. To bridge this gap, we propose a new pretraining method which learns from 700k radiographs given no manual annotations. We call our method as Comparing to Learn (C2L) because it learns robust features by comparing different image representations. To verify the effectiveness of C2L, we conduct comprehensive ablation studies and evaluate it on different tasks and datasets. The experimental results on radiographs show that C2L can outperform ImageNet pretraining and previous state-of-the-art approaches significantly. Code and models are available.

A Macro-Micro Weakly-supervised Framework for AS-OCT Tissue Segmentation

Primary angle closure glaucoma (PACG) is the leading cause of irreversible blindness among Asian people. Early detection of PACG is essential, so as to provide timely treatment and minimize the vision loss. In the clinical practice, PACG is diagnosed by analyzing the angle between the cornea and iris with anterior segment optical coherence tomography (AS-OCT). The rapid development of deep learning technologies provides the feasibility of building a computer-aided system for the fast and accurate segmentation of cornea and iris tissues. However, the application of deep learning methods in the medical imaging field is still restricted by the lack of enough fully-annotated samples. In this paper, we propose a novel framework to segment the target tissues accurately for the AS-OCT images, by using the combination of weakly-annotated images (majority) and fully-annotated images (minority). The proposed framework consists of two models which provide reliable guidance for each other. In addition, uncertainty guided strategies are adopted to increase the accuracy and stability of the guidance. Detailed experiments on the publicly available AGE dataset demonstrate that the proposed framework outperforms the state-of-the-art semi-/weakly-supervised methods and has a comparable performance as the fully-supervised method. Therefore, the proposed method is demonstrated to be effective in exploiting information contained in the weakly-annotated images and has the capability to substantively relieve the annotation workload.

A Global Benchmark of Algorithms for Segmenting Late Gadolinium-Enhanced Cardiac Magnetic Resonance Imaging

Segmentation of cardiac images, particularly late gadolinium-enhanced magnetic resonance imaging (LGE-MRI) widely used for visualizing diseased cardiac structures, is a crucial first step for clinical diagnosis and treatment. However, direct segmentation of LGE-MRIs is challenging due to its attenuated contrast. Since most clinical studies have relied on manual and labor-intensive approaches, automatic methods are of high interest, particularly optimized machine learning approaches. To address this, we organized the "2018 Left Atrium Segmentation Challenge" using 154 3D LGE-MRIs, currently the world's largest cardiac LGE-MRI dataset, and associated labels of the left atrium segmented by three medical experts, ultimately attracting the participation of 27 international teams. In this paper, extensive analysis of the submitted algorithms using technical and biological metrics was performed by undergoing subgroup analysis and conducting hyper-parameter analysis, offering an overall picture of the major design choices of convolutional neural networks (CNNs) and practical considerations for achieving state-of-the-art left atrium segmentation. Results show the top method achieved a dice score of 93.2% and a mean surface to a surface distance of 0.7 mm, significantly outperforming prior state-of-the-art. Particularly, our analysis demonstrated that double, sequentially used CNNs, in which a first CNN is used for automatic region-of-interest localization and a subsequent CNN is used for refined regional segmentation, achieved far superior results than traditional methods and pipelines containing single CNNs. This large-scale benchmarking study makes a significant step towards much-improved segmentation methods for cardiac LGE-MRIs, and will serve as an important benchmark for evaluating and comparing the future works in the field.

AGE Challenge: Angle Closure Glaucoma Evaluation in Anterior Segment Optical Coherence Tomography

Angle closure glaucoma (ACG) is a more aggressive disease than open-angle glaucoma, where the abnormal anatomical structures of the anterior chamber angle (ACA) may cause an elevated intraocular pressure and gradually leads to glaucomatous optic neuropathy and eventually to visual impairment and blindness. Anterior Segment Optical Coherence Tomography (AS-OCT) imaging provides a fast and contactless way to discriminate angle closure from open angle. Although many medical image analysis algorithms have been developed for glaucoma diagnosis, only a few studies have focused on AS-OCT imaging. In particular, there is no public AS-OCT dataset available for evaluating the existing methods in a uniform way, which limits the progress in the development of automated techniques for angle closure detection and assessment. To address this, we organized the Angle closure Glaucoma Evaluation challenge (AGE), held in conjunction with MICCAI 2019. The AGE challenge consisted of two tasks: scleral spur localization and angle closure classification. For this challenge, we released a large data of 4800 annotated AS-OCT images from 199 patients, and also proposed an evaluation framework to benchmark and compare different models. During the AGE challenge, over 200 teams registered online, and more than 1100 results were submitted for online evaluation. Finally, eight teams participated in the onsite challenge. In this paper, we summarize these eight onsite challenge methods and analyze their corresponding results in the two tasks. We further discuss limitations and future directions. In the AGE challenge, the top-performing approach had an average Euclidean Distance of 10 pixel in scleral spur localization, while in the task of angle closure classification, all the algorithms achieved the satisfactory performances, especially, 100% accuracy rate for top-two performances.