Personalized Diagnostic Tool for Thyroid Cancer Classification using Multi-view Ultrasound

Over the past decades, the incidence of thyroid cancer has been increasing globally. Accurate and early diagnosis allows timely treatment and helps to avoid over-diagnosis. Clinically, a nodule is commonly evaluated from both transverse and longitudinal views using thyroid ultrasound. However, the appearance of the thyroid gland and lesions can vary dramatically across individuals. Identifying key diagnostic information from both views requires specialized expertise. Furthermore, finding an optimal way to integrate multi-view information also relies on the experience of clinicians and adds further difficulty to accurate diagnosis. To address these, we propose a personalized diagnostic tool that can customize its decision-making process for different patients. It consists of a multi-view classification module for feature extraction and a personalized weighting allocation network that generates optimal weighting for different views. It is also equipped with a self-supervised view-aware contrastive loss to further improve the model robustness towards different patient groups. Experimental results show that the proposed framework can better utilize multi-view information and outperform the competing methods.

Online Reflective Learning for Robust Medical Image Segmentation

Deep segmentation models often face the failure risks when the testing image presents unseen distributions. Improving model robustness against these risks is crucial for the large-scale clinical application of deep models. In this study, inspired by human learning cycle, we propose a novel online reflective learning framework (RefSeg) to improve segmentation robustness. Based on the reflection-on-action conception, our RefSeg firstly drives the deep model to take action to obtain semantic segmentation. Then, RefSeg triggers the model to reflect itself. Because making deep models realize their segmentation failures during testing is challenging, RefSeg synthesizes a realistic proxy image from the semantic mask to help deep models build intuitive and effective reflections. This proxy translates and emphasizes the segmentation flaws. By maximizing the structural similarity between the raw input and the proxy, the reflection-on-action loop is closed with segmentation robustness improved. RefSeg runs in the testing phase and is general for segmentation models. Extensive validation on three medical image segmentation tasks with a public cardiac MR dataset and two in-house large ultrasound datasets show that our RefSeg remarkably improves model robustness and reports state-of-the-art performance over strong competitors.

Agent with Tangent-based Formulation and Anatomical Perception for Standard Plane Localization in 3D Ultrasound

Standard plane (SP) localization is essential in routine clinical ultrasound (US) diagnosis. Compared to 2D US, 3D US can acquire multiple view planes in one scan and provide complete anatomy with the addition of coronal plane. However, manually navigating SPs in 3D US is laborious and biased due to the orientation variability and huge search space. In this study, we introduce a novel reinforcement learning (RL) framework for automatic SP localization in 3D US. Our contribution is three-fold. First, we formulate SP localization in 3D US as a tangent-point-based problem in RL to restructure the action space and significantly reduce the search space. Second, we design an auxiliary task learning strategy to enhance the model's ability to recognize subtle differences crossing Non-SPs and SPs in plane search. Finally, we propose a spatial-anatomical reward to effectively guide learning trajectories by exploiting spatial and anatomical information simultaneously. We explore the efficacy of our approach on localizing four SPs on uterus and fetal brain datasets. The experiments indicate that our approach achieves a high localization accuracy as well as robust performance.

Weakly-supervised High-fidelity Ultrasound Video Synthesis with Feature Decoupling

Ultrasound (US) is widely used for its advantages of real-time imaging, radiation-free and portability. In clinical practice, analysis and diagnosis often rely on US sequences rather than a single image to obtain dynamic anatomical information. This is challenging for novices to learn because practicing with adequate videos from patients is clinically unpractical. In this paper, we propose a novel framework to synthesize high-fidelity US videos. Specifically, the synthesis videos are generated by animating source content images based on the motion of given driving videos. Our highlights are three-fold. First, leveraging the advantages of self- and fully-supervised learning, our proposed system is trained in weakly-supervised manner for keypoint detection. These keypoints then provide vital information for handling complex high dynamic motions in US videos. Second, we decouple content and texture learning using the dual decoders to effectively reduce the model learning difficulty. Last, we adopt the adversarial training strategy with GAN losses for further improving the sharpness of the generated videos, narrowing the gap between real and synthesis videos. We validate our method on a large in-house pelvic dataset with high dynamic motion. Extensive evaluation metrics and user study prove the effectiveness of our proposed method.

Fine-grained Correlation Loss for Regression

Regression learning is classic and fundamental for medical image analysis. It provides the continuous mapping for many critical applications, like the attribute estimation, object detection, segmentation and non-rigid registration. However, previous studies mainly took the case-wise criteria, like the mean square errors, as the optimization objectives. They ignored the very important population-wise correlation criterion, which is exactly the final evaluation metric in many tasks. In this work, we propose to revisit the classic regression tasks with novel investigations on directly optimizing the fine-grained correlation losses. We mainly explore two complementary correlation indexes as learnable losses: Pearson linear correlation (PLC) and Spearman rank correlation (SRC). The contributions of this paper are two folds. First, for the PLC on global level, we propose a strategy to make it robust against the outliers and regularize the key distribution factors. These efforts significantly stabilize the learning and magnify the efficacy of PLC. Second, for the SRC on local level, we propose a coarse-to-fine scheme to ease the learning of the exact ranking order among samples. Specifically, we convert the learning for the ranking of samples into the learning of similarity relationships among samples. We extensively validate our method on two typical ultrasound image regression tasks, including the image quality assessment and bio-metric measurement. Experiments prove that, with the fine-grained guidance in directly optimizing the correlation, the regression performances are significantly improved. Our proposed correlation losses are general and can be extended to more important applications.

Deep Motion Network for Freehand 3D Ultrasound Reconstruction

Freehand 3D ultrasound (US) has important clinical value due to its low cost and unrestricted field of view. Recently deep learning algorithms have removed its dependence on bulky and expensive external positioning devices. However, improving reconstruction accuracy is still hampered by difficult elevational displacement estimation and large cumulative drift. In this context, we propose a novel deep motion network (MoNet) that integrates images and a lightweight sensor known as the inertial measurement unit (IMU) from a velocity perspective to alleviate the obstacles mentioned above. Our contribution is two-fold. First, we introduce IMU acceleration for the first time to estimate elevational displacements outside the plane. We propose a temporal and multi-branch structure to mine the valuable information of low signal-to-noise ratio (SNR) acceleration. Second, we propose a multi-modal online self-supervised strategy that leverages IMU information as weak labels for adaptive optimization to reduce drift errors and further ameliorate the impacts of acceleration noise. Experiments show that our proposed method achieves the superior reconstruction performance, exceeding state-of-the-art methods across the board.

HASA: Hybrid Architecture Search with Aggregation Strategy for Echinococcosis Classification and Ovary Segmentation in Ultrasound Images

Different from handcrafted features, deep neural networks can automatically learn task-specific features from data. Due to this data-driven nature, they have achieved remarkable success in various areas. However, manual design and selection of suitable network architectures are time-consuming and require substantial effort of human experts. To address this problem, researchers have proposed neural architecture search (NAS) algorithms which can automatically generate network architectures but suffer from heavy computational cost and instability if searching from scratch. In this paper, we propose a hybrid NAS framework for ultrasound (US) image classification and segmentation. The hybrid framework consists of a pre-trained backbone and several searched cells (i.e., network building blocks), which takes advantage of the strengths of both NAS and the expert knowledge from existing convolutional neural networks. Specifically, two effective and lightweight operations, a mixed depth-wise convolution operator and a squeeze-and-excitation block, are introduced into the candidate operations to enhance the variety and capacity of the searched cells. These two operations not only decrease model parameters but also boost network performance. Moreover, we propose a re-aggregation strategy for the searched cells, aiming to further improve the performance for different vision tasks. We tested our method on two large US image datasets, including a 9-class echinococcosis dataset containing 9566 images for classification and an ovary dataset containing 3204 images for segmentation. Ablation experiments and comparison with other handcrafted or automatically searched architectures demonstrate that our method can generate more powerful and lightweight models for the above US image classification and segmentation tasks.

Sketch guided and progressive growing GAN for realistic and editable ultrasound image synthesis

Ultrasound (US) imaging is widely used for anatomical structure inspection in clinical diagnosis. The training of new sonographers and deep learning based algorithms for US image analysis usually requires a large amount of data. However, obtaining and labeling large-scale US imaging data are not easy tasks, especially for diseases with low incidence. Realistic US image synthesis can alleviate this problem to a great extent. In this paper, we propose a generative adversarial network (GAN) based image synthesis framework. Our main contributions include: 1) we present the first work that can synthesize realistic B-mode US images with high-resolution and customized texture editing features; 2) to enhance structural details of generated images, we propose to introduce auxiliary sketch guidance into a conditional GAN. We superpose the edge sketch onto the object mask and use the composite mask as the network input; 3) to generate high-resolution US images, we adopt a progressive training strategy to gradually generate high-resolution images from low-resolution images. In addition, a feature loss is proposed to minimize the difference of high-level features between the generated and real images, which further improves the quality of generated images; 4) the proposed US image synthesis method is quite universal and can also be generalized to the US images of other anatomical structures besides the three ones tested in our study (lung, hip joint, and ovary); 5) extensive experiments on three large US image datasets are conducted to validate our method. Ablation studies, customized texture editing, user studies, and segmentation tests demonstrate promising results of our method in synthesizing realistic US images.