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.
Tumor infiltration of the recurrent laryngeal nerve (RLN) is a contraindication for robotic thyroidectomy and can be difficult to detect via standard laryngoscopy. Ultrasound (US) is a viable alternative for RLN detection due to its safety and ability to provide real-time feedback. However, the tininess of the RLN, with a diameter typically less than 3mm, poses significant challenges to the accurate localization of the RLN. In this work, we propose a knowledge-driven framework for RLN localization, mimicking the standard approach surgeons take to identify the RLN according to its surrounding organs. We construct a prior anatomical model based on the inherent relative spatial relationships between organs. Through Bayesian shape alignment (BSA), we obtain the candidate coordinates of the center of a region of interest (ROI) that encloses the RLN. The ROI allows a decreased field of view for determining the refined centroid of the RLN using a dual-path identification network, based on multi-scale semantic information. Experimental results indicate that the proposed method achieves superior hit rates and substantially smaller distance errors compared with state-of-the-art methods.
We learn a deformable registration model for T1-weighted MR images by considering multiple image characteristics via a hybrid loss. Our method registers the OASIS dataset with high accuracy while preserving deformation smoothness.
Nodule segmentation from breast ultrasound images is challenging yet essential for the diagnosis. Weakly-supervised segmentation (WSS) can help reduce time-consuming and cumbersome manual annotation. Unlike existing weakly-supervised approaches, in this study, we propose a novel and general WSS framework called Flip Learning, which only needs the box annotation. Specifically, the target in the label box will be erased gradually to flip the classification tag, and the erased region will be considered as the segmentation result finally. Our contribution is three-fold. First, our proposed approach erases on superpixel level using a Multi-agent Reinforcement Learning framework to exploit the prior boundary knowledge and accelerate the learning process. Second, we design two rewards: classification score and intensity distribution reward, to avoid under- and over-segmentation, respectively. Third, we adopt a coarse-to-fine learning strategy to reduce the residual errors and improve the segmentation performance. Extensively validated on a large dataset, our proposed approach achieves competitive performance and shows great potential to narrow the gap between fully-supervised and weakly-supervised learning.
3D ultrasound (US) has become prevalent due to its rich spatial and diagnostic information not contained in 2D US. Moreover, 3D US can contain multiple standard planes (SPs) in one shot. Thus, automatically localizing SPs in 3D US has the potential to improve user-independence and scanning-efficiency. However, manual SP localization in 3D US is challenging because of the low image quality, huge search space and large anatomical variability. In this work, we propose a novel multi-agent reinforcement learning (MARL) framework to simultaneously localize multiple SPs in 3D US. Our contribution is four-fold. First, our proposed method is general and it can accurately localize multiple SPs in different challenging US datasets. Second, we equip the MARL system with a recurrent neural network (RNN) based collaborative module, which can strengthen the communication among agents and learn the spatial relationship among planes effectively. Third, we explore to adopt the neural architecture search (NAS) to automatically design the network architecture of both the agents and the collaborative module. Last, we believe we are the first to realize automatic SP localization in pelvic US volumes, and note that our approach can handle both normal and abnormal uterus cases. Extensively validated on two challenging datasets of the uterus and fetal brain, our proposed method achieves the average localization accuracy of 7.03 degrees/1.59mm and 9.75 degrees/1.19mm. Experimental results show that our light-weight MARL model has higher accuracy than state-of-the-art methods.
Accurate standard plane (SP) localization is the fundamental step for prenatal ultrasound (US) diagnosis. Typically, dozens of US SPs are collected to determine the clinical diagnosis. 2D US has to perform scanning for each SP, which is time-consuming and operator-dependent. While 3D US containing multiple SPs in one shot has the inherent advantages of less user-dependency and more efficiency. Automatically locating SP in 3D US is very challenging due to the huge search space and large fetal posture variations. Our previous study proposed a deep reinforcement learning (RL) framework with an alignment module and active termination to localize SPs in 3D US automatically. However, termination of agent search in RL is important and affects the practical deployment. In this study, we enhance our previous RL framework with a newly designed adaptive dynamic termination to enable an early stop for the agent searching, saving at most 67% inference time, thus boosting the accuracy and efficiency of the RL framework at the same time. Besides, we validate the effectiveness and generalizability of our algorithm extensively on our in-house multi-organ datasets containing 433 fetal brain volumes, 519 fetal abdomen volumes, and 683 uterus volumes. Our approach achieves localization error of 2.52mm/10.26 degrees, 2.48mm/10.39 degrees, 2.02mm/10.48 degrees, 2.00mm/14.57 degrees, 2.61mm/9.71 degrees, 3.09mm/9.58 degrees, 1.49mm/7.54 degrees for the transcerebellar, transventricular, transthalamic planes in fetal brain, abdominal plane in fetal abdomen, and mid-sagittal, transverse and coronal planes in uterus, respectively. Experimental results show that our method is general and has the potential to improve the efficiency and standardization of US scanning.
Ultrasound (US) image segmentation embraced its significant improvement in deep learning era. However, the lack of sharp boundaries in US images still remains an inherent challenge for segmentation. Previous methods often resort to global context, multi-scale cues or auxiliary guidance to estimate the boundaries. It is hard for these methods to approach pixel-level learning for fine-grained boundary generating. In this paper, we propose a novel and effective framework to improve boundary estimation in US images. Our work has three highlights. First, we propose to formulate the boundary estimation as a rendering task, which can recognize ambiguous points (pixels/voxels) and calibrate the boundary prediction via enriched feature representation learning. Second, we introduce point-wise contrastive learning to enhance the similarity of points from the same class and contrastively decrease the similarity of points from different classes. Boundary ambiguities are therefore further addressed. Third, both rendering and contrastive learning tasks contribute to consistent improvement while reducing network parameters. As a proof-of-concept, we performed validation experiments on a challenging dataset of 86 ovarian US volumes. Results show that our proposed method outperforms state-of-the-art methods and has the potential to be used in clinical practice.
Background and Objective: Biometric measurements of fetal head are important indicators for maternal and fetal health monitoring during pregnancy. 3D ultrasound (US) has unique advantages over 2D scan in covering the whole fetal head and may promote the diagnoses. However, automatically segmenting the whole fetal head in US volumes still pends as an emerging and unsolved problem. The challenges that automated solutions need to tackle include the poor image quality, boundary ambiguity, long-span occlusion, and the appearance variability across different fetal poses and gestational ages. In this paper, we propose the first fully-automated solution to segment the whole fetal head in US volumes. Methods: The segmentation task is firstly formulated as an end-to-end volumetric mapping under an encoder-decoder deep architecture. We then combine the segmentor with a proposed hybrid attention scheme (HAS) to select discriminative features and suppress the non-informative volumetric features in a composite and hierarchical way. With little computation overhead, HAS proves to be effective in addressing boundary ambiguity and deficiency. To enhance the spatial consistency in segmentation, we further organize multiple segmentors in a cascaded fashion to refine the results by revisiting context in the prediction of predecessors. Results: Validated on a large dataset collected from 100 healthy volunteers, our method presents superior segmentation performance (DSC (Dice Similarity Coefficient), 96.05%), remarkable agreements with experts. With another 156 volumes collected from 52 volunteers, we ahieve high reproducibilities (mean standard deviation 11.524 mL) against scan variations. Conclusion: This is the first investigation about whole fetal head segmentation in 3D US. Our method is promising to be a feasible solution in assisting the volumetric US-based prenatal studies.
Fetal cortical plate segmentation is essential in quantitative analysis of fetal brain maturation and cortical folding. Manual segmentation of the cortical plate, or manual refinement of automatic segmentations is tedious and time consuming, and automatic segmentation of the cortical plate is challenged by the relatively low resolution of the reconstructed fetal brain MRI scans compared to the thin structure of the cortical plate, partial voluming, and the wide range of variations in the morphology of the cortical plate as the brain matures during gestation. To reduce the burden of manual refinement of segmentations, we have developed a new and powerful deep learning segmentation method that exploits new deep attentive modules with mixed kernel convolutions within a fully convolutional neural network architecture that utilizes deep supervision and residual connections. Quantitative evaluation based on several performance measures and expert evaluations show that our method outperformed several state-of-the-art deep models for segmentation, as well as a state-of-the-art multi-atlas segmentation technique. In particular, we achieved average Dice similarity coefficient of 0.87, average Hausdroff distance of 0.96mm, and average symmetric surface difference of 0.28mm in cortical plate segmentation on reconstructed fetal brain MRI scans of fetuses scanned in the gestational age range of 16 to 39 weeks. By generating accurate cortical plate segmentations in less than 2 minutes, our method can facilitate and accelerate large-scale studies on normal and altered fetal brain cortical maturation and folding.