Under the global COVID-19 crisis, accurate diagnosis of COVID-19 from Chest X-ray (CXR) images is critical. To reduce intra- and inter-observer variability, during the radiological assessment, computer-aided diagnostic tools have been utilized to supplement medical decision-making and subsequent disease management. Computational methods with high accuracy and robustness are required for rapid triaging of patients and aiding radiologists in the interpretation of the collected data. In this study, we propose a novel multi-feature fusion network using parallel attention blocks to fuse the original CXR images and local-phase feature-enhanced CXR images at multi-scales. We examine our model on various COVID-19 datasets acquired from different organizations to assess the generalization ability. Our experiments demonstrate that our method achieves state-of-art performance and has improved generalization capability, which is crucial for widespread deployment.
* Machine.Learning.for.Biomedical.Imaging. 2 (2023) * Accepted for publication at the Journal of Machine Learning for
Biomedical Imaging (MELBA) https://melba-journal.org/2023:008
Collective insights from a group of experts have always proven to outperform an individual's best diagnostic for clinical tasks. For the task of medical image segmentation, existing research on AI-based alternatives focuses more on developing models that can imitate the best individual rather than harnessing the power of expert groups. In this paper, we introduce a single diffusion model-based approach that produces multiple plausible outputs by learning a distribution over group insights. Our proposed model generates a distribution of segmentation masks by leveraging the inherent stochastic sampling process of diffusion using only minimal additional learning. We demonstrate on three different medical image modalities- CT, ultrasound, and MRI that our model is capable of producing several possible variants while capturing the frequencies of their occurrences. Comprehensive results show that our proposed approach outperforms existing state-of-the-art ambiguous segmentation networks in terms of accuracy while preserving naturally occurring variation. We also propose a new metric to evaluate the diversity as well as the accuracy of segmentation predictions that aligns with the interest of clinical practice of collective insights.
Endometriosis is a non-malignant disorder that affects 176 million women globally. Diagnostic delays result in severe dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. Therefore, there is a significant need to diagnose patients at an early stage. Our objective in this work is to investigate the potential of deep learning methods to classify endometriosis from ultrasound data. Retrospective data from 100 subjects were collected at the Rutgers Robert Wood Johnson University Hospital (New Brunswick, NJ, USA). Endometriosis was diagnosed via laparoscopy or laparotomy. We designed and trained five different deep learning methods (Xception, Inception-V4, ResNet50, DenseNet, and EfficientNetB2) for the classification of endometriosis from ultrasound data. Using 5-fold cross-validation study we achieved an average area under the receiver operator curve (AUC) of 0.85 and 0.90 respectively for the two evaluation studies.
* Accepted to 2023 SPIE Medical Imaging Conference
Denoising diffusion models, a class of generative models, have garnered immense interest lately in various deep-learning problems. A diffusion probabilistic model defines a forward diffusion stage where the input data is gradually perturbed over several steps by adding Gaussian noise and then learns to reverse the diffusion process to retrieve the desired noise-free data from noisy data samples. Diffusion models are widely appreciated for their strong mode coverage and quality of the generated samples despite their known computational burdens. Capitalizing on the advances in computer vision, the field of medical imaging has also observed a growing interest in diffusion models. To help the researcher navigate this profusion, this survey intends to provide a comprehensive overview of diffusion models in the discipline of medical image analysis. Specifically, we introduce the solid theoretical foundation and fundamental concepts behind diffusion models and the three generic diffusion modelling frameworks: diffusion probabilistic models, noise-conditioned score networks, and stochastic differential equations. Then, we provide a systematic taxonomy of diffusion models in the medical domain and propose a multi-perspective categorization based on their application, imaging modality, organ of interest, and algorithms. To this end, we cover extensive applications of diffusion models in the medical domain. Furthermore, we emphasize the practical use case of some selected approaches, and then we discuss the limitations of the diffusion models in the medical domain and propose several directions to fulfill the demands of this field. Finally, we gather the overviewed studies with their available open-source implementations at https://github.com/amirhossein-kz/Awesome-Diffusion-Models-in-Medical-Imaging.
The role of chest X-ray (CXR) imaging, due to being more cost-effective, widely available, and having a faster acquisition time compared to CT, has evolved during the COVID-19 pandemic. To improve the diagnostic performance of CXR imaging a growing number of studies have investigated whether supervised deep learning methods can provide additional support. However, supervised methods rely on a large number of labeled radiology images, which is a time-consuming and complex procedure requiring expert clinician input. Due to the relative scarcity of COVID-19 patient data and the costly labeling process, self-supervised learning methods have gained momentum and has been proposed achieving comparable results to fully supervised learning approaches. In this work, we study the effectiveness of self-supervised learning in the context of diagnosing COVID-19 disease from CXR images. We propose a multi-feature Vision Transformer (ViT) guided architecture where we deploy a cross-attention mechanism to learn information from both original CXR images and corresponding enhanced local phase CXR images. We demonstrate the performance of the baseline self-supervised learning models can be further improved by leveraging the local phase-based enhanced CXR images. By using 10\% labeled CXR scans, the proposed model achieves 91.10\% and 96.21\% overall accuracy tested on total 35,483 CXR images of healthy (8,851), regular pneumonia (6,045), and COVID-19 (18,159) scans and shows significant improvement over state-of-the-art techniques. Code is available https://github.com/endiqq/Multi-Feature-ViT
* Accepted to the 2022 MICCAI Workshop on Medical Image Learning with
Limited and Noisy Data
Due to imaging artifacts and low signal-to-noise ratio in ultrasound images, automatic bone surface segmentation networks often produce fragmented predictions that can hinder the success of ultrasound-guided computer-assisted surgical procedures. Existing pixel-wise predictions often fail to capture the accurate topology of bone tissues due to a lack of supervision to enforce connectivity. In this work, we propose an orientation-guided graph convolutional network to improve connectivity while segmenting the bone surface. We also propose an additional supervision on the orientation of the bone surface to further impose connectivity. We validated our approach on 1042 vivo US scans of femur, knee, spine, and distal radius. Our approach improves over the state-of-the-art methods by 5.01% in connectivity metric.
Segmenting both bone surface and the corresponding acoustic shadow are fundamental tasks in ultrasound (US) guided orthopedic procedures. However, these tasks are challenging due to minimal and blurred bone surface response in US images, cross-machine discrepancy, imaging artifacts, and low signal-to-noise ratio. Notably, bone shadows are caused by a significant acoustic impedance mismatch between the soft tissue and bone surfaces. To leverage this mutual information between these highly related tasks, we propose a single end-to-end network with a shared transformer-based encoder and task independent decoders for simultaneous bone and shadow segmentation. To share complementary features, we propose a cross task feature transfer block which learns to transfer meaningful features from decoder of shadow segmentation to that of bone segmentation and vice-versa. We also introduce a correspondence consistency loss which makes sure that network utilizes the inter-dependency between the bone surface and its corresponding shadow to refine the segmentation. Validation against expert annotations shows that the method outperforms the previous state-of-the-art for both bone surface and shadow segmentation.
With the success of deep learning-based methods applied in medical image analysis, convolutional neural networks (CNNs) have been investigated for classifying liver disease from ultrasound (US) data. However, the scarcity of available large-scale labeled US data has hindered the success of CNNs for classifying liver disease from US data. In this work, we propose a novel generative adversarial network (GAN) architecture for realistic diseased and healthy liver US image synthesis. We adopt the concept of stacking to synthesize realistic liver US data. Quantitative and qualitative evaluation is performed on 550 in-vivo B-mode liver US images collected from 55 subjects. We also show that the synthesized images, together with real in vivo data, can be used to significantly improve the performance of traditional CNN architectures for Nonalcoholic fatty liver disease (NAFLD) classification.
* Accepted for presentation at the 2021 MICCAI-International Workshop
of Advances in Simplifying Medical UltraSound (ASMUS2021)
Computed tomography (CT) and chest X-ray (CXR) have been the two dominant imaging modalities deployed for improved management of Coronavirus disease 2019 (COVID-19). Due to faster imaging, less radiation exposure, and being cost-effective CXR is preferred over CT. However, the interpretation of CXR images, compared to CT, is more challenging due to low image resolution and COVID-19 image features being similar to regular pneumonia. Computer-aided diagnosis via deep learning has been investigated to help mitigate these problems and help clinicians during the decision-making process. The requirement for a large amount of labeled data is one of the major problems of deep learning methods when deployed in the medical domain. To provide a solution to this, in this work, we propose a semi-supervised learning (SSL) approach using minimal data for training. We integrate local-phase CXR image features into a multi-feature convolutional neural network architecture where the training of SSL method is obtained with a teacher/student paradigm. Quantitative evaluation is performed on 8,851 normal (healthy), 6,045 pneumonia, and 3,795 COVID-19 CXR scans. By only using 7.06% labeled and 16.48% unlabeled data for training, 5.53% for validation, our method achieves 93.61\% mean accuracy on a large-scale (70.93%) test data. We provide comparison results against fully supervised and SSL methods. Code: https://github.com/endiqq/Multi-Feature-Semi-Supervised-Learning-for-COVID-19-CXR-Images