Physics Driven Domain Specific Transporter Framework with Attention Mechanism for Ultrasound Imaging

Most applications of deep learning techniques in medical imaging are supervised and require a large number of labeled data which is expensive and requires many hours of careful annotation by experts. In this paper, we propose an unsupervised, physics driven domain specific transporter framework with an attention mechanism to identify relevant key points with applications in ultrasound imaging. The proposed framework identifies key points that provide a concise geometric representation highlighting regions with high structural variation in ultrasound videos. We incorporate physics driven domain specific information as a feature probability map and use the radon transform to highlight features in specific orientations. The proposed framework has been trained on130 Lung ultrasound (LUS) videos and 113 Wrist ultrasound (WUS) videos and validated on 100 Lung ultrasound (LUS) videos and 58 Wrist ultrasound (WUS) videos acquired from multiple centers across the globe. Images from both datasets were independently assessed by experts to identify clinically relevant features such as A-lines, B-lines and pleura from LUS and radial metaphysis, radial epiphysis and carpal bones from WUS videos. The key points detected from both datasets showed high sensitivity (LUS = 99\% , WUS = 74\%) in detecting the image landmarks identified by experts. Also, on employing for classification of the given lung image into normal and abnormal classes, the proposed approach, even with no prior training, achieved an average accuracy of 97\% and an average F1-score of 95\% respectively on the task of co-classification with 3 fold cross-validation. With the purely unsupervised nature of the proposed approach, we expect the key point detection approach to increase the applicability of ultrasound in various examination performed in emergency and point of care.

Unsupervised multi-latent space reinforcement learning framework for video summarization in ultrasound imaging

The COVID-19 pandemic has highlighted the need for a tool to speed up triage in ultrasound scans and provide clinicians with fast access to relevant information. The proposed video-summarization technique is a step in this direction that provides clinicians access to relevant key-frames from a given ultrasound scan (such as lung ultrasound) while reducing resource, storage and bandwidth requirements. We propose a new unsupervised reinforcement learning (RL) framework with novel rewards that facilitates unsupervised learning avoiding tedious and impractical manual labelling for summarizing ultrasound videos to enhance its utility as a triage tool in the emergency department (ED) and for use in telemedicine. Using an attention ensemble of encoders, the high dimensional image is projected into a low dimensional latent space in terms of: a) reduced distance with a normal or abnormal class (classifier encoder), b) following a topology of landmarks (segmentation encoder), and c) the distance or topology agnostic latent representation (convolutional autoencoders). The decoder is implemented using a bi-directional long-short term memory (Bi-LSTM) which utilizes the latent space representation from the encoder. Our new paradigm for video summarization is capable of delivering classification labels and segmentation of key landmarks for each of the summarized keyframes. Validation is performed on lung ultrasound (LUS) dataset, that typically represent potential use cases in telemedicine and ED triage acquired from different medical centers across geographies (India, Spain and Canada).

Learning the Imaging Landmarks: Unsupervised Key point Detection in Lung Ultrasound Videos

Lung ultrasound (LUS) is an increasingly popular diagnostic imaging modality for continuous and periodic monitoring of lung infection, given its advantages of non-invasiveness, non-ionizing nature, portability and easy disinfection. The major landmarks assessed by clinicians for triaging using LUS are pleura, A and B lines. There have been many efforts for the automatic detection of these landmarks. However, restricting to a few pre-defined landmarks may not reveal the actual imaging biomarkers particularly in case of new pathologies like COVID-19. Rather, the identification of key landmarks should be driven by data given the availability of a plethora of neural network algorithms. This work is a first of its kind attempt towards unsupervised detection of the key LUS landmarks in LUS videos of COVID-19 subjects during various stages of infection. We adapted the relatively newer approach of transporter neural networks to automatically mark and track pleura, A and B lines based on their periodic motion and relatively stable appearance in the videos. Initial results on unsupervised pleura detection show an accuracy of 91.8% employing 1081 LUS video frames.