End-to-End Discriminative Deep Network for Liver Lesion Classification

Colorectal liver metastasis is one of most aggressive liver malignancies. While the definition of lesion type based on CT images determines the diagnosis and therapeutic strategy, the discrimination between cancerous and non-cancerous lesions are critical and requires highly skilled expertise, experience and time. In the present work we introduce an end-to-end deep learning approach to assist in the discrimination between liver metastases from colorectal cancer and benign cysts in abdominal CT images of the liver. Our approach incorporates the efficient feature extraction of InceptionV3 combined with residual connections and pre-trained weights from ImageNet. The architecture also includes fully connected classification layers to generate a probabilistic output of lesion type. We use an in-house clinical biobank with 230 liver lesions originating from 63 patients. With an accuracy of 0.96 and a F1-score of 0.92, the results obtained with the proposed approach surpasses state of the art methods. Our work provides the basis for incorporating machine learning tools in specialized radiology software to assist physicians in the early detection and treatment of liver lesions.

The Liver Tumor Segmentation Benchmark (LiTS)

In this work, we report the set-up and results of the Liver Tumor Segmentation Benchmark (LITS) organized in conjunction with the IEEE International Symposium on Biomedical Imaging (ISBI) 2016 and International Conference On Medical Image Computing Computer Assisted Intervention (MICCAI) 2017. Twenty four valid state-of-the-art liver and liver tumor segmentation algorithms were applied to a set of 131 computed tomography (CT) volumes with different types of tumor contrast levels (hyper-/hypo-intense), abnormalities in tissues (metastasectomie) size and varying amount of lesions. The submitted algorithms have been tested on 70 undisclosed volumes. The dataset is created in collaboration with seven hospitals and research institutions and manually reviewed by independent three radiologists. We found that not a single algorithm performed best for liver and tumors. The best liver segmentation algorithm achieved a Dice score of 0.96(MICCAI) whereas for tumor segmentation the best algorithm evaluated at 0.67(ISBI) and 0.70(MICCAI). The LITS image data and manual annotations continue to be publicly available through an online evaluation system as an ongoing benchmarking resource.

Multi-Level Batch Normalization In Deep Networks For Invasive Ductal Carcinoma Cell Discrimination In Histopathology Images

Breast cancer is the most diagnosed cancer and the most predominant cause of death in women worldwide. Imaging techniques such as the breast cancer pathology helps in the diagnosis and monitoring of the disease. However identification of malignant cells can be challenging given the high heterogeneity in tissue absorbotion from staining agents. In this work, we present a novel approach for Invasive Ductal Carcinoma (IDC) cells discrimination in histopathology slides. We propose a model derived from the Inception architecture, proposing a multi-level batch normalization module between each convolutional steps. This module was used as a base block for the feature extraction in a CNN architecture. We used the open IDC dataset in which we obtained a balanced accuracy of 0.89 and an F1 score of 0.90, thus surpassing recent state of the art classification algorithms tested on this public dataset.

Liver lesion segmentation informed by joint liver segmentation

We propose a model for the joint segmentation of the liver and liver lesions in computed tomography (CT) volumes. We build the model from two fully convolutional networks, connected in tandem and trained together end-to-end. We evaluate our approach on the 2017 MICCAI Liver Tumour Segmentation Challenge, attaining competitive liver and liver lesion detection and segmentation scores across a wide range of metrics. Unlike other top performing methods, our model output post-processing is trivial, we do not use data external to the challenge, and we propose a simple single-stage model that is trained end-to-end. However, our method nearly matches the top lesion segmentation performance and achieves the second highest precision for lesion detection while maintaining high recall.

Dilatation of Lateral Ventricles with Brain Volumes in Infants with 3D Transfontanelle US

Ultrasound (US) can be used to assess brain development in newborns, as MRI is challenging due to immobilization issues, and may require sedation. Dilatation of the lateral ventricles in the brain is a risk factor for poorer neurodevelopment outcomes in infants. Hence, 3D US has the ability to assess the volume of the lateral ventricles similar to clinically standard MRI, but manual segmentation is time consuming. The objective of this study is to develop an approach quantifying the ratio of lateral ventricular dilatation with respect to total brain volume using 3D US, which can assess the severity of macrocephaly. Automatic segmentation of the lateral ventricles is achieved with a multi-atlas deformable registration approach using locally linear correlation metrics for US-MRI fusion, followed by a refinement step using deformable mesh models. Total brain volume is estimated using a 3D ellipsoid modeling approach. Validation was performed on a cohort of 12 infants, ranging from 2 to 8.5 months old, where 3D US and MRI were used to compare brain volumes and segmented lateral ventricles. Automatically extracted volumes from 3D US show a high correlation and no statistically significant difference when compared to ground truth measurements. Differences in volume ratios was 6.0 +/- 4.8% compared to MRI, while lateral ventricular segmentation yielded a mean Dice coefficient of 70.8 +/- 3.6% and a mean absolute distance (MAD) of 0.88 +/- 0.2mm, demonstrating the clinical benefit of this tool in paediatric ultrasound.

Spatiotemporal Manifold Prediction Model for Anterior Vertebral Body Growth Modulation Surgery in Idiopathic Scoliosis

Anterior Vertebral Body Growth Modulation (AVBGM) is a minimally invasive surgical technique that gradually corrects spine deformities while preserving lumbar motion. However the selection of potential surgical patients is currently based on clinical judgment and would be facilitated by the identification of patients responding to AVBGM prior to surgery. We introduce a statistical framework for predicting the surgical outcomes following AVBGM in adolescents with idiopathic scoliosis. A discriminant manifold is first constructed to maximize the separation between responsive and non-responsive groups of patients treated with AVBGM for scoliosis. The model then uses subject-specific correction trajectories based on articulated transformations in order to map spine correction profiles to a group-average piecewise-geodesic path. Spine correction trajectories are described in a piecewise-geodesic fashion to account for varying times at follow-up exams, regressing the curve via a quadratic optimization process. To predict the evolution of correction, a baseline reconstruction is projected onto the manifold, from which a spatiotemporal regression model is built from parallel transport curves inferred from neighboring exemplars. The model was trained on 438 reconstructions and tested on 56 subjects using 3D spine reconstructions from follow-up exams, with the probabilistic framework yielding accurate results with differences of 2.1 +/- 0.6deg in main curve angulation, and generating models similar to biomechanical simulations.

On orthogonality and learning recurrent networks with long term dependencies

It is well known that it is challenging to train deep neural networks and recurrent neural networks for tasks that exhibit long term dependencies. The vanishing or exploding gradient problem is a well known issue associated with these challenges. One approach to addressing vanishing and exploding gradients is to use either soft or hard constraints on weight matrices so as to encourage or enforce orthogonality. Orthogonal matrices preserve gradient norm during backpropagation and may therefore be a desirable property. This paper explores issues with optimization convergence, speed and gradient stability when encouraging or enforcing orthogonality. To perform this analysis, we propose a weight matrix factorization and parameterization strategy through which we can bound matrix norms and therein control the degree of expansivity induced during backpropagation. We find that hard constraints on orthogonality can negatively affect the speed of convergence and model performance.

Learning Normalized Inputs for Iterative Estimation in Medical Image Segmentation

In this paper, we introduce a simple, yet powerful pipeline for medical image segmentation that combines Fully Convolutional Networks (FCNs) with Fully Convolutional Residual Networks (FC-ResNets). We propose and examine a design that takes particular advantage of recent advances in the understanding of both Convolutional Neural Networks as well as ResNets. Our approach focuses upon the importance of a trainable pre-processing when using FC-ResNets and we show that a low-capacity FCN model can serve as a pre-processor to normalize medical input data. In our image segmentation pipeline, we use FCNs to obtain normalized images, which are then iteratively refined by means of a FC-ResNet to generate a segmentation prediction. As in other fully convolutional approaches, our pipeline can be used off-the-shelf on different image modalities. We show that using this pipeline, we exhibit state-of-the-art performance on the challenging Electron Microscopy benchmark, when compared to other 2D methods. We improve segmentation results on CT images of liver lesions, when contrasting with standard FCN methods. Moreover, when applying our 2D pipeline on a challenging 3D MRI prostate segmentation challenge we reach results that are competitive even when compared to 3D methods. The obtained results illustrate the strong potential and versatility of the pipeline by achieving highly accurate results on multi-modality images from different anatomical regions and organs.

3D Morphology Prediction of Progressive Spinal Deformities from Probabilistic Modeling of Discriminant Manifolds

We introduce a novel approach for predicting the progression of adolescent idiopathic scoliosis from 3D spine models reconstructed from biplanar X-ray images. Recent progress in machine learning have allowed to improve classification and prognosis rates, but lack a probabilistic framework to measure uncertainty in the data. We propose a discriminative probabilistic manifold embedding where locally linear mappings transform data points from high-dimensional space to corresponding low-dimensional coordinates. A discriminant adjacency matrix is constructed to maximize the separation between progressive and non-progressive groups of patients diagnosed with scoliosis, while minimizing the distance in latent variables belonging to the same class. To predict the evolution of deformation, a baseline reconstruction is projected onto the manifold, from which a spatiotemporal regression model is built from parallel transport curves inferred from neighboring exemplars. Rate of progression is modulated from the spine flexibility and curve magnitude of the 3D spine deformation. The method was tested on 745 reconstructions from 133 subjects using longitudinal 3D reconstructions of the spine, with results demonstrating the discriminatory framework can identify between progressive and non-progressive of scoliotic patients with a classification rate of 81% and prediction differences of 2.1$^{o}$ in main curve angulation, outperforming other manifold learning methods. Our method achieved a higher prediction accuracy and improved the modeling of spatiotemporal morphological changes in highly deformed spines compared to other learning methods.

The Importance of Skip Connections in Biomedical Image Segmentation

In this paper, we study the influence of both long and short skip connections on Fully Convolutional Networks (FCN) for biomedical image segmentation. In standard FCNs, only long skip connections are used to skip features from the contracting path to the expanding path in order to recover spatial information lost during downsampling. We extend FCNs by adding short skip connections, that are similar to the ones introduced in residual networks, in order to build very deep FCNs (of hundreds of layers). A review of the gradient flow confirms that for a very deep FCN it is beneficial to have both long and short skip connections. Finally, we show that a very deep FCN can achieve near-to-state-of-the-art results on the EM dataset without any further post-processing.