Image-Guided Autonomous Guidewire Navigation in Robot-Assisted Endovascular Interventions using Reinforcement Learning

Autonomous robots in endovascular interventions possess the potential to navigate guidewires with safety and reliability, while reducing human error and shortening surgical time. However, current methods of guidewire navigation based on Reinforcement Learning (RL) depend on manual demonstration data or magnetic guidance. In this work, we propose an Image-guided Autonomous Guidewire Navigation (IAGN) method. Specifically, we introduce BDA-star, a path planning algorithm with boundary distance constraints, for the trajectory planning of guidewire navigation. We established an IAGN-RL environment where the observations are real-time guidewire feeding images highlighting the position of the guidewire tip and the planned path. We proposed a reward function based on the distances from both the guidewire tip to the planned path and the target to evaluate the agent's actions. Furthermore, in policy network, we employ a pre-trained convolutional neural network to extract features, mitigating stability issues and slow convergence rates associated with direct learning from raw pixels. Experiments conducted on the aortic simulation IAGN platform demonstrated that the proposed method, targeting the left subclavian artery and the brachiocephalic artery, achieved a 100% guidewire navigation success rate, along with reduced movement and retraction distances and trajectories tend to the center of the vessels.

UDCR: Unsupervised Aortic DSA/CTA Rigid Registration Using Deep Reinforcement Learning and Overlap Degree Calculation

The rigid registration of aortic Digital Subtraction Angiography (DSA) and Computed Tomography Angiography (CTA) can provide 3D anatomical details of the vasculature for the interventional surgical treatment of conditions such as aortic dissection and aortic aneurysms, holding significant value for clinical research. However, the current methods for 2D/3D image registration are dependent on manual annotations or synthetic data, as well as the extraction of landmarks, which is not suitable for cross-modal registration of aortic DSA/CTA. In this paper, we propose an unsupervised method, UDCR, for aortic DSA/CTA rigid registration based on deep reinforcement learning. Leveraging the imaging principles and characteristics of DSA and CTA, we have constructed a cross-dimensional registration environment based on spatial transformations. Specifically, we propose an overlap degree calculation reward function that measures the intensity difference between the foreground and background, aimed at assessing the accuracy of registration between segmentation maps and DSA images. This method is highly flexible, allowing for the loading of pre-trained models to perform registration directly or to seek the optimal spatial transformation parameters through online learning. We manually annotated 61 pairs of aortic DSA/CTA for algorithm evaluation. The results indicate that the proposed UDCR achieved a Mean Absolute Error (MAE) of 2.85 mm in translation and 4.35{\deg} in rotation, showing significant potential for clinical applications.

Gland segmentation via dual encoders and boundary-enhanced attention

Accurate and automated gland segmentation on pathological images can assist pathologists in diagnosing the malignancy of colorectal adenocarcinoma. However, due to various gland shapes, severe deformation of malignant glands, and overlapping adhesions between glands. Gland segmentation has always been very challenging. To address these problems, we propose a DEA model. This model consists of two branches: the backbone encoding and decoding network and the local semantic extraction network. The backbone encoding and decoding network extracts advanced Semantic features, uses the proposed feature decoder to restore feature space information, and then enhances the boundary features of the gland through boundary enhancement attention. The local semantic extraction network uses the pre-trained DeepLabv3+ as a Local semantic-guided encoder to realize the extraction of edge features. Experimental results on two public datasets, GlaS and CRAG, confirm that the performance of our method is better than other gland segmentation methods.

Rethinking Mitosis Detection: Towards Diverse Data and Feature Representation

Mitosis detection is one of the fundamental tasks in computational pathology, which is extremely challenging due to the heterogeneity of mitotic cell. Most of the current studies solve the heterogeneity in the technical aspect by increasing the model complexity. However, lacking consideration of the biological knowledge and the complex model design may lead to the overfitting problem while limited the generalizability of the detection model. In this paper, we systematically study the morphological appearances in different mitotic phases as well as the ambiguous non-mitotic cells and identify that balancing the data and feature diversity can achieve better generalizability. Based on this observation, we propose a novel generalizable framework (MitDet) for mitosis detection. The data diversity is considered by the proposed diversity-guided sample balancing (DGSB). And the feature diversity is preserved by inter- and intra- class feature diversity-preserved module (InCDP). Stain enhancement (SE) module is introduced to enhance the domain-relevant diversity of both data and features simultaneously. Extensive experiments have demonstrated that our proposed model outperforms all the SOTA approaches in several popular mitosis detection datasets in both internal and external test sets using minimal annotation efforts with point annotations only. Comprehensive ablation studies have also proven the effectiveness of the rethinking of data and feature diversity balancing. By analyzing the results quantitatively and qualitatively, we believe that our proposed model not only achieves SOTA performance but also might inspire the future studies in new perspectives. Source code is at https://github.com/Onehour0108/MitDet.

DIAS: A Comprehensive Benchmark for DSA-sequence Intracranial Artery Segmentation

Automatic segmentation of the intracranial artery (IA) in digital subtraction angiography (DSA) sequence is an essential step in diagnosing IA-related diseases and guiding neuro-interventional surgery. However, the lack of publicly available datasets has impeded research in this area. In this paper, we release DIAS, an IA segmentation dataset, consisting of 120 DSA sequences from intracranial interventional therapy. In addition to pixel-wise annotations, this dataset provides two types of scribble annotations for weakly supervised IA segmentation research. We present a comprehensive benchmark for evaluating the performance of this challenging dataset by utilizing fully-, weakly-, and semi-supervised learning approaches. Specifically, we propose a method that incorporates a dimensionality reduction module into a 2D/3D model to achieve vessel segmentation in DSA sequences. For weakly-supervised learning, we propose a scribble learning-based image segmentation framework, SSCR, which comprises scribble supervision and consistency regularization. Furthermore, we introduce a random patch-based self-training framework that utilizes unlabeled DSA sequences to improve segmentation performance. Our extensive experiments on the DIAS dataset demonstrate the effectiveness of these methods as potential baselines for future research and clinical applications.

CoNIC Challenge: Pushing the Frontiers of Nuclear Detection, Segmentation, Classification and Counting

Nuclear detection, segmentation and morphometric profiling are essential in helping us further understand the relationship between histology and patient outcome. To drive innovation in this area, we setup a community-wide challenge using the largest available dataset of its kind to assess nuclear segmentation and cellular composition. Our challenge, named CoNIC, stimulated the development of reproducible algorithms for cellular recognition with real-time result inspection on public leaderboards. We conducted an extensive post-challenge analysis based on the top-performing models using 1,658 whole-slide images of colon tissue. With around 700 million detected nuclei per model, associated features were used for dysplasia grading and survival analysis, where we demonstrated that the challenge's improvement over the previous state-of-the-art led to significant boosts in downstream performance. Our findings also suggest that eosinophils and neutrophils play an important role in the tumour microevironment. We release challenge models and WSI-level results to foster the development of further methods for biomarker discovery.

A novel dataset and a two-stage mitosis nuclei detection method based on hybrid anchor branch

Mitosis detection is one of the challenging problems in computational pathology, and mitotic count is an important index of cancer grading for pathologists. However, current counts of mitotic nuclei rely on pathologists looking microscopically at the number of mitotic nuclei in hot spots, which is subjective and time-consuming. In this paper, we propose a two-stage cascaded network, named FoCasNet, for mitosis detection. In the first stage, a detection network named M_det is proposed to detect as many mitoses as possible. In the second stage, a classification network M_class is proposed to refine the results of the first stage. In addition, the attention mechanism, normalization method, and hybrid anchor branch classification subnet are introduced to improve the overall detection performance. Our method achieves the current highest F1-score of 0.888 on the public dataset ICPR 2012. We also evaluated our method on the GZMH dataset released by our research team for the first time and reached the highest F1-score of 0.563, which is also better than multiple classic detection networks widely used at present. It confirmed the effectiveness and generalization of our method. The code will be available at: https://github.com/antifen/mitosis-nuclei-detection.

A Novel Dataset and a Deep Learning Method for Mitosis Nuclei Segmentation and Classification

Mitosis nuclei count is one of the important indicators for the pathological diagnosis of breast cancer. The manual annotation needs experienced pathologists, which is very time-consuming and inefficient. With the development of deep learning methods, some models with good performance have emerged, but the generalization ability should be further strengthened. In this paper, we propose a two-stage mitosis segmentation and classification method, named SCMitosis. Firstly, the segmentation performance with a high recall rate is achieved by the proposed depthwise separable convolution residual block and channel-spatial attention gate. Then, a classification network is cascaded to further improve the detection performance of mitosis nuclei. The proposed model is verified on the ICPR 2012 dataset, and the highest F-score value of 0.8687 is obtained compared with the current state-of-the-art algorithms. In addition, the model also achieves good performance on GZMH dataset, which is prepared by our group and will be firstly released with the publication of this paper. The code will be available at: https://github.com/antifen/mitosis-nuclei-segmentation.

CKD-TransBTS: Clinical Knowledge-Driven Hybrid Transformer with Modality-Correlated Cross-Attention for Brain Tumor Segmentation

Brain tumor segmentation (BTS) in magnetic resonance image (MRI) is crucial for brain tumor diagnosis, cancer management and research purposes. With the great success of the ten-year BraTS challenges as well as the advances of CNN and Transformer algorithms, a lot of outstanding BTS models have been proposed to tackle the difficulties of BTS in different technical aspects. However, existing studies hardly consider how to fuse the multi-modality images in a reasonable manner. In this paper, we leverage the clinical knowledge of how radiologists diagnose brain tumors from multiple MRI modalities and propose a clinical knowledge-driven brain tumor segmentation model, called CKD-TransBTS. Instead of directly concatenating all the modalities, we re-organize the input modalities by separating them into two groups according to the imaging principle of MRI. A dual-branch hybrid encoder with the proposed modality-correlated cross-attention block (MCCA) is designed to extract the multi-modality image features. The proposed model inherits the strengths from both Transformer and CNN with the local feature representation ability for precise lesion boundaries and long-range feature extraction for 3D volumetric images. To bridge the gap between Transformer and CNN features, we propose a Trans&CNN Feature Calibration block (TCFC) in the decoder. We compare the proposed model with five CNN-based models and six transformer-based models on the BraTS 2021 challenge dataset. Extensive experiments demonstrate that the proposed model achieves state-of-the-art brain tumor segmentation performance compared with all the competitors.

HoVer-Trans: Anatomy-aware HoVer-Transformer for ROI-free Breast Cancer Diagnosis in Ultrasound Images

Ultrasonography is an important routine examination for breast cancer diagnosis, due to its non-invasive, radiation-free and low-cost properties. However, it is still not the first-line screening test for breast cancer due to its inherent limitations. It would be a tremendous success if we can precisely diagnose breast cancer by breast ultrasound images (BUS). Many learning-based computer-aided diagnostic methods have been proposed to achieve breast cancer diagnosis/lesion classification. However, most of them require a pre-define ROI and then classify the lesion inside the ROI. Conventional classification backbones, such as VGG16 and ResNet50, can achieve promising classification results with no ROI requirement. But these models lack interpretability, thus restricting their use in clinical practice. In this study, we propose a novel ROI-free model for breast cancer diagnosis in ultrasound images with interpretable feature representations. We leverage the anatomical prior knowledge that malignant and benign tumors have different spatial relationships between different tissue layers, and propose a HoVer-Transformer to formulate this prior knowledge. The proposed HoVer-Trans block extracts the inter- and intra-layer spatial information horizontally and vertically. We conduct and release an open dataset GDPH&GYFYY for breast cancer diagnosis in BUS. The proposed model is evaluated in three datasets by comparing with four CNN-based models and two vision transformer models via a five-fold cross validation. It achieves state-of-the-art classification performance with the best model interpretability.