Development and Characterization of a Chest CT Atlas

A major goal of lung cancer screening is to identify individuals with particular phenotypes that are associated with high risk of cancer. Identifying relevant phenotypes is complicated by the variation in body position and body composition. In the brain, standardized coordinate systems (e.g., atlases) have enabled separate consideration of local features from gross/global structure. To date, no analogous standard atlas has been presented to enable spatial mapping and harmonization in chest computational tomography (CT). In this paper, we propose a thoracic atlas built upon a large low dose CT (LDCT) database of lung cancer screening program. The study cohort includes 466 male and 387 female subjects with no screening detected malignancy (age 46-79 years, mean 64.9 years). To provide spatial mapping, we optimize a multi-stage inter-subject non-rigid registration pipeline for the entire thoracic space. We evaluate the optimized pipeline relative to two baselines with alternative non-rigid registration module: the same software with default parameters and an alternative software. We achieve a significant improvement in terms of registration success rate based on manual QA. For the entire study cohort, the optimized pipeline achieves a registration success rate of 91.7%. The application validity of the developed atlas is evaluated in terms of discriminative capability for different anatomic phenotypes, including body mass index (BMI), chronic obstructive pulmonary disease (COPD), and coronary artery calcification (CAC).

ASIST: Annotation-free synthetic instance segmentation and tracking for microscope video analysis

Instance object segmentation and tracking provide comprehensive quantification of objects across microscope videos. The recent single-stage pixel-embedding based deep learning approach has shown its superior performance compared with "segment-then-associate" two-stage solutions. However, one major limitation of applying a supervised pixel-embedding based method to microscope videos is the resource-intensive manual labeling, which involves tracing hundreds of overlapped objects with their temporal associations across video frames. Inspired by the recent generative adversarial network (GAN) based annotation-free image segmentation, we propose a novel annotation-free synthetic instance segmentation and tracking (ASIST) algorithm for analyzing microscope videos of sub-cellular microvilli. The contributions of this paper are three-fold: (1) proposing a new annotation-free video analysis paradigm is proposed. (2) aggregating the embedding based instance segmentation and tracking with annotation-free synthetic learning as a holistic framework; and (3) to the best of our knowledge, this is first study to investigate microvilli instance segmentation and tracking using embedding based deep learning. From the experimental results, the proposed annotation-free method achieved superior performance compared with supervised learning.

CaCL: Class-aware Codebook Learning for Weakly Supervised Segmentation on Diffuse Image Patterns

Weakly supervised learning has been rapidly advanced in biomedical image analysis to achieve pixel-wise labels (segmentation) from image-wise annotations (classification), as biomedical images naturally contain image-wise labels in many scenarios. The current weakly supervised learning algorithms from the computer vision community are largely designed for focal objects (e.g., dogs and cats). However, such algorithms are not optimized for diffuse patterns in biomedical imaging (e.g., stains and fluorescent in microscopy imaging). In this paper, we propose a novel class-aware codebook learning (CaCL) algorithm to perform weakly supervised learning for diffuse image patterns. Specifically, the CaCL algorithm is deployed to segment protein expressed brush border regions from histological images of human duodenum. This paper makes the following contributions: (1) we approach the weakly supervised segmentation from a novel codebook learning perspective; (2) the CaCL algorithm segments diffuse image patterns rather than focal objects; and (3) The proposed algorithm is implemented in a multi-task framework based on Vector Quantised-Variational AutoEncoder (VQ-VAE) to perform image reconstruction, classification, feature embedding, and segmentation. The experimental results show that our method achieved superior performance compared with baseline weakly supervised algorithms.

GAN based Unsupervised Segmentation: Should We Match the Exact Number of Objects

The unsupervised segmentation is an increasingly popular topic in biomedical image analysis. The basic idea is to approach the supervised segmentation task as an unsupervised synthesis problem, where the intensity images can be transferred to the annotation domain using cycle-consistent adversarial learning. The previous studies have shown that the macro-level (global distribution level) matching on the number of the objects (e.g., cells, tissues, protrusions etc.) between two domains resulted in better segmentation performance. However, no prior studies have exploited whether the unsupervised segmentation performance would be further improved when matching the exact number of objects at micro-level (mini-batch level). In this paper, we propose a deep learning based unsupervised segmentation method for segmenting highly overlapped and dynamic sub-cellular microvilli. With this challenging task, both micro-level and macro-level matching strategies were evaluated. To match the number of objects at the micro-level, the novel fluorescence-based micro-level matching approach was presented. From the experimental results, the micro-level matching did not improve the segmentation performance, compared with the simpler macro-level matching.

Deep Multi-path Network Integrating Incomplete Biomarker and Chest CT Data for Evaluating Lung Cancer Risk

Clinical data elements (CDEs) (e.g., age, smoking history), blood markers and chest computed tomography (CT) structural features have been regarded as effective means for assessing lung cancer risk. These independent variables can provide complementary information and we hypothesize that combining them will improve the prediction accuracy. In practice, not all patients have all these variables available. In this paper, we propose a new network design, termed as multi-path multi-modal missing network (M3Net), to integrate the multi-modal data (i.e., CDEs, biomarker and CT image) considering missing modality with multiple paths neural network. Each path learns discriminative features of one modality, and different modalities are fused in a second stage for an integrated prediction. The network can be trained end-to-end with both medical image features and CDEs/biomarkers, or make a prediction with single modality. We evaluate M3Net with datasets including three sites from the Consortium for Molecular and Cellular Characterization of Screen-Detected Lesions (MCL) project. Our method is cross validated within a cohort of 1291 subjects (383 subjects with complete CDEs/biomarkers and CT images), and externally validated with a cohort of 99 subjects (99 with complete CDEs/biomarkers and CT images). Both cross-validation and external-validation results show that combining multiple modality significantly improves the predicting performance of single modality. The results suggest that integrating subjects with missing either CDEs/biomarker or CT imaging features can contribute to the discriminatory power of our model (p < 0.05, bootstrap two-tailed test). In summary, the proposed M3Net framework provides an effective way to integrate image and non-image data in the context of missing information.

Reliable Liver Fibrosis Assessment from Ultrasound using Global Hetero-Image Fusion and View-Specific Parameterization

Ultrasound (US) is a critical modality for diagnosing liver fibrosis. Unfortunately, assessment is very subjective, motivating automated approaches. We introduce a principled deep convolutional neural network (CNN) workflow that incorporates several innovations. First, to avoid overfitting on non-relevant image features, we force the network to focus on a clinical region of interest (ROI), encompassing the liver parenchyma and upper border. Second, we introduce global heteroimage fusion (GHIF), which allows the CNN to fuse features from any arbitrary number of images in a study, increasing its versatility and flexibility. Finally, we use 'style'-based view-specific parameterization (VSP) to tailor the CNN processing for different viewpoints of the liver, while keeping the majority of parameters the same across views. Experiments on a dataset of 610 patient studies (6979 images) demonstrate that our pipeline can contribute roughly 7% and 22% improvements in partial area under the curve and recall at 90% precision, respectively, over conventional classifiers, validating our approach to this crucial problem.

Faster Mean-shift: GPU-accelerated Embedding-clustering for Cell Segmentation and Tracking

Recently, single-stage embedding based deep learning algorithms gain increasing attention in cell segmentation and tracking. Compared with the traditional "segment-then-associate" two-stage approach, a single-stage algorithm not only simultaneously achieves consistent instance cell segmentation and tracking but also gains superior performance when distinguishing ambiguous pixels on boundaries and overlapped objects. However, the deployment of an embedding based algorithm is restricted by slow inference speed (e.g., around 1-2 mins per frame). In this study, we propose a novel Faster Mean-shift algorithm, which tackles the computational bottleneck of embedding based cell segmentation and tracking. Different from previous GPU-accelerated fast mean-shift algorithms, a new online seed optimization policy (OSOP) is introduced to adaptively determine the minimal number of seeds, accelerate computation, and save GPU memory. With both embedding simulation and empirical validation via the four cohorts from the ISBI cell tracking challenge, the proposed Faster Mean-shift algorithm achieved 7-10 times speedup compared to the state-of-the-art embedding based cell instance segmentation and tracking algorithm. Our Faster Mean-shift algorithm also achieved the highest computational speed compared to other GPU benchmarks with optimized memory consumption. The Faster Mean-shift is a plug-and-play model, which can be employed on other pixel embedding based clustering inference for medical image analysis.

EasierPath: An Open-source Tool for Human-in-the-loop Deep Learning of Renal Pathology

Considerable morphological phenotyping studies in nephrology have emerged in the past few years, aiming to discover hidden regularities between clinical and imaging phenotypes. Such studies have been largely enabled by deep learning based image analysis to extract sparsely located targeting objects (e.g., glomeruli) on high-resolution whole slide images (WSI). However, such methods need to be trained using labor-intensive high-quality annotations, ideally labeled by pathologists. Inspired by the recent "human-in-the-loop" strategy, we developed EasierPath, an open-source tool to integrate human physicians and deep learning algorithms for efficient large-scale pathological image quantification as a loop. Using EasierPath, physicians are able to (1) optimize the recall and precision of deep learning object detection outcomes adaptively, (2) seamlessly support deep learning outcomes refining using either our EasierPath or prevalent ImageScope software without changing physician's user habit, and (3) manage and phenotype each object with user-defined classes. As a user case of EasierPath, we present the procedure of curating large-scale glomeruli in an efficient human-in-the-loop fashion (with two loops). From the experiments, the EasierPath saved 57 % of the annotation efforts to curate 8,833 glomeruli during the second loop. Meanwhile, the average precision of glomerular detection was leveraged from 0.504 to 0.620. The EasierPath software has been released as open-source to enable the large-scale glomerular prototyping. The code can be found in https://github.com/yuankaihuo/EasierPath

Instance Segmentation for Whole Slide Imaging: End-to-End or Detect-Then-Segment

Automatic instance segmentation of glomeruli within kidney Whole Slide Imaging (WSI) is essential for clinical research in renal pathology. In computer vision, the end-to-end instance segmentation methods (e.g., Mask-RCNN) have shown their advantages relative to detect-then-segment approaches by performing complementary detection and segmentation tasks simultaneously. As a result, the end-to-end Mask-RCNN approach has been the de facto standard method in recent glomerular segmentation studies, where downsampling and patch-based techniques are used to properly evaluate the high resolution images from WSI (e.g., >10,000x10,000 pixels on 40x). However, in high resolution WSI, a single glomerulus itself can be more than 1,000x1,000 pixels in original resolution which yields significant information loss when the corresponding features maps are downsampled via the Mask-RCNN pipeline. In this paper, we assess if the end-to-end instance segmentation framework is optimal for high-resolution WSI objects by comparing Mask-RCNN with our proposed detect-then-segment framework. Beyond such a comparison, we also comprehensively evaluate the performance of our detect-then-segment pipeline through: 1) two of the most prevalent segmentation backbones (U-Net and DeepLab_v3); 2) six different image resolutions (from 512x512 to 28x28); and 3) two different color spaces (RGB and LAB). Our detect-then-segment pipeline, with the DeepLab_v3 segmentation framework operating on previously detected glomeruli of 512x512 resolution, achieved a 0.953 dice similarity coefficient (DSC), compared with a 0.902 DSC from the end-to-end Mask-RCNN pipeline. Further, we found that neither RGB nor LAB color spaces yield better performance when compared against each other in the context of a detect-then-segment framework. Detect-then-segment pipeline achieved better segmentation performance compared with End-to-end method.

Harvesting, Detecting, and Characterizing Liver Lesions from Large-scale Multi-phase CT Data via Deep Dynamic Texture Learning

Effective and non-invasive radiological imaging based tumor/lesion characterization (e.g., subtype classification) has long been a major aim in the oncology diagnosis and treatment procedures, with the hope of reducing needs for invasive surgical biopsies. Prior work are generally very restricted to a limited patient sample size, especially using patient studies with confirmed pathological reports as ground truth. In this work, we curate a patient cohort of 1305 dynamic contrast CT studies (i.e., 5220 multi-phase 3D volumes) with pathology confirmed ground truth. A novel fully-automated and multi-stage liver tumor characterization framework is proposed, comprising four steps of tumor proposal detection, tumor harvesting, primary tumor site selection, and deep texture-based characterization. More specifically, (1) we propose a 3D non-isotropic anchor-free lesion detection method; (2) we present and validate the use of multi-phase deep texture learning for precise liver lesion tissue characterization, named spatially adaptive deep texture (SaDT); (3) we leverage small-sized public datasets to semi-automatically curate our large-scale clinical dataset of 1305 patients where four main liver tumor subtypes of primary, secondary, metastasized and benign are presented. Extensive evaluations demonstrate that our new data curation strategy, combined with the SaDT deep dynamic texture analysis, can effectively improve the mean F1 scores by >8.6% compared with baselines, in differentiating four major liver lesion types. This is a significant step towards the clinical goal.