Detecting Pancreatic Adenocarcinoma in Multi-phase CT Scans via Alignment Ensemble

Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers among population. Screening for PDACs in dynamic contrast-enhanced CT is beneficial for early diagnose. In this paper, we investigate the problem of automated detecting PDACs in multi-phase (arterial and venous) CT scans. Multiple phases provide more information than single phase, but they are unaligned and inhomogeneous in texture, making it difficult to combine cross-phase information seamlessly. We study multiple phase alignment strategies, i.e., early alignment (image registration), late alignment (high-level feature registration) and slow alignment (multi-level feature registration), and suggest an ensemble of all these alignments as a promising way to boost the performance of PDAC detection. We provide an extensive empirical evaluation on two PDAC datasets and show that the proposed alignment ensemble significantly outperforms previous state-of-the-art approaches, illustrating strong potential for clinical use.

CAKES: Channel-wise Automatic KErnel Shrinking for Efficient 3D Network

3D Convolution Neural Networks (CNNs) have been widely applied to 3D scene understanding, such as video analysis and volumetric image recognition. However, 3D networks can easily lead to over-parameterization which incurs expensive computation cost. In this paper, we propose Channel-wise Automatic KErnel Shrinking (CAKES), to enable efficient 3D learning by shrinking standard 3D convolutions into a set of economic operations (e.g., 1D, 2D convolutions). Unlike previous methods, our proposed CAKES performs channel-wise kernel shrinkage, which enjoys the following benefits: 1) encouraging operations deployed in every layer to be heterogeneous, so that they can extract diverse and complementary information to benefit the learning process; and 2) allowing for an efficient and flexible replacement design, which can be generalized to both spatial-temporal and volumetric data. Together with a neural architecture search framework, by applying CAKES to 3D C2FNAS and ResNet50, we achieve the state-of-the-art performance with much fewer parameters and computational costs on both 3D medical imaging segmentation and video action recognition.

Deep Distance Transform for Tubular Structure Segmentation in CT Scans

Tubular structure segmentation in medical images, e.g., segmenting vessels in CT scans, serves as a vital step in the use of computers to aid in screening early stages of related diseases. But automatic tubular structure segmentation in CT scans is a challenging problem, due to issues such as poor contrast, noise and complicated background. A tubular structure usually has a cylinder-like shape which can be well represented by its skeleton and cross-sectional radii (scales). Inspired by this, we propose a geometry-aware tubular structure segmentation method, Deep Distance Transform (DDT), which combines intuitions from the classical distance transform for skeletonization and modern deep segmentation networks. DDT first learns a multi-task network to predict a segmentation mask for a tubular structure and a distance map. Each value in the map represents the distance from each tubular structure voxel to the tubular structure surface. Then the segmentation mask is refined by leveraging the shape prior reconstructed from the distance map. We apply our DDT on six medical image datasets. The experiments show that (1) DDT can boost tubular structure segmentation performance significantly (e.g., over 13% improvement measured by DSC for pancreatic duct segmentation), and (2) DDT additionally provides a geometrical measurement for a tubular structure, which is important for clinical diagnosis (e.g., the cross-sectional scale of a pancreatic duct can be an indicator for pancreatic cancer).

UPC: Learning Universal Physical Camouflage Attacks on Object Detectors

In this paper, we study physical adversarial attacks on object detectors in the wild. Prior arts on this matter mostly craft instance-dependent perturbations only for rigid and planar objects. To this end, we propose to learn an adversarial pattern to effectively attack all instances belonging to the same object category (e.g., person, car), referred to as Universal Physical Camouflage Attack (UPC). Concretely, UPC crafts camouflage by jointly fooling the region proposal network, as well as misleading the classifier and the regressor to output errors. In order to make UPC effective for articulated non-rigid or non-planar objects, we introduce a set of transformations for the generated camouflage patterns to mimic their deformable properties. We additionally impose optimization constraint to make generated patterns look natural for human observers. To fairly evaluate the effectiveness of different physical-world attacks on object detectors, we present the first standardized virtual database, AttackScenes, which simulates the real 3D world in a controllable and reproducible environment. Extensive experiments suggest the superiority of our proposed UPC compared with existing physical adversarial attackers not only in virtual environments (AttackScenes), but also in real-world physical environments. Codes, models, and demos are publicly available at https://mesunhlf.github.io/index_physical.html.

Hyper-Pairing Network for Multi-Phase Pancreatic Ductal Adenocarcinoma Segmentation

Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers with an overall five-year survival rate of 8%. Due to subtle texture changes of PDAC, pancreatic dual-phase imaging is recommended for better diagnosis of pancreatic disease. In this study, we aim at enhancing PDAC automatic segmentation by integrating multi-phase information (i.e., arterial phase and venous phase). To this end, we present Hyper-Pairing Network (HPN), a 3D fully convolution neural network which effectively integrates information from different phases. The proposed approach consists of a dual path network where the two parallel streams are interconnected with hyper-connections for intensive information exchange. Additionally, a pairing loss is added to encourage the commonality between high-level feature representations of different phases. Compared to prior arts which use single phase data, HPN reports a significant improvement up to 7.73% (from 56.21% to 63.94%) in terms of DSC.

FusionNet: Incorporating Shape and Texture for Abnormality Detection in 3D Abdominal CT Scans

Automatic abnormality detection in abdominal CT scans can help doctors improve the accuracy and efficiency in diagnosis. In this paper we aim at detecting pancreatic ductal adenocarcinoma (PDAC), the most common pancreatic cancer. Taking the fact that the existence of tumor can affect both the shape and the texture of pancreas, we design a system to extract the shape and texture feature at the same time for detecting PDAC. In this paper we propose a two-stage method for this 3D classification task. First, we segment the pancreas into a binary mask. Second, a FusionNet is proposed to take both the binary mask and CT image as input and perform a binary classification. The optimal architecture of the FusionNet is obtained by searching a pre-defined functional space. We show that the classification results using either shape or texture information are complementary, and by fusing them with the optimized architecture, the performance improves by a large margin. Our method achieves a specificity of 97% and a sensitivity of 92% on 200 normal scans and 136 scans with PDAC.

Multi-Scale Attentional Network for Multi-Focal Segmentation of Active Bleed after Pelvic Fractures

Trauma is the worldwide leading cause of death and disability in those younger than 45 years, and pelvic fractures are a major source of morbidity and mortality. Automated segmentation of multiple foci of arterial bleeding from abdominopelvic trauma CT could provide rapid objective measurements of the total extent of active bleeding, potentially augmenting outcome prediction at the point of care, while improving patient triage, allocation of appropriate resources, and time to definitive intervention. In spite of the importance of active bleeding in the quick tempo of trauma care, the task is still quite challenging due to the variable contrast, intensity, location, size, shape, and multiplicity of bleeding foci. Existing work [4] presents a heuristic rule-based segmentation technique which requires multiple stages and cannot be efficiently optimized end-to-end. To this end, we present, Multi-Scale Attentional Network (MSAN), the first yet reliable end-to-end network, for automated segmentation of active hemorrhage from contrast-enhanced trauma CT scans. MSAN consists of the following components: 1) an encoder which fully integrates the global contextual information from holistic 2D slices; 2) a multi-scale strategy applied both in the training stage and the inference stage to handle the challenges induced by variation of target sizes; 3) an attentional module to further refine the deep features, leading to better segmentation quality; and 4) a multi-view mechanism to fully leverage the 3D information. Our MSAN reports a significant improvement of more than 7% compared to prior arts in terms of DSC.

Prior-aware Neural Network for Partially-Supervised Multi-Organ Segmentation

Accurate multi-organ abdominal CT segmentation is essential to many clinical applications such as computer-aided intervention. As data annotation requires massive human labor from experienced radiologists, it is common that training data are partially labeled, e.g., pancreas datasets only have the pancreas labeled while leaving the rest marked as background. However, these background labels can be misleading in multi-organ segmentation since the "background" usually contains some other organs of interest. To address the background ambiguity in these partially-labeled datasets, we propose Prior-aware Neural Network (PaNN) via explicitly incorporating anatomical priors on abdominal organ sizes, guiding the training process with domain-specific knowledge. More specifically, PaNN assumes that the average organ size distributions in the abdomen should approximate their empirical distributions, a prior statistics obtained from the fully-labeled dataset. As our training objective is difficult to be directly optimized using stochastic gradient descent [20], we propose to reformulate it in a min-max form and optimize it via the stochastic primal-dual gradient algorithm. PaNN achieves state-of-the-art performance on the MICCAI2015 challenge "Multi-Atlas Labeling Beyond the Cranial Vault", a competition on organ segmentation in the abdomen. We report an average Dice score of 84.97%, surpassing the prior art by a large margin of 3.27%.