Estimating the uncertainty of deep learning models in a reliable and efficient way has remained an open problem, where many different solutions have been proposed in the literature. Most common methods are based on Bayesian approximations, like Monte Carlo dropout (MCDO) or Deep ensembling (DE), but they have a high inference time (i.e. require multiple inference passes) and might not work for out-of-distribution detection (OOD) data (i.e. similar uncertainty for in-distribution (ID) and OOD). In safety critical environments, like medical applications, accurate and fast uncertainty estimation methods, able to detect OOD data, are crucial, since wrong predictions can jeopardize patients safety. In this study, we present an alternative direct uncertainty estimation method and apply it for a regression U-Net architecture. The method consists in the addition of a branch from the bottleneck which reconstructs the input. The input reconstruction error can be used as a surrogate of the model uncertainty. For the proof-of-concept, our method is applied to proton therapy dose prediction in head and neck cancer patients. Accuracy, time-gain, and OOD detection are analyzed for our method in this particular application and compared with the popular MCDO and DE. The input reconstruction method showed a higher Pearson correlation coefficient with the prediction error (0.620) than DE and MCDO (between 0.447 and 0.612). Moreover, our method allows an easier identification of OOD (Z-score of 34.05). It estimates the uncertainty simultaneously to the regression task, therefore requires less time or computational resources.
Breast cancer (BC) significantly contributes to cancer-related mortality in women, underscoring the criticality of early detection for optimal patient outcomes. A mammography is a key tool for identifying and diagnosing breast abnormalities; however, accurately distinguishing malignant mass lesions remains challenging. To address this issue, we propose a novel deep learning approach for BC screening utilizing mammography images. Our proposed model comprises three distinct stages: data collection from established benchmark sources, image segmentation employing an Atrous Convolution-based Attentive and Adaptive Trans-Res-UNet (ACA-ATRUNet) architecture, and BC identification via an Atrous Convolution-based Attentive and Adaptive Multi-scale DenseNet (ACA-AMDN) model. The hyperparameters within the ACA-ATRUNet and ACA-AMDN models are optimised using the Modified Mussel Length-based Eurasian Oystercatcher Optimization (MML-EOO) algorithm. Performance evaluation, leveraging multiple metrics, is conducted, and a comparative analysis against conventional methods is presented. Our experimental findings reveal that the proposed BC detection framework attains superior precision rates in early disease detection, demonstrating its potential to enhance mammography-based screening methodologies.
This study focuses on comparing deep learning methods for the segmentation and quantification of uncertainty in prostate segmentation from MRI images. The aim is to improve the workflow of prostate cancer detection and diagnosis. Seven different U-Net-based architectures, augmented with Monte-Carlo dropout, are evaluated for automatic segmentation of the central zone, peripheral zone, transition zone, and tumor, with uncertainty estimation. The top-performing model in this study is the Attention R2U-Net, achieving a mean Intersection over Union (IoU) of 76.3% and Dice Similarity Coefficient (DSC) of 85% for segmenting all zones. Additionally, Attention R2U-Net exhibits the lowest uncertainty values, particularly in the boundaries of the transition zone and tumor, when compared to the other models.
Despite recent medical advancements, breast cancer remains one of the most prevalent and deadly diseases among women. Although machine learning-based Computer-Aided Diagnosis (CAD) systems have shown potential to assist radiologists in analyzing medical images, the opaque nature of the best-performing CAD systems has raised concerns about their trustworthiness and interpretability. This paper proposes MT-BI-RADS, a novel explainable deep learning approach for tumor detection in Breast Ultrasound (BUS) images. The approach offers three levels of explanations to enable radiologists to comprehend the decision-making process in predicting tumor malignancy. Firstly, the proposed model outputs the BI-RADS categories used for BUS image analysis by radiologists. Secondly, the model employs multi-task learning to concurrently segment regions in images that correspond to tumors. Thirdly, the proposed approach outputs quantified contributions of each BI-RADS descriptor toward predicting the benign or malignant class using post-hoc explanations with Shapley Values.
Automatic methods for early detection of breast cancer on mammography can significantly decrease mortality. Broad uptake of those methods in hospitals is currently hindered because the methods have too many constraints. They assume annotations available for single images or even regions-of-interest (ROIs), and a fixed number of images per patient. Both assumptions do not hold in a general hospital setting. Relaxing those assumptions results in a weakly supervised learning setting, where labels are available per case, but not for individual images or ROIs. Not all images taken for a patient contain malignant regions and the malignant ROIs cover only a tiny part of an image, whereas most image regions represent benign tissue. In this work, we investigate a two-level multi-instance learning (MIL) approach for case-level breast cancer prediction on two public datasets (1.6k and 5k cases) and an in-house dataset of 21k cases. Observing that breast cancer is usually only present in one side, while images of both breasts are taken as a precaution, we propose a domain-specific MIL pooling variant. We show that two-level MIL can be applied in realistic clinical settings where only case labels, and a variable number of images per patient are available. Data in realistic settings scales with continuous patient intake, while manual annotation efforts do not. Hence, research should focus in particular on unsupervised ROI extraction, in order to improve breast cancer prediction for all patients.
Background: Prostate cancer (PC) MRI-based risk calculators are commonly based on biological (e.g. PSA), MRI markers (e.g. volume), and patient age. Whilst patient age measures the amount of years an individual has existed, biological age (BA) might better reflect the physiology of an individual. However, surrogates from prostate MRI and linkage with clinically significant PC (csPC) remain to be explored. Purpose: To obtain and evaluate Prostate Age Gap (PAG) as an MRI marker tool for csPC risk. Study type: Retrospective. Population: A total of 7243 prostate MRI slices from 468 participants who had undergone prostate biopsies. A deep learning model was trained on 3223 MRI slices cropped around the gland from 81 low-grade PC (ncsPC, Gleason score <=6) and 131 negative cases and tested on the remaining 256 participants. Assessment: Chronological age was defined as the age of the participant at the time of the visit and used to train the deep learning model to predict the age of the patient. Following, we obtained PAG, defined as the model predicted age minus the patient's chronological age. Multivariate logistic regression models were used to estimate the association through odds ratio (OR) and predictive value of PAG and compared against PSA levels and PI-RADS>=3. Statistical tests: T-test, Mann-Whitney U test, Permutation test and ROC curve analysis. Results: The multivariate adjusted model showed a significant difference in the odds of clinically significant PC (csPC, Gleason score >=7) (OR =3.78, 95% confidence interval (CI):2.32-6.16, P <.001). PAG showed a better predictive ability when compared to PI-RADS>=3 and adjusted by other risk factors, including PSA levels: AUC =0.981 vs AUC =0.704, p<.001. Conclusion: PAG was significantly associated with the risk of clinically significant PC and outperformed other well-established PC risk factors.
Breast Cancer is the most common cancer among women, which is also visible in men, and accounts for more than 1 in 10 new cancer diagnoses each year. It is also the second most common cause of women who die from cancer. Hence, it necessitates early detection and tailored treatment. Early detection can provide appropriate and patient-based therapeutic schedules. Moreover, early detection can also provide the type of cyst. This paper employs class-level data augmentation, addressing the undersampled classes and raising their detection rate. This approach suggests two key components: class-level data augmentation on structure-preserving stain normalization techniques to hematoxylin and eosin-stained images and transformer-based ViTNet architecture via transfer learning for multiclass classification of breast cancer images. This merger enables categorizing breast cancer images with advanced image processing and deep learning as either benign or as one of four distinct malignant subtypes by focusing on class-level augmentation and catering to unique characteristics of each class with increasing precision of classification on undersampled classes, which leads to lower mortality rates associated with breast cancer. The paper aims to ease the duties of the medical specialist by operating multiclass classification and categorizing the image into benign or one of four different malignant types of breast cancers.
Prostate cancer pathology plays a crucial role in clinical management but is time-consuming. Artificial intelligence (AI) shows promise in detecting prostate cancer and grading patterns. We tested an AI-based digital twin of a pathologist, vPatho, on 2,603 histology images of prostate tissue stained with hematoxylin and eosin. We analyzed various factors influencing tumor-grade disagreement between vPatho and six human pathologists. Our results demonstrated that vPatho achieved comparable performance in prostate cancer detection and tumor volume estimation, as reported in the literature. Concordance levels between vPatho and human pathologists were examined. Notably, moderate to substantial agreement was observed in identifying complementary histological features such as ductal, cribriform, nerve, blood vessels, and lymph cell infiltrations. However, concordance in tumor grading showed a decline when applied to prostatectomy specimens (kappa = 0.44) compared to biopsy cores (kappa = 0.70). Adjusting the decision threshold for the secondary Gleason pattern from 5% to 10% improved the concordance level between pathologists and vPatho for tumor grading on prostatectomy specimens (kappa from 0.44 to 0.64). Potential causes of grade discordance included the vertical extent of tumors toward the prostate boundary and the proportions of slides with prostate cancer. Gleason pattern 4 was particularly associated with discordance. Notably, grade discordance with vPatho was not specific to any of the six pathologists involved in routine clinical grading. In conclusion, our study highlights the potential utility of AI in developing a digital twin of a pathologist. This approach can help uncover limitations in AI adoption and the current grading system for prostate cancer pathology.
Segmentation of nodules in thyroid ultrasound imaging plays a crucial role in the detection and treatment of thyroid cancer. However, owing to the diversity of scanner vendors and imaging protocols in different hospitals, the automatic segmentation model, which has already demonstrated expert-level accuracy in the field of medical image segmentation, finds its accuracy reduced as the result of its weak generalization performance when being applied in clinically realistic environments. To address this issue, the present paper proposes ASTN, a framework for thyroid nodule segmentation achieved through a new type co-registration network. By extracting latent semantic information from the atlas and target images and utilizing in-depth features to accomplish the co-registration of nodules in thyroid ultrasound images, this framework can ensure the integrity of anatomical structure and reduce the impact on segmentation as the result of overall differences in image caused by different devices. In addition, this paper also provides an atlas selection algorithm to mitigate the difficulty of co-registration. As shown by the evaluation results collected from the datasets of different devices, thanks to the method we proposed, the model generalization has been greatly improved while maintaining a high level of segmentation accuracy.
Undoubtedly breast cancer identifies itself as one of the most widespread and terrifying cancers across the globe. Millions of women are getting affected each year from it. Breast cancer remains the major one for being the reason of largest number of demise of women. In the recent time of research, Medical Image Computing and Processing has been playing a significant role for detecting and classifying breast cancers from ultrasound images and mammograms, along with the celestial touch of deep neural networks. In this research, we focused mostly on our rigorous implementations and iterative result analysis of different cutting-edge modified versions of EfficientNet architectures namely EfficientNet-V1 (b0-b7) and EfficientNet-V2 (b0-b3) with ultrasound image, named as CEIMVEN. We utilized transfer learning approach here for using the pre-trained models of EfficientNet versions. We activated the hyper-parameter tuning procedures, added fully connected layers, discarded the unprecedented outliers and recorded the accuracy results from our custom modified EfficientNet architectures. Our deep learning model training approach was related to both identifying the cancer affected areas with region of interest (ROI) techniques and multiple classifications (benign, malignant and normal). The approximate testing accuracies we got from the modified versions of EfficientNet-V1 (b0- 99.15%, b1- 98.58%, b2- 98.43%, b3- 98.01%, b4- 98.86%, b5- 97.72%, b6- 97.72%, b7- 98.72%) and EfficientNet-V2 (b0- 99.29%, b1- 99.01%, b2- 98.72%, b3- 99.43%) are showing very bright future and strong potentials of deep learning approach for the successful detection and classification of breast cancers from the ultrasound images at a very early stage.