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Amber L. Simpson

Publications and source records attributed to Amber L. Simpson.

12 recordsLinked to original sources

Spectral Adapters for Segment Anything Model-based Segmentation of Colorectal Liver Metastases in Computed Tomography

Accurate segmentation of colorectal liver metastases (CRLM) in contrast-enhanced computed tomography (CT) is important for response assessment, surgical planning, and follow-up. We propose two parameter-efficient spectral adapters for the Segment Anything Model (SAM): the Directional Spectral Adapter (DiSECT) and Spectral Instance-Guided Adapter (SiGA). DiSECT uses singular value decomposition of frozen weights to constrain residual updates to leading spectral directions, while SiGA adds global and input-conditioned gating through a multilayer perceptron. We evaluate these methods on 446 contrast-enhanced CT volumes (355 training, 91 testing) and compare them with LoRA, QLoRA, convolutional adapters (CAD), and a 3D nnU-Net baseline. Experiments consider single-point, three-point, bounding-box, and no-prompt regimes. SiGA achieves the best single-point performance with a Dice score of 0.77, IoU of 0.69, and HD95 of 35.39 mm. Under no-prompt inference, SiGA reaches 0.76 Dice, 0.68 IoU, and 46.76 mm HD95, comparable to the nnU-Net baseline (0.758 Dice). DiSECT uses only 0.14 million trainable parameters. These results show that spectral adapters can efficiently adapt SAM for CRLM segmentation while retaining strong accuracy with limited trainable parameters.

cs.CV

The Patient/Industry Trade-off in Medical Artificial Intelligence

Artificial intelligence (AI) in healthcare has led to many promising developments; however, increasingly, AI research is funded by the private sector leading to potential trade-offs between benefits to patients and benefits to industry. Health AI practitioners should prioritize successful adaptation into clinical practice in order to provide meaningful benefits to patients, but translation usually requires collaboration with industry. We discuss three features of AI studies that hamper the integration of AI into clinical practice from the perspective of researchers and clinicians. These include lack of clinically relevant metrics, lack of clinical trials and longitudinal studies to validate results, and lack of patient and physician involvement in the development process. For partnerships between industry and health research to be sustainable, a balance must be established between patient and industry benefit. We propose three approaches for addressing this gap: improved transparency and explainability of AI models, fostering relationships with industry partners that have a reputation for centering patient benefit in their practices, and prioritization of overall healthcare benefits. With these priorities, we can sooner realize meaningful AI technologies used by clinicians where mutua

cs.CY

A Novel Patch-Based TDA Approach for Computed Tomography Imaging

The development of machine learning models based on computed tomography (CT) imaging has been a major focus due to the promise that imaging holds for diagnosis, staging, and prognostication. These models often rely on the extraction of hand-crafted features where incorporating robust feature engineering improves the performance of these models. Topological data analysis (TDA), based on the mathematical field of algebraic topology, focuses on data from a topological perspective, extracting deeper insight and higher dimensional structures. Persistent homology (PH), a fundamental tool in TDA, extracts topological features such as connected components, cycles, and voids. A popular approach to construct PH from 3D CT images is to utilize 3D cubical complex filtration, a method adapted for grid-structured data. However, this approach is subject to poor performance and high computational cost with higher resolution images. This study introduces a novel patch-based PH construction approach designed for volumetric CT imaging data that improves performance and reduces computational time. This study conducts a series of experiments to comprehensively analyze the performance of the proposed method and benchmarks against the cubical complex algorithm and radiomic features. Our results highlight the dominance of the patch-based TDA approach in terms of both classification performance and computational time. The proposed approach outperformed the cubical complex method and radiomic features, achieving average improvement of 7.2%, 3.6%, 2.7%, 8.0%, and 7.2% in accuracy, AUC, sensitivity, specificity, and F1 score, respectively, across all datasets. Finally, we provide a convenient Python package, Patch-TDA, to facilitate the utilization of the proposed approach.

cs.CV

Comparing the Effects of Persistence Barcodes Aggregation and Feature Concatenation on Medical Imaging

In medical image analysis, feature engineering plays an important role in the design and performance of machine learning models. Persistent homology (PH), from the field of topological data analysis (TDA), demonstrates robustness and stability to data perturbations and addresses the limitation from traditional feature extraction approaches where a small change in input results in a large change in feature representation. Using PH, we store persistent topological and geometrical features in the form of the persistence barcode whereby large bars represent global topological features and small bars encapsulate geometrical information of the data. When multiple barcodes are computed from 2D or 3D medical images, two approaches can be used to construct the final topological feature vector in each dimension: aggregating persistence barcodes followed by featurization or concatenating topological feature vectors derived from each barcode. In this study, we conduct a comprehensive analysis across diverse medical imaging datasets to compare the effects of the two aforementioned approaches on the performance of classification models. The results of this analysis indicate that feature concatenation preserves detailed topological information from individual barcodes, yields better classification performance and is therefore a preferred approach when conducting similar experiments.

cs.CV

Finding Reproducible and Prognostic Radiomic Features in Variable Slice Thickness Contrast Enhanced CT of Colorectal Liver Metastases

Establishing the reproducibility of radiomic signatures is a critical step in the path to clinical adoption of quantitative imaging biomarkers; however, radiomic signatures must also be meaningfully related to an outcome of clinical importance to be of value for personalized medicine. In this study, we analyze both the reproducibility and prognostic value of radiomic features extracted from the liver parenchyma and largest liver metastases in contrast enhanced CT scans of patients with colorectal liver metastases (CRLM). A prospective cohort of 81 patients from two major US cancer centers was used to establish the reproducibility of radiomic features extracted from images reconstructed with different slice thicknesses. A publicly available, single-center cohort of 197 preoperative scans from patients who underwent hepatic resection for treatment of CRLM was used to evaluate the prognostic value of features and models to predict overall survival. A standard set of 93 features was extracted from all images, with a set of eight different extractor settings. The feature extraction settings producing the most reproducible, as well as the most prognostically discriminative feature values were highly dependent on both the region of interest and the specific feature in question. While the best overall predictive model was produced using features extracted with a particular setting, without accounting for reproducibility, (C-index = 0.630 (0.603--0.649)) an equivalent-performing model (C-index = 0.629 (0.605--0.645)) was produced by pooling features from all extraction settings, and thresholding features with low reproducibility ($\mathrm{CCC} \geq 0.85$), prior to feature selection. Our findings support a data-driven approach to feature extraction and selection, preferring the inclusion of many features, and narrowing feature selection based on reproducibility when relevant data is available.

eess.IV

CT-based Anomaly Detection of Liver Tumors Using Generative Diffusion Prior

CT is a main modality for imaging liver diseases, valuable in detecting and localizing liver tumors. Traditional anomaly detection methods analyze reconstructed images to identify pathological structures. However, these methods may produce suboptimal results, overlooking subtle differences among various tissue types. To address this challenge, here we employ generative diffusion prior to inpaint the liver as the reference facilitating anomaly detection. Specifically, we use an adaptive threshold to extract a mask of abnormal regions, which are then inpainted using a diffusion prior to calculating an anomaly score based on the discrepancy between the original CT image and the inpainted counterpart. Our methodology has been tested on two liver CT datasets, demonstrating a significant improvement in detection accuracy, with a 7.9% boost in the area under the curve (AUC) compared to the state-of-the-art. This performance gain underscores the potential of our approach to refine the radiological assessment of liver diseases.

physics.med-ph

Parameter-Efficient Methods for Metastases Detection from Clinical Notes

Understanding the progression of cancer is crucial for defining treatments for patients. The objective of this study is to automate the detection of metastatic liver disease from free-style computed tomography (CT) radiology reports. Our research demonstrates that transferring knowledge using three approaches can improve model performance. First, we utilize generic language models (LMs), pretrained in a self-supervised manner. Second, we use a semi-supervised approach to train our model by automatically annotating a large unlabeled dataset; this approach substantially enhances the model's performance. Finally, we transfer knowledge from related tasks by designing a multi-task transfer learning methodology. We leverage the recent advancement of parameter-efficient LM adaptation strategies to improve performance and training efficiency. Our dataset consists of CT reports collected at Memorial Sloan Kettering Cancer Center (MSKCC) over the course of 12 years. 2,641 reports were manually annotated by domain experts; among them, 841 reports have been annotated for the presence of liver metastases. Our best model achieved an F1-score of 73.8%, a precision of 84%, and a recall of 65.8%.

cs.LG

Towards Optimal Patch Size in Vision Transformers for Tumor Segmentation

Detection of tumors in metastatic colorectal cancer (mCRC) plays an essential role in the early diagnosis and treatment of liver cancer. Deep learning models backboned by fully convolutional neural networks (FCNNs) have become the dominant model for segmenting 3D computerized tomography (CT) scans. However, since their convolution layers suffer from limited kernel size, they are not able to capture long-range dependencies and global context. To tackle this restriction, vision transformers have been introduced to solve FCNN's locality of receptive fields. Although transformers can capture long-range features, their segmentation performance decreases with various tumor sizes due to the model sensitivity to the input patch size. While finding an optimal patch size improves the performance of vision transformer-based models on segmentation tasks, it is a time-consuming and challenging procedure. This paper proposes a technique to select the vision transformer's optimal input multi-resolution image patch size based on the average volume size of metastasis lesions. We further validated our suggested framework using a transfer-learning technique, demonstrating that the highest Dice similarity coefficient (DSC) performance was obtained by pre-training on training data with a larger tumour volume using the suggested ideal patch size and then training with a smaller one. We experimentally evaluate this idea through pre-training our model on a multi-resolution public dataset. Our model showed consistent and improved results when applied to our private multi-resolution mCRC dataset with a smaller average tumor volume. This study lays the groundwork for optimizing semantic segmentation of small objects using vision transformers. The implementation source code is available at:https://github.com/Ramtin-Mojtahedi/OVTPS.

eess.IV

Attention-based CT Scan Interpolation for Lesion Segmentation of Colorectal Liver Metastases

Small liver lesions common to colorectal liver metastases (CRLMs) are challenging for convolutional neural network (CNN) segmentation models, especially when we have a wide range of slice thicknesses in the computed tomography (CT) scans. Slice thickness of CT images may vary by clinical indication. For example, thinner slices are used for presurgical planning when fine anatomic details of small vessels are required. While keeping the effective radiation dose in patients as low as possible, various slice thicknesses are employed in CRLMs due to their limitations. However, differences in slice thickness across CTs lead to significant performance degradation in CT segmentation models based on CNNs. This paper proposes a novel unsupervised attention-based interpolation model to generate intermediate slices from consecutive triplet slices in CT scans. We integrate segmentation loss during the interpolation model's training to leverage segmentation labels in existing slices to generate middle ones. Unlike common interpolation techniques in CT volumes, our model highlights the regions of interest (liver and lesions) inside the abdominal CT scans in the interpolated slice. Moreover, our model's outputs are consistent with the original input slices while increasing the segmentation performance in two cutting-edge 3D segmentation pipelines. We tested the proposed model on the CRLM dataset to upsample subjects with thick slices and create isotropic volume for our segmentation model. The produced isotropic dataset increases the Dice score in the segmentation of lesions and outperforms other interpolation approaches in terms of interpolation metrics.

eess.IV

Modality Completion via Gaussian Process Prior Variational Autoencoders for Multi-Modal Glioma Segmentation

In large studies involving multi protocol Magnetic Resonance Imaging (MRI), it can occur to miss one or more sub-modalities for a given patient owing to poor quality (e.g. imaging artifacts), failed acquisitions, or hallway interrupted imaging examinations. In some cases, certain protocols are unavailable due to limited scan time or to retrospectively harmonise the imaging protocols of two independent studies. Missing image modalities pose a challenge to segmentation frameworks as complementary information contributed by the missing scans is then lost. In this paper, we propose a novel model, Multi-modal Gaussian Process Prior Variational Autoencoder (MGP-VAE), to impute one or more missing sub-modalities for a patient scan. MGP-VAE can leverage the Gaussian Process (GP) prior on the Variational Autoencoder (VAE) to utilize the subjects/patients and sub-modalities correlations. Instead of designing one network for each possible subset of present sub-modalities or using frameworks to mix feature maps, missing data can be generated from a single model based on all the available samples. We show the applicability of MGP-VAE on brain tumor segmentation where either, two, or three of four sub-modalities may be missing. Our experiments against competitive segmentation baselines with missing sub-modality on BraTS'19 dataset indicate the effectiveness of the MGP-VAE model for segmentation tasks.

eess.IV

The Medical Segmentation Decathlon

International challenges have become the de facto standard for comparative assessment of image analysis algorithms given a specific task. Segmentation is so far the most widely investigated medical image processing task, but the various segmentation challenges have typically been organized in isolation, such that algorithm development was driven by the need to tackle a single specific clinical problem. We hypothesized that a method capable of performing well on multiple tasks will generalize well to a previously unseen task and potentially outperform a custom-designed solution. To investigate the hypothesis, we organized the Medical Segmentation Decathlon (MSD) - a biomedical image analysis challenge, in which algorithms compete in a multitude of both tasks and modalities. The underlying data set was designed to explore the axis of difficulties typically encountered when dealing with medical images, such as small data sets, unbalanced labels, multi-site data and small objects. The MSD challenge confirmed that algorithms with a consistent good performance on a set of tasks preserved their good average performance on a different set of previously unseen tasks. Moreover, by monitoring the MSD winner for two years, we found that this algorithm continued generalizing well to a wide range of other clinical problems, further confirming our hypothesis. Three main conclusions can be drawn from this study: (1) state-of-the-art image segmentation algorithms are mature, accurate, and generalize well when retrained on unseen tasks; (2) consistent algorithmic performance across multiple tasks is a strong surrogate of algorithmic generalizability; (3) the training of accurate AI segmentation models is now commoditized to non AI experts.

eess.IV

A large annotated medical image dataset for the development and evaluation of segmentation algorithms

Semantic segmentation of medical images aims to associate a pixel with a label in a medical image without human initialization. The success of semantic segmentation algorithms is contingent on the availability of high-quality imaging data with corresponding labels provided by experts. We sought to create a large collection of annotated medical image datasets of various clinically relevant anatomies available under open source license to facilitate the development of semantic segmentation algorithms. Such a resource would allow: 1) objective assessment of general-purpose segmentation methods through comprehensive benchmarking and 2) open and free access to medical image data for any researcher interested in the problem domain. Through a multi-institutional effort, we generated a large, curated dataset representative of several highly variable segmentation tasks that was used in a crowd-sourced challenge - the Medical Segmentation Decathlon held during the 2018 Medical Image Computing and Computer Aided Interventions Conference in Granada, Spain. Here, we describe these ten labeled image datasets so that these data may be effectively reused by the research community.

cs.CV