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Guotai Wang

Publications and source records attributed to Guotai Wang.

At least 73 records · Page 4Linked to original sources

Semi-Supervised Segmentation of Radiation-Induced Pulmonary Fibrosis from Lung CT Scans with Multi-Scale Guided Dense Attention

Computed Tomography (CT) plays an important role in monitoring radiation-induced Pulmonary Fibrosis (PF), where accurate segmentation of the PF lesions is highly desired for diagnosis and treatment follow-up. However, the task is challenged by ambiguous boundary, irregular shape, various position and size of the lesions, as well as the difficulty in acquiring a large set of annotated volumetric images for training. To overcome these problems, we propose a novel convolutional neural network called PF-Net and incorporate it into a semi-supervised learning framework based on Iterative Confidence-based Refinement And Weighting of pseudo Labels (I-CRAWL). Our PF-Net combines 2D and 3D convolutions to deal with CT volumes with large inter-slice spacing, and uses multi-scale guided dense attention to segment complex PF lesions. For semi-supervised learning, our I-CRAWL employs pixel-level uncertainty-based confidence-aware refinement to improve the accuracy of pseudo labels of unannotated images, and uses image-level uncertainty for confidence-based image weighting to suppress low-quality pseudo labels in an iterative training process. Extensive experiments with CT scans of Rhesus Macaques with radiation-induced PF showed that: 1) PF-Net achieved higher segmentation accuracy than existing 2D, 3D and 2.5D neural networks, and 2) I-CRAWL outperformed state-of-the-art semi-supervised learning methods for the PF lesion segmentation task. Our method has a potential to improve the diagnosis of PF and clinical assessment of side effects of radiotherapy for lung cancers.

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Domain Composition and Attention for Unseen-Domain Generalizable Medical Image Segmentation

Domain generalizable model is attracting increasing attention in medical image analysis since data is commonly acquired from different institutes with various imaging protocols and scanners. To tackle this challenging domain generalization problem, we propose a Domain Composition and Attention-based network (DCA-Net) to improve the ability of domain representation and generalization. First, we present a domain composition method that represents one certain domain by a linear combination of a set of basis representations (i.e., a representation bank). Second, a novel plug-and-play parallel domain preceptor is proposed to learn these basis representations and we introduce a divergence constraint function to encourage the basis representations to be as divergent as possible. Then, a domain attention module is proposed to learn the linear combination coefficients of the basis representations. The result of linear combination is used to calibrate the feature maps of an input image, which enables the model to generalize to different and even unseen domains. We validate our method on public prostate MRI dataset acquired from six different institutions with apparent domain shift. Experimental results show that our proposed model can generalize well on different and even unseen domains and it outperforms state-of-the-art methods on the multi-domain prostate segmentation task.

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Efficient Semi-Supervised Gross Target Volume of Nasopharyngeal Carcinoma Segmentation via Uncertainty Rectified Pyramid Consistency

Gross Target Volume (GTV) segmentation plays an irreplaceable role in radiotherapy planning for Nasopharyngeal Carcinoma (NPC). Despite that Convolutional Neural Networks (CNN) have achieved good performance for this task, they rely on a large set of labeled images for training, which is expensive and time-consuming to acquire. In this paper, we propose a novel framework with Uncertainty Rectified Pyramid Consistency (URPC) regularization for semi-supervised NPC GTV segmentation. Concretely, we extend a backbone segmentation network to produce pyramid predictions at different scales. The pyramid predictions network (PPNet) is supervised by the ground truth of labeled images and a multi-scale consistency loss for unlabeled images, motivated by the fact that prediction at different scales for the same input should be similar and consistent. However, due to the different resolution of these predictions, encouraging them to be consistent at each pixel directly has low robustness and may lose some fine details. To address this problem, we further design a novel uncertainty rectifying module to enable the framework to gradually learn from meaningful and reliable consensual regions at different scales. Experimental results on a dataset with 258 NPC MR images showed that with only 10% or 20% images labeled, our method largely improved the segmentation performance by leveraging the unlabeled images, and it also outperformed five state-of-the-art semi-supervised segmentation methods. Moreover, when only 50% images labeled, URPC achieved an average Dice score of 82.74% that was close to fully supervised learning.

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Contrastive Learning of Relative Position Regression for One-Shot Object Localization in 3D Medical Images

Deep learning networks have shown promising performance for accurate object localization in medial images, but require large amount of annotated data for supervised training, which is expensive and expertise burdensome. To address this problem, we present a one-shot framework for organ and landmark localization in volumetric medical images, which does not need any annotation during the training stage and could be employed to locate any landmarks or organs in test images given a support (reference) image during the inference stage. Our main idea comes from that tissues and organs from different human bodies have a similar relative position and context. Therefore, we could predict the relative positions of their non-local patches, thus locate the target organ. Our framework is composed of three parts: (1) A projection network trained to predict the 3D offset between any two patches from the same volume, where human annotations are not required. In the inference stage, it takes one given landmark in a reference image as a support patch and predicts the offset from a random patch to the corresponding landmark in the test (query) volume. (2) A coarse-to-fine framework contains two projection networks, providing more accurate localization of the target. (3) Based on the coarse-to-fine model, we transfer the organ boundingbox (B-box) detection to locating six extreme points along x, y and z directions in the query volume. Experiments on multi-organ localization from head-and-neck (HaN) CT volumes showed that our method acquired competitive performance in real time, which is more accurate and 10^5 times faster than template matching methods with the same setting. Code is available: https://github.com/LWHYC/RPR-Loc.

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SS-CADA: A Semi-Supervised Cross-Anatomy Domain Adaptation for Coronary Artery Segmentation

The segmentation of coronary arteries by convolutional neural network is promising yet requires a large amount of labor-intensive manual annotations. Transferring knowledge from retinal vessels in widely-available public labeled fundus images (FIs) has a potential to reduce the annotation requirement for coronary artery segmentation in X-ray angiograms (XAs) due to their common tubular structures. However, it is challenged by the cross-anatomy domain shift due to the intrinsically different vesselness characteristics in different anatomical regions under even different imaging protocols. To solve this problem, we propose a Semi-Supervised Cross-Anatomy Domain Adaptation (SS-CADA) which requires only limited annotations for coronary arteries in XAs. With the supervision from a small number of labeled XAs and publicly available labeled FIs, we propose a vesselness-specific batch normalization (VSBN) to individually normalize feature maps for them considering their different cross-anatomic vesselness characteristics. In addition, to further facilitate the annotation efficiency, we employ a self-ensembling mean-teacher (SEMT) to exploit abundant unlabeled XAs by imposing a prediction consistency constraint. Extensive experiments show that our SS-CADA is able to solve the challenging cross-anatomy domain shift, achieving accurate segmentation for coronary arteries given only a small number of labeled XAs.

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MIDeepSeg: Minimally Interactive Segmentation of Unseen Objects from Medical Images Using Deep Learning

Segmentation of organs or lesions from medical images plays an essential role in many clinical applications such as diagnosis and treatment planning. Though Convolutional Neural Networks (CNN) have achieved the state-of-the-art performance for automatic segmentation, they are often limited by the lack of clinically acceptable accuracy and robustness in complex cases. Therefore, interactive segmentation is a practical alternative to these methods. However, traditional interactive segmentation methods require a large amount of user interactions, and recently proposed CNN-based interactive segmentation methods are limited by poor performance on previously unseen objects. To solve these problems, we propose a novel deep learning-based interactive segmentation method that not only has high efficiency due to only requiring clicks as user inputs but also generalizes well to a range of previously unseen objects. Specifically, we first encode user-provided interior margin points via our proposed exponentialized geodesic distance that enables a CNN to achieve a good initial segmentation result of both previously seen and unseen objects, then we use a novel information fusion method that combines the initial segmentation with only few additional user clicks to efficiently obtain a refined segmentation. We validated our proposed framework through extensive experiments on 2D and 3D medical image segmentation tasks with a wide range of previous unseen objects that were not present in the training set. Experimental results showed that our proposed framework 1) achieves accurate results with fewer user interactions and less time compared with state-of-the-art interactive frameworks and 2) generalizes well to previously unseen objects.

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Automatic Segmentation of Organs-at-Risk from Head-and-Neck CT using Separable Convolutional Neural Network with Hard-Region-Weighted Loss

Nasopharyngeal Carcinoma (NPC) is a leading form of Head-and-Neck (HAN) cancer in the Arctic, China, Southeast Asia, and the Middle East/North Africa. Accurate segmentation of Organs-at-Risk (OAR) from Computed Tomography (CT) images with uncertainty information is critical for effective planning of radiation therapy for NPC treatment. Despite the stateof-the-art performance achieved by Convolutional Neural Networks (CNNs) for automatic segmentation of OARs, existing methods do not provide uncertainty estimation of the segmentation results for treatment planning, and their accuracy is still limited by several factors, including the low contrast of soft tissues in CT, highly imbalanced sizes of OARs and large inter-slice spacing. To address these problems, we propose a novel framework for accurate OAR segmentation with reliable uncertainty estimation. First, we propose a Segmental Linear Function (SLF) to transform the intensity of CT images to make multiple organs more distinguishable than existing methods based on a simple window width/level that often gives a better visibility of one organ while hiding the others. Second, to deal with the large inter-slice spacing, we introduce a novel 2.5D network (named as 3D-SepNet) specially designed for dealing with clinic HAN CT scans with anisotropic spacing. Thirdly, existing hardness-aware loss function often deal with class-level hardness, but our proposed attention to hard voxels (ATH) uses a voxel-level hardness strategy, which is more suitable to dealing with some hard regions despite that its corresponding class may be easy. Our code is now available at https://github.com/HiLab-git/SepNet.

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Automatic Segmentation of Gross Target Volume of Nasopharynx Cancer using Ensemble of Multiscale Deep Neural Networks with Spatial Attention

Radiotherapy is the main treatment modality for nasopharynx cancer. Delineation of Gross Target Volume (GTV) from medical images such as CT and MRI images is a prerequisite for radiotherapy. As manual delineation is time-consuming and laborious, automatic segmentation of GTV has a potential to improve this process. Currently, most of the deep learning-based automatic delineation methods of GTV are mainly performed on medical images like CT images. However, it is challenged by the low contrast between the pathology regions and surrounding soft tissues, small target region, and anisotropic resolution of clinical CT images. To deal with these problems, we propose a 2.5D Convolutional Neural Network (CNN) to handle the difference of inplane and through-plane resolution. Furthermore, we propose a spatial attention module to enable the network to focus on small target, and use channel attention to further improve the segmentation performance. Moreover, we use multi-scale sampling method for training so that the networks can learn features at different scales, which are combined with a multi-model ensemble method to improve the robustness of segmentation results. We also estimate the uncertainty of segmentation results based on our model ensemble, which is of great importance for indicating the reliability of automatic segmentation results for radiotherapy planning.

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Annotation-Efficient Learning for Medical Image Segmentation based on Noisy Pseudo Labels and Adversarial Learning

Despite that deep learning has achieved state-of-the-art performance for medical image segmentation, its success relies on a large set of manually annotated images for training that are expensive to acquire. In this paper, we propose an annotation-efficient learning framework for segmentation tasks that avoids annotations of training images, where we use an improved Cycle-Consistent Generative Adversarial Network (GAN) to learn from a set of unpaired medical images and auxiliary masks obtained either from a shape model or public datasets. We first use the GAN to generate pseudo labels for our training images under the implicit high-level shape constraint represented by a Variational Auto-encoder (VAE)-based discriminator with the help of the auxiliary masks, and build a Discriminator-guided Generator Channel Calibration (DGCC) module which employs our discriminator's feedback to calibrate the generator for better pseudo labels. To learn from the pseudo labels that are noisy, we further introduce a noise-robust iterative learning method using noise-weighted Dice loss. We validated our framework with two situations: objects with a simple shape model like optic disc in fundus images and fetal head in ultrasound images, and complex structures like lung in X-Ray images and liver in CT images. Experimental results demonstrated that 1) Our VAE-based discriminator and DGCC module help to obtain high-quality pseudo labels. 2) Our proposed noise-robust learning method can effectively overcome the effect of noisy pseudo labels. 3) The segmentation performance of our method without using annotations of training images is close or even comparable to that of learning from human annotations.

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Learning Euler's Elastica Model for Medical Image Segmentation

Image segmentation is a fundamental topic in image processing and has been studied for many decades. Deep learning-based supervised segmentation models have achieved state-of-the-art performance but most of them are limited by using pixel-wise loss functions for training without geometrical constraints. Inspired by Euler's Elastica model and recent active contour models introduced into the field of deep learning, we propose a novel active contour with elastica (ACE) loss function incorporating Elastica (curvature and length) and region information as geometrically-natural constraints for the image segmentation tasks. We introduce the mean curvature i.e. the average of all principal curvatures, as a more effective image prior to representing curvature in our ACE loss function. Furthermore, based on the definition of the mean curvature, we propose a fast solution to approximate the ACE loss in three-dimensional (3D) by using Laplace operators for 3D image segmentation. We evaluate our ACE loss function on four 2D and 3D natural and biomedical image datasets. Our results show that the proposed loss function outperforms other mainstream loss functions on different segmentation networks. Our source code is available at https://github.com/HiLab-git/ACELoss.

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CA-Net: Comprehensive Attention Convolutional Neural Networks for Explainable Medical Image Segmentation

Accurate medical image segmentation is essential for diagnosis and treatment planning of diseases. Convolutional Neural Networks (CNNs) have achieved state-of-the-art performance for automatic medical image segmentation. However, they are still challenged by complicated conditions where the segmentation target has large variations of position, shape and scale, and existing CNNs have a poor explainability that limits their application to clinical decisions. In this work, we make extensive use of multiple attentions in a CNN architecture and propose a comprehensive attention-based CNN (CA-Net) for more accurate and explainable medical image segmentation that is aware of the most important spatial positions, channels and scales at the same time. In particular, we first propose a joint spatial attention module to make the network focus more on the foreground region. Then, a novel channel attention module is proposed to adaptively recalibrate channel-wise feature responses and highlight the most relevant feature channels. Also, we propose a scale attention module implicitly emphasizing the most salient feature maps among multiple scales so that the CNN is adaptive to the size of an object. Extensive experiments on skin lesion segmentation from ISIC 2018 and multi-class segmentation of fetal MRI found that our proposed CA-Net significantly improved the average segmentation Dice score from 87.77% to 92.08% for skin lesion, 84.79% to 87.08% for the placenta and 93.20% to 95.88% for the fetal brain respectively compared with U-Net. It reduced the model size to around 15 times smaller with close or even better accuracy compared with state-of-the-art DeepLabv3+. In addition, it has a much higher explainability than existing networks by visualizing the attention weight maps. Our code is available at https://github.com/HiLab-git/CA-Net

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Automatic Ischemic Stroke Lesion Segmentation from Computed Tomography Perfusion Images by Image Synthesis and Attention-Based Deep Neural Networks

Ischemic stroke lesion segmentation from Computed Tomography Perfusion (CTP) images is important for accurate diagnosis of stroke in acute care units. However, it is challenged by low image contrast and resolution of the perfusion parameter maps, in addition to the complex appearance of the lesion. To deal with this problem, we propose a novel framework based on synthesized pseudo Diffusion-Weighted Imaging (DWI) from perfusion parameter maps to obtain better image quality for more accurate segmentation. Our framework consists of three components based on Convolutional Neural Networks (CNNs) and is trained end-to-end. First, a feature extractor is used to obtain both a low-level and high-level compact representation of the raw spatiotemporal Computed Tomography Angiography (CTA) images. Second, a pseudo DWI generator takes as input the concatenation of CTP perfusion parameter maps and our extracted features to obtain the synthesized pseudo DWI. To achieve better synthesis quality, we propose a hybrid loss function that pays more attention to lesion regions and encourages high-level contextual consistency. Finally, we segment the lesion region from the synthesized pseudo DWI, where the segmentation network is based on switchable normalization and channel calibration for better performance. Experimental results showed that our framework achieved the top performance on ISLES 2018 challenge and: 1) our method using synthesized pseudo DWI outperformed methods segmenting the lesion from perfusion parameter maps directly; 2) the feature extractor exploiting additional spatiotemporal CTA images led to better synthesized pseudo DWI quality and higher segmentation accuracy; and 3) the proposed loss functions and network structure improved the pseudo DWI synthesis and lesion segmentation performance.

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Uncertainty-Guided Efficient Interactive Refinement of Fetal Brain Segmentation from Stacks of MRI Slices

Segmentation of the fetal brain from stacks of motion-corrupted fetal MRI slices is important for motion correction and high-resolution volume reconstruction. Although Convolutional Neural Networks (CNNs) have been widely used for automatic segmentation of the fetal brain, their results may still benefit from interactive refinement for challenging slices. To improve the efficiency of interactive refinement process, we propose an Uncertainty-Guided Interactive Refinement (UGIR) framework. We first propose a grouped convolution-based CNN to obtain multiple automatic segmentation predictions with uncertainty estimation in a single forward pass, then guide the user to provide interactions only in a subset of slices with the highest uncertainty. A novel interactive level set method is also proposed to obtain a refined result given the initial segmentation and user interactions. Experimental results show that: (1) our proposed CNN obtains uncertainty estimation in real time which correlates well with mis-segmentations, (2) the proposed interactive level set is effective and efficient for refinement, (3) UGIR obtains accurate refinement results with around 30% improvement of efficiency by using uncertainty to guide user interactions. Our code is available online.

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Weakly Supervised Vessel Segmentation in X-ray Angiograms by Self-Paced Learning from Noisy Labels with Suggestive Annotation

The segmentation of coronary arteries in X-ray angiograms by convolutional neural networks (CNNs) is promising yet limited by the requirement of precisely annotating all pixels in a large number of training images, which is extremely labor-intensive especially for complex coronary trees. To alleviate the burden on the annotator, we propose a novel weakly supervised training framework that learns from noisy pseudo labels generated from automatic vessel enhancement, rather than accurate labels obtained by fully manual annotation. A typical self-paced learning scheme is used to make the training process robust against label noise while challenged by the systematic biases in pseudo labels, thus leading to the decreased performance of CNNs at test time. To solve this problem, we propose an annotation-refining self-paced learning framework (AR-SPL) to correct the potential errors using suggestive annotation. An elaborate model-vesselness uncertainty estimation is also proposed to enable the minimal annotation cost for suggestive annotation, based on not only the CNNs in training but also the geometric features of coronary arteries derived directly from raw data. Experiments show that our proposed framework achieves 1) comparable accuracy to fully supervised learning, which also significantly outperforms other weakly supervised learning frameworks; 2) largely reduced annotation cost, i.e., 75.18% of annotation time is saved, and only 3.46% of image regions are required to be annotated; and 3) an efficient intervention process, leading to superior performance with even fewer manual interactions.

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Automatic Segmentation of Vestibular Schwannoma from T2-Weighted MRI by Deep Spatial Attention with Hardness-Weighted Loss

Automatic segmentation of vestibular schwannoma (VS) tumors from magnetic resonance imaging (MRI) would facilitate efficient and accurate volume measurement to guide patient management and improve clinical workflow. The accuracy and robustness is challenged by low contrast, small target region and low through-plane resolution. We introduce a 2.5D convolutional neural network (CNN) able to exploit the different in-plane and through-plane resolutions encountered in standard of care imaging protocols. We use an attention module to enable the CNN to focus on the small target and propose a supervision on the learning of attention maps for more accurate segmentation. Additionally, we propose a hardness-weighted Dice loss function that gives higher weights to harder voxels to boost the training of CNNs. Experiments with ablation studies on the VS tumor segmentation task show that: 1) the proposed 2.5D CNN outperforms its 2D and 3D counterparts, 2) our supervised attention mechanism outperforms unsupervised attention, 3) the voxel-level hardness-weighted Dice loss can improve the performance of CNNs. Our method achieved an average Dice score and ASSD of 0.87 and 0.43~mm respectively. This will facilitate patient management decisions in clinical practice.

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Aleatoric uncertainty estimation with test-time augmentation for medical image segmentation with convolutional neural networks

Despite the state-of-the-art performance for medical image segmentation, deep convolutional neural networks (CNNs) have rarely provided uncertainty estimations regarding their segmentation outputs, e.g., model (epistemic) and image-based (aleatoric) uncertainties. In this work, we analyze these different types of uncertainties for CNN-based 2D and 3D medical image segmentation tasks. We additionally propose a test-time augmentation-based aleatoric uncertainty to analyze the effect of different transformations of the input image on the segmentation output. Test-time augmentation has been previously used to improve segmentation accuracy, yet not been formulated in a consistent mathematical framework. Hence, we also propose a theoretical formulation of test-time augmentation, where a distribution of the prediction is estimated by Monte Carlo simulation with prior distributions of parameters in an image acquisition model that involves image transformations and noise. We compare and combine our proposed aleatoric uncertainty with model uncertainty. Experiments with segmentation of fetal brains and brain tumors from 2D and 3D Magnetic Resonance Images (MRI) showed that 1) the test-time augmentation-based aleatoric uncertainty provides a better uncertainty estimation than calculating the test-time dropout-based model uncertainty alone and helps to reduce overconfident incorrect predictions, and 2) our test-time augmentation outperforms a single-prediction baseline and dropout-based multiple predictions.

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Automatic Brain Tumor Segmentation using Convolutional Neural Networks with Test-Time Augmentation

Automatic brain tumor segmentation plays an important role for diagnosis, surgical planning and treatment assessment of brain tumors. Deep convolutional neural networks (CNNs) have been widely used for this task. Due to the relatively small data set for training, data augmentation at training time has been commonly used for better performance of CNNs. Recent works also demonstrated the usefulness of using augmentation at test time, in addition to training time, for achieving more robust predictions. We investigate how test-time augmentation can improve CNNs' performance for brain tumor segmentation. We used different underpinning network structures and augmented the image by 3D rotation, flipping, scaling and adding random noise at both training and test time. Experiments with BraTS 2018 training and validation set show that test-time augmentation helps to improve the brain tumor segmentation accuracy and obtain uncertainty estimation of the segmentation results.

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Weakly-Supervised Convolutional Neural Networks for Multimodal Image Registration

One of the fundamental challenges in supervised learning for multimodal image registration is the lack of ground-truth for voxel-level spatial correspondence. This work describes a method to infer voxel-level transformation from higher-level correspondence information contained in anatomical labels. We argue that such labels are more reliable and practical to obtain for reference sets of image pairs than voxel-level correspondence. Typical anatomical labels of interest may include solid organs, vessels, ducts, structure boundaries and other subject-specific ad hoc landmarks. The proposed end-to-end convolutional neural network approach aims to predict displacement fields to align multiple labelled corresponding structures for individual image pairs during the training, while only unlabelled image pairs are used as the network input for inference. We highlight the versatility of the proposed strategy, for training, utilising diverse types of anatomical labels, which need not to be identifiable over all training image pairs. At inference, the resulting 3D deformable image registration algorithm runs in real-time and is fully-automated without requiring any anatomical labels or initialisation. Several network architecture variants are compared for registering T2-weighted magnetic resonance images and 3D transrectal ultrasound images from prostate cancer patients. A median target registration error of 3.6 mm on landmark centroids and a median Dice of 0.87 on prostate glands are achieved from cross-validation experiments, in which 108 pairs of multimodal images from 76 patients were tested with high-quality anatomical labels.

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