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Ioannis Sechopoulos

Publications and source records attributed to Ioannis Sechopoulos.

7 recordsLinked to original sources

A theory of ROC analysis of rule-out and rule-in diagnostics with applications to mammography data

Multiple diagnostic tests are frequently used to determine the presence of a disease condition in patients. In this paper, we use bivariate copulas to examine the properties of receiver operating characteristic (ROC) curves formed when two correlated diagnostic tests are used together to rule-out ("believe the negative") and rule-in ("believe the positive") patients for disease. We use this theory to analyze three mammography data sets where AI devices are applied to reduce radiologists' workload or improve diagnostic performance. Our analysis shows with generality that increasing the radiologist-AI correlation for diseased cases enhances the area under the ROC curve (AUC) of a radiologist-AI rule-out curve, whereas decreasing correlation for non-diseased cases has a similar effect. The opposite trends hold for rule-in scenarios. Applications to clinical mammography data show that projected empirical radiologist performance under a rule-out or rule-in scenario is consistent with the theory.

stat.ME

Proceedings Virtual Imaging Trials in Medicine 2024

This submission comprises the proceedings of the 1st Virtual Imaging Trials in Medicine conference, organized by Duke University on April 22-24, 2024. The listed authors serve as the program directors for this conference. The VITM conference is a pioneering summit uniting experts from academia, industry and government in the fields of medical imaging and therapy to explore the transformative potential of in silico virtual trials and digital twins in revolutionizing healthcare. The proceedings are categorized by the respective days of the conference: Monday presentations, Tuesday presentations, Wednesday presentations, followed by the abstracts for the posters presented on Monday and Tuesday.

physics.med-ph

Super Phantoms: advanced models for testing medical imaging technologies

Phantoms are test objects used for initial testing and optimization of medical imaging techniques, but these rarely capture the complex properties of the tissue. Here we introduce super phantoms, that surpass standard phantoms being able to replicate complex anatomic and functional imaging properties of tissues and organs. These super phantoms can be computer models, inanimate physical objects, or ex-vivo organs. Testing on these super phantoms, will enable iterative improvements well before in-vivo studies, fostering innovation. We illustrate super phantom examples, address development challenges, and envision centralized facilities supporting multiple institutions in applying these models for medical advancements.

physics.med-ph

FlowNet-PET: Unsupervised Learning to Perform Respiratory Motion Correction in PET Imaging

To correct for respiratory motion in PET imaging, an interpretable and unsupervised deep learning technique, FlowNet-PET, was constructed. The network was trained to predict the optical flow between two PET frames from different breathing amplitude ranges. The trained model aligns different retrospectively-gated PET images, providing a final image with similar counting statistics as a non-gated image, but without the blurring effects. FlowNet-PET was applied to anthropomorphic digital phantom data, which provided the possibility to design robust metrics to quantify the corrections. When comparing the predicted optical flows to the ground truths, the median absolute error was found to be smaller than the pixel and slice widths. The improvements were illustrated by comparing against images without motion and computing the intersection over union (IoU) of the tumors as well as the enclosed activity and coefficient of variation (CoV) within the no-motion tumor volume before and after the corrections were applied. The average relative improvements provided by the network were 64%, 89%, and 75% for the IoU, total activity, and CoV, respectively. FlowNet-PET achieved similar results as the conventional retrospective phase binning approach, but only required one sixth of the scan duration. The code and data have been made publicly available (https://github.com/teaghan/FlowNet_PET).

eess.IV

Deep learning reconstruction of digital breast tomosynthesis images for accurate breast density and patient-specific radiation dose estimation

The two-dimensional nature of mammography makes estimation of the overall breast density challenging, and estimation of the true patient-specific radiation dose impossible. Digital breast tomosynthesis (DBT), a pseudo-3D technique, is now commonly used in breast cancer screening and diagnostics. Still, the severely limited 3rd dimension information in DBT has not been used, until now, to estimate the true breast density or the patient-specific dose. This study proposes a reconstruction algorithm for DBT based on deep learning specifically optimized for these tasks. The algorithm, which we name DBToR, is based on unrolling a proximal-dual optimization method. The proximal operators are replaced with convolutional neural networks and prior knowledge is included in the model. This extends previous work on a deep learning-based reconstruction model by providing both the primal and the dual blocks with breast thickness information, which is available in DBT. Training and testing of the model were performed using virtual patient phantoms from two different sources. Reconstruction performance, and accuracy in estimation of breast density and radiation dose, were estimated, showing high accuracy (density <+/-3%; dose <+/-20%) without bias, significantly improving on the current state-of-the-art. This work also lays the groundwork for developing a deep learning-based reconstruction algorithm for the task of image interpretation by radiologists.

physics.med-ph

Deep Learning-based Initialization of Iterative Reconstruction for Breast Tomosynthesis

Reconstruction of digital breast tomosynthesis is a challenging problem due to the limited angle data available in such systems. Due to memory limitations, deep learning-based methods can help improve these reconstructions, but can not (yet) attain sufficiently high resolution. In addition to this practical issue, questions remain on the possibility of such models introducing 'ghost' information from the training data that is not compatible with the projection data. To take advantage of some of the benefits of deep learning-based reconstructions while avoiding these limitations, we propose to use the low resolution deep learning-based reconstruction as an initialization of a regular high resolution iterative method. The network was trained using digital phantoms, some based on a mathematical model and some derived from patient dedicated breast CT scans. The output of this network was then used as initialization for 10 000 iterations of MLTR for nine patient based phantoms that were not included in the training. The same nine cases were also reconstructed without any initialization for comparison. The reconstructions including initialization were found to reach a lower mean squared error than those without, and visual inspection found much improved retrieval of the breast outline and depiction of the skin, confirming that adding the deep learning-based initialization adds valuable information to the reconstruction.

physics.med-ph

Deep Learning Framework for Digital Breast Tomosynthesis Reconstruction

Digital breast tomosynthesis is rapidly replacing digital mammography as the basic x-ray technique for evaluation of the breasts. However, the sparse sampling and limited angular range gives rise to different artifacts, which manufacturers try to solve in several ways. In this study we propose an extension of the Learned Primal-Dual algorithm for digital breast tomosynthesis. The Learned Primal-Dual algorithm is a deep neural network consisting of several `reconstruction blocks', which take in raw sinogram data as the initial input, perform a forward and a backward pass by taking projections and back-projections, and use a convolutional neural network to produce an intermediate reconstruction result which is then improved further by the successive reconstruction block. We extend the architecture by providing breast thickness measurements as a mask to the neural network and allow it to learn how to use this thickness mask. We have trained the algorithm on digital phantoms and the corresponding noise-free/noisy projections, and then tested the algorithm on digital phantoms for varying level of noise. Reconstruction performance of the algorithms was compared visually, using MSE loss and Structural Similarity Index. Results indicate that the proposed algorithm outperforms the baseline iterative reconstruction algorithm in terms of reconstruction quality for both breast edges and internal structures and is robust to noise.

physics.med-ph