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Purang Abolmaesumi

Publications and source records attributed to Purang Abolmaesumi.

54 records · Page 3Linked to original sources

TRUSformer: Improving Prostate Cancer Detection from Micro-Ultrasound Using Attention and Self-Supervision

A large body of previous machine learning methods for ultrasound-based prostate cancer detection classify small regions of interest (ROIs) of ultrasound signals that lie within a larger needle trace corresponding to a prostate tissue biopsy (called biopsy core). These ROI-scale models suffer from weak labeling as histopathology results available for biopsy cores only approximate the distribution of cancer in the ROIs. ROI-scale models do not take advantage of contextual information that are normally considered by pathologists, i.e. they do not consider information about surrounding tissue and larger-scale trends when identifying cancer. We aim to improve cancer detection by taking a multi-scale, i.e. ROI-scale and biopsy core-scale, approach. Methods: Our multi-scale approach combines (i) an "ROI-scale" model trained using self-supervised learning to extract features from small ROIs and (ii) a "core-scale" transformer model that processes a collection of extracted features from multiple ROIs in the needle trace region to predict the tissue type of the corresponding core. Attention maps, as a byproduct, allow us to localize cancer at the ROI scale. We analyze this method using a dataset of micro-ultrasound acquired from 578 patients who underwent prostate biopsy, and compare our model to baseline models and other large-scale studies in the literature. Results and Conclusions: Our model shows consistent and substantial performance improvements compared to ROI-scale-only models. It achieves 80.3% AUROC, a statistically significant improvement over ROI-scale classification. We also compare our method to large studies on prostate cancer detection, using other imaging modalities. Our code is publicly available at www.github.com/med-i-lab/TRUSFormer

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Deep Learning for Detection and Localization of B-Lines in Lung Ultrasound

Lung ultrasound (LUS) is an important imaging modality used by emergency physicians to assess pulmonary congestion at the patient bedside. B-line artifacts in LUS videos are key findings associated with pulmonary congestion. Not only can the interpretation of LUS be challenging for novice operators, but visual quantification of B-lines remains subject to observer variability. In this work, we investigate the strengths and weaknesses of multiple deep learning approaches for automated B-line detection and localization in LUS videos. We curate and publish, BEDLUS, a new ultrasound dataset comprising 1,419 videos from 113 patients with a total of 15,755 expert-annotated B-lines. Based on this dataset, we present a benchmark of established deep learning methods applied to the task of B-line detection. To pave the way for interpretable quantification of B-lines, we propose a novel "single-point" approach to B-line localization using only the point of origin. Our results show that (a) the area under the receiver operating characteristic curve ranges from 0.864 to 0.955 for the benchmarked detection methods, (b) within this range, the best performance is achieved by models that leverage multiple successive frames as input, and (c) the proposed single-point approach for B-line localization reaches an F1-score of 0.65, performing on par with the inter-observer agreement. The dataset and developed methods can facilitate further biomedical research on automated interpretation of lung ultrasound with the potential to expand the clinical utility.

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Self-Supervised Learning with Limited Labeled Data for Prostate Cancer Detection in High Frequency Ultrasound

Deep learning-based analysis of high-frequency, high-resolution micro-ultrasound data shows great promise for prostate cancer detection. Previous approaches to analysis of ultrasound data largely follow a supervised learning paradigm. Ground truth labels for ultrasound images used for training deep networks often include coarse annotations generated from the histopathological analysis of tissue samples obtained via biopsy. This creates inherent limitations on the availability and quality of labeled data, posing major challenges to the success of supervised learning methods. On the other hand, unlabeled prostate ultrasound data are more abundant. In this work, we successfully apply self-supervised representation learning to micro-ultrasound data. Using ultrasound data from 1028 biopsy cores of 391 subjects obtained in two clinical centres, we demonstrate that feature representations learnt with this method can be used to classify cancer from non-cancer tissue, obtaining an AUROC score of 91% on an independent test set. To the best of our knowledge, this is the first successful end-to-end self-supervised learning approach for prostate cancer detection using ultrasound data. Our method outperforms baseline supervised learning approaches, generalizes well between different data centers, and scale well in performance as more unlabeled data are added, making it a promising approach for future research using large volumes of unlabeled data.

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Towards Confident Detection of Prostate Cancer using High Resolution Micro-ultrasound

MOTIVATION: Detection of prostate cancer during transrectal ultrasound-guided biopsy is challenging. The highly heterogeneous appearance of cancer, presence of ultrasound artefacts, and noise all contribute to these difficulties. Recent advancements in high-frequency ultrasound imaging - micro-ultrasound - have drastically increased the capability of tissue imaging at high resolution. Our aim is to investigate the development of a robust deep learning model specifically for micro-ultrasound-guided prostate cancer biopsy. For the model to be clinically adopted, a key challenge is to design a solution that can confidently identify the cancer, while learning from coarse histopathology measurements of biopsy samples that introduce weak labels. METHODS: We use a dataset of micro-ultrasound images acquired from 194 patients, who underwent prostate biopsy. We train a deep model using a co-teaching paradigm to handle noise in labels, together with an evidential deep learning method for uncertainty estimation. We evaluate the performance of our model using the clinically relevant metric of accuracy vs. confidence. RESULTS: Our model achieves a well-calibrated estimation of predictive uncertainty with area under the curve of 88$\%$. The use of co-teaching and evidential deep learning in combination yields significantly better uncertainty estimation than either alone. We also provide a detailed comparison against state-of-the-art in uncertainty estimation.

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Class Impression for Data-free Incremental Learning

Standard deep learning-based classification approaches require collecting all samples from all classes in advance and are trained offline. This paradigm may not be practical in real-world clinical applications, where new classes are incrementally introduced through the addition of new data. Class incremental learning is a strategy allowing learning from such data. However, a major challenge is catastrophic forgetting, i.e., performance degradation on previous classes when adapting a trained model to new data. Prior methodologies to alleviate this challenge save a portion of training data require perpetual storage of such data that may introduce privacy issues. Here, we propose a novel data-free class incremental learning framework that first synthesizes data from the model trained on previous classes to generate a \ours. Subsequently, it updates the model by combining the synthesized data with new class data. Furthermore, we incorporate a cosine normalized Cross-entropy loss to mitigate the adverse effects of the imbalance, a margin loss to increase separation among previous classes and new ones, and an intra-domain contrastive loss to generalize the model trained on the synthesized data to real data. We compare our proposed framework with state-of-the-art methods in class incremental learning, where we demonstrate improvement in accuracy for the classification of 11,062 echocardiography cine series of patients.

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Echo-SyncNet: Self-supervised Cardiac View Synchronization in Echocardiography

In echocardiography (echo), an electrocardiogram (ECG) is conventionally used to temporally align different cardiac views for assessing critical measurements. However, in emergencies or point-of-care situations, acquiring an ECG is often not an option, hence motivating the need for alternative temporal synchronization methods. Here, we propose Echo-SyncNet, a self-supervised learning framework to synchronize various cross-sectional 2D echo series without any external input. The proposed framework takes advantage of both intra-view and inter-view self supervisions. The former relies on spatiotemporal patterns found between the frames of a single echo cine and the latter on the interdependencies between multiple cines. The combined supervisions are used to learn a feature-rich embedding space where multiple echo cines can be temporally synchronized. We evaluate the framework with multiple experiments: 1) Using data from 998 patients, Echo-SyncNet shows promising results for synchronizing Apical 2 chamber and Apical 4 chamber cardiac views; 2) Using data from 3070 patients, our experiments reveal that the learned representations of Echo-SyncNet outperform a supervised deep learning method that is optimized for automatic detection of fine-grained cardiac phase; 3) We show the usefulness of the learned representations in a one-shot learning scenario of cardiac keyframe detection. Without any fine-tuning, keyframes in 1188 validation patient studies are identified by synchronizing them with only one labeled reference study. We do not make any prior assumption about what specific cardiac views are used for training and show that Echo-SyncNet can accurately generalize to views not present in its training set. Project repository: github.com/fatemehtd/Echo-SyncNet.

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U-LanD: Uncertainty-Driven Video Landmark Detection

This paper presents U-LanD, a framework for joint detection of key frames and landmarks in videos. We tackle a specifically challenging problem, where training labels are noisy and highly sparse. U-LanD builds upon a pivotal observation: a deep Bayesian landmark detector solely trained on key video frames, has significantly lower predictive uncertainty on those frames vs. other frames in videos. We use this observation as an unsupervised signal to automatically recognize key frames on which we detect landmarks. As a test-bed for our framework, we use ultrasound imaging videos of the heart, where sparse and noisy clinical labels are only available for a single frame in each video. Using data from 4,493 patients, we demonstrate that U-LanD can exceedingly outperform the state-of-the-art non-Bayesian counterpart by a noticeable absolute margin of 42% in R2 score, with almost no overhead imposed on the model size. Our approach is generic and can be potentially applied to other challenging data with noisy and sparse training labels.

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Reciprocal Landmark Detection and Tracking with Extremely Few Annotations

Localization of anatomical landmarks to perform two-dimensional measurements in echocardiography is part of routine clinical workflow in cardiac disease diagnosis. Automatic localization of those landmarks is highly desirable to improve workflow and reduce interobserver variability. Training a machine learning framework to perform such localization is hindered given the sparse nature of gold standard labels; only few percent of cardiac cine series frames are normally manually labeled for clinical use. In this paper, we propose a new end-to-end reciprocal detection and tracking model that is specifically designed to handle the sparse nature of echocardiography labels. The model is trained using few annotated frames across the entire cardiac cine sequence to generate consistent detection and tracking of landmarks, and an adversarial training for the model is proposed to take advantage of these annotated frames. The superiority of the proposed reciprocal model is demonstrated using a series of experiments.

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PEP: Parameter Ensembling by Perturbation

Ensembling is now recognized as an effective approach for increasing the predictive performance and calibration of deep networks. We introduce a new approach, Parameter Ensembling by Perturbation (PEP), that constructs an ensemble of parameter values as random perturbations of the optimal parameter set from training by a Gaussian with a single variance parameter. The variance is chosen to maximize the log-likelihood of the ensemble average ($\mathbb{L}$) on the validation data set. Empirically, and perhaps surprisingly, $\mathbb{L}$ has a well-defined maximum as the variance grows from zero (which corresponds to the baseline model). Conveniently, calibration level of predictions also tends to grow favorably until the peak of $\mathbb{L}$ is reached. In most experiments, PEP provides a small improvement in performance, and, in some cases, a substantial improvement in empirical calibration. We show that this "PEP effect" (the gain in log-likelihood) is related to the mean curvature of the likelihood function and the empirical Fisher information. Experiments on ImageNet pre-trained networks including ResNet, DenseNet, and Inception showed improved calibration and likelihood. We further observed a mild improvement in classification accuracy on these networks. Experiments on classification benchmarks such as MNIST and CIFAR-10 showed improved calibration and likelihood, as well as the relationship between the PEP effect and overfitting; this demonstrates that PEP can be used to probe the level of overfitting that occurred during training. In general, no special training procedure or network architecture is needed, and in the case of pre-trained networks, no additional training is needed.

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Confidence Calibration and Predictive Uncertainty Estimation for Deep Medical Image Segmentation

Fully convolutional neural networks (FCNs), and in particular U-Nets, have achieved state-of-the-art results in semantic segmentation for numerous medical imaging applications. Moreover, batch normalization and Dice loss have been used successfully to stabilize and accelerate training. However, these networks are poorly calibrated i.e. they tend to produce overconfident predictions both in correct and erroneous classifications, making them unreliable and hard to interpret. In this paper, we study predictive uncertainty estimation in FCNs for medical image segmentation. We make the following contributions: 1) We systematically compare cross entropy loss with Dice loss in terms of segmentation quality and uncertainty estimation of FCNs; 2) We propose model ensembling for confidence calibration of the FCNs trained with batch normalization and Dice loss; 3) We assess the ability of calibrated FCNs to predict segmentation quality of structures and detect out-of-distribution test examples. We conduct extensive experiments across three medical image segmentation applications of the brain, the heart, and the prostate to evaluate our contributions. The results of this study offer considerable insight into the predictive uncertainty estimation and out-of-distribution detection in medical image segmentation and provide practical recipes for confidence calibration. Moreover, we consistently demonstrate that model ensembling improves confidence calibration.

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Variational Learning with Disentanglement-PyTorch

Unsupervised learning of disentangled representations is an open problem in machine learning. The Disentanglement-PyTorch library is developed to facilitate research, implementation, and testing of new variational algorithms. In this modular library, neural architectures, dimensionality of the latent space, and the training algorithms are fully decoupled, allowing for independent and consistent experiments across variational methods. The library handles the training scheduling, logging, and visualizations of reconstructions and latent space traversals. It also evaluates the encodings based on various disentanglement metrics. The library, so far, includes implementations of the following unsupervised algorithms VAE, Beta-VAE, Factor-VAE, DIP-I-VAE, DIP-II-VAE, Info-VAE, and Beta-TCVAE, as well as conditional approaches such as CVAE and IFCVAE. The library is compatible with the Disentanglement Challenge of NeurIPS 2019, hosted on AICrowd, and achieved the 3rd rank in both the first and second stages of the challenge.

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A Study into Echocardiography View Conversion

Transthoracic echo is one of the most common means of cardiac studies in the clinical routines. During the echo exam, the sonographer captures a set of standard cross sections (echo views) of the heart. Each 2D echo view cuts through the 3D cardiac geometry via a unique plane. Consequently, different views share some limited information. In this work, we investigate the feasibility of generating a 2D echo view using another view based on adversarial generative models. The objective optimized to train the view-conversion model is based on the ideas introduced by LSGAN, PatchGAN and Conditional GAN (cGAN). The size and length of the left ventricle in the generated target echo view is compared against that of the target ground-truth to assess the validity of the echo view conversion. Results show that there is a correlation of 0.50 between the LV areas and 0.49 between the LV lengths of the generated target frames and the real target frames.

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A Preliminary Study of Disentanglement With Insights on the Inadequacy of Metrics

Disentangled encoding is an important step towards a better representation learning. However, despite the numerous efforts, there still is no clear winner that captures the independent features of the data in an unsupervised fashion. In this work we empirically evaluate the performance of six unsupervised disentanglement approaches on the mpi3d toy dataset curated and released for the NeurIPS 2019 Disentanglement Challenge. The methods investigated in this work are Beta-VAE, Factor-VAE, DIP-I-VAE, DIP-II-VAE, Info-VAE, and Beta-TCVAE. The capacities of all models were progressively increased throughout the training and the hyper-parameters were kept intact across experiments. The methods were evaluated based on five disentanglement metrics, namely, DCI, Factor-VAE, IRS, MIG, and SAP-Score. Within the limitations of this study, the Beta-TCVAE approach was found to outperform its alternatives with respect to the normalized sum of metrics. However, a qualitative study of the encoded latents reveal that there is not a consistent correlation between the reported metrics and the disentanglement potential of the model.

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GAN-enhanced Conditional Echocardiogram Generation

Echocardiography (echo) is a common means of evaluating cardiac conditions. Due to the label scarcity, semi-supervised paradigms in automated echo analysis are getting traction. One of the most sought-after problems in echo is the segmentation of cardiac structures (e.g. chambers). Accordingly, we propose an echocardiogram generation approach using generative adversarial networks with a conditional patch-based discriminator. In this work, we validate the feasibility of GAN-enhanced echo generation with different conditions (segmentation masks), namely, the left ventricle, ventricular myocardium, and atrium. Results show that the proposed adversarial algorithm can generate high-quality echo frames whose cardiac structures match the given segmentation masks. This method is expected to facilitate the training of other machine learning models in a semi-supervised fashion as suggested in similar researches.

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On Modelling Label Uncertainty in Deep Neural Networks: Automatic Estimation of Intra-observer Variability in 2D Echocardiography Quality Assessment

Uncertainty of labels in clinical data resulting from intra-observer variability can have direct impact on the reliability of assessments made by deep neural networks. In this paper, we propose a method for modelling such uncertainty in the context of 2D echocardiography (echo), which is a routine procedure for detecting cardiovascular disease at point-of-care. Echo imaging quality and acquisition time is highly dependent on the operator's experience level. Recent developments have shown the possibility of automating echo image quality quantification by mapping an expert's assessment of quality to the echo image via deep learning techniques. Nevertheless, the observer variability in the expert's assessment can impact the quality quantification accuracy. Here, we aim to model the intra-observer variability in echo quality assessment as an aleatoric uncertainty modelling regression problem with the introduction of a novel method that handles the regression problem with categorical labels. A key feature of our design is that only a single forward pass is sufficient to estimate the level of uncertainty for the network output. Compared to the $0.11 \pm 0.09$ absolute error (in a scale from 0 to 1) archived by the conventional regression method, the proposed method brings the error down to $0.09 \pm 0.08$, where the improvement is statistically significant and equivalents to $5.7\%$ test accuracy improvement. The simplicity of the proposed approach means that it could be generalized to other applications of deep learning in medical imaging, where there is often uncertainty in clinical labels.

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Variational Shape Completion for Virtual Planning of Jaw Reconstructive Surgery

The premorbid geometry of the mandible is of significant relevance in jaw reconstructive surgeries and occasionally unknown to the surgical team. In this paper, an optimization framework is introduced to train deep models for completion (reconstruction) of the missing segments of the bone based on the remaining healthy structure. To leverage the contextual information of the surroundings of the dissected region, the voxel-weighted Dice loss is introduced. To address the non-deterministic nature of the shape completion problem, we leverage a weighted multi-target probabilistic solution which is an extension to the conditional variational autoencoder (CVAE). This approach considers multiple targets as acceptable reconstructions, each weighted according to their conformity with the original shape. We quantify the performance gain of the proposed method against similar algorithms, including CVAE, where we report statistically significant improvements in both deterministic and probabilistic paradigms. The probabilistic model is also evaluated on its ability to generate anatomically relevant variations for the missing bone. As a unique aspect of this work, the model is tested on real surgical cases where the clinical relevancy of its reconstructions and their compliance with surgeon's virtual plan are demonstrated as necessary steps towards clinical adoption.

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Deep Neural Maps

We introduce a new unsupervised representation learning and visualization using deep convolutional networks and self organizing maps called Deep Neural Maps (DNM). DNM jointly learns an embedding of the input data and a mapping from the embedding space to a two-dimensional lattice. We compare visualizations of DNM with those of t-SNE and LLE on the MNIST and COIL-20 data sets. Our experiments show that the DNM can learn efficient representations of the input data, which reflects characteristics of each class. This is shown via back-projecting the neurons of the map on the data space.

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Transfer Learning for Domain Adaptation in MRI: Application in Brain Lesion Segmentation

Magnetic Resonance Imaging (MRI) is widely used in routine clinical diagnosis and treatment. However, variations in MRI acquisition protocols result in different appearances of normal and diseased tissue in the images. Convolutional neural networks (CNNs), which have shown to be successful in many medical image analysis tasks, are typically sensitive to the variations in imaging protocols. Therefore, in many cases, networks trained on data acquired with one MRI protocol, do not perform satisfactorily on data acquired with different protocols. This limits the use of models trained with large annotated legacy datasets on a new dataset with a different domain which is often a recurring situation in clinical settings. In this study, we aim to answer the following central questions regarding domain adaptation in medical image analysis: Given a fitted legacy model, 1) How much data from the new domain is required for a decent adaptation of the original network?; and, 2) What portion of the pre-trained model parameters should be retrained given a certain number of the new domain training samples? To address these questions, we conducted extensive experiments in white matter hyperintensity segmentation task. We trained a CNN on legacy MR images of brain and evaluated the performance of the domain-adapted network on the same task with images from a different domain. We then compared the performance of the model to the surrogate scenarios where either the same trained network is used or a new network is trained from scratch on the new dataset.The domain-adapted network tuned only by two training examples achieved a Dice score of 0.63 substantially outperforming a similar network trained on the same set of examples from scratch.

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