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Thomas A. Lasko

Publications and source records attributed to Thomas A. Lasko.

24 records · Page 2Linked to original sources

Characterizing Renal Structures with 3D Block Aggregate Transformers

Efficiently quantifying renal structures can provide distinct spatial context and facilitate biomarker discovery for kidney morphology. However, the development and evaluation of the transformer model to segment the renal cortex, medulla, and collecting system remains challenging due to data inefficiency. Inspired by the hierarchical structures in vision transformer, we propose a novel method using a 3D block aggregation transformer for segmenting kidney components on contrast-enhanced CT scans. We construct the first cohort of renal substructures segmentation dataset with 116 subjects under institutional review board (IRB) approval. Our method yields the state-of-the-art performance (Dice of 0.8467) against the baseline approach of 0.8308 with the data-efficient design. The Pearson R achieves 0.9891 between the proposed method and manual standards and indicates the strong correlation and reproducibility for volumetric analysis. We extend the proposed method to the public KiTS dataset, the method leads to improved accuracy compared to transformer-based approaches. We show that the 3D block aggregation transformer can achieve local communication between sequence representations without modifying self-attention, and it can serve as an accurate and efficient quantification tool for characterizing renal structures.

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Lung Cancer Risk Estimation with Incomplete Data: A Joint Missing Imputation Perspective

Data from multi-modality provide complementary information in clinical prediction, but missing data in clinical cohorts limits the number of subjects in multi-modal learning context. Multi-modal missing imputation is challenging with existing methods when 1) the missing data span across heterogeneous modalities (e.g., image vs. non-image); or 2) one modality is largely missing. In this paper, we address imputation of missing data by modeling the joint distribution of multi-modal data. Motivated by partial bidirectional generative adversarial net (PBiGAN), we propose a new Conditional PBiGAN (C-PBiGAN) method that imputes one modality combining the conditional knowledge from another modality. Specifically, C-PBiGAN introduces a conditional latent space in a missing imputation framework that jointly encodes the available multi-modal data, along with a class regularization loss on imputed data to recover discriminative information. To our knowledge, it is the first generative adversarial model that addresses multi-modal missing imputation by modeling the joint distribution of image and non-image data. We validate our model with both the national lung screening trial (NLST) dataset and an external clinical validation cohort. The proposed C-PBiGAN achieves significant improvements in lung cancer risk estimation compared with representative imputation methods (e.g., AUC values increase in both NLST (+2.9\%) and in-house dataset (+4.3\%) compared with PBiGAN, p$<$0.05).

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Synthesized Difference in Differences

We consider estimating the conditional average treatment effect for everyone by eliminating confounding and selection bias. Unfortunately, randomized clinical trials (RCTs) eliminate confounding but impose strict exclusion criteria that prevent sampling of the entire clinical population. Observational datasets are more inclusive but suffer from confounding. We therefore analyze RCT and observational data simultaneously in order to extract the strengths of each. Our solution builds upon Difference in Differences (DD), an algorithm that eliminates confounding from observational data by comparing outcomes before and after treatment administration. DD requires a parallel slopes assumption that may not apply in practice when confounding shifts across time. We instead propose Synthesized Difference in Differences (SDD) that infers the correct (possibly non-parallel) slopes by linearly adjusting a conditional version of DD using additional RCT data. The algorithm achieves state of the art performance across multiple synthetic and real datasets even when the RCT excludes the majority of patients.

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Computational Phenotype Discovery via Probabilistic Independence

Computational Phenotype Discovery research has taken various pragmatic approaches to disentangling phenotypes from the episodic observations in Electronic Health Records. In this work, we use transformation into continuous, longitudinal curves to abstract away the sparse irregularity of the data, and we introduce probabilistic independence as a guiding principle for disentangling phenotypes into patterns that may more closely match true pathophysiologic mechanisms. We use the identification of liver disease patterns that presage development of Hepatocellular Carcinoma as a proof-of-concept demonstration.

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Fully Automatic Liver Attenuation Estimation Combing CNN Segmentation and Morphological Operations

Manually tracing regions of interest (ROIs) within the liver is the de facto standard method for measuring liver attenuation on computed tomography (CT) in diagnosing nonalcoholic fatty liver disease (NAFLD). However, manual tracing is resource intensive. To address these limitations and to expand the availability of a quantitative CT measure of hepatic steatosis, we propose the automatic liver attenuation ROI-based measurement (ALARM) method for automated liver attenuation estimation. The ALARM method consists of two major stages: (1) deep convolutional neural network (DCNN)-based liver segmentation and (2) automated ROI extraction. First, liver segmentation was achieved using our previously developed SS-Net. Then, a single central ROI (center-ROI) and three circles ROI (periphery-ROI) were computed based on liver segmentation and morphological operations. The ALARM method is available as an open source Docker container (https://github.com/MASILab/ALARM).246 subjects with 738 abdomen CT scans from the African American-Diabetes Heart Study (AA-DHS) were used for external validation (testing), independent from the training and validation cohort (100 clinically acquired CT abdominal scans).

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Efficient Inference of Gaussian Process Modulated Renewal Processes with Application to Medical Event Data

The episodic, irregular and asynchronous nature of medical data render them difficult substrates for standard machine learning algorithms. We would like to abstract away this difficulty for the class of time-stamped categorical variables (or events) by modeling them as a renewal process and inferring a probability density over continuous, longitudinal, nonparametric intensity functions modulating that process. Several methods exist for inferring such a density over intensity functions, but either their constraints and assumptions prevent their use with our potentially bursty event streams, or their time complexity renders their use intractable on our long-duration observations of high-resolution events, or both. In this paper we present a new and efficient method for inferring a distribution over intensity functions that uses direct numeric integration and smooth interpolation over Gaussian processes. We demonstrate that our direct method is up to twice as accurate and two orders of magnitude more efficient than the best existing method (thinning). Importantly, the direct method can infer intensity functions over the full range of bursty to memoryless to regular events, which thinning and many other methods cannot. Finally, we apply the method to clinical event data and demonstrate the face-validity of the abstraction, which is now amenable to standard learning algorithms.

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