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Yuankai Huo

Publications and source records attributed to Yuankai Huo.

At least 181 records · Page 10Linked to original sources

Outlier Guided Optimization of Abdominal Segmentation

Abdominal multi-organ segmentation of computed tomography (CT) images has been the subject of extensive research interest. It presents a substantial challenge in medical image processing, as the shape and distribution of abdominal organs can vary greatly among the population and within an individual over time. While continuous integration of novel datasets into the training set provides potential for better segmentation performance, collection of data at scale is not only costly, but also impractical in some contexts. Moreover, it remains unclear what marginal value additional data have to offer. Herein, we propose a single-pass active learning method through human quality assurance (QA). We built on a pre-trained 3D U-Net model for abdominal multi-organ segmentation and augmented the dataset either with outlier data (e.g., exemplars for which the baseline algorithm failed) or inliers (e.g., exemplars for which the baseline algorithm worked). The new models were trained using the augmented datasets with 5-fold cross-validation (for outlier data) and withheld outlier samples (for inlier data). Manual labeling of outliers increased Dice scores with outliers by 0.130, compared to an increase of 0.067 with inliers (p<0.001, two-tailed paired t-test). By adding 5 to 37 inliers or outliers to training, we find that the marginal value of adding outliers is higher than that of adding inliers. In summary, improvement on single-organ performance was obtained without diminishing multi-organ performance or significantly increasing training time. Hence, identification and correction of baseline failure cases present an effective and efficient method of selecting training data to improve algorithm performance.

cs.CV↗

Validation and Optimization of Multi-Organ Segmentation on Clinical Imaging Archives

Segmentation of abdominal computed tomography(CT) provides spatial context, morphological properties, and a framework for tissue-specific radiomics to guide quantitative Radiological assessment. A 2015 MICCAI challenge spurred substantial innovation in multi-organ abdominal CT segmentation with both traditional and deep learning methods. Recent innovations in deep methods have driven performance toward levels for which clinical translation is appealing. However, continued cross-validation on open datasets presents the risk of indirect knowledge contamination and could result in circular reasoning. Moreover, 'real world' segmentations can be challenging due to the wide variability of abdomen physiology within patients. Herein, we perform two data retrievals to capture clinically acquired deidentified abdominal CT cohorts with respect to a recently published variation on 3D U-Net (baseline algorithm). First, we retrieved 2004 deidentified studies on 476 patients with diagnosis codes involving spleen abnormalities (cohort A). Second, we retrieved 4313 deidentified studies on 1754 patients without diagnosis codes involving spleen abnormalities (cohort B). We perform prospective evaluation of the existing algorithm on both cohorts, yielding 13% and 8% failure rate, respectively. Then, we identified 51 subjects in cohort A with segmentation failures and manually corrected the liver and gallbladder labels. We re-trained the model adding the manual labels, resulting in performance improvement of 9% and 6% failure rate for the A and B cohorts, respectively. In summary, the performance of the baseline on the prospective cohorts was similar to that on previously published datasets. Moreover, adding data from the first cohort substantively improved performance when evaluated on the second withheld validation cohort.

eess.IV↗

Internal-transfer Weighting of Multi-task Learning for Lung Cancer Detection

Recently, multi-task networks have shown to both offer additional estimation capabilities, and, perhaps more importantly, increased performance over single-task networks on a "main/primary" task. However, balancing the optimization criteria of multi-task networks across different tasks is an area of active exploration. Here, we extend a previously proposed 3D attention-based network with four additional multi-task subnetworks for the detection of lung cancer and four auxiliary tasks (diagnosis of asthma, chronic bronchitis, chronic obstructive pulmonary disease, and emphysema). We introduce and evaluate a learning policy, Periodic Focusing Learning Policy (PFLP), that alternates the dominance of tasks throughout the training. To improve performance on the primary task, we propose an Internal-Transfer Weighting (ITW) strategy to suppress the loss functions on auxiliary tasks for the final stages of training. To evaluate this approach, we examined 3386 patients (single scan per patient) from the National Lung Screening Trial (NLST) and de-identified data from the Vanderbilt Lung Screening Program, with a 2517/277/592 (scans) split for training, validation, and testing. Baseline networks include a single-task strategy and a multi-task strategy without adaptive weights (PFLP/ITW), while primary experiments are multi-task trials with either PFLP or ITW or both. On the test set for lung cancer prediction, the baseline single-task network achieved prediction AUC of 0.8080 and the multi-task baseline failed to converge (AUC 0.6720). However, applying PFLP helped multi-task network clarify and achieved test set lung cancer prediction AUC of 0.8402. Furthermore, our ITW technique boosted the PFLP enabled multi-task network and achieved an AUC of 0.8462 (McNemar test, p < 0.01).

cs.CV↗

Stochastic tissue window normalization of deep learning on computed tomography

Tissue window filtering has been widely used in deep learning for computed tomography (CT) image analyses to improve training performance (e.g., soft tissue windows for abdominal CT). However, the effectiveness of tissue window normalization is questionable since the generalizability of the trained model might be further harmed, especially when such models are applied to new cohorts with different CT reconstruction kernels, contrast mechanisms, dynamic variations in the acquisition, and physiological changes. We evaluate the effectiveness of both with and without using soft tissue window normalization on multisite CT cohorts. Moreover, we propose a stochastic tissue window normalization (SWN) method to improve the generalizability of tissue window normalization. Different from the random sampling, the SWN method centers the randomization around the soft tissue window to maintain the specificity for abdominal organs. To evaluate the performance of different strategies, 80 training and 453 validation and testing scans from six datasets are employed to perform multi-organ segmentation using standard 2D U-Net. The six datasets cover the scenarios, where the training and testing scans are from (1) same scanner and same population, (2) same CT contrast but different pathology, and (3) different CT contrast and pathology. The traditional soft tissue window and nonwindowed approaches achieved better performance on (1). The proposed SWN achieved general superior performance on (2) and (3) with statistical analyses, which offers better generalizability for a trained model.

eess.IV↗

Contrast Phase Classification with a Generative Adversarial Network

Dynamic contrast enhanced computed tomography (CT) is an imaging technique that provides critical information on the relationship of vascular structure and dynamics in the context of underlying anatomy. A key challenge for image processing with contrast enhanced CT is that phase discrepancies are latent in different tissues due to contrast protocols, vascular dynamics, and metabolism variance. Previous studies with deep learning frameworks have been proposed for classifying contrast enhancement with networks inspired by computer vision. Here, we revisit the challenge in the context of whole abdomen contrast enhanced CTs. To capture and compensate for the complex contrast changes, we propose a novel discriminator in the form of a multi-domain disentangled representation learning network. The goal of this network is to learn an intermediate representation that separates contrast enhancement from anatomy and enables classification of images with varying contrast time. Briefly, our unpaired contrast disentangling GAN(CD-GAN) Discriminator follows the ResNet architecture to classify a CT scan from different enhancement phases. To evaluate the approach, we trained the enhancement phase classifier on 21060 slices from two clinical cohorts of 230 subjects. Testing was performed on 9100 slices from 30 independent subjects who had been imaged with CT scans from all contrast phases. Performance was quantified in terms of the multi-class normalized confusion matrix. The proposed network significantly improved correspondence over baseline UNet, ResNet50 and StarGAN performance of accuracy scores 0.54. 0.55, 0.62 and 0.91, respectively. The proposed discriminator from the disentangled network presents a promising technique that may allow deeper modeling of dynamic imaging against patient specific anatomies.

eess.IV↗

Semi-Supervised Multi-Organ Segmentation through Quality Assurance Supervision

Human in-the-loop quality assurance (QA) is typically performed after medical image segmentation to ensure that the systems are performing as intended, as well as identifying and excluding outliers. By performing QA on large-scale, previously unlabeled testing data, categorical QA scores can be generatedIn this paper, we propose a semi-supervised multi-organ segmentation deep neural network consisting of a traditional segmentation model generator and a QA involved discriminator. A large-scale dataset of 2027 volumes are used to train the generator, whose 2-D montage images and segmentation mask with QA scores are used to train the discriminator. To generate the QA scores, the 2-D montage images were reviewed manually and coded 0 (success), 1 (errors consistent with published performance), and 2 (gross failure). Then, the ResNet-18 network was trained with 1623 montage images in equal distribution of all three code labels and achieved an accuracy 94% for classification predictions with 404 montage images withheld for the test cohort. To assess the performance of using the QA supervision, the discriminator was used as a loss function in a multi-organ segmentation pipeline. The inclusion of QA-loss function boosted performance on the unlabeled test dataset from 714 patients to 951 patients over the baseline model. Additionally, the number of failures decreased from 606 (29.90%) to 402 (19.83%). The contributions of the proposed method are threefold: We show that (1) the QA scores can be used as a loss function to perform semi-supervised learning for unlabeled data, (2) the well trained discriminator is learnt by QA score rather than traditional true/false, and (3) the performance of multi-organ segmentation on unlabeled datasets can be fine-tuned with more robust and higher accuracy than the original baseline method.

eess.IV↗

SynSeg-Net: Synthetic Segmentation Without Target Modality Ground Truth

A key limitation of deep convolutional neural networks (DCNN) based image segmentation methods is the lack of generalizability. Manually traced training images are typically required when segmenting organs in a new imaging modality or from distinct disease cohort. The manual efforts can be alleviated if the manually traced images in one imaging modality (e.g., MRI) are able to train a segmentation network for another imaging modality (e.g., CT). In this paper, we propose an end-to-end synthetic segmentation network (SynSeg-Net) to train a segmentation network for a target imaging modality without having manual labels. SynSeg-Net is trained by using (1) unpaired intensity images from source and target modalities, and (2) manual labels only from source modality. SynSeg-Net is enabled by the recent advances of cycle generative adversarial networks (CycleGAN) and DCNN. We evaluate the performance of the SynSeg-Net on two experiments: (1) MRI to CT splenomegaly synthetic segmentation for abdominal images, and (2) CT to MRI total intracranial volume synthetic segmentation (TICV) for brain images. The proposed end-to-end approach achieved superior performance to two stage methods. Moreover, the SynSeg-Net achieved comparable performance to the traditional segmentation network using target modality labels in certain scenarios. The source code of SynSeg-Net is publicly available (https://github.com/MASILab/SynSeg-Net).

cs.CV↗

Distanced LSTM: Time-Distanced Gates in Long Short-Term Memory Models for Lung Cancer Detection

The field of lung nodule detection and cancer prediction has been rapidly developing with the support of large public data archives. Previous studies have largely focused on cross-sectional (single) CT data. Herein, we consider longitudinal data. The Long Short-Term Memory (LSTM) model addresses learning with regularly spaced time points (i.e., equal temporal intervals). However, clinical imaging follows patient needs with often heterogeneous, irregular acquisitions. To model both regular and irregular longitudinal samples, we generalize the LSTM model with the Distanced LSTM (DLSTM) for temporally varied acquisitions. The DLSTM includes a Temporal Emphasis Model (TEM) that enables learning across regularly and irregularly sampled intervals. Briefly, (1) the time intervals between longitudinal scans are modeled explicitly, (2) temporally adjustable forget and input gates are introduced for irregular temporal sampling; and (3) the latest longitudinal scan has an additional emphasis term. We evaluate the DLSTM framework in three datasets including simulated data, 1794 National Lung Screening Trial (NLST) scans, and 1420 clinically acquired data with heterogeneous and irregular temporal accession. The experiments on the first two datasets demonstrate that our method achieves competitive performance on both simulated and regularly sampled datasets (e.g. improve LSTM from 0.6785 to 0.7085 on F1 score in NLST). In external validation of clinically and irregularly acquired data, the benchmarks achieved 0.8350 (CNN feature) and 0.8380 (LSTM) on the area under the ROC curve (AUC) score, while the proposed DLSTM achieves 0.8905.

eess.IV↗

Generalizing Deep Whole Brain Segmentation for Pediatric and Post-Contrast MRI with Augmented Transfer Learning

Generalizability is an important problem in deep neural networks, especially in the context of the variability of data acquisition in clinical magnetic resonance imaging (MRI). Recently, the Spatially Localized Atlas Network Tiles (SLANT) approach has been shown to effectively segment whole brain non-contrast T1w MRI with 132 volumetric labels. Enhancing generalizability of SLANT would enable broader application of volumetric assessment in multi-site studies. Transfer learning (TL) is commonly used to update the neural network weights for local factors; yet, it is commonly recognized to risk degradation of performance on the original validation/test cohorts. Here, we explore TL by data augmentation to address these concerns in the context of adapting SLANT to anatomical variation and scanning protocol. We consider two datasets: First, we optimize for age with 30 T1w MRI of young children with manually corrected volumetric labels, and accuracy of automated segmentation defined relative to the manually provided truth. Second, we optimize for acquisition with 36 paired datasets of pre- and post-contrast clinically acquired T1w MRI, and accuracy of the post-contrast segmentations assessed relative to the pre-contrast automated assessment. For both studies, we augment the original TL step of SLANT with either only the new data or with both original and new data. Over baseline SLANT, both approaches yielded significantly improved performance (signed rank tests; pediatric: 0.89 vs. 0.82 DSC, p<0.001; contrast: 0.80 vs 0.76, p<0.001). The performance on the original test set decreased with the new-data only transfer learning approach, so data augmentation was superior to strict transfer learning.

eess.IV↗

Cortical Surface Parcellation using Spherical Convolutional Neural Networks

We present cortical surface parcellation using spherical deep convolutional neural networks. Traditional multi-atlas cortical surface parcellation requires inter-subject surface registration using geometric features with high processing time on a single subject (2-3 hours). Moreover, even optimal surface registration does not necessarily produce optimal cortical parcellation as parcel boundaries are not fully matched to the geometric features. In this context, a choice of training features is important for accurate cortical parcellation. To utilize the networks efficiently, we propose cortical parcellation-specific input data from an irregular and complicated structure of cortical surfaces. To this end, we align ground-truth cortical parcel boundaries and use their resulting deformation fields to generate new pairs of deformed geometric features and parcellation maps. To extend the capability of the networks, we then smoothly morph cortical geometric features and parcellation maps using the intermediate deformation fields. We validate our method on 427 adult brains for 49 labels. The experimental results show that our method out-performs traditional multi-atlas and naive spherical U-Net approaches, while achieving full cortical parcellation in less than a minute.

q-bio.NC↗

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).

eess.IV↗

3D Whole Brain Segmentation using Spatially Localized Atlas Network Tiles

Detailed whole brain segmentation is an essential quantitative technique, which provides a non-invasive way of measuring brain regions from a structural magnetic resonance imaging (MRI). Recently, deep convolution neural network (CNN) has been applied to whole brain segmentation. However, restricted by current GPU memory, 2D based methods, downsampling based 3D CNN methods, and patch-based high-resolution 3D CNN methods have been the de facto standard solutions. 3D patch-based high resolution methods typically yield superior performance among CNN approaches on detailed whole brain segmentation (>100 labels), however, whose performance are still commonly inferior compared with multi-atlas segmentation methods (MAS) due to the following challenges: (1) a single network is typically used to learn both spatial and contextual information for the patches, (2) limited manually traced whole brain volumes are available (typically less than 50) for training a network. In this work, we propose the spatially localized atlas network tiles (SLANT) method to distribute multiple independent 3D fully convolutional networks (FCN) for high-resolution whole brain segmentation. To address the first challenge, multiple spatially distributed networks were used in the SLANT method, in which each network learned contextual information for a fixed spatial location. To address the second challenge, auxiliary labels on 5111 initially unlabeled scans were created by multi-atlas segmentation for training. Since the method integrated multiple traditional medical image processing methods with deep learning, we developed a containerized pipeline to deploy the end-to-end solution. From the results, the proposed method achieved superior performance compared with multi-atlas segmentation methods, while reducing the computational time from >30 hours to 15 minutes (https://github.com/MASILab/SLANTbrainSeg).

cs.CV↗

Lung Cancer Detection using Co-learning from Chest CT Images and Clinical Demographics

Early detection of lung cancer is essential in reducing mortality. Recent studies have demonstrated the clinical utility of low-dose computed tomography (CT) to detect lung cancer among individuals selected based on very limited clinical information. However, this strategy yields high false positive rates, which can lead to unnecessary and potentially harmful procedures. To address such challenges, we established a pipeline that co-learns from detailed clinical demographics and 3D CT images. Toward this end, we leveraged data from the Consortium for Molecular and Cellular Characterization of Screen-Detected Lesions (MCL), which focuses on early detection of lung cancer. A 3D attention-based deep convolutional neural net (DCNN) is proposed to identify lung cancer from the chest CT scan without prior anatomical location of the suspicious nodule. To improve upon the non-invasive discrimination between benign and malignant, we applied a random forest classifier to a dataset integrating clinical information to imaging data. The results show that the AUC obtained from clinical demographics alone was 0.635 while the attention network alone reached an accuracy of 0.687. In contrast when applying our proposed pipeline integrating clinical and imaging variables, we reached an AUC of 0.787 on the testing dataset. The proposed network both efficiently captures anatomical information for classification and also generates attention maps that explain the features that drive performance.

cs.CV↗

Reproducibility Evaluation of SLANT Whole Brain Segmentation Across Clinical Magnetic Resonance Imaging Protocols

Whole brain segmentation on structural magnetic resonance imaging (MRI) is essential for understanding neuroanatomical-functional relationships. Traditionally, multi-atlas segmentation has been regarded as the standard method for whole brain segmentation. In past few years, deep convolutional neural network (DCNN) segmentation methods have demonstrated their advantages in both accuracy and computational efficiency. Recently, we proposed the spatially localized atlas network tiles (SLANT) method, which is able to segment a 3D MRI brain scan into 132 anatomical regions. Commonly, DCNN segmentation methods yield inferior performance under external validations, especially when the testing patterns were not presented in the training cohorts. Recently, we obtained a clinically acquired, multi-sequence MRI brain cohort with 1480 clinically acquired, de-identified brain MRI scans on 395 patients using seven different MRI protocols. Moreover, each subject has at least two scans from different MRI protocols. Herein, we assess the SLANT method's intra- and inter-protocol reproducibility. SLANT achieved less than 0.05 coefficient of variation (CV) for intra-protocol experiments and less than 0.15 CV for inter-protocol experiments. The results show that the SLANT method achieved high intra- and inter- protocol reproducibility.

cs.CV↗

Montage based 3D Medical Image Retrieval from Traumatic Brain Injury Cohort using Deep Convolutional Neural Network

Brain imaging analysis on clinically acquired computed tomography (CT) is essential for the diagnosis, risk prediction of progression, and treatment of the structural phenotypes of traumatic brain injury (TBI). However, in real clinical imaging scenarios, entire body CT images (e.g., neck, abdomen, chest, pelvis) are typically captured along with whole brain CT scans. For instance, in a typical sample of clinical TBI imaging cohort, only ~15% of CT scans actually contain whole brain CT images suitable for volumetric brain analyses; the remaining are partial brain or non-brain images. Therefore, a manual image retrieval process is typically required to isolate the whole brain CT scans from the entire cohort. However, the manual image retrieval is time and resource consuming and even more difficult for the larger cohorts. To alleviate the manual efforts, in this paper we propose an automated 3D medical image retrieval pipeline, called deep montage-based image retrieval (dMIR), which performs classification on 2D montage images via a deep convolutional neural network. The novelty of the proposed method for image processing is to characterize the medical image retrieval task based on the montage images. In a cohort of 2000 clinically acquired TBI scans, 794 scans were used as training data, 206 scans were used as validation data, and the remaining 1000 scans were used as testing data. The proposed achieved accuracy=1.0, recall=1.0, precision=1.0, f1=1.0 for validation data, while achieved accuracy=0.988, recall=0.962, precision=0.962, f1=0.962 for testing data. Thus, the proposed dMIR is able to perform accurate CT whole brain image retrieval from large-scale clinical cohorts.

cs.IR↗

Towards Machine Learning Prediction of Deep Brain Stimulation (DBS) Intra-operative Efficacy Maps

Deep brain stimulation (DBS) has the potential to improve the quality of life of people with a variety of neurological diseases. A key challenge in DBS is in the placement of a stimulation electrode in the anatomical location that maximizes efficacy and minimizes side effects. Pre-operative localization of the optimal stimulation zone can reduce surgical times and morbidity. Current methods of producing efficacy probability maps follow an anatomical guidance on magnetic resonance imaging (MRI) to identify the areas with the highest efficacy in a population. In this work, we propose to revisit this problem as a classification problem, where each voxel in the MRI is a sample informed by the surrounding anatomy. We use a patch-based convolutional neural network to classify a stimulation coordinate as having a positive reduction in symptoms during surgery. We use a cohort of 187 patients with a total of 2,869 stimulation coordinates, upon which 3D patches were extracted and associated with an efficacy score. We compare our results with a registration-based method of surgical planning. We show an improvement in the classification of intraoperative stimulation coordinates as a positive response in reduction of symptoms with AUC of 0.670 compared to a baseline registration-based approach, which achieves an AUC of 0.627 (p < 0.01). Although additional validation is needed, the proposed classification framework and deep learning method appear well-suited for improving pre-surgical planning and personalize treatment strategies.

cs.CV↗

Coronary Calcium Detection using 3D Attention Identical Dual Deep Network Based on Weakly Supervised Learning

Coronary artery calcium (CAC) is biomarker of advanced subclinical coronary artery disease and predicts myocardial infarction and death prior to age 60 years. The slice-wise manual delineation has been regarded as the gold standard of coronary calcium detection. However, manual efforts are time and resource consuming and even impracticable to be applied on large-scale cohorts. In this paper, we propose the attention identical dual network (AID-Net) to perform CAC detection using scan-rescan longitudinal non-contrast CT scans with weakly supervised attention by only using per scan level labels. To leverage the performance, 3D attention mechanisms were integrated into the AID-Net to provide complementary information for classification tasks. Moreover, the 3D Gradient-weighted Class Activation Mapping (Grad-CAM) was also proposed at the testing stage to interpret the behaviors of the deep neural network. 5075 non-contrast chest CT scans were used as training, validation and testing datasets. Baseline performance was assessed on the same cohort. From the results, the proposed AID-Net achieved the superior performance on classification accuracy (0.9272) and AUC (0.9627).

cs.CV↗

Splenomegaly Segmentation on Multi-modal MRI using Deep Convolutional Networks

The findings of splenomegaly, abnormal enlargement of the spleen, is a non-invasive clinical biomarker for liver and spleen disease. Automated segmentation methods are essential to efficiently quantify splenomegaly from clinically acquired abdominal magnetic resonance imaging (MRI) scans. However, the task is challenging due to (1) large anatomical and spatial variations of splenomegaly, (2) large inter- and intra-scan intensity variations on multi-modal MRI, and (3) limited numbers of labeled splenomegaly scans. In this paper, we propose the Splenomegaly Segmentation Network (SS-Net) to introduce the deep convolutional neural network (DCNN) approaches in multi-modal MRI splenomegaly segmentation. Large convolutional kernel layers were used to address the spatial and anatomical variations, while the conditional generative adversarial networks (GAN) were employed to leverage the segmentation performance of SS-Net in an end-to-end manner. A clinically acquired cohort containing both T1-weighted (T1w) and T2-weighted (T2w) MRI splenomegaly scans was used to train and evaluate the performance of multi-atlas segmentation (MAS), 2D DCNN networks, and a 3D DCNN network. From the experimental results, the DCNN methods achieved superior performance to the state-of-the-art MAS method. The proposed SS-Net method achieved the highest median and mean Dice scores among investigated baseline DCNN methods.

cs.CV↗