3D fully convolutional networks for subcortical segmentation in MRI: A large-scale study

On-board synthetic 4D MRI generation from 4D CBCT for radiotherapy of abdominal tumors: A feasibility study

BACKGROUND

Magnetic resonance-guided radiotherapy with an MR-guided LINAC represents potential clinical benefits in abdominal treatments due to the superior soft-tissue contrast compared to kV-based images in conventional treatment units. However, due to the high cost associated with this technology, only a few centers have access to it. As an alternative, synthetic 4D MRI generation based on artificial intelligence methods could be implemented. Nevertheless, appropriate MRI texture generation from CT images might be challenging and prone to hallucinations, compromising motion accuracy.

PURPOSE

To evaluate the feasibility of on-board synthetic motion-resolved 4D MRI generation from prior 4D MRI, on-board 4D cone beam CT (CBCT) images, motion modeling information, and deep learning models using the digital anthropomorphic phantom XCAT.

METHODS

The synthetic 4D MRI corresponds to phases from on-board 4D CBCT. Each synthetic MRI volume in the 4D MRI was generated by warping a reference 3D MRI (MRIref, end of expiration phase from a prior 4D MRI) with a deformation field map (DFM) determined by (I) the eigenvectors from the principal component analysis (PCA) motion-modeling of the prior 4D MRI, and (II) the corresponding eigenvalues predicted by a convolutional neural network (CNN) model using the on-board 4D CBCT images as input. The CNN was trained with 1000 deformations of one reference CT (CTref, same conditions as MRIref) generated by applying 1000 DFMs computed by randomly sampling the original eigenvalues from the prior 4D MRI PCA model. The evaluation metrics for the CNN model were root-mean-square error (RMSE) and mean absolute error (MAE). Finally, different on-board 4D-MRI generation scenarios were assessed by changing the respiratory period, the amplitude of the diaphragm, and the chest wall motion of the 4D CBCT using normalized root-mean-square error (nRMSE) and structural similarity index measure (SSIM) for image-based evaluation, and volume dice coefficient (VDC), volume percent difference (VPD), and center-of-mass shift (COMS) for contour-based evaluation of liver and target volumes.

RESULTS

The RMSE and MAE values of the CNN model reported 0.012 ± 0.001 and 0.010 ± 0.001, respectively for the first eigenvalue predictions. SSIM and nRMSE were 0.96 ± 0.06 and 0.22 ± 0.08, respectively. VDC, VPD, and COMS were 0.92 ± 0.06, 3.08 ± 3.73 %, and 2.3 ± 2.1 mm, respectively, for the target volume. The more challenging synthetic 4D-MRI generation scenario was for one 4D-CBCT with increased chest wall motion amplitude, reporting SSIM and nRMSE of 0.82 and 0.51, respectively.

CONCLUSIONS

On-board synthetic 4D-MRI generation based on predicting actual treatment deformation from on-board 4D-CBCT represents a method that can potentially improve the treatment-setup localization in abdominal radiotherapy treatments with a conventional kV-based LINAC.

Leveraging Pretrained Transformers for Efficient Segmentation and Lesion Detection in Cone-Beam Computed Tomography Scans

INTRODUCTION

Cone-beam computed tomography (CBCT) is widely used to detect jaw lesions, although CBCT interpretation is time-consuming and challenging. Artificial intelligence for CBCT segmentation may improve lesion detection accuracy. However, consistent automated lesion detection remains difficult, especially with limited training data. This study aimed to assess the applicability of pretrained transformer-based architectures for semantic segmentation of CBCT volumes when applied to periapical lesion detection.

METHODS

CBCT volumes (n = 138) were collected and annotated by expert clinicians using 5 labels - "lesion," "restorative material," "bone," "tooth structure," and "background." U-Net (convolutional neural network-based) and Swin-UNETR (transformer-based) models, pretrained (Swin-UNETR-PRETRAIN), and from scratch (Swin-UNETR-SCRATCH), were trained with subsets of the annotated CBCTs. These models were then evaluated for semantic segmentation performance using the Sørensen-Dice coefficient (DICE), lesion detection performance using sensitivity and specificity, and training sample size requirements by comparing models trained with 20, 40, 60, or 103 samples.

RESULTS

Trained with 103 samples, Swin-UNETR-PRETRAIN achieved a DICE of 0.8512 for "lesion," 0.8282 for "restorative materials," 0.9178 for "bone," 0.9029 for "tooth structure," and 0.9901 for "background." "Lesion" DICE was statistically similar between Swin-UNETR-PRETRAIN trained with 103 and 60 images (P > .05), with the latter achieving 1.00 sensitivity and 0.94 specificity in lesion detection. With small training sets, Swin-UNETR-PRETRAIN outperformed Swin-UNETR-SCRATCH in DICE over all labels (P < .001 [n = 20], P < .001 [n = 40]), and U-Net in lesion detection specificity (P = .006 [n = 20], P = .031 [n = 40]).

CONCLUSIONS

Transformer-based Swin-UNETR architectures allowed for excellent semantic segmentation and periapical lesion detection. Pretrained, it may provide an alternative with smaller training datasets compared to classic U-Net architectures.

LYNSU: automated 3D neuropil segmentation of fluorescent images for Drosophila brains

The brain atlas, which provides information about the distribution of genes, proteins, neurons, or anatomical regions, plays a crucial role in contemporary neuroscience research. To analyze the spatial distribution of those substances based on images from different brain samples, we often need to warp and register individual brain images to a standard brain template. However, the process of warping and registration may lead to spatial errors, thereby severely reducing the accuracy of the analysis. To address this issue, we develop an automated method for segmenting neuropils in the Drosophila brain for fluorescence images from the FlyCircuit database. This technique allows future brain atlas studies to be conducted accurately at the individual level without warping and aligning to a standard brain template. Our method, LYNSU (Locating by YOLO and Segmenting by U-Net), consists of two stages. In the first stage, we use the YOLOv7 model to quickly locate neuropils and rapidly extract small-scale 3D images as input for the second stage model. This stage achieves a 99.4% accuracy rate in neuropil localization. In the second stage, we employ the 3D U-Net model to segment neuropils. LYNSU can achieve high accuracy in segmentation using a small training set consisting of images from merely 16 brains. We demonstrate LYNSU on six distinct neuropils or structures, achieving a high segmentation accuracy comparable to professional manual annotations with a 3D Intersection-over-Union (IoU) reaching up to 0.869. Our method takes only about 7 s to segment a neuropil while achieving a similar level of performance as the human annotators. To demonstrate a use case of LYNSU, we applied it to all female Drosophila brains from the FlyCircuit database to investigate the asymmetry of the mushroom bodies (MBs), the learning center of fruit flies. We used LYNSU to segment bilateral MBs and compare the volumes between left and right for each individual. Notably, of 8,703 valid brain samples, 10.14% showed bilateral volume differences that exceeded 10%. The study demonstrated the potential of the proposed method in high-throughput anatomical analysis and connectomics construction of the Drosophila brain.

Deep Learning Auto-Segmentation Network for Pediatric Computed Tomography Data Sets: Can We Extrapolate From Adults?

PURPOSE

Artificial intelligence (AI)-based auto-segmentation models hold promise for enhanced efficiency and consistency in organ contouring for adaptive radiation therapy and radiation therapy planning. However, their performance on pediatric computed tomography (CT) data and cross-scanner compatibility remain unclear. This study aimed to evaluate the performance of AI-based auto-segmentation models trained on adult CT data when applied to pediatric data sets and explore the improvement in performance gained by including pediatric training data. It also examined their ability to accurately segment CT data acquired from different scanners.

METHODS AND MATERIALS

Using the nnU-Net framework, segmentation models were trained on data sets of adult, pediatric, and combined CT scans for 7 pelvic/thoracic organs. Each model was trained on 290 to 300 cases per category and organ. Training data sets included a combination of clinical data and several open repositories. The study incorporated a database of 459 pediatric (0-16 years) CT scans and 950 adults (>18 years), ensuring all scans had human expert ground-truth contours of the selected organs. Performance was evaluated based on Dice similarity coefficients (DSC) of the model-generated contours.

RESULTS

AI models trained exclusively on adult data underperformed on pediatric data, especially for the 0 to 2 age group: mean DSC was below 0.5 for the bladder and spleen. The addition of pediatric training data demonstrated significant improvement for all age groups, achieving a mean DSC of above 0.85 for all organs in every age group. Larger organs like the liver and kidneys maintained consistent performance for all models across age groups. No significant difference emerged in the cross-scanner performance evaluation, suggesting robust cross-scanner generalization.

CONCLUSIONS

For optimal segmentation across age groups, it is important to include pediatric data in the training of segmentation models. The successful cross-scanner generalization also supports the real-world clinical applicability of these AI models. This study emphasizes the significance of data set diversity in training robust AI systems for medical image interpretation tasks.

A Narrative Review on 3-Dimensional Visualization Techniques in Neurosurgical Education, Simulation, and Planning

BACKGROUND

High-fidelity visualization of anatomical organs is crucial for neurosurgical education, simulation, and planning. This becomes much more important for minimally invasive neurosurgical procedures. Realistic anatomical visualization can allow resident surgeons to learn visual cues and orient themselves with the complex 3-dimensional (3D) anatomy. Achieving full fidelity in 3D medical visualization is an active area of research; however, the prior reviews focus on the application area and lack the underlying technical principles. Accordingly, the present study attempts to bridge this gap by providing a narrative review of the techniques used for 3D visualization.

METHODS

We conducted a literature review on 3D medical visualization technology from 2018 to 2023 using the PubMed and Google Scholar search engines. The cross-referenced manuscripts were extensively studied to find literature that discusses technology relevant to 3D medical visualization. We also compiled and ran software applications that were accessible to us in order to better understand them.

RESULTS

We present the underlying fundamental technology used in 3D medical visualization in the context of neurosurgical education, simulation, and planning. Further, we discuss and categorize a few important applications based on the 3D visualization techniques they use.

CONCLUSIONS

The visualization of virtual human organs has not yet achieved a level of realism close to reality. This gap is largely due to the interdisciplinary nature of this research, population diversity, and validation complexities. With the advancements in computational resources and automation of 3D visualization pipelines, next-gen applications may offer enhanced medical 3D visualization fidelity.

STF-Net: sparsification transformer coding guided network for subcortical brain structure segmentation

Subcortical brain structure segmentation plays an important role in the diagnosis of neuroimaging and has become the basis of computer-aided diagnosis. Due to the blurred boundaries and complex shapes of subcortical brain structures, labeling these structures by hand becomes a time-consuming and subjective task, greatly limiting their potential for clinical applications. Thus, this paper proposes the sparsification transformer (STF) module for accurate brain structure segmentation. The self-attention mechanism is used to establish global dependencies to efficiently extract the global information of the feature map with low computational complexity. Also, the shallow network is used to compensate for low-level detail information through the localization of convolutional operations to promote the representation capability of the network. In addition, a hybrid residual dilated convolution (HRDC) module is introduced at the bottom layer of the network to extend the receptive field and extract multi-scale contextual information. Meanwhile, the octave convolution edge feature extraction (OCT) module is applied at the skip connections of the network to pay more attention to the edge features of brain structures. The proposed network is trained with a hybrid loss function. The experimental evaluation on two public datasets: IBSR and MALC, shows outstanding performance in terms of objective and subjective quality.

Improved segmentation of basal ganglia from MR images using convolutional neural network with crossover-typed skip connection

PURPOSE

Accurate and automatic segmentation of basal ganglia from magnetic resonance (MR) images is important for diagnosis and treatment of various brain disorders. However, the basal ganglia segmentation is a challenging task because of the class imbalance and the unclear boundaries among basal ganglia anatomical structures. Thus, we aim to present an encoder-decoder convolutional neural network (CNN)-based method for improved segmentation of basal ganglia by focusing on skip connections that determine the segmentation performance of encoder-decoder CNNs. We also aim to reveal the effect of skip connections on the segmentation of basal ganglia with unclear boundaries.

METHODS

We used the encoder-decoder CNNs with the following five patterns of skip connections: without skip connection, with full-resolution horizontal skip connection, with horizontal skip connections, with vertical skip connections, and with crossover-typed skip connections (the proposed method). We compared and evaluated the performance of the CNNs in the experiment of basal ganglia segmentation using T1-weighted MR brain images of 79 patients.

RESULTS

The experimental results showed that the skip connections at each scale level help CNNs to acquire multi-scale image features, the vertical skip connections contribute on acquiring finer image features for segmentation of smaller anatomical structures with more blurred boundaries, and the crossover-typed skip connections, a combination of horizontal and vertical skip connections, provided better segmentation accuracy.

CONCLUSION

This paper investigated the effect of skip connections on the basal ganglia segmentation and revealed the crossover-typed skip connections might be effective for improving the segmentation of basal ganglia with the class imbalance and the unclear boundaries.

Development of the next-generation functional neuro-cognitive imaging protocol - Part 1: A 3D sliding-window convolutional neural net for automated brain parcellation

Functional MRI has emerged as a powerful tool to assess the severity of Post-concussion syndrome (PCS) and to provide guidance for neuro-cognitive therapists during treatment. The next-generation functional neuro-cognitive imaging protocol (fNCI2) has been developed to provide this assessment. This paper covers the first step in the analysis process, the development of a rapidly re-trainable, machine-learning, brain parcellation tool. The use of a sufficiently deep U-Net architecture encompassing a small (39 × 39 × 39 voxel input, 27 × 27 × 27 voxel output) sliding window to sample the entirety of the 3D image allows for the prediction of the entire image using only a single trained network. A large number of training, validating, and testing windows are thus generated from the 101 manually-labeled Mindboggle images, and full-image prediction is provided via a voxel-vote method using overlapping windows. Our method produces parcellated images that are highly consistent with standard atlas-based methods in under 3 min on a modern GPU, and the single network architecture allows for rapid retraining (<36 hr) as needed.

Do we really need dice? The hidden region-size biases of segmentation losses

Most segmentation losses are arguably variants of the Cross-Entropy (CE) or Dice losses. On the surface, these two categories of losses (i.e., distribution based vs. geometry based) seem unrelated, and there is no clear consensus as to which category is a better choice, with varying performances for each across different benchmarks and applications. Furthermore, it is widely argued within the medical-imaging community that Dice and CE are complementary, which has motivated the use of compound CE-Dice losses. In this work, we provide a theoretical analysis, which shows that CE and Dice share a much deeper connection than previously thought. First, we show that, from a constrained-optimization perspective, they both decompose into two components, i.e., a similar ground-truth matching term, which pushes the predicted foreground regions towards the ground-truth, and a region-size penalty term imposing different biases on the size (or proportion) of the predicted regions. Then, we provide bound relationships and an information-theoretic analysis, which uncover hidden region-size biases: Dice has an intrinsic bias towards specific extremely imbalanced solutions, whereas CE implicitly encourages the ground-truth region proportions. Our theoretical results explain the wide experimental evidence in the medical-imaging literature, whereby Dice losses bring improvements for imbalanced segmentation. It also explains why CE dominates natural-image problems with diverse class proportions, in which case Dice might have difficulty adapting to different region-size distributions. Based on our theoretical analysis, we propose a principled and simple solution, which enables to control explicitly the region-size bias. The proposed method integrates CE with explicit terms based on L1 or the KL divergence, which encourage segmenting region proportions to match target class proportions, thereby mitigating class imbalance but without losing generality. Comprehensive experiments and ablation studies over different losses and applications validate our theoretical analysis, as well as the effectiveness of explicit and simple region-size terms. The code is available at https://github.com/by-liu/SegLossBias .

Toward hippocampal volume measures on ultra-high field magnetic resonance imaging: a comprehensive comparison study between deep learning and conventional approaches

The hippocampus is a complex brain structure that plays an important role in various cognitive aspects such as memory, intelligence, executive function, and path integration. The volume of this highly plastic structure is identified as one of the most important biomarkers of specific neuropsychiatric and neurodegenerative diseases. It has also been extensively investigated in numerous aging studies. However, recent studies on aging show that the performance of conventional approaches in measuring the hippocampal volume is still far from satisfactory, especially in terms of delivering longitudinal measures from ultra-high field magnetic resonance images (MRIs), which can visualize more boundary details. The advancement of deep learning provides an alternative solution to measuring the hippocampal volume. In this work, we comprehensively compared a deep learning pipeline based on nnU-Net with several conventional approaches including Freesurfer, FSL and DARTEL, for automatically delivering hippocampal volumes: (1) Firstly, we evaluated the segmentation accuracy and precision on a public dataset through cross-validation. Results showed that the deep learning pipeline had the lowest mean (L = 1.5%, R = 1.7%) and the lowest standard deviation (L = 5.2%, R = 6.2%) in terms of volume percentage error. (2) Secondly, sub-millimeter MRIs of a group of healthy adults with test-retest 3T and 7T sessions were used to extensively assess the test-retest reliability. Results showed that the deep learning pipeline achieved very high intraclass correlation coefficients (L = 0.990, R = 0.986 for 7T; L = 0.985, R = 0.983 for 3T) and very small volume percentage differences (L = 1.2%, R = 0.9% for 7T; L = 1.3%, R = 1.3% for 3T). (3) Thirdly, a Bayesian linear mixed effect model was constructed with respect to the hippocampal volumes of two healthy adult datasets with longitudinal 7T scans and one disease-related longitudinal dataset. It was found that the deep learning pipeline detected both the subtle and disease-related changes over time with high sensitivity as well as the mild differences across subjects. Comparison results from the aforementioned three aspects showed that the deep learning pipeline significantly outperformed the conventional approaches by large margins. Results also showed that the deep learning pipeline can better accommodate longitudinal analysis purposes.

3D automatic liver and spleen assessment in predicting overt hepatic encephalopathy before TIPS: a multi-center study

BACKGROUND

Overt hepatic encephalopathy (HE) should be predicted preoperatively to identify suitable candidates for transjugular intrahepatic portosystemic shunt (TIPS) instead of first-line treatment. This study aimed to construct a 3D assessment-based model to predict post-TIPS overt HE.

METHODS

In this multi-center cohort study, 487 patients who underwent TIPS were subdivided into a training dataset (390 cases from three hospitals) and an external validation dataset (97 cases from another two hospitals). Candidate factors included clinical, vascular, and 2D and 3D data. Combining the least absolute shrinkage and operator method, support vector machine, and probability calibration by isotonic regression, we constructed four predictive models: clinical, 2D, 3D, and combined models. Their discrimination and calibration were compared to identify the optimal model, with subgroup analysis performed.

RESULTS

The 3D model showed better discrimination than did the 2D model (training: 0.719 vs. 0.691; validation: 0.730 vs. 0.622). The model combining clinical and 3D factors outperformed the clinical and 3D models (training: 0.802 vs. 0.735 vs. 0.719; validation: 0.816 vs. 0.723 vs. 0.730; all p < 0.050). Moreover, the combined model had the best calibration. The performance of the best model was not affected by the total bilirubin level, Child-Pugh score, ammonia level, or the indication for TIPS.

CONCLUSION

3D assessment of the liver and the spleen provided additional information to predict overt HE, improving the chance of TIPS for suitable patients. 3D assessment could also be used in similar studies related to cirrhosis.

Subject-Specific Automatic Reconstruction of White Matter Tracts

MRI-based tractography is still underexploited and unsuited for routine use in brain tumor surgery due to heterogeneity of methods and functional-anatomical definitions and above all, the lack of a turn-key system. Standardization of methods is therefore desirable, whereby an objective and reliable approach is a prerequisite before the results of any automated procedure can subsequently be validated and used in neurosurgical practice. In this work, we evaluated these preliminary but necessary steps in healthy volunteers. Specifically, we evaluated the robustness and reliability (i.e., test-retest reproducibility) of tractography results of six clinically relevant white matter tracts by using healthy volunteer data (N = 136) from the Human Connectome Project consortium. A deep learning convolutional network-based approach was used for individualized segmentation of regions of interest, combined with an evidence-based tractography protocol and appropriate post-tractography filtering. Robustness was evaluated by estimating the consistency of tractography probability maps, i.e., averaged tractograms in normalized space, through the use of a hold-out cross-validation approach. No major outliers were found, indicating a high robustness of the tractography results. Reliability was evaluated at the individual level. First by examining the overlap of tractograms that resulted from repeatedly processed identical MRI scans (N = 10, 10 iterations) to establish an upper limit of reliability of the pipeline. Second, by examining the overlap for subjects that were scanned twice at different time points (N = 40). Both analyses indicated high reliability, with the second analysis showing a reliability near the upper limit. The robust and reliable subject-specific generation of white matter tracts in healthy subjects holds promise for future validation of our pipeline in a clinical population and subsequent implementation in brain tumor surgery.

Topological Data Analysis for Multivariate Time Series Data

Over the last two decades, topological data analysis (TDA) has emerged as a very powerful data analytic approach that can deal with various data modalities of varying complexities. One of the most commonly used tools in TDA is persistent homology (PH), which can extract topological properties from data at various scales. The aim of this article is to introduce TDA concepts to a statistical audience and provide an approach to analyzing multivariate time series data. The application's focus will be on multivariate brain signals and brain connectivity networks. Finally, this paper concludes with an overview of some open problems and potential application of TDA to modeling directionality in a brain network, as well as the casting of TDA in the context of mixed effect models to capture variations in the topological properties of data collected from multiple subjects.

Multi-task learning for arousal and sleep stage detection using fully convolutional networks

Objective.Sleep is a critical physiological process that plays a vital role in maintaining physical and mental health. Accurate detection of arousals and sleep stages is essential for the diagnosis of sleep disorders, as frequent and excessive occurrences of arousals disrupt sleep stage patterns and lead to poor sleep quality, negatively impacting physical and mental health. Polysomnography is a traditional method for arousal and sleep stage detection that is time-consuming and prone to high variability among experts.Approach. In this paper, we propose a novel multi-task learning approach for arousal and sleep stage detection using fully convolutional neural networks. Our model, FullSleepNet, accepts a full-night single-channel EEG signal as input and produces segmentation masks for arousal and sleep stage labels. FullSleepNet comprises four modules: a convolutional module to extract local features, a recurrent module to capture long-range dependencies, an attention mechanism to focus on relevant parts of the input, and a segmentation module to output final predictions.Main results.By unifying the two interrelated tasks as segmentation problems and employing a multi-task learning approach, FullSleepNet achieves state-of-the-art performance for arousal detection with an area under the precision-recall curve of 0.70 on Sleep Heart Health Study and Multi-Ethnic Study of Atherosclerosis datasets. For sleep stage classification, FullSleepNet obtains comparable performance on both datasets, achieving an accuracy of 0.88 and an F1-score of 0.80 on the former and an accuracy of 0.83 and an F1-score of 0.76 on the latter.Significance. Our results demonstrate that FullSleepNet offers improved practicality, efficiency, and accuracy for the detection of arousal and classification of sleep stages using raw EEG signals as input.

Qualitative Classification of Proximal Femoral Bone Using Geometric Features and Texture Analysis in Collected MRI Images for Bone Density Evaluation

The aim of this study was to use geometric features and texture analysis to discriminate between healthy and unhealthy femurs and to identify the most influential features. We scanned proximal femoral bone (PFB) of 284 Iranian cases (21 to 83 years old) using different dual-energy X-ray absorptiometry (DEXA) scanners and magnetic resonance imaging (MRI) machines. Subjects were labeled as "healthy" (T-score > -0.9) and "unhealthy" based on the results of DEXA scans. Based on the geometry and texture of the PFB in MRI, 204 features were retrieved. We used support vector machine (SVM) with different kernels, decision tree, and logistic regression algorithms as classifiers and the Genetic algorithm (GA) to select the best set of features and to maximize accuracy. There were 185 participants classified as healthy and 99 as unhealthy. The SVM with radial basis function kernels had the best performance (89.08%) and the most influential features were geometrical ones. Even though our findings show the high performance of this model, further investigation with more subjects is suggested. To our knowledge, this is the first study that investigates qualitative classification of PFBs based on MRI with reference to DEXA scans using machine learning methods and the GA.

Perspective of artificial intelligence in healthcare data management: A journey towards precision medicine

Mounting evidence has highlighted the implementation of big data handling and management in the healthcare industry to improve the clinical services. Various private and public companies have generated, stored, and analyzed different types of big healthcare data, such as omics data, clinical data, electronic health records, personal health records, and sensing data with the aim to move in the direction of precision medicine. Additionally, with the advancement in technologies, researchers are curious to extract the potential involvement of artificial intelligence and machine learning on big healthcare data to enhance the quality of patient's lives. However, seeking solutions from big healthcare data requires proper management, storage, and analysis, which imposes hinderances associated with big data handling. Herein, we briefly discuss the implication of big data handling and the role of artificial intelligence in precision medicine. Further, we also highlighted the potential of artificial intelligence in integrating and analyzing the big data that offer personalized treatment. In addition, we briefly discuss the applications of artificial intelligence in personalized treatment, especially in neurological diseases. Lastly, we discuss the challenges and limitations imposed by artificial intelligence in big data management and analysis to hinder precision medicine.

An automatic and accurate deep learning-based neuroimaging pipeline for the neonatal brain

BACKGROUND

Accurate segmentation of neonatal brain tissues and structures is crucial for studying normal development and diagnosing early neurodevelopmental disorders. However, there is a lack of an end-to-end pipeline for automated segmentation and imaging analysis of the normal and abnormal neonatal brain.

OBJECTIVE

To develop and validate a deep learning-based pipeline for neonatal brain segmentation and analysis of structural magnetic resonance images (MRI).

MATERIALS AND METHODS

Two cohorts were enrolled in the study, including cohort 1 (582 neonates from the developing Human Connectome Project) and cohort 2 (37 neonates imaged using a 3.0-tesla MRI scanner in our hospital).We developed a deep leaning-based architecture capable of brain segmentation into 9 tissues and 87 structures. Then, extensive validations were performed for accuracy, effectiveness, robustness and generality of the pipeline. Furthermore, regional volume and cortical surface estimation were measured through in-house bash script implemented in FSL (Oxford Centre for Functional MRI of the Brain Software Library) to ensure reliability of the pipeline. Dice similarity score (DSC), the 95th percentile Hausdorff distance (H95) and intraclass correlation coefficient (ICC) were calculated to assess the quality of our pipeline. Finally, we finetuned and validated our pipeline on 2-dimensional thick-slice MRI in cohorts 1 and 2.

RESULTS

The deep learning-based model showed excellent performance for neonatal brain tissue and structural segmentation, with the best DSC and the 95th percentile Hausdorff distance (H95) of 0.96 and 0.99 mm, respectively. In terms of regional volume and cortical surface analysis, our model showed good agreement with ground truth. The ICC values for the regional volume were all above 0.80. Considering the thick-slice image pipeline, the same trend was observed for brain segmentation and analysis. The best DSC and H95 were 0.92 and 3.00 mm, respectively. The regional volumes and surface curvature had ICC values just below 0.80.

CONCLUSIONS

We propose an automatic, accurate, stable and reliable pipeline for neonatal brain segmentation and analysis from thin and thick structural MRI. The external validation showed very good reproducibility of the pipeline.

Evaluation of motion artefact reduction depending on the artefacts' directions in head MRI using conditional generative adversarial networks

Motion artefacts caused by the patient's body movements affect magnetic resonance imaging (MRI) accuracy. This study aimed to compare and evaluate the accuracy of motion artefacts correction using a conditional generative adversarial network (CGAN) with an autoencoder and U-net models. The training dataset consisted of motion artefacts generated through simulations. Motion artefacts occur in the phase encoding direction, which is set to either the horizontal or vertical direction of the image. To create T2-weighted axial images with simulated motion artefacts, 5500 head images were used in each direction. Of these data, 90% were used for training, while the remainder were used for the evaluation of image quality. Moreover, the validation data used in the model training consisted of 10% of the training dataset. The training data were divided into horizontal and vertical directions of motion artefact appearance, and the effect of combining this data with the training dataset was verified. The resulting corrected images were evaluated using structural image similarity (SSIM) and peak signal-to-noise ratio (PSNR), and the metrics were compared with the images without motion artefacts. The best improvements in the SSIM and PSNR were observed in the consistent condition in the direction of the occurrence of motion artefacts in the training and evaluation datasets. However, SSIM > 0.9 and PSNR > 29 dB were accomplished for the learning model with both image directions. The latter model exhibited the highest robustness for actual patient motion in head MRI images. Moreover, the image quality of the corrected image with the CGAN was the closest to that of the original image, while the improvement rates for SSIM and PSNR were approximately 26% and 7.7%, respectively. The CGAN model demonstrated a high image reproducibility, and the most significant model was the consistent condition of the learning model and the direction of the appearance of motion artefacts.

An attention-based context-informed deep framework for infant brain subcortical segmentation

Precise segmentation of subcortical structures from infant brain magnetic resonance (MR) images plays an essential role in studying early subcortical structural and functional developmental patterns and diagnosis of related brain disorders. However, due to the dynamic appearance changes, low tissue contrast, and tiny subcortical size in infant brain MR images, infant subcortical segmentation is a challenging task. In this paper, we propose a context-guided, attention-based, coarse-to-fine deep framework to precisely segment the infant subcortical structures. At the coarse stage, we aim to directly predict the signed distance maps (SDMs) from multi-modal intensity images, including T1w, T2w, and the ratio of T1w and T2w images, with an SDM-Unet, which can leverage the spatial context information, including the structural position information and the shape information of the target structure, to generate high-quality SDMs. At the fine stage, the predicted SDMs, which encode spatial-context information of each subcortical structure, are integrated with the multi-modal intensity images as the input to a multi-source and multi-path attention Unet (M2A-Unet) for achieving refined segmentation. Both the 3D spatial and channel attention blocks are added to guide the M2A-Unet to focus more on the important subregions and channels. We additionally incorporate the inner and outer subcortical boundaries as extra labels to help precisely estimate the ambiguous boundaries. We validate our method on an infant MR image dataset and on an unrelated neonatal MR image dataset. Compared to eleven state-of-the-art methods, the proposed framework consistently achieves higher segmentation accuracy in both qualitative and quantitative evaluations of infant MR images and also exhibits good generalizability in the neonatal dataset.

Learning to segment fetal brain tissue from noisy annotations

Automatic fetal brain tissue segmentation can enhance the quantitative assessment of brain development at this critical stage. Deep learning methods represent the state of the art in medical image segmentation and have also achieved impressive results in brain segmentation. However, effective training of a deep learning model to perform this task requires a large number of training images to represent the rapid development of the transient fetal brain structures. On the other hand, manual multi-label segmentation of a large number of 3D images is prohibitive. To address this challenge, we segmented 272 training images, covering 19-39 gestational weeks, using an automatic multi-atlas segmentation strategy based on deformable registration and probabilistic atlas fusion, and manually corrected large errors in those segmentations. Since this process generated a large training dataset with noisy segmentations, we developed a novel label smoothing procedure and a loss function to train a deep learning model with smoothed noisy segmentations. Our proposed methods properly account for the uncertainty in tissue boundaries. We evaluated our method on 23 manually-segmented test images of a separate set of fetuses. Results show that our method achieves an average Dice similarity coefficient of 0.893 and 0.916 for the transient structures of younger and older fetuses, respectively. Our method generated results that were significantly more accurate than several state-of-the-art methods including nnU-Net that achieved the closest results to our method. Our trained model can serve as a valuable tool to enhance the accuracy and reproducibility of fetal brain analysis in MRI.

HC-Net: A hybrid convolutional network for non-human primate brain extraction

Brain extraction (skull stripping) is an essential step in the magnetic resonance imaging (MRI) analysis of brain sciences. However, most of the current brain extraction methods that achieve satisfactory results for human brains are often challenged by non-human primate brains. Due to the small sample characteristics and the nature of thick-slice scanning of macaque MRI data, traditional deep convolutional neural networks (DCNNs) are unable to obtain excellent results. To overcome this challenge, this study proposed a symmetrical end-to-end trainable hybrid convolutional neural network (HC-Net). It makes full use of the spatial information between adjacent slices of the MRI image sequence and combines three consecutive slices from three axes for 3D convolutions, which reduces the calculation consumption and promotes accuracy. The HC-Net consists of encoding and decoding structures of 3D convolutions and 2D convolutions in series. The effective use of 2D convolutions and 3D convolutions relieves the underfitting of 2D convolutions to spatial features and the overfitting of 3D convolutions to small samples. After evaluating macaque brain data from different sites, the results showed that HC-Net performed better in inference time (approximately 13 s per volume) and accuracy (mean Dice coefficient reached 95.46%). The HC-Net model also had good generalization ability and stability in different modes of brain extraction tasks.

A review of the application of three-dimensional convolutional neural networks for the diagnosis of Alzheimer's disease using neuroimaging

Alzheimer's disease (AD) is a degenerative disorder that leads to progressive, irreversible cognitive decline. To obtain an accurate and timely diagnosis and detect AD at an early stage, numerous approaches based on convolutional neural networks (CNNs) using neuroimaging data have been proposed. Because 3D CNNs can extract more spatial discrimination information than 2D CNNs, they have emerged as a promising research direction in the diagnosis of AD. The aim of this article is to present the current state of the art in the diagnosis of AD using 3D CNN models and neuroimaging modalities, focusing on the 3D CNN architectures and classification methods used, and to highlight potential future research topics. To give the reader a better overview of the content mentioned in this review, we briefly introduce the commonly used imaging datasets and the fundamentals of CNN architectures. Then we carefully analyzed the existing studies on AD diagnosis, which are divided into two levels according to their inputs: 3D subject-level CNNs and 3D patch-level CNNs, highlighting their contributions and significance in the field. In addition, this review discusses the key findings and challenges from the studies and highlights the lessons learned as a roadmap for future research. Finally, we summarize the paper by presenting some major findings, identifying open research challenges, and pointing out future research directions.

Boundary-Sensitive Loss Function With Location Constraint for Hard Region Segmentation

In computer-aided diagnosis and treatment planning, accurate segmentation of medical images plays an essential role, especially for some hard regions including boundaries, small objects and background interference. However, existing segmentation loss functions including distribution-, region- and boundary-based losses cannot achieve satisfactory performances on these hard regions. In this paper, a boundary-sensitive loss function with location constraint is proposed for hard region segmentation in medical images, which provides three advantages: i) our Boundary-Sensitive loss (BS-loss) can automatically pay more attention to the hard-to-segment boundaries (e.g., thin structures and blurred boundaries), thus obtaining finer object boundaries; ii) BS-loss also can adjust its attention to small objects during training to segment them more accurately; and iii) our location constraint can alleviate the negative impact of the background interference, through the distribution matching of pixels between prediction and Ground Truth (GT) along each axis. By resorting to the proposed BS-loss and location constraint, the hard regions in both foreground and background are considered. Experimental results on three public datasets demonstrate the superiority of our method. Specifically, compared to the second-best method tested in this study, our method improves performance on hard regions in terms of Dice similarity coefficient (DSC) and 95% Hausdorff distance (95%HD) of up to 4.17% and 73% respectively. In addition, it also achieves the best overall segmentation performance. Hence, we can conclude that our method can accurately segment these hard regions and improve the overall segmentation performance in medical images.

ConvNets for automatic detection of polyglutamine SCAs from brain MRIs: state of the art applications

Polyglutamine spinocerebellar ataxias (polyQ SCAs) are a group of neurodegenerative diseases, clinically and genetically heterogeneous, characterized by loss of balance and motor coordination due to dysfunction of the cerebellum and its connections. The diagnosis of each type of polyQ SCA, alongside with genetic tests, includes medical images analysis, and its automation may help specialists to distinguish between each type. Convolutional neural networks (ConvNets or CNNs) have been recently used for medical image processing, with outstanding results. In this work, we present the main clinical and imaging features of polyglutamine SCAs, and the basics of CNNs. Finally, we review studies that have used this approach to automatically process brain medical images and may be applied to SCAs detection. We conclude by discussing the possible limitations and opportunities of using ConvNets for SCAs diagnose in the future.

Segmentation with mixed supervision: Confidence maximization helps knowledge distillation

Despite achieving promising results in a breadth of medical image segmentation tasks, deep neural networks (DNNs) require large training datasets with pixel-wise annotations. Obtaining these curated datasets is a cumbersome process which limits the applicability of DNNs in scenarios where annotated images are scarce. Mixed supervision is an appealing alternative for mitigating this obstacle. In this setting, only a small fraction of the data contains complete pixel-wise annotations and other images have a weaker form of supervision, e.g., only a handful of pixels are labeled. In this work, we propose a dual-branch architecture, where the upper branch (teacher) receives strong annotations, while the bottom one (student) is driven by limited supervision and guided by the upper branch. Combined with a standard cross-entropy loss over the labeled pixels, our novel formulation integrates two important terms: (i) a Shannon entropy loss defined over the less-supervised images, which encourages confident student predictions in the bottom branch; and (ii) a Kullback-Leibler (KL) divergence term, which transfers the knowledge (i.e., predictions) of the strongly supervised branch to the less-supervised branch and guides the entropy (student-confidence) term to avoid trivial solutions. We show that the synergy between the entropy and KL divergence yields substantial improvements in performance. We also discuss an interesting link between Shannon-entropy minimization and standard pseudo-mask generation, and argue that the former should be preferred over the latter for leveraging information from unlabeled pixels. We evaluate the effectiveness of the proposed formulation through a series of quantitative and qualitative experiments using two publicly available datasets. Results demonstrate that our method significantly outperforms other strategies for semantic segmentation within a mixed-supervision framework, as well as recent semi-supervised approaches. Moreover, in line with recent observations in classification, we show that the branch trained with reduced supervision and guided by the top branch largely outperforms the latter. Our code is publicly available: https://github.com/by-liu/ConfKD.

Deep learning empowered volume delineation of whole-body organs-at-risk for accelerated radiotherapy

In radiotherapy for cancer patients, an indispensable process is to delineate organs-at-risk (OARs) and tumors. However, it is the most time-consuming step as manual delineation is always required from radiation oncologists. Herein, we propose a lightweight deep learning framework for radiotherapy treatment planning (RTP), named RTP-Net, to promote an automatic, rapid, and precise initialization of whole-body OARs and tumors. Briefly, the framework implements a cascade coarse-to-fine segmentation, with adaptive module for both small and large organs, and attention mechanisms for organs and boundaries. Our experiments show three merits: 1) Extensively evaluates on 67 delineation tasks on a large-scale dataset of 28,581 cases; 2) Demonstrates comparable or superior accuracy with an average Dice of 0.95; 3) Achieves near real-time delineation in most tasks with <2 s. This framework could be utilized to accelerate the contouring process in the All-in-One radiotherapy scheme, and thus greatly shorten the turnaround time of patients.

EA-Net: Edge-aware network for brain structure segmentation via decoupled high and low frequency features

Automatic brain structure segmentation in Magnetic Resonance Image (MRI) plays an important role in the diagnosis of various neuropsychiatric diseases. However, most existing methods yield unsatisfactory results due to blurred boundaries and complex structures. Improving the segmentation ability requires the model to be explicit about the spatial localization and shape appearance of targets, which correspond to the low-frequency content features and the high-frequency edge features, respectively. Therefore, in this paper, to extract rich edge and content feature representations, we focus on the composition of the feature and utilize a frequency decoupling (FD) block to separate the low-frequency and high-frequency parts of the feature. Further, a novel edge-aware network (EA-Net) is proposed for jointly learning to segment brain structures and detect object edges. First, an encoder-decoder sub-network is utilized to obtain multi-level information from the input MRI, which is then sent to the FD block to complete the frequency separation. Further, we use different mechanisms to optimize both the low-frequency and high-frequency features. Finally, these two parts are fused to generate the final prediction. In particular, we extract the content mask and the edge mask from the optimization feature with different supervisions, which forces the network to learn the boundary features of the object. Extensive experiments are performed on two public brain MRI T1 scan datasets (the IBSR dataset and the MALC dataset) to evaluate the effectiveness of the proposed algorithm. The experiments show that the EA-Net achieves the best performance compared with the state-of-the-art methods, and improves the segmentation DSC score by 1.31% at most compared with the U-Net model and its variants. Moreover, we evaluate the EA-Net under different noise disturbances, and the results demonstrate the robustness and superiority of our method under low-quality noisy MRI. Code is available at https://github.com/huqian999/EA-Net.

Automatic autism spectrum disorder detection using artificial intelligence methods with MRI neuroimaging: A review

Autism spectrum disorder (ASD) is a brain condition characterized by diverse signs and symptoms that appear in early childhood. ASD is also associated with communication deficits and repetitive behavior in affected individuals. Various ASD detection methods have been developed, including neuroimaging modalities and psychological tests. Among these methods, magnetic resonance imaging (MRI) imaging modalities are of paramount importance to physicians. Clinicians rely on MRI modalities to diagnose ASD accurately. The MRI modalities are non-invasive methods that include functional (fMRI) and structural (sMRI) neuroimaging methods. However, diagnosing ASD with fMRI and sMRI for specialists is often laborious and time-consuming; therefore, several computer-aided design systems (CADS) based on artificial intelligence (AI) have been developed to assist specialist physicians. Conventional machine learning (ML) and deep learning (DL) are the most popular schemes of AI used for diagnosing ASD. This study aims to review the automated detection of ASD using AI. We review several CADS that have been developed using ML techniques for the automated diagnosis of ASD using MRI modalities. There has been very limited work on the use of DL techniques to develop automated diagnostic models for ASD. A summary of the studies developed using DL is provided in the Supplementary Appendix. Then, the challenges encountered during the automated diagnosis of ASD using MRI and AI techniques are described in detail. Additionally, a graphical comparison of studies using ML and DL to diagnose ASD automatically is discussed. We suggest future approaches to detecting ASDs using AI techniques and MRI neuroimaging.

Integrated 3d flow-based multi-atlas brain structure segmentation

MRI brain structure segmentation plays an important role in neuroimaging studies. Existing methods either spend much CPU time, require considerable annotated data, or fail in segmenting volumes with large deformation. In this paper, we develop a novel multi-atlas-based algorithm for 3D MRI brain structure segmentation. It consists of three modules: registration, atlas selection and label fusion. Both registration and label fusion leverage an integrated flow based on grayscale and SIFT features. We introduce an effective and efficient strategy for atlas selection by employing the accompanying energy generated in the registration step. A 3D sequential belief propagation method and a 3D coarse-to-fine flow matching approach are developed in both registration and label fusion modules. The proposed method is evaluated on five public datasets. The results show that it has the best performance in almost all the settings compared to competitive methods such as ANTs, Elastix, Learning to Rank and Joint Label Fusion. Moreover, our registration method is more than 7 times as efficient as that of ANTs SyN, while our label transfer method is 18 times faster than Joint Label Fusion in CPU time. The results on the ADNI dataset demonstrate that our method is applicable to image pairs that require a significant transformation in registration. The performance on a composite dataset suggests that our method succeeds in a cross-modality manner. The results of this study show that the integrated 3D flow-based method is effective and efficient for brain structure segmentation. It also demonstrates the power of SIFT features, multi-atlas segmentation and classical machine learning algorithms for a medical image analysis task. The experimental results on public datasets show the proposed method's potential for general applicability in various brain structures and settings.

Learning to detect boundary information for brain image segmentation

MRI brain images are always of low contrast, which makes it difficult to identify to which area the information at the boundary of brain images belongs. This can make the extraction of features at the boundary more challenging, since those features can be misleading as they might mix properties of different brain regions. Hence, to alleviate such a problem, image boundary detection plays a vital role in medical image segmentation, and brain segmentation in particular, as unclear boundaries can worsen brain segmentation results. Yet, given the low quality of brain images, boundary detection in the context of brain image segmentation remains challenging. Despite the research invested to improve boundary detection and brain segmentation, these two problems were addressed independently, i.e., little attention was paid to applying boundary detection to brain segmentation tasks. Therefore, in this paper, we propose a boundary detection-based model for brain image segmentation. To this end, we first design a boundary segmentation network for detecting and segmenting images brain tissues. Then, we design a boundary information module (BIM) to distinguish boundaries from the three different brain tissues. After that, we add a boundary attention gate (BAG) to the encoder output layers of our transformer to capture more informative local details. We evaluate our proposed model on two datasets of brain tissue images, including infant and adult brains. The extensive evaluation experiments of our model show better performance (a Dice Coefficient (DC) accuracy of up to \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$5.3\%$$\end{document}5.3% compared to the state-of-the-art models) in detecting and segmenting brain tissue images.

Convolutional Neural Networks for Classification of T2DM Cognitive Impairment Based on Whole Brain Structural Features

Purpose

Cognitive impairment is generally found in individuals with type 2 diabetes mellitus (T2DM). Although they may not have visible symptoms of cognitive impairment in the early stages of the disorder, they are considered to be at high risk. Therefore, the classification of these patients is important for preventing the progression of cognitive impairment.

Methods

In this study, a convolutional neural network was used to construct a model for classifying 107 T2DM patients with and without cognitive impairment based on T1-weighted structural MRI. The Montreal cognitive assessment score served as an index of the cognitive status of the patients.

Results

The classifier could identify T2DM-related cognitive decline with a classification accuracy of 84.85% and achieved an area under the curve of 92.65%.

Conclusions

The model can help clinicians analyze and predict cognitive impairment in patients and enable early treatment.

SM-SegNet: A Lightweight Squeeze M-SegNet for Tissue Segmentation in Brain MRI Scans

In this paper, we propose a novel squeeze M-SegNet (SM-SegNet) architecture featuring a fire module to perform accurate as well as fast segmentation of the brain on magnetic resonance imaging (MRI) scans. The proposed model utilizes uniform input patches, combined-connections, long skip connections, and squeeze-expand convolutional layers from the fire module to segment brain MRI data. The proposed SM-SegNet architecture involves a multi-scale deep network on the encoder side and deep supervision on the decoder side, which uses combined-connections (skip connections and pooling indices) from the encoder to the decoder layer. The multi-scale side input layers support the deep network layers' extraction of discriminative feature information, and the decoder side provides deep supervision to reduce the gradient problem. By using combined-connections, extracted features can be transferred from the encoder to the decoder resulting in recovering spatial information, which makes the model converge faster. Long skip connections were used to stabilize the gradient updates in the network. Owing to the adoption of the fire module, the proposed model was significantly faster to train and offered a more efficient memory usage with 83% fewer parameters than previously developed methods, owing to the adoption of the fire module. The proposed method was evaluated using the open-access series of imaging studies (OASIS) and the internet brain segmentation registry (IBSR) datasets. The experimental results demonstrate that the proposed SM-SegNet architecture achieves segmentation accuracies of 95% for cerebrospinal fluid, 95% for gray matter, and 96% for white matter, which outperforms the existing methods in both subjective and objective metrics in brain MRI segmentation.

A Novel U-Net Based Deep Learning Method for 3D Cardiovascular MRI Segmentation

Medical multiobjective image segmentation aims to group pixels to form multiple regions based on the different properties of the medical images. Segmenting the 3D cardiovascular magnetic resonance (CMR) images is still a challenging task owing to several reasons, including individual differences in heart shapes, varying signal intensities, and differences in data signal-to-noise ratios. This paper proposes a novel and efficient U-Net-based 3D sparse convolutional network named SparseVoxNet. In this network, there are direct connections between any two layers with the same feature-map size, and the number of connections is reduced. Therefore, the SparseVoxNet can effectively cope with the optimization problem of gradients vanishing when training a 3D deep neural network model on small sample data by significantly decreasing the network depth, and achieveing better feature representation using a spatial self-attention mechanism finally. The proposed method in this paper has been thoroughly evaluated on the HVSMR 2016 dataset. Compared with other methods, the method achieves better performance.

Role of artificial intelligence in MS clinical practice

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For medical applications, machine learning (including deep learning) are the most commonly used artificial intelligence (AI) approaches.

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It can improve multiple sclerosis (MS) diagnosis, prognostication and treatment monitoring.

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Thanks to AI, MRI and cognitive phenotypes of MS patients were identified.

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AI can shorten MRI protocols for MS, allowing the application of advanced techniques.

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It can reduce the human effort for MRI analysis, especially for lesion segmentation.

Machine learning (ML) and its subset, deep learning (DL), are branches of artificial intelligence (AI) showing promising findings in the medical field, especially when applied to imaging data. Given the substantial role of MRI in the diagnosis and management of patients with multiple sclerosis (MS), this disease is an ideal candidate for the application of AI techniques. In this narrative review, we are going to discuss the potential applications of AI for MS clinical practice, together with their limitations. Among their several advantages, ML algorithms are able to automate repetitive tasks, to analyze more data in less time and to achieve higher accuracy and reproducibility than the human counterpart. To date, these algorithms have been applied to MS diagnosis, prognosis, disease and treatment monitoring. Other fields of application have been improvement of MRI protocols as well as automated lesion and tissue segmentation. However, several challenges remain, including a better understanding of the information selected by AI algorithms, appropriate multicenter and longitudinal validations of results and practical aspects regarding hardware and software integration. Finally, one cannot overemphasize the paramount importance of human supervision, in order to optimize the use and take full advantage of the potential of AI approaches.

ID-Seg: an infant deep learning-based segmentation framework to improve limbic structure estimates

Infant brain magnetic resonance imaging (MRI) is a promising approach for studying early neurodevelopment. However, segmenting small regions such as limbic structures is challenging due to their low inter-regional contrast and high curvature. MRI studies of the adult brain have successfully applied deep learning techniques to segment limbic structures, and similar deep learning models are being leveraged for infant studies. However, these deep learning-based infant MRI segmentation models have generally been derived from small datasets, and may suffer from generalization problems. Moreover, the accuracy of segmentations derived from these deep learning models relative to more standard Expectation-Maximization approaches has not been characterized. To address these challenges, we leveraged a large, public infant MRI dataset (n = 473) and the transfer-learning technique to first pre-train a deep convolutional neural network model on two limbic structures: amygdala and hippocampus. Then we used a leave-one-out cross-validation strategy to fine-tune the pre-trained model and evaluated it separately on two independent datasets with manual labels. We term this new approach the Infant Deep learning SEGmentation Framework (ID-Seg). ID-Seg performed well on both datasets with a mean dice similarity score (DSC) of 0.87, a mean intra-class correlation (ICC) of 0.93, and a mean average surface distance (ASD) of 0.31 mm. Compared to the Developmental Human Connectome pipeline (dHCP) pipeline, ID-Seg significantly improved segmentation accuracy. In a third infant MRI dataset (n = 50), we used ID-Seg and dHCP separately to estimate amygdala and hippocampus volumes and shapes. The estimates derived from ID-seg, relative to those from the dHCP, showed stronger associations with behavioral problems assessed in these infants at age 2. In sum, ID-Seg consistently performed well on two different datasets with an 0.87 DSC, however, multi-site testing and extension for brain regions beyond the amygdala and hippocampus are still needed.

Understanding the Research Landscape of Deep Learning in Biomedical Science: Scientometric Analysis

BACKGROUND

Advances in biomedical research using deep learning techniques have generated a large volume of related literature. However, there is a lack of scientometric studies that provide a bird's-eye view of them. This absence has led to a partial and fragmented understanding of the field and its progress.

OBJECTIVE

This study aimed to gain a quantitative and qualitative understanding of the scientific domain by analyzing diverse bibliographic entities that represent the research landscape from multiple perspectives and levels of granularity.

METHODS

We searched and retrieved 978 deep learning studies in biomedicine from the PubMed database. A scientometric analysis was performed by analyzing the metadata, content of influential works, and cited references.

RESULTS

In the process, we identified the current leading fields, major research topics and techniques, knowledge diffusion, and research collaboration. There was a predominant focus on applying deep learning, especially convolutional neural networks, to radiology and medical imaging, whereas a few studies focused on protein or genome analysis. Radiology and medical imaging also appeared to be the most significant knowledge sources and an important field in knowledge diffusion, followed by computer science and electrical engineering. A coauthorship analysis revealed various collaborations among engineering-oriented and biomedicine-oriented clusters of disciplines.

CONCLUSIONS

This study investigated the landscape of deep learning research in biomedicine and confirmed its interdisciplinary nature. Although it has been successful, we believe that there is a need for diverse applications in certain areas to further boost the contributions of deep learning in addressing biomedical research problems. We expect the results of this study to help researchers and communities better align their present and future work.

A cascaded nested network for 3T brain MR image segmentation guided by 7T labeling

Accurate segmentation of the brain into gray matter, white matter, and cerebrospinal fluid using magnetic resonance (MR) imaging is critical for visualization and quantification of brain anatomy. Compared to 3T MR images, 7T MR images exhibit higher tissue contrast that is contributive to accurate tissue delineation for training segmentation models. In this paper, we propose a cascaded nested network (CaNes-Net) for segmentation of 3T brain MR images, trained by tissue labels delineated from the corresponding 7T images. We first train a nested network (Nes-Net) for a rough segmentation. The second Nes-Net uses tissue-specific geodesic distance maps as contextual information to refine the segmentation. This process is iterated to build CaNes-Net with a cascade of Nes-Net modules to gradually refine the segmentation. To alleviate the misalignment between 3T and corresponding 7T MR images, we incorporate a correlation coefficient map to allow well-aligned voxels to play a more important role in supervising the training process. We compared CaNes-Net with SPM and FSL tools, as well as four deep learning models on 18 adult subjects and the ADNI dataset. Our results indicate that CaNes-Net reduces segmentation errors caused by the misalignment and improves segmentation accuracy substantially over the competing methods.

Subcortical Segmentation of the Fetal Brain in 3D Ultrasound using Deep Learning

The quantification of subcortical volume development from 3D fetal ultrasound can provide important diagnostic information during pregnancy monitoring. However, manual segmentation of subcortical structures in ultrasound volumes is time-consuming and challenging due to low soft tissue contrast, speckle and shadowing artifacts. For this reason, we developed a convolutional neural network (CNN) for the automated segmentation of the choroid plexus (CP), lateral posterior ventricle horns (LPVH), cavum septum pellucidum et vergae (CSPV), and cerebellum (CB) from 3D ultrasound. As ground-truth labels are scarce and expensive to obtain, we applied few-shot learning, in which only a small number of manual annotations (n = 9) are used to train a CNN. We compared training a CNN with only a few individually annotated volumes versus many weakly labelled volumes obtained from atlas-based segmentations. This showed that segmentation performance close to intra-observer variability can be obtained with only a handful of manual annotations. Finally, the trained models were applied to a large number (n = 278) of ultrasound image volumes of a diverse, healthy population, obtaining novel US-specific growth curves of the respective structures during the second trimester of gestation.

Deep Learning Segmentation of Satellite Imagery Identifies Aquatic Vegetation Associated with Snail Intermediate Hosts of Schistosomiasis in Senegal, Africa

Schistosomiasis is a debilitating parasitic disease of poverty that affects more than 200 million people worldwide, mostly in sub-Saharan Africa, and is clearly associated with the construction of dams and water resource management infrastructure in tropical and subtropical areas. Changes to hydrology and salinity linked to water infrastructure development may create conditions favorable to the aquatic vegetation that is suitable habitat for the intermediate snail hosts of schistosome parasites. With thousands of small and large water reservoirs, irrigation canals, and dams developed or under construction in Africa, it is crucial to accurately assess the spatial distribution of high-risk environments that are habitat for freshwater snail intermediate hosts of schistosomiasis in rapidly changing ecosystems. Yet, standard techniques for monitoring snails are labor-intensive, time-consuming, and provide information limited to the small areas that can be manually sampled. Consequently, in low-income countries where schistosomiasis control is most needed, there are formidable challenges to identifying potential transmission hotspots for targeted medical and environmental interventions. In this study, we developed a new framework to map the spatial distribution of suitable snail habitat across large spatial scales in the Senegal River Basin by integrating satellite data, high-definition, low-cost drone imagery, and an artificial intelligence (AI)-powered computer vision technique called semantic segmentation. A deep learning model (U-Net) was built to automatically analyze high-resolution satellite imagery to produce segmentation maps of aquatic vegetation, with a fast and robust generalized prediction that proved more accurate than a more commonly used random forest approach. Accurate and up-to-date knowledge of areas at highest risk for disease transmission can increase the effectiveness of control interventions by targeting habitat of disease-carrying snails. With the deployment of this new framework, local governments or health actors might better target environmental interventions to where and when they are most needed in an integrated effort to reach the goal of schistosomiasis elimination.

Deep Learning for Smart Healthcare-A Survey on Brain Tumor Detection from Medical Imaging

Advances in technology have been able to affect all aspects of human life. For example, the use of technology in medicine has made significant contributions to human society. In this article, we focus on technology assistance for one of the most common and deadly diseases to exist, which is brain tumors. Every year, many people die due to brain tumors; based on "braintumor" website estimation in the U.S., about 700,000 people have primary brain tumors, and about 85,000 people are added to this estimation every year. To solve this problem, artificial intelligence has come to the aid of medicine and humans. Magnetic resonance imaging (MRI) is the most common method to diagnose brain tumors. Additionally, MRI is commonly used in medical imaging and image processing to diagnose dissimilarity in different parts of the body. In this study, we conducted a comprehensive review on the existing efforts for applying different types of deep learning methods on the MRI data and determined the existing challenges in the domain followed by potential future directions. One of the branches of deep learning that has been very successful in processing medical images is CNN. Therefore, in this survey, various architectures of CNN were reviewed with a focus on the processing of medical images, especially brain MRI images.

Deep Interpretable Classification and Weakly-Supervised Segmentation of Histology Images via Max-Min Uncertainty

Weakly-supervised learning (WSL) has recently triggered substantial interest as it mitigates the lack of pixel-wise annotations. Given global image labels, WSL methods yield pixel-level predictions (segmentations), which enable to interpret class predictions. Despite their recent success, mostly with natural images, such methods can face important challenges when the foreground and background regions have similar visual cues, yielding high false-positive rates in segmentations, as is the case in challenging histology images. WSL training is commonly driven by standard classification losses, which implicitly maximize model confidence, and locate the discriminative regions linked to classification decisions. Therefore, they lack mechanisms for modeling explicitly non-discriminative regions and reducing false-positive rates. We propose novel regularization terms, which enable the model to seek both non-discriminative and discriminative regions, while discouraging unbalanced segmentations. We introduce high uncertainty as a criterion to localize non-discriminative regions that do not affect classifier decision, and describe it with original Kullback-Leibler (KL) divergence losses evaluating the deviation of posterior predictions from the uniform distribution. Our KL terms encourage high uncertainty of the model when the latter inputs the latent non-discriminative regions. Our loss integrates: (i) a cross-entropy seeking a foreground, where model confidence about class prediction is high; (ii) a KL regularizer seeking a background, where model uncertainty is high; and (iii) log-barrier terms discouraging unbalanced segmentations. Comprehensive experiments and ablation studies over the public GlaS colon cancer data and a Camelyon16 patch-based benchmark for breast cancer show substantial improvements over state-of-the-art WSL methods, and confirm the effect of our new regularizers (our code is publicly available at https://github.com/sbelharbi/deep-wsl-histo-min-max-uncertainty).

Convolutional Neural Networks for Segmenting Cerebellar Fissures from Magnetic Resonance Imaging

The human cerebellum plays an important role in coordination tasks. Diseases such as spinocerebellar ataxias tend to cause severe damage to the cerebellum, leading patients to a progressive loss of motor coordination. The detection of such damages can help specialists to approximate the state of the disease, as well as to perform statistical analysis, in order to propose treatment therapies for the patients. Manual segmentation of such patterns from magnetic resonance imaging is a very difficult and time-consuming task, and is not a viable solution if the number of images to process is relatively large. In recent years, deep learning techniques such as convolutional neural networks (CNNs or convnets) have experienced an increased development, and many researchers have used them to automatically segment medical images. In this research, we propose the use of convolutional neural networks for automatically segmenting the cerebellar fissures from brain magnetic resonance imaging. Three models are presented, based on the same CNN architecture, for obtaining three different binary masks: fissures, cerebellum with fissures, and cerebellum without fissures. The models perform well in terms of precision and efficiency. Evaluation results show that convnets can be trained for such purposes, and could be considered as additional tools in the diagnosis and characterization of neurodegenerative diseases.