Learning from Multiple Datasets with Heterogeneous and Partial Labels for Universal Lesion Detection in CT
PAII Inc.（PAII公司）；Virginia Polytechnic Institute and State University（弗吉尼亚理工学院暨州立大学）；Ping An Insurance (Group) Company of China, Ltd.（中国平安保险（集团）股份有限公司）
Ke Yan, Jinzheng Cai, Youjing Zheng, Adam P. Harrison, Dakai Jin, Youbao Tang, Yuxing Tang, Lingyun Huang, Jing Xiao, Le Lu
Large-scale datasets with high-quality labels are desired for training accurate deep learning models. However, due to the annotation cost, datasets in medical imaging are often either partially-labeled or small. For example, DeepLesion is such a large-scale CT image dataset with lesions of various types, but it also has many unlabeled lesions (missing annotations). When training a lesion detector on a partially-labeled dataset, the missing annotations will generate incorrect negative signals and degrade the performance. Besides DeepLesion, there are several small single-type datasets, such as LUNA for lung nodules and LiTS for liver tumors. These datasets have heterogeneous label scopes, i.e., different lesion types are labeled in different datasets with other types ignored. In this work, we aim to develop a universal lesion detection algorithm to detect a variety of lesions. The problem of heterogeneous and partial labels is tackled. First, we build a simple yet effective lesion detection framework named Lesion ENSemble (LENS). LENS can efficiently learn from multiple heterogeneous lesion datasets in a multi-task fashion and leverage their synergy by proposal fusion. Next, we propose strategies to mine missing annotations from partially-labeled datasets by exploiting clinical prior knowledge and cross-dataset knowledge transfer. Finally, we train our framework on four public lesion datasets and evaluate it on 800 manually-labeled sub-volumes in DeepLesion. Our method brings a relative improvement of 49% compared to the current state-of-the-art approach in the metric of average sensitivity. We have publicly released our manual 3D annotations of DeepLesion in https://github.com/viggin/DeepLesion_manual_test_set.
Lesion detection is an important problem within medical imaging analysis. Most previous work focuses on detecting and segmenting a specialized category of lesions (e.g., lung nodules). However, in clinical practice, radiologists are responsible for finding all possible types of anomalies. The task of universal lesion detection (ULD) was proposed to address this challenge by detecting a large variety of lesions from the whole body. There are multiple heterogeneously labeled datasets with varying label completeness: DeepLesion, the largest dataset of 32,735 annotated lesions of various types, bu…
We propose a novel deep learning model for classifying medical images in the setting where there is a large amount of unlabelled medical data available, but labelled data is in limited supply. We consider the specific case of classifying skin lesions as either malignant or benign. In this setting, the proposed approach -- the semi-supervised, denoising adversarial autoencoder -- is able to utilise vast amounts of unlabelled data to learn a representation for skin lesions, and small amounts of labelled data to assign class labels based on the learned representation. We analyse the contributions…
National Center for Biotechnology Information, National Library of Medicine（美国国家医学图书馆国家生物技术信息中心）
In radiologists' routine work, one major task is to read a medical image, e.g., a CT scan, find significant lesions, and describe them in the radiology report. In this paper, we study the lesion description or annotation problem. Given a lesion image, our aim is to predict a comprehensive set of relevant labels, such as the lesion's body part, type, and attributes, which may assist downstream fine-grained diagnosis. To address this task, we first design a deep learning module to extract relevant semantic labels from the radiology reports associated with the lesion images. With the images and t…
National Institutes of Health (NIH) Clinical Center（美国国立卫生研究院临床中心）；National Center for Biotechnology Information, National Library of Medicine, NIH（美国国立卫生研究院国家医学图书馆国家生物技术信息中心）
In radiologists' routine work, one major task is to read a medical image, e.g., a CT scan, find significant lesions, and write sentences in the radiology report to describe them. In this paper, we study the lesion description or annotation problem as an important step of computer-aided diagnosis (CAD). Given a lesion image, our aim is to predict multiple relevant labels, such as the lesion's body part, type, and attributes. To address this problem, we define a set of 145 labels based on RadLex to describe a large variety of lesions in the DeepLesion dataset. We directly mine training labels fr…
Fully annotated large-scale medical image datasets are highly valuable. However, because labeling medical images is tedious and requires specialized knowledge, the large-scale datasets available often have missing annotation issues. For instance, DeepLesion, a large-scale CT image dataset with labels for various kinds of lesions, is reported to have a missing annotation rate of 50\%. Directly training a lesion detector on it would suffer from false negative supervision caused by unannotated lesions. To address this issue, previous works have used sophisticated multi-stage strategies to switch …
The Chinese University of Hong Kong（香港中文大学）；Imsight Medical Technology Inc（视见医疗科技公司）
Deep neural networks (DNNs) have achieved great success in a wide variety of medical image analysis tasks. However, these achievements indispensably rely on the accurately-annotated datasets. If with the noisy-labeled images, the training procedure will immediately encounter difficulties, leading to a suboptimal classifier. This problem is even more crucial in the medical field, given that the annotation quality requires great expertise. In this paper, we propose an effective iterative learning framework for noisy-labeled medical image classification, to combat the lacking of high quality anno…
National Institutes of Health Clinical Center（美国国立卫生研究院临床中心）
Extracting, harvesting and building large-scale annotated radiological image datasets is a greatly important yet challenging problem. It is also the bottleneck to designing more effective data-hungry computing paradigms (e.g., deep learning) for medical image analysis. Yet, vast amounts of clinical annotations (usually associated with disease image findings and marked using arrows, lines, lesion diameters, segmentation, etc.) have been collected over several decades and stored in hospitals' Picture Archiving and Communication Systems. In this paper, we mine and harvest one major type of clinic…
Accurate, automated lesion detection in Computed Tomography (CT) is an important yet challenging task due to the large variation of lesion types, sizes, locations and appearances. Recent work on CT lesion detection employs two-stage region proposal based methods trained with centroid or bounding-box annotations. We propose a highly accurate and efficient one-stage lesion detector, by re-designing a RetinaNet to meet the particular challenges in medical imaging. Specifically, we optimize the anchor configurations using a differential evolution search algorithm. For training, we leverage the res…
PAII Inc.（PAII公司）；Vanderbilt University（范德堡大学）；Virginia Polytechnic Institute and State University（弗吉尼亚理工学院暨州立大学）；Ping An Insurance (Group) Company of China, Ltd.（中国平安保险（集团）股份有限公司）；University of Florida（佛罗里达大学）
Acquiring large-scale medical image data, necessary for training machine learning algorithms, is frequently intractable, due to prohibitive expert-driven annotation costs. Recent datasets extracted from hospital archives, e.g., DeepLesion, have begun to address this problem. However, these are often incompletely or noisily labeled, e.g., DeepLesion leaves over 50% of its lesions unlabeled. Thus, effective methods to harvest missing annotations are critical for continued progress in medical image analysis. This is the goal of our work, where we develop a powerful system to harvest missing lesio…
PAII Inc.（PAII公司）；The University of Texas at Arlington（德克萨斯大学阿灵顿分校）；Chang Gung Memorial Hospital（长庚纪念医院）；PingAn Technology（平安科技）
In medical imaging, organ/pathology segmentation models trained on current publicly available and fully-annotated datasets usually do not well-represent the heterogeneous modalities, phases, pathologies, and clinical scenarios encountered in real environments. On the other hand, there are tremendous amounts of unlabelled patient imaging scans stored by many modern clinical centers. In this work, we present a novel segmentation strategy, co-heterogenous and adaptive segmentation (CHASe), which only requires a small labeled cohort of single phase imaging data to adapt to any unlabeled cohort of …
National Engineering School of Sousse（苏塞国家工程学院）；University of Dundee（邓迪大学）
We introduce a dynamic multiscale tree (DMT) architecture that learns how to leverage the strengths of different existing classifiers for supervised multi-label image segmentation. Unlike previous works that simply aggregate or cascade classifiers for addressing image segmentation and labeling tasks, we propose to embed strong classifiers into a tree structure that allows bi-directional flow of information between its classifier nodes to gradually improve their performances. Our DMT is a generic classification model that inherently embeds different cascades of classifiers while enhancing learn…
Semi-supervised learning has the potential to improve the data-efficiency of training data-hungry deep neural networks, which is especially important for medical image analysis tasks where labeled data is scarce. In this work, we present a simple semi-supervised learning method for lesion segmentation tasks based on the ideas of cut-paste augmentation and consistency regularization. By exploiting the mask information available in the labeled data, we synthesize partially labeled samples from the unlabeled images so that the usual supervised learning objective (e.g., binary cross entropy) can b…
Lesion detection in brain Magnetic Resonance Images (MRI) remains a challenging task. State-of-the-art approaches are mostly based on supervised learning making use of large annotated datasets. Human beings, on the other hand, even non-experts, can detect most abnormal lesions after seeing a handful of healthy brain images. Replicating this capability of using prior information on the appearance of healthy brain structure to detect lesions can help computers achieve human level abnormality detection, specifically reducing the need for numerous labeled examples and bettering generalization of p…
Lesion segmentation in medical imaging serves as an effective tool for assessing tumor sizes and monitoring changes in growth. However, not only is manual lesion segmentation time-consuming, but it is also expensive and requires expert radiologist knowledge. Therefore many hospitals rely on a loose substitute called response evaluation criteria in solid tumors (RECIST). Although these annotations are far from precise, they are widely used throughout hospitals and are found in their picture archiving and communication systems (PACS). Therefore, these annotations have the potential to serve as a…
Stanford University（斯坦福大学）；University of California, San Diego Medical Center（加州大学圣地亚哥医学中心）
We propose a novel method, the adaptive local window, for improving level set segmentation technique. The window is estimated separately for each contour point, over iterations of the segmentation process, and for each individual object. Our method considers the object scale, the spatial texture, and changes of the energy functional over iterations. Global and local statistics are considered by calculating several gray level co-occurrence matrices. We demonstrate the capabilities of the method in the domain of medical imaging for segmenting 233 images with liver lesions. To illustrate the stre…
Incorporating data-specific domain knowledge in deep networks explicitly can provide important cues beneficial for lesion detection and can mitigate the need for diverse heterogeneous datasets for learning robust detectors. In this paper, we exploit the domain information present in computed tomography (CT) scans and propose a robust universal lesion detection (ULD) network that can detect lesions across all organs of the body by training on a single dataset, DeepLesion. We analyze CT-slices of varying intensities, generated using heuristically determined Hounsfield Unit(HU) windows that indiv…
Friedrich-Alexander-University Erlangen-Nuremberg（埃尔朗根-纽伦堡大学）；Universitat Politècnica de València（瓦伦西亚理工大学）；Universitätsklinikum Erlangen（埃尔朗根大学医院）
Magnetic resonance imaging (MRI) is an effective imaging modality for identifying and localizing breast lesions in women. Accurate and precise lesion segmentation using a computer-aided-diagnosis (CAD) system, is a crucial step in evaluating tumor volume and in the quantification of tumor characteristics. However, this is a challenging task, since breast lesions have sophisticated shape, topological structure, and high variance in their intensity distribution across patients. In this paper, we propose a novel marker-controlled watershed transformation-based approach, which uses the brightest p…
Imaging Biomarkers and Computer-Aided Diagnosis Laboratory（影像生物标志物与计算机辅助诊断实验室）；NVIDIA（英伟达）；Clinical Image Processing Service（临床图像处理服务部）；Ping An Insurance Company of China（中国平安保险（集团）股份有限公司）；National Institutes of Health Clinical Center（美国国立卫生研究院临床中心）
Response evaluation criteria in solid tumors (RECIST) is the standard measurement for tumor extent to evaluate treatment responses in cancer patients. As such, RECIST annotations must be accurate. However, RECIST annotations manually labeled by radiologists require professional knowledge and are time-consuming, subjective, and prone to inconsistency among different observers. To alleviate these problems, we propose a cascaded convolutional neural network based method to semi-automatically label RECIST annotations and drastically reduce annotation time. The proposed method consists of two stage…
Comparative evaluation of training strategies using partially labelled datasets for segmentation of white matter hyperintensities and stroke lesions in FLAIR MRI
SLPT: Selective Labeling Meets Prompt Tuning on Label-Limited Lesion Segmentation
The Chinese University of Hong Kong（香港中文大学）；DAMO Academy, Alibaba Group（阿里巴巴集团达摩院）；Hupan Lab（湖畔实验室）；Shengjing Hospital of China Medical University（中国医科大学附属盛京医院）；Southern University of Science and Technology（南方科技大学）
Australian Institute for Machine Learning, University of Adelaide（阿德莱德大学澳大利亚机器学习研究所）；Universität Ulm（乌尔姆大学）
Effective semi-supervised learning (SSL) in medical image analysis (MIA) must address two challenges: 1) work effectively on both multi-class (e.g., lesion classification) and multi-label (e.g., multiple-disease diagnosis) problems, and 2) handle imbalanced learning (because of the high variance in disease prevalence). One strategy to explore in SSL MIA is based on the pseudo labelling strategy, but it has a few shortcomings. Pseudo-labelling has in general lower accuracy than consistency learning, it is not specifically designed for both multi-class and multi-label problems, and it can be cha…
Sun Yat-sen University（中山大学）；The First Affiliated Hospital, Sun Yat-sen University（中山大学附属第一医院）；Infervision Inc.（推想医疗科技股份有限公司）
Hepatocellular carcinoma (HCC) is the second most frequent cause of malignancy-related death and is one of the diseases with the highest incidence in the world. Because the liver is the only organ in the human body that is supplied by two major vessels: the hepatic artery and the portal vein, various types of malignant tumors can spread from other organs to the liver. And due to the liver masses' heterogeneous and diffusive shape, the tumor lesions are very difficult to be recognized, thus automatic lesion detection is necessary for the doctors with huge workloads. To assist doctors, this work…
Robert Bosch GmbH（罗伯特·博世有限公司）；TU Dortmund University（多特蒙德工业大学）；Max Planck Institute for Intelligent Systems（马克斯·普朗克智能系统研究所）
Convolutional neural networks (CNNs) show impressive performance for image classification and detection, extending heavily to the medical image domain. Nevertheless, medical experts are sceptical in these predictions as the nonlinear multilayer structure resulting in a classification outcome is not directly graspable. Recently, approaches have been shown which help the user to understand the discriminative regions within an image which are decisive for the CNN to conclude to a certain class. Although these approaches could help to build trust in the CNNs predictions, they are only slightly sho…
Text-Driven Weakly Supervised OCT Lesion Segmentation with Structural Guidance
CUNY Graduate Center（CUNY研究生中心）；New York University Department of Ophthalmology（纽约大学眼科系）；NYU Langone Health（NYU兰格one健康）；Massachusetts General Hospital and Harvard Medical School（麻省总医院和哈佛医学院）；Stony Brook University（石溪大学）
Stanford University（斯坦福大学）；Oslo University Hospital（奥斯陆大学医院）
Deep learning has proven to be an essential tool for medical image analysis. However, the need for accurately labeled input data, often requiring time- and labor-intensive annotation by experts, is a major limitation to the use of deep learning. One solution to this challenge is to allow for use of coarse or noisy labels, which could permit more efficient and scalable labeling of images. In this work, we develop a lopsided loss function based on entropy regularization that assumes the existence of a nontrivial false negative rate in the target annotations. Starting with a carefully annotated b…
FMaMIL: Frequency-Driven Mamba Multi-Instance Learning for Weakly Supervised Lesion Segmentation in Medical Images
College of Computer Science and Technology (College of Data Science), Taiyuan University of Technology, Taiyuan, Shanxi, 030024, China（计算机科学与技术学院（数据科学学院），太原科技大学，太原，山西，030024，中国）；College of Artificial Intelligence, Taiyuan University of Technology, Taiyuan, Shanxi, 030024, China（人工智能学院，太原科技大学，太原，山西，030024，中国）；School of mathematics, Taiyuan University of Technology, Taiyuan, 030024, China（数学学院，太原科技大学，太原，030024，中国）；School of Artificial Intelligence, Beijing Normal University, Beijing, 100875, China（人工智能学院，北京师范大学，北京，100875，中国）；National Institute for Data Science in Health（健康数据科学国家研究院）；the Department of Computer Science, School of Informatics, Xiammen, 361005, China（信息学院计算机科学系，厦门，361005，中国）；School of Software, Dalian University of Technology, Dalian,116621, China（软件学院，大连理工大学，大连，116621，中国）
University of Iceland（冰岛大学）；Landspitali - University Hospital（兰斯皮塔利大学医院）；The Icelandic Heart Association（冰岛心脏协会）；The Johns Hopkins University（约翰斯·霍普金斯大学）
Lesions that appear hyperintense in both Fluid Attenuated Inversion Recovery (FLAIR) and T2-weighted magnetic resonance images (MRIs) of the human brain are common in the brains of the elderly population and may be caused by ischemia or demyelination. Lesions are biomarkers for various neurodegenerative diseases, making accurate quantification of them important for both disease diagnosis and progression. Automatic lesion detection using supervised learning requires manually annotated images, which can often be impractical to acquire. Unsupervised lesion detection, on the other hand, does not r…
National Institutes of Health（美国国立卫生研究院）；National Institute of Diabetes and Digestive and Kidney Diseases（国家糖尿病、消化和肾脏疾病研究所）
Finding small lesions is very challenging due to lack of noticeable features, severe class imbalance, as well as the size itself. One approach to improve small lesion segmentation is to reduce the region of interest and inspect it at a higher sensitivity rather than performing it for the entire region. It is usually implemented as sequential or joint segmentation of organ and lesion, which requires additional supervision on organ segmentation. Instead, we propose to utilize an intensity distribution of a target lesion at no additional labeling cost to effectively separate regions where the les…
Universidad Nacional de Colombia（哥伦比亚国立大学）；Fundación Oftalmológica Nacional（国家眼科基金会）；Universidad del Rosario（罗萨里奥大学）
Diabetic retinopathy (DR) is the result of a complication of diabetes affecting the retina. It can cause blindness, if left undiagnosed and untreated. An ophthalmologist performs the diagnosis by screening each patient and analyzing the retinal lesions via ocular imaging. In practice, such analysis is time-consuming and cumbersome to perform. This paper presents a model for automatic DR classification on eye fundus images. The approach identifies the main ocular lesions related to DR and subsequently diagnoses the illness. The proposed method follows the same workflow as the clinicians, provid…
Multi-Granularity 3D Kidney Lesion Characterization from CT Volumes
Department of Health Outcomes and Biomedical Informatics, University of Florida（健康结果与生物医学信息学系，佛罗里达大学）；Department of Urology, University of Florida（泌尿外科，佛罗里达大学）；Department of Biostatistics and Health Data Science, Indiana University School of Medicine（生物统计学与健康数据科学系，印第安纳大学医学院）；Center of Biomedical Informatics（生物医学信息学中心）
McGill University（麦吉尔大学）；MILA Quebec AI Institute（魁北克人工智能研究所（MILA））；Montreal Neurological Institute（蒙特利尔神经学研究所）
Precision medicine for chronic diseases such as multiple sclerosis (MS) involves choosing a treatment which best balances efficacy and side effects/preferences for individual patients. Making this choice as early as possible is important, as delays in finding an effective therapy can lead to irreversible disability accrual. To this end, we present the first deep neural network model for individualized treatment decisions from baseline magnetic resonance imaging (MRI) (with clinical information if available) for MS patients. Our model (a) predicts future new and enlarging T2 weighted (NE-T2) le…
Medical images are widely used in clinical practice for diagnosis. Automatically generating interpretable medical reports can reduce radiologists' burden and facilitate timely care. However, most existing approaches to automatic report generation require sufficient labeled data for training. In addition, the learned model can only generate reports for the training classes, lacking the ability to adapt to previously unseen novel diseases. To this end, we propose a lesion guided explainable few weak-shot medical report generation framework that learns correlation between seen and novel classes t…
Sliding Window FastEdit: A Framework for Lesion Annotation in Whole-body PET Images
HIDSS4Health - Helmholtz Information and Data Science School for Health（亥姆霍兹信息与健康数据科学学院）；Institute for AI in Medicine (IKIM), University Hospital Essen（埃森大学医院医学人工智能研究所）
Vanderbilt University（范德堡大学）；Vanderbilt University Medical Center（范德堡大学医学中心）
Automated segmentation of multiple sclerosis (MS) lesions from MRI scans is important to quantify disease progression. In recent years, convolutional neural networks (CNNs) have shown top performance for this task when a large amount of labeled data is available. However, the accuracy of CNNs suffers when dealing with few and/or sparsely labeled datasets. A potential solution is to leverage the information available in large public datasets in conjunction with a target dataset which only has limited labeled data. In this paper, we propose a training framework, SSL2 (self-supervised-semi-superv…
University of Chinese Academy of Sciences（中国科学院大学）
Weakly-supervised learning under image-level labels supervision has been widely applied to semantic segmentation of medical lesions regions. However, 1) most existing models rely on effective constraints to explore the internal representation of lesions, which only produces inaccurate and coarse lesions regions; 2) they ignore the strong probabilistic dependencies between target lesions dataset (e.g., enteroscopy images) and well-to-annotated source diseases dataset (e.g., gastroscope images). To better utilize these dependencies, we present a new semantic lesions representation transfer model…
We propose a novel convolutional neural network for lesion detection from weak labels. Only a single, global label per image - the lesion count - is needed for training. We train a regression network with a fully convolutional architecture combined with a global pooling layer to aggregate the 3D output into a scalar indicating the lesion count. When testing on unseen images, we first run the network to estimate the number of lesions. Then we remove the global pooling layer to compute localization maps of the size of the input image. We evaluate the proposed network on the detection of enlarged…
As an essential indicator for cancer progression and treatment response, tumor size is often measured following the response evaluation criteria in solid tumors (RECIST) guideline in CT slices. By marking each lesion with its longest axis and the longest perpendicular one, laborious pixel-wise manual annotation can be avoided. However, such a coarse substitute cannot provide a rich and accurate base to allow versatile quantitative analysis of lesions. To this end, we propose a novel weakly supervised framework to exploit the existing rich RECIST annotations for pixel-wise lesion segmentation. …
In this study, we investigate what a practically useful approach is in order to achieve robust skin disease diagnosis. A direct approach is to target the ground truth diagnosis labels, while an alternative approach instead focuses on determining skin lesion characteristics that are more visually consistent and discernible. We argue that, for computer-aided skin disease diagnosis, it is both more realistic and more useful that lesion type tags should be considered as the target of an automated diagnosis system such that the system can first achieve a high accuracy in describing skin lesions, an…
SegHeD+: Segmentation of Heterogeneous Data for Multiple Sclerosis Lesions with Anatomical Constraints and Lesion-aware Augmentation
Imperial College London（帝国理工学院）；Data Science Institute, Imperial College London（帝国理工学院数据科学研究所）；UK Dementia Research Institute, Imperial College London（帝国理工学院英国痴呆症研究所）；Rosalind Franklin Institute（罗莎琳德·富兰克林研究所）
Segmenting skin lesions images is relevant both for itself and for assisting in lesion classification, but suffers from the challenge in obtaining annotated data. In this work, we show that segmentation may improve with less data, by selecting the training samples with best inter-annotator agreement, and conditioning the ground-truth masks to remove excessive detail. We perform an exhaustive experimental design considering several sources of variation, including three different test sets, two different deep-learning architectures, and several replications, for a total of 540 experimental runs.…
The Chinese University of Hong Kong（香港中文大学）；Imsight Medical Technology, Inc.（Imsight医疗科技公司）
Automatic skin lesion segmentation on dermoscopic images is an essential component in computer-aided diagnosis of melanoma. Recently, many fully supervised deep learning based methods have been proposed for automatic skin lesion segmentation. However, these approaches require massive pixel-wise annotation from experienced dermatologists, which is very costly and time-consuming. In this paper, we present a novel semi-supervised method for skin lesion segmentation by leveraging both labeled and unlabeled data. The network is optimized by the weighted combination of a common supervised loss for l…
