TRUSformer: Improving Prostate Cancer Detection from Micro-Ultrasound Using Attention and Self-Supervision
Queen’s University（女王大学）；University of British Columbia（不列颠哥伦比亚大学）；Exact Imaging（Exact Imaging公司）
Mahdi Gilany, Paul Wilson, Andrea Perera-Ortega, Amoon Jamzad, Minh Nguyen Nhat To, Fahimeh Fooladgar, Brian Wodlinger, Purang Abolmaesumi, Parvin Mousavi
A large body of previous machine learning methods for ultrasound-based prostate cancer detection classify small regions of interest (ROIs) of ultrasound signals that lie within a larger needle trace corresponding to a prostate tissue biopsy (called biopsy core). These ROI-scale models suffer from weak labeling as histopathology results available for biopsy cores only approximate the distribution of cancer in the ROIs. ROI-scale models do not take advantage of contextual information that are normally considered by pathologists, i.e. they do not consider information about surrounding tissue and larger-scale trends when identifying cancer. We aim to improve cancer detection by taking a multi-scale, i.e. ROI-scale and biopsy core-scale, approach. Methods: Our multi-scale approach combines (i) an "ROI-scale" model trained using self-supervised learning to extract features from small ROIs and (ii) a "core-scale" transformer model that processes a collection of extracted features from multiple ROIs in the needle trace region to predict the tissue type of the corresponding core. Attention maps, as a byproduct, allow us to localize cancer at the ROI scale. We analyze this method using a dataset of micro-ultrasound acquired from 578 patients who underwent prostate biopsy, and compare our model to baseline models and other large-scale studies in the literature. Results and Conclusions: Our model shows consistent and substantial performance improvements compared to ROI-scale-only models. It achieves 80.3% AUROC, a statistically significant improvement over ROI-scale classification. We also compare our method to large studies on prostate cancer detection, using other imaging modalities. Our code is publicly available at www.github.com/med-i-lab/TRUSFormer
Queen’s University（女王大学）；University of British Columbia（不列颠哥伦比亚大学）；Exact Imaging
MOTIVATION: Detection of prostate cancer during transrectal ultrasound-guided biopsy is challenging. The highly heterogeneous appearance of cancer, presence of ultrasound artefacts, and noise all contribute to these difficulties. Recent advancements in high-frequency ultrasound imaging - micro-ultrasound - have drastically increased the capability of tissue imaging at high resolution. Our aim is to investigate the development of a robust deep learning model specifically for micro-ultrasound-guided prostate cancer biopsy. For the model to be clinically adopted, a key challenge is to design a so…
Medical imaging based prostate cancer diagnosis procedure uses intra-operative transrectal ultrasound (TRUS) imaging to visualize the prostate shape and location to collect tissue samples. Correct tissue sampling from prostate requires accurate prostate segmentation in TRUS images. To achieve this, this study uses a novel residual connection based fully convolutional network. The advantage of this segmentation technique is that it requires no pre-processing of TRUS images to perform the segmentation. Thus, it offers a faster and straightforward prostate segmentation from TRUS images. Results s…
Siemens Healthineers（西门子医疗）；Imperial College London（帝国理工学院）
Real-time localization of prostate gland in trans-rectal ultrasound images is a key technology that is required to automate the ultrasound guided prostate biopsy procedures. In this paper, we propose a new deep learning based approach which is aimed at localizing several prostate landmarks efficiently and robustly. We propose a multitask learning approach primarily to make the overall algorithm more contextually aware. In this approach, we not only consider the explicit learning of landmark locations, but also build-in a mechanism to learn the contour of the prostate. This multitask learning i…
Weakly Supervised Spatial Grounding for Discriminative Attention-Based Ultrasound-Histopathology Alignment in Prostate Cancer Grading
University of British Columbia（不列颠哥伦比亚大学）；Vector Institute（向量研究所）；Ordensklinikum Linz（林茨教团医院）；University of Alberta（阿尔伯塔大学）；Exact Imaging（Exact Imaging公司）
Queen’s University（女王大学）；University of British Columbia（不列颠哥伦比亚大学）；Exact Imaging（Exact Imaging公司）
Deep learning-based analysis of high-frequency, high-resolution micro-ultrasound data shows great promise for prostate cancer detection. Previous approaches to analysis of ultrasound data largely follow a supervised learning paradigm. Ground truth labels for ultrasound images used for training deep networks often include coarse annotations generated from the histopathological analysis of tissue samples obtained via biopsy. This creates inherent limitations on the availability and quality of labeled data, posing major challenges to the success of supervised learning methods. On the other hand, …
In this work we propose to segment the prostate on a challenging dataset of trans-rectal ultrasound (TRUS) images using convolutional neural networks (CNNs) and statistical shape models (SSMs). TRUS is commonly used for a number of image-guided interventions on the prostate. Fast and accurate segmentation on the organ in these images is crucial to planning and fusion with other modalities such as magnetic resonance images (MRIs) . However, TRUS has limited soft tissue contrast and signal to noise ratio which makes the task of segmenting the prostate challenging and subject to inter-observer an…
University of California, San Francisco（加州大学旧金山分校）；Duke University（杜克大学）；University of Dusseldorf（杜塞尔多夫大学）；University of Washington（华盛顿大学）
Non-invasive prostate cancer detection from MRI has the potential to revolutionize patient care by providing early detection of clinically-significant disease (ISUP grade group >= 2), but has thus far shown limited positive predictive value. To address this, we present an MRI-based deep learning method for predicting clinically significant prostate cancer applicable to a patient population with subsequent ground truth biopsy results ranging from benign pathology to ISUP grade group~5. Specifically, we demonstrate that mixed supervision via diverse histopathological ground truth improves classi…
Radiological imaging of prostate is becoming more popular among researchers and clinicians in searching for diseases, primarily cancer. Scans might be acquired at different times, with patient movement between scans, or with different equipment, resulting in multiple datasets that need to be registered. For this issue, we introduce a registration method using anatomical feature-guided mutual information. Prostate scans of the same patient taken in three different orientations are first aligned for the accurate detection of anatomical features in 3D. Then, our pipeline allows for multiple modal…
Stanford University（斯坦福大学）；University College London（伦敦大学学院）；University of California Los Angeles（加利福尼亚大学洛杉矶分校）
Prostate biopsy and image-guided treatment procedures are often performed under the guidance of ultrasound fused with magnetic resonance images (MRI). Accurate image fusion relies on accurate segmentation of the prostate on ultrasound images. Yet, the reduced signal-to-noise ratio and artifacts (e.g., speckle and shadowing) in ultrasound images limit the performance of automated prostate segmentation techniques and generalizing these methods to new image domains is inherently difficult. In this study, we address these challenges by introducing a novel 2.5D deep neural network for prostate segm…
A Narrative Review of Image Processing Techniques Related to Prostate Ultrasound
School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University（深圳大学医学部生物医学工程学院）；Department of Computer Science and Engineering, The Chinese University of Hong Kong（香港中文大学计算机科学与工程学系）
3D EAGAN: 3D edge-aware attention generative adversarial network for prostate segmentation in transrectal ultrasound images
Nanchang Hangkong University（南昌航空大学）；Nanjing University of Information Science and Technology（南京信息工程大学）；The First Affiliated Hospital of Nanchang University（南昌大学第一附属医院）
Towards Multi-modality Fusion and Prototype-based Feature Refinement for Clinically Significant Prostate Cancer Classification in Transrectal Ultrasound
School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University（深圳大学医学部生物医学工程学院）；Sun Yat-sen University Cancer Center（中山大学肿瘤防治中心）
Mask Enhanced Deeply Supervised Prostate Cancer Detection on B-mode Micro-Ultrasound
Stanford University（斯坦福大学）；The Catholic University of Korea（韩国天主教大学）；University of Alberta（阿尔伯塔大学）；University of California Los Angeles（加州大学洛杉矶分校）；Humanitas University（乌尼塔斯大学）；IRCCS Humanitas Research Hospital（IRCCS乌尼塔斯研究医院）；University of Florida（佛罗里达大学）；University of California San Diego（加州大学圣地亚哥分校）
Hybrid-View Attention Network for Clinically Significant Prostate Cancer Classification in Transrectal Ultrasound
Smart Medical Imaging, Learning and Engineering (SMILE) Lab（智能医学影像、学习与工程实验室）；Medical UltraSound Image Computing (MUSIC) Lab（超声影像计算（MUSIC）实验室）；School of Biomedical Engineering（生物医学工程学院）；Shenzhen University Medical School（深圳大学医学院）；Shenzhen University（深圳大学）；The Department of Ultrasound（超声科）；State Key Laboratory of Oncology in South China（南方肿瘤学关键实验室）；Guangdong Provincial Clinical Research Center for Cancer（广东省癌症临床研究中心）；Sun Yat-sen University Cancer Center（中山大学肿瘤中心）
Deep Attentive Features for Prostate Segmentation in 3D Transrectal Ultrasound
Shenzhen University（深圳大学）；The Chinese University of Hong Kong（香港中文大学）；The Hong Kong Polytechnic University（香港理工大学）；Sun Yat-Sen University（中山大学）；the First Affiliated Hospital（第一附属医院）
Do High-Performance Image-to-Image Translation Networks Enable the Discovery of Radiomic Features? Application to MRI Synthesis from Ultrasound in Prostate Cancer
Influence of High-Performance Image-to-Image Translation Networks on Clinical Visual Assessment and Outcome Prediction: Utilizing Ultrasound to MRI Translation in Prostate Cancer
Clinically significant prostate cancer has a better chance to be sampled during ultrasound-guided biopsy procedures, if suspected lesions found in pre-operative magnetic resonance (MR) images are used as targets. However, the diagnostic accuracy of the biopsy procedure is limited by the operator-dependent skills and experience in sampling the targets, a sequential decision making process that involves navigating an ultrasound probe and placing a series of sampling needles for potentially multiple targets. This work aims to learn a reinforcement learning (RL) policy that optimises the actions o…
Queen’s University（女王大学）；University of British Columbia（不列颠哥伦比亚大学）；University of Alberta（阿尔伯塔大学）；Exact Imaging（Exact影像）
Purpose: Medical foundation models (FMs) offer a path to build high-performance diagnostic systems. However, their application to prostate cancer (PCa) detection from micro-ultrasound (μUS) remains untested in clinical settings. We present ProstNFound+, an adaptation of FMs for PCa detection from μUS, along with its first prospective validation. Methods: ProstNFound+ incorporates a medical FM, adapter tuning, and a custom prompt encoder that embeds PCa-specific clinical biomarkers. The model generates a cancer heatmap and a risk score for clinically significant PCa. Following training on multi…
Eindhoven University of Technology（埃因霍温理工大学）；Shandong University of Science and Technology（山东科技大学）；Philips Research（飞利浦研究院）
Medical instrument detection is essential for computer-assisted interventions since it would facilitate the surgeons to find the instrument efficiently with a better interpretation, which leads to a better outcome. This article reviews medical instrument detection methods in the ultrasound-guided intervention. First, we present a comprehensive review of instrument detection methodologies, which include traditional non-data-driven methods and data-driven methods. The non-data-driven methods were extensively studied prior to the era of machine learning, i.e. data-driven approaches. We discuss th…
Salient Region Matching for Fully Automated MR-TRUS Registration
School of Biomedical Engineering, Shenzhen University（深圳大学生物医学工程学院）；Medical UltraSound Image Computing (MUSIC) Lab（医学超声影像计算实验室）；Smart Medical Imaging, Learning and Engineering (SMILE) Lab（智能医学影像、学习与工程实验室）
Poisson Ordinal Network for Gleason Group Estimation Using Bi-Parametric MRI
Centre for Medical Image Computing, University College London（伦敦大学学院医学影像计算中心）；School of Artificial Intelligence, Beijing University of Posts and Telecommunications（北京邮电大学人工智能学院）；Centre for Medical Imaging, University College London（伦敦大学学院医学影像中心）；National Institute of Health Data Science, Peking University（北京大学健康数据科学国家研究院）
Background: Transrectal ultrasound guided systematic biopsies of the prostate is a routine procedure to establish a prostate cancer diagnosis. However, the 10-12 prostate core biopsies only sample a relatively small volume of the prostate, and tumour lesions in regions between biopsy cores can be missed, leading to a well-known low sensitivity to detect clinically relevant cancer. As a proof-of-principle, we developed and validated a deep convolutional neural network model to distinguish between morphological patterns in benign prostate biopsy whole slide images from men with and without estab…
University College London（伦敦大学学院）；University of Leeds（利兹大学）
Biomechanical modelling of soft tissue provides a non-data-driven method for constraining medical image registration, such that the estimated spatial transformation is considered biophysically plausible. This has not only been adopted in real-world clinical applications, such as the MR-to-ultrasound registration for prostate intervention of interest in this work, but also provides an explainable means of understanding the organ motion and spatial correspondence establishment. This work instantiates the recently-proposed physics-informed neural networks (PINNs) to a 3D linear elastic model for …
