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We aim at segmenting a wide variety of organs, including tiny targets (e.g., adrenal gland), and neoplasms (e.g., pancreatic cyst), from abdominal CT scans. This is a challenging task in two aspects. First, some organs (e.g., the pancreas), are highly variable in both anatomy and geometry, and thus very difficult to depict. Second, the neoplasms often vary a lot in its size, shape, as well as its location within the organ. Third, the targets (organs and neoplasms) can be considerably small compared to the human body, and so standard deep networks for segmentation are often less sensitive to these targets and thus predict less accurately especially around their boundaries. In this paper, we present an end-to-end framework named recurrent saliency transformation network (RSTN) for segmenting tiny and/or variable targets. The RSTN is a coarse-to-fine approach that uses prediction from the first (coarse) stage to shrink the input region for the second (fine) stage. A saliency transformation module is inserted between these two stages so that 1) the coarse-scaled segmentation mask can be transferred as spatial weights and applied to the fine stage and 2) the gradients can be back-propagated from the loss layer to the entire network so that the two stages are optimized in a joint manner. In the testing stage, we perform segmentation iteratively to improve accuracy. In this extended journal paper, we allow a gradual optimization to improve the stability of the RSTN, and introduce a hierarchical version named H-RSTN to segment tiny and variable neoplasms such as pancreatic cysts. Experiments are performed on several CT datasets including a public pancreas segmentation dataset, our own multi-organ dataset, and a cystic pancreas dataset. In all these cases, the RSTN outperforms the baseline (a stage-wise coarse-to-fine approach) significantly. Confirmed by the radiologists in our team, these promising segmentation results can help early diagnosis of pancreatic cancer. The code and pre-trained models of our project were made available at https://github.com/198808xc/OrganSegRSTN. [ABSTRACT FROM AUTHOR]

Objective: False positive reduction is one of the most crucial components in an automated pulmonary nodule detection system, which plays an important role in lung cancer diagnosis and early treatment. The objective of this paper is to effectively address the challenges in this task and therefore to accurately discriminate the true nodules from a large number of candidates. Methods: We propose a novel method employing three-dimensional (3-D) convolutional neural networks (CNNs) for false positive reduction in automated pulmonary nodule detection from volumetric computed tomography (CT) scans. Compared with its 2-D counterparts, the 3-D CNNs can encode richer spatial information and extract more representative features via their hierarchical architecture trained with 3-D samples. More importantly, we further propose a simple yet effective strategy to encode multilevel contextual information to meet the challenges coming with the large variations and hard mimics of pulmonary nodules. Results: The proposed framework has been extensively validated in the LUNA16 challenge held in conjunction with ISBI 2016, where we achieved the highest competition performance metric (CPM) score in the false positive reduction track. Conclusion: Experimental results demonstrated the importance and effectiveness of integrating multilevel contextual information into 3-D CNN framework for automated pulmonary nodule detection in volumetric CT data. Significance: While our method is tailored for pulmonary nodule detection, the proposed framework is general and can be easily extended to many other 3-D object detection tasks from volumetric medical images, where the targeting objects have large variations and are accompanied by a number of hard mimics. [ABSTRACT FROM AUTHOR]

We introduce a new computer aided detection and diagnosis system for lung cancer screening with low-dose CT scans that produces meaningful probability assessments. Our system is based entirely on 3D convolutional neural networks and achieves state-of-the-art performance for both lung nodule detection and malignancy classification tasks on the publicly available LUNA16 and Kaggle Data Science Bowl challenges. While nodule detection systems are typically designed and optimized on their own, we find that it is important to consider the coupling between detection and diagnosis components. Exploiting this coupling allows us to develop an end-to-end system that has higher and more robust performance and eliminates the need for a nodule detection false positive reduction stage. Furthermore, we characterize model uncertainty in our deep learning systems, a first for lung CT analysis, and show that we can use this to provide well-calibrated classification probabilities for both nodule detection and patient malignancy diagnosis. These calibrated probabilities informed by model uncertainty can be used for subsequent risk-based decision making towards diagnostic interventions or disease treatments, as we demonstrate using a probability-based patient referral strategy to further improve our results. [ABSTRACT FROM AUTHOR]