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Objectives: The molecular subtyping of diffuse gliomas is important. The aim of this study was to establish predictive models based on preoperative multiparametric MRI. Methods: A total of 1016 diffuse glioma patients were retrospectively collected from Beijing Tiantan Hospital. Patients were randomly divided into the training (n = 780) and validation (n = 236) sets. According to the 2016 WHO classification, diffuse gliomas can be classified into four binary classification tasks (tasks I–IV). Predictive models based on radiomics and deep convolutional neural network (DCNN) were developed respectively, and their performances were compared with receiver operating characteristic (ROC) curves. Additionally, the radiomics and DCNN features were visualized and compared with the t-distributed stochastic neighbor embedding technique and Spearman's correlation test. Results: In the training set, areas under the curves (AUCs) of the DCNN models (ranging from 0.99 to 1.00) outperformed the radiomics models in all tasks, and the accuracies of the DCNN models (ranging from 0.90 to 0.94) outperformed the radiomics models in tasks I, II, and III. In the independent validation set, the accuracies of the DCNN models outperformed the radiomics models in all tasks (0.74–0.83), and the AUCs of the DCNN models (0.85–0.89) outperformed the radiomics models in tasks I, II, and III. DCNN features demonstrated more superior discriminative capability than the radiomics features in feature visualization analysis, and their general correlations were weak. Conclusions: Both the radiomics and DCNN models could preoperatively predict the molecular subtypes of diffuse gliomas, and the latter performed better in most circumstances. Key Points: • The molecular subtypes of diffuse gliomas could be predicted with MRI. • Deep learning features tend to outperform radiomics features in large cohorts. • The correlation between the radiomics features and DCNN features was low. [ABSTRACT FROM AUTHOR]

Till March 31st, 2021, the coronavirus disease 2019 (COVID-19) had reportedly infected more than 127 million people and caused over 2.5 million deaths worldwide. Timely diagnosis of COVID-19 is crucial for management of individual patients as well as containment of the highly contagious disease. Having realized the clinical value of non-contrast chest computed tomography (CT) for diagnosis of COVID-19, deep learning (DL) based automated methods have been proposed to aid the radiologists in reading the huge quantities of CT exams as a result of the pandemic. In this work, we address an overlooked problem for training deep convolutional neural networks for COVID-19 classification using real-world multi-source data, namely, the data source bias problem. The data source bias problem refers to the situation in which certain sources of data comprise only a single class of data, and training with such source-biased data may make the DL models learn to distinguish data sources instead of COVID-19. To overcome this problem, we propose MIx-aNd-Interpolate (MINI), a conceptually simple, easy-to-implement, efficient yet effective training strategy. The proposed MINI approach generates volumes of the absent class by combining the samples collected from different hospitals, which enlarges the sample space of the original source-biased dataset. Experimental results on a large collection of real patient data (1,221 COVID-19 and 1,520 negative CT images, and the latter consisting of 786 community acquired pneumonia and 734 non-pneumonia) from eight hospitals and health institutions show that: 1) MINI can improve COVID-19 classification performance upon the baseline (which does not deal with the source bias), and 2) MINI is superior to competing methods in terms of the extent of improvement. [ABSTRACT FROM AUTHOR]

Purpose: Microvascular invasion (MVI) is a valuable predictor of survival in hepatocellular carcinoma (HCC) patients. This study developed predictive models using eXtreme Gradient Boosting (XGBoost) and deep learning based on CT images to predict MVI preoperatively. Methods: In total, 405 patients were included. A total of 7302 radiomic features and 17 radiological features were extracted by a radiomics feature extraction package and radiologists, respectively. We developed a XGBoost model based on radiomics features, radiological features and clinical variables and a three-dimensional convolutional neural network (3D-CNN) to predict MVI status. Next, we compared the efficacy of the two models. Results: Of the 405 patients, 220 (54.3%) were MVI positive, and 185 (45.7%) were MVI negative. The areas under the receiver operating characteristic curves (AUROCs) of the Radiomics-Radiological-Clinical (RRC) Model and 3D-CNN Model in the training set were 0.952 (95% confidence interval (CI) 0.923–0.973) and 0.980 (95% CI 0.959–0.993), respectively (p = 0.14). The AUROCs of the RRC Model and 3D-CNN Model in the validation set were 0.887 (95% CI 0.797–0.947) and 0.906 (95% CI 0.821–0.960), respectively (p = 0.83). Based on the MVI status predicted by the RRC and 3D-CNN Models, the mean recurrence-free survival (RFS) was significantly better in the predicted MVI-negative group than that in the predicted MVI-positive group (RRC Model: 69.95 vs. 24.80 months, p < 0.001; 3D-CNN Model: 64.06 vs. 31.05 months, p = 0.027). Conclusion: The RRC Model and 3D-CNN models showed considerable efficacy in identifying MVI preoperatively. These machine learning models may facilitate decision-making in HCC treatment but requires further validation. [ABSTRACT FROM AUTHOR]

Fully convolutional neural networks have made promising progress in joint liver and liver tumor segmentation. Instead of following the debates over 2D versus 3D networks (for example, pursuing the balance between large-scale 2D pretraining and 3D context), in this paper, we novelly identify the wide variation in the ratio between intra- and inter-slice resolutions as a crucial obstacle to the performance. To tackle the mismatch between the intra- and inter-slice information, we propose a slice-aware 2.5D network that emphasizes extracting discriminative features utilizing not only in-plane semantics but also out-of-plane coherence for each separate slice. Specifically, we present a slice-wise multi-input multi-output architecture to instantiate such a design paradigm, which contains a Multi-Branch Decoder (MD) with a Slice-centric Attention Block (SAB) for learning slice-specific features and a Densely Connected Dice (DCD) loss to regularize the inter-slice predictions to be coherent and continuous. Based on the aforementioned innovations, we achieve state-of-the-art results on the MICCAI 2017 Liver Tumor Segmentation (LiTS) dataset. Besides, we also test our model on the ISBI 2019 Segmentation of THoracic Organs at Risk (SegTHOR) dataset, and the result proves the robustness and generalizability of the proposed method in other segmentation tasks. [ABSTRACT FROM AUTHOR]

• Crossover-Net is designed for non-elongated tissues segmentation in medical images. • Crossover-patch provides crossover relation information to Crossover-Net. • Crossover-Net learns features of crossover-patch from two directions simultaneously. • Target-guided information could be effectively highlighted by new loss function. Accurate boundary segmentation in medical images is significant yet challenging due to large variation of shape, size and appearance within intra- and inter- samples. In this paper, we present a novel deep model termed as Crossover-Net for robust segmentation in medical images. The proposed model is inspired by an interesting observation – the features learned from horizontal and vertical directions can provide informative and complement contextual information to enhance discriminative ability between different tissues. Specifically, we first originally propose a cross-shaped patch, namely crossover-patch which consists of a pair of (orthogonal and overlapping) vertical and horizontal patches. Then, we develop our Crossover-Net to learn the vertical and horizontal crossover relation according to the proposed crossover-patches. To train our model end-to-end, we design a novel loss function to (1) impose the consistency on overlapping region of vertical and horizontal patches and (2) preserve the diversity on their non-overlapping regions. We have extensively evaluated our method on CT kidney tumor, MR cardiac, and X-ray breast mass segmentation tasks, showing promising results compared with the current state-of-the-art methods. The code is available at https://github.com/Qianyu1226/Crossover-Net. [ABSTRACT FROM AUTHOR]

Layer segmentation is important to quantitative analysis of retinal optical coherence tomography (OCT). Recently, deep learning based methods have been developed to automate this task and yield remarkable performance. However, due to the large spatial gap and potential mismatch between the B-scans of an OCT volume, all of them were based on 2D segmentation of individual B-scans, which may lose the continuity and diagnostic information of the retinal layers in 3D space. Besides, most of these methods required dense annotation of the OCT volumes, which is labor-intensive and expertise-demanding. This work presents a novel framework based on hybrid 2D–3D convolutional neural networks (CNNs) to obtain continuous 3D retinal layer surfaces from OCT volumes, which works well with both full and sparse annotations. The 2D features of individual B-scans are extracted by an encoder consisting of 2D convolutions. These 2D features are then used to produce the alignment displacement vectors and layer segmentation by two 3D decoders coupled via a spatial transformer module. Two losses are proposed to utilize the retinal layers' natural property of being smooth for B-scan alignment and layer segmentation, respectively, and are the key to the semi-supervised learning with sparse annotation. The entire framework is trained end-to-end. To the best of our knowledge, this is the first work that attempts 3D retinal layer segmentation in volumetric OCT images based on CNNs. Experiments on a synthetic dataset and three public clinical datasets show that our framework can effectively align the B-scans for potential motion correction, and achieves superior performance to state-of-the-art 2D deep learning methods in terms of both layer segmentation accuracy and cross-B-scan 3D continuity in both fully and semi-supervised settings, thus offering more clinical values than previous works. • Simultaneous B-scan alignment and 3D layer segmentation of retinal OCT images. • Hybrid 2D–3D architecture accommodating highly anisotropic OCT data. • Spatial transformer module coupling B-scan motion correction with layer segmentation. • Global coherence loss encouraging coherent layer surfaces in 3D. • Effective fully and semi-supervised learning with a single unified framework. [Display omitted] [ABSTRACT FROM AUTHOR]

• A novel deep CNN architecture is proposed for jointly learning the expert consensus label and the annotator's label. The proposed architecture (Fig. 1) consists of two coupled CNNs where one estimates the expert consensus label probabilities and the other models the characteristics of individual annotators (e.g., tendency to over-segmentation, mix-up between different classes, etc) by estimating the pixel-wise confusion matrices (CMs) on a per image basis. Unlike STAPLE [25] and its variants, our method models, and disentangles with deep neural networks, the complex mappings from the input images to the annotator behaviours and to the expert consensus label. • The parameters of our CNNs are "global variables" that are optimised across different image samples; this enables the model to disentangle robustly the annotators' mistakes and the expert consensus label based on correlations between similar image samples, even when the number of available annotations is small per image (e.g., a single annotation per image). In contrast, this would not be possible with STAPLE [25] and its variants [5,8] where the annotators' parameters are estimated on every target image separately. • This paper extends the preliminary version of our method presented at the NeurIPS Thirty-fourth Annual Conference on Neural Information Processing Systems [30] , by extensively evaluating our model on a new created real-world multiple sclerosis lesion dataset (QSMSC at UCL: Queen Square Multiple Sclerosis Center at UCL, UK). This dataset is generated with manual segmentations from 4 different annotators (3 radiologists with different level skills and 1 expert to generate the expert consensus label). Additionally, we presented a comprehensive discussion about our model's potential applications (e.g., estimate annotator's quality and annotation's quality), the future works we are going to explore, and the potential limitations of our model. [Display omitted] Supervised machine learning methods have been widely developed for segmentation tasks in recent years. However, the quality of labels has high impact on the predictive performance of these algorithms. This issue is particularly acute in the medical image domain, where both the cost of annotation and the inter-observer variability are high. Different human experts contribute estimates of the "actual" segmentation labels in a typical label acquisition process, influenced by their personal biases and competency levels. The performance of automatic segmentation algorithms is limited when these noisy labels are used as the expert consensus label. In this work, we use two coupled CNNs to jointly learn, from purely noisy observations alone, the reliability of individual annotators and the expert consensus label distributions. The separation of the two is achieved by maximally describing the annotator's "unreliable behavior" (we call it "maximally unreliable") while achieving high fidelity with the noisy training data. We first create a toy segmentation dataset using MNIST and investigate the properties of the proposed algorithm. We then use three public medical imaging segmentation datasets to demonstrate our method's efficacy, including both simulated (where necessary) and real-world annotations: 1) ISBI2015 (multiple-sclerosis lesions); 2) BraTS (brain tumors); 3) LIDC-IDRI (lung abnormalities). Finally, we create a real-world multiple sclerosis lesion dataset (QSMSC at UCL: Queen Square Multiple Sclerosis Center at UCL, UK) with manual segmentations from 4 different annotators (3 radiologists with different level skills and 1 expert to generate the expert consensus label). In all datasets, our method consistently outperforms competing methods and relevant baselines, especially when the number of annotations is small and the amount of disagreement is large. The studies also reveal that the system is capable of capturing the complicated spatial characteristics of annotators' mistakes. [ABSTRACT FROM AUTHOR]

• We introduce a new task named Noisy Supervised Domain Adaptation (NSDA), which is both challenging and meaningful for real-world applications in medical image segmentation. • We propose a novel self-cleansing unsupervised domain adaptation (S-CUDA) method to address the NSDA problem for medical image segmentation, which trains two peer adversarial networks simultaneously in a co-training and co-cleansing style. For each peer network, we divide the training samples into the high-confidence clean labeled set (i.e., clean data) and noisy labeled set (i.e., noisy data) based on its per-sample loss. The identified clean data are then used to train the peer networks, which keep diverging to another one, to filter different type of errors and avoid confirmation bias in the self-training. • We propose to clean and reuse the identified high-confidence noisy labeled samples to provide more diversity and useful information to learn a robust model. For the identified high-confidence noisy data, we clean and refine their labels using the network's predictions as pseudo labels, which will be further reused in the following learning iterations. • We design a novel loss function to use both the original noisy labels and the updated cleaned labels from the peer network to break up the chain of "error propagation". The new loss function can help the cross-reviewing framework alleviate the "learning trap" problem exiting in self-training process (i.e., the quality of pseudo labels does not get improved and the new supervision from them becomes weaker and weaker). • We conduct extensive experiments on public datasets, i.e., two retinal fundus image datasets and a public spinal cord gray matter segmentation challenge dataset, to demonstrate the effectiveness of our proposed S-CUDA framework. The comprehensive results demonstrate the superior performance of our method compared with existing state-of-the-art methods. [Display omitted] Medical image segmentation tasks hitherto have achieved excellent progresses with large-scale datasets, which empowers us to train potent deep convolutional neural networks (DCNNs). However, labeling such large-scale datasets is laborious and error-prone, which leads the noisy (or incorrect) labels to be an ubiquitous problem in the real-world scenarios. In addition, data collected from different sites usually exhibit significant data distribution shift (or domain shift). As a result, noisy label and domain shift become two common problems in medical imaging application scenarios, especially in medical image segmentation, which degrade the performance of deep learning models significantly. In this paper, we identify a novel problem hidden in medical image segmentation, which is unsupervised domain adaptation on noisy labeled data, and propose a novel algorithm named "Self-Cleansing Unsupervised Domain Adaptation" (S-CDUA) to address such issue. S-CUDA sets up a realistic scenario to solve the above problems simultaneously where training data (i.e., source domain) not only shows domain shift w.r.t. unsupervised test data (i.e., target domain) but also contains noisy labels. The key idea of S-CUDA is to learn noise-excluding and domain invariant knowledge from noisy supervised data, which will be applied on the highly corrupted data for label cleansing and further data-recycling, as well as on the test data with domain shift for supervised propagation. To this end, we propose a novel framework leveraging noisy-label learning and domain adaptation techniques to cleanse the noisy labels and learn from trustable clean samples, thus enabling robust adaptation and prediction on the target domain. Specifically, we train two peer adversarial networks to identify high-confidence clean data and exchange them in companions to eliminate the error accumulation problem and narrow the domain gap simultaneously. In the meantime, the high-confidence noisy data are detected and cleansed in order to reuse the contaminated training data. Therefore, our proposed method can not only cleanse the noisy labels in the training set but also take full advantage of the existing noisy data to update the parameters of the network. For evaluation, we conduct experiments on two popular datasets (REFUGE and Drishti-GS) for optic disc (OD) and optic cup (OC) segmentation, and on another public multi-vendor dataset for spinal cord gray matter (SCGM) segmentation. Experimental results show that our proposed method can cleanse noisy labels efficiently and obtain a model with better generalization performance at the same time, which outperforms previous state-of-the-art methods by large margin. Our code can be found at https://github.com/zzdxjtu/S-cuda. [ABSTRACT FROM AUTHOR]

• A benchmark study of a global segmentation challenge conducted on the largest atrial LGE-MRI dataset. • Performed rigorous subgroup analysis and hyper-parameter tuning experiments. • U-Net achieved better performance compared to others. • 2D and 3D CNN methods had comparable accuracies. • The double, sequentially used CNNs achieved superior results. Segmentation of medical images, particularly late gadolinium-enhanced magnetic resonance imaging (LGE-MRI) used for visualizing diseased atrial structures, is a crucial first step for ablation treatment of atrial fibrillation. However, direct segmentation of LGE-MRIs is challenging due to the varying intensities caused by contrast agents. Since most clinical studies have relied on manual, labor-intensive approaches, automatic methods are of high interest, particularly optimized machine learning approaches. To address this, we organized the 2018 Left Atrium Segmentation Challenge using 154 3D LGE-MRIs, currently the world's largest atrial LGE-MRI dataset, and associated labels of the left atrium segmented by three medical experts, ultimately attracting the participation of 27 international teams. In this paper, extensive analysis of the submitted algorithms using technical and biological metrics was performed by undergoing subgroup analysis and conducting hyper-parameter analysis, offering an overall picture of the major design choices of convolutional neural networks (CNNs) and practical considerations for achieving state-of-the-art left atrium segmentation. Results show that the top method achieved a Dice score of 93.2% and a mean surface to surface distance of 0.7 mm, significantly outperforming prior state-of-the-art. Particularly, our analysis demonstrated that double sequentially used CNNs, in which a first CNN is used for automatic region-of-interest localization and a subsequent CNN is used for refined regional segmentation, achieved superior results than traditional methods and machine learning approaches containing single CNNs. This large-scale benchmarking study makes a significant step towards much-improved segmentation methods for atrial LGE-MRIs, and will serve as an important benchmark for evaluating and comparing the future works in the field. Furthermore, the findings from this study can potentially be extended to other imaging datasets and modalities, having an impact on the wider medical imaging community. Image, graphical abstract [ABSTRACT FROM AUTHOR]