Purpose: In surgical navigation, pre-operative organ models are presented to surgeons during the intervention to help them in efficiently finding their target. In the case of soft tissue, these models need to be deformed and adapted to the current situation by using intra-operative sensor data. A promising method to realize this are real-time capable biomechanical models. Methods: We train a fully convolutional neural network to estimate a displacement field of all points inside an organ when given only the displacement of a part of the organ's surface. The network trains on entirely synthetic data of random organ-like meshes, which allows us to generate much more data than is otherwise available. The input and output data is discretized into a regular grid, allowing us to fully utilize the capabilities of convolutional operators and to train and infer in a highly parallelized manner. Results: The system is evaluated on in-silico liver models, phantom liver data and human in-vivo breathing data. We test the performance with varying material parameters, organ shapes and amount of visible surface. Even though the network is only trained on synthetic data, it adapts well to the various cases and gives a good estimation of the internal organ displacement. The inference runs at over 50 frames per second. Conclusions: We present a novel method for training a data-driven, real-time capable deformation model. The accuracy is comparable to other registration methods, it adapts very well to previously unseen organs and does not need to be re-trained for every patient. The high inferring speed makes this method useful for many applications such as surgical navigation and real-time simulation.
@cite_7 show that neural networks can estimate the deformation of a liver from the known displacement of a partial surface. They report very small errors while using only 3 Approaches which generalize to new patients were made by @cite_9 , who estimate the liver's deformation from breathing motion using various machine learning methods and Martínez- @cite_4 who estimate breast compression. However, both methods focus on single scenarios where the main direction of the forces stay similar throughout all experiments.
@cite_9 @cite_4 @cite_7
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Deformation estimation of elastic object assuming an internal organ is important for the computer navigation of surgery. The aim of this study is to estimate the deformation of an entire three-dimensional elastic object using displacement information of very few observation points. A learning approach with a neural network was introduced to estimate the entire deformation of an object. We applied our method to two elastic objects; a rectangular parallelepiped model, and a human liver model reconstructed from computed tomography data. The average estimation error for the human liver model was 0.041 mm when the object was deformed up to 66.4 mm, from only around 3 observations. These results indicate that the deformation of an entire elastic object can be estimated with an acceptable level of error from limited observations by applying a trained neural network to a new deformation. Machine learning (ML) to model the liver biomechanical behaviour during breathing.ML is much faster than the popular FEM, allowing real-time soft tissue modelling.Modelling scheme able to predict deformation for a new load and a new liver.ML regression models were used: three tree-based methods and two simpler ones.Good prediction performance was obtained: all samples with an error under 1źmm. Progress in biomechanical modelling of human soft tissue is the basis for the development of new clinical applications capable of improving the diagnosis and treatment of some diseases (e.g. cancer), as well as the surgical planning and guidance of some interventions. The finite element method (FEM) is one of the most popular techniques used to predict the deformation of the human soft tissue due to its high accuracy. However, FEM has an associated high computational cost, which makes it difficult its integration in real-time computer-aided surgery systems. An alternative for simulating the mechanical behaviour of human organs in real time comes from the use of machine learning (ML) techniques, which are much faster than FEM. This paper assesses the feasibility of ML methods for modelling the biomechanical behaviour of the human liver during the breathing process, which is crucial for guiding surgeons during interventions where it is critical to track this deformation (e.g. some specific kind of biopsies) or for the accurate application of radiotherapy dose to liver tumours. For this purpose, different ML regression models were investigated, including three tree-based methods (decision trees, random forests and extremely randomised trees) and other two simpler regression techniques (dummy model and linear regression). In order to build and validate the ML models, a labelled data set was constructed from modelling the deformation of eight ex-vivo human livers using FEM. The best prediction performance was obtained using extremely randomised trees, with a mean error of 0.07źmm and all the samples with an error under 1źmm. The achieved results lay the foundation for the future development of some real-time software capable of simulating the human liver deformation during the breathing process during clinical interventions. This paper presents a new method for simulating the deformation of organ models by using a neural network. The proposed method is based on the idea proposed by [2] that a deformed model can be estimated from the superposition of basic deformation modes. The neural network finds a relationship between external forces and the models deformed by the forces. The experimental results show that the trained network can achieve a real-time simulation while keeping the acceptable accuracy compared with the nonlinear FEM computation. Abstract This work presents a data-driven method to simulate, in real-time, the biomechanical behavior of the breast tissues in some image-guided interventions such as biopsies or radiotherapy dose delivery as well as to speed up multimodal registration algorithms. Ten real breasts were used for this work. Their deformation due to the displacement of two compression plates was simulated off-line using the finite element (FE) method. Three machine learning models were trained with the data from those simulations. Then, they were used to predict in real-time the deformation of the breast tissues during the compression. The models were a decision tree and two tree-based ensemble methods (extremely randomized trees and random forest). Two different experimental setups were designed to validate and study the performance of these models under different conditions. The mean 3D Euclidean distance between nodes predicted by the models and those extracted from the FE simulations was calculated to assess the performance of the models in the validation set. The experiments proved that extremely randomized trees performed better than the other two models. The mean error committed by the three models in the prediction of the nodal displacements was under 2 mm, a threshold usually set for clinical applications. The time needed for breast compression prediction is sufficiently short to allow its use in real-time ( 0.2 s). Abstract Deep learning methods, and in particular convolutional neural networks (CNNs), have led to an enormous breakthrough in a wide range of computer vision tasks, primarily by using large-scale annotated datasets. However, obtaining such datasets in the medical domain remains a challenge. In this paper, we present methods for generating synthetic medical images using recently presented deep learning Generative Adversarial Networks (GANs). Furthermore, we show that generated medical images can be used for synthetic data augmentation, and improve the performance of CNN for medical image classification. Our novel method is demonstrated on a limited dataset of computed tomography (CT) images of 182 liver lesions (53 cysts, 64 metastases and 65 hemangiomas). We first exploit GAN architectures for synthesizing high quality liver lesion ROIs. Then we present a novel scheme for liver lesion classification using CNN. Finally, we train the CNN using classic data augmentation and our synthetic data augmentation and compare performance. In addition, we explore the quality of our synthesized examples using visualization and expert assessment. The classification performance using only classic data augmentation yielded 78.6 sensitivity and 88.4 specificity. By adding the synthetic data augmentation the results increased to 85.7 sensitivity and 92.4 specificity. We believe that this approach to synthetic data augmentation can generalize to other medical classification applications and thus support radiologists’ efforts to improve diagnosis. Abstract Objectives Accurate reconstruction and visualisation of soft tissue deformation in real time is crucial in image-guided surgery, particularly in augmented reality (AR) applications. Current deformation models are characterised by a trade-off between accuracy and computational speed. We propose an approach to derive a patient-specific deformation model for brain pathologies by combining the results of pre-computed finite element method (FEM) simulations with machine learning algorithms. The models can be computed instantaneously and offer an accuracy comparable to FEM models. Method A brain tumour is used as the subject of the deformation model. Load-driven FEM simulations are performed on a tetrahedral brain mesh afflicted by a tumour. Forces of varying magnitudes, positions, and inclination angles are applied onto the brain's surface. Two machine learning algorithms—artificial neural networks (ANNs) and support vector regression (SVR)—are employed to derive a model that can predict the resulting deformation for each node in the tumour's mesh. Results The tumour deformation can be predicted in real time given relevant information about the geometry of the anatomy and the load, all of which can be measured instantly during a surgical operation. The models can predict the position of the nodes with errors below 0.3 mm, beyond the general threshold of surgical accuracy and suitable for high fidelity AR systems. The SVR models perform better than the ANN's, with positional errors for SVR models reaching under 0.2 mm. Conclusions The results represent an improvement over existing deformation models for real time applications, providing smaller errors and high patient-specificity. The proposed approach addresses the current needs of image-guided surgical systems and has the potential to be employed to model the deformation of any type of soft tissue. Abstract The ability to make decisions based on quantities of interest that depend on variables inferred from measurement finds application in different fields of mechanics and physics. The evaluation of the inferred variables, and hence the quantities of interest, from the measurement typically requires the solution of an inverse problem. For example, in medical imaging the elastic heterogeneity of a tumor and its nonlinear elastic response can be used to distinguish benign tumors from their malignant counterparts. These images of linear and nonlinear elastic parameters of tissue are typically obtained by using a measured displacement field and solving a complex inverse elasticity problem. In this paper we consider circumventing the solution of the inverse problem by using measured displacements as input to a deep convolutional neural network (CNN) and training it to classify tumors on the basis of their elastic heterogeneity and nonlinearity. For a simple, 5-layer CNN trained with 8,000 samples for heterogeneity, and a 4-layer CNN trained with 4,000 samples for nonlinear elasticity we report classification accuracies in the range of 99 . 7 − 99 . 9 . The training and testing data are both obtained from the forward solution of finite element models of samples. We also analyze the weights of the trained model to understand the process through which the network extracts features of elastic moduli from the input displacement images. Finally, we apply the nonlinear elasticity classifier, which is trained entirely using simulated data, to displacement images obtained from ten patients with breast lesions and note that it correctly classifies eight out of ten cases. This application illustrates how data from physics-based models can be used in improving the performance of a data-driven algorithm in data-sparse scenarios. Convolutional neural networks (CNNs) have been successfully used for fast and accurate estimation of dense correspondences between images in computer vision applications. However, much of their success is based on the availability of large training datasets with dense ground truth correspondences, which are only rarely available in medical applications. In this paper, we, therefore, address the problem of CNNs learning from few training data for medical image registration. Our contributions are threefold: (1) We present a novel approach for learning highly expressive appearance models from few training samples, (2) we show that this approach can be used to synthesize huge amounts of realistic ground truth training data for CNN-based medical image registration, and (3) we adapt the FlowNet architecture for CNN-based optical flow estimation to the medical image registration problem. This pipeline is applied to two medical data sets with less than 40 training images. We show that CNNs learned from the proposed generative model outperform those trained on random deformations or displacement fields estimated via classical image registration. Recent advances in 3D fully convolutional networks (FCN) have made it feasible to produce dense voxel-wise predictions of full volumetric images. In this work, we show that a multi-class 3D FCN trained on manually labeled CT scans of seven abdominal structures (artery, vein, liver, spleen, stomach, gallbladder, and pancreas) can achieve competitive segmentation results, while avoiding the need for handcrafting features or training organ-specific models. To this end, we propose a two-stage, coarse-to-fine approach that trains an FCN model to roughly delineate the organs of interest in the first stage (seeing @math 40 of the voxels within a simple, automatically generated binary mask of the patient's body). We then use these predictions of the first-stage FCN to define a candidate region that will be used to train a second FCN. This step reduces the number of voxels the FCN has to classify to @math 10 while maintaining a recall high of @math 99 . This second-stage FCN can now focus on more detailed segmentation of the organs. We respectively utilize training and validation sets consisting of 281 and 50 clinical CT images. Our hierarchical approach provides an improved Dice score of 7.5 percentage points per organ on average in our validation set. We furthermore test our models on a completely unseen data collection acquired at a different hospital that includes 150 CT scans with three anatomical labels (liver, spleen, and pancreas). In such challenging organs as the pancreas, our hierarchical approach improves the mean Dice score from 68.5 to 82.2 , achieving the highest reported average score on this dataset. Automatic segmentation of the liver and its lesion is an important step towards deriving quantitative biomarkers for accurate clinical diagnosis and computer-aided decision support systems. This paper presents a method to automatically segment liver and lesions in CT abdomen images using cascaded fully convolutional neural networks (CFCNs) and dense 3D conditional random fields (CRFs). We train and cascade two FCNs for a combined segmentation of the liver and its lesions. In the first step, we train a FCN to segment the liver as ROI input for a second FCN. The second FCN solely segments lesions from the predicted liver ROIs of step 1. We refine the segmentations of the CFCN using a dense 3D CRF that accounts for both spatial coherence and appearance. CFCN models were trained in a 2-fold cross-validation on the abdominal CT dataset 3DIRCAD comprising 15 hepatic tumor volumes. Our results show that CFCN-based semantic liver and lesion segmentation achieves Dice scores over (94 , ) for liver with computation times below 100 s per volume. We experimentally demonstrate the robustness of the proposed method as a decision support system with a high accuracy and speed for usage in daily clinical routine. While deep convolutional neural networks (CNN) have been successfully applied for 2D image analysis, it is still challenging to apply them to 3D anisotropic volumes, especially when the within-slice resolution is much higher than the between-slice resolution and when the amount of 3D volumes is relatively small. On one hand, direct learning of CNN with 3D convolution kernels suffers from the lack of data and likely ends up with poor generalization; insufficient GPU memory limits the model size or representational power. On the other hand, applying 2D CNN with generalizable features to 2D slices ignores between-slice information. Coupling 2D network with LSTM to further handle the between-slice information is not optimal due to the difficulty in LSTM learning. To overcome the above challenges, we propose a 3D Anisotropic Hybrid Network (AH-Net) that transfers convolutional features learned from 2D images to 3D anisotropic volumes. Such a transfer inherits the desired strong generalization capability for within-slice information while naturally exploiting between-slice information for more effective modelling. The focal loss is further utilized for more effective end-to-end learning. We experiment with the proposed 3D AH-Net on two different medical image analysis tasks, namely lesion detection from a Digital Breast Tomosynthesis volume, and liver and liver tumor segmentation from a Computed Tomography volume and obtain the state-of-the-art results. Liver cancer is one of the leading causes of cancer death. To assist doctors in hepatocellular carcinoma diagnosis and treatment planning, an accurate and automatic liver and tumor segmentation method is highly demanded in the clinical practice. Recently, fully convolutional neural networks (FCNs), including 2D and 3D FCNs, serve as the back-bone in many volumetric image segmentation. However, 2D convolutions can not fully leverage the spatial information along the third dimension while 3D convolutions suffer from high computational cost and GPU memory consumption. To address these issues, we propose a novel hybrid densely connected UNet (H-DenseUNet), which consists of a 2D DenseUNet for efficiently extracting intra-slice features and a 3D counterpart for hierarchically aggregating volumetric contexts under the spirit of the auto-context algorithm for liver and tumor segmentation. We propose a new training strategy by formulating the learning process of H-DenseUNet in an end-to-end manner, where the intra-slice representations and inter-slice features can be jointly optimized through a hybrid feature fusion (HFF) layer. We extensively evaluated our method on the dataset of MICCAI 2017 Liver Tumor Segmentation (LiTS) Challenge. Our method outperformed other state-of-the-arts on the segmentation results of tumors and achieved very competitive performance for liver segmentation even with a single model. We propose a novel approach to 3D human pose estimation from a single depth map. Recently, convolutional neural network (CNN) has become a powerful paradigm in computer vision. Many of computer vision tasks have benefited from CNNs, however, the conventional approach to directly regress 3D body joint locations from an image does not yield a noticeably improved performance. In contrast, we formulate the problem as estimating per-voxel likelihood of key body joints from a 3D occupancy grid. We argue that learning a mapping from volumetric input to volumetric output with 3D convolution consistently improves the accuracy when compared to learning a regression from depth map to 3D joint coordinates. We propose a two-stage approach to reduce the computational overhead caused by volumetric representation and 3D convolution: Holistic 2D prediction and Local 3D prediction. In the first stage, Planimetric Network (P-Net) estimates per-pixel likelihood for each body joint in the holistic 2D space. In the second stage, Volumetric Network (V-Net) estimates the per-voxel likelihood of each body joints in the local 3D space around the 2D estimations of the first stage, effectively reducing the computational cost. Our model outperforms existing methods by a large margin in publicly available datasets. Existing deformable registration methods require exhaustively iterative optimization, along with careful parameter tuning, to estimate the deformation field between images. Although some learning-based methods have been proposed for initiating deformation estimation, they are often template-specific and not flexible in practical use. In this paper, we propose a convolutional neural network (CNN) based regression model to directly learn the complex mapping from the input image pair (i.e., a pair of template and subject) to their corresponding deformation field. Specifically, our CNN architecture is designed in a patch-based manner to learn the complex mapping from the input patch pairs to their respective deformation field. First, the equalized active-points guided sampling strategy is introduced to facilitate accurate CNN model learning upon a limited image dataset. Then, the similarity-steered CNN architecture is designed, where we propose to add the auxiliary contextual cue, i.e., the similarity between input patches, to more directly guide the learning process. Experiments on different brain image datasets demonstrate promising registration performance based on our CNN model. Furthermore, it is found that the trained CNN model from one dataset can be successfully transferred to another dataset, although brain appearances across datasets are quite variable. This paper focuses on the 3D shape recovery and augmented reality on elastic objects with self-occlusions handling, using only single view images. Shape recovery from a monocular video sequence is an underconstrained problem and many approaches have been proposed to enforce constraints and resolve the ambiguities. State-of-the art solutions enforce smoothness or geometric constraints, consider specific deformation properties such as inextensibility or resort to shading constraints. However, few of them can handle properly large elastic deformations. We propose in this paper a real-time method that uses a mechanical model and able to handle highly elastic objects. The problem is formulated as an energy minimization problem accounting for a non-linear elastic model constrained by external image points acquired from a monocular camera. This method prevents us from formulating restrictive assumptions and specific constraint terms in the minimization. In addition, we propose to handle self-occluded regions thanks to the ability of mechanical models to provide appropriate predictions of the shape. Our method is compared to existing techniques with experiments conducted on computer-generated and real data that show the effectiveness of recovering and augmenting 3D elastic objects. Additionally, experiments in the context of minimally invasive liver surgery are also provided and results on deformations with the presence of self-occlusions are exposed. Display Omitted Survival prediction of HCC patients is modeled in a real and high complex scenario.Its complexity is due to a small dataset with heterogeneous and missing input data.We propose a new cluster-based oversampling method to overcome these drawbacks.Neural networks and logistic regression are applied in the classification stage.Experimental results show that our method outperforms previous existing approaches. Liver cancer is the sixth most frequently diagnosed cancer and, particularly, Hepatocellular Carcinoma (HCC) represents more than 90 of primary liver cancers. Clinicians assess each patients treatment on the basis of evidence-based medicine, which may not always apply to a specific patient, given the biological variability among individuals. Over the years, and for the particular case of Hepatocellular Carcinoma, some research studies have been developing strategies for assisting clinicians in decision making, using computational methods (e.g. machine learning techniques) to extract knowledge from the clinical data. However, these studies have some limitations that have not yet been addressed: some do not focus entirely on Hepatocellular Carcinoma patients, others have strict application boundaries, and none considers the heterogeneity between patients nor the presence of missing data, a common drawback in healthcare contexts. In this work, a real complex Hepatocellular Carcinoma database composed of heterogeneous clinical features is studied. We propose a new cluster-based oversampling approach robust to small and imbalanced datasets, which accounts for the heterogeneity of patients with Hepatocellular Carcinoma. The preprocessing procedures of this work are based on data imputation considering appropriate distance metrics for both heterogeneous and missing data (HEOM) and clustering studies to assess the underlying patient groups in the studied dataset (K-means). The final approach is applied in order to diminish the impact of underlying patient profiles with reduced sizes on survival prediction. It is based on K-means clustering and the SMOTE algorithm to build a representative dataset and use it as training example for different machine learning procedures (logistic regression and neural networks). The results are evaluated in terms of survival prediction and compared across baseline approaches that do not consider clustering and or oversampling using the Friedman rank test. Our proposed methodology coupled with neural networks outperformed all others, suggesting an improvement over the classical approaches currently used in Hepatocellular Carcinoma prediction models. Abstract In many medical image analysis applications, only a limited amount of training data is available due to the costs of image acquisition and the large manual annotation effort required from experts. Training recent state-of-the-art machine learning methods like convolutional neural networks (CNNs) from small datasets is a challenging task. In this work on anatomical landmark localization, we propose a CNN architecture that learns to split the localization task into two simpler sub-problems, reducing the overall need for large training datasets. Our fully convolutional SpatialConfiguration-Net (SCN) learns this simplification due to multiplying the heatmap predictions of its two components and by training the network in an end-to-end manner. Thus, the SCN dedicates one component to locally accurate but ambiguous candidate predictions, while the other component improves robustness to ambiguities by incorporating the spatial configuration of landmarks. In our extensive experimental evaluation, we show that the proposed SCN outperforms related methods in terms of landmark localization error on a variety of size-limited 2D and 3D landmark localization datasets, i.e., hand radiographs, lateral cephalograms, hand MRIs, and spine CTs. While deep convolutional neural networks (CNNs) have achieved remarkable success in 2D medical image segmentation, it is still a difficult task for CNNs to segment important organs or structures from 3D medical images owing to several mutually affected challenges, including the complicated anatomical environments in volumetric images, optimization difficulties of 3D networks and inadequacy of training samples. In this paper, we present a novel and efficient 3D fully convolutional network equipped with a 3D deep supervision mechanism to comprehensively address these challenges; we call it 3D DSN. Our proposed 3D DSN is capable of conducting volume-to-volume learning and inference, which can eliminate redundant computations and alleviate the risk of over-fitting on limited training data. More importantly, the 3D deep supervision mechanism can effectively cope with the optimization problem of gradients vanishing or exploding when training a 3D deep model, accelerating the convergence speed and simultaneously improving the discrimination capability. Such a mechanism is developed by deriving an objective function that directly guides the training of both lower and upper layers in the network, so that the adverse effects of unstable gradient changes can be counteracted during the training procedure. We also employ a fully connected conditional random field model as a post-processing step to refine the segmentation results. We have extensively validated the proposed 3D DSN on two typical yet challenging volumetric medical image segmentation tasks: (i) liver segmentation from 3D CT scans and (ii) whole heart and great vessels segmentation from 3D MR images, by participating two grand challenges held in conjunction with MICCAI. We have achieved competitive segmentation results to state-of-the-art approaches in both challenges with a much faster speed, corroborating the effectiveness of our proposed 3D DSN. In this paper we present a hierarchical, learning-based approach for automatic and accurate liver segmentation from 3D CT volumes. We target CT volumes that come from largely diverse sources (e.g., diseased in six different organs) and are generated by different scanning protocols (e.g., contrast and non-contrast, various resolution and position). Three key ingredients are combined to solve the segmentation problem. First, a hierarchical framework is used to efficiently and effectively monitor the accuracy propagation in a coarse-to-fine fashion. Second, two new learning techniques, marginal space learning and steerable features, are applied for robust boundary inference. This enables handling of highly heterogeneous texture pattern. Third, a novel shape space initialization is proposed to improve traditional methods that are limited to similarity transformation. The proposed approach is tested on a challenging dataset containing 174 volumes. Our approach not only produces excellent segmentation accuracy, but also runs about fifty times faster than state-of-the-art solutions [7, 9]. The 3D convolutional neural network (CNN) is able to make full use of the spatial 3D context information of lung nodules, and the multi-view strategy has been shown to be useful for improving the performance of 2D CNN in classifying lung nodules. In this paper, we explore the classification of lung nodules using the 3D multi-view convolutional neural networks (MV-CNN) with both chain architecture and directed acyclic graph architecture, including 3D Inception and 3D Inception-ResNet. All networks employ the multi-view-one-network strategy. We conduct a binary classification (benign and malignant) and a ternary classification (benign, primary malignant and metastatic malignant) on Computed Tomography (CT) images from Lung Image Database Consortium and Image Database Resource Initiative database (LIDC-IDRI). All results are obtained via 10-fold cross validation. As regards the MV-CNN with chain architecture, results show that the performance of 3D MV-CNN surpasses that of 2D MV-CNN by a significant margin. Finally, a 3D Inception network achieved an error rate of 4.59 for the binary classification and 7.70 for the ternary classification, both of which represent superior results for the corresponding task. We compare the multi-view-one-network strategy with the one-view-one-network strategy. The results reveal that the multi-view-one-network strategy can achieve a lower error rate than the one-view-one-network strategy.