We aim at segmenting small organs (e.g., the pancreas) from abdominal CT scans. As the target often occupies a relatively small region in the input image, deep neural networks can be easily confused by the complex and variable background. To alleviate this, researchers proposed a coarse-to-fine approach, which used prediction from the first (coarse) stage to indicate a smaller input region for the second (fine) stage. Despite its effectiveness, this algorithm dealt with two stages individually, which lacked optimizing a global energy function, and limited its ability to incorporate multi-stage visual cues. Missing contextual information led to unsatisfying convergence in iterations, and that the fine stage sometimes produced even lower segmentation accuracy than the coarse stage. This paper presents a Recurrent Saliency Transformation Network. The key innovation is a saliency transformation module, which repeatedly converts the segmentation probability map from the previous iteration as spatial weights and applies these weights to the current iteration. This brings us two-fold benefits. In training, it allows joint optimization over the deep networks dealing with different input scales. In testing, it propagates multi-stage visual information throughout iterations to improve segmentation accuracy. Experiments in the NIH pancreas segmentation dataset demonstrate the state-of-the-art accuracy, which outperforms the previous best by an average of over 2 . Much higher accuracies are also reported on several small organs in a larger dataset collected by ourselves. In addition, our approach enjoys better convergence properties, making it more efficient and reliable in practice.
Computer-aided diagnosis (CAD) is an important technique which can assist human doctors in many clinical scenarios. An important prerequisite of CAD is medical imaging analysis. As a popular and cheap way of medical imaging, contrast-enhanced computed tomography (CECT) produces detailed images of internal organs, bones, soft tissues and blood vessels. It is of great value to automatically segment organs and or soft tissues from these CT volumes for further diagnosis @cite_2 @cite_44 @cite_23 @cite_45 . To capture specific properties of different organs, researchers often design individualized algorithms for each of them. Typical examples include the the liver @cite_15 @cite_33 , the spleen @cite_24 , the kidneys @cite_20 @cite_6 , the lungs @cite_3 , the pancreas @cite_19 @cite_32 , etc . Small organs ( e.g. , the pancreas ) are often more difficult to segment, partly due to their low contrast and large anatomical variability in size and (most often irregular) shape.
@cite_33 @cite_32 @cite_6 @cite_3 @cite_44 @cite_24 @cite_19 @cite_45 @cite_23 @cite_2 @cite_15 @cite_20
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Computer-aided diagnosis (CAD) has become one of the major research subjects in medical imaging and diagnostic radiology. In this article, the motivation and philosophy for early development of CAD schemes are presented together with the current status and future potential of CAD in a PACS environment. With CAD, radiologists use the computer output as a “second opinion” and make the final decisions. CAD is a concept established by taking into account equally the roles of physicians and computers, whereas automated computer diagnosis is a concept based on computer algorithms only. With CAD, the performance by computers does not have to be comparable to or better than that by physicians, but needs to be complementary to that by physicians. In fact, a large number of CAD systems have been employed for assisting physicians in the early detection of breast cancers on mammograms. A CAD scheme that makes use of lateral chest images has the potential to improve the overall performance in the detection of lung nodules when combined with another CAD scheme for PA chest images. Because vertebral fractures can be detected reliably by computer on lateral chest radiographs, radiologists’ accuracy in the detection of vertebral fractures would be improved by the use of CAD, and thus early diagnosis of osteoporosis would become possible. In MRA, a CAD system has been developed for assisting radiologists in the detection of intracranial aneurysms. On successive bone scan images, a CAD scheme for detection of interval changes has been developed by use of temporal subtraction images. In the future, many CAD schemes could be assembled as packages and implemented as a part of PACS. For example, the package for chest CAD may include the computerized detection of lung nodules, interstitial opacities, cardiomegaly, vertebral fractures, and interval changes in chest radiographs as well as the computerized classification of benign and malignant nodules and the differential diagnosis of interstitial lung diseases. In order to assist in the differential diagnosis, it would be possible to search for and retrieve images (or lesions) with known pathology, which would be very similar to a new unknown case, from PACS when a reliable and useful method has been developed for quantifying the similarity of a pair of images for visual comparison by radiologists. Automated tissue characterization is one of the most crucial components of a computer aided diagnosis (CAD) system for interstitial lung diseases (ILDs). Although much research has been conducted in this field, the problem remains challenging. Deep learning techniques have recently achieved impressive results in a variety of computer vision problems, raising expectations that they might be applied in other domains, such as medical image analysis. In this paper, we propose and evaluate a convolutional neural network (CNN), designed for the classification of ILD patterns. The proposed network consists of 5 convolutional layers with 2 @math 2 kernels and LeakyReLU activations, followed by average pooling with size equal to the size of the final feature maps and three dense layers. The last dense layer has 7 outputs, equivalent to the classes considered: healthy, ground glass opacity (GGO), micronodules, consolidation, reticulation, honeycombing and a combination of GGO reticulation. To train and evaluate the CNN, we used a dataset of 14696 image patches, derived by 120 CT scans from different scanners and hospitals. To the best of our knowledge, this is the first deep CNN designed for the specific problem. A comparative analysis proved the effectiveness of the proposed CNN against previous methods in a challenging dataset. The classification performance ( @math ) demonstrated the potential of CNNs in analyzing lung patterns. Future work includes, extending the CNN to three-dimensional data provided by CT volume scans and integrating the proposed method into a CAD system that aims to provide differential diagnosis for ILDs as a supportive tool for radiologists. Abstract Accurate and automatic organ segmentation from 3D radiological scans is an important yet challenging problem for medical image analysis. Specifically, as a small, soft, and flexible abdominal organ, the pancreas demonstrates very high inter-patient anatomical variability in both its shape and volume. This inhibits traditional automated segmentation methods from achieving high accuracies, especially compared to the performance obtained for other organs, such as the liver, heart or kidneys. To fill this gap, we present an automated system from 3D computed tomography (CT) volumes that is based on a two-stage cascaded approach—pancreas localization and pancreas segmentation. For the first step, we localize the pancreas from the entire 3D CT scan, providing a reliable bounding box for the more refined segmentation step. We introduce a fully deep-learning approach, based on an efficient application of holistically-nested convolutional networks (HNNs) on the three orthogonal axial, sagittal, and coronal views. The resulting HNN per-pixel probability maps are then fused using pooling to reliably produce a 3D bounding box of the pancreas that maximizes the recall. We show that our introduced localizer compares favorably to both a conventional non-deep-learning method and a recent hybrid approach based on spatial aggregation of superpixels using random forest classification. The second, segmentation, phase operates within the computed bounding box and integrates semantic mid-level cues of deeply-learned organ interior and boundary maps, obtained by two additional and separate realizations of HNNs. By integrating these two mid-level cues, our method is capable of generating boundary-preserving pixel-wise class label maps that result in the final pancreas segmentation. Quantitative evaluation is performed on a publicly available dataset of 82 patient CT scans using 4-fold cross-validation (CV). We achieve a (mean ± std. dev.) Dice similarity coefficient (DSC) of 81.27 ± 6.27 in validation, which significantly outperforms both a previous state-of-the art method and a preliminary version of this work that report DSCs of 71.80 ± 10.70 and 78.01 ± 8.20 , respectively, using the same dataset. A robust automated segmentation of abdominal organs can be crucial for computer aided diagnosis and laparoscopic surgery assistance. Many existing methods are specialized to the segmentation of individual organs and struggle to deal with the variability of the shape and position of abdominal organs. We present a general, fully-automated method for multi-organ segmentation of abdominal computed tomography (CT) scans. The method is based on a hierarchical atlas registration and weighting scheme that generates target specific priors from an atlas database by combining aspects from multi-atlas registration and patch-based segmentation, two widely used methods in brain segmentation. The final segmentation is obtained by applying an automatically learned intensity model in a graph-cuts optimization step, incorporating high-level spatial knowledge. The proposed approach allows to deal with high inter-subject variation while being flexible enough to be applied to different organs. We have evaluated the segmentation on a database of 150 manually segmented CT images. The achieved results compare well to state-of-the-art methods, that are usually tailored to more specific questions, with Dice overlap values of 94 , 93 , 70 , and 92 for liver, kidneys, pancreas, and spleen, respectively.