Despite recent efforts, deep learning techniques remain often heavily dependent on a large quantity of labeled data. This problem is even more challenging in medical image analysis where the annotator expertise is often scarce. In this paper we propose a novel data-augmentation method to regularize neural network regressors, learning from a single global label per image. The principle of the method is to create new samples by recombining existing ones. We demonstrate the performance of our algorithm on two tasks: the regression of number of enlarged perivascular spaces in the basal ganglia; and the regression of white matter hyperintensities volume. We show that the proposed method improves the performance even when more basic data augmentation is used. Furthermore we reached an intraclass correlation coefficient between ground truth and network predictions of 0.73 on the first task and 0.86 on the second task, only using between 25 and 30 scans with a single global label per scan for training. To achieve a similar correlation on the first task, state-of-the-art methods needed more than 1000 training scans.
Recently, methods employing neural network regressors trained with global labels have been proposed for biomarker extraction @cite_9 @cite_1 @cite_16 . @cite_9 predict brain age from 3D images of grey matter density computed from MRI scans. @cite_1 predict the number of enlarged perivascular spaces in a 3D region of interest in the brain extracted from a MRI scan. And @cite_16 predict Agatston scores to quantify coronary artery calcifications from 3D non-contrast non-ECG gated chest CT scans. These networks needed hundreds training samples to be trained accurately. With our method, we can achieve the level of interrater agreement only using 25 training scans, which could for instance only require one to two hours of labeling from an expert rater.
@cite_9 @cite_16 @cite_1
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Abstract Enlarged perivascular spaces (EPVS) in the brain are an emerging imaging marker for cerebral small vessel disease, and have been shown to be related to increased risk of various neurological diseases, including stroke and dementia. Automated quantification of EPVS would greatly help to advance research into its etiology and its potential as a risk indicator of disease. We propose a convolutional network regression method to quantify the extent of EPVS in the basal ganglia from 3D brain MRI. We first segment the basal ganglia and subsequently apply a 3D convolutional regression network designed for small object detection within this region of interest. The network takes an image as input, and outputs a quantification score of EPVS. The network has significantly more convolution operations than pooling ones and no final activation, allowing it to span the space of real numbers. We validated our approach using a dataset of 2000 brain MRI scans scored visually. Experiments with varying sizes of training and test sets showed that a good performance can be achieved with a training set of only 200 scans. With a training set of 1000 scans, the intraclass correlation coefficient (ICC) between our scoring method and the expert’s visual score was 0.74. Our method outperforms by a large margin - more than 0.10 - four more conventional automated approaches based on intensities, scale-invariant feature transform, and random forest. We show that the network learns the structures of interest and investigate the influence of hyper-parameters on the performance. We also evaluate the reproducibility of our network using a set of 60 subjects scanned twice (scan-rescan reproducibility). On this set our network achieves an ICC of 0.93, while the intrarater agreement reaches 0.80. Furthermore, the automated EPVS scoring correlates similarly to age as visual scoring. Training deep fully convolutional neural networks (F-CNNs) for semantic image segmentation requires access to abundant labeled data. While large datasets of unlabeled image data are available in medical applications, access to manually labeled data is very limited. We propose to automatically create auxiliary labels on initially unlabeled data with existing tools and to use them for pre-training. For the subsequent fine-tuning of the network with manually labeled data, we introduce error corrective boosting (ECB), which emphasizes parameter updates on classes with lower accuracy. Furthermore, we introduce SkipDeconv-Net (SD-Net), a new F-CNN architecture for brain segmentation that combines skip connections with the unpooling strategy for upsampling. The SD-Net addresses challenges of severe class imbalance and errors along boundaries. With application to whole-brain MRI T1 scan segmentation, we generate auxiliary labels on a large dataset with FreeSurfer and fine-tune on two datasets with manual annotations. Our results show that the inclusion of auxiliary labels and ECB yields significant improvements. SD-Net segments a 3D scan in 7 secs in comparison to 30 hours for the closest multi-atlas segmentation method, while reaching similar performance. It also outperforms the latest state-of-the-art F-CNN models. A significant proportion of patients scanned in a clinical setting have follow-up scans. We show in this work that such longitudinal scans alone can be used as a form of “free” self-supervision for training a deep network. We demonstrate this self-supervised learning for the case of T2-weighted sagittal lumbar Magnetic Resonance Images (MRIs). A Siamese convolutional neural network (CNN) is trained using two losses: (i) a contrastive loss on whether the scan is of the same person (i.e. longitudinal) or not, together with (ii) a classification loss on predicting the level of vertebral bodies. The performance of this pre-trained network is then assessed on a grading classification task. We experiment on a dataset of 1016 subjects, 423 possessing follow-up scans, with the end goal of learning the disc degeneration radiological gradings attached to the intervertebral discs. We show that the performance of the pre-trained CNN on the supervised classification task is (i) superior to that of a network trained from scratch; and (ii) requires far fewer annotated training samples to reach an equivalent performance to that of the network trained from scratch. We present an adversarial domain adaptation based deep learning approach for automatic tumor segmentation from T2-weighted MRI. Our approach is composed of two steps: (i) a tumor-aware unsupervised cross-domain adaptation (CT to MRI), followed by (ii) semi-supervised tumor segmentation using Unet trained with synthesized and limited number of original MRIs. We introduced a novel target specific loss, called tumor-aware loss, for unsupervised cross-domain adaptation that helps to preserve tumors on synthesized MRIs produced from CT images. In comparison, state-of-the art adversarial networks trained without our tumor-aware loss produced MRIs with ill-preserved or missing tumors. All networks were trained using labeled CT images from 377 patients with non-small cell lung cancer obtained from the Cancer Imaging Archive and unlabeled T2w MRIs from a completely unrelated cohort of 6 patients with pre-treatment and 36 on-treatment scans. Next, we combined 6 labeled pre-treatment MRI scans with the synthesized MRIs to boost tumor segmentation accuracy through semi-supervised learning. Semi-supervised training of cycle-GAN produced a segmentation accuracy of 0.66 computed using Dice Score Coefficient (DSC). Our method trained with only synthesized MRIs produced an accuracy of 0.74 while the same method trained in semi-supervised setting produced the best accuracy of 0.80 on test. Our results show that tumor-aware adversarial domain adaptation helps to achieve reasonably accurate cancer segmentation from limited MRI data by leveraging large CT datasets.