Abstract

ObjectivesTo develop a convolutional neural network system to jointly segment and classify a hepatic lesion selected by user clicks in ultrasound images.MethodsIn total, 4309 anonymized ultrasound images of 3873 patients with hepatic cyst (n = 1214), hemangioma (n = 1220), metastasis (n = 1001), or hepatocellular carcinoma (HCC) (n = 874) were collected and annotated. The images were divided into 3909 training and 400 test images. Our network is composed of one shared encoder and two inference branches used for segmentation and classification and takes the concatenation of an input image and two Euclidean distance maps of foreground and background clicks provided by a user as input. The performance of hepatic lesion segmentation was evaluated based on the Jaccard index (JI), and the performance of classification was based on accuracy, sensitivity, specificity, and the area under the receiver operating characteristic curve (AUROC).ResultsWe achieved performance improvements by jointly conducting segmentation and classification. In the segmentation only system, the mean JI was 68.5%. In the classification only system, the accuracy of classifying four types of hepatic lesions was 79.8%. The mean JI and classification accuracy were 68.5% and 82.2%, respectively, for the proposed joint system. The optimal sensitivity and specificity and the AUROC of classifying benign and malignant hepatic lesions of the joint system were 95.0%, 86.0%, and 0.970, respectively. The respective sensitivity, specificity, and the AUROC for classifying four hepatic lesions of the joint system were 86.7%, 89.7%, and 0.947.ConclusionsThe proposed joint system exhibited fair performance compared to segmentation only and classification only systems.Key Points• The joint segmentation and classification system using deep learning accurately segmented and classified hepatic lesions selected by user clicks in US examination.• The joint segmentation and classification system for hepatic lesions in US images exhibited higher performance than segmentation only and classification only systems.• The joint segmentation and classification system could assist radiologists with minimal experience in US imaging by characterizing hepatic lesions.

Highlights

  • Ultrasound (US) is a widespread first-line imaging modality used in the diagnosis of liver diseases given its low cost, nonionizing characteristics, portable features, and ability for real-time image acquisition and display

  • The joint segmentation and classification system achieved a mean Jaccard index (JI) of 70.0% when trained with the binary classification task (p < 0.001) and exhibited a comparable result (68.5%) when trained with the four-class classification task (p = 0.95) (Table 1)

  • We proposed a joint segmentation and classification system for hepatic lesions on US images based on user clicks

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Summary

Introduction

Ultrasound (US) is a widespread first-line imaging modality used in the diagnosis of liver diseases given its low cost, nonionizing characteristics, portable features, and ability for real-time image acquisition and display. The confusion created by overlapping US features of hepatic focal lesions is a factor that limits interpretation [1,2,3]. To overcome these limitations, many computer-aided systems for hepatic lesion segmentation and classification, including deep learning, have been developed [4]. In 2016, Xu et al [6] developed a semiautomatic segmentation system based on deep learning, which requires user clicks to segment a specific object in a given image. The segmentation could provide an ROI for classification, and the classification could provide any cues, such as desired shapes based on the lesion types, for segmentation. The purpose of this study is to develop a convolutional neural network (CNN) system to jointly segment and classify a hepatic lesion selected by user clicks in US examination

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