Abstract

The diagnosis of risk level of gastrointestinal stromal tumor (GIST) is of great clinical significance. The morphology of GIST in endoscopic ultrasound (EUS) images has been normally used by radiologists to diagnosis the risk level of GISTs. Hence, accurate segmentation of GISTs in EUS images is a crucial factor to influence the diagnosis. U-net, an elegant network, has been commonly used in medical images. However, due to the plain architecture and complicated up-sampling path of U-net, classical U-net does not perform well in segmenting GISTs in EUS images with diverse size, heavy shadow and ambiguous boundary. Hence, this paper proposes a novel multi-task refined boundary-supervision U-net (MRBSU-net) for GIST segmentation in EUS images. In our network, multi-task refined U-net (RU-net) is set to deal with heavy shadow and diverse size. Boundary cross entropy in loss function of multi-task RU-net boosts the influence of small size tumors and the refinement avoid the noise information in EUS images propagating to the higher resolution layers. Then we design a refined boundary-supervision U-net (RBSU-net) to solve the ambiguous problem. The boundary supervision in RBSU-net leads the network focus on finding boundary in the down-sampling part and segmenting region on the up-sampling path. At last, we put multi-task RU-net in front of the RBSU-net to increase the stability of the network, what is called MRBSU-net. Extensive experiments have been designed to evaluate the performance of the proposed network. The comparison experiments include the results from traditional U-net, generative adversarial network (GAN) and Deep Attentional Features (DAF). The results of our proposed method perform best among all the comparison methods, which proves that the proposed network could be potentially used in clinic.

Highlights

  • Gastrointestinal stromal tumors (GISTs) are uncommon tumors of the GI tract

  • We propose a novel multi-task refined boundary-supervision U-net (MRBSU-net) and a modified loss function to improve GISTs segmentation in endoscopic ultrasound (EUS) images with small size and ambiguous boundary

  • These details in TABLE 3. show the significant improvement of multi-task enhances the Dice similarity coefficient (DSC) which focus on the overall segmentation performance and the improvement of boundary supervision devotes to find the region of interest

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Summary

Introduction

Gastrointestinal stromal tumors (GISTs) are uncommon tumors of the GI tract. They arise in very early forms of special cells called interstitial cell of Cajal [1]. Several imaging modalities are applied into diagnosis and follow-up treatment of GISTs, such as the computerized tomography (CT), the magnetic resonance imaging (MRI) and the endoscopic. Due to its real-time nature, non-invasive, inexpensive, and non-radiation, endoscopic ultrasound is used to assess patient specific gastrointestinal structure and function [2]. Risk level determines a patient whether to undergo the targeted therapy or not. The lower risk level group (LRG) and the higher risk group (HRG) are two level groups of GISTs. In particular, HRG patients should take the targeted therapy before surgery, while LRG patients do not need.

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