Machine Learning In Medical Imaging Research Articles

Hidden Stratification Causes Clinically Meaningful Failures in Machine Learning for Medical Imaging.

Machine learning models for medical image analysis often suffer from poor performance on important subsets of a population that are not identified during training or testing. For example, overall performance of a cancer detection model may be high, but the model may still consistently miss a rare but aggressive cancer subtype. We refer to this problem as hidden stratification, and observe that it results from incompletely describing the meaningful variation in a dataset. While hidden stratification can substantially reduce the clinical efficacy of machine learning models, its effects remain difficult to measure. In this work, we assess the utility of several possible techniques for measuring hidden stratification effects, and characterize these effects both via synthetic experiments on the CIFAR-100 benchmark dataset and on multiple real-world medical imaging datasets. Using these measurement techniques, we find evidence that hidden stratification can occur in unidentified imaging subsets with low prevalence, low label quality, subtle distinguishing features, or spurious correlates, and that it can result in relative performance differences of over 20% on clinically important subsets. Finally, we discuss the clinical implications of our findings, and suggest that evaluation of hidden stratification should be a critical component of any machine learning deployment in medical imaging.

Semi-Supervised Multi-Organ Segmentation through Quality Assurance Supervision.

Human in-the-loop quality assurance (QA) is typically performed after medical image segmentation to ensure that the systems are performing as intended, as well as identifying and excluding outliers. By performing QA on large-scale, previously unlabeled testing data, categorical QA scores (e.g. "successful" versus "unsuccessful") can be generated. Unfortunately, the precious use of resources for human in-the-loop QA scores are not typically reused in medical image machine learning, especially to train a deep neural network for image segmentation. Herein, we perform a pilot study to investigate if the QA labels can be used as supplementary supervision to augment the training process in a semi-supervised fashion. In this paper, we propose a semi-supervised multi-organ segmentation deep neural network consisting of a traditional segmentation model generator and a QA involved discriminator. An existing 3-D abdominal segmentation network is employed, while the pre-trained ResNet-18 network is used as discriminator. A large-scale dataset of 2027 volumes are used to train the generator, whose 2-D montage images and segmentation mask with QA scores are used to train the discriminator. To generate the QA scores, the 2-D montage images were reviewed manually and coded 0 (success), 1 (errors consistent with published performance), and 2 (gross failure). Then, the ResNet-18 network was trained with 1623 montage images in equal distribution of all three code labels and achieved an accuracy 94% for classification predictions with 404 montage images withheld for the test cohort. To assess the performance of using the QA supervision, the discriminator was used as a loss function in a multi-organ segmentation pipeline. The inclusion of QA-loss function boosted performance on the unlabeled test dataset from 714 patients to 951 patients over the baseline model. Additionally, the number of failures decreased from 606 (29.90%) to 402 (19.83%). The contributions of the proposed method are three-fold: We show that (1) the QA scores can be used as a loss function to perform semi-supervised learning for unlabeled data, (2) the well trained discriminator is learnt by QA score rather than traditional "true/false", and (3) the performance of multi-organ segmentation on unlabeled datasets can be fine-tuned with more robust and higher accuracy than the original baseline method. The use of QA-inspired loss functions represents a promising area of future research and may permit tighter integration of supervised and semi-supervised learning.

Reducing image variability across OCT devices with unsupervised unpaired learning for improved segmentation of retina.

Diagnosis and treatment in ophthalmology depend on modern retinal imaging by optical coherence tomography (OCT). The recent staggering results of machine learning in medical imaging have inspired the development of automated segmentation methods to identify and quantify pathological features in OCT scans. These models need to be sensitive to image features defining patterns of interest, while remaining robust to differences in imaging protocols. A dominant factor for such image differences is the type of OCT acquisition device. In this paper, we analyze the ability of recently developed unsupervised unpaired image translations based on cycle consistency losses (cycleGANs) to deal with image variability across different OCT devices (Spectralis and Cirrus). This evaluation was performed on two clinically relevant segmentation tasks in retinal OCT imaging: fluid and photoreceptor layer segmentation. Additionally, a visual Turing test designed to assess the quality of the learned translation models was carried out by a group of 18 participants with different background expertise. Results show that the learned translation models improve the generalization ability of segmentation models to other OCT-vendors/domains not seen during training. Moreover, relationships between model hyper-parameters and the realism as well as the morphological consistency of the generated images could be identified.

Machine Learning in Medical Imaging

The papers in this special issue focus on machine learning for use in medical image processing applications. The use of machine learning in this area has become indispensable in diagnosis and treatment of many diseases. With advances in new imaging techniques, the need to take full advantage of abundant images draws more and more attention. Machine learning, including deep learning particularly, provides us a new paradigm to learn and to utilize the overwhelming volume of big imaging data smartly. Nowadays, machine learning in medical imaging has become one of the most promising and growing fields of research. The main aim of this special issue is to help advance the scientific research within the broad field of machine learning in medical imaging. The special issue was planned in conjunction with the International Workshop on Machine Learning in Medical Imaging (MLMI) 2017.

A Road Map for Translational Research on Artificial Intelligence in Medical Imaging: From the 2018 National Institutes of Health/RSNA/ACR/The Academy Workshop

Advances in machine learning in medical imaging are occurring at a rapid pace in research laboratories both at academic institutions and in industry. Important artificial intelligence (AI) tools for diagnostic imaging include algorithms for disease detection and classification, image optimization, radiation reduction, and workflow enhancement. Although advances in foundational research are occurring rapidly, translation to routine clinical practice has been slower. In August 2018, the National Institutes of Health assembled multiple relevant stakeholders at a public meeting to discuss the current state of knowledge, infrastructure gaps, and challenges to wider implementation. The conclusions of that meeting are summarized in two publications that identify and prioritize initiatives to accelerate foundational and translational research in AI for medical imaging. This publication summarizes key priorities for translational research developed at the workshop including: (1) creating structured AI use cases, defining and highlighting clinical challenges potentially solvable by AI; (2) establishing methods to encourage data sharing for training and testing AI algorithms to promote generalizability to widespread clinical practice and mitigate unintended bias; (3) establishing tools for validation and performance monitoring of AI algorithms to facilitate regulatory approval; and (4) developing standards and common data elements for seamless integration of AI tools into existing clinical workflows. An important goal of the resulting road map is to grow an ecosystem, facilitated by professional societies, industry, and government agencies, that will allow robust collaborations between practicing clinicians and AI researchers to advance foundational and translational research relevant to medical imaging.

A Special Section on Machine Learning in Medical Imaging and Health Informatics

<i>A Special Section on</i> Machine Learning in Medical Imaging and Health Informatics

SP-0026: Machine learning in medical imaging: challenges and opportunities

SP-0026: Machine learning in medical imaging: challenges and opportunities

Collaborative and Reproducible Research: Goals, Challenges, and Strategies

Combining imaging biomarkers with genomic and clinical phenotype data is the foundation of precision medicine research efforts. Yet, biomedical imaging research requires unique infrastructure compared with principally text-driven clinical electronic medical record (EMR) data. The issues are related to the binary nature of the file format and transport mechanism for medical images as well as the post-processing image segmentation and registration needed to combine anatomical and physiological imaging data sources. The SiiM Machine Learning Committee was formed to analyze the gaps and challenges surrounding research into machine learning in medical imaging and to find ways to mitigate these issues. At the 2017 annual meeting, a whiteboard session was held to rank the most pressing issues and develop strategies to meet them. The results, and further reflections, are summarized in this paper.

Machine Learning in Medical Imaging

Advances in both imaging and computers have synergistically led to a rapid rise in the potential use of artificial intelligence in various radiological imaging tasks, such as risk assessment, detection, diagnosis, prognosis, and therapy response, as well as in multi-omics disease discovery. A brief overview of the field is given here, allowing the reader to recognize the terminology, the various subfields, and components of machine learning, as well as the clinical potential. Radiomics, an expansion of computer-aided diagnosis, has been defined as the conversion of images to minable data. The ultimate benefit of quantitative radiomics is to (1) yield predictive image-based phenotypes of disease for precision medicine or (2) yield quantitative image-based phenotypes for data mining with other -omics for discovery (ie, imaging genomics). For deep learning in radiology to succeed, note that well-annotated large data sets are needed since deep networks are complex, computer software and hardware are evolving constantly, and subtle differences in disease states are more difficult to perceive than differences in everyday objects. In the future, machine learning in radiology is expected to have a substantial clinical impact with imaging examinations being routinely obtained in clinical practice, providing an opportunity to improve decision support in medical image interpretation. The term of note is decision support, indicating that computers will augment human decision making, making it more effective and efficient. The clinical impact of having computers in the routine clinical practice may allow radiologists to further integrate their knowledge with their clinical colleagues in other medical specialties and allow for precision medicine.

Overview of deep learning in medical imaging.

The use of machine learning (ML) has been increasing rapidly in the medical imaging field, including computer-aided diagnosis (CAD), radiomics, and medical image analysis. Recently, an ML area called deep learning emerged in the computer vision field and became very popular in many fields. It started from an event in late 2012, when a deep-learning approach based on a convolutional neural network (CNN) won an overwhelming victory in the best-known worldwide computer vision competition, ImageNet Classification. Since then, researchers in virtually all fields, including medical imaging, have started actively participating in the explosively growing field of deep learning. In this paper, the area of deep learning in medical imaging is overviewed, including (1) what was changed in machine learning before and after the introduction of deep learning, (2) what is the source of the power of deep learning, (3) two major deep-learning models: a massive-training artificial neural network (MTANN) and a convolutional neural network (CNN), (4) similarities and differences between the two models, and (5) their applications to medical imaging. This review shows that ML with feature input (or feature-based ML) was dominant before the introduction of deep learning, and that the major and essential difference between ML before and after deep learning is the learning of image data directly without object segmentation or feature extraction; thus, it is the source of the power of deep learning, although the depth of the model is an important attribute. The class of ML with image input (or image-based ML) including deep learning has a long history, but recently gained popularity due to the use of the new terminology, deep learning. There are two major models in this class of ML in medical imaging, MTANN and CNN, which have similarities as well as several differences. In our experience, MTANNs were substantially more efficient in their development, had a higher performance, and required a lesser number of training cases than did CNNs. "Deep learning", or ML with image input, in medical imaging is an explosively growing, promising field. It is expected that ML with image input will be the mainstream area in the field of medical imaging in the next few decades.

Machine Learning in Medical Imaging Before and After Introduction of Deep Learning

Machine Learning in Medical Imaging Before and After Introduction of Deep Learning

Machine Learning for Medical Imaging.

Machine learning is a technique for recognizing patterns that can be applied to medical images. Although it is a powerful tool that can help in rendering medical diagnoses, it can be misapplied. Machine learning typically begins with the machine learning algorithm system computing the image features that are believed to be of importance in making the prediction or diagnosis of interest. The machine learning algorithm system then identifies the best combination of these image features for classifying the image or computing some metric for the given image region. There are several methods that can be used, each with different strengths and weaknesses. There are open-source versions of most of these machine learning methods that make them easy to try and apply to images. Several metrics for measuring the performance of an algorithm exist; however, one must be aware of the possible associated pitfalls that can result in misleading metrics. More recently, deep learning has started to be used; this method has the benefit that it does not require image feature identification and calculation as a first step; rather, features are identified as part of the learning process. Machine learning has been used in medical imaging and will have a greater influence in the future. Those working in medical imaging must be aware of how machine learning works. ©RSNA, 2017.

Robotics and machine learning approaches to improve robustness of USgFUS: FUTURA

Surgical robotics, machine learning for medical imaging, and focused ultrasound surgery (FUS) have the same long term goals: reducing invasiveness of therapies, augmenting the number of treatable diseases and, more in general, helping the healthcare system in terms of costs and benefits. Potentials from synergies among these fields are undeniable; cross-fertilization are expected to advance the applicability, robustness and safety of noninvasive therapies. Ultrasound guided FUS is a promising strategy for the treatment of pathologies in the abdomen. However, some limitations dramatically slow a widespread diffusion in operating rooms, such as the limited accuracy, the 2D monitoring and the time cost for registration and repositioning.

Machine learning in medical imaging

Machine learning in medical imaging

Machine Learning in Medical Imaging

Medical imaging is becoming indispensable for patients' healthcare. Machine learning plays an essential role in the medical imaging field, including computer-aided diagnosis, image segmentation, image registration, image fusion, image-guided therapy, image annotation, and image database retrieval. With advances in medical imaging, new imaging modalities and methodologies such as cone-beam/multislice CT, 3D ultrasound imaging, tomosynthesis, diffusion-weighted magnetic resonance imaging (MRI), positron-emission tomography (PET)/CT, electrical impedance tomography, and diffuse optical tomography, new machine-learning algorithms/applications are demanded in the medical imaging field. Because of large variations and complexityit is generally difficult to derive analytic solutions or simple equations to represent objects such as lesions and anatomy in medical images. Therefore, tasks in medical imaging require “learning from examples” for accurate representation of data and prior knowledge. Because of its essential needs, machine learning in medical imaging is one of the most promising, growing fields. The main aim of this special issue is to help advance the scientific research within the broad field of machine learning in medical imaging. The special issue was planned in conjunction with the International Workshop on Machine Learning in Medical Imaging (MLMI 2010) [1], which was the first workshop on this topic, held at the 13th International Conference on Medical Image Computing and Computer-Assisted Intervention (MICCAI 2010) in September, 2010, in Beijing, China. This special issue is one in a series of special issues of journals on this topic [2]; it focuses on major trends and challenges in this area, and it presents work aimed at identifying new cutting-edge techniques and their use in medical imaging. The quality level of the submissions for this special issue was very high. A total of 17 papers were submitted to this issue in response to the call for papers. Based on a rigorous review process, 10 papers (59%) were accepted for publication in the special issue. The special issue starts by a review of studies on a class of machine-learning techniques, called pixel/voxel-based machine learning, in medical imaging by K. Suzuki. A series of medical imaging applications of machine-learning techniques are presented. A large variety of applications are well represented here, including organ modeling by D. Wang et al. and X. Qiao and Y.-W. Chen, brain function estimation by V. Michel et al., image reconstruction by H. Shouno et al., lesion classification by P. Wighton et al., modality classification by X.-H. Han and Y.-W. Chen, lesion segmentation by M. Zortea et al., organ segmentation by S. Alzubi et al., and visualization of molecular signals by F. Mattoli et al. Also, the issue covers various biomedical imaging modalities, including MRI by D. Wang et al., CT by X. Qiao and Y.-W. Chen and H. Shouno et al., functional MRI by V. Michel et al., dermoscopy by P. Wighton et al. and M. Zortea et al., scintigraphy by X.-H. Han and Y.-W. Chen, ultrasound imaging by X.-H. Han and Y.-W. Chen, radiography by X.-H. Han and Y.-W. Chen, MR angiography by S. Alzubi et al., and microscopy by F. Mattoli et al. as well as a variety of organs, including the kidneys by D. Wang et al., liver by X. Qiao and Y.-W. Chen, brain by V. Michel et al. and F. Mattoli et al., chest by S. Alzubi et al., skin by P. Wighton et al. and M. Zortea et al., and heart by F. Mattoli et al. Various machine-learning techniques were developed/used to solve the respective problems, including structured dictionary learning by D. Wang et al., generalized N-dimensional principal component analysis by X. Qiao et al., multiclass sparse Bayesian regression by V. Michel et al., Bayesian hyperparameter inference by H. Shouno et al., supervised learning of probabilistic models based on maximum aposteriori estimation and conditional random fields by P. Wighton et al., joint kernel equal contribution in support vector classification by X.-H. Han and Y.-W. Chen, and iterative hybrid classification by M. Zortea et al. We are grateful to all authors for their excellent contributions to this special issue and to all reviewers for their reviews and constructive suggestions. We hope that this special issue will inspire further ideas for creative research, advance the field of machine learning in medical imaging, and facilitate the translation of the research from bench to bedside. Kenji Suzuki Pingkun Yan Fei Wang Dinggang Shen

Pixel-based machine learning in medical imaging.

Machine learning (ML) plays an important role in the medical imaging field, including medical image analysis and computer-aided diagnosis, because objects such as lesions and organs may not be represented accurately by a simple equation; thus, medical pattern recognition essentially require “learning from examples.” One of the most popular uses of ML is classification of objects such as lesions into certain classes (e.g., abnormal or normal, or lesions or nonlesions) based on input features (e.g., contrast and circularity) obtained from segmented object candidates. Recently, pixel/voxel-based ML (PML) emerged in medical image processing/analysis, which use pixel/voxel values in images directly instead of features calculated from segmented objects as input information; thus, feature calculation or segmentation is not required. Because the PML can avoid errors caused by inaccurate feature calculation and segmentation which often occur for subtle or complex objects, the performance of the PML can potentially be higher for such objects than that of common classifiers (i.e., feature-based MLs). In this paper, PMLs are surveyed to make clear (a) classes of PMLs, (b) similarities and differences within (among) different PMLs and those between PMLs and feature-based MLs, (c) advantages and limitations of PMLs, and (d) their applications in medical imaging.

Machine Learning in Medical Imaging.

This article will discuss very different ways of using machine learning that may be less familiar, and we will demonstrate through examples the role of these concepts in medical imaging. Although the term machine learning is relatively recent, the ideas of machine learning have been applied to medical imaging for decades, perhaps most notably in the areas of computer-aided diagnosis (CAD) and functional brain mapping. We will not attempt in this brief article to survey the rich literature of this field. Instead our goals will be 1) to acquaint the reader with some modern techniques that are now staples of the machine-learning field and 2) to illustrate how these techniques can be employed in various ways in medical imaging.