基于3D体素增强和3D alpha背景分离的多发性硬化症病灶分割方法

目的:提出一种用于T1加权像、T2加权像和流体衰减反演恢复（Flair）磁共振图像的多发性硬化症（MS）病变分割方法。方法:首先基于3D图像增强技术,将高强度MS病变区域与其他组织区域区分开来。然后利用假阳性降低方法,去除一些强度和密度不均匀的假阳性目标区域（VOI）,并利用颜色分割法去除白质之外的VOI。最后利用彩色MR技术生成3个区域,以便细化分割MS病变。结果:在CHB数据集上进行测试,得到真阳率均值为0.48,Dice相似系数均值为0.52。结论:该方法能够有效去除噪声及其他无关非病变组织,并能准确识别并分割MS病变,该方法的有效性、准确性能为后续的MS分割技术分析提供依据。同时为MS病变的预防治疗、病情跟踪提供客观、方便的诊疗方法。 【关键词】多发性硬化症;病灶分割;3D体素增强;3D alpha背景分离;颜色分割技术     

Unified Approach for Multiple Sclerosis Lesion Segmentation on Brain MRI

The presence of large number of false lesion classification on segmented brain MR images is a major problem in the accurate determination of lesion volumes in multiple sclerosis (MS) brains. In order to minimize the false lesion classifications, a strategy that combines parametric and nonparametric techniques is developed and implemented. This approach uses the information from the proton density (PD)- and T2-weighted and fluid attenuation inversion recovery (FLAIR) images. This strategy involves CSF and lesion classification using the Parzen window classifier. Image processing, morphological operations, and ratio maps of PD- and T2-weighted images are used for minimizing false positives. Contextual information is exploited for minimizing the false negative lesion classifications using hidden Markov random field-expectation maximization (HMRF-EM) algorithm. Lesions are delineated using fuzzy connectivity. The performance of this algorithm is quantitatively evaluated on 23 MS patients. Similarity index, percentages of over, under, and correct estimations of lesions are computed by spatially comparing the results of present procedure with expert manual segmentation. The automated processing scheme detected 80% of the manually segmented lesions in the case of low lesion load and 93% of the lesions in those cases with high lesion load.     

基于模糊连接度的多发性硬化症MR图像自动分割算法

多发性硬化症(MS)是一种严重威胁中枢神经功能的疾病,利用磁共振成像技术能够无损伤地检出其病灶。为了自动地对多发性硬化症病灶进行分割,提出了基于模糊连接度的分割算法,实现了种子点的自动选取。作为多发性硬化症分割的预处理,针对脑部MR FLAIR图像的特征,基于区域增长方法,还提出了脑部组织提取算法。通过对临床患者MR图像的分割实验,表明该分割算法能够比较准确地分割多发性硬化症病灶,其分割效果明显好于模糊C-均值聚类算法和基于马尔可夫场模型的分割算法。该算法还具有无监督、运算速度快、稳健性好等优点,能够应用于多发性硬化症的临床辅助诊断。     

A hybrid approach based on logistic classification and iterative contrast enhancement algorithm for hyperintense multiple sclerosis lesion segmentation

Multiple sclerosis (MS) is a neurodegenerative disease with increasing importance in recent years, in which the T2 weighted with fluid attenuation inversion recovery (FLAIR) MRI imaging technique has been addressed for the hyperintense MS lesion assessment. Many automatic lesion segmentation approaches have been proposed in the literature in order to assist health professionals. In this study, a new hybrid lesion segmentation approach based on logistic classification (LC) and the iterative contrast enhancement (ICE) method is proposed (LC+ICE). T1 and FLAIR MRI images from 32 secondary progressive MS (SPMS) patients were used in the LC+ICE method, in which manual segmentation was used as the ground truth lesion segmentation. The DICE, Sensitivity, Specificity, Area under the ROC curve (AUC), and Volume Similarity measures showed that the LC+ICE method is able to provide a precise and robust lesion segmentation estimate, which was compared with two recent FLAIR lesion segmentation approaches. In addition, the proposed method also showed a stable segmentation among lesion loads, showing a wide applicability to different disease stages. The LC+ICE procedure is a suitable alternative to assist the manual FLAIR hyperintense MS lesion segmentation task.     

A novel active contour model for fully automated segmentation of intravascular ultrasound images: in vivo validation in human coronary arteries

The detection of lumen and media-adventitia borders in intravascular ultrasound (IVUS) images constitutes a necessary step for the quantitative assessment of atherosclerotic lesions. To date, most of the segmentation methods reported are either manual, or semi-automated, requiring user interaction at some extent, which increases the analysis time and detection errors. In this work, a fully automated approach for lumen and media-adventitia border detection is presented based on an active contour model, the initialization of which is performed via an analysis mechanism that takes advantage of the inherent morphologic characteristics of IVUS images. The in vivo validation of the proposed model in human coronary arteries revealed that it is a feasible approach, enabling accurate and rapid segmentation of multiple IVUS images.     

An Efficient Implementation of Deep Convolutional Neural Networks for MRI Segmentation

Image segmentation is one of the most common steps in digital image processing, classifying a digital image into different segments. The main goal of this paper is to segment brain tumors in magnetic resonance images (MRI) using deep learning. Tumors having different shapes, sizes, brightness and textures can appear anywhere in the brain. These complexities are the reasons to choose a high-capacity Deep Convolutional Neural Network (DCNN) containing more than one layer. The proposed DCNN contains two parts: architecture and learning algorithms. The architecture and the learning algorithms are used to design a network model and to optimize parameters for the network training phase, respectively. The architecture contains five convolutional layers, all using 3?×?3 kernels, and one fully connected layer. Due to the advantage of using small kernels with fold, it allows making the effect of larger kernels with smaller number of parameters and fewer computations. Using the Dice Similarity Coefficient metric, we report accuracy results on the BRATS 2016, brain tumor segmentation challenge dataset, for the complete, core, and enhancing regions as 0.90, 0.85, and 0.84 respectively. The learning algorithm includes the task-level parallelism. All the pixels of an MR image are classified using a patch-based approach for segmentation. We attain a good performance and the experimental results show that the proposed DCNN increases the segmentation accuracy compared to previous techniques.     

Dullrazor: A software approach to hair removal from images

Recently, there has been a growing number of studies applying image processing techniques to analyze melanocytic lesions for atypia and possible malignancy and for total-body mole mapping. However, such lesions can be partially obscured by body hairs. None of these studies has fully addressed the problem of human hairs occluding the imaged lesions. In our previous study we designed an automatic segmentation program to differentiate skin lesions from the normal healthy skin, and learned that the program performed well with most of the images, the exception being those with hairs, especially dark thick hairs, covering part of the lesions. These thick dark hairs confused the program, resulting in unsatisfactory segmentation results. In this paper, we present a method to remove hairs from an image using a pre-processing program we have called DullRazor^®. This pre-processing step enables the segmentation program to achieve satisfactory results. DullRazor^® can be downloaded as shareware from http://www.derm.ubc.ca.     

CVSnet: A machine learning approach for automated central vein sign assessment in multiple sclerosis

The central vein sign (CVS) is an efficient imaging biomarker for multiple sclerosis (MS) diagnosis, but its application in clinical routine is limited by inter‐rater variability and the expenditure of time associated with manual assessment. We describe a deep learning‐based prototype for automated assessment of the CVS in white matter MS lesions using data from three different imaging centers. We retrospectively analyzed data from 3 T magnetic resonance images acquired on four scanners from two different vendors, including adults with MS (n = 42), MS mimics (n = 33, encompassing 12 distinct neurological diseases mimicking MS) and uncertain diagnosis (n = 5). Brain white matter lesions were manually segmented on FLAIR* images. Perivenular assessment was performed according to consensus guidelines and used as ground truth, yielding 539 CVS‐positive (CVS⁺) and 448 CVS‐negative (CVS^?) lesions. A 3D convolutional neural network (“CVSnet”) was designed and trained on 47 datasets, keeping 33 for testing. FLAIR* lesion patches of CVS⁺/CVS^? lesions were used for training and validation (n = 375/298) and for testing (n = 164/150). Performance was evaluated lesion‐wise and subject‐wise and compared with a state‐of‐the‐art vesselness filtering approach through McNemar's test. The proposed CVSnet approached human performance, with lesion‐wise median balanced accuracy of 81%, and subject‐wise balanced accuracy of 89% on the validation set, and 91% on the test set. The process of CVS assessment, in previously manually segmented lesions, was ~ 600‐fold faster using the proposed CVSnet compared with human visual assessment (test set: 4 seconds vs. 40 minutes). On the validation and test sets, the lesion‐wise performance outperformed the vesselness filter method (P < 0.001). The proposed deep learning prototype shows promising performance in differentiating MS from its mimics. Our approach was evaluated using data from different hospitals, enabling larger multicenter trials to evaluate the benefit of introducing the CVS marker into MS diagnostic criteria.     

Deep learning‐based fully automatic segmentation of wrist cartilage in MR images

The study objective was to investigate the performance of a dedicated convolutional neural network (CNN) optimized for wrist cartilage segmentation from 2D MR images. CNN utilized a planar architecture and patch‐based (PB) training approach that ensured optimal performance in the presence of a limited amount of training data. The CNN was trained and validated in 20 multi‐slice MRI datasets acquired with two different coils in 11 subjects (healthy volunteers and patients). The validation included a comparison with the alternative state‐of‐the‐art CNN methods for the segmentation of joints from MR images and the ground‐truth manual segmentation. When trained on the limited training data, the CNN outperformed significantly image‐based and PB‐U‐Net networks. Our PB‐CNN also demonstrated a good agreement with manual segmentation (Sørensen–Dice similarity coefficient [DSC] = 0.81) in the representative (central coronal) slices with a large amount of cartilage tissue. Reduced performance of the network for slices with a very limited amount of cartilage tissue suggests the need for fully 3D convolutional networks to provide uniform performance across the joint. The study also assessed inter‐ and intra‐observer variability of the manual wrist cartilage segmentation (DSC = 0.78‐0.88 and 0.9, respectively). The proposed deep learning‐based segmentation of the wrist cartilage from MRI could facilitate research of novel imaging markers of wrist osteoarthritis to characterize its progression and response to therapy.     

基于空间FCM与MRF方法的乳腺MRI序列三维病灶分割研究

针对乳腺DCE-MRI病灶分割,提出一种空间FCM聚类与MRF随机场相结合的三维分割方法。首先,对MRI图像进行空间FCM粗分割,提取病灶粗轮廓。然后,在其基础上进行MRF精分割,并结合病灶三维信息：用相邻切片分割结果对应标号矩阵初始化MRF精分割标号场,同时用该张切片粗分割所得隶属度矩阵对MRF精分割进行参数自适应调整。用该方法与空间FCM、水平集、模糊MRF方法对50例MRI数据进行分割对比实验,得到良、恶性病灶分割重叠率分别为76.4、75.5;相比于空间FCM的68.%、69.5水平集的70.8、72.6以及模糊MRF的72.9、73.6有明显提升。对所有175例MRI数据分割结果进行非监督评价,得到良、恶性病灶区域均匀性均大于0.92;区域内差异性良性病灶92%小于150、恶性病灶98%小于150;区域间差异性良性病灶87%大于0.25、恶性病灶90%大于0.3综上表明,该方法具有较高的分割精度。     

Automated segmentation of multiple sclerosis lesions in multispectral MR imaging using fuzzy clustering

A method is presented for fully automated detection of Multiple Sclerosis (MS) lesions in multispectral magnetic resonance (MR) imaging. Based on the Fuzzy C-Means (FCM) algorithm, the method starts with a segmentation of an MR image to extract an external CSF/lesions mask, preceded by a local image contrast enhancement procedure. This binary mask is then superimposed on the corresponding data set yielding an image containing only CSF structures and lesions. The FCM is then reapplied to this masked image to obtain a mask of lesions and some undesired substructures which are removed using anatomical knowledge. Any lesion size found to be less than an input bound is eliminated from consideration. Results are presented for test runs of the method on 10 patients. Finally, the potential of the method as well as its limitations are discussed.     

Multiscale active contour model for vessel segmentation

This paper presents a novel multiscale active contour model for vessel segmentation. The model is based on accurate analysis of the vessel structure in the image. According to different scale response of the eigenvalues of local second order derivative (Hessian matrix), a new vessel region information function, which shows a valid estimation of the vesselness measure, is defined. We introduce the posteriori probability estimation into the active contours framework and design a new objective function. The defined objective function is minimized using the variational method, and a new region-based external force is obtained, which is more accurate to the vessel structure and not sensitive to the initial condition. This active contour model combines the obtained region-based and conventional boundary-based force, which aims at finding more accurate vessel edges even when the vessel branches are low contrast or blurry. Furthermore, the proposed model is implemented by an implicit method of level set framework, the solution of which is steady and suitable for various topology changes. Moreover, two new speed functions for vessel segmentation in the level set method are presented, one for fast marching and the other for a narrow-band algorithm. The vessel segmentation experiments compared with previous geometric active contour models are shown on several medical images. The experimental results demonstrate the performance of our approach.     

Computer-aided detection of interstitial abnormalities in chest radiographs using a reference standard based on computed tomography

A computer-aided detection (CAD) system is presented for the localization of interstitial lesions in chest radiographs. The system analyzes the complete lung fields using a two-class supervised pattern classification approach to distinguish between normal texture and texture affected by interstitial lung disease. Analysis is done pixel-wise and produces a probability map for an image where each pixel in the lung fields is assigned a probability of being abnormal. Interstitial lesions are often subtle and ill defined on x-rays and hence difficult to detect, even for expert radiologists. Therefore a new, semiautomatic method is proposed for setting a reference standard for training and evaluating the CAD system. The proposed method employs the fact that interstitial lesions are more distinct on a computed tomography (CT) scan than on a radiograph. Lesion outlines, manually drawn on coronal slices of a CT scan of the same patient, are automatically transformed to corresponding outlines on the chest x-ray, using manually indicated correspondences for a small set of anatomical landmarks. For the texture analysis, local structures are described by means of the multiscale Gaussian filter bank. The system performance is evaluated with ROC analysis on a database of digital chest radiographs containing 44 abnormal and 8 normal cases. The best performance is achieved for the linear discriminant and support vector machine classifiers, with an area under the ROC curve (A(z)) of 0.78. Separate ROC curves are built for classification of abnormalities of different degrees of subtlety versus normal class. Here the best performance in terms of A(z) is 0.90 for differentiation between obviously abnormal and normal pixels. The system is compared with two human observers, an expert chest radiologist and a chest radiologist in training, on evaluation of regions. Each lung field is divided in four regions, and the reference standard and the probability maps are converted into region scores. The system performance does not significantly differ from that of the observers, when the perihilar regions are excluded from evaluation, and reaches A(z) = 0.85 for the system, with A(z) = 0.88 for both observers.     

A hybrid tissue segmentation approach for brain MR images

A novel hybrid algorithm for the tissue segmentation of brain magnetic resonance images is proposed. The core of the algorithm is a probabilistic neural network (PNN) in which weighting factors are added to the summation layer, such that partial volume effects can be taken into account in the modeling process. The mean vectors for the probability density function estimation and the corresponding weighting factors are generated by a hierarchical scheme involving a self-organizing map neural network and an expectation maximization algorithm. Unlike conventional PNN, this approach circumvents the need for training sets. Tissue segmentation results from various algorithms are compared and the effectiveness and robustness of the proposed approach are demonstrated.     

Level Set Segmentation of Breast Masses in Contrast-Enhanced Dedicated Breast CT and Evaluation of Stopping Criteria

Dedicated breast CT (bCT) produces high-resolution 3D tomographic images of the breast, fully resolving fibroglandular tissue structures within the breast and allowing for breast lesion detection and assessment in 3D. In order to enable quantitative analysis, such as volumetrics, automated lesion segmentation on bCT is highly desirable. In addition, accurate output from CAD (computer-aided detection/diagnosis) methods depends on sufficient segmentation of lesions. Thus, in this study, we present a 3D lesion segmentation method for breast masses in contrast-enhanced bCT images. The segmentation algorithm follows a two-step approach. First, 3D radial-gradient index segmentation is used to obtain a crude initial contour, which is then refined by a 3D level set-based active contour algorithm. The data set included contrast-enhanced bCT images from 33 patients containing 38 masses (25 malignant, 13 benign). The mass centers served as input to the algorithm. In this study, three criteria for stopping the contour evolution were compared, based on (1) the change of region volume, (2) the average intensity in the segmented region increase at each iteration, and (3) the rate of change of the average intensity inside and outside the segmented region. Lesion segmentation was evaluated by computing the overlap ratio between computer segmentations and manually drawn lesion outlines. For each lesion, the overlap ratio was averaged across coronal, sagittal, and axial planes. The average overlap ratios for the three stopping criteria ranged from 0.66 to 0.68 (dice coefficient of 0.80 to 0.81), indicating that the proposed segmentation procedure is promising for use in quantitative dedicated bCT analyses.     

一种基于概率配分和最大模糊熵的CT图像分割方法

为了从CT图像中提取到多个组织的解剖特征,克服运算速度快与运算结果不稳定的矛盾,提出了一种基于概率分布和模糊熵的CT图像分割方法。为了找到分割灰度图象的最佳阈值,根据模糊聚类和概率配分之间的关系,以及模糊熵有最大值的必要条件,从而得到各类的概率配分,因此在搜索阈值组合时,先搜索满足各类概率配分的阈值,然后从这些阈值中搜索使模糊熵最大的阈值。实验结果表明该方法能很好地完成CT图象的分割。此算法运算速度较快;与用遗传算法、模拟退火算法相比较,运算结果稳定,分割更准确。     

Multiple sclerosis cortical lesion detection with deep learning at ultra-high-field MRI

Manually segmenting multiple sclerosis (MS) cortical lesions (CLs) is extremely time consuming, and past studies have shown only moderate inter-rater reliability. To accelerate this task, we developed a deep-learning-based framework (CLAIMS: Cortical Lesion AI-Based Assessment in Multiple Sclerosis) for the automated detection and classification of MS CLs with 7 T MRI. Two 7 T datasets, acquired at different sites, were considered. The first consisted of 60 scans that include 0.5 mm isotropic MP2RAGE acquired four times (MP2RAGE×4), 0.7 mm MP2RAGE, 0.5 mm T₂*-weighted GRE, and 0.5 mm T₂*-weighted EPI. The second dataset consisted of 20 scans including only 0.75 × 0.75 × 0.9 mm³ MP2RAGE. CLAIMS was first evaluated using sixfold cross-validation with single and multi-contrast 0.5 mm MRI input. Second, the performance of the model was tested on 0.7 mm MP2RAGE images after training with either 0.5 mm MP2RAGE×4, 0.7 mm MP2RAGE, or alternating the two. Third, its generalizability was evaluated on the second external dataset and compared with a state-of-the-art technique based on partial volume estimation and topological constraints (MSLAST). CLAIMS trained only with MP2RAGE×4 achieved results comparable to those of the multi-contrast model, reaching a CL true positive rate of 74% with a false positive rate of 30%. Detection rate was excellent for leukocortical and subpial lesions (83%, and 70%, respectively), whereas it reached 53% for intracortical lesions. The correlation between disability measures and CL count was similar for manual and CLAIMS lesion counts. Applying a domain-scanner adaptation approach and testing CLAIMS on the second dataset, the performance was superior to MSLAST when considering a minimum lesion volume of 6 μL (lesion-wise detection rate of 71% versus 48%). The proposed framework outperforms previous state-of-the-art methods for automated CL detection across scanners and protocols. In the future, CLAIMS may be useful to support clinical decisions at 7 T MRI, especially in the field of diagnosis and differential diagnosis of MS patients.     

Evaluation of Semiautomatic and Deep Learning–Based Fully Automatic Segmentation Methods on [18F]FDG PET/CT Images from Patients with Lymphoma: Influence on Tumor Characterization

The objective is to assess the performance of seven semiautomatic and two fully automatic segmentation methods on [¹⁸F]FDG PET/CT lymphoma images and evaluate their influence on tumor quantification. All lymphoma lesions identified in 65 whole-body [¹⁸F]FDG PET/CT staging images were segmented by two experienced observers using manual and semiautomatic methods. Semiautomatic segmentation using absolute and relative thresholds, k-means and Bayesian clustering, and a self-adaptive configuration (SAC) of k-means and Bayesian was applied. Three state-of-the-art deep learning–based segmentations methods using a 3D U-Net architecture were also applied. One was semiautomatic and two were fully automatic, of which one is publicly available. Dice coefficient (DC) measured segmentation overlap, considering manual segmentation the ground truth. Lymphoma lesions were characterized by 31 features. Intraclass correlation coefficient (ICC) assessed features agreement between different segmentation methods. Nine hundred twenty [¹⁸F]FDG-avid lesions were identified. The SAC Bayesian method achieved the highest median intra-observer DC (0.87). Inter-observers’ DC was higher for SAC Bayesian than manual segmentation (0.94 vs 0.84, p < 0.001). Semiautomatic deep learning–based median DC was promising (0.83 (Obs1), 0.79 (Obs2)). Threshold-based methods and publicly available 3D U-Net gave poorer results (0.56 ≤ DC ≤ 0.68). Maximum, mean, and peak standardized uptake values, metabolic tumor volume, and total lesion glycolysis showed excellent agreement (ICC ≥ 0.92) between manual and SAC Bayesian segmentation methods. The SAC Bayesian classifier is more reproducible and produces similar lesion features compared to manual segmentation, giving the best concordant results of all other methods. Deep learning–based segmentation can achieve overall good segmentation results but failed in few patients impacting patients’ clinical evaluation.

     

Statistical cerebrovascular segmentation in three-dimensional rotational angiography based on maximum intensity projections

Segmentation of three-dimensional rotational angiography (3D-RA) can provide quantitative 3D morphological information of vasculature. The expectation maximization-(EM-) based segmentation techniques have been widely used in the medical image processing community, because of the implementation simplicity, and computational efficiency of the approach. In a brain 3D-RA, vascular regions usually occupy a very small proportion (around 1%) inside an entire image volume. This severe imbalance between the intensity distributions of vessels and background can lead to inaccurate statistical modeling in the EM-based segmentation methods, and thus adversely affect the segmentation quality for 3D-RA. In this paper we present a new method for the extraction of vasculature in 3D-RA images. The new method is fully automatic and computationally efficient. As compared with the original 3D-RA volume, there is a larger proportion (around 20%) of vessels in its corresponding maximum intensity projection (MIP) image. The proposed method exploits this property to increase the accuracy of statistical modeling with the EM algorithm. The algorithm takes an iterative approach to compiling the 3D vascular segmentation progressively with the segmentation of MIP images along the three principal axes, and use a winner-takes-all strategy to combine the results obtained along individual axes. Experimental results on 12 3D-RA clinical datasets indicate that the segmentations obtained by the new method exhibit a high degree of agreement to the ground truth segmentations and are comparable to those produced by the manual optimal global thresholding method.     

Partial volume segmentation of brain magnetic resonance images based on maximum a posteriori probability

Noise, partial volume (PV) effect, and image-intensity inhomogeneity render a challenging task for segmentation of brain magnetic resonance (MR) images. Most of the current MR image segmentation methods focus on only one or two of the above-mentioned effects. The objective of this paper is to propose a unified framework, based on the maximum a posteriori probability principle, by taking all these effects into account simultaneously in order to improve image segmentation performance. Instead of labeling each image voxel with a unique tissue type, the percentage of each voxel belonging to different tissues, which we call a mixture, is considered to address the PV effect. A Markov random field model is used to describe the noise effect by considering the nearby spatial information of the tissue mixture. The inhomogeneity effect is modeled as a bias field characterized by a zero mean Gaussian prior probability. The well-known fuzzy C-mean model is extended to define the likelihood function of the observed image. This framework reduces theoretically, under some assumptions, to the adaptive fuzzy C-mean (AFCM) algorithm proposed by Pham and Prince. Digital phantom and real clinical MR images were used to test the proposed framework. Improved performance over the AFCM algorithm was observed in a clinical environment where the inhomogeneity, noise level, and PV effect are commonly encountered.