Abstract

Peripheral nerve blocks are crucial to treatment of post-surgical pain and are associated with reduction in perioperative opioid use and hospital stay. Accurate interpretation of sono-anatomy is critical for the success of ultrasound (US) guided peripheral nerve blocks and can be challenging to the new operators. This prospective study enrolled 227 subjects who were systematically scanned for supraclavicular and interscalene brachial plexus in various settings using three different US machines to create a dataset of 227 unique videos. In total, 41,000 video frames were annotated by experienced anaesthesiologists using partial automation with object tracking and active contour algorithms. Four baseline neural network models were trained on the dataset and their performance was evaluated for object detection and segmentation tasks. Generalizability of the best suited model was then tested on the datasets constructed

Abstract

A method for real-time detection of nerves together with a needle and its trajectory in ultrasound videos to autonomously guide the needle towards nerve block target. We also publicly release needle annotations for further research.

Abstract

Biological processes like growth, aging, and disease progression are generally studied with follow-up scans taken at different time points, i.e., with image time series (TS) based analysis. Comparison between TS representing a biological process of two individuals/populations is of interest. A metric to quantify the difference between TS is desirable for such a comparison. The two TS represent the evolution of two different subject/population average anatomies through two paths. A method to untangle and quantify the path and inter-subject anatomy(shape) difference between the TS is presented in this paper. The proposed metric is a generalized version of Fréchet distance designed to compare curves. The proposed method is evaluated with simulated and adult and fetal neuro templates. Results show that the metric is able to separate and quantify the path and shape differences between TS. Keywords: Image TS · Time-dependant variation · Time dependant variation.

Abstract

Alzheimer’s disease (AD) and Mild Cognitive Impairment (MCI) are neurogenerative impairments with similar symptoms and risk factors. Sulcal width and depth are known biomarkers for discriminating between AD and MCI. This paper presents a novel 2D image representation for a brain mesh surface, called a height map. The basic idea behind the height map is to represent the surface as a function of spherical coordinates of the mesh vertices. We present a method to derive a height map from a given neuroimage (MRI) and extract sulcal regions from the height map. We demonstrate the height map’s utility for classifying a given neuroimage into healthy, MCI and AD classes. Two approaches for extracting sulcal regions are explored. The proposed method is computationally light, and obtaining sulcal regions from a brain surface mesh takes about 24 seconds on a standard Intel i5-7200 CPU. The proposed method achieves 76.1% accuracy, and 76.3% F1-score for healthy, MCI, AD classification on a publicly available dataset.

Abstract

Normative aging trends of the brain can serve as an important reference in the assessment of neurological structural disorders. Such models are typically developed from longitudinal brain image data—follow-up data of the same subject over diferent time points. In practice, obtaining such longitudinal data is difcult. We propose a method to develop an aging model for a given population, in the absence of longitudinal data, by using images from diferent subjects at diferent time points, the so-called cross-sectional data. We defne an aging model as a difeomorphic deformation on a structural template derived from the data and propose a method that develops topology preserving aging model close to natural aging. The proposed model is successfully validated on two public crosssectional datasets which provide templates constructed from diferent sets of subjects at diferent age points.

Abstract

Deep learning based methods have shown great promise in achieving accurate automatic detection of Coronavirus Disease (COVID) - 19 from Chest X-Ray ( CXR) images.However, incorporating explainability in these so- lutions remains relatively less explored. We present a hi- erarchical classification approach for separating normal, non- COVID pneumonia (NCP ) and COVID cases using CXR im- ages. We demonstrate that the proposed method achieves clinically consistent explainations. We achieve this using a novel multi-scale attention architecture called Multi-scale Attention Residual Learning (MARL ) and a new loss function based on conicity for training the proposed architecture. The proposed classification strategy has two stages. The first stage uses a model derived from DenseNet to sepa- rate pneumonia cases from normal cases while the second stage uses the MARL architecture to discriminate between COVID and NCP cases. With a five-fold cross validation the proposed method achieves 93%, 96.28%, and 84.51% accu- racy respectively over three large, public datasets for nor- mal vs. NCP vs. COVID classification. This is competitive to the state-of-the-art methods. We also provide explanations in the form of GradCAM attributions, which are well aligned with expert annotations. The attributions are also seen to clearly indicate that MARL deems the peripheral regions of the lungs to be more important in the case of COVID cases while central regions are seen as more important in NCP cases. This observation matches the criteria described by radiologists in clinical literature, thereby attesting to the utility of the derived explanations.

Abstract

Segmentation and analysis of sub-cortical structures is of interest in diagnosing some neurological diseases. Segmentation is a challenging task because of brain tissue ambiguity and data scarcity. Deep learning (DL) solutions are widely used for this purpose by considering the problem as a semantic segmentation of the brain. In general, DL approaches exhibit a bias towards larger structures when training is done on the whole brain. We propose a method to address this problem wherein a pre-training step is used to learn tissue characteristics and a rough ROI extraction step aids focusing on local context. We use a Residual U-net for demonstrating the proposed method. Experiments on the IBSR and MICCAI datasets show that our proposed solution leads to an improvement in segmentation performance in general with medium and small size structures benefiting significantly. The performance with the proposed method is also marginally better than a more complex, state of art sub-cortical structure segmentation method. A strength of the proposed method is that it can also be applied as a modification to any existing segmentation solution.

Abstract

Deep neural networks suffer from Catastrophic Forgetting (CF) on old tasks when they are trained to learn new tasks sequentially, since the parameters of the model will change to optimize on the new class. The problem of alleviating CF is of interest to Computer aided diagnostic (CAD) sys- tems community to facilitate class incremental learning (IL): learn new classes as and when new data/annotations are made available and old data is no longer accessible. However, IL has not been explored much in CAD development. We pro- pose a novel approach that ensures that a model remembers the causal factor behind the decisions on the old classes, while incrementally learning new classes. We introduce a common auxiliary task during the course of incremental training, whose hidden representations are shared across all the classification heads. Since the hidden representation is no longer task-specific, it leads to a significant reduction in CF. We demonstrate our approach by incrementally learning 5 different tasks on Chest-Xrays and compare the results with the state-of-the-art regularization methods. Our approach performs consistently well in reducing CF in all the tasks with almost zero CF in most of the cases unlike standard regularisation-based approaches.

Abstract

Anatomical variabilities seen in longitudinal data or inter- subject data is usually described by the underlying deformation, cap- tured by non-rigid registration of these images. Stationary Velocity Field (SVF) based non-rigid registration algorithms are widely used for reg- istration. However, these methods cover only a limited degree of defor- mations. We address this limitation and define an approximate metric space for the manifold of diffeomorphisms G. We propose a method to break down the large deformation into finite set of small sequential defor- mations. This results in a broken geodesic path on G and its length now forms an approximate registration metric. We illustrate the method using a simple, intensity-based, log-demon implementation. Validation results of the proposed method show that it can capture large and complex de- formations while producing qualitatively better results than state-of-the- art methods. The results also demonstrate that the proposed registration metric is a good indicator of the degree of deformation.

Abstract

Explainable AI aims to build systems that not only give high performance but also are able to provide insights that drive the decision making. However, deriving this explanation is often dependent on fully annotated (class label and local annotation) data, which are not readily available in the medical domain. Approach: This paper addresses the above-mentioned aspects and presents an innovative approach to classifying a lung nodule in a CT volume as malignant or benign, and generating a morphologically meaningful explanation for the decision in the form of attributes such as nodule margin, sphericity, and spiculation. A deep learning architecture that is trained using a multi-phase training regime is proposed. The nodule class label (benign/malignant) is learned with full supervision and is guided by semantic attributes that are learned in a weakly supervised manner. Results: Results of an extensive evaluation of the proposed system on the LIDC-IDRI dataset show good performance compared with state-of-the-art, fully supervised methods. The proposed model is able to label nodules (after full supervision) with an accuracy of 89.1% and an area under curve of 0.91 and to provide eight attributes scores as an explanation, which is learned from a much smaller training set. The proposed system's potential to be integrated with a sub-optimal nodule detection system was also tested, and our system handled 95% of false positive or random regions in the input well by labeling them as benign, which underscores its robustness. Conclusions: The proposed approach offers a way to address computer-aided diagnosis system design under the constraint of sparse availability of fully annotated images.