A key step in medical image-based diagnosis is image segmentation. A common use case for medical image segmentation is the identification of single structures of an elliptical shape. Most organs like the heart and kidneys fall into this category, as well as skin lesions, polyps, and other types of abnormalities. Neural networks have dramatically improved medical image segmentation results, but still require large amounts of training data and long training times to converge. In this paper, we propose a general way to improve neural network segmentation performance and data efficiency on medical imaging segmentation tasks where the goal is to segment a single roughly elliptically distributed object. We propose training a neural network on polar transformations of the original dataset, such that the polar origin for the transformation is the center point of the object. This results in a reduction of dimensionality as well as a separation of segmentation and localization tasks, allowing the network to more easily converge. Additionally, we propose two different approaches to obtaining an optimal polar origin: (1) estimation via a segmentation trained on non-polar images and (2) estimation via a model trained to predict the optimal origin. We evaluate our method on the tasks of liver, polyp, skin lesion, and epicardial adipose tissue segmentation. We show that our method produces state-of-the-art results for lesion, liver, and polyp segmentation and performs better than most common neural network architectures for biomedical image segmentation. Additionally, when used as a pre-processing step, our method generally improves data efficiency across datasets and neural network architectures.
Epicardial and pericardial adipose tissues (EAT and PAT), which are located around the heart, have been linked to coronary atherosclerosis, cardiomyopathy, coronary artery disease, and other cardiovascular diseases. Additionally, the volume and thickness of EAT are good predictors of CVD risk levels. Manual quantification of these tissues is a tedious and error-prone process. This paper presents a comprehensive and critical overview of research on the epicardial and pericardial adipose tissue segmentation and quantification methods, evaluates their effectiveness in terms of segmentation time and accuracy, provides a critical comparison of the methods, and presents ongoing and future challenges in the field. Described methods are classified into pericardial adipose tissue segmentation, direct epicardial adipose tissue segmentation, and epicardial adipose tissue segmentation via pericardium delineation. A comprehensive categorization of the underlying methods is conducted with insights into their evolution from traditional image processing methods to recent deep learning-based methods. The paper also provides an overview of the research on the clinical significance of epicardial and pericardial adipose tissues as well as the terminology and definitions used in the medical literature.
Epicardial adipose tissue is a type of adipose tissue located between the heart wall and a protective layer around the heart called the pericardium. The volume and thickness of epicardial adipose tissue are linked to various cardiovascular diseases. It is shown to be an independent cardiovascular disease risk factor. Fully automatic and reliable measurements of epicardial adipose tissue from CT scans could provide better disease risk assessment and enable the processing of large CT image data sets for a systemic epicardial adipose tissue study. This paper proposes a method for fully automatic semantic segmentation of epicardial adipose tissue from CT images using a deep neural network. The proposed network uses a U-Net-based architecture with slice depth information embedded in the input image to segment a pericardium region of interest, which is used to obtain an epicardial adipose tissue segmentation. Image augmentation is used to increase model robustness. Cross-validation of the proposed method yields a Dice score of 0.86 on the CT scans of 20 patients.
Medical image segmentation often requires segmenting multiple elliptical objects on a single image. This includes, among other tasks, segmenting vessels such as the aorta in axial CTA slices. In this paper, we present a general approach to improving the semantic segmentation performance of neural networks in these tasks and validate our approach on the task of aorta segmentation. We use a cascade of two neural networks, where one performs a rough segmentation based on the U-Net architecture and the other performs the final segmentation on polar image transformations of the input. Connected component analysis of the rough segmentation is used to construct the polar transformations, and predictions on multiple transformations of the same image are fused using hysteresis thresholding. We show that this method improves aorta segmentation performance without requiring complex neural network architectures. In addition, we show that our approach improves robustness and pixel-level recall while achieving segmentation performance in line with the state of the art.
One of the largest problems in medical image processing is the lack of annotated data. Labeling medical images often requires highly trained experts and can be a time-consuming process. In this paper, we evaluate a method of reducing the need for labeled data in medical image object detection by using self-supervised neural network pretraining. We use a dataset of chest X-ray images with bounding box labels for 13 different classes of anomalies. The networks are pretrained on a percentage of the dataset without labels and then finetuned on the rest of the dataset. We show that it is possible to achieve similar performance to a fully supervised model in terms of mean average precision and accuracy with only 60% of the labeled data. We also show that it is possible to increase the maximum performance of a fully-supervised model by adding a self-supervised pretraining step, and this effect can be observed with even a small amount of unlabeled data for pretraining.
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