Discriminating lung nodules as malignant or benign is still an underlying challenge. To address this challenge, radiologists need computer aided diagnosis (CAD) systems which can assist in learning discriminative imaging features corresponding to malignant and benign nodules. However, learning highly discriminative imaging features is an open problem. In this paper, our aim is to learn the most discriminative features pertaining to lung nodules by using an adversarial learning methodology. Specifically, we propose to use unsupervised learning with Deep Convolutional-Generative Adversarial Networks (DC-GANs) to generate lung nodule samples realistically. We hypothesize that imaging features of lung nodules will be discriminative if it is hard to differentiate them (fake) from real (true) nodules. To test this hypothesis, we present Visual Turing tests to two radiologists in order to evaluate the quality of the generated (fake) nodules. Extensive comparisons are performed in discerning real, generated, benign, and malignant nodules. This experimental set up allows us to validate the overall quality of the generated nodules, which can then be used to (1) improve diagnostic decisions by mining highly discriminative imaging features, (2) train radiologists for educational purposes, and (3) generate realistic samples to train deep networks with big data.

Abstract. Risk stratification of lung nodules is a task of primary importance in lung cancer diagnosis. Any improvement in robust and accurate nodule characterization can assist in identifying cancer stage, prognosis, and improving treatment planning. In this study, we propose a 3D Convolutional Neural Network (CNN) based nodule characterization strategy. With a completely 3D approach, we utilize the volumetric information from a CT scan which would be otherwise lost in the conventional 2D CNN based approaches. In order to address the need for a large amount for training data for CNN, we resort to transfer learning to obtain highly discriminative features. Moreover, we also acquire the task dependent feature representation for six high-level nodule attributes and fuse this complementary information via a Multi-task learning (MTL) framework. Finally, we propose to incorporate potential disagreement among radiologists while scoring different nodule attributes in a graph regularized sparse multi-task learning. We evaluated our proposed approach on one of the largest publicly available lung nodule datasets comprising 1018 scans and obtained state-of-the-art results in regressing the malignancy scores.

Deep learning has demonstrated tremendous revolutionary changes in the computing industry and its effects in radiology and imaging sciences have begun to dramatically change screening paradigms. Specifically, these advances have influenced the development of computer-aided detection and diagnosis (CAD) systems. These technologies have long been thought of as "second-opinion" tools for radiologists and clinicians. However, with significant improvements in deep neural networks, the diagnostic capabilities of learning algorithms are approaching levels of human expertise (radiologists, clinicians etc.), shifting the CAD paradigm from a "second opinion" tool to a more collaborative utility. This paper reviews recently developed CAD systems based on deep learning technologies for breast cancer diagnosis, explains their superiorities with respect to previously established systems, defines the methodologies behind the improved achievements including algorithmic developments, and describes remaining challenges in breast cancer screening and diagnosis. We also discuss possible future directions for new CAD models that continue to change as artificial intelligence algorithms evolve.

Risk stratification (characterization) of tumors from radiology images can be more accurate and faster with computeraided diagnosis (CAD) tools. Tumor characterization through such tools can also enable non-invasive cancer staging, prognosis, and foster personalized treatment planning as a part of precision medicine. In this study, we propose both supervised and unsupervised machine learning strategies to improve tumor characterization. Our first approach is based on supervised learning for which we demonstrate significant gains with deep learning algorithms, particularly by utilizing a 3D Convolutional Neural Network and Transfer Learning. Motivated by the radiologists' interpretations of the scans, we then show how to incorporate task dependent feature representations into a CAD system via a graph-regularized sparse Multi-Task Learning (MTL) framework.In the second approach, we explore an unsupervised learning algorithm to address the limited availability of labeled training data, a common problem in medical imaging applications. Inspired by learning from label proportion (LLP) approaches in computer vision, we propose to use proportion-SVM for characterizing tumors. We also seek the answer to the fundamental question about the goodness of "deep features" for unsupervised tumor classification. We evaluate our proposed supervised and unsupervised learning algorithms on two different tumor diagnosis challenges: lung and pancreas with 1018 CT and 171 MRI scans, respectively, and obtain the state-of-the-art sensitivity and specificity results in both problems.

Characterization of lung nodules as benign or malignant is one of the most important tasks in lung cancer diagnosis, staging and treatment planning. While the variation in the appearance of the nodules remains large, there is a need for a fast and robust computer aided system. In this work, we propose an end-to-end trainable multi-view deep Convolutional Neural Network (CNN) for nodule characterization. First, we use median intensity projection to obtain a 2D patch corresponding to each dimension. The three images are then concatenated to form a tensor, where the images serve as different channels of the input image. In order to increase the number of training samples, we perform data augmentation by scaling, rotating and adding noise to the input image. The trained network is used to extract features from the input image followed by a Gaussian Process (GP) regression to obtain the malignancy score. We also empirically establish the significance of different high level nodule attributes such as calcification, sphericity and others for malignancy determination. These attributes are found to be complementary to the deep multi-view CNN features and a significant improvement over other methods is obtained.

In this paper, we investigate the automatic detection of white and brown adipose tissues using Positron Emission Tomography/Computed Tomography (PET/CT) scans, and develop methods for the quantification of these tissues at the whole-body and body-region levels. We propose a patient-specific automatic adiposity analysis system with two modules. In the first module, we detect white adipose tissue (WAT) and its two sub-types from CT scans: Visceral Adipose Tissue (VAT) and Subcutaneous Adipose Tissue (SAT). This process relies conventionally on manual or semi-automated segmentation, leading to inefficient solutions. Our novel framework addresses this challenge by proposing an unsupervised learning method to separate VAT from SAT in the abdominal region for the clinical quantification of central obesity. This step is followed by a context driven label fusion algorithm through sparse 3D Conditional Random Fields (CRF) for volumetric adiposity analysis. In the second module, we automatically detect, segment, and quantify brown adipose tissue (BAT) using PET scans because unlike WAT, BAT is metabolically active. After identifying BAT regions using PET, we perform a co-segmentation procedure utilizing asymmetric complementary information from PET and CT. Finally, we present a new probabilistic distance metric for differentiating BAT from non-BAT regions. Both modules are integrated via an automatic body-region detection unit based on one-shot learning. Experimental evaluations conducted on 151 PET/CT scans achieve state-of-the-art performances in both central obesity as well as brown adiposity quantification.

Objective This study aimed to evaluate a deep learning protocol to identify neoplasia in intraductal papillary mucinous neoplasia (IPMN) in comparison to current radiographic criteria. Methods A computer-aided framework was designed using convolutional neural networks to classify IPMN. The protocol was applied to magnetic resonance images of the pancreas. Features of IPMN were classified according to American Gastroenterology Association guidelines, Fukuoka guidelines, and the new deep learning protocol. Sensitivity and specificity were calculated using surgically resected cystic lesions or healthy controls. Results Of 139 cases, 58 (42%) were male; mean (standard deviation) age was 65.3 (11.9) years. Twenty-two percent had normal pancreas; 34%, low-grade dysplasia; 14%, high-grade dysplasia; and 29%, adenocarcinoma. The deep learning protocol sensitivity and specificity to detect dysplasia were 92% and 52%, respectively. Sensitivity and specificity to identify high-grade dysplasia or cancer were 75% and 78%, respectively. Diagnostic performance was similar to radiologic criteria. Areas under the receiver operating curves (95% confidence interval) were 0.76 (0.70–0.84) for American Gastroenterology Association, 0.77 (0.70–0.85) for Fukuoka, and 0.78 (0.71–0.85) for the deep learning protocol (P = 0.90). Conclusions The deep learning protocol showed accuracy comparable to current radiographic criteria. Computer-aided frameworks could be implemented as aids for radiologists to identify high-risk IPMN.

The findings suggest that active BAT detected by F-FDG PET/CT is associated with less central obesity and liver fat. The presence of foci of BAT may be protective against features of the metabolic syndrome.