Rapid advances in image processing capabilities have been seen across many domains, fostered by the  application of machine learning algorithms to "big-data". However, within the realm of medical image analysis, advances have been curtailed, in part, due to the limited availability of large-scale, well-annotated datasets. One of the main reasons for this is the high cost often associated with producing large amounts of high-quality meta-data. Recently, there has been growing interest in the application of crowdsourcing for this purpose; a technique that has proven effective for creating large-scale datasets across a range of disciplines, from computer vision to astrophysics. Despite the growing popularity of this approach, there has not yet been a comprehensive literature review to provide guidance to researchers considering using crowdsourcing methodologies in their own medical imaging analysis. In this survey, we review studies applying crowdsourcing to the analysis of medical images, published prior to July 2018. We identify common approaches, challenges and considerations, providing guidance of utility to researchers adopting this approach. Finally, we discuss future opportunities for development within this emerging domain.

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We propose an end-to-end deep learning method that learns to estimate emphysema extent from proportions of the diseased tissue. These proportions were visually estimated by experts using a standard grading system, in which grades correspond to intervals (label example: 1-5% of diseased tissue). The proposed architecture encodes the knowledge that the labels represent a volumetric proportion. A custom loss is designed to learn with intervals. Thus, during training, our network learns to segment the diseased tissue such that its proportions fit the ground truth intervals. Our architecture and loss combined improve the performance substantially (8% ICC) compared to a more conventional regression network. We outperform traditional lung densitometry and two recently published methods for emphysema quantification by a large margin (at least 7% AUC and 15% ICC), and achieve near-human-level performance. Moreover, our method generates emphysema segmentations that predict the spatial distribution of emphysema at human level.

Suppose one is faced with the challenge of tissue segmentation in MR images, without annotators at their center to provide labeled training data. One option is to go to another medical center for a trained classifier. Sadly, tissue classifiers do not generalize well across centers due to voxel intensity shifts caused by center-specific acquisition protocols. However, certain aspects of segmentations, such as spatial smoothness, remain relatively consistent and can be learned separately. Here we present a smoothness prior that is fit to segmentations produced at another medical center. This informative prior is presented to an unsupervised Bayesian model. The model clusters the voxel intensities, such that it produces segmentations that are similarly smooth to those of the other medical center. In addition, the unsupervised Bayesian model is extended to a semi-supervised variant, which needs no visual interpretation of clusters into tissues.

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