Leveraging Self-Supervised Learning for Fetal Cardiac Planes Classification using Ultrasound Scan Videos

Self-supervised learning (SSL) methods are popular since they can address situations with limited annotated data by directly utilising the underlying data distribution. However, the adoption of such methods is not explored enough in ultrasound (US) imaging, especially for fetal assessment. We investigate the potential of dual-encoder SSL in utilizing unlabelled US video data to improve the performance of challenging downstream Standard Fetal Cardiac Planes (SFCP) classification using limited labelled 2D US images. We study 7 SSL approaches based on reconstruction, contrastive loss, distillation, and information theory and evaluate them extensively on a large private US dataset. Our observations and findings are consolidated from more than 500 downstream training experiments under different settings. Our primary observation shows that for SSL training, the variance of the dataset is more crucial than its size because it allows the model to learn generalisable representations, which improve the performance of downstream tasks. Overall, the BarlowTwins method shows robust performance, irrespective of the training settings and data variations, when used as an initialisation for downstream tasks. Notably, full fine-tuning with 1% of labelled data outperforms ImageNet initialisation by 12% in F1-score and outperforms other SSL initialisations by at least 4% in F1-score, thus making it a promising candidate for transfer learning from US video to image data.

SurvRNC: Learning Ordered Representations for Survival Prediction using Rank-N-Contrast

Predicting the likelihood of survival is of paramount importance for individuals diagnosed with cancer as it provides invaluable information regarding prognosis at an early stage. This knowledge enables the formulation of effective treatment plans that lead to improved patient outcomes. In the past few years, deep learning models have provided a feasible solution for assessing medical images, electronic health records, and genomic data to estimate cancer risk scores. However, these models often fall short of their potential because they struggle to learn regression-aware feature representations. In this study, we propose Survival Rank-N Contrast (SurvRNC) method, which introduces a loss function as a regularizer to obtain an ordered representation based on the survival times. This function can handle censored data and can be incorporated into any survival model to ensure that the learned representation is ordinal. The model was extensively evaluated on a HEad \& NeCK TumOR (HECKTOR) segmentation and the outcome-prediction task dataset. We demonstrate that using the SurvRNC method for training can achieve higher performance on different deep survival models. Additionally, it outperforms state-of-the-art methods by 3.6% on the concordance index. The code is publicly available on https://github.com/numanai/SurvRNC

FUSC: Fetal Ultrasound Semantic Clustering of Second Trimester Scans Using Deep Self-supervised Learning

Ultrasound is the primary imaging modality in clinical practice during pregnancy. More than 140M fetuses are born yearly, resulting in numerous scans. The availability of a large volume of fetal ultrasound scans presents the opportunity to train robust machine learning models. However, the abundance of scans also has its challenges, as manual labeling of each image is needed for supervised methods. Labeling is typically labor-intensive and requires expertise to annotate the images accurately. This study presents an unsupervised approach for automatically clustering ultrasound images into a large range of fetal views, reducing or eliminating the need for manual labeling. Our Fetal Ultrasound Semantic Clustering (FUSC) method is developed using a large dataset of 88,063 images and further evaluated on an additional unseen dataset of 8,187 images achieving over 92% clustering purity. The result of our investigation hold the potential to significantly impact the field of fetal ultrasound imaging and pave the way for more advanced automated labeling solutions. Finally, we make the code and the experimental setup publicly available to help advance the field.

MGMT promoter methylation status prediction using MRI scans? An extensive experimental evaluation of deep learning models

The number of studies on deep learning for medical diagnosis is expanding, and these systems are often claimed to outperform clinicians. However, only a few systems have shown medical efficacy. From this perspective, we examine a wide range of deep learning algorithms for the assessment of glioblastoma - a common brain tumor in older adults that is lethal. Surgery, chemotherapy, and radiation are the standard treatments for glioblastoma patients. The methylation status of the MGMT promoter, a specific genetic sequence found in the tumor, affects chemotherapy's effectiveness. MGMT promoter methylation improves chemotherapy response and survival in several cancers. MGMT promoter methylation is determined by a tumor tissue biopsy, which is then genetically tested. This lengthy and invasive procedure increases the risk of infection and other complications. Thus, researchers have used deep learning models to examine the tumor from brain MRI scans to determine the MGMT promoter's methylation state. We employ deep learning models and one of the largest public MRI datasets of 585 participants to predict the methylation status of the MGMT promoter in glioblastoma tumors using MRI scans. We test these models using Grad-CAM, occlusion sensitivity, feature visualizations, and training loss landscapes. Our results show no correlation between these two, indicating that external cohort data should be used to verify these models' performance to assure the accuracy and reliability of deep learning systems in cancer diagnosis.

Weakly Unsupervised Domain Adaptation for Vestibular Schwannoma Segmentation

Vestibular schwannoma (VS) is a non-cancerous tumor located next to the ear that can cause hearing loss. Most brain MRI images acquired from patients are contrast-enhanced T1 (ceT1), with a growing interest in high-resolution T2 images (hrT2) to replace ceT1, which involves the use of a contrast agent. As hrT2 images are currently scarce, it is less likely to train robust machine learning models to segment VS or other brain structures. In this work, we propose a weakly supervised machine learning approach that learns from only ceT1 scans and adapts to segment two structures from hrT2 scans: the VS and the cochlea from the crossMoDA dataset. Our model 1) generates fake hrT2 scans from ceT1 images and segmentation masks, 2) is trained using the fake hrT2 scans, 3) predicts the augmented real hrT2 scans, and 4) is retrained again using both the fake and real hrT2. The final result of this model has been computed on an unseen testing dataset provided by the 2022 crossMoDA challenge organizers. The mean dice score and average symmetric surface distance (ASSD) are 0.78 and 0.46, respectively. The predicted segmentation masks achieved a dice score of 0.83 and an ASSD of 0.56 on the VS, and a dice score of 0.74 and an ASSD of 0.35 on the cochleas.

Automatic Segmentation of Head and Neck Tumor: How Powerful Transformers Are?

Cancer is one of the leading causes of death worldwide, and head and neck (H&N) cancer is amongst the most prevalent types. Positron emission tomography and computed tomography are used to detect and segment the tumor region. Clinically, tumor segmentation is extensively time-consuming and prone to error. Machine learning, and deep learning in particular, can assist to automate this process, yielding results as accurate as the results of a clinician. In this research study, we develop a vision transformers-based method to automatically delineate H&N tumor, and compare its results to leading convolutional neural network (CNN)-based models. We use multi-modal data of CT and PET scans to do this task. We show that the selected transformer-based model can achieve results on a par with CNN-based ones. With cross validation, the model achieves a mean dice similarity coefficient of 0.736, mean precision of 0.766 and mean recall of 0.766. This is only 0.021 less than the 2020 competition winning model in terms of the DSC score. This indicates that the exploration of transformer-based models is a promising research area.