TopoTxR: A topology-guided deep convolutional network for breast parenchyma learning on DCE-MRIs

Characterization of breast parenchyma in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is a challenging task owing to the complexity of underlying tissue structures. Existing quantitative approaches, like radiomics and deep learning models, lack explicit quantification of intricate and subtle parenchymal structures, including fibroglandular tissue. To address this, we propose a novel topological approach that explicitly extracts multi-scale topological structures to better approximate breast parenchymal structures, and then incorporates these structures into a deep-learning-based prediction model via an attention mechanism. Our topology-informed deep learning model, \emph{TopoTxR}, leverages topology to provide enhanced insights into tissues critical for disease pathophysiology and treatment response. We empirically validate \emph{TopoTxR} using the VICTRE phantom breast dataset, showing that the topological structures extracted by our model effectively approximate the breast parenchymal structures. We further demonstrate \emph{TopoTxR}'s efficacy in predicting response to neoadjuvant chemotherapy. Our qualitative and quantitative analyses suggest differential topological behavior of breast tissue in treatment-na\"ive imaging, in patients who respond favorably to therapy as achieving pathological complete response (pCR) versus those who do not. In a comparative analysis with several baselines on the publicly available I-SPY 1 dataset (N=161, including 47 patients with pCR and 114 without) and the Rutgers proprietary dataset (N=120, with 69 patients achieving pCR and 51 not), \emph{TopoTxR} demonstrates a notable improvement, achieving a 2.6\% increase in accuracy and a 4.6\% enhancement in AUC compared to the state-of-the-art method.

Attention based CNN-LSTM Network for Pulmonary Embolism Prediction on Chest Computed Tomography Pulmonary Angiograms

With more than 60,000 deaths annually in the United States, Pulmonary Embolism (PE) is among the most fatal cardiovascular diseases. It is caused by an artery blockage in the lung; confirming its presence is time-consuming and is prone to over-diagnosis. The utilization of automated PE detection systems is critical for diagnostic accuracy and efficiency. In this study we propose a two-stage attention-based CNN-LSTM network for predicting PE, its associated type (chronic, acute) and corresponding location (leftsided, rightsided or central) on computed tomography (CT) examinations. We trained our model on the largest available public Computed Tomography Pulmonary Angiogram PE dataset (RSNA-STR Pulmonary Embolism CT (RSPECT) Dataset, N=7279 CT studies) and tested it on an in-house curated dataset of N=106 studies. Our framework mirrors the radiologic diagnostic process via a multi-slice approach so that the accuracy and pathologic sequela of true pulmonary emboli may be meticulously assessed, enabling physicians to better appraise the morbidity of a PE when present. Our proposed method outperformed a baseline CNN classifier and a single-stage CNN-LSTM network, achieving an AUC of 0.95 on the test set for detecting the presence of PE in the study.