Evaluating Pre-trained Convolutional Neural Networks and Foundation Models as Feature Extractors for Content-based Medical Image Retrieval

Medical image retrieval refers to the task of finding similar images for given query images in a database, with applications such as diagnosis support, treatment planning, and educational tools for inexperienced medical practitioners. While traditional medical image retrieval was performed using clinical metadata, content-based medical image retrieval (CBMIR) relies on the characteristic features of the images, such as color, texture, shape, and spatial features. Many approaches have been proposed for CBMIR, and among them, using pre-trained convolutional neural networks (CNNs) is a widely utilized approach. However, considering the recent advances in the development of foundation models for various computer vision tasks, their application for CBMIR can be also investigated for its potentially superior performance. In this study, we used several pre-trained feature extractors from well-known pre-trained CNNs (VGG19, ResNet-50, DenseNet121, and EfficientNetV2M) and pre-trained foundation models (MedCLIP, BioMedCLIP, OpenCLIP, CONCH and UNI) and investigated the CBMIR performance on a subset of the MedMNIST V2 dataset, including eight types of 2D and 3D medical images. Furthermore, we also investigated the effect of image size on the CBMIR performance. Our results show that, overall, for the 2D datasets, foundation models deliver superior performance by a large margin compared to CNNs, with UNI providing the best overall performance across all datasets and image sizes. For 3D datasets, CNNs and foundation models deliver more competitive performance, with CONCH achieving the best overall performance. Moreover, our findings confirm that while using larger image sizes (especially for 2D datasets) yields slightly better performance, competitive CBMIR performance can still be achieved even with smaller image sizes. Our codes to generate and reproduce the results are available on GitHub.

WCEbleedGen: A wireless capsule endoscopy dataset and its benchmarking for automatic bleeding classification, detection, and segmentation

Computer-based analysis of Wireless Capsule Endoscopy (WCE) is crucial. However, a medically annotated WCE dataset for training and evaluation of automatic classification, detection, and segmentation of bleeding and non-bleeding frames is currently lacking. The present work focused on development of a medically annotated WCE dataset called WCEbleedGen for automatic classification, detection, and segmentation of bleeding and non-bleeding frames. It comprises 2,618 WCE bleeding and non-bleeding frames which were collected from various internet resources and existing WCE datasets. A comprehensive benchmarking and evaluation of the developed dataset was done using nine classification-based, three detection-based, and three segmentation-based deep learning models. The dataset is of high-quality, is class-balanced and contains single and multiple bleeding sites. Overall, our standard benchmark results show that Visual Geometric Group (VGG) 19, You Only Look Once version 8 nano (YOLOv8n), and Link network (Linknet) performed best in automatic classification, detection, and segmentation-based evaluations, respectively. Automatic bleeding diagnosis is crucial for WCE video interpretations. This diverse dataset will aid in developing of real-time, multi-task learning-based innovative solutions for automatic bleeding diagnosis in WCE. The dataset and code are publicly available at https://zenodo.org/records/10156571 and https://github.com/misahub2023/Benchmarking-Codes-of-the-WCEBleedGen-dataset.

Capsule Vision 2024 Challenge: Multi-Class Abnormality Classification for Video Capsule Endoscopy

We present the Capsule Vision 2024 Challenge: Multi-Class Abnormality Classification for Video Capsule Endoscopy. It is being virtually organized by the Research Center for Medical Image Analysis and Artificial Intelligence (MIAAI), Department of Medicine, Danube Private University, Krems, Austria and Medical Imaging and Signal Analysis Hub (MISAHUB) in collaboration with the 9th International Conference on Computer Vision & Image Processing (CVIP 2024) being organized by the Indian Institute of Information Technology, Design and Manufacturing (IIITDM) Kancheepuram, Chennai, India. This document describes the overview of the challenge, its registration and rules, submission format, and the description of the utilized datasets.

A Self-Supervised Image Registration Approach for Measuring Local Response Patterns in Metastatic Ovarian Cancer

High-grade serous ovarian carcinoma (HGSOC) is characterised by significant spatial and temporal heterogeneity, typically manifesting at an advanced metastatic stage. A major challenge in treating advanced HGSOC is effectively monitoring localised change in tumour burden across multiple sites during neoadjuvant chemotherapy (NACT) and predicting long-term pathological response and overall patient survival. In this work, we propose a self-supervised deformable image registration algorithm that utilises a general-purpose image encoder for image feature extraction to co-register contrast-enhanced computerised tomography scan images acquired before and after neoadjuvant chemotherapy. This approach addresses challenges posed by highly complex tumour deformations and longitudinal lesion matching during treatment. Localised tumour changes are calculated using the Jacobian determinant maps of the registration deformation at multiple disease sites and their macroscopic areas, including hypo-dense (i.e., cystic/necrotic), hyper-dense (i.e., calcified), and intermediate density (i.e., soft tissue) portions. A series of experiments is conducted to understand the role of a general-purpose image encoder and its application in quantifying change in tumour burden during neoadjuvant chemotherapy in HGSOC. This work is the first to demonstrate the feasibility of a self-supervised image registration approach in quantifying NACT-induced localised tumour changes across the whole disease burden of patients with complex multi-site HGSOC, which could be used as a potential marker for ovarian cancer patient's long-term pathological response and survival.

Breast Histopathology Image Retrieval by Attention-based Adversarially Regularized Variational Graph Autoencoder with Contrastive Learning-Based Feature Extraction

Breast cancer is a significant global health concern, particularly for women. Early detection and appropriate treatment are crucial in mitigating its impact, with histopathology examinations playing a vital role in swift diagnosis. However, these examinations often require a substantial workforce and experienced medical experts for proper recognition and cancer grading. Automated image retrieval systems have the potential to assist pathologists in identifying cancerous tissues, thereby accelerating the diagnostic process. Nevertheless, due to considerable variability among the tissue and cell patterns in histological images, proposing an accurate image retrieval model is very challenging. This work introduces a novel attention-based adversarially regularized variational graph autoencoder model for breast histological image retrieval. Additionally, we incorporated cluster-guided contrastive learning as the graph feature extractor to boost the retrieval performance. We evaluated the proposed model's performance on two publicly available datasets of breast cancer histological images and achieved superior or very competitive retrieval performance, with average mAP scores of 96.5% for the BreakHis dataset and 94.7% for the BACH dataset, and mVP scores of 91.9% and 91.3%, respectively. Our proposed retrieval model has the potential to be used in clinical settings to enhance diagnostic performance and ultimately benefit patients.

Improving Generalization Capability of Deep Learning-Based Nuclei Instance Segmentation by Non-deterministic Train Time and Deterministic Test Time Stain Normalization

With the advent of digital pathology and microscopic systems that can scan and save whole slide histological images automatically, there is a growing trend to use computerized methods to analyze acquired images. Among different histopathological image analysis tasks, nuclei instance segmentation plays a fundamental role in a wide range of clinical and research applications. While many semi- and fully-automatic computerized methods have been proposed for nuclei instance segmentation, deep learning (DL)-based approaches have been shown to deliver the best performances. However, the performance of such approaches usually degrades when tested on unseen datasets. In this work, we propose a novel approach to improve the generalization capability of a DL-based automatic segmentation approach. Besides utilizing one of the state-of-the-art DL-based models as a baseline, our method incorporates non-deterministic train time and deterministic test time stain normalization. We trained the model with one single training set and evaluated its segmentation performance on seven test datasets. Our results show that the proposed method provides up to 5.77%, 5.36%, and 5.27% better performance in segmenting nuclei based on Dice score, aggregated Jaccard index, and panoptic quality score, respectively, compared to the baseline segmentation model.

Breast MRI radiomics and machine learning radiomics-based predictions of response to neoadjuvant chemotherapy -- how are they affected by variations in tumour delineation?

Manual delineation of volumes of interest (VOIs) by experts is considered the gold-standard method in radiomics analysis. However, it suffers from inter- and intra-operator variability. A quantitative assessment of the impact of variations in these delineations on the performance of the radiomics predictors is required to develop robust radiomics based prediction models. In this study, we developed radiomics models for the prediction of pathological complete response to neoadjuvant chemotherapy in patients with two different breast cancer subtypes based on contrast-enhanced magnetic resonance imaging acquired prior to treatment (baseline MRI scans). Different mathematical operations such as erosion, smoothing, dilation, randomization, and ellipse fitting were applied to the original VOIs delineated by experts to simulate variations of segmentation masks. The effects of such VOI modifications on various steps of the radiomics workflow, including feature extraction, feature selection, and prediction performance, were evaluated. Using manual tumor VOIs and radiomics features extracted from baseline MRI scans, an AUC of up to 0.96 and 0.89 was achieved for human epidermal growth receptor 2 positive and triple-negative breast cancer, respectively. For smoothing and erosion, VOIs yielded the highest number of robust features and the best prediction performance, while ellipse fitting and dilation lead to the lowest robustness and prediction performance for both breast cancer subtypes. At most 28% of the selected features were similar to manual VOIs when different VOI delineation data were used. Differences in VOI delineation affects different steps of radiomics analysis, and their quantification is therefore important for development of standardized radiomics research.

NuInsSeg: A Fully Annotated Dataset for Nuclei Instance Segmentation in H&E-Stained Histological Images

In computational pathology, automatic nuclei instance segmentation plays an essential role in whole slide image analysis. While many computerized approaches have been proposed for this task, supervised deep learning (DL) methods have shown superior segmentation performances compared to classical machine learning and image processing techniques. However, these models need fully annotated datasets for training which is challenging to acquire, especially in the medical domain. In this work, we release one of the biggest fully manually annotated datasets of nuclei in Hematoxylin and Eosin (H&E)-stained histological images, called NuInsSeg. This dataset contains 665 image patches with more than 30,000 manually segmented nuclei from 31 human and mouse organs. Moreover, for the first time, we provide additional ambiguous area masks for the entire dataset. These vague areas represent the parts of the images where precise and deterministic manual annotations are impossible, even for human experts. The dataset and detailed step-by-step instructions to generate related segmentation masks are publicly available at https://www.kaggle.com/datasets/ipateam/nuinsseg and https://github.com/masih4/NuInsSeg, respectively.

Calibrating Ensembles for Scalable Uncertainty Quantification in Deep Learning-based Medical Segmentation

Uncertainty quantification in automated image analysis is highly desired in many applications. Typically, machine learning models in classification or segmentation are only developed to provide binary answers; however, quantifying the uncertainty of the models can play a critical role for example in active learning or machine human interaction. Uncertainty quantification is especially difficult when using deep learning-based models, which are the state-of-the-art in many imaging applications. The current uncertainty quantification approaches do not scale well in high-dimensional real-world problems. Scalable solutions often rely on classical techniques, such as dropout, during inference or training ensembles of identical models with different random seeds to obtain a posterior distribution. In this paper, we show that these approaches fail to approximate the classification probability. On the contrary, we propose a scalable and intuitive framework to calibrate ensembles of deep learning models to produce uncertainty quantification measurements that approximate the classification probability. On unseen test data, we demonstrate improved calibration, sensitivity (in two out of three cases) and precision when being compared with the standard approaches. We further motivate the usage of our method in active learning, creating pseudo-labels to learn from unlabeled images and human-machine collaboration.

3D deformable registration of longitudinal abdominopelvic CT images using unsupervised deep learning

This study investigates the use of the unsupervised deep learning framework VoxelMorph for deformable registration of longitudinal abdominopelvic CT images acquired in patients with bone metastases from breast cancer. The CT images were refined prior to registration by automatically removing the CT table and all other extra-corporeal components. To improve the learning capabilities of VoxelMorph when only a limited amount of training data is available, a novel incremental training strategy is proposed based on simulated deformations of consecutive CT images. In a 4-fold cross-validation scheme, the incremental training strategy achieved significantly better registration performance compared to training on a single volume. Although our deformable image registration method did not outperform iterative registration using NiftyReg (considered as a benchmark) in terms of registration quality, the registrations were approximately 300 times faster. This study showed the feasibility of deep learning based deformable registration of longitudinal abdominopelvic CT images via a novel incremental training strategy based on simulated deformations.