Reducing Overtreatment of Indeterminate Thyroid Nodules Using a Multimodal Deep Learning Model

Objective: Molecular testing (MT) classifies cytologically indeterminate thyroid nodules as benign or malignant with high sensitivity but low positive predictive value (PPV), only using molecular profiles, ignoring ultrasound (US) imaging and biopsy. We address this limitation by applying attention multiple instance learning (AMIL) to US images. Methods: We retrospectively reviewed 333 patients with indeterminate thyroid nodules at UCLA medical center (259 benign, 74 malignant). A multi-modal deep learning AMIL model was developed, combining US images and MT to classify the nodules as benign or malignant and enhance the malignancy risk stratification of MT. Results: The final AMIL model matched MT sensitivity (0.946) while significantly improving PPV (0.477 vs 0.448 for MT alone), indicating fewer false positives while maintaining high sensitivity. Conclusion: Our approach reduces false positives compared to MT while maintaining the same ability to identify positive cases, potentially reducing unnecessary benign thyroid resections in patients with indeterminate nodules.

Ultrasound Image Enhancement using CycleGAN and Perceptual Loss

Purpose: The objective of this work is to introduce an advanced framework designed to enhance ultrasound images, especially those captured by portable hand-held devices, which often produce lower quality images due to hardware constraints. Additionally, this framework is uniquely capable of effectively handling non-registered input ultrasound image pairs, addressing a common challenge in medical imaging. Materials and Methods: In this retrospective study, we utilized an enhanced generative adversarial network (CycleGAN) model for ultrasound image enhancement across five organ systems. Perceptual loss, derived from deep features of pretrained neural networks, is applied to ensure the human-perceptual quality of the enhanced images. These images are compared with paired images acquired from high resolution devices to demonstrate the model's ability to generate realistic high-quality images across organ systems. Results: Preliminary validation of the framework reveals promising performance metrics. The model generates images that result in a Structural Similarity Index (SSI) score of 0.722, Locally Normalized Cross-Correlation (LNCC) score of 0.902 and 28.802 for the Peak Signal-to-Noise Ratio (PSNR) metric. Conclusion: This work presents a significant advancement in medical imaging through the development of a CycleGAN model enhanced with Perceptual Loss (PL), effectively bridging the quality gap between ultrasound images from varied devices. By training on paired images, the model not only improves image quality but also ensures the preservation of vital anatomic structural content. This approach may improve equity in access to healthcare by enhancing portable device capabilities, although further validation and optimizations are necessary for broader clinical application.

Making Thermal Imaging More Equitable and Accurate: Resolving Solar Loading Biases

Thermal cameras and thermal point detectors are used to measure the temperature of human skin. These are important devices that are used everyday in clinical and mass screening settings, particularly in an epidemic. Unfortunately, despite the wide use of thermal sensors, the temperature estimates from thermal sensors do not work well in uncontrolled scene conditions. Previous work has studied the effect of wind and other environment factors on skin temperature, but has not considered the heating effect from sunlight, which is termed solar loading. Existing device manufacturers recommend that a subject who has been outdoors in sun re-acclimate to an indoor environment after a waiting period. The waiting period, up to 30 minutes, is insufficient for a rapid screening tool. Moreover, the error bias from solar loading is greater for darker skin tones since melanin absorbs solar radiation. This paper explores two approaches to address this problem. The first approach uses transient behavior of cooling to more quickly extrapolate the steady state temperature. A second approach explores the spatial modulation of solar loading, to propose single-shot correction with a wide-field thermal camera. A real world dataset comprising of thermal point, thermal image, subjective, and objective measurements of melanin is collected with statistical significance for the effect size observed. The single-shot correction scheme is shown to eliminate solar loading bias in the time of a typical frame exposure (33ms).

MIME: Minority Inclusion for Majority Group Enhancement of AI Performance

Several papers have rightly included minority groups in artificial intelligence (AI) training data to improve test inference for minority groups and/or society-at-large. A society-at-large consists of both minority and majority stakeholders. A common misconception is that minority inclusion does not increase performance for majority groups alone. In this paper, we make the surprising finding that including minority samples can improve test error for the majority group. In other words, minority group inclusion leads to majority group enhancements (MIME) in performance. A theoretical existence proof of the MIME effect is presented and found to be consistent with experimental results on six different datasets. Project webpage: https://visual.ee.ucla.edu/mime.htm/