Abstract: State of the art machine learning methods need huge amounts of data with unambiguous annotations for their training. In the context of medical imaging this is, in general, a very difficult task due to limited access to clinical data, the time required for manual annotations and variability across experts. Simulated data could serve for data augmentation provided that its appearance was comparable to the actual appearance of intra-operative acquisitions. Generative Adversarial Networks (GANs) are a powerful tool for artistic style transfer, but lack a criteria for selecting epochs ensuring also preservation of intra-operative content.
We propose a multi-objective optimization strategy for a selection of cycleGAN epochs ensuring a mapping between virtual images and the intra-operative domain preserving anatomical content. Our approach has been applied to simulate intra-operative bronchoscopic videos and chest CT scans from virtual sketches generated using simple graphical primitives.

Abstract: Dimensionality reduction is key to alleviate machine learning artifacts in clinical applications with Small Sample Size (SSS) unbalanced datasets. Existing methods rely on either the probabilistic distribution of training data or the discriminant power of the reduced space, disregarding the impact of repeatability and uncertainty in features.In the present study is proposed the use of reproducibility of radiomics features to select features with high inter-class correlation coefficient (ICC). The reproducibility includes the variability introduced in the image acquisition, like medical scans acquisition parameters and convolution kernels, that affects intensity-based features and tumor annotations made by physicians, that influences morphological descriptors of the lesion.For the reproducibility of radiomics features three studies were conducted on cases collected at Vall Hebron Oncology Institute (VHIO) on responders to oncology treatment. The studies focused on the variability due to the convolution kernel, image acquisition parameters, and the inter-observer lesion identification. The features selected were those features with a ICC higher than 0.7 in the three studies.The selected features based on reproducibility were evaluated for lesion malignancy classification using a different database. Results show better performance compared to several state-of-the-art methods including Principal Component Analysis (PCA), Kernel Discriminant Analysis via QR decomposition (KDAQR), LASSO, and an own built Convolutional Neural Network.

Abstract: Bronchoscopy examinations allow biopsy of pulmonary nodules with minimum risk for the patient. Even for experienced bronchoscopists, it is difficult to guide the bronchoscope to most distal lesions and obtain an accurate diagnosis. This paper presents an image-based codification of the bronchial anatomy for bronchoscopy biopsy guiding. The 3D anatomy of each patient is codified as a binary tree with nodes representing bronchial levels and edges labeled using their position on images projecting the 3D anatomy from a set of branching points. The paths from the root to leaves provide a codification of navigation routes with spatially consistent labels according to the anatomy observes in video bronchoscopy explorations. We evaluate our labeling approach as a guiding system in terms of the number of bronchial levels correctly codified, also in the number of labels-based instructions correctly supplied, using generalized mixed models and computer-generated data. Results obtained for three independent observers prove the consistency and reproducibility of our guiding system. We trust that our codification based on viewer’s projection might be used as a foundation for the navigation process in Virtual Bronchoscopy systems.

Abstract: Confocal Laser Endomicroscopy (CLE) is an emerging imaging technique that allows the in-vivo acquisition of cell patterns of potentially malignant lesions. Such patterns could discriminate between inflammatory and neoplastic lesions and, thus, serve as a first in-vivo biopsy to discard cases that do not actually require a cell biopsy.
The goal of this work is to explore whether CLE images obtained during videobronchoscopy contain enough visual information to discriminate between benign and malign peripheral lesions for lung cancer diagnosis. To do so, we have performed a pilot comparative study with 12 patients (6 adenocarcinoma and 6 benign-inflammatory) using 2 different methods for CLE pattern analysis: visual analysis by 3 experts and a novel methodology that uses graph methods to find patterns in pre-trained feature spaces. Our preliminary results indicate that although visual analysis can only achieve a 60.2% of accuracy, the accuracy of the proposed unsupervised image pattern classification raises to 84.6%.
We conclude that CLE images visual information allow in-vivo detection of neoplastic lesions and graph structural analysis applied to deep-learning feature spaces can achieve competitive results.

Abstract: Bronchoscopy allows to examine the patient airways for detection of lesions and sampling of tissues without surgery. A main drawback in lung cancer diagnosis is the diculty to check whether the exploration is following the correct path to the nodule that has to be biopsied. The most extended guidance uses uoroscopy which implies repeated radiation of clinical sta and patients. Alternatives such as virtual bronchoscopy or electromagnetic navigation are very expensive and not completely robust to blood, mocus or deformations as to be extensively used. We propose a method that extracts and tracks stable lumen regions at dierent levels of the bronchial tree. The tracked regions are stored in a tree that encodes the anatomical structure of the scene which can be useful to retrieve the path to the lesion that the clinician should follow to do the biopsy. We present a multi-expert validation of our anatomical landmark extraction in 3 intra-operative ultrathin explorations.