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Debora Gil; Antonio Esteban Lansaque; Sebastian Stefaniga; Mihail Gaianu; Carles Sanchez |
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Title |
Data Augmentation from Sketch |
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Conference Article |
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2019 |
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International Workshop on Uncertainty for Safe Utilization of Machine Learning in Medical Imaging |
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11840 |
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155-162 |
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Data augmentation; cycleGANs; Multi-objective optimization |
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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. |
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Shenzhen; China; October 2019 |
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IAM; 600.145; 601.337; 600.139; 600.145 |
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Admin @ si @ GES2019 |
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3359 |
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Debora Gil; Carles Sanchez; Agnes Borras; Marta Diez-Ferrer; Antoni Rosell |
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Title |
Segmentation of Distal Airways using Structural Analysis |
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2019 |
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PloS one |
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Plos |
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14 |
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12 |
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Segmentation of airways in Computed Tomography (CT) scans is a must for accurate support of diagnosis and intervention of many pulmonary disorders. In particular, lung cancer diagnosis would benefit from segmentations reaching most distal airways. We present a method that combines descriptors of bronchi local appearance and graph global structural analysis to fine-tune thresholds on the descriptors adapted for each bronchial level. We have compared our method to the top performers of the EXACT09 challenge and to a commercial software for biopsy planning evaluated in an own-collected data-base of high resolution CT scans acquired under different breathing conditions. Results on EXACT09 data show that our method provides a high leakage reduction with minimum loss in airway detection. Results on our data-base show the reliability across varying breathing conditions and a competitive performance for biopsy planning compared to a commercial solution. |
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IAM; 600.139; 600.145 |
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Admin @ si @ GSB2019 |
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3357 |
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Debora Gil; Ruth Aris; Agnes Borras; Esmitt Ramirez; Rafael Sebastian; Mariano Vazquez |
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Influence of fiber connectivity in simulations of cardiac biomechanics |
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2019 |
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International Journal of Computer Assisted Radiology and Surgery |
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IJCAR |
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14 |
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1 |
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63–72 |
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Cardiac electromechanical simulations; Diffusion tensor imaging; Fiber connectivity |
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PURPOSE:
Personalized computational simulations of the heart could open up new improved approaches to diagnosis and surgery assistance systems. While it is fully recognized that myocardial fiber orientation is central for the construction of realistic computational models of cardiac electromechanics, the role of its overall architecture and connectivity remains unclear. Morphological studies show that the distribution of cardiac muscular fibers at the basal ring connects epicardium and endocardium. However, computational models simplify their distribution and disregard the basal loop. This work explores the influence in computational simulations of fiber distribution at different short-axis cuts.
METHODS:
We have used a highly parallelized computational solver to test different fiber models of ventricular muscular connectivity. We have considered two rule-based mathematical models and an own-designed method preserving basal connectivity as observed in experimental data. Simulated cardiac functional scores (rotation, torsion and longitudinal shortening) were compared to experimental healthy ranges using generalized models (rotation) and Mahalanobis distances (shortening, torsion).
RESULTS:
The probability of rotation was significantly lower for ruled-based models [95% CI (0.13, 0.20)] in comparison with experimental data [95% CI (0.23, 0.31)]. The Mahalanobis distance for experimental data was in the edge of the region enclosing 99% of the healthy population.
CONCLUSIONS:
Cardiac electromechanical simulations of the heart with fibers extracted from experimental data produce functional scores closer to healthy ranges than rule-based models disregarding architecture connectivity. |
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IAM; 600.096; 601.323; 600.139; 600.145 |
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Admin @ si @ GAB2019a |
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3133 |
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Esmitt Ramirez; Carles Sanchez; Debora Gil |
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Title |
Localizing Pulmonary Lesions Using Fuzzy Deep Learning |
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2019 |
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21st International Symposium on Symbolic and Numeric Algorithms for Scientific Computing |
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290-294 |
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The usage of medical images is part of the clinical daily in several healthcare centers around the world. Particularly, Computer Tomography (CT) images are an important key in the early detection of suspicious lung lesions. The CT image exploration allows the detection of lung lesions before any invasive procedure (e.g. bronchoscopy, biopsy). The effective localization of lesions is performed using different image processing and computer vision techniques. Lately, the usage of deep learning models into medical imaging from detection to prediction shown that is a powerful tool for Computer-aided software. In this paper, we present an approach to localize pulmonary lung lesion using fuzzy deep learning. Our approach uses a simple convolutional neural network based using the LIDC-IDRI dataset. Each image is divided into patches associated a probability vector (fuzzy) according their belonging to anatomical structures on a CT. We showcase our approach as part of a full CAD system to exploration, planning, guiding and detection of pulmonary lesions. |
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Timisoara; Rumania; September 2019 |
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SYNASC |
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IAM; 600.145; 600.140; 601.337; 601.323 |
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Admin @ si @ RSG2019 |
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3531 |
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Marta Diez-Ferrer; Arturo Morales; Rosa Lopez Lisbona; Noelia Cubero; Cristian Tebe; Susana Padrones; Samantha Aso; Jordi Dorca; Debora Gil; Antoni Rosell |
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Ultrathin Bronchoscopy with and without Virtual Bronchoscopic Navigation: Influence of Segmentation on Diagnostic Yield |
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2019 |
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Respiration |
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97 |
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3 |
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252-258 |
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Lung cancer; Peripheral lung lesion; Diagnosis; Bronchoscopy; Ultrathin bronchoscopy; Virtual bronchoscopic navigation |
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Background: Bronchoscopy is a safe technique for diagnosing peripheral pulmonary lesions (PPLs), and virtual bronchoscopic navigation (VBN) helps guide the bronchoscope to PPLs. Objectives: We aimed to compare the diagnostic yield of VBN-guided and unguided ultrathin bronchoscopy (UTB) and explore clinical and technical factors associated with better results. We developed a diagnostic algorithm for deciding whether to use VBN to reach PPLs or choose an alternative diagnostic approach. Methods: We compared diagnostic yield between VBN-UTB (prospective cases) and unguided UTB (historical controls) and analyzed the VBN-UTB subgroup to identify clinical and technical variables that could predict the success of VBN-UTB. Results: Fifty-five cases and 110 controls were included. The overall diagnostic yield did not differ between the VBN-guided and unguided arms (47 and 40%, respectively; p = 0.354). Although the yield was slightly higher for PPLs ≤20 mm in the VBN-UTB arm, the difference was not significant (p = 0.069). No other clinical characteristics were associated with a higher yield in a subgroup analysis, but an 85% diagnostic yield was observed when segmentation was optimal and the PPL was endobronchial (vs. 30% when segmentation was suboptimal and 20% when segmentation was optimal but the PPL was extrabronchial). Conclusions: VBN-guided UTB is not superior to unguided UTB. A greater impact of VBN-guided over unguided UTB is highly dependent on both segmentation quality and an endobronchial location of the PPL. Segmentation quality should be considered before starting a procedure, when an alternative technique that may improve yield can be chosen, saving time and resources. |
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IAM; 600.145; 600.139 |
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Admin @ si @ DML2019 |
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3134 |
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Marta Ligero; Guillermo Torres; Carles Sanchez; Katerine Diaz; Raquel Perez; Debora Gil |
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Selection of Radiomics Features based on their Reproducibility |
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Conference Article |
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2019 |
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41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society |
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403-408 |
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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. |
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Berlin; Alemanya; July 2019 |
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EMBC |
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IAM; 600.139; 600.145 |
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Admin @ si @ LTS2019 |
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3358 |
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Carles Sanchez; Miguel Viñas; Coen Antens; Agnes Borras; Debora Gil |
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Back to Front Architecture for Diagnosis as a Service |
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2018 |
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20th International Symposium on Symbolic and Numeric Algorithms for Scientific Computing |
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343-346 |
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Software as a Service (SaaS) is a cloud computing model in which a provider hosts applications in a server that customers use via internet. Since SaaS does not require to install applications on customers' own computers, it allows the use by multiple users of highly specialized software without extra expenses for hardware acquisition or licensing. A SaaS tailored for clinical needs not only would alleviate licensing costs, but also would facilitate easy access to new methods for diagnosis assistance. This paper presents a SaaS client-server architecture for Diagnosis as a Service (DaaS). The server is based on docker technology in order to allow execution of softwares implemented in different languages with the highest portability and scalability. The client is a content management system allowing the design of websites with multimedia content and interactive visualization of results allowing user editing. We explain a usage case that uses our DaaS as crowdsourcing platform in a multicentric pilot study carried out to evaluate the clinical benefits of a software for assessment of central airway obstruction. |
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Timisoara; Rumania; September 2018 |
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IAM; 600.145 |
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Admin @ si @ SVA2018 |
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3360 |
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Debora Gil; Rosa Maria Ortiz; Carles Sanchez; Antoni Rosell |
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Objective endoscopic measurements of central airway stenosis. A pilot study |
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2018 |
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95 |
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63–69 |
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Bronchoscopy; Tracheal stenosis; Airway stenosis; Computer-assisted analysis |
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Endoscopic estimation of the degree of stenosis in central airway obstruction is subjective and highly variable. Objective: To determine the benefits of using SENSA (System for Endoscopic Stenosis Assessment), an image-based computational software, for obtaining objective stenosis index (SI) measurements among a group of expert bronchoscopists and general pulmonologists. Methods: A total of 7 expert bronchoscopists and 7 general pulmonologists were enrolled to validate SENSA usage. The SI obtained by the physicians and by SENSA were compared with a reference SI to set their precision in SI computation. We used SENSA to efficiently obtain this reference SI in 11 selected cases of benign stenosis. A Web platform with three user-friendly microtasks was designed to gather the data. The users had to visually estimate the SI from videos with and without contours of the normal and the obstructed area provided by SENSA. The users were able to modify the SENSA contours to define the reference SI using morphometric bronchoscopy. Results: Visual SI estimation accuracy was associated with neither bronchoscopic experience (p = 0.71) nor the contours of the normal and the obstructed area provided by the system (p = 0.13). The precision of the SI by SENSA was 97.7% (95% CI: 92.4-103.7), which is significantly better than the precision of the SI by visual estimation (p < 0.001), with an improvement by at least 15%. Conclusion: SENSA provides objective SI measurements with a precision of up to 99.5%, which can be calculated from any bronchoscope using an affordable scalable interface. Providing normal and obstructed contours on bronchoscopic videos does not improve physicians' visual estimation of the SI. |
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IAM; 600.075; 600.096; 600.145 |
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Admin @ si @ GOS2018 |
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3043 |
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Esmitt Ramirez; Carles Sanchez; Agnes Borras; Marta Diez-Ferrer; Antoni Rosell; Debora Gil |
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BronchoX: bronchoscopy exploration software for biopsy intervention planning |
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2018 |
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Healthcare Technology Letters |
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HTL |
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5 |
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5 |
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177–182 |
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Virtual bronchoscopy (VB) is a non-invasive exploration tool for intervention planning and navigation of possible pulmonary lesions (PLs). A VB software involves the location of a PL and the calculation of a route, starting from the trachea, to reach it. The selection of a VB software might be a complex process, and there is no consensus in the community of medical software developers in which is the best-suited system to use or framework to choose. The authors present Bronchoscopy Exploration (BronchoX), a VB software to plan biopsy interventions that generate physician-readable instructions to reach the PLs. The authors’ solution is open source, multiplatform, and extensible for future functionalities, designed by their multidisciplinary research and development group. BronchoX is a compound of different algorithms for segmentation, visualisation, and navigation of the respiratory tract. Performed results are a focus on the test the effectiveness of their proposal as an exploration software, also to measure its accuracy as a guiding system to reach PLs. Then, 40 different virtual planning paths were created to guide physicians until distal bronchioles. These results provide a functional software for BronchoX and demonstrate how following simple instructions is possible to reach distal lesions from the trachea. |
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IAM; 600.096; 600.075; 601.323; 601.337; 600.145 |
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Admin @ si @ RSB2018a |
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Esmitt Ramirez; Carles Sanchez; Agnes Borras; Marta Diez-Ferrer; Antoni Rosell; Debora Gil |
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Image-Based Bronchial Anatomy Codification for Biopsy Guiding in Video Bronchoscopy |
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2018 |
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OR 2.0 Context-Aware Operating Theaters, Computer Assisted Robotic Endoscopy, Clinical Image-Based Procedures, and Skin Image Analysis |
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11041 |
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Biopsy guiding; Bronchoscopy; Lung biopsy; Intervention guiding; Airway codification |
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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. |
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Granada; September 2018 |
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MICCAIW |
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IAM; 600.096; 600.075; 601.323; 600.145 |
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Admin @ si @ RSB2018b |
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3137 |
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