Pierre Decazes

Zacharia Mesbah, Léo Mottay, Romain Modzelewski et al.

For the last three years, the AutoPET competition gathered the medical imaging community around a hot topic: lesion segmentation on Positron Emitting Tomography (PET) scans. Each year a different aspect of the problem is presented; in 2024 the multiplicity of existing and used tracers was at the core of the challenge. Specifically, this year's edition aims to develop a fully automatic algorithm capable of performing lesion segmentation on a PET/CT scan, without knowing the tracer, which can either be a FDG or PSMA-based tracer. In this paper we describe how we used the nnUNetv2 framework to train two sets of 6 fold ensembles of models to perform fully automatic PET/CT lesion segmentation as well as a MIP-CNN to choose which set of models to use for segmentation.

Ling Huang, Su Ruan, Pierre Decazes et al.

Single-modality medical images generally do not contain enough information to reach an accurate and reliable diagnosis. For this reason, physicians generally diagnose diseases based on multimodal medical images such as, e.g., PET/CT. The effective fusion of multimodal information is essential to reach a reliable decision and explain how the decision is made as well. In this paper, we propose a fusion framework for multimodal medical image segmentation based on deep learning and the Dempster-Shafer theory of evidence. In this framework, the reliability of each single modality image when segmenting different objects is taken into account by a contextual discounting operation. The discounted pieces of evidence from each modality are then combined by Dempster's rule to reach a final decision. Experimental results with a PET-CT dataset with lymphomas and a multi-MRI dataset with brain tumors show that our method outperforms the state-of-the-art methods in accuracy and reliability.

Numan Saeed, Salma Hassan, Shahad Hardan et al.

We present a publicly available multimodal dataset for head and neck cancer research, comprising 1123 annotated Positron Emission Tomography/Computed Tomography (PET/CT) studies from patients with histologically confirmed disease, acquired from 10 international medical centers. All studies contain co-registered PET/CT scans with varying acquisition protocols, reflecting real-world clinical diversity from a long-term, multi-institution retrospective collection. Primary gross tumor volumes (GTVp) and involved lymph nodes (GTVn) were manually segmented by experienced radiation oncologists and radiologists following established guidelines. We provide anonymized NifTi files, expert-annotated segmentation masks, comprehensive clinical metadata, and radiotherapy dose distributions for a patient subset. The metadata include TNM staging, HPV status, demographics, long-term follow-up outcomes, survival times, censoring indicators, and treatment information. To demonstrate its utility, we benchmark three key clinical tasks: automated tumor segmentation, recurrence-free survival prediction, and HPV status classification, using state-of-the-art deep learning models like UNet, SegResNet, and multimodal prognostic frameworks.

Ling Huang, Su Ruan, Pierre Decazes et al.

An automatic evidential segmentation method based on Dempster-Shafer theory and deep learning is proposed to segment lymphomas from three-dimensional Positron Emission Tomography (PET) and Computed Tomography (CT) images. The architecture is composed of a deep feature-extraction module and an evidential layer. The feature extraction module uses an encoder-decoder framework to extract semantic feature vectors from 3D inputs. The evidential layer then uses prototypes in the feature space to compute a belief function at each voxel quantifying the uncertainty about the presence or absence of a lymphoma at this location. Two evidential layers are compared, based on different ways of using distances to prototypes for computing mass functions. The whole model is trained end-to-end by minimizing the Dice loss function. The proposed combination of deep feature extraction and evidential segmentation is shown to outperform the baseline UNet model as well as three other state-of-the-art models on a dataset of 173 patients.

Fereshteh Yousefirizi, Pierre Decazes, Amine Amyar et al.

Artificial intelligence (AI) techniques have significant potential to enable effective, robust and automated image phenotyping including identification of subtle patterns. AI-based detection searches the image space to find the regions of interest based on patterns and features. There is a spectrum of tumor histologies from benign to malignant that can be identified by AI-based classification approaches using image features. The extraction of minable information from images gives way to the field of radiomics and can be explored via explicit (handcrafted/engineered) and deep radiomics frameworks. Radiomics analysis has the potential to be utilized as a noninvasive technique for the accurate characterization of tumors to improve diagnosis and treatment monitoring. This work reviews AI-based techniques, with a special focus on oncological PET and PET/CT imaging, for different detection, classification, and prediction/prognosis tasks. We also discuss needed efforts to enable the translation of AI techniques to routine clinical workflows, and potential improvements and complementary techniques such as the use of natural language processing on electronic health records and neuro-symbolic AI techniques.

Ling Huang, Thierry Denoeux, David Tonnelet et al.

Lymphoma detection and segmentation from whole-body Positron Emission Tomography/Computed Tomography (PET/CT) volumes are crucial for surgical indication and radiotherapy. Designing automatic segmentation methods capable of effectively exploiting the information from PET and CT as well as resolving their uncertainty remain a challenge. In this paper, we propose an lymphoma segmentation model using an UNet with an evidential PET/CT fusion layer. Single-modality volumes are trained separately to get initial segmentation maps and an evidential fusion layer is proposed to fuse the two pieces of evidence using Dempster-Shafer theory (DST). Moreover, a multi-task loss function is proposed: in addition to the use of the Dice loss for PET and CT segmentation, a loss function based on the concordance between the two segmentation is added to constrain the final segmentation. We evaluate our proposal on a database of polycentric PET/CT volumes of patients treated for lymphoma, delineated by the experts. Our method get accurate segmentation results with Dice score of 0.726, without any user interaction. Quantitative results show that our method is superior to the state-of-the-art methods.

Ling Huang, Su Ruan, Pierre Decazes et al.

PET and CT are two modalities widely used in medical image analysis. Accurately detecting and segmenting lymphomas from these two imaging modalities are critical tasks for cancer staging and radiotherapy planning. However, this task is still challenging due to the complexity of PET/CT images, and the computation cost to process 3D data. In this paper, a segmentation method based on belief functions is proposed to segment lymphomas in 3D PET/CT images. The architecture is composed of a feature extraction module and an evidential segmentation (ES) module. The ES module outputs not only segmentation results (binary maps indicating the presence or absence of lymphoma in each voxel) but also uncertainty maps quantifying the classification uncertainty. The whole model is optimized by minimizing Dice and uncertainty loss functions to increase segmentation accuracy. The method was evaluated on a database of 173 patients with diffuse large b-cell lymphoma. Quantitative and qualitative results show that our method outperforms the state-of-the-art methods.

Amine Amyar, Su Ruan, Pierre Vera et al.

One of the most challenges in medical imaging is the lack of data. It is proven that classical data augmentation methods are useful but still limited due to the huge variation in images. Using generative adversarial networks (GAN) is a promising way to address this problem, however, it is challenging to train one model to generate different classes of lesions. In this paper, we propose a deep convolutional conditional generative adversarial network to generate MIP positron emission tomography image (PET) which is a 2D image that represents a 3D volume for fast interpretation, according to different lesions or non lesion (normal). The advantage of our proposed method consists of one model that is capable of generating different classes of lesions trained on a small sample size for each class of lesion, and showing a very promising results. In addition, we show that a walk through a latent space can be used as a tool to evaluate the images generated.