Engin Dikici, Xuan V. Nguyen, Matthew Bigelow et al.
The detection of brain metastases (BM) in their early stages could have a positive impact on the outcome of cancer patients. We previously developed a framework for detecting small BM (with diameters of less than 15mm) in T1-weighted Contrast-Enhanced 3D Magnetic Resonance images (T1c) to assist medical experts in this time-sensitive and high-stakes task. The framework utilizes a dedicated convolutional neural network (CNN) trained using labeled T1c data, where the ground truth BM segmentations were provided by a radiologist. This study aims to advance the framework with a noisy student-based self-training strategy to make use of a large corpus of unlabeled T1c data (i.e., data without BM segmentations or detections). Accordingly, the work (1) describes the student and teacher CNN architectures, (2) presents data and model noising mechanisms, and (3) introduces a novel pseudo-labeling strategy factoring in the learned BM detection sensitivity of the framework. Finally, it describes a semi-supervised learning strategy utilizing these components. We performed the validation using 217 labeled and 1247 unlabeled T1c exams via 2-fold cross-validation. The framework utilizing only the labeled exams produced 9.23 false positives for 90% BM detection sensitivity; whereas, the framework using the introduced learning strategy led to ~9% reduction in false detections (i.e., 8.44) for the same sensitivity level. Furthermore, while experiments utilizing 75% and 50% of the labeled datasets resulted in algorithm performance degradation (12.19 and 13.89 false positives respectively), the impact was less pronounced with the noisy student-based training strategy (10.79 and 12.37 false positives respectively).