Dae Kyung Sohn

Joohyung Lee, Jieun Oh, Inkyu Shin et al.

Volumetric images from Magnetic Resonance Imaging (MRI) provide invaluable information in preoperative staging of rectal cancer. Above all, accurate preoperative discrimination between T2 and T3 stages is arguably both the most challenging and clinically significant task for rectal cancer treatment, as chemo-radiotherapy is usually recommended to patients with T3 (or greater) stage cancer. In this study, we present a volumetric convolutional neural network to accurately discriminate T2 from T3 stage rectal cancer with rectal MR volumes. Specifically, we propose 1) a custom ResNet-based volume encoder that models the inter-slice relationship with late fusion (i.e., 3D convolution at the last layer), 2) a bilinear computation that aggregates the resulting features from the encoder to create a volume-wise feature, and 3) a joint minimization of triplet loss and focal loss. With MR volumes of pathologically confirmed T2/T3 rectal cancer, we perform extensive experiments to compare various designs within the framework of residual learning. As a result, our network achieves an AUC of 0.831, which is higher than the reported accuracy of the professional radiologist groups. We believe this method can be extended to other volume analysis tasks

Joohyung Lee, Ji Eun Oh, Min Ju Kim et al.

In preoperative imaging, the demarcation of rectal cancer with magnetic resonance images provides an important basis for cancer staging and treatment planning. Recently, deep learning has greatly improved the state-of-the-art method in automatic segmentation. However, limitations in data availability in the medical field can cause large variance and consequent overfitting to medical image segmentation networks. In this study, we propose methods to reduce the model variance of a rectal cancer segmentation network by adding a rectum segmentation task and performing data augmentation; the geometric correlation between the rectum and rectal cancer motivated the former approach. Moreover, we propose a method to perform a bias-variance analysis within an arbitrary region-of-interest (ROI) of a segmentation network, which we applied to assess the efficacy of our approaches in reducing model variance. As a result, adding a rectum segmentation task reduced the model variance of the rectal cancer segmentation network within tumor regions by a factor of 0.90; data augmentation further reduced the variance by a factor of 0.89. These approaches also reduced the training duration by a factor of 0.96 and a further factor of 0.78, respectively. Our approaches will improve the quality of rectal cancer staging by increasing the accuracy of its automatic demarcation and by providing rectum boundary information since rectal cancer staging requires the demarcation of both rectum and rectal cancer. Besides such clinical benefits, our method also enables segmentation networks to be assessed with bias-variance analysis within an arbitrary ROI, such as a cancerous region.