Matthew Bigelow

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).

Richard D. White, Barbaros S. Erdal, Mutlu Demirer et al.

Coronary Computed Tomography Angiography (CCTA) evaluation of chest-pain patients in an Emergency Department (ED) is considered appropriate. While a negative CCTA interpretation supports direct patient discharge from an ED, labor-intensive analyses are required, with accuracy in jeopardy from distractions. We describe the development of an Artificial Intelligence (AI) algorithm and workflow for assisting interpreting physicians in CCTA screening for the absence of coronary atherosclerosis. The two-phase approach consisted of (1) Phase 1 - focused on the development and preliminary testing of an algorithm for vessel-centerline extraction classification in a balanced study population (n = 500 with 50% disease prevalence) derived by retrospective random case selection; and (2) Phase 2 - concerned with simulated-clinical Trialing of the developed algorithm on a per-case basis in a more real-world study population (n = 100 with 28% disease prevalence) from an ED chest-pain series. This allowed pre-deployment evaluation of the AI-based CCTA screening application which provides a vessel-by-vessel graphic display of algorithm inference results integrated into a clinically capable viewer. Algorithm performance evaluation used Area Under the Receiver-Operating-Characteristic Curve (AUC-ROC); confusion matrices reflected ground-truth vs AI determinations. The vessel-based algorithm demonstrated strong performance with AUC-ROC = 0.96. In both Phase 1 and Phase 2, independent of disease prevalence differences, negative predictive values at the case level were very high at 95%. The rate of completion of the algorithm workflow process (96% with inference results in 55-80 seconds) in Phase 2 depended on adequate image quality. There is potential for this AI application to assist in CCTA interpretation to help extricate atherosclerosis from chest-pain presentations.

Sema Candemir, Xuan V. Nguyen, Luciano M. Prevedello et al.

Purpose: This study investigates whether a machine-learning-based system can predict the rate of cognitive decline in mildly cognitively impaired patients by processing only the clinical and imaging data collected at the initial visit. Approach: We built a predictive model based on a supervised hybrid neural network utilizing a 3-Dimensional Convolutional Neural Network to perform volume analysis of Magnetic Resonance Imaging and integration of non-imaging clinical data at the fully connected layer of the architecture. The experiments are conducted on the Alzheimers Disease Neuroimaging Initiative dataset. Results: Experimental results confirm that there is a correlation between cognitive decline and the data obtained at the first visit. The system achieved an area under the receiver operator curve (AUC) of 0.70 for cognitive decline class prediction. Conclusion: To our knowledge, this is the first study that predicts slowly deteriorating/stable or rapidly deteriorating classes by processing routinely collected baseline clinical and demographic data (Baseline MRI, Baseline MMSE, Scalar Volumetric data, Age, Gender, Education, Ethnicity, and Race). The training data is built based on MMSE-rate values. Unlike the studies in the literature that focus on predicting Mild Cognitive Impairment-to-Alzheimer`s disease conversion and disease classification, we approach the problem as an early prediction of cognitive decline rate in MCI patients.