Rupert Ecker

Amirreza Mahbod, Gerald Schaefer, Rupert Ecker et al.

Foot ulcer is a common complication of diabetes mellitus and, associated with substantial morbidity and mortality, remains a major risk factor for lower leg amputations. Extracting accurate morphological features from foot wounds is crucial for appropriate treatment. Although visual inspection by a medical professional is the common approach for diagnosis, this is subjective and error-prone, and computer-aided approaches thus provide an interesting alternative. Deep learning-based methods, and in particular convolutional neural networks (CNNs), have shown excellent performance for various tasks in medical image analysis including medical image segmentation. In this paper, we propose an ensemble approach based on two encoder-decoder-based CNN models, namely LinkNet and U-Net, to perform foot ulcer segmentation. To deal with a limited number of available training samples, we use pre-trained weights (EfficientNetB1 for the LinkNet model and EfficientNetB2 for the U-Net model) and perform further pre-training using the Medetec dataset while also applying a number of morphological-based and colour-based augmentation techniques. To boost the segmentation performance, we incorporate five-fold cross-validation, test time augmentation and result fusion. Applied on the publicly available chronic wound dataset and the MICCAI 2021 Foot Ulcer Segmentation (FUSeg) Challenge, our method achieves state-of-the-art performance with data-based Dice scores of 92.07% and 88.80%, respectively, and is the top ranked method in the FUSeg challenge leaderboard. The Dockerised guidelines, inference codes and saved trained models are publicly available at https://github.com/masih4/Foot_Ulcer_Segmentation.

Amirreza Mahbod, Gerald Schaefer, Benjamin Bancher et al.

Nuclei instance segmentation plays an important role in the analysis of Hematoxylin and Eosin (H&E)-stained images. While supervised deep learning (DL)-based approaches represent the state-of-the-art in automatic nuclei instance segmentation, annotated datasets are required to train these models. There are two main types of tissue processing protocols, namely formalin-fixed paraffin-embedded samples (FFPE) and frozen tissue samples (FS). Although FFPE-derived H&E stained tissue sections are the most widely used samples, H&E staining on frozen sections derived from FS samples is a relevant method in intra-operative surgical sessions as it can be performed fast. Due to differences in the protocols of these two types of samples, the derived images and in particular the nuclei appearance may be different in the acquired whole slide images. Analysis of FS-derived H&E stained images can be more challenging as rapid preparation, staining, and scanning of FS sections may lead to deterioration in image quality. In this paper, we introduce CryoNuSeg, the first fully annotated FS-derived cryosectioned and H&E-stained nuclei instance segmentation dataset. The dataset contains images from 10 human organs that were not exploited in other publicly available datasets, and is provided with three manual mark-ups to allow measuring intra-observer and inter-observer variability. Moreover, we investigate the effects of tissue fixation/embedding protocol (i.e., FS or FFPE) on the automatic nuclei instance segmentation performance of one of the state-of-the-art DL approaches. We also create a baseline segmentation benchmark for the dataset that can be used in future research. A step-by-step guide to generate the dataset as well as the full dataset and other detailed information are made available to fellow researchers at https://github.com/masih4/CryoNuSeg.

Amirreza Mahbod, Rupert Ecker, Ramona Woitek

Accurate classification of skin lesions from dermatoscopic images is essential for diagnosis and treatment of skin cancer. In this study, we investigate the utility of a dermatology-specific foundation model, PanDerm, in comparison with two Vision Transformer (ViT) architectures (ViT base and Swin Transformer V2 base) for the task of skin lesion classification. Using frozen features extracted from PanDerm, we apply non-linear probing with three different classifiers, namely, multi-layer perceptron (MLP), XGBoost, and TabNet. For the ViT-based models, we perform full fine-tuning to optimize classification performance. Our experiments on the HAM10000 and MSKCC datasets demonstrate that the PanDerm-based MLP model performs comparably to the fine-tuned Swin transformer model, while fusion of PanDerm and Swin Transformer predictions leads to further performance improvements. Future work will explore additional foundation models, fine-tuning strategies, and advanced fusion techniques.

Amirreza Mahbod, Gerald Schaefer, Rupert Ecker et al.

Pollen grain micrograph classification has multiple applications in medicine and biology. Automatic pollen grain image classification can alleviate the problems of manual categorisation such as subjectivity and time constraints. While a number of computer-based methods have been introduced in the literature to perform this task, classification performance needs to be improved for these methods to be useful in practice. In this paper, we present an ensemble approach for pollen grain microscopic image classification into four categories: Corylus Avellana well-developed pollen grain, Corylus Avellana anomalous pollen grain, Alnus well-developed pollen grain, and non-pollen (debris) instances. In our approach, we develop a classification strategy that is based on fusion of four state-of-the-art fine-tuned convolutional neural networks, namely EfficientNetB0, EfficientNetB1, EfficientNetB2 and SeResNeXt-50 deep models. These models are trained with images of three fixed sizes (224x224, 240x240, and 260x260 pixels) and their prediction probability vectors are then fused in an ensemble method to form a final classification vector for a given pollen grain image. Our proposed method is shown to yield excellent classification performance, obtaining an accuracy of of 94.48% and a weighted F1-score of 94.54% on the ICPR 2020 Pollen Grain Classification Challenge training dataset based on five-fold cross-validation. Evaluated on the test set of the challenge, our approach achieved a very competitive performance in comparison to the top ranked approaches with an accuracy and a weighted F1-score of 96.28% and 96.30%, respectively.

Amirreza Mahbod, Philipp Tschandl, Georg Langs et al.

Malignant melanoma (MM) is one of the deadliest types of skin cancer. Analysing dermatoscopic images plays an important role in the early detection of MM and other pigmented skin lesions. Among different computer-based methods, deep learning-based approaches and in particular convolutional neural networks have shown excellent classification and segmentation performances for dermatoscopic skin lesion images. These models can be trained end-to-end without requiring any hand-crafted features. However, the effect of using lesion segmentation information on classification performance has remained an open question. In this study, we explicitly investigated the impact of using skin lesion segmentation masks on the performance of dermatoscopic image classification. To do this, first, we developed a baseline classifier as the reference model without using any segmentation masks. Then, we used either manually or automatically created segmentation masks in both training and test phases in different scenarios and investigated the classification performances. Evaluated on the ISIC 2017 challenge dataset which contained two binary classification tasks (i.e. MM vs. all and seborrheic keratosis (SK) vs. all) and based on the derived area under the receiver operating characteristic curve scores, we observed four main outcomes. Our results show that 1) using segmentation masks did not significantly improve the MM classification performance in any scenario, 2) in one of the scenarios (using segmentation masks for dilated cropping), SK classification performance was significantly improved, 3) removing all background information by the segmentation masks significantly degraded the overall classification performance, and 4) in case of using the appropriate scenario (using segmentation for dilated cropping), there is no significant difference of using manually or automatically created segmentation masks.

Amirreza Mahbod, Gerald Schaefer, Chunliang Wang et al.

Skin cancer is among the most common cancer types. Dermoscopic image analysis improves the diagnostic accuracy for detection of malignant melanoma and other pigmented skin lesions when compared to unaided visual inspection. Hence, computer-based methods to support medical experts in the diagnostic procedure are of great interest. Fine-tuning pre-trained convolutional neural networks (CNNs) has been shown to work well for skin lesion classification. Pre-trained CNNs are usually trained with natural images of a fixed image size which is typically significantly smaller than captured skin lesion images and consequently dermoscopic images are downsampled for fine-tuning. However, useful medical information may be lost during this transformation. In this paper, we explore the effect of input image size on skin lesion classification performance of fine-tuned CNNs. For this, we resize dermoscopic images to different resolutions, ranging from 64x64 to 768x768 pixels and investigate the resulting classification performance of three well-established CNNs, namely DenseNet-121, ResNet-18, and ResNet-50. Our results show that using very small images (of size 64x64 pixels) degrades the classification performance, while images of size 128x128 pixels and above support good performance with larger image sizes leading to slightly improved classification. We further propose a novel fusion approach based on a three-level ensemble strategy that exploits multiple fine-tuned networks trained with dermoscopic images at various sizes. When applied on the ISIC 2017 skin lesion classification challenge, our fusion approach yields an area under the receiver operating characteristic curve of 89.2% and 96.6% for melanoma classification and seborrheic keratosis classification, respectively, outperforming state-of-the-art algorithms.

Amirreza Mahbod, Gerald Schaefer, Chunliang Wang et al.

Skin cancer is one of the major types of cancers with an increasing incidence over the past decades. Accurately diagnosing skin lesions to discriminate between benign and malignant skin lesions is crucial to ensure appropriate patient treatment. While there are many computerised methods for skin lesion classification, convolutional neural networks (CNNs) have been shown to be superior over classical methods. In this work, we propose a fully automatic computerised method for skin lesion classification which employs optimised deep features from a number of well-established CNNs and from different abstraction levels. We use three pre-trained deep models, namely AlexNet, VGG16 and ResNet-18, as deep feature generators. The extracted features then are used to train support vector machine classifiers. In the final stage, the classifier outputs are fused to obtain a classification. Evaluated on the 150 validation images from the ISIC 2017 classification challenge, the proposed method is shown to achieve very good classification performance, yielding an area under receiver operating characteristic curve of 83.83% for melanoma classification and of 97.55% for seborrheic keratosis classification.