Amirreza Mahbod

Amirreza Mahbod, Christine Polak, Katharina Feldmann et al.

In computational pathology, automatic nuclei instance segmentation plays an essential role in whole slide image analysis. While many computerized approaches have been proposed for this task, supervised deep learning (DL) methods have shown superior segmentation performances compared to classical machine learning and image processing techniques. However, these models need fully annotated datasets for training which is challenging to acquire, especially in the medical domain. In this work, we release one of the biggest fully manually annotated datasets of nuclei in Hematoxylin and Eosin (H&E)-stained histological images, called NuInsSeg. This dataset contains 665 image patches with more than 30,000 manually segmented nuclei from 31 human and mouse organs. Moreover, for the first time, we provide additional ambiguous area masks for the entire dataset. These vague areas represent the parts of the images where precise and deterministic manual annotations are impossible, even for human experts. The dataset and detailed step-by-step instructions to generate related segmentation masks are publicly available at https://www.kaggle.com/datasets/ipateam/nuinsseg and https://github.com/masih4/NuInsSeg, respectively.

Amirreza Mahbod, Nematollah Saeidi, Sepideh Hatamikia et al.

Medical image retrieval refers to the task of finding similar images for given query images in a database, with applications such as diagnosis support. While traditional medical image retrieval relied on clinical metadata, content-based medical image retrieval (CBMIR) depends on image features, which can be extracted automatically or semi-automatically. Many approaches have been proposed for CBMIR, and among them, using pre-trained convolutional neural networks (CNNs) is a widely utilized approach. However, considering the recent advances in the development of foundation models for various computer vision tasks, their application for CBMIR can also be investigated. In this study, we used several pre-trained feature extractors from well-known pre-trained CNNs and pre-trained foundation models and investigated the CBMIR performance on eight types of two-dimensional (2D) and three-dimensional (3D) medical images. Furthermore, we investigated the effect of image size on the CBMIR performance. Our results show that, overall, for the 2D datasets, foundation models deliver superior performance by a large margin compared to CNNs, with the general-purpose self-supervised model for computational pathology (UNI) providing the best overall performance across all datasets and image sizes. For 3D datasets, CNNs and foundation models deliver more competitive performance, with contrastive learning from captions for histopathology model (CONCH) achieving the best overall performance. Moreover, our findings confirm that while using larger image sizes (especially for 2D datasets) yields slightly better performance, competitive CBMIR performance can still be achieved even with smaller image sizes. Our codes to reproduce the results are available at: https://github.com/masih4/MedImageRetrieval.

Palak Handa, Manas Dhir, Amirreza Mahbod et al.

Computer-based analysis of Wireless Capsule Endoscopy (WCE) is crucial. However, a medically annotated WCE dataset for training and evaluation of automatic classification, detection, and segmentation of bleeding and non-bleeding frames is currently lacking. The present work focused on development of a medically annotated WCE dataset called WCEbleedGen for automatic classification, detection, and segmentation of bleeding and non-bleeding frames. It comprises 2,618 WCE bleeding and non-bleeding frames which were collected from various internet resources and existing WCE datasets. A comprehensive benchmarking and evaluation of the developed dataset was done using nine classification-based, three detection-based, and three segmentation-based deep learning models. The dataset is of high-quality, is class-balanced and contains single and multiple bleeding sites. Overall, our standard benchmark results show that Visual Geometric Group (VGG) 19, You Only Look Once version 8 nano (YOLOv8n), and Link network (Linknet) performed best in automatic classification, detection, and segmentation-based evaluations, respectively. Automatic bleeding diagnosis is crucial for WCE video interpretations. This diverse dataset will aid in developing of real-time, multi-task learning-based innovative solutions for automatic bleeding diagnosis in WCE. The dataset and code are publicly available at https://zenodo.org/records/10156571 and https://github.com/misahub2023/Benchmarking-Codes-of-the-WCEBleedGen-dataset.

Palak Handa, Amirreza Mahbod, Florian Schwarzhans et al.

We present the Capsule Vision 2024 Challenge: Multi-Class Abnormality Classification for Video Capsule Endoscopy. It was virtually organized by the Research Center for Medical Image Analysis and Artificial Intelligence (MIAAI), Department of Medicine, Danube Private University, Krems, Austria in collaboration with the 9th International Conference on Computer Vision & Image Processing (CVIP 2024) being organized by the Indian Institute of Information Technology, Design and Manufacturing (IIITDM) Kancheepuram, Chennai, India. This document provides an overview of the challenge, including the registration process, rules, submission format, description of the datasets used, qualified team rankings, all team descriptions, and the benchmarking results reported by the organizers.

Amirreza Mahbod, Rahim Entezari, Isabella Ellinger et al.

Recently, pruning deep neural networks (DNNs) has received a lot of attention for improving accuracy and generalization power, reducing network size, and increasing inference speed on specialized hardwares. Although pruning was mainly tested on computer vision tasks, its application in the context of medical image analysis has hardly been explored. This work investigates the impact of well-known pruning techniques, namely layer-wise and network-wide magnitude pruning, on the nuclei instance segmentation performance in histological images. Our utilized instance segmentation model consists of two main branches: (1) a semantic segmentation branch, and (2) a deep regression branch. We investigate the impact of weight pruning on the performance of both branches separately and on the final nuclei instance segmentation result. Evaluated on two publicly available datasets, our results show that layer-wise pruning delivers slightly better performance than networkwide pruning for small compression ratios (CRs) while for large CRs, network-wide pruning yields superior performance. For semantic segmentation, deep regression and final instance segmentation, 93.75 %, 95 %, and 80 % of the model weights can be pruned by layer-wise pruning with less than 2 % reduction in the performance of respective models.

Sepideh Hatamikia, Geevarghese George, Florian Schwarzhans et al.

Objectives: High-grade serous ovarian carcinoma (HGSOC) is typically diagnosed at an advanced stage with extensive peritoneal metastases, making treatment challenging. Neoadjuvant chemotherapy (NACT) is often used to reduce tumor burden before surgery, but about 40% of patients show limited response. Radiomics, combined with machine learning (ML), offers a promising non-invasive method for predicting NACT response by analyzing computed tomography (CT) imaging data. This study aimed to improve response prediction in HGSOC patients undergoing NACT by integration different feature selection methods. Materials and methods: A framework for selecting robust radiomics features was introduced by employing an automated randomisation algorithm to mimic inter-observer variability, ensuring a balance between feature robustness and prediction accuracy. Four response metrics were used: chemotherapy response score (CRS), RECIST, volume reduction (VolR), and diameter reduction (DiaR). Lesions in different anatomical sites were studied. Pre- and post-NACT CT scans were used for feature extraction and model training on one cohort, and an independent cohort was used for external testing. Results: The best prediction performance was achieved using all lesions combined for VolR prediction, with an AUC of 0.83. Omental lesions provided the best results for CRS prediction (AUC 0.77), while pelvic lesions performed best for DiaR (AUC 0.76). Conclusion: The integration of robustness into the feature selection processes ensures the development of reliable models and thus facilitates the implementation of the radiomics models in clinical applications for HGSOC patients. Future work should explore further applications of radiomics in ovarian cancer, particularly in real-time clinical settings.

Amirreza Mahbod, Ramona Woitek, Jeanne Shen

In computational pathology, nuclear instance segmentation is a fundamental task with many downstream clinical applications. With the advent of deep learning, many approaches, including convolutional neural networks (CNNs) and vision transformers (ViTs), have been proposed for this task, along with both machine learning-based and non-machine learning-based pre- and post-processing techniques to further boost performance. However, one fundamental aspect that has received less attention is the evaluation pipeline. In this study, we identify four key issues associated with nuclear instance segmentation evaluation and propose corresponding solutions. Our proposed modifications, namely handling vague regions, score normalization, overlapping instances, and border uncertainty, are integrated into a unified framework called NucEval, which enables robust evaluation of nuclear instance segmentation. We evaluate this pipeline using the NuInsSeg dataset, which provides unique characteristics that make it particularly suitable for this study, as well as two additional external datasets, with three CNN- and ViT-based nuclear instance segmentation models, to demonstrate the impact of these modifications on instance segmentation metrics. The code, along with complete guidelines and illustrative examples, is publicly available at: https://github.com/masih4/nuc_eval.

Nima Torbati, Anastasia Meshcheryakova, Ramona Woitek et al.

Melanoma is the most lethal form of skin cancer, with an increasing incidence rate worldwide. Analyzing histological images of melanoma by localizing and classifying tissues and cell nuclei is considered the gold standard method for diagnosis and treatment options for patients. While many computerized approaches have been proposed for automatic analysis, most perform tissue-based analysis and nuclei (cell)-based analysis as separate tasks, which might be suboptimal. In this work, using the PUMA challenge dataset, we propose a novel multi-stage deep learning approach by combining tissue and nuclei information in a unified framework based on the auto-context concept to perform segmentation and classification in histological images of melanoma. Through pre-training and further post-processing, our approach achieved second and first place rankings in the PUMA challenge, with average micro Dice tissue score and summed nuclei F1-score of 73.40% for Track 1 and 63.48% for Track 2, respectively. Furthermore, through a comprehensive ablation study and additional evaluation on an external dataset, we demonstrated the effectiveness of the framework components as well as the generalization capabilities of the proposed approach. Our implementation for training and testing is available at: https://github.com/NimaTorbati/PumaSubmit

Nima Torbati, Anastasia Meshcheryakova, Ramona Woitek et al.

Automated histopathological image analysis plays a vital role in computer-aided diagnosis of various diseases. Among developed algorithms, deep learning-based approaches have demonstrated excellent performance in multiple tasks, including semantic tissue segmentation in histological images. In this study, we propose a novel approach based on attention-driven feature fusion of convolutional neural networks (CNNs) and vision transformers (ViTs) within a unified dual-encoder model to improve semantic segmentation performance. Evaluation on two publicly available datasets showed that our model achieved μIoU/μDice scores of 76.79%/86.87% on the GCPS dataset and 64.93%/76.60% on the PUMA dataset, outperforming state-of-the-art and baseline benchmarks. The implementation of our method is publicly available in a GitHub repository: https://github.com/NimaTorbati/ACS-SegNet

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.

Nematollah Saeidi, Hossein Karshenas, Bijan Shoushtarian et al.

Breast cancer is the most common cancer type in women worldwide. Early detection and appropriate treatment can significantly reduce its impact. While histopathology examinations play a vital role in rapid and accurate diagnosis, they often require experienced medical experts for proper recognition and cancer grading. Automated image retrieval systems have the potential to assist pathologists in identifying cancerous tissues, thereby accelerating the diagnostic process. Nevertheless, proposing an accurate image retrieval model is challenging due to considerable variability among the tissue and cell patterns in histological images. In this work, we leverage the features from foundation models in a novel attention-based adversarially regularized variational graph autoencoder model for breast histological image retrieval. Our results confirm the superior performance of models trained with foundation model features compared to those using pre-trained convolutional neural networks (up to 7.7% and 15.5% for mAP and mMV, respectively), with the pre-trained general-purpose self-supervised model for computational pathology (UNI) delivering the best overall performance. By evaluating two publicly available histology image datasets of breast cancer, our top-performing model, trained with UNI features, achieved average mAP/mMV scores of 96.7%/91.5% and 97.6%/94.2% for the BreakHis and BACH datasets, respectively. Our proposed retrieval model has the potential to be used in clinical settings to enhance diagnostic performance and ultimately benefit patients.

Nima Torbati, Anastasia Meshcheryakova, Ramona Woitek et al.

Nuclei instance segmentation in hematoxylin and eosin (H&E)-stained images plays an important role in automated histological image analysis, with various applications in downstream tasks. While several machine learning and deep learning approaches have been proposed for nuclei instance segmentation, most research in this field focuses on developing new segmentation algorithms and benchmarking them on a limited number of arbitrarily selected public datasets. In this work, rather than focusing on model development, we focused on the datasets used for this task. Based on an extensive literature review, we identified manually annotated, publicly available datasets of H&E-stained images for nuclei instance segmentation and standardized them into a unified input and annotation format. Using two state-of-the-art segmentation models, one based on convolutional neural networks (CNNs) and one based on a hybrid CNN and vision transformer architecture, we systematically evaluated and ranked these datasets based on their nuclei instance segmentation performance. Furthermore, we proposed a unified test set (NucFuse-test) for fair cross-dataset evaluation and a unified training set (NucFuse-train) for improved segmentation performance by merging images from multiple datasets. By evaluating and ranking the datasets, performing comprehensive analyses, generating fused datasets, conducting external validation, and making our implementation publicly available, we provided a new benchmark for training, testing, and evaluating nuclei instance segmentation models on H&E-stained histological images.

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, Georg Dorffner, Isabella Ellinger et al.

With the advent of digital pathology and microscopic systems that can scan and save whole slide histological images automatically, there is a growing trend to use computerized methods to analyze acquired images. Among different histopathological image analysis tasks, nuclei instance segmentation plays a fundamental role in a wide range of clinical and research applications. While many semi- and fully-automatic computerized methods have been proposed for nuclei instance segmentation, deep learning (DL)-based approaches have been shown to deliver the best performances. However, the performance of such approaches usually degrades when tested on unseen datasets. In this work, we propose a novel method to improve the generalization capability of a DL-based automatic segmentation approach. Besides utilizing one of the state-of-the-art DL-based models as a baseline, our method incorporates non-deterministic train time and deterministic test time stain normalization, and ensembling to boost the segmentation performance. We trained the model with one single training set and evaluated its segmentation performance on seven test datasets. Our results show that the proposed method provides up to 4.9%, 5.4%, and 5.9% better average performance in segmenting nuclei based on Dice score, aggregated Jaccard index, and panoptic quality score, respectively, compared to the baseline segmentation model.

Chuanbo Wang, Amirreza Mahbod, Isabella Ellinger et al.

Acute and chronic wounds with varying etiologies burden the healthcare systems economically. The advanced wound care market is estimated to reach $22 billion by 2024. Wound care professionals provide proper diagnosis and treatment with heavy reliance on images and image documentation. Segmentation of wound boundaries in images is a key component of the care and diagnosis protocol since it is important to estimate the area of the wound and provide quantitative measurement for the treatment. Unfortunately, this process is very time-consuming and requires a high level of expertise. Recently automatic wound segmentation methods based on deep learning have shown promising performance but require large datasets for training and it is unclear which methods perform better. To address these issues, we propose the Foot Ulcer Segmentation challenge (FUSeg) organized in conjunction with the 2021 International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI). We built a wound image dataset containing 1,210 foot ulcer images collected over 2 years from 889 patients. It is pixel-wise annotated by wound care experts and split into a training set with 1010 images and a testing set with 200 images for evaluation. Teams around the world developed automated methods to predict wound segmentations on the testing set of which annotations were kept private. The predictions were evaluated and ranked based on the average Dice coefficient. The FUSeg challenge remains an open challenge as a benchmark for wound segmentation after the conference.

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.