Kang Zheng

Fakai Wang, Kang Zheng, Yirui Wang et al.

Osteoporosis is a common chronic metabolic bone disease that is often under-diagnosed and under-treated due to the limited access to bone mineral density (BMD) examinations, Dual-energy X-ray Absorptiometry (DXA). In this paper, we propose a method to predict BMD from Chest X-ray (CXR), one of the most common, accessible, and low-cost medical image examinations. Our method first automatically detects Regions of Interest (ROIs) of local and global bone structures from the CXR. Then a multi-ROI model is developed to exploit both local and global information in the chest X-ray image for accurate BMD estimation. Our method is evaluated on 329 CXR cases with ground truth BMD measured by DXA. The model predicted BMD has a strong correlation with the gold standard DXA BMD (Pearson correlation coefficient 0.840). When applied for osteoporosis screening, it achieves a high classification performance (AUC 0.936). As the first effort in the field to use CXR scans to predict the spine BMD, the proposed algorithm holds strong potential in enabling early osteoporosis screening through routine chest X-rays and contributing to the enhancement of public health.

Kang Zheng, Yirui Wang, Xiaoyun Zhou et al.

Bone mineral density (BMD) is a clinically critical indicator of osteoporosis, usually measured by dual-energy X-ray absorptiometry (DEXA). Due to the limited accessibility of DEXA machines and examinations, osteoporosis is often under-diagnosed and under-treated, leading to increased fragility fracture risks. Thus it is highly desirable to obtain BMDs with alternative cost-effective and more accessible medical imaging examinations such as X-ray plain films. In this work, we formulate the BMD estimation from plain hip X-ray images as a regression problem. Specifically, we propose a new semi-supervised self-training algorithm to train the BMD regression model using images coupled with DEXA measured BMDs and unlabeled images with pseudo BMDs. Pseudo BMDs are generated and refined iteratively for unlabeled images during self-training. We also present a novel adaptive triplet loss to improve the model's regression accuracy. On an in-house dataset of 1,090 images (819 unique patients), our BMD estimation method achieves a high Pearson correlation coefficient of 0.8805 to ground-truth BMDs. It offers good feasibility to use the more accessible and cheaper X-ray imaging for opportunistic osteoporosis screening.

Yirui Wang, Kang Zheng, Chi-Tung Chang et al.

Exploiting available medical records to train high performance computer-aided diagnosis (CAD) models via the semi-supervised learning (SSL) setting is emerging to tackle the prohibitively high labor costs involved in large-scale medical image annotations. Despite the extensive attentions received on SSL, previous methods failed to 1) account for the low disease prevalence in medical records and 2) utilize the image-level diagnosis indicated from the medical records. Both issues are unique to SSL for CAD models. In this work, we propose a new knowledge distillation method that effectively exploits large-scale image-level labels extracted from the medical records, augmented with limited expert annotated region-level labels, to train a rib and clavicle fracture CAD model for chest X-ray (CXR). Our method leverages the teacher-student model paradigm and features a novel adaptive asymmetric label sharpening (AALS) algorithm to address the label imbalance problem that specially exists in medical domain. Our approach is extensively evaluated on all CXR (N = 65,845) from the trauma registry of anonymous hospital over a period of 9 years (2008-2016), on the most common rib and clavicle fractures. The experiment results demonstrate that our method achieves the state-of-the-art fracture detection performance, i.e., an area under receiver operating characteristic curve (AUROC) of 0.9318 and a free-response receiver operating characteristic (FROC) score of 0.8914 on the rib fractures, significantly outperforming previous approaches by an AUROC gap of 1.63% and an FROC improvement by 3.74%. Consistent performance gains are also observed for clavicle fracture detection.

Yuhang Lu, Kang Zheng, Weijian Li et al.

Accurate segmentation of anatomical structures is vital for medical image analysis. The state-of-the-art accuracy is typically achieved by supervised learning methods, where gathering the requisite expert-labeled image annotations in a scalable manner remains a main obstacle. Therefore, annotation-efficient methods that permit to produce accurate anatomical structure segmentation are highly desirable. In this work, we present Contour Transformer Network (CTN), a one-shot anatomy segmentation method with a naturally built-in human-in-the-loop mechanism. We formulate anatomy segmentation as a contour evolution process and model the evolution behavior by graph convolutional networks (GCNs). Training the CTN model requires only one labeled image exemplar and leverages additional unlabeled data through newly introduced loss functions that measure the global shape and appearance consistency of contours. On segmentation tasks of four different anatomies, we demonstrate that our one-shot learning method significantly outperforms non-learning-based methods and performs competitively to the state-of-the-art fully supervised deep learning methods. With minimal human-in-the-loop editing feedback, the segmentation performance can be further improved to surpass the fully supervised methods.

Yuhang Lu, Weijian Li, Kang Zheng et al.

Accurate segmentation of critical anatomical structures is at the core of medical image analysis. The main bottleneck lies in gathering the requisite expert-labeled image annotations in a scalable manner. Methods that permit to produce accurate anatomical structure segmentation without using a large amount of fully annotated training images are highly desirable. In this work, we propose a novel contribution of Contour Transformer Network (CTN), a one-shot anatomy segmentor including a naturally built-in human-in-the-loop mechanism. Segmentation is formulated by learning a contour evolution behavior process based on graph convolutional networks (GCNs). Training of our CTN model requires only one labeled image exemplar and leverages additional unlabeled data through newly introduced loss functions that measure the global shape and appearance consistency of contours. We demonstrate that our one-shot learning method significantly outperforms non-learning-based methods and performs competitively to the state-of-the-art fully supervised deep learning approaches. With minimal human-in-the-loop editing feedback, the segmentation performance can be further improved and tailored towards the observer desired outcomes. This can facilitate the clinician designed imaging-based biomarker assessments (to support personalized quantitative clinical diagnosis) and outperforms fully supervised baselines.

Haomin Chen, Yirui Wang, Kang Zheng et al.

Visual cues of enforcing bilaterally symmetric anatomies as normal findings are widely used in clinical practice to disambiguate subtle abnormalities from medical images. So far, inadequate research attention has been received on effectively emulating this practice in CAD methods. In this work, we exploit semantic anatomical symmetry or asymmetry analysis in a complex CAD scenario, i.e., anterior pelvic fracture detection in trauma PXRs, where semantically pathological (refer to as fracture) and non-pathological (e.g., pose) asymmetries both occur. Visually subtle yet pathologically critical fracture sites can be missed even by experienced clinicians, when limited diagnosis time is permitted in emergency care. We propose a novel fracture detection framework that builds upon a Siamese network enhanced with a spatial transformer layer to holistically analyze symmetric image features. Image features are spatially formatted to encode bilaterally symmetric anatomies. A new contrastive feature learning component in our Siamese network is designed to optimize the deep image features being more salient corresponding to the underlying semantic asymmetries (caused by pelvic fracture occurrences). Our proposed method have been extensively evaluated on 2,359 PXRs from unique patients (the largest study to-date), and report an area under ROC curve score of 0.9771. This is the highest among state-of-the-art fracture detection methods, with improved clinical indications.

Jun Zhou, Yuhang Lu, Kang Zheng et al.

The surfaces of many cultural heritage objects were embellished with various patterns, especially curve patterns. In practice, most of the unearthed cultural heritage objects are highly fragmented, e.g., sherds of potteries or vessels, and each of them only shows a very small portion of the underlying full design, with noise and deformations. The goal of this paper is to address the challenging problem of automatically identifying the underlying full design of curve patterns from such a sherd. Specifically, we formulate this problem as template matching: curve structure segmented from the sherd is matched to each location with each possible orientation of each known full design. In this paper, we propose a new two-stage matching algorithm, with a different matching cost in each stage. In Stage 1, we use a traditional template matching, which is highly computationally efficient, over the whole search space and identify a small set of candidate matchings. In Stage 2, we derive a new matching cost by training a dual-source Convolutional Neural Network (CNN) and apply it to re-rank the candidate matchings identified in Stage 1. We collect 600 pottery sherds with 98 full designs from the Woodland Period in Southeastern North America for experiments and the performance of the proposed algorithm is very competitive.

Xiaochuan Fan, Hao Guo, Kang Zheng et al.

Region-based Convolutional Neural Networks (R-CNNs) have achieved great success in the field of object detection. The existing R-CNNs usually divide a Region-of-Interest (ROI) into grids, and then localize objects by utilizing the spatial information reflected by the relative position of each grid in the ROI. In this paper, we propose a novel feature-encoding approach, where spatial information is represented through the spatial distributions of visual patterns. In particular, we design a Mask Weight Network (MWN) to learn a set of masks and then apply channel-wise masking operations to ROI feature map, followed by a global pooling and a cheap fully-connected layer. We integrate the newly designed feature encoder into the Faster R-CNN architecture. The resulting new Faster R-CNNs can preserve the object-detection accuracy of the standard Faster R-CNNs by using substantially fewer parameters. Compared to R-FCNs using state-of-art PS ROI pooling and deformable PS ROI pooling, the new Faster R-CNNs can produce higher object-detection accuracy with good run-time efficiency. We also show that a specifically designed and learned MWN can capture global contextual information and further improve the object-detection accuracy. Validation experiments are conducted on both PASCAL VOC and MS COCO datasets.

Hongkai Yu, Youjie Zhou, Hui Qian et al.

One popular approach to interactively segment the foreground object of interest from an image is to annotate a bounding box that covers the foreground object. Then, a binary labeling is performed to achieve a refined segmentation. One major issue of the existing algorithms for such interactive image segmentation is their preference of an input bounding box that tightly encloses the foreground object. This increases the annotation burden, and prevents these algorithms from utilizing automatically detected bounding boxes. In this paper, we develop a new LooseCut algorithm that can handle cases where the input bounding box only loosely covers the foreground object. We propose a new Markov Random Fields (MRF) model for segmentation with loosely bounded boxes, including a global similarity constraint to better distinguish the foreground and background, and an additional energy term to encourage consistent labeling of similar-appearance pixels. This MRF model is then solved by an iterated max-flow algorithm. In the experiments, we evaluate LooseCut in three publicly-available image datasets, and compare its performance against several state-of-the-art interactive image segmentation algorithms. We also show that LooseCut can be used for enhancing the performance of unsupervised video segmentation and image saliency detection.

Xiaochuan Fan, Kang Zheng, Yuewei Lin et al.

We propose a new learning-based method for estimating 2D human pose from a single image, using Dual-Source Deep Convolutional Neural Networks (DS-CNN). Recently, many methods have been developed to estimate human pose by using pose priors that are estimated from physiologically inspired graphical models or learned from a holistic perspective. In this paper, we propose to integrate both the local (body) part appearance and the holistic view of each local part for more accurate human pose estimation. Specifically, the proposed DS-CNN takes a set of image patches (category-independent object proposals for training and multi-scale sliding windows for testing) as the input and then learns the appearance of each local part by considering their holistic views in the full body. Using DS-CNN, we achieve both joint detection, which determines whether an image patch contains a body joint, and joint localization, which finds the exact location of the joint in the image patch. Finally, we develop an algorithm to combine these joint detection/localization results from all the image patches for estimating the human pose. The experimental results show the effectiveness of the proposed method by comparing to the state-of-the-art human-pose estimation methods based on pose priors that are estimated from physiologically inspired graphical models or learned from a holistic perspective.