Farzad Khalvati

Khashayar Namdar, Matthias W. Wagner, Birgit B. Ertl-Wagner et al. · utoronto

Background: As an important branch of machine learning pipelines in medical imaging, radiomics faces two major challenges namely reproducibility and accessibility. In this work, we introduce open-radiomics, a set of radiomics datasets along with a comprehensive radiomics pipeline based on our proposed technical protocol to improve the reproducibility of the results. Methods: We curated large-scale radiomics datasets based on three open-source datasets; BraTS 2020 for high-grade glioma (HGG) versus low-grade glioma (LGG) classification and survival analysis, BraTS 2023 for O6-methylguanine-DNA methyltransferase classification, and non-small cell lung cancer survival analysis from the Cancer Imaging Archive. Using BraTS 2020 Magnetic Resonance Imaging (MRI) dataset, we applied our protocol to 369 brain tumor patients (76 LGG, 293 HGG). Leveraging PyRadiomics for LGG vs. HGG classification, we generated 288 datasets from 4 MRI sequences, 3 binWidths, 6 normalization methods, and 4 tumor subregions. Random Forest classifiers were trained and validated (60%,20%,20%) across 100 different data splits (28,800 test results), evaluating Area Under the Receiver Operating Characteristic Curve (AUROC). Results: Unlike binWidth and image normalization, tumor subregion and imaging sequence significantly affected performance of the models. T1 contrast-enhanced sequence and the union of Necrotic and the non-enhancing tumor core subregions resulted in the highest AUROCs (average test AUROC 0.951, 95% confidence interval of (0.949, 0.952)). Although several settings and data splits (28 out of 28800) yielded test AUROC of 1, they were irreproducible. Conclusion: Our experiments demonstrate the sources of variability in radiomics pipelines (e.g., tumor subregion) can have a significant impact on the results, which may lead to superficial perfect performances that are irreproducible.

Khashayar Namdar, Partoo Vafaeikia, Farzad Khalvati · utoronto

Generalizability is the ultimate goal of Machine Learning (ML) image classifiers, for which noise and limited dataset size are among the major concerns. We tackle these challenges through utilizing the framework of deep Multitask Learning (dMTL) and incorporating image depth estimation as an auxiliary task. On a customized and depth-augmented derivation of the MNIST dataset, we show a) multitask loss functions are the most effective approach of implementing dMTL, b) limited dataset size primarily contributes to classification inaccuracy, and c) depth estimation is mostly impacted by noise. In order to further validate the results, we manually labeled the NYU Depth V2 dataset for scene classification tasks. As a contribution to the field, we have made the data in python native format publicly available as an open-source dataset and provided the scene labels. Our experiments on MNIST and NYU-Depth-V2 show dMTL improves generalizability of the classifiers when the dataset is noisy and the number of examples is limited.

Khashayar Namdar, Matthias W. Wagner, Kareem Kudus et al. · utoronto

Background and Purpose: Pediatric low-grade glioma (pLGG) is the most common type of brain tumor in children, and identification of molecular markers for pLGG is crucial for successful treatment planning. Convolutional Neural Network (CNN) models for pLGG subtype identification rely on tumor segmentation. We hypothesize tumor segmentations are suboptimal and thus, we propose to augment the CNN models using tumor location probability in MRI data. Materials and Methods: Our REB-approved retrospective study included MRI Fluid-Attenuated Inversion Recovery (FLAIR) sequences of 143 BRAF fused and 71 BRAF V600E mutated tumors. Tumor segmentations (regions of interest (ROIs)) were provided by a pediatric neuroradiology fellow and verified by a senior pediatric neuroradiologist. In each experiment, we randomly split the data into development and test with an 80/20 ratio. We combined the 3D binary ROI masks for each class in the development dataset to derive the probability density functions (PDF) of tumor location, and developed three pipelines: location-based, CNN-based, and hybrid. Results: We repeated the experiment with different model initializations and data splits 100 times and calculated the Area Under Receiver Operating Characteristic Curve (AUC). The location-based classifier achieved an AUC of 77.90, 95% confidence interval (CI) (76.76, 79.03). CNN-based classifiers achieved AUC of 86.11, CI (84.96, 87.25), while the tumor-location-guided CNNs outperformed the formers with an average AUC of 88.64 CI (87.57, 89.72), which was statistically significant (Student's t-test p-value 0.0018). Conclusion: We achieved statistically significant improvements by incorporating tumor location into the CNN models. Our results suggest that manually segmented ROIs may not be optimal.

Chaojun Chen, Khashayar Namdar, Yujie Wu et al. · utoronto

Scoliosis is a three-dimensional deformity of the spine, most often diagnosed in childhood. It affects 2-3% of the population, which is approximately seven million people in North America. Currently, the reference standard for assessing scoliosis is based on the manual assignment of Cobb angles at the site of the curvature center. This manual process is time consuming and unreliable as it is affected by inter- and intra-observer variance. To overcome these inaccuracies, machine learning (ML) methods can be used to automate the Cobb angle measurement process. This paper proposes to address the Cobb angle measurement task using YOLACT, an instance segmentation model. The proposed method first segments the vertebrae in an X-Ray image using YOLACT, then it tracks the important landmarks using the minimum bounding box approach. Lastly, the extracted landmarks are used to calculate the corresponding Cobb angles. The model achieved a Symmetric Mean Absolute Percentage Error (SMAPE) score of 10.76%, demonstrating the reliability of this process in both vertebra localization and Cobb angle measurement.

Akino Watanabe, Sara Ketabi, Khashayar et al. · utoronto

As deep learning is widely used in the radiology field, the explainability of such models is increasingly becoming essential to gain clinicians' trust when using the models for diagnosis. In this research, three experiment sets were conducted with a U-Net architecture to improve the classification performance while enhancing the heatmaps corresponding to the model's focus through incorporating heatmap generators during training. All of the experiments used the dataset that contained chest radiographs, associated labels from one of the three conditions ("normal", "congestive heart failure (CHF)", and "pneumonia"), and numerical information regarding a radiologist's eye-gaze coordinates on the images. The paper (A. Karargyris and Moradi, 2021) that introduced this dataset developed a U-Net model, which was treated as the baseline model for this research, to show how the eye-gaze data can be used in multi-modal training for explainability improvement. To compare the classification performances, the 95% confidence intervals (CI) of the area under the receiver operating characteristic curve (AUC) were measured. The best method achieved an AUC of 0.913 (CI: 0.860-0.966). The greatest improvements were for the "pneumonia" and "CHF" classes, which the baseline model struggled most to classify, resulting in AUCs of 0.859 (CI: 0.732-0.957) and 0.962 (CI: 0.933-0.989), respectively. The proposed method's decoder was also able to produce probability masks that highlight the determining image parts in model classifications, similarly as the radiologist's eye-gaze data. Hence, this work showed that incorporating heatmap generators and eye-gaze information into training can simultaneously improve disease classification and provide explainable visuals that align well with how the radiologist viewed the chest radiographs when making diagnosis.

Meng Zhou, Matthias W Wagner, Uri Tabori et al.

Medical image analysis has significantly benefited from advancements in deep learning, particularly in the application of Generative Adversarial Networks (GANs) for generating realistic and diverse images that can augment training datasets. However, the effectiveness of such approaches is often limited by the amount of available data in clinical settings. Additionally, the common GAN-based approach is to generate entire image volumes, rather than solely the region of interest (ROI). Research on deep learning-based brain tumor classification using MRI has shown that it is easier to classify the tumor ROIs compared to the entire image volumes. In this work, we present a novel framework that uses vector-quantization GAN and a transformer incorporating masked token modeling to generate high-resolution and diverse 3D brain tumor ROIs that can be directly used as augmented data for the classification of brain tumor ROI. We apply our method to two imbalanced datasets where we augment the minority class: (1) the Multimodal Brain Tumor Segmentation Challenge (BraTS) 2019 dataset to generate new low-grade glioma (LGG) ROIs to balance with high-grade glioma (HGG) class; (2) the internal pediatric LGG (pLGG) dataset tumor ROIs with BRAF V600E Mutation genetic marker to balance with BRAF Fusion genetic marker class. We show that the proposed method outperforms various baseline models in both qualitative and quantitative measurements. The generated data was used to balance the data in the brain tumor types classification task. Using the augmented data, our approach surpasses baseline models by 6.4% in AUC on the BraTS 2019 dataset and 4.3% in AUC on our internal pLGG dataset. The results indicate the generated tumor ROIs can effectively address the imbalanced data problem. Our proposed method has the potential to facilitate an accurate diagnosis of rare brain tumors using MRI scans.

Jay J. Yoo, Khashayar Namdar, Matthias W. Wagner et al. · utoronto

Segmentation of regions of interest (ROIs) for identifying abnormalities is a leading problem in medical imaging. Using machine learning for this problem generally requires manually annotated ground-truth segmentations, demanding extensive time and resources from radiologists. This work presents a weakly supervised approach that utilizes binary image-level labels, which are much simpler to acquire, to effectively segment anomalies in 2D magnetic resonance images without ground truth annotations. We train a generative adversarial network (GAN) that converts cancerous images to healthy variants, which are used along with localization seeds as priors to generate improved weakly supervised segmentations. The non-cancerous variants can also be used to evaluate the segmentations in a weakly supervised fashion, which allows for the most effective segmentations to be identified and then applied to downstream clinical classification tasks. On the Multimodal Brain Tumor Segmentation (BraTS) 2020 dataset, our proposed method generates and identifies segmentations that achieve test Dice coefficients of 83.91%. Using these segmentations for pathology classification results with a test AUC of 93.32% which is comparable to the test AUC of 95.80% achieved when using true segmentations.

Jay J. Yoo, Khashayar Namdar, Sean Carey et al. · utoronto

Objectives: To develop and evaluate a radiomics machine learning model for detecting liver fibrosis on CT of the liver. Methods: For this retrospective, single-centre study, radiomic features were extracted from Regions of Interest (ROIs) on CT images of patients who underwent simultaneous liver biopsy and CT examinations. Combinations of contrast, normalization, machine learning model, and feature selection method were determined based on their mean test Area Under the Receiver Operating Characteristic curve (AUC) on randomly placed ROIs. The combination and selected features with the highest AUC were used to develop a final liver fibrosis screening model. Results: The study included 101 male and 68 female patients (mean age = 51.2 years $\pm$ 14.7 [SD]). When averaging the AUC across all combinations, non-contrast enhanced (NC) CT (AUC, 0.6100; 95% CI: 0.5897, 0.6303) outperformed contrast-enhanced CT (AUC, 0.5680; 95% CI: 0.5471, 0.5890). The combination of hyperparameters and features that yielded the highest AUC was a logistic regression model with inputs features of maximum, energy, kurtosis, skewness, and small area high gray level emphasis extracted from non-contrast enhanced NC CT normalized using Gamma correction with $γ$ = 1.5 (AUC, 0.7833; 95% CI: 0.7821, 0.7845), (sensitivity, 0.9091; 95% CI: 0.9091, 0.9091). Conclusions: Radiomics-based machine learning models allow for the detection of liver fibrosis with reasonable accuracy and high sensitivity on NC CT. Thus, these models can be used to non-invasively screen for liver fibrosis, contributing to earlier detection of the disease at a potentially curable stage.

Jay J. Yoo, Khashayar Namdar, Farzad Khalvati · utoronto

Training machine learning models to segment tumors and other anomalies in medical images is an important step for developing diagnostic tools but generally requires manually annotated ground truth segmentations, which necessitates significant time and resources. This work proposes the use of a superpixel generation model and a superpixel clustering model to enable weakly supervised brain tumor segmentations. The proposed method utilizes binary image-level classification labels, which are readily accessible, to significantly improve the initial region of interest segmentations generated by standard weakly supervised methods without requiring ground truth annotations. We used 2D slices of magnetic resonance brain scans from the Multimodal Brain Tumor Segmentation Challenge 2020 dataset and labels indicating the presence of tumors to train the pipeline. On the test cohort, our method achieved a mean Dice coefficient of 0.691 and a mean 95% Hausdorff distance of 18.1, outperforming existing superpixel-based weakly supervised segmentation methods.

Pranav Agnihotri, Sara Ketabi, Khashayar et al. · utoronto

Traditional datasets for the radiological diagnosis tend to only provide the radiology image alongside the radiology report. However, radiology reading as performed by radiologists is a complex process, and information such as the radiologist's eye-fixations over the course of the reading has the potential to be an invaluable data source to learn from. Nonetheless, the collection of such data is expensive and time-consuming. This leads to the question of whether such data is worth the investment to collect. This paper utilizes the recently published Eye-Gaze dataset to perform an exhaustive study on the impact on performance and explainability of deep learning (DL) classification in the face of varying levels of input features, namely: radiology images, radiology report text, and radiologist eye-gaze data. We find that the best classification performance of X-ray images is achieved with a combination of radiology report free-text and radiology image, with the eye-gaze data providing no performance boost. Nonetheless, eye-gaze data serving as secondary ground truth alongside the class label results in highly explainable models that generate better attention maps compared to models trained to do classification and attention map generation without eye-gaze data.

Zilun Zhang, Farzad Khalvati

Many high-performance classification models utilize complex CNN-based architectures for Alzheimer's Disease classification. We aim to investigate two relevant questions regarding classification of Alzheimer's Disease using MRI: "Do Vision Transformer-based models perform better than CNN-based models?" and "Is it possible to use a shallow 3D CNN-based model to obtain satisfying results?" To achieve these goals, we propose two models that can take in and process 3D MRI scans: Convolutional Voxel Vision Transformer (CVVT) architecture, and ConvNet3D-4, a shallow 4-block 3D CNN-based model. Our results indicate that the shallow 3D CNN-based models are sufficient to achieve good classification results for Alzheimer's Disease using MRI scans.

Sajith Rajapaksa, Jean Marie Uwabeza Vianney, Renell Castro et al.

This paper investigates the potential usage of large text-to-image (LTI) models for the automated diagnosis of a few skin conditions with rarity or a serious lack of annotated datasets. As the input to the LTI model, we provide the targeted instantiation of a generic but succinct prompt structure designed upon careful observations of the conditional narratives from the standard medical textbooks. In this regard, we pave the path to utilizing accessible textbook descriptions for automated diagnosis of conditions with data scarcity through the lens of LTI models. Experiments show the efficacy of the proposed framework, including much better localization of the infected regions. Moreover, it has the immense possibility for generalization across the medical sub-domains, not only to mitigate the data scarcity issue but also to debias automated diagnostics from the all-pervasive racial biases.

Sajith Rajapaksa, Farzad Khalvati

Deep learning techniques have greatly benefited computer-aided diagnostic systems. However, unlike other fields, in medical imaging, acquiring large fine-grained annotated datasets such as 3D tumour segmentation is challenging due to the high cost of manual annotation and privacy regulations. This has given interest to weakly-supervise methods to utilize the weakly labelled data for tumour segmentation. In this work, we propose a weakly supervised approach to obtain regions of interest using binary class labels. Furthermore, we propose a novel objective function to train the generator model based on a pretrained binary classification model. Finally, we apply our method to the brain tumour segmentation problem in MRI.

Meng Zhou, Yuxuan Zhang, Xiaolan Xu et al. · utoronto

Multimodal medical image fusion is a crucial task that combines complementary information from different imaging modalities into a unified representation, thereby enhancing diagnostic accuracy and treatment planning. While deep learning methods, particularly Convolutional Neural Networks (CNNs) and Transformers, have significantly advanced fusion performance, some of the existing CNN-based methods fall short in capturing fine-grained multiscale and edge features, leading to suboptimal feature integration. Transformer-based models, on the other hand, are computationally intensive in both the training and fusion stages, making them impractical for real-time clinical use. Moreover, the clinical application of fused images remains unexplored. In this paper, we propose a novel CNN-based architecture that addresses these limitations by introducing a Dilated Residual Attention Network Module for effective multiscale feature extraction, coupled with a gradient operator to enhance edge detail learning. To ensure fast and efficient fusion, we present a parameter-free fusion strategy based on the weighted nuclear norm of softmax, which requires no additional computations during training or inference. Extensive experiments, including a downstream brain tumor classification task, demonstrate that our approach outperforms various baseline methods in terms of visual quality, texture preservation, and fusion speed, making it a possible practical solution for real-world clinical applications. The code will be released at https://github.com/simonZhou86/en_dran.

Sara Ketabi, Matthias W. Wagner, Birgit Betina Ertl-Wagner et al.

In spite of the strong performance of machine learning (ML) models in radiology, they have not been widely accepted by radiologists, limiting clinical integration. A key reason is the lack of explainability, which ensures that model predictions are understandable and verifiable by clinicians. Several methods and tools have been proposed to improve explainability, but most reflect developers' perspectives and lack systematic clinical validation. In this work, we gathered insights from radiologists with varying experience and specialties into explainable ML requirements through a structured questionnaire. They also highlighted key clinical tasks where ML could be most beneficial and how it might be deployed. Based on their input, we propose guidelines for designing and developing explainable ML models in radiology. These guidelines can help researchers develop clinically useful models, facilitating integration into radiology practice as a supportive tool.

Arash Zargar, Abolfazl Moshiri, Mitra Shafaei et al.

Recent advancements of the Artificial Intelligence (AI) have led to the development of large language models (LLMs) that are capable of understanding, analysing, and creating textual data. These language models open a significant opportunity in analyzing the literature and more specifically poetry. In the present work, we employ multiple Bidirectional encoder representations from transformers (BERT) and Generative Pre-trained Transformer (GPT) based language models to analyze the works of two prominent Persian poets: Jalal al-Din Muhammad Rumi (Rumi) and Parvin E'tesami. The main objective of this research is to investigate the capability of the modern language models in grasping complexities of the Persian poetry and explore potential correlations between the poems' sentiment and their meters. Our findings in this study indicates that GPT4o language model can reliably be used in analysis of Persian poetry. Furthermore, the results of our sentiment analysis revealed that in general, Rumi's poems express happier sentiments compared to Parvin E'tesami's poems. Furthermore, comparing the utilization of poetic meters highlighted Rumi's poems superiority in using meters to express a wider variety of sentiments. These findings are significant as they confirm that LLMs can be effectively applied in conducting computer-based semantic studies, where human interpretations are not required, and thereby significantly reducing potential biases in the analysis.

Yucheng Zhang, Edrise M. Lobo-Mueller, Paul Karanicolas et al.

As an analytic pipeline for quantitative imaging feature extraction and analysis, radiomics has grown rapidly in the past a few years. Recent studies in radiomics aim to investigate the relationship between tumors imaging features and clinical outcomes. Open source radiomics feature banks enable the extraction and analysis of thousands of predefined features. On the other hand, recent advances in deep learning have shown significant potential in the quantitative medical imaging field, raising the research question of whether predefined radiomics features have predictive information in addition to deep learning features. In this study, we propose a feature fusion method and investigate whether a combined feature bank of deep learning and predefined radiomics features can improve the prognostics performance. CT images from resectable Pancreatic Adenocarcinoma (PDAC) patients were used to compare the prognosis performance of common feature reduction and fusion methods and the proposed risk-score based feature fusion method for overall survival. It was shown that the proposed feature fusion method significantly improves the prognosis performance for overall survival in resectable PDAC cohorts, elevating the area under ROC curve by 51% compared to predefined radiomics features alone, by 16% compared to deep learning features alone, and by 32% compared to existing feature fusion and reduction methods for a combination of deep learning and predefined radiomics features.

Khashayar Namdar, Matthias W. Wagner, Cynthia Hawkins et al.

Pediatric Low-Grade Neuroepithelial Tumors (PLGNT) are the most common pediatric cancer type, accounting for 40% of brain tumors in children, and identifying PLGNT molecular subtype is crucial for treatment planning. However, the gold standard to determine the PLGNT subtype is biopsy, which can be impractical or dangerous for patients. This research improves the performance of Convolutional Neural Networks (CNNs) in classifying PLGNT subtypes through MRI scans by introducing a loss function that specifically improves the model's Area Under the Receiver Operating Characteristic (ROC) Curve (AUROC), offering a non-invasive diagnostic alternative. In this study, a retrospective dataset of 339 children with PLGNT (143 BRAF fusion, 71 with BRAF V600E mutation, and 125 non-BRAF) was curated. We employed a CNN model with Monte Carlo random data splitting. The baseline model was trained using binary cross entropy (BCE), and achieved an AUROC of 86.11% for differentiating BRAF fusion and BRAF V600E mutations, which was improved to 87.71% using our proposed AUROC loss function (p-value 0.045). With multiclass classification, the AUROC improved from 74.42% to 76. 59% (p-value 0.0016).

Sara Ketabi, Matthias W. Wagner, Cynthia Hawkins et al.

Despite the promising performance of convolutional neural networks (CNNs) in brain tumor diagnosis from magnetic resonance imaging (MRI), their integration into the clinical workflow has been limited. That is mainly due to the fact that the features contributing to a model's prediction are unclear to radiologists and hence, clinically irrelevant, i.e., lack of explainability. As the invaluable sources of radiologists' knowledge and expertise, radiology reports can be integrated with MRI in a contrastive learning (CL) framework, enabling learning from image-report associations, to improve CNN explainability. In this work, we train a multimodal CL architecture on 3D brain MRI scans and radiology reports to learn informative MRI representations. Furthermore, we integrate tumor location, salient to several brain tumor analysis tasks, into this framework to improve its generalizability. We then apply the learnt image representations to improve explainability and performance of genetic marker classification of pediatric Low-grade Glioma, the most prevalent brain tumor in children, as a downstream task. Our results indicate a Dice score of 31.1% between the model's attention maps and manual tumor segmentation (as an explainability measure) with test classification performance of 87.7%, significantly outperforming the baselines. These enhancements can build trust in our model among radiologists, facilitating its integration into clinical practices for more efficient tumor diagnosis.

Arash Rasti Meymandi, Zahra Hosseini, Sina Davari et al. · utoronto

This study explores the integration of advanced Natural Language Processing (NLP) and Artificial Intelligence (AI) techniques to analyze and interpret Persian literature, focusing on the poetry of Forough Farrokhzad. Utilizing computational methods, we aim to unveil thematic, stylistic, and linguistic patterns in Persian poetry. Specifically, the study employs AI models including transformer-based language models for clustering of the poems in an unsupervised framework. This research underscores the potential of AI in enhancing our understanding of Persian literary heritage, with Forough Farrokhzad's work providing a comprehensive case study. This approach not only contributes to the field of Persian Digital Humanities but also sets a precedent for future research in Persian literary studies using computational techniques.

Martin Licht, Sara Ketabi, Farzad Khalvati

Topic modeling is a useful tool for analyzing large corpora of written documents, particularly academic papers. Despite a wide variety of proposed topic modeling techniques, these techniques do not perform well when applied to medical texts. This can be due to the low number of documents available for some topics in the healthcare domain. In this paper, we propose ProtoTopic, a prototypical network-based topic model used for topic generation for a set of medical paper abstracts. Prototypical networks are efficient, explainable models that make predictions by computing distances between input datapoints and a set of prototype representations, making them particularly effective in low-data or few-shot learning scenarios. With ProtoTopic, we demonstrate improved topic coherence and diversity compared to two topic modeling baselines used in the literature, demonstrating the ability of our model to generate medically relevant topics even with limited data.

Felicia Liu, Jay J. Yoo, Farzad Khalvati

Large Language Models (LLMs) have shown strong performance in text-based healthcare tasks. However, their utility in image-based applications remains unexplored. We investigate the effectiveness of LLMs for medical imaging tasks, specifically glioma classification and segmentation, and compare their performance to that of traditional convolutional neural networks (CNNs). Using the BraTS 2020 dataset of multi-modal brain MRIs, we evaluated a general-purpose vision-language LLM (LLaMA 3.2 Instruct) both before and after fine-tuning, and benchmarked its performance against custom 3D CNNs. For glioma classification (Low-Grade vs. High-Grade), the CNN achieved 80% accuracy and balanced precision and recall. The general LLM reached 76% accuracy but suffered from a specificity of only 18%, often misclassifying Low-Grade tumors. Fine-tuning improved specificity to 55%, but overall performance declined (e.g., accuracy dropped to 72%). For segmentation, three methods - center point, bounding box, and polygon extraction, were implemented. CNNs accurately localized gliomas, though small tumors were sometimes missed. In contrast, LLMs consistently clustered predictions near the image center, with no distinction of glioma size, location, or placement. Fine-tuning improved output formatting but failed to meaningfully enhance spatial accuracy. The bounding polygon method yielded random, unstructured outputs. Overall, CNNs outperformed LLMs in both tasks. LLMs showed limited spatial understanding and minimal improvement from fine-tuning, indicating that, in their current form, they are not well-suited for image-based tasks. More rigorous fine-tuning or alternative training strategies may be needed for LLMs to achieve better performance, robustness, and utility in the medical space.

Meng Zhou, Farzad Khalvati

Multimodal medical image fusion integrates complementary information from different imaging modalities to enhance diagnostic accuracy and treatment planning. While deep learning methods have advanced performance, existing approaches face critical limitations: Convolutional Neural Networks (CNNs) excel at local feature extraction but struggle to model global context effectively, while Transformers achieve superior long-range modeling at the cost of quadratic computational complexity, limiting clinical deployment. Recent State Space Models (SSMs) offer a promising alternative, enabling efficient long-range dependency modeling in linear time through selective scan mechanisms. Despite these advances, the extension to 3D volumetric data and the clinical validation of fused images remains underexplored. In this work, we propose ClinicalFMamba, a novel end-to-end CNN-Mamba hybrid architecture that synergistically combines local and global feature modeling for 2D and 3D images. We further design a tri-plane scanning strategy for effectively learning volumetric dependencies in 3D images. Comprehensive evaluations on three datasets demonstrate the superior fusion performance across multiple quantitative metrics while achieving real-time fusion. We further validate the clinical utility of our approach on downstream 2D/3D brain tumor classification tasks, achieving superior performance over baseline methods. Our method establishes a new paradigm for efficient multimodal medical image fusion suitable for real-time clinical deployment.

Connor Ludwig, Khashayar Namdar, Farzad Khalvati · utoronto

Medical image segmentation has greatly aided medical diagnosis, with U-Net based architectures and nnU-Net providing state-of-the-art performance. There have been numerous general promptable models and medical variations introduced in recent years, but there is currently a lack of evaluation and comparison of these models across a variety of prompt qualities on a common medical dataset. This research uses Segment Anything Model (SAM), Segment Anything Model 2 (SAM 2), MedSAM, SAM-Med-3D, and nnU-Net to obtain zero-shot inference on the BraTS 2023 adult glioma and pediatrics dataset across multiple prompt qualities for both points and bounding boxes. Several of these models exhibit promising Dice scores, particularly SAM and SAM 2 achieving scores of up to 0.894 and 0.893, respectively when given extremely accurate bounding box prompts which exceeds nnU-Net's segmentation performance. However, nnU-Net remains the dominant medical image segmentation network due to the impracticality of providing highly accurate prompts to the models. The model and prompt evaluation, as well as the comparison, are extended through fine-tuning SAM, SAM 2, MedSAM, and SAM-Med-3D on the pediatrics dataset. The improvements in point prompt performance after fine-tuning are substantial and show promise for future investigation, but are unable to achieve better segmentation than bounding boxes or nnU-Net.

Yue Tong Leung, Farzad Khalvati

The COVID-19 pandemic has affected lives of people from different countries for almost two years. The changes on lifestyles due to the pandemic may cause psychosocial stressors for individuals, and have a potential to lead to mental health problems. To provide high quality mental health supports, healthcare organization need to identify the COVID-19 specific stressors, and notice the trends of prevalence of those stressors. This study aims to apply natural language processing (NLP) on social media data to identify the psychosocial stressors during COVID-19 pandemic, and to analyze the trend on prevalence of stressors at different stages of the pandemic. We obtained dataset of 9266 Reddit posts from subreddit \rCOVID19_support, from 14th Feb ,2020 to 19th July 2021. We used Latent Dirichlet Allocation (LDA) topic model and lexicon methods to identify the topics that were mentioned on the subreddit. Our result presented a dashboard to visualize the trend of prevalence of topics about covid-19 related stressors being discussed on social media platform. The result could provide insights about the prevalence of pandemic related stressors during different stages of COVID-19. The NLP techniques leveraged in this study could also be applied to analyze event specific stressors in the future.

Partoo Vafaeikia, Matthias W. Wagner, Uri Tabori et al.

Brain tumor segmentation is a critical task for tumor volumetric analyses and AI algorithms. However, it is a time-consuming process and requires neuroradiology expertise. While there has been extensive research focused on optimizing brain tumor segmentation in the adult population, studies on AI guided pediatric tumor segmentation are scarce. Furthermore, MRI signal characteristics of pediatric and adult brain tumors differ, necessitating the development of segmentation algorithms specifically designed for pediatric brain tumors. We developed a segmentation model trained on magnetic resonance imaging (MRI) of pediatric patients with low-grade gliomas (pLGGs) from The Hospital for Sick Children (Toronto, Ontario, Canada). The proposed model utilizes deep Multitask Learning (dMTL) by adding tumor's genetic alteration classifier as an auxiliary task to the main network, ultimately improving the accuracy of the segmentation results.

Sajith Rajapaksa, Farzad Khalvati

Deep convolutional neural networks (CNNs) have become an essential tool in the medical imaging-based computer-aided diagnostic pipeline. However, training accurate and reliable CNNs requires large fine-grain annotated datasets. To alleviate this, weakly-supervised methods can be used to obtain local information from global labels. This work proposes the use of localized perturbations as a weakly-supervised solution to extract segmentation masks of brain tumours from a pretrained 3D classification model. Furthermore, we propose a novel optimal perturbation method that exploits 3D superpixels to find the most relevant area for a given classification using a U-net architecture. Our method achieved a Dice similarity coefficient (DSC) of 0.44 when compared with expert annotations. When compared against Grad-CAM, our method outperformed both in visualization and localization ability of the tumour region, with Grad-CAM only achieving 0.11 average DSC.

Saman Motamed, Farzad Khalvati

Generative Adversarial Networks can learn the mapping of random noise to realistic images in a semi-supervised framework. This mapping ability can be used for semi-supervised image classification to detect images of an unknown class where there is no training data to be used for supervised classification. However, if the unknown class shares similar characteristics to the known class(es), GANs can learn to generalize and generate images that look like both classes. This generalization ability can hinder the classification performance. In this work, we propose the Vanishing Twin GAN. By training a weak GAN and using its generated output image parallel to the regular GAN, the Vanishing Twin training improves semi-supervised image classification where image similarity can hurt classification tasks.

Saman Motamed, Farzad Khalvati

From generating never-before-seen images to domain adaptation, applications of Generative Adversarial Networks (GANs) spread wide in the domain of vision and graphics problems. With the remarkable ability of GANs in learning the distribution and generating images of a particular class, they can be used for semi-supervised classification tasks. However, the problem is that if two classes of images share similar characteristics, the GAN might learn to generalize and hinder the classification of the two classes. In this paper, we use various images from MNIST and Fashion-MNIST datasets to illustrate how similar images cause the GAN to generalize, leading to the poor classification of images. We propose a modification to the traditional training of GANs that allows for improved multi-class classification in similar classes of images in a semi-supervised learning framework.

Ruqian Hao, Khashayar Namdar, Lin Liu et al.

Brain tumor is one of the leading causes of cancer-related death globally among children and adults. Precise classification of brain tumor grade (low-grade and high-grade glioma) at early stage plays a key role in successful prognosis and treatment planning. With recent advances in deep learning, Artificial Intelligence-enabled brain tumor grading systems can assist radiologists in the interpretation of medical images within seconds. The performance of deep learning techniques is, however, highly depended on the size of the annotated dataset. It is extremely challenging to label a large quantity of medical images given the complexity and volume of medical data. In this work, we propose a novel transfer learning based active learning framework to reduce the annotation cost while maintaining stability and robustness of the model performance for brain tumor classification. We employed a 2D slice-based approach to train and finetune our model on the Magnetic Resonance Imaging (MRI) training dataset of 203 patients and a validation dataset of 66 patients which was used as the baseline. With our proposed method, the model achieved Area Under Receiver Operating Characteristic (ROC) Curve (AUC) of 82.89% on a separate test dataset of 66 patients, which was 2.92% higher than the baseline AUC while saving at least 40% of labeling cost. In order to further examine the robustness of our method, we created a balanced dataset, which underwent the same procedure. The model achieved AUC of 82% compared with AUC of 78.48% for the baseline, which reassures the robustness and stability of our proposed transfer learning augmented with active learning framework while significantly reducing the size of training data.

Saman Motamed, Patrik Rogalla, Farzad Khalvati

COVID-19 spread across the globe at an immense rate has left healthcare systems incapacitated to diagnose and test patients at the needed rate. Studies have shown promising results for detection of COVID-19 from viral bacterial pneumonia in chest X-rays. Automation of COVID-19 testing using medical images can speed up the testing process of patients where health care systems lack sufficient numbers of the reverse-transcription polymerase chain reaction (RT-PCR) tests. Supervised deep learning models such as convolutional neural networks (CNN) need enough labeled data for all classes to correctly learn the task of detection. Gathering labeled data is a cumbersome task and requires time and resources which could further strain health care systems and radiologists at the early stages of a pandemic such as COVID-19. In this study, we propose a randomized generative adversarial network (RANDGAN) that detects images of an unknown class (COVID-19) from known and labelled classes (Normal and Viral Pneumonia) without the need for labels and training data from the unknown class of images (COVID-19). We used the largest publicly available COVID-19 chest X-ray dataset, COVIDx, which is comprised of Normal, Pneumonia, and COVID-19 images from multiple public databases. In this work, we use transfer learning to segment the lungs in the COVIDx dataset. Next, we show why segmentation of the region of interest (lungs) is vital to correctly learn the task of classification, specifically in datasets that contain images from different resources as it is the case for the COVIDx dataset. Finally, we show improved results in detection of COVID-19 cases using our generative model (RANDGAN) compared to conventional generative adversarial networks (GANs) for anomaly detection in medical images, improving the area under the ROC curve from 0.71 to 0.77.

Sina Akbarian, Laleh Seyyed-Kalantari, Farzad Khalvati et al.

Deep learning and knowledge transfer techniques have permeated the field of medical imaging and are considered as key approaches for revolutionizing diagnostic imaging practices. However, there are still challenges for the successful integration of deep learning into medical imaging tasks due to a lack of large annotated imaging data. To address this issue, we propose a teacher-student learning framework to transfer knowledge from a carefully pre-trained convolutional neural network (CNN) teacher to a student CNN. In this study, we explore the performance of knowledge transfer in the medical imaging setting. We investigate the proposed network's performance when the student network is trained on a small dataset (target dataset) as well as when teacher's and student's domains are distinct. The performances of the CNN models are evaluated on three medical imaging datasets including Diabetic Retinopathy, CheXpert, and ChestX-ray8. Our results indicate that the teacher-student learning framework outperforms transfer learning for small imaging datasets. Particularly, the teacher-student learning framework improves the area under the ROC Curve (AUC) of the CNN model on a small sample of CheXpert (n=5k) by 4% and on ChestX-ray8 (n=5.6k) by 9%. In addition to small training data size, we also demonstrate a clear advantage of the teacher-student learning framework in the medical imaging setting compared to transfer learning. We observe that the teacher-student network holds a great promise not only to improve the performance of diagnosis but also to reduce overfitting when the dataset is small.

Partoo Vafaeikia, Khashayar Namdar, Farzad Khalvati

Multi-task learning (MTL) optimizes several learning tasks simultaneously and leverages their shared information to improve generalization and the prediction of the model for each task. Auxiliary tasks can be added to the main task to ultimately boost the performance. In this paper, we provide a brief review on the recent deep multi-task learning (dMTL) approaches followed by methods on selecting useful auxiliary tasks that can be used in dMTL to improve the performance of the model for the main task.

Khashayar Namdar, Masoom A. Haider, Farzad Khalvati

Receiver operating characteristic (ROC) curve is an informative tool in binary classification and Area Under ROC Curve (AUC) is a popular metric for reporting performance of binary classifiers. In this paper, first we present a comprehensive review of ROC curve and AUC metric. Next, we propose a modified version of AUC that takes confidence of the model into account and at the same time, incorporates AUC into Binary Cross Entropy (BCE) loss used for training a Convolutional neural Network for classification tasks. We demonstrate this on three datasets: MNIST, prostate MRI, and brain MRI. Furthermore, we have published GenuineAI, a new python library, which provides the functions for conventional AUC and the proposed modified AUC along with metrics including sensitivity, specificity, recall, precision, and F1 for each point of the ROC curve.

Saman Motamed, Patrik Rogalla, Farzad Khalvati

Successful training of convolutional neural networks (CNNs) requires a substantial amount of data. With small datasets networks generalize poorly. Data Augmentation techniques improve the generalizability of neural networks by using existing training data more effectively. Standard data augmentation methods, however, produce limited plausible alternative data. Generative Adversarial Networks (GANs) have been utilized to generate new data and improve the performance of CNNs. Nevertheless, data augmentation techniques for training GANs are under-explored compared to CNNs. In this work, we propose a new GAN architecture for augmentation of chest X-rays for semi-supervised detection of pneumonia and COVID-19 using generative models. We show that the proposed GAN can be used to effectively augment data and improve classification accuracy of disease in chest X-rays for pneumonia and COVID-19. We compare our augmentation GAN model with Deep Convolutional GAN and traditional augmentation methods (rotate, zoom, etc) on two different X-ray datasets and show our GAN-based augmentation method surpasses other augmentation methods for training a GAN in detecting anomalies in X-ray images.

Ruqian Hao, Khashayar Namdar, Lin Liu et al.

Data augmentation refers to a group of techniques whose goal is to battle limited amount of available data to improve model generalization and push sample distribution toward the true distribution. While different augmentation strategies and their combinations have been investigated for various computer vision tasks in the context of deep learning, a specific work in the domain of medical imaging is rare and to the best of our knowledge, there has been no dedicated work on exploring the effects of various augmentation methods on the performance of deep learning models in prostate cancer detection. In this work, we have statically applied five most frequently used augmentation techniques (random rotation, horizontal flip, vertical flip, random crop, and translation) to prostate Diffusion-weighted Magnetic Resonance Imaging training dataset of 217 patients separately and evaluated the effect of each method on the accuracy of prostate cancer detection. The augmentation algorithms were applied independently to each data channel and a shallow as well as a deep Convolutional Neural Network (CNN) were trained on the five augmented sets separately. We used Area Under Receiver Operating Characteristic (ROC) curve (AUC) to evaluate the performance of the trained CNNs on a separate test set of 95 patients, using a validation set of 102 patients for finetuning. The shallow network outperformed the deep network with the best 2D slice-based AUC of 0.85 obtained by the rotation method.

Khashayar Namdar, Isha Gujrathi, Masoom A. Haider et al.

Convolutional Neural Networks (CNNs) have been used for automated detection of prostate cancer where Area Under Receiver Operating Characteristic (ROC) curve (AUC) is usually used as the performance metric. Given that AUC is not differentiable, common practice is to train the CNN using a loss functions based on other performance metrics such as cross entropy and monitoring AUC to select the best model. In this work, we propose to fine-tune a trained CNN for prostate cancer detection using a Genetic Algorithm to achieve a higher AUC. Our dataset contained 6-channel Diffusion-Weighted MRI slices of prostate. On a cohort of 2,955 training, 1,417 validation, and 1,334 test slices, we reached test AUC of 0.773; a 9.3% improvement compared to the base CNN model.

Saman Motamed, Isha Gujrathi, Dominik Deniffel et al.

The segmentation of prostate whole gland and transition zone in Diffusion Weighted MRI (DWI) are the first step in designing computer-aided detection algorithms for prostate cancer. However, variations in MRI acquisition parameters and scanner manufacturing result in different appearances of prostate tissue in the images. Convolutional neural networks (CNNs) which have shown to be successful in various medical image analysis tasks including segmentation are typically sensitive to the variations in imaging parameters. This sensitivity leads to poor segmentation performance of CNNs trained on a source cohort and tested on a target cohort from a different scanner and hence, it limits the applicability of CNNs for cross-cohort training and testing. Contouring prostate whole gland and transition zone in DWI images are time-consuming and expensive. Thus, it is important to enable CNNs pretrained on images of source domain, to segment images of target domain with minimum requirement for manual segmentation of images from the target domain. In this work, we propose a transfer learning method based on a modified U-net architecture and loss function, for segmentation of prostate whole gland and transition zone in DWIs using a CNN pretrained on a source dataset and tested on the target dataset. We explore the effect of the size of subset of target dataset used for fine-tuning the pre-trained CNN on the overall segmentation accuracy. Our results show that with a fine-tuning data as few as 30 patients from the target domain, the proposed transfer learning-based algorithm can reach dice score coefficient of 0.80 for both prostate whole gland and transition zone segmentation. Using a fine-tuning data of 115 patients from the target domain, dice score coefficient of 0.85 and 0.84 are achieved for segmentation of whole gland and transition zone, respectively, in the target domain.

Yucheng Zhang, Edrise M. Lobo-Mueller, Paul Karanicolas et al.

Cox proportional hazard model (CPH) is commonly used in clinical research for survival analysis. In quantitative medical imaging (radiomics) studies, CPH plays an important role in feature reduction and modeling. However, the underlying linear assumption of CPH model limits the prognostic performance. In addition, the multicollinearity of radiomic features and multiple testing problem further impedes the CPH models performance. In this work, using transfer learning, a convolutional neural network (CNN) based survival model was built and tested on preoperative CT images of resectable Pancreatic Ductal Adenocarcinoma (PDAC) patients. The proposed CNN-based survival model outperformed the traditional CPH-based radiomics approach in terms of concordance index by 22%, providing a better fit for patients' survival patterns. The proposed CNN-based survival model outperforms CPH-based radiomics pipeline in PDAC prognosis. This approach offers a better fit for survival patterns based on CT images and overcomes the limitations of conventional survival models.

Sunghwan Yoo, Isha Gujrathi, Masoom A. Haider et al.

Prostate cancer is one of the most common forms of cancer and the third leading cause of cancer death in North America. As an integrated part of computer-aided detection (CAD) tools, diffusion-weighted magnetic resonance imaging (DWI) has been intensively studied for accurate detection of prostate cancer. With deep convolutional neural networks (CNNs) significant success in computer vision tasks such as object detection and segmentation, different CNNs architectures are increasingly investigated in medical imaging research community as promising solutions for designing more accurate CAD tools for cancer detection. In this work, we developed and implemented an automated CNNs-based pipeline for detection of clinically significant prostate cancer (PCa) for a given axial DWI image and for each patient. DWI images of 427 patients were used as the dataset, which contained 175 patients with PCa and 252 healthy patients. To measure the performance of the proposed pipeline, a test set of 108 (out of 427) patients were set aside and not used in the training phase. The proposed pipeline achieved area under the receiver operating characteristic curve (AUC) of 0.87 (95% Confidence Interval (CI): 0.84-0.90) and 0.84 (95% CI: 0.76-0.91) at slice level and patient level, respectively.

Yucheng Zhang, Edrise M. Lobo-Mueller, Paul Karanicolas et al.

Pancreatic Ductal Adenocarcinoma (PDAC) is one of the most aggressive cancers with an extremely poor prognosis. Radiomics has shown prognostic ability in multiple types of cancer including PDAC. However, the prognostic value of traditional radiomics pipelines, which are based on hand-crafted radiomic features alone is limited. Convolutional neural networks (CNNs) have been shown to outperform these feature-based models in computer vision tasks. However, training a CNN from scratch needs a large sample size which is not feasible in most medical imaging studies. As an alternative solution, CNN-based transfer learning has shown potential for achieving reasonable performance using small datasets. In this work, we developed and validated a CNN-based transfer learning approach for prognostication of PDAC patients for overall survival using two independent resectable PDAC cohorts. The proposed deep transfer learning model for prognostication of PDAC achieved the area under the receiver operating characteristic curve of 0.74, which was significantly higher than that of the traditional radiomics model (0.56) as well as a CNN model trained from scratch (0.50). These results suggest that deep transfer learning may significantly improve prognosis performance using small datasets in medical imaging.

Xiaodan Hu, Audrey G. Chung, Paul Fieguth et al.

Generative Adversarial Networks (GANs) have shown considerable promise for mitigating the challenge of data scarcity when building machine learning-driven analysis algorithms. Specifically, a number of studies have shown that GAN-based image synthesis for data augmentation can aid in improving classification accuracy in a number of medical image analysis tasks, such as brain and liver image analysis. However, the efficacy of leveraging GANs for tackling prostate cancer analysis has not been previously explored. Motivated by this, in this study we introduce ProstateGAN, a GAN-based model for synthesizing realistic prostate diffusion imaging data. More specifically, in order to generate new diffusion imaging data corresponding to a particular cancer grade (Gleason score), we propose a conditional deep convolutional GAN architecture that takes Gleason scores into consideration during the training process. Experimental results show that high-quality synthetic prostate diffusion imaging data can be generated using the proposed ProstateGAN for specified Gleason scores.

Mohammad Javad Shafiee, Audrey G. Chung, Farzad Khalvati et al.

While lung cancer is the second most diagnosed form of cancer in men and women, a sufficiently early diagnosis can be pivotal in patient survival rates. Imaging-based, or radiomics-driven, detection methods have been developed to aid diagnosticians, but largely rely on hand-crafted features which may not fully encapsulate the differences between cancerous and healthy tissue. Recently, the concept of discovery radiomics was introduced, where custom abstract features are discovered from readily available imaging data. We propose a novel evolutionary deep radiomic sequencer discovery approach based on evolutionary deep intelligence. Motivated by patient privacy concerns and the idea of operational artificial intelligence, the evolutionary deep radiomic sequencer discovery approach organically evolves increasingly more efficient deep radiomic sequencers that produce significantly more compact yet similarly descriptive radiomic sequences over multiple generations. As a result, this framework improves operational efficiency and enables diagnosis to be run locally at the radiologist's computer while maintaining detection accuracy. We evaluated the evolved deep radiomic sequencer (EDRS) discovered via the proposed evolutionary deep radiomic sequencer discovery framework against state-of-the-art radiomics-driven and discovery radiomics methods using clinical lung CT data with pathologically-proven diagnostic data from the LIDC-IDRI dataset. The evolved deep radiomic sequencer shows improved sensitivity (93.42%), specificity (82.39%), and diagnostic accuracy (88.78%) relative to previous radiomics approaches.

Edward Li, Farzad Khalvati, Mohammad Javad Shafiee et al.

Magnetic Resonance Imaging (MRI) is a crucial medical imaging technology for the screening and diagnosis of frequently occurring cancers. However image quality may suffer by long acquisition times for MRIs due to patient motion, as well as result in great patient discomfort. Reducing MRI acquisition time can reduce patient discomfort and as a result reduces motion artifacts from the acquisition process. Compressive sensing strategies, when applied to MRI, have been demonstrated to be effective at decreasing acquisition times significantly by sparsely sampling the \emph{k}-space during the acquisition process. However, such a strategy requires advanced reconstruction algorithms to produce high quality and reliable images from compressive sensing MRI. This paper proposes a new reconstruction approach based on cross-domain stochastically fully connected conditional random fields (CD-SFCRF) for compressive sensing MRI. The CD-SFCRF introduces constraints in both \emph{k}-space and spatial domains within a stochastically fully connected graphical model to produce improved MRI reconstruction. Experimental results using T2-weighted (T2w) imaging and diffusion-weighted imaging (DWI) of the prostate show strong performance in preserving fine details and tissue structures in the reconstructed images when compared to other tested methods even at low sampling rates.

Ameneh Boroomand, Mohammad Javad Shafiee, Farzad Khalvati et al.

Diffusion weighted magnetic resonance imaging (DW-MR) is a powerful tool in imaging-based prostate cancer screening and detection. Endorectal coils are commonly used in DW-MR imaging to improve the signal-to-noise ratio (SNR) of the acquisition, at the expense of significant intensity inhomogeneities (bias field) that worsens as we move away from the endorectal coil. The presence of bias field can have a significant negative impact on the accuracy of different image analysis tasks, as well as prostate tumor localization, thus leading to increased inter- and intra-observer variability. Retrospective bias correction approaches are introduced as a more efficient way of bias correction compared to the prospective methods such that they correct for both of the scanner and anatomy-related bias fields in MR imaging. Previously proposed retrospective bias field correction methods suffer from undesired noise amplification that can reduce the quality of bias-corrected DW-MR image. Here, we propose a unified data reconstruction approach that enables joint compensation of bias field as well as data noise in DW-MR imaging. The proposed noise-compensated, bias-corrected (NCBC) data reconstruction method takes advantage of a novel stochastically fully connected joint conditional random field (SFC-JCRF) model to mitigate the effects of data noise and bias field in the reconstructed MR data. The proposed NCBC reconstruction method was tested on synthetic DW-MR data, physical DW-phantom as well as real DW-MR data all acquired using endorectal MR coil. Both qualitative and quantitative analysis illustrated that the proposed NCBC method can achieve improved image quality when compared to other tested bias correction methods. As such, the proposed NCBC method may have potential as a useful retrospective approach for improving the consistency of image interpretations.

Mohammad Javad Shafiee, Audrey G. Chung, Devinder Kumar et al.

Radiomics has proven to be a powerful prognostic tool for cancer detection, and has previously been applied in lung, breast, prostate, and head-and-neck cancer studies with great success. However, these radiomics-driven methods rely on pre-defined, hand-crafted radiomic feature sets that can limit their ability to characterize unique cancer traits. In this study, we introduce a novel discovery radiomics framework where we directly discover custom radiomic features from the wealth of available medical imaging data. In particular, we leverage novel StochasticNet radiomic sequencers for extracting custom radiomic features tailored for characterizing unique cancer tissue phenotype. Using StochasticNet radiomic sequencers discovered using a wealth of lung CT data, we perform binary classification on 42,340 lung lesions obtained from the CT scans of 93 patients in the LIDC-IDRI dataset. Preliminary results show significant improvement over previous state-of-the-art methods, indicating the potential of the proposed discovery radiomics framework for improving cancer screening and diagnosis.

Zehra Camlica, H. R. Tizhoosh, Farzad Khalvati

Good results on image classification and retrieval using support vector machines (SVM) with local binary patterns (LBPs) as features have been extensively reported in the literature where an entire image is retrieved or classified. In contrast, in medical imaging, not all parts of the image may be equally significant or relevant to the image retrieval application at hand. For instance, in lung x-ray image, the lung region may contain a tumour, hence being highly significant whereas the surrounding area does not contain significant information from medical diagnosis perspective. In this paper, we propose to detect salient regions of images during training and fold the data to reduce the effect of irrelevant regions. As a result, smaller image areas will be used for LBP features calculation and consequently classification by SVM. We use IRMA 2009 dataset with 14,410 x-ray images to verify the performance of the proposed approach. The results demonstrate the benefits of saliency-based folding approach that delivers comparable classification accuracies with state-of-the-art but exhibits lower computational cost and storage requirements, factors highly important for big data analytics.

Devinder Kumar, Mohammad Javad Shafiee, Audrey G. Chung et al.

Lung cancer is the leading cause for cancer related deaths. As such, there is an urgent need for a streamlined process that can allow radiologists to provide diagnosis with greater efficiency and accuracy. A powerful tool to do this is radiomics: a high-dimension imaging feature set. In this study, we take the idea of radiomics one step further by introducing the concept of discovery radiomics for lung cancer prediction using CT imaging data. In this study, we realize these custom radiomic sequencers as deep convolutional sequencers using a deep convolutional neural network learning architecture. To illustrate the prognostic power and effectiveness of the radiomic sequences produced by the discovered sequencer, we perform cancer prediction between malignant and benign lesions from 97 patients using the pathologically-proven diagnostic data from the LIDC-IDRI dataset. Using the clinically provided pathologically-proven data as ground truth, the proposed framework provided an average accuracy of 77.52% via 10-fold cross-validation with a sensitivity of 79.06% and specificity of 76.11%, surpassing the state-of-the art method.

Audrey G. Chung, Mohammad Javad Shafiee, Devinder Kumar et al.

Prostate cancer is the most diagnosed form of cancer in Canadian men, and is the third leading cause of cancer death. Despite these statistics, prognosis is relatively good with a sufficiently early diagnosis, making fast and reliable prostate cancer detection crucial. As imaging-based prostate cancer screening, such as magnetic resonance imaging (MRI), requires an experienced medical professional to extensively review the data and perform a diagnosis, radiomics-driven methods help streamline the process and has the potential to significantly improve diagnostic accuracy and efficiency, and thus improving patient survival rates. These radiomics-driven methods currently rely on hand-crafted sets of quantitative imaging-based features, which are selected manually and can limit their ability to fully characterize unique prostate cancer tumour phenotype. In this study, we propose a novel \textit{discovery radiomics} framework for generating custom radiomic sequences tailored for prostate cancer detection. Discovery radiomics aims to uncover abstract imaging-based features that capture highly unique tumour traits and characteristics beyond what can be captured using predefined feature models. In this paper, we discover new custom radiomic sequencers for generating new prostate radiomic sequences using multi-parametric MRI data. We evaluated the performance of the discovered radiomic sequencer against a state-of-the-art hand-crafted radiomic sequencer for computer-aided prostate cancer detection with a feedforward neural network using real clinical prostate multi-parametric MRI data. Results for the discovered radiomic sequencer demonstrate good performance in prostate cancer detection and clinical decision support relative to the hand-crafted radiomic sequencer. The use of discovery radiomics shows potential for more efficient and reliable automatic prostate cancer detection.

Zehra Camlica, H. R. Tizhoosh, Farzad Khalvati

Content-based image retrieval (CBIR) of medical images is a crucial task that can contribute to a more reliable diagnosis if applied to big data. Recent advances in feature extraction and classification have enormously improved CBIR results for digital images. However, considering the increasing accessibility of big data in medical imaging, we are still in need of reducing both memory requirements and computational expenses of image retrieval systems. This work proposes to exclude the features of image blocks that exhibit a low encoding error when learned by a $n/p/n$ autoencoder ($p\!<\!n$). We examine the histogram of autoendcoding errors of image blocks for each image class to facilitate the decision which image regions, or roughly what percentage of an image perhaps, shall be declared relevant for the retrieval task. This leads to reduction of feature dimensionality and speeds up the retrieval process. To validate the proposed scheme, we employ local binary patterns (LBP) and support vector machines (SVM) which are both well-established approaches in CBIR research community. As well, we use IRMA dataset with 14,410 x-ray images as test data. The results show that the dimensionality of annotated feature vectors can be reduced by up to 50% resulting in speedups greater than 27% at expense of less than 1% decrease in the accuracy of retrieval when validating the precision and recall of the top 20 hits.