John Simpson

Samuel Budd, Thomas Day, John Simpson et al.

Probably yes. -- Supervised Deep Learning dominates performance scores for many computer vision tasks and defines the state-of-the-art. However, medical image analysis lags behind natural image applications. One of the many reasons is the lack of well annotated medical image data available to researchers. One of the first things researchers are told is that we require significant expertise to reliably and accurately interpret and label such data. We see significant inter- and intra-observer variability between expert annotations of medical images. Still, it is a widely held assumption that novice annotators are unable to provide useful annotations for use by clinical Deep Learning models. In this work we challenge this assumption and examine the implications of using a minimally trained novice labelling workforce to acquire annotations for a complex medical image dataset. We study the time and cost implications of using novice annotators, the raw performance of novice annotators compared to gold-standard expert annotators, and the downstream effects on a trained Deep Learning segmentation model's performance for detecting a specific congenital heart disease (hypoplastic left heart syndrome) in fetal ultrasound imaging.

Samuel Budd, Matthew Sinclair, Thomas Day et al.

Fetal ultrasound screening during pregnancy plays a vital role in the early detection of fetal malformations which have potential long-term health impacts. The level of skill required to diagnose such malformations from live ultrasound during examination is high and resources for screening are often limited. We present an interpretable, atlas-learning segmentation method for automatic diagnosis of Hypo-plastic Left Heart Syndrome (HLHS) from a single `4 Chamber Heart' view image. We propose to extend the recently introduced Image-and-Spatial Transformer Networks (Atlas-ISTN) into a framework that enables sensitising atlas generation to disease. In this framework we can jointly learn image segmentation, registration, atlas construction and disease prediction while providing a maximum level of clinical interpretability compared to direct image classification methods. As a result our segmentation allows diagnoses competitive with expert-derived manual diagnosis and yields an AUC-ROC of 0.978 (1043 cases for training, 260 for validation and 325 for testing).