This paper proposes an automated classification method of COVID-19 chest CT volumes using improved 3D MLP-Mixer. Novel coronavirus disease 2019 (COVID-19) spreads over the world, causing a large number of infected patients and deaths. Sudden increase in the number of COVID-19 patients causes a manpower shortage in medical institutions. Computer-aided diagnosis (CAD) system provides quick and quantitative diagnosis results. CAD system for COVID-19 enables efficient diagnosis workflow and contributes to reduce such manpower shortage. In image-based diagnosis of viral pneumonia cases including COVID-19, both local and global image features are important because viral pneumonia cause many ground glass opacities and consolidations in large areas in the lung. This paper proposes an automated classification method of chest CT volumes for COVID19 diagnosis assistance. MLP-Mixer is a recent method of image classification using Vision Transformer-like architecture. It performs classification using both local and global image features. To classify 3D CT volumes, we developed a hybrid classification model that consists of both a 3D convolutional neural network (CNN) and a 3D version of the MLP-Mixer. Classification accuracy of the proposed method was evaluated using a dataset that contains 1205 CT volumes and obtained 79.5% of classification accuracy. The accuracy was higher than that of conventional 3D CNN models consists of 3D CNN layers and simple MLP layers.
Medical image analysis approaches such as data augmentation and domain adaption need huge amounts of realistic medical images. Generating realistic medical images by machine learning is a feasible approach. We propose L-former, a lightweight Transformer for realistic medical image generation. L-former can generate more reliable and realistic medical images than recent generative adversarial networks (GANs). Meanwhile, L-former does not consume as high computational cost as conventional Transformer-based generative models. L-former uses Transformers to generate low-resolution feature vectors at shallow layers, and uses convolutional neural networks to generate high-resolution realistic medical images at deep layers. Experimental results showed that L-former outperformed conventional GANs by FID scores 33.79 and 76.85 on two datasets, respectively. We further conducted a downstream study by using the images generated by L-former to perform a super-resolution task. A high PSNR score of 27.87 proved L-former’s ability to generate reliable images for super-resolution and showed its potential for applications in medical diagnosis.
Purpose: We propose a super-resolution (SR) method, named SR-CycleGAN, for SR of clinical computed tomography (CT) images to the micro-focus x-ray CT CT (μCT) level. Due to the resolution limitations of clinical CT (about 500 × 500 × 500 μm3 / voxel), it is challenging to obtain enough pathological information. On the other hand, μCT scanning allows the imaging of lung specimens with significantly higher resolution (about 50 × 50 × 50 μm3 / voxel or higher), which allows us to obtain and analyze detailed anatomical information. As a way to obtain detailed information such as cancer invasion and bronchioles from preoperative clinical CT images of lung cancer patients, the SR of clinical CT images to the μCT level is desired.
Approach: Typical SR methods require aligned pairs of low-resolution (LR) and high-resolution images for training, but it is infeasible to obtain precisely aligned paired clinical CT and μCT images. To solve this problem, we propose an unpaired SR approach that can perform SR on clinical CT to the μCT level. We modify a conventional image-to-image translation network named CycleGAN to an inter-modality translation network named SR-CycleGAN. The modifications consist of three parts: (1) an innovative loss function named multi-modality super-resolution loss, (2) optimized SR network structures for enlarging the input LR image to k2-times by width and height to obtain the SR output, and (3) sub-pixel shuffling layers for reducing computing time.
Results: Experimental results demonstrated that our method successfully performed SR of lung clinical CT images. SSIM and PSNR scores of our method were 0.54 and 17.71, higher than the conventional CycleGAN’s scores of 0.05 and 13.64, respectively.
Conclusions: The proposed SR-CycleGAN is usable for the SR of a lung clinical CT into μCT scale, while conventional CycleGAN output images with low qualitative and quantitative values. More lung micro-anatomy information could be observed to aid diagnosis, such as the shape of bronchioles walls.
This paper proposes a super-resolution (SR) method, for performing SR of medical images training on a newly-built lung clinical CT / micro CT dataset. Conventional SR methods are always trained on bicubic downsampled images (LR) / original images (HR) image pairs. However, registration precision between LR and HR images is not satisfying for SR. Low precision of registration results in conventional SR methods’ unsatisfactory performance in medical imaging. We propose a coarse-to-fine cascade framework for performing SR of medical images. First, we design a coarse SR network to translate LR medical images into coarse SR images. Next, we utilize a fully convolutional network (FCN) to perform fine SR (translate coarse SR images to fine SR images). We conducted experiments using a newly-built clinical / micro CT lung specimen dataset. Experimental results illustrated that our method obtained PSNR of 27.30 and SSIM of 0.75, outperforming conventional method’s PSNR 19.08 and SSIM 0.63.
This paper proposes an automated classification method of chest CT volumes based on likelihood of COVID-19 cases. Novel coronavirus disease 2019 (COVID-19) spreads over the world, causing a large number of infected patients and deaths. Sudden increase in the number of COVID-19 patients causes a manpower shortage in medical institutions. Computer-aided diagnosis (CAD) system provides quick and quantitative diagnosis results. CAD system for COVID-19 enables efficient diagnosis workflow and contributes to reduce such manpower shortage. This paper proposes an automated classification method of chest CT volumes for COVID-19 diagnosis assistance. We propose a COVID-19 classification convolutional neural network (CNN) that has a 2D/3D hybrid feature extraction flows. The 2D/3D hybrid feature extraction flows are designed to effectively extract image features from anisotropic volumes such as chest CT volumes for diagnosis. The flows extract image features on three mutually perpendicular planes in CT volumes and then combine the features to perform classification. Classification accuracy of the proposed method was evaluated using a dataset that contains 1288 CT volumes. An averaged classification accuracy was 83.3%. The accuracy was higher than that of a classification CNN which does not have 2D and 3D hybrid feature extraction flows.
This paper newly proposes a segmentation method of infected area for COVID-19 (Coronavirus Disease 2019) infected lung clinical CT volumes. COVID-19 spread globally from 2019 to 2020, causing the world to face a globally health crisis. It is desired to estimate severity of COVID-19, based on observing the infected area segmented from clinical computed tomography (CT) volume of COVID-19 patients. Given the lung field from a COVID-19 lung clinical CT volume as input, we desire an automated approach that could perform segmentation of infected area. Since labeling infected area for supervised segmentation needs a lot of labor, we propose a segmentation method without labeling of infected area. Our method refers to a baseline method utilizing representation learning and clustering. However, the baseline method is likely to segment anatomical structures with high H.U. (Houns field) intensity such as blood vessel into infected area. Aiming to solve this problem, we propose a novel pre-processing method that could transform high intensity anatomical structures into low intensity structures. This pre-processing method avoids high intensity anatomical structures to be mis-segmented into infected area. Given the lung field extracted from a CT volume, our method segment the lung field into normal tissue, ground GGO (ground glass opacity), and consolidation. Our method consists of three steps: 1) pulmonary blood vessel segmentation, 2) image inpainting of pulmonary blood vessel based on blood vessel segmentation result, and 3) segmentation of infected area. Compared to the baseline method, experimental results showed that our method contributes to the segmentation accuracy, especially on tubular structures such as blood vessels. Our method improved normalized mutual information score from 0.280 (the baseline method) to 0.394.
This paper newly introduces multi-modality loss function for GAN-based super-resolution that can maintain image structure and intensity on unpaired training dataset of clinical CT and micro CT volumes. Precise non- invasive diagnosis of lung cancer mainly utilizes 3D multidetector computed-tomography (CT) data. On the other hand, we can take μCT images of resected lung specimen in 50 μm or higher resolution. However, μCT scanning cannot be applied to living human imaging. For obtaining highly detailed information such as cancer invasion area from pre-operative clinical CT volumes of lung cancer patients, super-resolution (SR) of clinical CT volumes to μCT level might be one of substitutive solutions. While most SR methods require paired low- and high-resolution images for training, it is infeasible to obtain precisely paired clinical CT and μCT volumes. We aim to propose unpaired SR approaches for clincial CT using micro CT images based on unpaired image translation methods such as CycleGAN or UNIT. Since clinical CT and μCT are very different in structure and intensity, direct appliation of GAN-based unpaired image translation methods in super-resolution tends to generate arbitrary images. Aiming to solve this problem, we propose new loss function called multi-modality loss function to maintain the similarity of input images and corresponding output images in super-resolution task. Experimental results demonstrated that the newly proposed loss function made CycleGAN and UNIT to successfully perform SR of clinical CT images of lung cancer patients into μCT level resolution, while original CycleGAN and UNIT failed in super-resolution.
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