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Segmentation of cardiac structures is one of the fundamental steps to estimate volumetric indices of the heart. This step is still performed semiautomatically in clinical routine and is, thus, prone to interobserver and intraobserver variabilities. Recent studies have shown that deep learning has the potential to perform fully automatic segmentation. However, the current best solutions still suffer from a lack of robustness in terms of accuracy and number of outliers. The goal of this work is to introduce a novel network designed to improve the overall segmentation accuracy of left ventricular structures (endocardial and epicardial borders) while enhancing the estimation of the corresponding clinical indices and reducing the number of outliers. This network is based on a multistage framework where both the localization and segmentation steps are optimized jointly through an end-to-end scheme. Results obtained on a large open access data set show that our method outperforms the current best-performing deep learning solution with a lighter architecture and achieved an overall segmentation accuracy lower than the intraobserver variability for the epicardial border (i.e., on average a mean absolute error of 1.5 mm and a Hausdorff distance of 5.1mm) with 11% of outliers. Moreover, we demonstrate that our method can closely reproduce the expert analysis for the end-diastolic and end-systolic left ventricular volumes, with a mean correlation of 0.96 and a mean absolute error of 7.6 ml. Concerning the ejection fraction of the left ventricle, results are more contrasted with a mean correlation coefficient of 0.83 and an absolute mean error of 5.0%, producing scores that are slightly below the intraobserver margin. Based on this observation, areas for improvement are suggested.

Delineation of the cardiac structures from 2D echocardiographic images is a common clinical task to establish a diagnosis. Over the past decades, the automation of this task has been the subject of intense research. In this paper, we evaluate how far the state-of-the-art encoder-decoder deep convolutional neural network methods can go at assessing 2D echocardiographic images, i.e., segmenting cardiac structures and estimating clinical indices, on a dataset, especially, designed to answer this objective. We, therefore, introduce the cardiac acquisitions for multi-structure ultrasound segmentation dataset, the largest publicly-available and fully-annotated dataset for the purpose of echocardiographic assessment. The dataset contains two and four-chamber acquisitions from 500 patients with reference measurements from one cardiologist on the full dataset and from three cardiologists on a fold of 50 patients. Results show that encoder-decoder-based architectures outperform state-of-the-art non-deep learning methods and faithfully reproduce the expert analysis for the end-diastolic and end-systolic left ventricular volumes, with a mean correlation of 0.95 and an absolute mean error of 9.5 ml. Concerning the ejection fraction of the left ventricle, results are more contrasted with a mean correlation coefficient of 0.80 and an absolute mean error of 5.6%. Although these results are below the inter-observer scores, they remain slightly worse than the intra-observer's ones. Based on this observation, areas for improvement are defined, which open the door for accurate and fully-automatic analysis of 2D echocardiographic images.

We have designed a computer-aided diagnosis system to discriminate between hypermetabolic cancer lesions and hypermetabolic inflammatory or physiological but noncancerous processes in FDG PET/CT exams of lymphoma patients. Detection performance of the support vector machine (SVM) classifier was assessed based on feature sets including 105 positron emission tomography (PET) and Computed tomography (CT) characteristics derived from the clinical practice and from more sophisticated texture analysis. An original feature selection method based on combining different filter methods was proposed. The evaluation database consisted of 156 lymphomatous and 32 suspicious but nonlymphomatous regions of interest. Different types of training databases including either the PET and CT features or the PET features only, with or without feature selection, were evaluated to assess the added value of multimodality and texture information on classification performance. An optimization study was conducted for each classifier separately to select the best combination of parameters. Promising classification performance was achieved by the SVM classifier combined with the 12 most discriminant PET and CT features with a value of the area under the receiver operating curve of 0.91.

Building an accurate training database is challenging in supervised classification. For instance, in medical imaging, radiologists often delineate malignant and benign tissues without access to the histological ground truth, leading to uncertain data sets. This paper addresses the pattern classification problem arising when available target data include some uncertainty information. Target data considered here are both qualitative (a class label) or quantitative (an estimation of the posterior probability). In this context, usual discriminative methods, such as the support vector machine (SVM), fail either to learn a robust classifier or to predict accurate probability estimates. We generalize the regular SVM by introducing a new formulation of the learning problem to take into account class labels as well as class probability estimates. This original reformulation into a probabilistic SVM (P-SVM) can be efficiently solved by adapting existing flexible SVM solvers. Furthermore, this framework allows deriving a unique learned prediction function for both decision and posterior probability estimation providing qualitative and quantitative predictions. The method is first tested on synthetic data sets to evaluate its properties as compared with the classical SVM and fuzzy-SVM. It is then evaluated on a clinical data set of multiparametric prostate magnetic resonance images to assess its performances in discriminating benign from malignant tissues. P-SVM is shown to outperform classical SVM as well as the fuzzy-SVM in terms of probability predictions and classification performances, and demonstrates its potential for the design of an efficient computer-aided decision system for prostate cancer diagnosis based on multiparametric magnetic resonance (MR) imaging.

This paper presents the Virtual Imaging Platform (VIP), a platform accessible at http://vip.creatis.insa-lyon.fr to facilitate the sharing of object models and medical image simulators, and to provide access to distributed computing and storage resources. A complete overview is presented, describing the ontologies designed to share models in a common repository, the workflow template used to integrate simulators, and the tools and strategies used to exploit computing and storage resources. Simulation results obtained in four image modalities and with different models show that VIP is versatile and robust enough to support large simulations. The platform currently has 200 registered users who consumed 33 years of CPU time in 2011.

Two groups of bootstrap methods have been proposed to estimate the statistical properties of positron emission tomography (PET) images by generating multiple statistically equivalent data sets from few data samples. The first group generates resampled data based on a parametric approach assuming that data from which resampling is performed follows a Poisson distribution while the second group consists of nonparametric approaches. These methods either require a unique original sample or a series of statistically equivalent data that can be list-mode files or sinograms. Previous reports regarding these bootstrap approaches suggest different results. This work compares the accuracy of three of these bootstrap methods for 3-D PET imaging based on simulated data. Two methods are based on a unique file, namely a list-mode based nonparametric (LMNP) method and a sinogram based parametric (SP) method. The third method is a sinogram-based nonparametric (SNP) method. Another original method (extended LMNP) was also investigated, which is an extension of the LMNP methods based on deriving a resampled list-mode file by drawings events from multiple original list-mode files. Our comparison is based on the analysis of the statistical moments estimated on the repeated and resampled data. This includes the probability density function and the moments of order 1 and 2. Results show that the two methods based on multiple original data (SNP and extended LMNP) are the only methods that correctly estimate the statistical parameters. Performances of the LMNP and SP methods are variable. Simulated data used in this study were characterized by a high noise level. Differences among the tested strategies might be reduced with clinical data sets with lower noise.