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The success of deep learning relies heavily on large labeled datasets, but we often only have access to several small datasets associated with partial labels. To address this problem, we propose a new initiative, "Label-Assemble", that aims to unleash the full potential of partial labels from an assembly of public datasets. We discovered that learning from negative examples facilitates both computer-aided disease diagnosis and detection. This discovery will be particularly crucial in novel disease diagnosis, where positive examples are hard to collect, yet negative examples are relatively easier to assemble. For example, assembling existing labels from NIH ChestX-ray14 (available since 2017) significantly improves the accuracy of COVID-19 diagnosis from 96.3% to 99.3%. In addition to diagnosis, assembling labels can also improve disease detection, e.g., the detection of pancreatic ductal adenocarcinoma (PDAC) can greatly benefit from leveraging the labels of Cysts and PanNets (two other types of pancreatic abnormalities), increasing sensitivity from 52.1% to 84.0% while maintaining a high specificity of 98.0%., Comment: ISBI 2023

Pancreatic ductal adenocarcinoma (PDAC) is the third most common cause of cancer death in the United States. Predicting tumors like PDACs (including both classification and segmentation) from medical images by deep learning is becoming a growing trend, but usually a large number of annotated data are required for training, which is very labor-intensive and time-consuming. In this paper, we consider a partially supervised setting, where cheap image-level annotations are provided for all the training data, and the costly per-voxel annotations are only available for a subset of them. We propose an Inductive Attention Guidance Network (IAG-Net) to jointly learn a global image-level classifier for normal/PDAC classification and a local voxel-level classifier for semi-supervised PDAC segmentation. We instantiate both the global and the local classifiers by multiple instance learning (MIL), where the attention guidance, indicating roughly where the PDAC regions are, is the key to bridging them: For global MIL based normal/PDAC classification, attention serves as a weight for each instance (voxel) during MIL pooling, which eliminates the distraction from the background; For local MIL based semi-supervised PDAC segmentation, the attention guidance is inductive, which not only provides bag-level pseudo-labels to training data without per-voxel annotations for MIL training, but also acts as a proxy of an instance-level classifier. Experimental results show that our IAG-Net boosts PDAC segmentation accuracy by more than 5% compared with the state-of-the-arts.

Human body is a complex dynamic system composed of various sub-dynamic parts. Especially, thoracic and abdominal organs have complex internal shape variations with different frequencies by various reasons such as respiration with fast motion and peristalsis with slower motion. CT protocols for abdominal lesions are multi-phase scans for various tumor detection to use different vascular contrast, however, they are not aligned well enough to visually check the same area. In this paper, we propose a time-efficient and accurate deformable registration algorithm for multi-phase CT scans considering abdominal organ motions, which can be applied for differentiable or non-differentiable motions of abdominal organs. Experimental results shows the registration accuracy as 0.85 +/- 0.45mm (mean +/- STD) for pancreas within 1 minute for the whole abdominal region.

Although deep neural networks have been a dominant method for many 2D vision tasks, it is still challenging to apply them to 3D tasks, such as medical image segmentation, due to the limited amount of annotated 3D data and limited computational resources. In this chapter, by rethinking the strategy to apply 3D Convolutional Neural Networks to segment medical images, we propose a novel 3D-based coarse-to-fine framework to efficiently tackle these challenges. The proposed 3D-based framework outperforms their 2D counterparts by a large margin since it can leverage the rich spatial information along all three axes. We further analyze the threat of adversarial attacks on the proposed framework and show how to defense against the attack. We conduct experiments on three datasets, the NIH pancreas dataset, the JHMI pancreas dataset and the JHMI pathological cyst dataset, where the first two and the last one contain healthy and pathological pancreases respectively, and achieve the current state-of-the-art in terms of Dice-Sorensen Coefficient (DSC) on all of them. Especially, on the NIH pancreas segmentation dataset, we outperform the previous best by an average of over $2\%$, and the worst case is improved by $7\%$ to reach almost $70\%$, which indicates the reliability of our framework in clinical applications., Comment: arXiv admin note: substantial text overlap with arXiv:1712.00201

Obesity increases significantly cancer risk in various organs. Although this has been recognized for decades, the mechanism through which this happens has never been explained. Here, we show that the volumes of kidneys, pancreas, and liver are strongly correlated (median correlation = 0.625; P-value<10-47) with the body mass index (BMI) of an individual. We also find a significant relationship between the increase in organ volume and the increase in cancer risk (P-value<10-12). These results provide a mechanism explaining why obese individuals have higher cancer risk in several organs: the larger the organ volume the more cells at risk of becoming cancerous. These findings are important for a better understanding of the effects obesity has on cancer risk and, more generally, for the development of better preventive strategies to limit the mortality caused by obesity.

This work presents comprehensive results to detect in the early stage the pancreatic neuroendocrine tumors (PNETs), a group of endocrine tumors arising in the pancreas, which are the second common type of pancreatic cancer, by checking the abdominal CT scans. To the best of our knowledge, this task has not been studied before as a computational task. To provide radiologists with tumor locations, we adopt a segmentation framework to classify CT volumes by checking if at least a sufficient number of voxels is segmented as tumors. To quantitatively analyze our method, we collect and voxelwisely label a new abdominal CT dataset containing $376$ cases with both arterial and venous phases available for each case, in which $228$ cases were diagnosed with PNETs while the remaining $148$ cases are normal, which is currently the largest dataset for PNETs to the best of our knowledge. In order to incorporate rich knowledge of radiologists to our framework, we annotate dilated pancreatic duct as well, which is regarded as the sign of high risk for pancreatic cancer. Quantitatively, our approach outperforms state-of-the-art segmentation networks and achieves a sensitivity of $89.47\%$ at a specificity of $81.08\%$, which indicates a potential direction to achieve a clinical impact related to cancer diagnosis by earlier tumor detection.

Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers among the population. Screening for PDACs in dynamic contrast-enhanced CT is beneficial for early diagnosis. In this paper, we investigate the problem of automated detecting PDACs in multi-phase (arterial and venous) CT scans. Multiple phases provide more information than single phase, but they are unaligned and inhomogeneous in texture, making it difficult to combine cross-phase information seamlessly. We study multiple phase alignment strategies, i.e., early alignment (image registration), late alignment (high-level feature registration), and slow alignment (multi-level feature registration), and suggest an ensemble of all these alignments as a promising way to boost the performance of PDAC detection. We provide an extensive empirical evaluation on two PDAC datasets and show that the proposed alignment ensemble significantly outperforms previous state-of-the-art approaches, illustrating the strong potential for clinical use., Comment: The first two authors contributed equally to this work. Accepted to MICCAI 2020

Tubular structure segmentation in medical images, e.g., segmenting vessels in CT scans, serves as a vital step in the use of computers to aid in screening early stages of related diseases. But automatic tubular structure segmentation in CT scans is a challenging problem, due to issues such as poor contrast, noise and complicated background. A tubular structure usually has a cylinder-like shape which can be well represented by its skeleton and cross-sectional radii (scales). Inspired by this, we propose a geometry-aware tubular structure segmentation method, Deep Distance Transform (DDT), which combines intuitions from the classical distance transform for skeletonization and modern deep segmentation networks. DDT first learns a multi-task network to predict a segmentation mask for a tubular structure and a distance map. Each value in the map represents the distance from each tubular structure voxel to the tubular structure surface. Then the segmentation mask is refined by leveraging the shape prior reconstructed from the distance map. We apply our DDT on six medical image datasets. The experiments show that (1) DDT can boost tubular structure segmentation performance significantly (e.g., over 13% improvement measured by DSC for pancreatic duct segmentation), and (2) DDT additionally provides a geometrical measurement for a tubular structure, which is important for clinical diagnosis (e.g., the cross-sectional scale of a pancreatic duct can be an indicator for pancreatic cancer).