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Automation of medical image interpretation could alleviate bottlenecks in diagnostic workflows, and has become of particular interest in recent years due to advancements in natural language processing. Great strides have been made towards automated radiology report generation via AI, yet ensuring clinical accuracy in generated reports is a significant challenge, hindering deployment of such methods in clinical practice. In this work we propose a quality control framework for assessing the reliability of AI-generated radiology reports with respect to semantics of diagnostic importance using modular auxiliary auditing components (AC). Evaluating our pipeline on the MIMIC-CXR dataset, our findings show that incorporating ACs in the form of disease-classifiers can enable auditing that identifies more reliable reports, resulting in higher F1 scores compared to unfiltered generated reports. Additionally, leveraging the confidence of the AC labels further improves the audit's effectiveness., Comment: Accepted to MICCAI UNSURE Workshop

Recent work has uncovered alarming disparities in the performance of machine learning models in healthcare. In this study, we explore whether such disparities are present in the UK Biobank fundus retinal images by training and evaluating a disease classification model on these images. We assess possible disparities across various population groups and find substantial differences despite strong overall performance of the model. In particular, we discover unfair performance for certain assessment centres, which is surprising given the rigorous data standardisation protocol. We compare how these differences emerge and apply a range of existing bias mitigation methods to each one. A key insight is that each disparity has unique properties and responds differently to the mitigation methods. We also find that these methods are largely unable to enhance fairness, highlighting the need for better bias mitigation methods tailored to the specific type of bias., Comment: To appear at MICCAI FAIMI Workshop 2024

The 5-year survival rate of Head and Neck Cancer (HNC) has not improved over the past decade and one common cause of treatment failure is recurrence. In this paper, we built Cox proportional hazard (CoxPH) models that predict the recurrence free survival (RFS) of oropharyngeal HNC patients. Our models utilise both clinical information and multimodal radiomics features extracted from tumour regions in Computed Tomography (CT) and Positron Emission Tomography (PET). Furthermore, we were one of the first studies to explore the impact of segmentation accuracy on the predictive power of the extracted radiomics features, through under- and over-segmentation study. Our models were trained using the HEad and neCK TumOR (HECKTOR) challenge data, and the best performing model achieved a concordance index (C-index) of 0.74 for the model utilising clinical information and multimodal CT and PET radiomics features, which compares favourably with the model that only used clinical information (C-index of 0.67). Our under- and over-segmentation study confirms that segmentation accuracy affects radiomics extraction, however, it affects PET and CT differently.

Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) combined with Computed Tomography (CT) scans are critical in oncology to the identification of solid tumours and the monitoring of their progression. However, precise and consistent lesion segmentation remains challenging, as manual segmentation is time-consuming and subject to intra- and inter-observer variability. Despite their promise, automated segmentation methods often struggle with false positive segmentation of regions of healthy metabolic activity, particularly when presented with such a complex range of tumours across the whole body. In this paper, we explore the application of the nnUNet to tumour segmentation of whole-body PET-CT scans and conduct different experiments on optimal training and post-processing strategies. Our best model obtains a Dice score of 69\% and a false negative and false positive volume of 6.27 and 5.78 mL respectively, on our internal test set. This model is submitted as part of the autoPET 2023 challenge. Our code is available at: https://github.com/anissa218/autopet\_nnunet

Segmentation of head and neck (H\&N) tumours and prediction of patient outcome are crucial for patient's disease diagnosis and treatment monitoring. Current developments of robust deep learning models are hindered by the lack of large multi-centre, multi-modal data with quality annotations. The MICCAI 2021 HEad and neCK TumOR (HECKTOR) segmentation and outcome prediction challenge creates a platform for comparing segmentation methods of the primary gross target volume on fluoro-deoxyglucose (FDG)-PET and Computed Tomography images and prediction of progression-free survival in H\&N oropharyngeal cancer.For the segmentation task, we proposed a new network based on an encoder-decoder architecture with full inter- and intra-skip connections to take advantage of low-level and high-level semantics at full scales. Additionally, we used Conditional Random Fields as a post-processing step to refine the predicted segmentation maps. We trained multiple neural networks for tumor volume segmentation, and these segmentations were ensembled achieving an average Dice Similarity Coefficient of 0.75 in cross-validation, and 0.76 on the challenge testing data set. For prediction of patient progression free survival task, we propose a Cox proportional hazard regression combining clinical, radiomic, and deep learning features. Our survival prediction model achieved a concordance index of 0.82 in cross-validation, and 0.62 on the challenge testing data set., Comment: 13 pages, 3 figures, 2 tables. To appear in Head and Neck Tumor Segmentation in PET/CT: The HECKTOR Challenge,Valentin Oreiller et al., Medical Image Analysis,2021, HECKTOR 2021, Lecture Notes in Computer Science, Springer