Background: Lung region segmentation is an important stage of automated image-based approaches for the diagnosis of respiratory diseases. Manual methods executed by experts are considered the gold standard, but it is time consuming and the accuracy is dependent on radiologists’ experience. Automated methods are relatively fast and reproducible with potential to facilitate physician interpretation of images. However, these benefits are possible only after overcoming several challenges. The traditional methods that are formulated as a three-stage segmentation demonstrate promising results on normal CT data but perform poorly in the presence of pathological features and variations in image quality attributes. The implementation of deep learning methods that can demonstrate superior performance over traditional methods is dependent on the quantity, quality, cost and the time it takes to generate training data. Thus, efficient and clinically relevant automated segmentation method is desired for the diagnosis of respiratory diseases. Methods: We implement each of the three stages of traditional methods using deep learning methods trained on five different configurations of training data with ground truths obtained from the 3D Image Reconstruction for Comparison of Algorithm Database (3DIRCAD) and the Interstitial Lung Diseases (ILD) database. The data was augmented with the Lung Image Database Consortium (LIDC-IDRI) image collection and a realistic phantom. A convolutional neural network (CNN) at the preprocessing stage classifies the input into lung and none lung regions. The processing stage was implemented using a CNN-based U-net while the postprocessing stage utilize another U-net and CNN for contour refinement and filtering out false positives, respectively. Results: The performance of the proposed method was evaluated on 1230 and 1100 CT slices from the 3DIRCAD and ILD databases. We investigate the performance of the proposed method on five configurations of training data and three configurations of the segmentation system; three-stage segmentation and three-stage segmentation without a CNN classifier and contrast enhancement, respectively. The Dice-score recorded by the proposed method range from 0.76 to 0.95. Conclusion: The clinical relevance and segmentation accuracy of deep learning models can improve though deep learning-based three-stage segmentation, image quality evaluation and enhancement as well as augmenting the training data with large volume of cheap and quality training data. We propose a new and novel deep learning-based method of contour refinement.

Background: Saliency-based algorithms are able to explain the relationship between input image pixels and deep-learning model predictions. However, it may be difficult to assess the clinical value of the most important image features and the model predictions derived from the raw saliency map. This study proposes to enhance the interpretability of saliency-based deep learning model for survival classification of patients with gliomas, by extracting domain knowledge-based information from the raw saliency maps. Materials and methods: Our study includes presurgical T1-weighted (pre- and post-contrast), T2-weighted and T2-FLAIR MRIs of 147 glioma patients from the BraTs 2020 challenge dataset aligned to the SRI 24 anatomical atlas. Each image exam includes a segmentation mask and the information of overall survival (OS) from time of diagnosis (in days). This dataset was divided into training ( $$n=118$$n = 118 ) and validation ( $$n=29$$n = 29 ) datasets. The extent of surgical resection for all patients was gross total resection. We categorized the data into 42 short (mean $$\mu =157$$μ = 157 days), 30 medium ( $$\mu =369$$μ = 369 days), and 46 long ( $$\mu =761$$μ = 761 days) survivors. A 3D convolutional neural network (CNN) trained on brain tumour MRI volumes classified all patients based on expected prognosis of either short-term, medium-term, or long-term survival. We extend the popular 2D Gradient-weighted Class Activation Mapping (Grad-CAM), for the generation of saliency map, to 3D and combined it with the anatomical atlas, to extract brain regions, brain volume and probability map that reveal domain knowledge-based information. Results: For each OS class, a larger tumor volume was associated with a shorter OS. There were 10, 7 and 27 tumor locations in brain regions that uniquely associate with the short-term, medium-term, and long-term survival, respectively. Tumors located in the transverse temporal gyrus, fusiform, and palladium are associated with short, medium and long-term survival, respectively. The visual and textual information displayed during OS prediction highlights tumor location and the contribution of different brain regions to the prediction of OS. This algorithm design feature assists the physician in analyzing and understanding different model prediction stages. Conclusions: Domain knowledge-based information extracted from the saliency map can enhance the interpretability of deep learning models. Our findings show that tumors overlapping eloquent brain regions are associated with short patient survival.

Noise-based quality evaluation of MRI images is highly desired in noise-dominant environments. Current noise-based MRI quality evaluation methods have drawbacks which limit their effective performance. Traditional full-reference methods such as SNR and most of the model-based techniques cannot provide perceptual quality metrics required for accurate diagnosis, treatment and monitoring of diseases. Although techniques based on the Moran coefficients are perceptual quality metrics, they are full-reference methods and will be ineffective in applications where the reference image is not available. Furthermore, the predicted quality scores are difficult to interpret because their quality indices are not standardized. In this paper, we propose a new no-reference perceptual quality evaluation method for grayscale images such as MRI images. Our approach is formulated to mimic how humans perceive an image. It transforms noise level into a standardized perceptual quality score. Global Moran statistics is combined with local indicators of spatial autocorrelation in the form of local Moran statistics. Quality score is predicted from perceptually weighted combination of clustered and random pixels. Performance evaluation, comparative performance evaluation and validation by human observers, shows that the proposed method will be a useful tool in the evaluation of retrospectively acquired MRI images and the evaluation of noise reduction algorithms.

Magnetic resonance imaging (MRI) system images are important components in the development of drugs because it can reveal the underlying pathology in diseases. Unfortunately, the processes of image acquisition, storage, transmission, processing, and analysis can influence image quality with the risk of compromising the reliability of MRI-based data. Therefore, it is necessary to monitor image quality throughout the different stages of the imaging workflow. This report describes a new approach to evaluate the quality of an MRI slice in multi-center clinical trials. The design philosophy assumes that an MRI slice, such as all natural images, possess statistical properties that can describe different levels of contrast degradation. A unique set of pixel configuration is assigned to each possible level of contrast-distorted MRI slice. Invocation of the central limit theorem results in two separate Gaussian distributions. The central limit theorem says that the mean and standard deviation of pixel configuration assigned to each possible level of contrast degradation will follow a normal distribution. The mean of each normal distribution corresponds to the mean and standard deviation of the underlying ideal image. Quality prediction processes for a test image can be summarized into four steps. The first step extracts local contrast feature image from the test image. The second step computes the mean and standard deviation of the feature image. The third step separately standardizes each normal distribution using the mean and standard deviation computed from the feature image. This gives two separate z-scores. The fourth step predicts the lightness contrast quality score and the texture contrast quality score from cumulative distribution function of the appropriate normal distribution. The proposed method was evaluated objectively on brain and cardiac MRI volume data using four different types and levels of degradation. The four types of degradation are Rician noise, circular blur, motion blur, and intensity nonuniformity also known as bias fields. Objective evaluation was validated using a proposed variation of difference of mean opinion scores. Results from performance evaluation show that the proposed method will be suitable to monitor and standardize image quality throughout the different stages of imaging workflow in large clinical trials. MATLAB implementation of the proposed objective quality evaluation method can be downloaded from (https://github.com/ezimic/Image-Quality-Evaluation).

Currently, no classical clustering algorithm is efficient on its own. The predefined number of clusters required for their operation does not consistently produce satisfactory segmentation results. They exhibit cluster instability, are vulnerable to the local optimum trap, and are sensitive to noise and imaging artefacts. Most contributions designed to overcome these drawbacks incorporate prior knowledge such as cluster label information and statistic measures that demand minimal labelled training data. Although these approaches improve the segmentation accuracy, they tend to diminish the advantages of clustering algorithms over the supervised learning methods. This study proposes a shift from the use of a predefined number of clusters to a clustering tree‐based method for performance enhancement of classical clustering algorithms. The proposed method is a three‐stage algorithm. It begins with the extraction of low‐level features from a clustering tree. Clustering trees are sets of labelled clusters of an image at multiple clustering resolutions. The second stage extracts high‐level features by coupling the clustering tree to a single‐layer feedforward neural network. The third stage is the classification stage, where the basic model of a neural network extracts the tumour from a high‐level feature map. Because neither of the neural networks requires training, the proposed method is both fully unsupervised and fully automated and retains all its advantages over supervised methods. A performance evaluation using FLAIR MRI images of brain tumour patients from the BRATS2015 and BRATS2020 databases demonstrates significant performance enhancement over four classical clustering algorithms and two of the four proposed techniques were comparable to deep learning methods.