Detecting bone lesions in X-ray under diverse acquisition conditions.

Purpose: The diagnosis of primary bone tumors is challenging as the initial complaints are often non-specific. The early detection of bone cancer is crucial for a favorable prognosis. Incidentally, lesions may be found on radiographs obtained for other reasons. However, these early indications are often missed. We propose an automatic algorithm to detect bone lesions in conventional radiographs to facilitate early diagnosis. Detecting lesions in such radiographs is challenging. First, the prevalence of bone cancer is very low; any method must show high precision to avoid a prohibitive number of false alarms. Second, radiographs taken in health maintenance organizations (HMOs) or emergency departments (EDs) suffer from inherent diversity due to different X-ray machines, technicians, and imaging protocols. This diversity poses a major challenge to any automatic analysis method. Approach: We propose training an off-the-shelf object detection algorithm to detect lesions in radiographs. The novelty of our approach stems from a dedicated preprocessing stage that directly addresses the diversity of the data. The preprocessing consists of self-supervised region-of-interest detection using vision transformer (ViT), and a foreground-based histogram equalization for contrast enhancement to relevant regions only. Results: We evaluate our method via a retrospective study that analyzes bone tumors on radiographs acquired from January 2003 to December 2018 under diverse acquisition protocols. Our method obtains 82.43% sensitivity at a 1.5% false-positive rate and surpasses existing preprocessing methods. For lesion detection, our method achieves 82.5% accuracy and an IoU of 0.69. Conclusions: The proposed preprocessing method enables effectively coping with the inherent diversity of radiographs acquired in HMOs and EDs.

CellSighter: a neural network to classify cells in highly multiplexed images.

Multiplexed imaging enables measurement of multiple proteins in situ, offering an unprecedented opportunity to chart various cell types and states in tissues. However, cell classification, the task of identifying the type of individual cells, remains challenging, labor-intensive, and limiting to throughput. Here, we present CellSighter, a deep-learning based pipeline to accelerate cell classification in multiplexed images. Given a small training set of expert-labeled images, CellSighter outputs the label probabilities for all cells in new images. CellSighter achieves over 80% accuracy for major cell types across imaging platforms, which approaches inter-observer concordance. Ablation studies and simulations show that CellSighter is able to generalize its training data and learn features of protein expression levels, as well as spatial features such as subcellular expression patterns. CellSighter's design reduces overfitting, and it can be trained with only thousands or even hundreds of labeled examples. CellSighter also outputs a prediction confidence, allowing downstream experts control over the results. Altogether, CellSighter drastically reduces hands-on time for cell classification in multiplexed images, while improving accuracy and consistency across datasets.

Integrating Domain Knowledge Into Deep Networks for Lung Ultrasound With Applications to COVID-19.

Lung ultrasound (LUS) is a cheap, safe and non-invasive imaging modality that can be performed at patient bed-side. However, to date LUS is not widely adopted due to lack of trained personnel required for interpreting the acquired LUS frames. In this work we propose a framework for training deep artificial neural networks for interpreting LUS, which may promote broader use of LUS. When using LUS to evaluate a patient's condition, both anatomical phenomena (e.g., the pleural line, presence of consolidations), as well as sonographic artifacts (such as A- and B-lines) are of importance. In our framework, we integrate domain knowledge into deep neural networks by inputting anatomical features and LUS artifacts in the form of additional channels containing pleural and vertical artifacts masks along with the raw LUS frames. By explicitly supplying this domain knowledge, standard off-the-shelf neural networks can be rapidly and efficiently finetuned to accomplish various tasks on LUS data, such as frame classification or semantic segmentation. Our framework allows for a unified treatment of LUS frames captured by either convex or linear probes. We evaluated our proposed framework on the task of COVID-19 severity assessment using the ICLUS dataset. In particular, we finetuned simple image classification models to predict per-frame COVID-19 severity score. We also trained a semantic segmentation model to predict per-pixel COVID-19 severity annotations. Using the combined raw LUS frames and the detected lines for both tasks, our off-the-shelf models performed better than complicated models specifically designed for these tasks, exemplifying the efficacy of our framework.