Fractal-Based Analysis of Histological Features of Brain Tumors.

The structural complexity of brain tumor tissue represents a major challenge for effective histopathological diagnosis. Tumor vasculature is known to be heterogeneous, and mixtures of patterns are usually present. Therefore, extracting key descriptive features for accurate quantification is not a straightforward task. Several steps are involved in the texture analysis process where tissue heterogeneity contributes to the variability of the results. One of the interesting aspects of the brain lies in its fractal nature. Many regions within the brain tissue yield similar statistical properties at different scales of magnification. Fractal-based analysis of the histological features of brain tumors can reveal the underlying complexity of tissue structure and angiostructure, also providing an indication of tissue abnormality development. It can further be used to quantify the chaotic signature of disease to distinguish between different temporal tumor stages and histopathological grades.Brain meningioma subtype classifications' improvement from histopathological images is the main focus of this chapter. Meningioma tissue texture exhibits a wide range of histological patterns whereby a single slide may show a combination of multiple patterns. Distinctive fractal patterns quantified in a multiresolution manner would be for better spatial relationship representation. Fractal features extracted from textural tissue patterns can be useful in characterizing meningioma tumors in terms of subtype classification, a challenging problem compared to histological grading, and furthermore can provide an objective measure for quantifying subtle features within subtypes that are hard to discriminate.

Computational Fractal-Based Analysis of Brain Tumor Microvascular Networks.

Brain parenchyma microvasculature is set in disarray in the presence of tumors, and malignant brain tumors are among the most vascularized neoplasms in humans. As microvessels can be easily identified in histologic specimens, quantification of microvascularity can be used alone or in combination with other histological features to increase the understanding of the dynamic behavior, diagnosis, and prognosis of brain tumors. Different brain tumors, and even subtypes of the same tumor, show specific microvascular patterns, as a kind of "microvascular fingerprint," which is particular to each histotype. Reliable morphometric parameters are required for the qualitative and quantitative characterization of the neoplastic angioarchitecture, although the lack of standardization of a technique able to quantify the microvascular patterns in an objective way has limited the "morphometric approach" in neuro-oncology.In this chapter, we focus on the importance of computational-based morphometrics, for the objective description of tumoral microvascular fingerprinting. By also introducing the concept of "angio-space," which is the tumoral space occupied by the microvessels, we here present fractal analysis as the most reliable computational tool able to offer objective parameters for the description of the microvascular networks.The spectrum of different angioarchitectural configurations can be quantified by means of Euclidean and fractal-based parameters in a multiparametric analysis, aimed to offer surrogate biomarkers of cancer. Such parameters are here described from the methodological point of view (i.e., feature extraction) as well as from the clinical perspective (i.e., relation to underlying physiology), in order to offer new computational parameters to the clinicians with the final goal of improving diagnostic and prognostic power of patients affected by brain tumors.

Empowering brain cancer diagnosis: harnessing artificial intelligence for advanced imaging insights.

Artificial intelligence (AI) is increasingly being used in the medical field, specifically for brain cancer imaging. In this review, we explore how AI-powered medical imaging can impact the diagnosis, prognosis, and treatment of brain cancer. We discuss various AI techniques, including deep learning and causality learning, and their relevance. Additionally, we examine current applications that provide practical solutions for detecting, classifying, segmenting, and registering brain tumors. Although challenges such as data quality, availability, interpretability, transparency, and ethics persist, we emphasise the enormous potential of intelligent applications in standardising procedures and enhancing personalised treatment, leading to improved patient outcomes. Innovative AI solutions have the power to revolutionise neuro-oncology by enhancing the quality of routine clinical practice.

Unpaired MR-CT brain dataset for unsupervised image translation.

The data presented in this article deals with the problem of brain tumor image translation across different modalities. The provided dataset represents unpaired brain magnetic resonance (MR) and computed tomography (CT) image data volumes of 20 patients. This includes 179 two-dimensional (2D) axial MR and CT images. The MR cases are acquired using Siemens Verio scanner, while the CT images with a Siemens Somatom scanner. The MR and CT tumor volumes were collected, diagnosed and annotated by experienced radiologists specialized in oncology and radiotherapy. The collected image volumes can be useful for researchers working in the field of artificial intelligence (AI) applications for brain tumor detection, classification and segmentation in MR and CT modalities. The provided tumor masks per each tumor volume can assist data scientists with limited background in cancer imaging. Moreover, clinical interpretation is given per each tumor volume, which can assist in deep learning model training with multiple source data (non-imaging or textual data) as well. The provided dataset can facilitate for annotation-efficient lesion segmentation using bidirectional MR-CT cross-modality image translation.

Paired-unpaired Unsupervised Attention Guided GAN with transfer learning for bidirectional brain MR-CT synthesis.

Medical image acquisition plays a significant role in the diagnosis and management of diseases. Magnetic Resonance (MR) and Computed Tomography (CT) are considered two of the most popular modalities for medical image acquisition. Some considerations, such as cost and radiation dose, may limit the acquisition of certain image modalities. Therefore, medical image synthesis can be used to generate required medical images without actual acquisition. In this paper, we propose a paired-unpaired Unsupervised Attention Guided Generative Adversarial Network (uagGAN) model to translate MR images to CT images and vice versa. The uagGAN model is pre-trained with a paired dataset for initialization and then retrained on an unpaired dataset using a cascading process. In the paired pre-training stage, we enhance the loss function of our model by combining the Wasserstein GAN adversarial loss function with a new combination of non-adversarial losses (content loss and L1) to generate fine structure images. This will ensure global consistency, and better capture of the high and low frequency details of the generated images. The uagGAN model is employed as it generates more accurate and sharper images through the production of attention masks. Knowledge from a non-medical pre-trained model is also transferred to the uagGAN model for improved learning and better image translation performance. Quantitative evaluation and qualitative perceptual analysis by radiologists indicate that employing transfer learning with the proposed paired-unpaired uagGAN model can achieve better performance as compared to other rival image-to-image translation models.

Prediction of FDG-PET stage and uptake for non-small cell lung cancer on non-contrast enhanced CT scans via fractal analysis.

PURPOSE: To investigate whether the FD of non-small cell lung cancer (NSCLC) on CT predicts tumor stage and uptake on 18F-fluorodeoxyglucose positron emission tomography. MATERIAL AND METHODS: The FD within a tumor region was determined using a box counting algorithm and compared to the lymph node involvement (NI) and metastatic involvement (MI) and overall stage as determined from PET. A Mann-Whitney U test was applied to the extracted FD features for the NI and the MI. RESULTS: The two tests showed good significance with p < .05 (pNI = 0.0139, pMI = 0.0194). Also after performing fractal analysis to all cases, it was found that for those who had a CT of stage I or II had a higher likelihood of the NI and/or MI stage being upstaged by PET, Odds Ratio 5.38 (95% CI 0.99-29.3). For those who are CT stage III or IV had an increased likelihood of the NI and/or MI stage being down staged by PET, Odds Ratio: 7.33 (95% CI 0.48-111.2). CONCLUSION: Initial results of this study indicate higher FD in CT images of NSCLC is associated with advanced stage and greater FDG uptake on PET. Measurements of tumor fractal analysis on conventional non-contrast CT examinations could potentially be used as a prognostic marker and/or to select patients for PET.

Spatio-Temporal Segmentation in 3-D Echocardiographic Sequences Using Fractional Brownian Motion.

An important aspect for an improved cardiac functional analysis is the accurate segmentation of the left ventricle (LV). A novel approach for fully-automated segmentation of the LV endocardium and epicardium contours is presented. This is mainly based on the natural physical characteristics of the LV shape structure. Both sides of the LV boundaries exhibit natural elliptical curvatures by having details on various scales, i.e. exhibiting fractal-like characteristics. The fractional Brownian motion (fBm), which is a non-stationary stochastic process, integrates well with the stochastic nature of ultrasound echoes. It has the advantage of representing a wide range of non-stationary signals and can quantify statistical local self-similarity throughout the time-sequence ultrasound images. The locally characterized boundaries of the fBm segmented LV were further iteratively refined using global information by means of second-order moments. The method is benchmarked using synthetic 3D+time echocardiographic sequences for normal and different ischemic cardiomyopathy, and results compared with state-of-the-art LV segmentation. Furthermore, the framework was validated against real data from canine cases with expert-defined segmentations and demonstrated improved accuracy. The fBm-based segmentation algorithm is fully automatic and has the potential to be used clinically together with 3D echocardiography for improved cardiovascular disease diagnosis.

Heterogeneous Tissue Characterization Using Ultrasound: A Comparison of Fractal Analysis Backscatter Models on Liver Tumors.

Assessment of tumor tissue heterogeneity via ultrasound has recently been suggested as a method for predicting early response to treatment. The ultrasound backscattering characteristics can assist in better understanding the tumor texture by highlighting the local concentration and spatial arrangement of tissue scatterers. However, it is challenging to quantify the various tissue heterogeneities ranging from fine to coarse of the echo envelope peaks in tumor texture. Local parametric fractal features extracted via maximum likelihood estimation from five well-known statistical model families are evaluated for the purpose of ultrasound tissue characterization. The fractal dimension (self-similarity measure) was used to characterize the spatial distribution of scatterers, whereas the lacunarity (sparsity measure) was applied to determine scatterer number density. Performance was assessed based on 608 cross-sectional clinical ultrasound radiofrequency images of liver tumors (230 and 378 representing respondent and non-respondent cases, respectively). Cross-validation via leave-one-tumor-out and with different k-fold methodologies using a Bayesian classifier was employed for validation. The fractal properties of the backscattered echoes based on the Nakagami model (Nkg) and its extend four-parameter Nakagami-generalized inverse Gaussian (NIG) distribution achieved best results-with nearly similar performance-in characterizing liver tumor tissue. The accuracy, sensitivity and specificity of Nkg/NIG were 85.6%/86.3%, 94.0%/96.0% and 73.0%/71.0%, respectively. Other statistical models, such as the Rician, Rayleigh and K-distribution, were found to not be as effective in characterizing subtle changes in tissue texture as an indication of response to treatment. Employing the most relevant and practical statistical model could have potential consequences for the design of an early and effective clinical therapy.

Quantification of ultrasonic texture intra-heterogeneity via volumetric stochastic modeling for tissue characterization.

Intensity variations in image texture can provide powerful quantitative information about physical properties of biological tissue. However, tissue patterns can vary according to the utilized imaging system and are intrinsically correlated to the scale of analysis. In the case of ultrasound, the Nakagami distribution is a general model of the ultrasonic backscattering envelope under various scattering conditions and densities where it can be employed for characterizing image texture, but the subtle intra-heterogeneities within a given mass are difficult to capture via this model as it works at a single spatial scale. This paper proposes a locally adaptive 3D multi-resolution Nakagami-based fractal feature descriptor that extends Nakagami-based texture analysis to accommodate subtle speckle spatial frequency tissue intensity variability in volumetric scans. Local textural fractal descriptors - which are invariant to affine intensity changes - are extracted from volumetric patches at different spatial resolutions from voxel lattice-based generated shape and scale Nakagami parameters. Using ultrasound radio-frequency datasets we found that after applying an adaptive fractal decomposition label transfer approach on top of the generated Nakagami voxels, tissue characterization results were superior to the state of art. Experimental results on real 3D ultrasonic pre-clinical and clinical datasets suggest that describing tumor intra-heterogeneity via this descriptor may facilitate improved prediction of therapy response and disease characterization.

A multiresolution clinical decision support system based on fractal model design for classification of histological brain tumours.

Tissue texture is known to exhibit a heterogeneous or non-stationary nature; therefore using a single resolution approach for optimum classification might not suffice. A clinical decision support system that exploits the subbands' textural fractal characteristics for best bases selection of meningioma brain histopathological image classification is proposed. Each subband is analysed using its fractal dimension instead of energy, which has the advantage of being less sensitive to image intensity and abrupt changes in tissue texture. The most significant subband that best identifies texture discontinuities will be chosen for further decomposition, and its fractal characteristics would represent the optimal feature vector for classification. The performance was tested using the support vector machine (SVM), Bayesian and k-nearest neighbour (kNN) classifiers and a leave-one-patient-out method was employed for validation. Our method outperformed the classical energy based selection approaches, achieving for SVM, Bayesian and kNN classifiers an overall classification accuracy of 94.12%, 92.50% and 79.70%, as compared to 86.31%, 83.19% and 51.63% for the co-occurrence matrix, and 76.01%, 73.50% and 50.69% for the energy texture signatures; respectively. These results indicate the potential usefulness as a decision support system that could complement radiologists' diagnostic capability to discriminate higher order statistical textural information; for which it would be otherwise difficult via ordinary human vision.

Texture analysis of aggressive and nonaggressive lung tumor CE CT images.

This paper presents the potential for fractal analysis of time sequence contrast-enhanced (CE) computed tomography (CT) images to differentiate between aggressive and nonaggressive malignant lung tumors (i.e., high and low metabolic tumors). The aim is to enhance CT tumor staging prediction accuracy through identifying malignant aggressiveness of lung tumors. As branching of blood vessels can be considered a fractal process, the research examines vascularized tumor regions that exhibit strong fractal characteristics. The analysis is performed after injecting 15 patients with a contrast agent and transforming at least 11 time sequence CE CT images from each patient to the fractal dimension and determining corresponding lacunarity. The fractal texture features were averaged over the tumor region and quantitative classification showed up to 83.3% accuracy in distinction between advanced (aggressive) and early-stage (nonaggressive) malignant tumors. Also, it showed strong correlation with corresponding lung tumor stage and standardized tumor uptake value of fluorodeoxyglucose as determined by positron emission tomography. These results indicate that fractal analysis of time sequence CE CT images of malignant lung tumors could provide additional information about likely tumor aggression that could potentially impact on clinical management decisions in choosing the appropriate treatment procedure.