Coronary artery calcium (CAC) is biomarker of advanced subclinical coronary artery disease and predicts myocardial infarction and death prior to age 60 years. The slice-wise manual delineation has been regarded as the gold standard of coronary calcium detection. However, manual efforts are time and resource consuming and even impracticable to be applied on large-scale cohorts. In this paper, we propose the attention identical dual network (AID-Net) to perform CAC detection using scan-rescan longitudinal non-contrast CT scans with weakly supervised attention by only using per scan level labels. To leverage the performance, 3D attention mechanisms were integrated into the AID-Net to provide complementary information for classification tasks. Moreover, the 3D Gradient-weighted Class Activation Mapping (Grad-CAM) was also proposed at the testing stage to interpret the behaviors of the deep neural network. 5075 non-contrast chest CT scans were used as training, validation and testing datasets. Baseline performance was assessed on the same cohort. From the results, the proposed AID-Net achieved the superior performance on classification accuracy (0.9272) and AUC (0.9627).
Whole brain segmentation on structural magnetic resonance imaging (MRI) is essential for understanding neuroanatomical-functional relationships. Traditionally, multi-atlas segmentation has been regarded as the standard method for whole brain segmentation. In past few years, deep convolutional neural network (DCNN) segmentation methods have demonstrated their advantages in both accuracy and computational efficiency. Recently, we proposed the spatially localized atlas network tiles (SLANT) method, which is able to segment a 3D MRI brain scan into 132 anatomical regions. Commonly, DCNN segmentation methods yield inferior performance under external validations, especially when the testing patterns were not presented in the training cohorts. Recently, we obtained a clinically acquired, multi-sequence MRI brain cohort with 1480 clinically acquired, de-identified brain MRI scans on 395 patients using seven different MRI protocols. Moreover, each subject has at least two scans from different MRI protocols. Herein, we assess the SLANT method’s intra- and inter-protocol reproducibility. SLANT achieved less than 0.05 coefficient of variation (CV) for intra-protocol experiments and less than 0.15 CV for inter-protocol experiments. The results show that the SLANT method achieved high intra- and inter- protocol reproducibility.
Early detection of lung cancer is essential in reducing mortality. Recent studies have demonstrated the clinical utility of low-dose computed tomography (CT) to detect lung cancer among individuals selected based on very limited clinical information. However, this strategy yields high false positive rates, which can lead to unnecessary and potentially harmful procedures. To address such challenges, we established a pipeline that co-learns from detailed clinical demographics and 3D CT images. Toward this end, we leveraged data from the Consortium for Molecular and Cellular Characterization of Screen-Detected Lesions (MCL), which focuses on early detection of lung cancer. A 3D attention-based deep convolutional neural net (DCNN) is proposed to identify lung cancer from the chest CT scan without prior anatomical location of the suspicious nodule. To improve upon the non-invasive discrimination between benign and malignant, we applied a random forest classifier to a dataset integrating clinical information to imaging data. The results show that the AUC obtained from clinical demographics alone was 0.635 while the attention network alone reached an accuracy of 0.687. In contrast when applying our proposed pipeline integrating clinical and imaging variables, we reached an AUC of 0.787 on the testing dataset. The proposed network both efficiently captures anatomical information for classification and also generates attention maps that explain the features that drive performance.