The MAGIC-5 CAD for nodule detection in low dose and thin slice lung CT. Piergiorgio Cerello - INFN

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The MAGIC-5 CAD for nodule detection in low dose and thin slice lung CT Piergiorgio Cerello - INFN Frascati, 27/11/2009

Computer Assisted Detection (CAD) MAGIC-5 & Distributed Computing Infrastructure (GRID) GRID Why Medical Imaging Applications? Move the algorithm, not the data Interface to GRID Services (Meth. Inf. Med., 2005) Medical (Imaging) Applications Analysis of Digital Images Mammography (2002 ->) Lung CTs (2004 ->) Brain MRIs (2006 ->) 2

CAD for Lung Cancer? (y 2003) 5 years survival rate for lung cancer: 14% (US), 10-15% (EU) No significant improvement in the past 20 years Low dose CT: 6 times more efficient than Chest X-Ray (CXR) in the detection of state I malignant nodules CAD methods are being explored Gurcan et al., Med. Phys. 29(11), Nov. 2002, 2552: computerized detection for lung nodules in helical CT images is promising large variations in performance, indicating that the computer vision techniques in this area have not been fully developed. Continued effort will be required to bring the performances of these computerized detection systems to a level acceptable for clinical implementation 3

Lung CAD systems: the goal CAD input internal nodule detection juxtapleural nodule detection CAD output 4

The MAGIC-5 Strategy CT scans DataBase(s): Lung Segmentation Low-dose helical multi-slice CT: slice-thickness <= 1.25 mm Annotation by 1 or more radiologists (up to 4) Nodules of radius > 3, 4, 5 mm according to the different protocols Agreement sometimes ~ 60% between radiologists Lung Volume in CT Nodule Detection (3 parallel developments) list of ROIs Nodule Classification list of ROIs with probabilities Results and Validation 5

The Data Sets 6

The MAGIC-5 Database Lung Nodule Annotation (LUNA) tool developed ~ 163 CT scans in the DB Annotation by 2 to 4 radiologists from Pisa and Lecce nodules with diameter > 5 mm Data Size: ~ 250-500 slices, 512x512x2 bytes each: ~ 120-250 MB/scan 7

n 1 Other Databases n 2 n 3 LIDC https://imaging.nci.nih.gov/ncia/login.jsf ~ 100 CT scans (rapidly increasing), with annotations by 1, 2, 3, 4, radiologists nodules: > 3 mm diameter ANODE09 http://anode09.isi.uu.nl/ 5 (50) scans with (without) annotation nodules > 4 mm diameter 8

MAGIC-5 / Lung CT Analysis A typical CT scan - 3D Matrix recorded as a DICOMDIR - Granularity (512x512x300 ca. voxels) - Intensity: Hounsfield units: (X-rays attenuation in matter) [CT (-1000,+3000)] Frequency CT number [Hounsfield units] Air Water 9

The Lung Volume

MAGIC-5 / Lung Segmentation Segmenter: 3D approach Region Growing Wavefront Algorithm 11

MAGIC-5 / Lung Segmentation Segmentation Steps Evaluation of an approximated threshold value (intensity histogram) 3D Region Growing (RG): tree segmentation Wavefront simulation algorithm: trachea and external bronchi removal Left/Right Lung splitting 3D Region Growing on left and right lung Morphological 3D closing: inclusion of pleural nodules 12

MAGIC-5 / Lung Segmentation Segmenter Performance: smoothing test Smoothing index σ = Adjacent Slice Area Intersection / Adjacent Slice Area Union 13

Voxel Based Neural Approach Region Growing Virtual Ant Colonies

Voxel Based Neural Approach

MAGIC-5 / VBNA CAD input CAD I CAD JP ROI CAD structure Lung segmentation ROI identification ROI classification ROI z-1 z CAD output z-1 z z+1 z+1 16

MAGIC-5 / VBNA Modeling the lung structures: Nodules spherical shapes Blood vessels and airway walls elongated shapes Fissures planar shapes σ 1 σ n Convolution with 3D gaussians Eigenvalues of the Hessian λ 11, λ 12, λ 13 λ n1, λ n2, λ n3 matrix ζ 1 ζ n ζ max = max [ζ 1 ζ n ] Filter function ζ max is computed for each voxel ζζ i = λ i3 2 / λ i1 If λ i1 λ i2 λ i3 < 0 ζζ i = 0 otherwise 17

MAGIC-5 / VBNA voxel v in ROI vector of features (33) neural classifier rolled-down 3D neighborhood (27) voxel v + 3 eigenvalues of gradient matrix three-layer feedforward backpropagation neural network slice-1 slice + 3 eigenvalues of Hessian matrix slice+1 18

MAGIC-5 / VBNA From voxel classification to ROI classification: The trained neural network is applied to the voxels of each nodule candidate A nodule candidate is finally classified as nodule if the number of voxels tagged as nodule by the neural classifier is above a threshold internal nodule juxtapleural nodule normal tissue Voxels classified as nodule Voxels classified as normal tissue 19

MAGIC-5 / VBNA Pleural nodules: convex surface the inward-pointing fixed-length surface normal vectors crossing the nodule surface intersect within the nodule tissue A 3D matrix A(x,y,z) counts the number of surface normals that pass through the voxel (x,y,z) A(x,y,z) is smoothed with a gaussian to enhance the regions where many normals intersect The local maxima in that matrix are nodule candidates 20

Region Growing

MAGIC-5 / Region Growing Inside the lung segmented volume Search for seeds (voxels that meet the inclusion rules) Growth around the seeds by checking neighbours for inclusion rules, until no neighbour is accepted Grown regions are stored in memory and removed from the CT scan -> Regions Of Interest list 22

MAGIC-5 / Region Growing The inclusion rules Average Bottom Threshold Average intensity of voxel + 26 first order neighbours > Th 1 Simple Bottom Threshold Voxel Intensity > Th 2 23

MAGIC-5 / Region Growing Nodule Hunter Filter Volume (V 1 < V < V 2 ) Neural Network Classification Sphericity Radius Average Intensity Intensity Std. deviation Radius Sphericity Volume Volume Average Intensity Intensity STD Volume 24 Volume

MAGIC-5 / Region Growing Neural Network Classification with Cross Validation Positives P1 P2 N1 For the Training Comparable numbers of negatives/positives are used Negatives Na1 N2 Na2 PHASE1) Training: P1+N1 Testing: P2+ N2+Na2 PHASE2) Training: P2+N2 Testing: P1+N1+Na1 Efficiency Evaluation 25

Virtual Ant Colonies

MAGIC-5 / Virtual Ant Colonies Ant Colonies Communities of individuals that evolve according to the set of ant colonies biological rules Communication through modifications of the environment (i.e., depositing pheromones) The system is NON-LINEAR 27

MAGIC-5 Virtual Ants in a Lung CT Ants in nature show an ability to find: - structures (sources of food) - the shortest way to reach them we need to find complex structures (food, i.e. bronchial and vascular trees), that are the background to our search for nodules Ants can find structure borders we need to find the pleura Ants can define shapes we look for ~ spherical nodules Ant colonies act according to global information ex: Region Growing implies a deterministic choice any time a voxel is analysed 28

The basic Idea MAGIC-5 Ant Colony Evolution Segment the bronchial and the vascular tree with a Virtual Ant Colony - Remove the segmented bronchial and vascular trees - Look for nodule structures in the subtracted image with the same tools used for Region Growing (Nodule Hunter & ) 29

MAGIC-5 / Virtual Ant Colonies The Channeler Ant Model The Queen Pheromone Release Moving Rules Energy: birth, reproduction, death 30

MAGIC-5 / Virtual Ant Colonies The Queen Sets the Anthill position ( hilus pulmonis ) Manages the ant birth, movements, death Manages the pheromone release Extinguishes the colony 31

MAGIC-5 / Virtual Ant Colonies The Pheromone Release Before moving to another voxel, each ant releases an amount of pheromone T given by: is the minimum amount of released pheromone is a scaling factor is a function of the voxel intensity I(v i ) η = 0.07 H fac = 2.0 Δ ph = I(v i ) +Imin 32

MAGIC-5 / Virtual Ant Colonies The Moving Rules Only neighbouring voxels are possible destinations Only free voxels are allowed The probability for a voxel to be selected is a function of its amount of pheromone Voxels with amount of pheromone above the maximum threshold are forbidden until the colony extinction β osmotropotaxis sensitivity 1/δ sensory capacity = 3.5 = 0.2 1/δ 33

MAGIC-5 / Virtual Ant Colonies The Ant Energy Energy at birth: Energy variation: α = 0.2 is the amount of pheromone released in cycle i+1 by ant k is the average release of pheromone in the colony since its evolution started Death E d E 0 E r Reproduction E d = 1.0 E 0 = 1.2 E r = 1.3 34

MAGIC-5 Virtual Ants in a Lung CT Original Counts Pheromone 35

Results & Plans

MAGIC-5 Lung CAD FROC curves Gold Standard Validation DB (28 nodules) Ideal Performance Region Growing VBNA Virtual Ants 37

MAGIC-5 Lung CAD FROC curves Sensitivity VBNA RG V-ANTS FP/scan 38

MAGIC-5 Lung CAD ANODE09 Challenge Sensitivity D = VBNA B = RG C = V-ANTS FP/scan 39

MAGIC-5 / Lung CAD Summary Three parallel approaches to lung nodule detection The ANODE09 challenge showed that: they are competitive combining algorithms improves the global performance there is room for further improvements Plans Validation test on new CT data (from LIDC) Algorithm improvements Algorithm merging 40