Automatic cervical lymphadenopathy segmentation from CT data using deep learning

Manual segmentation in lumbar paraspinal muscle studies is time-consuming, subject to variability, and limits comprehensive evaluation. To solve the problems, we aim to develop a deep learning algorithm for the automatic segmentation and multi-parameter quantification of eight paraspinal muscles in lumbar CT. We collected CT images covering the range from the superior endplate of the L1 vertebra to the inferior endplate of the S1 vertebra. The dataset was partitioned into training, validation, and test sets in a ratio of 7:1:2. Six convolutional neural networks were employed to automatically segment the bilateral psoas major, quadratus lumborum, erector spinae, and multifidus across all slices. Model performance was evaluated using the Dice Similarity Coefficient (DSC), Hausdorff Distance (HD), and mean Intersection over Union (mIoU). Muscle parameters including cross-sectional area, muscle volume, fat infiltration, CT density, and paraspinal muscle index were calculated. The Intraclass Correlation Coefficient [ICC(3,1)] was used to assess agreement between model's segmentations and manual ground truth. 100 lumbar CT scans (age, 55.02 ± 16.2; 62 female) were used for model development. The mean DSC across all six models ranged from 0.754 to 0.903. TransUNet demonstrated the best overall (DSC, 0.903; 95% CI: 0.902, 0.913) (HD, 9.934mm; 95% CI: 9.815, 11.902) (mIoU, 0.841; 95% CI: 0.839, 0.850). For individual muscles segmented by TransUNet, the highest DSC was 0.936 (95% CI: 0.934-0.938) for the right multifidus. The mean ICC for all parameters was 0.931. The highest ICC value was 0.999 (p < 0.001). The deep learning tool enables automatic and accurate segmentation of eight lumbar paraspinal muscles. Muscle parameter measurements derived from model's segmentations and manual ground truth exhibit high agreement. Accurate segmentation and quantification of paraspinal muscle parameters facilitates large-scale epidemiological studies of paraspinal muscles and spine-related diseases, overcoming the limitations in manual methods.

There has been a significant increase from 2010 to 2016 in the number of people suffering from spine problems. The automatic image segmentation of the spine obtained from a computed tomography (CT) image is important for diagnosing spine conditions and for performing surgery with computer-assisted surgery systems. The spine has a complex anatomy that consists of 33 vertebrae, 23 intervertebral disks, the spinal cord, and connecting ribs. As a result, the spinal surgeon is faced with the challenge of needing a robust algorithm to segment and create a model of the spine. In this study, we developed a fully automatic segmentation method to segment the spine from CT images, and we compared our segmentation results with reference segmentations obtained by well-known methods. We use a hybrid method. This method combines the convolutional neural network (CNN) and fully convolutional network (FCN), and utilizes class redundancy as a soft constraint to greatly improve the segmentation results. The proposed method was found to significantly enhance the accuracy of the segmentation results and the system processing time. Our comparison was based on 12 measurements: the Dice coefficient (94%), Jaccard index (93%), volumetric similarity (96%), sensitivity (97%), specificity (99%), precision (over segmentation 8.3 and under segmentation 2.6), accuracy (99%), Matthews correlation coefficient (0.93), mean surface distance (0.16 mm), Hausdorff distance (7.4 mm), and global consistency error (0.02). We experimented with CT images from 32 patients, and the experimental results demonstrated the efficiency of the proposed method. Highlights A method to enhance the accuracy of spine segmentation from CT data was proposed. The proposed method uses Convolutional Neural Network via redundant generation of class labels. Experiments show the segmentation accuracy has been enhanced.

BackgroundNasopharyngeal carcinoma (NPC), an endemic malignancy in Southeast Asia and southern China, necessitates precise delineation of the gross tumor volume (GTV) for radiotherapy to optimize patient prognosis. Positron emission tomography (PET) imaging offers valuable metabolic insights to guide radiotherapy planning but is hampered by manual GTV segmentation, which is labor-intensive and prone to inter- and intra-observer variability. Conventional segmentation methods are inherently limited, and comparative evaluations of deep learning (DL) frameworks for PET-based primary NPC lesion segmentation remain scarce. Thus, this study aimed to optimize the delineation of primary NPC radiotherapy target volumes by leveraging PET-image-based DL segmentation technology, with the goal of enhancing both the precision and efficiency of lesion delineation.MethodsResearchers retrospectively collected PET imaging data from 212 NPC patients at the Affiliated Hospital of Guangdong Medical University. The patients were randomly divided into training (170 patients) and testing (42 patients) datasets. A radiation oncologist and a nuclear medicine physician collaboratively delineated the cancer lesion boundaries through consensus. After data preprocessing, three DL models (Res-Unet, Nn-Unet, and Nn-Former) were used to automatically segment the lesions. Training was based on the training dataset. During evaluation, the models’ segmentation performance was comprehensively assessed using Dice similarity coefficient (DSC) and Hausdorff distance (HD). A visual analysis of the results was also conducted to intuitively understand the models’ segmentation capabilities.ResultsIn the training set, Nn-Unet achieved the highest DSC of 0.869, whereas in the testing set, its DSC was 0.833. The DSC for Nn-Former hovered around 0.8 in both the training and testing sets. In contrast, Res-Unet demonstrated the lowest DSC values among the three models, particularly in the testing set (DSC =0.794). Statistical analysis revealed that the DSC of Nn-Unet was significantly higher than that of both Res-Unet and Nn-Former in the training set (P<0.01 for both comparisons). Regarding the 95% HD and average surface distance (ASD) values, Nn-Unet outperformed the other two models in both the training and testing sets. However, Res-Unet exhibited a much higher HD value in the testing set compared to the training set. The Loss curves for all models gradually decreased as training progressed, indicating that the models were learning relevant features of NPC lesions. The final Loss value for Res-Unet was approximately 0.7, whereas Nn-Unet and Nn-Former had final Loss values below 0.8.ConclusionsThe PET-image-based automatic segmentation model for the primary tumor of NPC established in this study demonstrates the clinical potential of Nn-Unet in primary lesion of NPC segmentation tasks.

HomeRadiology: Imaging CancerVol. 2, No. 2 Previous Research HighlightsFree AccessA New Approach for Automated Image Segmentation of Organs at Risk in Cervical CancerMeredith Jones, Lacey R. McNallyMeredith Jones, Lacey R. McNallyMeredith JonesLacey R. McNallyPublished Online:Mar 27 2020https://doi.org/10.1148/rycan.2020204010MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked InEmail Take-Away Points■ Major Focus: Development of an automated multiclass image segmentation model to identify organs at risk (OARs) on CT scans in patients with locally advanced cervical cancer, prior to radiation therapy.■ Key Results: The convolutional neural network model outperformed model-based, intensity-based, and atlas-based segmentation algorithms, with comparable results to other deep learning segmentation models while also decreasing the time needed for image segmentation by several thousand-fold.■ Impact: Reduction of intra- and interuser variability imposed by manual OAR delineation can lead to more accurate and efficient radiation therapy planning.The recent article by Liu et al developed an automated multiclass image segmentation model to identify organs at risk (OARs) on CT scans. To plan effective and safe radiation therapy in the context of cervical cancer, a CT scan is often acquired prior to the first treatment. Currently, a radiation oncologist will segment the CT images by hand, which is a time-consuming process, subject to intra- and interobserver variability, to identify OARs. To overcome these potential limitations and biases, automated image segmentation techniques can be utilized to improve accuracy and speed of annotating each image. A major problem in creation of deep learning image segmentation models for medical images is the lack of available datasets for model training and validation. Liu et al developed a two-dimensional image segmentation model based off the established convolutional neural network architecture, U-Net. U-Net was utilized because it is feasible to train from scratch with a small training set.This study looked at the CT scans of 105 patients with locally advanced cervical cancer. OAR segmentation for cervical cancer is a particularly challenging problem due to variability in organ size and frequent unclear boundaries. Even an experienced radiologist will have trouble. Seven organs were identified as OARs for cervical cancer radiation therapy: bladder, bone marrow, femoral head left, femoral head right, rectum, small intestine, and spinal cord.The model uses context aggregation blocks where U-Net has convolution layers. These context aggregation blocks use dilation convolution layers with different dilated rates and normal convolution layers with different kernel sizes to yield a low false-positive rate and accurate feature extraction in a large receptive field. A squeeze-extract block was used to ensure proper consideration of organs that are small. A class-weighted cross-entropy loss function was also used to overcome the imbalance in the datasets created by the differences in size and shape of each OAR.A ground truth was available based on the radiation oncologist’s annotations, allowing a Dice similarity coefficient (DSC) and 95th Hausdorff distance (HD) to be calculated and used as an evaluation metric. The DSC and the HD metrics indicated a comparable performance to other deep learning image segmentation models in most of the organs analyzed; inferior results were seen in the rectum and superior results in the intestines. All results were analyzed by an oncologist who determined that greater than 90% of results produced by this model were highly acceptable to be used during radiation therapy planning. To make the model more robust and generalizable, it is necessary to acquire a larger dataset with scans from different sources. Translation of this model to three dimensional may ultimately improve clinical translation.Highlighted ArticleLiu Z, Liu X, Xiao B, et al. Segmentation of organs-at-risk in cervical cancer CT images with a convolutional neural network. Physica Medica 2020;69:184-191. doi: https://doi.org/10.1016/j.ejmp.2019.12.008Highlighted ArticleLiu Z, Liu X, Xiao B, et al. Segmentation of organs-at-risk in cervical cancer CT images with a convolutional neural network. Physica Medica 2020;69:184-191. doi: https://doi.org/10.1016/j.ejmp.2019.12.008 Crossref, Medline, Google ScholarArticle HistoryPublished online: Mar 27 2020 FiguresReferencesRelatedDetailsCited ByJournal of Biomimetics, Biomaterials and Biomedical Engineering, Vol. 49Mathematical Problems in Engineering, Vol. 2020Recommended Articles nnU-Net: Further Automating Biomedical Image AutosegmentationRadiology: Imaging Cancer2021Volume: 3Issue: 1Deep Learning: A Primer for RadiologistsRadioGraphics2017Volume: 37Issue: 7pp. 2113-2131Generative Adversarial Networks: A Primer for RadiologistsRadioGraphics2021Volume: 41Issue: 3pp. 840-857Current Applications and Future Impact of Machine Learning in RadiologyRadiology2018Volume: 288Issue: 2pp. 318-328Deep Generative Adversarial Networks: Applications in Musculoskeletal ImagingRadiology: Artificial Intelligence2021Volume: 3Issue: 3See More RSNA Education Exhibits A Multidisciplinary Approach for Program Development with Artificial Intelligence in Pancreatic Cancer: How We Fit InDigital Posters2019Abnormal Changes After Radiation Therapy: What Radiologists Should KnowDigital Posters2018Artificial Intelligence in Diagnostic Imaging: Current Applications and Future PerspectiveDigital Posters2019 RSNA Case Collection Acute Radiation EnteropathyRSNA Case Collection2021Small Bowel LymphomaRSNA Case Collection2021Hirschsprung DiseaseRSNA Case Collection2021 Vol. 2, No. 2 Metrics Downloaded 310 times Altmetric Score

IntroductionNarrow Band Imaging (NBI) is an endoscopic visualization technique useful for upper aero-digestive tract (UADT) cancer detection and margins evaluation. However, NBI analysis is strongly operator-dependent and requires high expertise, thus limiting its wider implementation. Recently, artificial intelligence (AI) has demonstrated potential for applications in UADT videoendoscopy. Among AI methods, deep learning algorithms, and especially convolutional neural networks (CNNs), are particularly suitable for delineating cancers on videoendoscopy. This study is aimed to develop a CNN for automatic semantic segmentation of UADT cancer on endoscopic images.Materials and MethodsA dataset of white light and NBI videoframes of laryngeal squamous cell carcinoma (LSCC) was collected and manually annotated. A novel DL segmentation model (SegMENT) was designed. SegMENT relies on DeepLabV3+ CNN architecture, modified using Xception as a backbone and incorporating ensemble features from other CNNs. The performance of SegMENT was compared to state-of-the-art CNNs (UNet, ResUNet, and DeepLabv3). SegMENT was then validated on two external datasets of NBI images of oropharyngeal (OPSCC) and oral cavity SCC (OSCC) obtained from a previously published study. The impact of in-domain transfer learning through an ensemble technique was evaluated on the external datasets.Results219 LSCC patients were retrospectively included in the study. A total of 683 videoframes composed the LSCC dataset, while the external validation cohorts of OPSCC and OCSCC contained 116 and 102 images. On the LSCC dataset, SegMENT outperformed the other DL models, obtaining the following median values: 0.68 intersection over union (IoU), 0.81 dice similarity coefficient (DSC), 0.95 recall, 0.78 precision, 0.97 accuracy. For the OCSCC and OPSCC datasets, results were superior compared to previously published data: the median performance metrics were, respectively, improved as follows: DSC=10.3% and 11.9%, recall=15.0% and 5.1%, precision=17.0% and 14.7%, accuracy=4.1% and 10.3%.ConclusionSegMENT achieved promising performances, showing that automatic tumor segmentation in endoscopic images is feasible even within the highly heterogeneous and complex UADT environment. SegMENT outperformed the previously published results on the external validation cohorts. The model demonstrated potential for improved detection of early tumors, more precise biopsies, and better selection of resection margins.

Most recently transformer models became the state of the art in various medical image segmentation tasks and challenges, outperforming most of the conventional deep learning approaches. Picking up on that trend, this study aims at applying various transformer models to the highly challenging task of colorectal cancer (CRC) segmentation in CT imaging and assessing how they hold up to the current state-of-the-art convolutional neural network (CNN), the nnUnet. Furthermore, we wanted to investigate the impact of the network size on the resulting accuracies, since transformer models tend to be significantly larger than conventional network architectures. For this purpose, six different transformer models, with specific architectural advancements and network sizes were implemented alongside the aforementioned nnUnet and were applied to the CRC segmentation task of the medical segmentation decathlon. The best results were achieved with the Swin-UNETR, D-Former, and VT-Unet, each transformer models, with a Dice similarity coefficient (DSC) of 0.60, 0.59 and 0.59, respectively. Therefore, the current state-of-the-art CNN, the nnUnet could be outperformed by transformer architectures regarding this task. Furthermore, a comparison with the inter-observer variability (IOV) of approx. 0.64 DSC indicates almost expert-level accuracy. The comparatively low IOV emphasizes the complexity and challenge of CRC segmentation, as well as indicating limitations regarding the achievable segmentation accuracy. As a result of this study, transformer models underline their current upward trend in producing state-of-the-art results also for the challenging task of CRC segmentation. However, with ever smaller advances in total accuracies, as demonstrated in this study by the on par performances of multiple network variants, other advantages like efficiency, low computation demands, or ease of adaption to new tasks become more and more relevant.

Domain- and task-specific transfer learning for medical segmentation tasks

Background: This study aims to develop an automatic segmentation model based on U-Net architecture. The model will delineate the high-risk clinical target volume (HR-CTV) and pelvic organs at risk (OARs) in brachytherapy for cervical cancer. The goal is to improve the consistency and clinical efficiency of segmentation results. Methods: The automatic segmentation model was developed by U-Net architecture, and the Computed Tomography (CT) images of 102 cervical cancer patients receiving Three-Dimensional image-guided brachytherapy (3D IGBT) were used for network training (63 cases in training set, 20 cases in test set, and 19 cases in validation set). The segmentation objects included HR-CTV, sigmoid colon, rectum, bladder and small intestine. The accuracy of the automatic segmentation model was evaluated by Dice similarity coefficient (DSC) and Hausdorff distance (HD). In addition, the time efficiency was evaluated by comparing the time of manual delineation and the time of artificial intelligence (AI) assisted automatic delineation. Results: The auto-segmentation performance of HR-CTV and OARs was good, with an average DSC of 0.90 ± 0.03 and 0.85 ± 0.04, respectively. The DSC values of the rectum, sigmoid colon and bladder were 0.91 ± 0.04, 0.88 ± 0.06 and 0.86 ± 0.04, respectively. Among the organs at risk, the small intestine had the lowest segmentation data, with a DSC of only 0.77 ± 0.20 and a HD of 25.06 ± 16.24 mm. The automatic delineation took only 1.53 ± 0.03 minutes, while the manual delineation took the longest time. AI assisted manual delineation shortened the delineation time of HR-CTV and OARs by 5 minutes and 10 minutes, respectively. Conclusions: U-Net meets clinical expectations in the delineation of HR-CTV and OARs in brachytherapy for cervical cancer, and performs better than the traditional model in HR-CTV. However, the delineation results of small intestine and sigmoid colon need to be further verified by a larger sample size.

Objective:Precise segmentation of human organs and anatomic structures (especially organs at risk, OARs) is the basis and prerequisite for the treatment planning of radiation therapy. In order to ensure rapid and accurate design of radiotherapy treatment planning, an automatic organ segmentation technique was investigated based on deep learning convolutional neural network.MethodA deep learning convolutional neural network (CNN) algorithm called BCDU-Net has been modified and developed further by us. Twenty two thousand CT images and the corresponding organ contours of 17 types delineated manually by experienced physicians from 329 patients were used to train and validate the algorithm. The CT images randomly selected were employed to test the modified BCDU-Net algorithm. The weight parameters of the algorithm model were acquired from the training of the convolutional neural network.ResultThe average Dice similarity coefficient (DSC) of the automatic segmentation and manual segmentation of the human organs of 17 types reached 0.8376, and the best coefficient reached up to 0.9676. It took 1.5–2 s and about 1 h to automatically segment the contours of an organ in an image of the CT dataset for a patient and the 17 organs for the CT dataset with the method developed by us, respectively.ConclusionThe modified deep neural network algorithm could be used to automatically segment human organs of 17 types quickly and accurately. The accuracy and speed of the method meet the requirements of its application in radiotherapy.

BackgroundRecently, deep learning via convolutional neural networks (CNNs) has largely superseded conventional methods for proton (1H)‐MRI lung segmentation. However, previous deep learning studies have utilized single‐center data and limited acquisition parameters.PurposeDevelop a generalizable CNN for lung segmentation in 1H‐MRI, robust to pathology, acquisition protocol, vendor, and center.Study typeRetrospective.PopulationA total of 809 1H‐MRI scans from 258 participants with various pulmonary pathologies (median age (range): 57 (6–85); 42% females) and 31 healthy participants (median age (range): 34 (23–76); 34% females) that were split into training (593 scans (74%); 157 participants (55%)), testing (50 scans (6%); 50 participants (17%)) and external validation (164 scans (20%); 82 participants (28%)) sets.Field Strength/Sequence1.5‐T and 3‐T/3D spoiled‐gradient recalled and ultrashort echo‐time 1H‐MRI.Assessment2D and 3D CNNs, trained on single‐center, multi‐sequence data, and the conventional spatial fuzzy c‐means (SFCM) method were compared to manually delineated expert segmentations. Each method was validated on external data originating from several centers. Dice similarity coefficient (DSC), average boundary Hausdorff distance (Average HD), and relative error (XOR) metrics to assess segmentation performance.Statistical TestsKruskal–Wallis tests assessed significances of differences between acquisitions in the testing set. Friedman tests with post hoc multiple comparisons assessed differences between the 2D CNN, 3D CNN, and SFCM. Bland–Altman analyses assessed agreement with manually derived lung volumes. A P value of <0.05 was considered statistically significant.ResultsThe 3D CNN significantly outperformed its 2D analog and SFCM, yielding a median (range) DSC of 0.961 (0.880–0.987), Average HD of 1.63 mm (0.65–5.45) and XOR of 0.079 (0.025–0.240) on the testing set and a DSC of 0.973 (0.866–0.987), Average HD of 1.11 mm (0.47–8.13) and XOR of 0.054 (0.026–0.255) on external validation data.Data ConclusionThe 3D CNN generated accurate 1H‐MRI lung segmentations on a heterogenous dataset, demonstrating robustness to disease pathology, sequence, vendor, and center.Evidence Level4.Technical EfficacyStage 1.

ObjectivesBack pain, especially lower back pain, is experienced in 60% to 80% of adults at some points during their lives. Various studies have found that lower back pain is a very common problem among adolescents, and the highest incidence rates are for adults in their 30s. There has been a remarkable increase in using computer-aided diagnosis to assist doctors in the interpretation of medical images. Spine segmentation in computed tomography (CT) scans using algorithmic methods allows improved diagnosis of back pain.MethodsIn this study, we developed a web-based automatic spine segmentation method using deep learning and obtained the dice coefficient by comparison with the predicted image. Our method is based on convolutional neural networks for segmentation. More specifically, we train a hierarchical data format file using U-Net architecture and then insert the test data label to perform segmentation. Thus, we obtained more specific and detailed results. A total of 344 CT images were used in the experiment. Of these, 330 were used for learning, and the remaining 14 for testing.ResultsOur method achieved an average dice coefficient of 90.4%, a precision of 96.81%, and an F1-score of 91.64%.ConclusionsThe proposed web-based deep learning approach can be very practical and accurate for spine segmentation as a diagnostic method.

Separate renal function assessment is important in clinical decision making. The single-photon emission computed tomography is commonly used for the assessment although radioactive, tedious and of high cost. This study aimed to automatically assess the separate renal function using plain CT images and artificial intelligence methods, including deep learning-based automatic segmentation and radiomics modeling. We performed a retrospective study on 281 patients with nephrarctia or hydronephrosis from two centers (Training set: 159 patients from Center I; Test set: 122 patients from Center II). The renal parenchyma and hydronephrosis regions in plain CT images were automatically segmented using deep learning-based U-Net transformers (UNETR). Radiomic features were extracted from the two regions and used to build radiomic signature using the ElasticNet, then further combined with clinical characteristics using multivariable logistic regression to obtain an integrated model. The automatic segmentation was evaluated using the dice similarity coefficient (DSC). The mean DSC of automatic kidney segmentation based on UNETR was 0.894 and 0.881 in the training and test sets. The average time of automatic and manual segmentation was 3.4s/case and 1477.9s/case. The AUC of radiomic signature was 0.778 in the training set and 0.801 in the test set. The AUC of the integrated model was 0.792 and 0.825 in the training and test sets. It is feasible to assess the renal function of each kidney separately using plain CT and AI methods. Our method can minimize the radiation risk, improve the diagnostic efficiency and reduce the costs.

The global incidence and mortality rates of pancreatic cancer have been on the rise in recent decades. At the same time, pancreatic cancer occupies a leading position among malignant neoplasms, which are often first detected at advanced stages, which significantly worsens the prognosis for patients. In this regard, it is important to create automated systems capable of accurately segmenting and diagnosing pancreatic tumors at an early stage. A diagnostic model based on U-Net is proposed and evaluated, aimed at improving the accuracy of automatic segmentation of medical images for segmentation of the pancreas and identification of malignant changes in computed tomography (CT) images. The diagnostic model of the algorithm was based on the U-Net architecture, and image texture indices were used as control features. The neural network algorithm was trained using CT data from 310 patients with pancreatic neoplasms. Segmentation datasets from 280 pancreatic cancer studies from an open source, Memorial Sloan Kettering Cancer Center, was used to segment medical images and train the algorithm. Manual segmentation of medical images obtained at Regional Clinical Hospital of the Kaliningrad was performed using specialized three-dimensional (3D) Slicer software: CT images of 30 patients with pancreatic neoplasms. Diagnoses in the patient group were confirmed by morphological diagnostics, including examination of biopsy samples and/or surgical material. Four types of indicators were used to quantify segmentation results: Dice similarity coefficient (DSC), accuracy, sensitivity, and specificity. The diagnostic model achieved an accuracy of 88% in the classification of pancreatic cancer, and the DSC segmentation accuracy factor was 70%, demonstrating sensitivity of 98% and specificity of 98%. The results obtained emphasize the effectiveness of CT image analysis for the diagnosis of pancreatic malignancies using a neural network algorithm that uses textural features of medical images. In the course of the work, a number of limitations were identified: obtaining false positive results during segmentation, a limited number of medical images and clinical data that may affect the representativeness of the developed diagnostic model. Nevertheless, the results show the prospects for integrating artificial intelligence (AI) technologies into clinical practice, which can significantly improve diagnostic efficiency. The use of neural network algorithms based on the textural features of medical images has significant potential in the field of clinical decision support systems. Despite certain limitations in the course of work, the using textural features for training neural networks will increase the accuracy of diagnosis of pancreatic malignancies and will play an important role in determining patient management strategies and monitoring the effectiveness of prescribed treatment methods. It is necessary to further study additional textural characteristics, utilize 3D models, and include more clinical data to improve the accuracy of the diagnostic model when differentiating malignant tumors from healthy tissues.

Background Deep learning may help to improve computer-aided detection of volume (CADv) measurement of pulmonary nodules at chest CT. Purpose To determine the efficacy of a deep learning method for improving CADv for measuring the solid and ground-glass opacity (GGO) volumes of a nodule, doubling time (DT), and the change in volume at chest CT. Materials and Methods From January 2014 to December 2016, patients with pulmonary nodules at CT were retrospectively reviewed. CADv without and with a convolutional neural network (CNN) automatically determined total nodule volume change per day and DT. Area under the curves (AUCs) on a per-nodule basis and diagnostic accuracy on a per-patient basis were compared among all indexes from CADv with and without CNN for differentiating benign from malignant nodules. Results The CNN training set was 294 nodules in 217 patients, the validation set was 41 nodules in 32 validation patients, and the test set was 290 nodules in 188 patients. A total of 170 patients had 290 nodules (mean size ± standard deviation, 11 mm ± 5; range, 4-29 mm) diagnosed as 132 malignant nodules and 158 benign nodules. There were 132 solid nodules (46%), 106 part-solid nodules (36%), and 52 ground-glass nodules (18%). The test set results showed that the diagnostic performance of the CNN with CADv for total nodule volume change per day was larger than DT of CADv with CNN (AUC, 0.94 [95% confidence interval {CI}: 0.90, 0.96] vs 0.67 [95% CI: 0.60, 0.74]; P < .001) and CADv without CNN (total nodule volume change per day: AUC, 0.69 [95% CI: 0.62, 0.75]; P < .001; DT: AUC, 0.58 [95% CI: 0.51, 0.65]; P < .001). The accuracy of total nodule volume change per day of CADv with CNN was significantly higher than that of CADv without CNN (P < .001) and DT of both methods (P < .001). Conclusion Convolutional neural network is useful for improving accuracy of computer-aided detection of volume measurement and nodule differentiation capability at CT for patients with pulmonary nodules. © RSNA, 2020 Online supplemental material is available for this article.

In the last few years, Deep Learning (DL) has been showing superior performance in different modalities of bio-medical image analysis. Several DL architectures have been proposed for classification, segmentation, and detection tasks in medical imaging and computational pathology. In this paper, we propose a new DL architecture, the NABLA-N network (∇N-Net), with better feature fusion techniques in decoding units for dermoscopic image segmentation tasks. The ∇N-Net has several advances for segmentation tasks. First, this model ensures better feature representation for semantic segmentation with a combination of low to high-level feature maps. Second, this network shows better quantitative and qualitative results with the same or fewer network parameters compared to other methods. In addition, the Inception Recurrent Residual Convolutional Neural Network (IRRCNN) model is used for skin cancer classification. The proposed ∇N-Net network and IRRCNN models are evaluated for skin cancer segmentation and classification on the benchmark datasets from the International Skin Imaging Collaboration 2018 (ISIC-2018). The experimental results show superior performance on segmentation tasks compared to the Recurrent Residual U-Net (R2U-Net). The classification model shows around 87% testing accuracy for dermoscopic skin cancer classification on ISIC2018 dataset.