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      Semantic segmentation of cerebrospinal fluid and brain volume with a convolutional neural network in pediatric hydrocephalus—transfer learning from existing algorithms

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          Abstract

          Background

          For the segmentation of medical imaging data, a multitude of precise but very specific algorithms exist. In previous studies, we investigated the possibility of segmenting MRI data to determine cerebrospinal fluid and brain volume using a classical machine learning algorithm. It demonstrated good clinical usability and a very accurate correlation of the volumes to the single area determination in a reproducible axial layer. This study aims to investigate whether these established segmentation algorithms can be transferred to new, more generalizable deep learning algorithms employing an extended transfer learning procedure and whether medically meaningful segmentation is possible.

          Methods

          Ninety-five routinely performed true FISP MRI sequences were retrospectively analyzed in 43 patients with pediatric hydrocephalus. Using a freely available and clinically established segmentation algorithm based on a hidden Markov random field model, four classes of segmentation (brain, cerebrospinal fluid (CSF), background, and tissue) were generated. Fifty-nine randomly selected data sets (10,432 slices) were used as a training data set. Images were augmented for contrast, brightness, and random left/right and X/Y translation. A convolutional neural network (CNN) for semantic image segmentation composed of an encoder and corresponding decoder subnetwork was set up. The network was pre-initialized with layers and weights from a pre-trained VGG 16 model. Following the network was trained with the labeled image data set. A validation data set of 18 scans (3289 slices) was used to monitor the performance as the deep CNN trained. The classification results were tested on 18 randomly allocated labeled data sets (3319 slices) and on a T2-weighted BrainWeb data set with known ground truth.

          Results

          The segmentation of clinical test data provided reliable results (global accuracy 0.90, Dice coefficient 0.86), while the CNN segmentation of data from the BrainWeb data set showed comparable results (global accuracy 0.89, Dice coefficient 0.84). The segmentation of the BrainWeb data set with the classical FAST algorithm produced consistent findings (global accuracy 0.90, Dice coefficient 0.87). Likewise, the area development of brain and CSF in the long-term clinical course of three patients was presented.

          Conclusion

          Using the presented methods, we showed that conventional segmentation algorithms can be transferred to new advances in deep learning with comparable accuracy, generating a large number of training data sets with relatively little effort. A clinically meaningful segmentation possibility was demonstrated.

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          Most cited references22

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          Deep Learning in Medical Image Analysis

          This review covers computer-assisted analysis of images in the field of medical imaging. Recent advances in machine learning, especially with regard to deep learning, are helping to identify, classify, and quantify patterns in medical images. At the core of these advances is the ability to exploit hierarchical feature representations learned solely from data, instead of features designed by hand according to domain-specific knowledge. Deep learning is rapidly becoming the state of the art, leading to enhanced performance in various medical applications. We introduce the fundamentals of deep learning methods and review their successes in image registration, detection of anatomical and cellular structures, tissue segmentation, computer-aided disease diagnosis and prognosis, and so on. We conclude by discussing research issues and suggesting future directions for further improvement.
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            Convolutional Neural Networks for Medical Image Analysis: Full Training or Fine Tuning?

            Training a deep convolutional neural network (CNN) from scratch is difficult because it requires a large amount of labeled training data and a great deal of expertise to ensure proper convergence. A promising alternative is to fine-tune a CNN that has been pre-trained using, for instance, a large set of labeled natural images. However, the substantial differences between natural and medical images may advise against such knowledge transfer. In this paper, we seek to answer the following central question in the context of medical image analysis: Can the use of pre-trained deep CNNs with sufficient fine-tuning eliminate the need for training a deep CNN from scratch? To address this question, we considered four distinct medical imaging applications in three specialties (radiology, cardiology, and gastroenterology) involving classification, detection, and segmentation from three different imaging modalities, and investigated how the performance of deep CNNs trained from scratch compared with the pre-trained CNNs fine-tuned in a layer-wise manner. Our experiments consistently demonstrated that 1) the use of a pre-trained CNN with adequate fine-tuning outperformed or, in the worst case, performed as well as a CNN trained from scratch; 2) fine-tuned CNNs were more robust to the size of training sets than CNNs trained from scratch; 3) neither shallow tuning nor deep tuning was the optimal choice for a particular application; and 4) our layer-wise fine-tuning scheme could offer a practical way to reach the best performance for the application at hand based on the amount of available data.
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              Deep Learning Techniques for Medical Image Segmentation: Achievements and Challenges

              Deep learning-based image segmentation is by now firmly established as a robust tool in image segmentation. It has been widely used to separate homogeneous areas as the first and critical component of diagnosis and treatment pipeline. In this article, we present a critical appraisal of popular methods that have employed deep-learning techniques for medical image segmentation. Moreover, we summarize the most common challenges incurred and suggest possible solutions.
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                Author and article information

                Contributors
                florian.grimm@med.uni-tuebingen.de
                Journal
                Acta Neurochir (Wien)
                Acta Neurochir (Wien)
                Acta Neurochirurgica
                Springer Vienna (Vienna )
                0001-6268
                0942-0940
                25 June 2020
                25 June 2020
                2020
                : 162
                : 10
                : 2463-2474
                Affiliations
                [1 ]GRID grid.411544.1, ISNI 0000 0001 0196 8249, Department of Neurosurgery, , University Hospital Tübingen, ; Hoppe-Seyler-Strasse 3, 72076 Tubingen, Germany
                [2 ]GRID grid.411544.1, ISNI 0000 0001 0196 8249, Division of Pediatric Neurosurgery, , University Hospital Tübingen, ; Tubingen, Germany
                [3 ]GRID grid.10392.39, ISNI 0000 0001 2190 1447, Integrative Transcriptomics, Interfaculty Institute for Biomedical Informatics, , University of Tübingen, ; Tubingen, Germany
                Author information
                http://orcid.org/0000-0001-8862-814X
                Article
                4447
                10.1007/s00701-020-04447-x
                7496050
                32583085
                d8f4dae1-4b1b-45b8-9480-410daef9a365
                © The Author(s) 2020

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 30 March 2020
                : 1 June 2020
                Funding
                Funded by: Universitätsklinikum Tübingen (8868)
                Categories
                Original Article - Pediatric Neurosurgery
                Custom metadata
                © Springer-Verlag GmbH Austria, part of Springer Nature 2020

                Surgery
                deep learning,image segmentation,csf volume,brain volume,pediatric hydrocephalus,area determination

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