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Automatic quantitative assessment of Pectus Excavatum severity using CT images and deep learning

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Resumo:Pectus excavatum (PE) is the most common congenital abnormality of the thoracic cage, characterized by the inward displacement of the sternum and the adjacent costal cartilages. To assess and quantify the patient’s severity, three standard indices are extracted from computed tomography (CT) images: the Haller index; the correction index; and the asymmetry index. Currently, there is no solution to automate the extraction of these indices. The focus of this thesis is to develop an automatic system that analyzes the CT of the patient and, as a result, provides the measurements and indices of PE with accuracy and reproducibility, saving healthcare professionals’ time and increasing measurements’ reproducibility, which may ultimately improve patients’ diagnosis and care. Through the use of deep learning, a framework was developed consisting of three stages. In the first two stages, two convolution neural networks (CNNs), based on the UNet++ architecture, were used to learn the CT images’ features in order to select the optimal CT slice to take the measurements and identify the relevant eight keypoints. The final stage relies on geometric rules to calculate the measurements and indices of PE from the identified keypoints. Both automatic and manual analyses were performed on 269 CTs of 92 patients. For comparative purposes, intra-observer, inter-observer, and intra-patient variability of the estimated indices were analyzed in a subset of patients. The developed system proved to be viable, showing a good agreement with the manual approach, with small bias and narrow limits of agreement (LOA), being the results comparable with the inter-observer agreement. In the intra-patient analysis, the proposed framework outperformed the expert, showing a higher reproducibility between indices extracted from distinct CTs of the same patient. The developed system achieved an average relative error against manually extracted values of 4.09%, 5.59% and 1.91% for the Haller, correction and asymmetry indices, respectively. The results are promising, supporting the feasibility of using the developed framework for the automatic and accurate quantification of PE severity in a clinical context.
Autores principais:Silva, Bruno André Pires da
Assunto:Pectus excavatum Computer-aided diagnosis Medical image analysis Deep learning Convolutional neural network Diagnóstico auxiliado por computador Análise de imagens médicas Aprendizagem profunda Rede neural convolucional Engenharia e Tecnologia::Engenharia Eletrotécnica, Eletrónica e Informática
Ano:2021
País:Portugal
Tipo de documento:dissertação de mestrado
Tipo de acesso:acesso aberto
Instituição associada:Universidade do Minho
Idioma:inglês
Origem:RepositóriUM - Universidade do Minho
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author Silva, Bruno André Pires da
author_facet Silva, Bruno André Pires da
author_role author
contributor_name_str_mv Fonseca, Jaime C.
Queirós, Sandro Filipe Monteiro
RepositóriUM - Universidade do Minho
country_str PT
creators_json_txt [{\"Person.name\":\"Silva, Bruno André Pires da\"}]
datacite.contributors.contributor.contributorName.fl_str_mv Fonseca, Jaime C.
Queirós, Sandro Filipe Monteiro
RepositóriUM - Universidade do Minho
datacite.creators.creator.creatorName.fl_str_mv Silva, Bruno André Pires da
datacite.date.Accepted.fl_str_mv 2021-01-01T00:00:00Z
datacite.rights.fl_str_mv http://purl.org/coar/access_right/c_abf2
datacite.subjects.subject.fl_str_mv Pectus excavatum
Computer-aided diagnosis
Medical image analysis
Deep learning
Convolutional neural network
Diagnóstico auxiliado por computador
Análise de imagens médicas
Aprendizagem profunda
Rede neural convolucional
Engenharia e Tecnologia::Engenharia Eletrotécnica, Eletrónica e Informática
datacite.titles.title.fl_str_mv Automatic quantitative assessment of Pectus Excavatum severity using CT images and deep learning
dc.contributor.none.fl_str_mv Fonseca, Jaime C.
Queirós, Sandro Filipe Monteiro
RepositóriUM - Universidade do Minho
dc.creator.none.fl_str_mv Silva, Bruno André Pires da
dc.date.Accepted.fl_str_mv 2021-01-01T00:00:00Z
dc.format.none.fl_str_mv application/pdf
dc.identifier.none.fl_str_mv https://hdl.handle.net/1822/76561
dc.language.none.fl_str_mv eng
dc.rights.cclincense.fl_str_mv http://creativecommons.org/licenses/by-nc/4.0/
dc.rights.none.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.rights.rights.copyright.fl_str_mv openAccess
dc.subject.none.fl_str_mv Pectus excavatum
Computer-aided diagnosis
Medical image analysis
Deep learning
Convolutional neural network
Diagnóstico auxiliado por computador
Análise de imagens médicas
Aprendizagem profunda
Rede neural convolucional
Engenharia e Tecnologia::Engenharia Eletrotécnica, Eletrónica e Informática
dc.title.fl_str_mv Automatic quantitative assessment of Pectus Excavatum severity using CT images and deep learning
dc.type.none.fl_str_mv http://purl.org/coar/resource_type/c_bdcc
description Pectus excavatum (PE) is the most common congenital abnormality of the thoracic cage, characterized by the inward displacement of the sternum and the adjacent costal cartilages. To assess and quantify the patient’s severity, three standard indices are extracted from computed tomography (CT) images: the Haller index; the correction index; and the asymmetry index. Currently, there is no solution to automate the extraction of these indices. The focus of this thesis is to develop an automatic system that analyzes the CT of the patient and, as a result, provides the measurements and indices of PE with accuracy and reproducibility, saving healthcare professionals’ time and increasing measurements’ reproducibility, which may ultimately improve patients’ diagnosis and care. Through the use of deep learning, a framework was developed consisting of three stages. In the first two stages, two convolution neural networks (CNNs), based on the UNet++ architecture, were used to learn the CT images’ features in order to select the optimal CT slice to take the measurements and identify the relevant eight keypoints. The final stage relies on geometric rules to calculate the measurements and indices of PE from the identified keypoints. Both automatic and manual analyses were performed on 269 CTs of 92 patients. For comparative purposes, intra-observer, inter-observer, and intra-patient variability of the estimated indices were analyzed in a subset of patients. The developed system proved to be viable, showing a good agreement with the manual approach, with small bias and narrow limits of agreement (LOA), being the results comparable with the inter-observer agreement. In the intra-patient analysis, the proposed framework outperformed the expert, showing a higher reproducibility between indices extracted from distinct CTs of the same patient. The developed system achieved an average relative error against manually extracted values of 4.09%, 5.59% and 1.91% for the Haller, correction and asymmetry indices, respectively. The results are promising, supporting the feasibility of using the developed framework for the automatic and accurate quantification of PE severity in a clinical context.
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spelling engporPectus excavatum (PE) is the most common congenital abnormality of the thoracic cage, characterized by the inward displacement of the sternum and the adjacent costal cartilages. To assess and quantify the patient’s severity, three standard indices are extracted from computed tomography (CT) images: the Haller index; the correction index; and the asymmetry index. Currently, there is no solution to automate the extraction of these indices. The focus of this thesis is to develop an automatic system that analyzes the CT of the patient and, as a result, provides the measurements and indices of PE with accuracy and reproducibility, saving healthcare professionals’ time and increasing measurements’ reproducibility, which may ultimately improve patients’ diagnosis and care. Through the use of deep learning, a framework was developed consisting of three stages. In the first two stages, two convolution neural networks (CNNs), based on the UNet++ architecture, were used to learn the CT images’ features in order to select the optimal CT slice to take the measurements and identify the relevant eight keypoints. The final stage relies on geometric rules to calculate the measurements and indices of PE from the identified keypoints. Both automatic and manual analyses were performed on 269 CTs of 92 patients. For comparative purposes, intra-observer, inter-observer, and intra-patient variability of the estimated indices were analyzed in a subset of patients. The developed system proved to be viable, showing a good agreement with the manual approach, with small bias and narrow limits of agreement (LOA), being the results comparable with the inter-observer agreement. In the intra-patient analysis, the proposed framework outperformed the expert, showing a higher reproducibility between indices extracted from distinct CTs of the same patient. The developed system achieved an average relative error against manually extracted values of 4.09%, 5.59% and 1.91% for the Haller, correction and asymmetry indices, respectively. The results are promising, supporting the feasibility of using the developed framework for the automatic and accurate quantification of PE severity in a clinical context.application/pdfporAutomatic quantitative assessment of Pectus Excavatum severity using CT images and deep learningSilva, Bruno André Pires daFonseca, Jaime C.Queirós, Sandro Filipe MonteiroHostingInstitutionOrganizationalRepositóriUM - Universidade do Minhoe-mailmailto:repositorium@usdb.uminho.ptrepositorium@usdb.uminho.ptTID20279781320212021-01-01T00:00:00ZHandlehttps://hdl.handle.net/1822/76561http://purl.org/coar/access_right/c_abf2open accessPectus excavatumComputer-aided diagnosisMedical image analysisDeep learningConvolutional neural networkDiagnóstico auxiliado por computadorAnálise de imagens médicasAprendizagem profundaRede neural convolucionalhttp://www.oecd.org/science/inno/38235147.pdfFields of Science and Technology (FOS)Engenharia e Tecnologia::Engenharia Eletrotécnica, Eletrónica e Informática9105725 bytesliteraturehttp://purl.org/coar/resource_type/c_bdccmaster thesis2021http://creativecommons.org/licenses/by-nc/4.0/openAccesshttp://purl.org/coar/access_right/c_abf2application/pdfhttps://repositorium.uminho.pt/bitstreams/5f07c186-64cc-4ede-acaf-4174372eff94/download
spellingShingle Automatic quantitative assessment of Pectus Excavatum severity using CT images and deep learning
Silva, Bruno André Pires da
Pectus excavatum
Computer-aided diagnosis
Medical image analysis
Deep learning
Convolutional neural network
Diagnóstico auxiliado por computador
Análise de imagens médicas
Aprendizagem profunda
Rede neural convolucional
Engenharia e Tecnologia::Engenharia Eletrotécnica, Eletrónica e Informática
status SINGLETON
subject.fl_str_mv Pectus excavatum
Computer-aided diagnosis
Medical image analysis
Deep learning
Convolutional neural network
Diagnóstico auxiliado por computador
Análise de imagens médicas
Aprendizagem profunda
Rede neural convolucional
subject.other.fl_str_mv Engenharia e Tecnologia::Engenharia Eletrotécnica, Eletrónica e Informática
title Automatic quantitative assessment of Pectus Excavatum severity using CT images and deep learning
title_full Automatic quantitative assessment of Pectus Excavatum severity using CT images and deep learning
title_fullStr Automatic quantitative assessment of Pectus Excavatum severity using CT images and deep learning
title_full_unstemmed Automatic quantitative assessment of Pectus Excavatum severity using CT images and deep learning
title_short Automatic quantitative assessment of Pectus Excavatum severity using CT images and deep learning
title_sort Automatic quantitative assessment of Pectus Excavatum severity using CT images and deep learning
topic Pectus excavatum
Computer-aided diagnosis
Medical image analysis
Deep learning
Convolutional neural network
Diagnóstico auxiliado por computador
Análise de imagens médicas
Aprendizagem profunda
Rede neural convolucional
Engenharia e Tecnologia::Engenharia Eletrotécnica, Eletrónica e Informática
topic_facet Pectus excavatum
Computer-aided diagnosis
Medical image analysis
Deep learning
Convolutional neural network
Diagnóstico auxiliado por computador
Análise de imagens médicas
Aprendizagem profunda
Rede neural convolucional
Engenharia e Tecnologia::Engenharia Eletrotécnica, Eletrónica e Informática
url https://hdl.handle.net/1822/76561
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