The Special Issue “Advanced Computational Methods for Oncological Image Analysis”, published for the Journal of Imaging, covered original research papers about state-of-the-art and novel algorithms and methodologies, as well as applications of computational methods for oncological image analysis, ranging from radiogenomics to deep learning [...] Full article

Breast cancer is one of the leading causes of death among women, more so than all other cancers. The accurate diagnosis of breast cancer is very difficult due to the complexity of the disease, changing treatment procedures and different patient population samples. Diagnostic techniques with better performance are very important for personalized care and treatment and to reduce and control the recurrence of cancer. The main objective of this research was to select feature selection techniques using correlation analysis and variance of input features before passing these significant features to a classification method. We used an ensemble method to improve the classification of breast cancer. The proposed approach was evaluated using the public WBCD dataset (Wisconsin Breast Cancer Dataset). Correlation analysis and principal component analysis were used for dimensionality reduction. Performance was evaluated for well-known machine learning classifiers, and the best seven classifiers were chosen for the next step. Hyper-parameter tuning was performed to improve the performances of the classifiers. The best performing classification algorithms were combined with two different voting techniques. Hard voting predicts the class that gets the majority vote, whereas soft voting predicts the class based on highest probability. The proposed approach performed better than state-of-the-art work, achieving an accuracy of 98.24%, high precision (99.29%) and a recall value of 95.89%. Full article

A brain Magnetic resonance imaging (MRI) scan of a single individual consists of several slices across the 3D anatomical view. Therefore, manual segmentation of brain tumors from magnetic resonance (MR) images is a challenging and time-consuming task. In addition, an automated brain tumor classification from an MRI scan is non-invasive so that it avoids biopsy and make the diagnosis process safer. Since the beginning of this millennia and late nineties, the effort of the research community to come-up with automatic brain tumor segmentation and classification method has been tremendous. As a result, there are ample literature on the area focusing on segmentation using region growing, traditional machine learning and deep learning methods. Similarly, a number of tasks have been performed in the area of brain tumor classification into their respective histological type, and an impressive performance results have been obtained. Considering state of-the-art methods and their performance, the purpose of this paper is to provide a comprehensive survey of three, recently proposed, major brain tumor segmentation and classification model techniques, namely, region growing, shallow machine learning and deep learning. The established works included in this survey also covers technical aspects such as the strengths and weaknesses of different approaches, pre- and post-processing techniques, feature extraction, datasets, and models’ performance evaluation metrics. Full article

Mammography is the primary medical imaging method used for routine screening and early detection of breast cancer in women. However, the process of manually inspecting, detecting, and delimiting the tumoral massess in 2D images is a very time-consuming task, subject to human errors due to fatigue. Therefore, integrated computer-aided detection systems have been proposed, based on modern computer vision and machine learning methods. In the present work, mammogram images from the publicly available Inbreast dataset are first converted to pseudo-color and then used to train and test a Mask R-CNN deep neural network. The most common approach is to start with a dataset and split the images into train and test set randomly. However, since there are often two or more images of the same case in the dataset, the way the dataset is split may have an impact on the results. Our experiments show that random partition of the data can produce unreliable training, so the dataset must be split using case-wise partition for more stable results. In experimental results, the method achieves an average true positive rate of 0.936 with 0.063 standard deviation using random partition and 0.908 with 0.002 standard deviation using case-wise partition, showing that case-wise partition must be used for more reliable results. Full article

Prostate cancer (PCa) is the second most diagnosed cancer in men. Patients with PCa often develop metastases, with more than 80% of this metastases occurring in bone. The most common imaging technique used for screening, diagnosis and follow-up of disease evolution is bone scintigraphy, due to its high sensitivity and widespread availability at nuclear medicine facilities. To date, the assessment of bone scans relies solely on the interpretation of an expert physician who visually assesses the scan. Besides this being a time consuming task, it is also subjective, as there is no absolute criteria neither to identify bone metastases neither to quantify them by a straightforward and universally accepted procedure. In this paper, a new algorithm for the false positives reduction of automatically detected hotspots in bone scintigraphy images is proposed. The motivation relies in the difficulty of building a fully annotated database. In this way, our algorithm is a semisupervised method that works in an iterative way. The ultimate goal is to provide the physician with a fast, precise and reliable tool to quantify bone scans and evaluate disease progression and response to treatment. The algorithm is tested in a set of bone scans manually labeled according to the patient’s medical record. The achieved classification sensitivity, specificity and false negative rate were 63%, 58% and 37%, respectively. Comparison with other state-of-the-art classification algorithms shows superiority of the proposed method. Full article

The role of medical image computing in oncology is growing stronger, not least due to the unprecedented advancement of computational AI techniques, providing a technological bridge between radiology and oncology, which could significantly accelerate the advancement of precision medicine throughout the cancer care continuum. Medical image processing has been an active field of research for more than three decades, focusing initially on traditional image analysis tasks such as registration segmentation, fusion, and contrast optimization. However, with the advancement of model-based medical image processing, the field of imaging biomarker discovery has focused on transforming functional imaging data into meaningful biomarkers that are able to provide insight into a tumor’s pathophysiology. More recently, the advancement of high-performance computing, in conjunction with the availability of large medical imaging datasets, has enabled the deployment of sophisticated machine learning techniques in the context of radiomics and deep learning modeling. This paper reviews and discusses the evolving role of image analysis and processing through the lens of the abovementioned developments, which hold promise for accelerating precision oncology, in the sense of improved diagnosis, prognosis, and treatment planning of cancer. Full article

Structural and metabolic imaging are fundamental for diagnosis, treatment and follow-up in oncology. Beyond the well-established diagnostic imaging applications, ultrasounds are currently emerging in the clinical practice as a noninvasive technology for therapy. Indeed, the sound waves can be used to increase the temperature inside the target solid tumors, leading to apoptosis or necrosis of neoplastic tissues. The Magnetic resonance-guided focused ultrasound surgery (MRgFUS) technology represents a valid application of this ultrasound property, mainly used in oncology and neurology. In this paper; patient safety during MRgFUS treatments was investigated by a series of experiments in a tissue-mimicking phantom and performing ex vivo skin samples, to promptly identify unwanted temperature rises. The acquired MR images, used to evaluate the temperature in the treated areas, were analyzed to compare classical proton resonance frequency (PRF) shift techniques and referenceless thermometry methods to accurately assess the temperature variations. We exploited radial basis function (RBF) neural networks for referenceless thermometry and compared the results against interferometric optical fiber measurements. The experimental measurements were obtained using a set of interferometric optical fibers aimed at quantifying temperature variations directly in the sonication areas. The temperature increases during the treatment were not accurately detected by MRI-based referenceless thermometry methods, and more sensitive measurement systems, such as optical fibers, would be required. In-depth studies about these aspects are needed to monitor temperature and improve safety during MRgFUS treatments. Full article

In this paper we consider radar approaches for breast cancer detection. The aim is to give a brief review of the main features of incoherent methods, based on beam-forming and Multiple SIgnal Classification (MUSIC) algorithms, that we have recently developed, and to compare them with classical coherent beam-forming. Those methods have the remarkable advantage of not requiring antenna characterization/compensation, which can be problematic in view of the close (to the breast) proximity set-up usually employed in breast imaging. Moreover, we proceed to an experimental validation of one of the incoherent methods, i.e., the I-MUSIC, using the multimodal breast phantom we have previously developed. While in a previous paper we focused on the phantom manufacture and characterization, here we are mainly concerned with providing the detail of the reconstruction algorithm, in particular for a new multi-step clutter rejection method that was employed and only barely described. In this regard, this contribution can be considered as a completion of our previous study. The experiments against the phantom show promising results and highlight the crucial role played by the clutter rejection procedure. Full article

A brain tumor is one of the foremost reasons for the rise in mortality among children and adults. A brain tumor is a mass of tissue that propagates out of control of the normal forces that regulate growth inside the brain. A brain tumor appears when one type of cell changes from its normal characteristics and grows and multiplies abnormally. The unusual growth of cells within the brain or inside the skull, which can be cancerous or non-cancerous has been the reason for the death of adults in developed countries and children in under developing countries like Ethiopia. The studies have shown that the region growing algorithm initializes the seed point either manually or semi-manually which as a result affects the segmentation result. However, in this paper, we proposed an enhanced region-growing algorithm for the automatic seed point initialization. The proposed approach’s performance was compared with the state-of-the-art deep learning algorithms using the common dataset, BRATS2015. In the proposed approach, we applied a thresholding technique to strip the skull from each input brain image. After the skull is stripped the brain image is divided into 8 blocks. Then, for each block, we computed the mean intensities and from which the five blocks with maximum mean intensities were selected out of the eight blocks. Next, the five maximum mean intensities were used as a seed point for the region growing algorithm separately and obtained five different regions of interest (ROIs) for each skull stripped input brain image. The five ROIs generated using the proposed approach were evaluated using dice similarity score (DSS), intersection over union (IoU), and accuracy (Acc) against the ground truth (GT), and the best region of interest is selected as a final ROI. Finally, the final ROI was compared with different state-of-the-art deep learning algorithms and region-based segmentation algorithms in terms of DSS. Our proposed approach was validated in three different experimental setups. In the first experimental setup where 15 randomly selected brain images were used for testing and achieved a DSS value of 0.89. In the second and third experimental setups, the proposed approach scored a DSS value of 0.90 and 0.80 for 12 randomly selected and 800 brain images respectively. The average DSS value for the three experimental setups was 0.86. Full article

Evaluating the quality of reconstructed images requires consistent approaches to extracting information and applying metrics. Partitioning medical images into tissue types permits the quantitative assessment of regions that contain a specific tissue. The assessment facilitates the evaluation of an imaging algorithm in terms of its ability to reconstruct the properties of various tissue types and identify anomalies. Microwave tomography is an imaging modality that is model-based and reconstructs an approximation of the actual internal spatial distribution of the dielectric properties of a breast over a reconstruction model consisting of discrete elements. The breast tissue types are characterized by their dielectric properties, so the complex permittivity profile that is reconstructed may be used to distinguish different tissue types. This manuscript presents a robust and flexible medical image segmentation technique to partition microwave breast images into tissue types in order to facilitate the evaluation of image quality. The approach combines an unsupervised machine learning method with statistical techniques. The key advantage for using the algorithm over other approaches, such as a threshold-based segmentation method, is that it supports this quantitative analysis without prior assumptions such as knowledge of the expected dielectric property values that characterize each tissue type. Moreover, it can be used for scenarios where there is a scarcity of data available for supervised learning. Microwave images are formed by solving an inverse scattering problem that is severely ill-posed, which has a significant impact on image quality. A number of strategies have been developed to alleviate the ill-posedness of the inverse scattering problem. The degree of success of each strategy varies, leading to reconstructions that have a wide range of image quality. A requirement for the segmentation technique is the ability to partition tissue types over a range of image qualities, which is demonstrated in the first part of the paper. The segmentation of images into regions of interest corresponding to various tissue types leads to the decomposition of the breast interior into disjoint tissue masks. An array of region and distance-based metrics are applied to compare masks extracted from reconstructed images and ground truth models. The quantitative results reveal the accuracy with which the geometric and dielectric properties are reconstructed. The incorporation of the segmentation that results in a framework that effectively furnishes the quantitative assessment of regions that contain a specific tissue is also demonstrated. The algorithm is applied to reconstructed microwave images derived from breasts with various densities and tissue distributions to demonstrate the flexibility of the algorithm and that it is not data-specific. The potential for using the algorithm to assist in diagnosis is exhibited with a tumor tracking example. This example also establishes the usefulness of the approach in evaluating the performance of the reconstruction algorithm in terms of its sensitivity and specificity to malignant tissue and its ability to accurately reconstruct malignant tissue. Full article

Immunotherapy is regarded as one of the most significant breakthroughs in cancer treatment. Unfortunately, only a small percentage of patients respond properly to the treatment. Moreover, to date, there are no efficient bio-markers able to early discriminate the patients eligible for this treatment. In order to help overcome these limitations, an innovative non-invasive deep pipeline, integrating Computed Tomography (CT) imaging, is investigated for the prediction of a response to immunotherapy treatment. We report preliminary results collected as part of a case study in which we validated the implemented method on a clinical dataset of patients affected by Metastatic Urothelial Carcinoma. The proposed pipeline aims to discriminate patients with high chances of response from those with disease progression. Specifically, the authors propose ad-hoc 3D Deep Networks integrating Self-Attention mechanisms in order to estimate the immunotherapy treatment response from CT-scan images and such hemato-chemical data of the patients. The performance evaluation (average accuracy close to 92%) confirms the effectiveness of the proposed approach as an immunotherapy treatment response biomarker. Full article

Malignant melanoma is the deadliest form of skin cancer and, in recent years, is rapidly growing in terms of the incidence worldwide rate. The most effective approach to targeted treatment is early diagnosis. Deep learning algorithms, specifically convolutional neural networks, represent a methodology for the image analysis and representation. They optimize the features design task, essential for an automatic approach on different types of images, including medical. In this paper, we adopted pretrained deep convolutional neural networks architectures for the image representation with purpose to predict skin lesion melanoma. Firstly, we applied a transfer learning approach to extract image features. Secondly, we adopted the transferred learning features inside an ensemble classification context. Specifically, the framework trains individual classifiers on balanced subspaces and combines the provided predictions through statistical measures. Experimental phase on datasets of skin lesion images is performed and results obtained show the effectiveness of the proposed approach with respect to state-of-the-art competitors. Full article

Breast cancer affects thousands of women across the world, every year. Methods to predict risk of breast cancer, or to stratify women in different risk levels, could help to achieve an early diagnosis, and consequently a reduction of mortality. This paper aims to review articles that extracted texture features from mammograms and used those features along with machine learning algorithms to assess breast cancer risk. Besides that, deep learning methodologies that aimed for the same goal were also reviewed. In this work, first, a brief introduction to breast cancer statistics and screening programs is presented; after that, research done in the field of breast cancer risk assessment are analyzed, in terms of both methodologies used and results obtained. Finally, considerations about the analyzed papers are conducted. The results of this review allow to conclude that both machine and deep learning methodologies provide promising results in the field of risk analysis, either in a stratification in risk groups, or in a prediction of a risk score. Although promising, future endeavors in this field should consider the possibility of the implementation of the methodology in clinical practice. Full article

Quantitative analysis of the brain tumors provides valuable information for understanding the tumor characteristics and treatment planning better. The accurate segmentation of lesions requires more than one image modalities with varying contrasts. As a result, manual segmentation, which is arguably the most accurate segmentation method, would be impractical for more extensive studies. Deep learning has recently emerged as a solution for quantitative analysis due to its record-shattering performance. However, medical image analysis has its unique challenges. This paper presents a review of state-of-the-art deep learning methods for brain tumor segmentation, clearly highlighting their building blocks and various strategies. We end with a critical discussion of open challenges in medical image analysis. Full article