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Publications

Publications by António Cunha

2020

Pre-Training Autoencoder for Lung Nodule Malignancy Assessment Using CT Images

Authors
Silva, F; Pereira, T; Frade, J; Mendes, J; Freitas, C; Hespanhol, V; Luis Costa, JL; Cunha, A; Oliveira, HP;

Publication
APPLIED SCIENCES-BASEL

Abstract
Lung cancer late diagnosis has a large impact on the mortality rate numbers, leading to a very low five-year survival rate of 5%. This issue emphasises the importance of developing systems to support a diagnostic at earlier stages. Clinicians use Computed Tomography (CT) scans to assess the nodules and the likelihood of malignancy. Automatic solutions can help to make a faster and more accurate diagnosis, which is crucial for the early detection of lung cancer. Convolutional neural networks (CNN) based approaches have shown to provide a reliable feature extraction ability to detect the malignancy risk associated with pulmonary nodules. This type of approach requires a massive amount of data to model training, which usually represents a limitation in the biomedical field due to medical data privacy and security issues. Transfer learning (TL) methods have been widely explored in medical imaging applications, offering a solution to overcome problems related to the lack of training data publicly available. For the clinical annotations experts with a deep understanding of the complex physiological phenomena represented in the data are required, which represents a huge investment. In this direction, this work explored a TL method based on unsupervised learning achieved when training a Convolutional Autoencoder (CAE) using images in the same domain. For this, lung nodules from the Lung Image Database Consortium and Image Database Resource Initiative (LIDC-IDRI) were extracted and used to train a CAE. Then, the encoder part was transferred, and the malignancy risk was assessed in a binary classification-benign and malignant lung nodules, achieving an Area Under the Curve (AUC) value of 0.936. To evaluate the reliability of this TL approach, the same architecture was trained from scratch and achieved an AUC value of 0.928. The results reported in this comparison suggested that the feature learning achieved when reconstructing the input with an encoder-decoder based architecture can be considered an useful knowledge that might allow overcoming labelling constraints.

2021

Multivariate Outlier Detection in Postprocessing of Multi-temporal PS-InSAR Results using Deep Learning

Authors
Aguiar, P; Cunha, A; Bakon, M; Ruiz Armenteros, AM; Sousa, JJ;

Publication
INTERNATIONAL CONFERENCE ON ENTERPRISE INFORMATION SYSTEMS / INTERNATIONAL CONFERENCE ON PROJECT MANAGEMENT / INTERNATIONAL CONFERENCE ON HEALTH AND SOCIAL CARE INFORMATION SYSTEMS AND TECHNOLOGIES 2020 (CENTERIS/PROJMAN/HCIST 2020)

Abstract
Multi-temporal InSAR (MT-InSAR) techniques proved to be very effective for deformation monitoring. However, decorrelation and other noise sources, can be limiting factors in MT-InSAR. The obtained observations (PS - Persistent scatterers) are usually very demanding from a computational perspective, as they can reach hundreds of thousands of observations. To simplify and speed up the classification process, in this study we present an approach based on Convolutional Neural Networks (CNN) classification models, for the detection of MT-InSAR outlying observations. For each PS, the corresponding MT-InSAR parameters, its neighbouring scatterers parameters and its relative position are considered. Tests in two independent PS datasets, covering the regions of Bratislava city and the suburbs of Prievidza, Slovakia, were performed. The results showed that such models are robust and reduced computation time method for the evaluation of MT-InSAR outlying observations. However, the applicability of these models is limited by the deformation pattern in which such models were trained. (C) 2021 The Authors. Published by Elsevier B.V.

2021

Comprehensive Perspective for Lung Cancer Characterisation Based on AI Solutions Using CT Images

Authors
Pereira, T; Freitas, C; Costa, JL; Morgado, J; Silva, F; Negrao, E; de Lima, BF; da Silva, MC; Madureira, AJ; Ramos, I; Hespanhol, V; Cunha, A; Oliveira, HP;

Publication
JOURNAL OF CLINICAL MEDICINE

Abstract
Lung cancer is still the leading cause of cancer death in the world. For this reason, novel approaches for early and more accurate diagnosis are needed. Computer-aided decision (CAD) can be an interesting option for a noninvasive tumour characterisation based on thoracic computed tomography (CT) image analysis. Until now, radiomics have been focused on tumour features analysis, and have not considered the information on other lung structures that can have relevant features for tumour genotype classification, especially for epidermal growth factor receptor (EGFR), which is the mutation with the most successful targeted therapies. With this perspective paper, we aim to explore a comprehensive analysis of the need to combine the information from tumours with other lung structures for the next generation of CADs, which could create a high impact on targeted therapies and personalised medicine. The forthcoming artificial intelligence (AI)-based approaches for lung cancer assessment should be able to make a holistic analysis, capturing information from pathological processes involved in cancer development. The powerful and interpretable AI models allow us to identify novel biomarkers of cancer development, contributing to new insights about the pathological processes, and making a more accurate diagnosis to help in the treatment plan selection.

2021

LNDb challenge on automatic lung cancer patient management

Authors
Pedrosa, J; Aresta, G; Ferreira, C; Atwal, G; Phoulady, HA; Chen, XY; Chen, RZ; Li, JL; Wang, LS; Galdran, A; Bouchachia, H; Kaluva, KC; Vaidhya, K; Chunduru, A; Tarai, S; Nadimpalli, SPP; Vaidya, S; Kim, I; Rassadin, A; Tian, ZH; Sun, ZW; Jia, YZ; Men, XJ; Ramos, I; Cunha, A; Campilho, A;

Publication
MEDICAL IMAGE ANALYSIS

Abstract
Lung cancer is the deadliest type of cancer worldwide and late detection is the major factor for the low survival rate of patients. Low dose computed tomography has been suggested as a potential screening tool but manual screening is costly and time-consuming. This has fuelled the development of automatic methods for the detection, segmentation and characterisation of pulmonary nodules. In spite of promising results, the application of automatic methods to clinical routine is not straightforward and only a limited number of studies have addressed the problem in a holistic way. With the goal of advancing the state of the art, the Lung Nodule Database (LNDb) Challenge on automatic lung cancer patient management was organized. The LNDb Challenge addressed lung nodule detection, segmentation and characterization as well as prediction of patient follow-up according to the 2017 Fleischner society pulmonary nodule guidelines. 294 CT scans were thus collected retrospectively at the Centro Hospitalar e Universitrio de So Joo in Porto, Portugal and each CT was annotated by at least one radiologist. Annotations comprised nodule centroids, segmentations and subjective characterization. 58 CTs and the corresponding annotations were withheld as a separate test set. A total of 947 users registered for the challenge and 11 successful submissions for at least one of the sub-challenges were received. For patient follow-up prediction, a maximum quadratic weighted Cohen's kappa of 0.580 was obtained. In terms of nodule detection, a sensitivity below 0.4 (and 0.7) at 1 false positive per scan was obtained for nodules identified by at least one (and two) radiologist(s). For nodule segmentation, a maximum Jaccard score of 0.567 was obtained, surpassing the interobserver variability. In terms of nodule texture characterization, a maximum quadratic weighted Cohen's kappa of 0.733 was obtained, with part solid nodules being particularly challenging to classify correctly. Detailed analysis of the proposed methods and the differences in performance allow to identify the major challenges remaining and future directions data collection, augmentation/generation and evaluation of under-represented classes, the incorporation of scan-level information for better decision making and the development of tools and challenges with clinical-oriented goals. The LNDb Challenge and associated data remain publicly available so that future methods can be tested and benchmarked, promoting the development of new algorithms in lung cancer medical image analysis and patient followup recommendation.

2021

Machine Learning and Feature Selection Methods for EGFR Mutation Status Prediction in Lung Cancer

Authors
Morgado, J; Pereira, T; Silva, F; Freitas, C; Negrao, E; de Lima, BF; da Silva, MC; Madureira, AJ; Ramos, I; Hespanhol, V; Costa, JL; Cunha, A; Oliveira, HP;

Publication
APPLIED SCIENCES-BASEL

Abstract
The evolution of personalized medicine has changed the therapeutic strategy from classical chemotherapy and radiotherapy to a genetic modification targeted therapy, and although biopsy is the traditional method to genetically characterize lung cancer tumor, it is an invasive and painful procedure for the patient. Nodule image features extracted from computed tomography (CT) scans have been used to create machine learning models that predict gene mutation status in a noninvasive, fast, and easy-to-use manner. However, recent studies have shown that radiomic features extracted from an extended region of interest (ROI) beyond the tumor, might be more relevant to predict the mutation status in lung cancer, and consequently may be used to significantly decrease the mortality rate of patients battling this condition. In this work, we investigated the relation between image phenotypes and the mutation status of Epidermal Growth Factor Receptor (EGFR), the most frequently mutated gene in lung cancer with several approved targeted-therapies, using radiomic features extracted from the lung containing the nodule. A variety of linear, nonlinear, and ensemble predictive classification models, along with several feature selection methods, were used to classify the binary outcome of wild-type or mutant EGFR mutation status. The results show that a comprehensive approach using a ROI that included the lung with nodule can capture relevant information and successfully predict the EGFR mutation status with increased performance compared to local nodule analyses. Linear Support Vector Machine, Elastic Net, and Logistic Regression, combined with the Principal Component Analysis feature selection method implemented with 70% of variance in the feature set, were the best-performing classifiers, reaching Area Under the Curve (AUC) values ranging from 0.725 to 0.737. This approach that exploits a holistic analysis indicates that information from more extensive regions of the lung containing the nodule allows a more complete lung cancer characterization and should be considered in future radiogenomic studies.

2021

EGFR Assessment in Lung Cancer CT Images: Analysis of Local and Holistic Regions of Interest Using Deep Unsupervised Transfer Learning

Authors
Silva, F; Pereira, T; Morgado, J; Frade, J; Mendes, J; Freitas, C; Negrao, E; De Lima, BF; Da Silva, MC; Madureira, AJ; Ramos, I; Hespanhol, V; Costa, JL; Cunha, A; Oliveira, HP;

Publication
IEEE ACCESS

Abstract
Statistics have demonstrated that one of the main factors responsible for the high mortality rate related to lung cancer is the late diagnosis. Precision medicine practices have shown advances in the individualized treatment according to the genetic profile of each patient, providing better control on cancer response. Medical imaging offers valuable information with an extensive perspective of the cancer, opening opportunities to explore the imaging manifestations associated with the tumor genotype in a non-invasive way. This work aims to study the relevance of physiological features captured from Computed Tomography images, using three different 2D regions of interest to assess the Epidermal growth factor receptor (EGFR) mutation status: nodule, lung containing the main nodule, and both lungs. A Convolutional Autoencoder was developed for the reconstruction of the input image. Thereafter, the encoder block was used as a feature extractor, stacking a classifier on top to assess the EGFR mutation status. Results showed that extending the analysis beyond the local nodule allowed the capture of more relevant information, suggesting the presence of useful biomarkers using the lung with nodule region of interest, which allowed to obtain the best prediction ability. This comparative study represents an innovative approach for gene mutations status assessment, contributing to the discussion on the extent of pathological phenomena associated with cancer development, and its contribution to more accurate Artificial Intelligence-based solutions, and constituting, to the best of our knowledge, the first deep learning approach that explores a comprehensive analysis for the EGFR mutation status classification.

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