In recent days, Deep Learning (DL) techniques have become an emerging transformation in the field of machine learning, artificial intelligence, computer vision, and so on. Subsequently, researchers and industries have been highly endorsed in the medical field, predicting and controlling diverse diseases at specific intervals. Liver tumor prediction is a vital chore in analyzing and treating liver diseases. This paper proposes a novel approach for predicting liver tumors using Convolutional Neural Networks (CNN) and a depth-based variant search algorithm with advanced attention mechanisms (CNN-DS-AM). The proposed work aims to improve accuracy and robustness in diagnosing and treating liver diseases. The anticipated model is assessed on a Computed Tomography (CT) scan dataset containing both benign and malignant liver tumors. The proposed approach achieved high accuracy in predicting liver tumors, outperforming other state-of-the-art methods. Additionally, advanced attention mechanisms were incorporated into the CNN model to enable the identification and highlighting of regions of the CT scans most relevant to predicting liver tumors. The results suggest that incorporating attention mechanisms and a depth-based variant search algorithm into the CNN model is a promising approach for improving the accuracy and robustness of liver tumor prediction. It can assist radiologists in their diagnosis and treatment planning. The proposed system achieved a high accuracy of 95.5% in predicting liver tumors, outperforming other state-of-the-art methods.

This study leverages synthetic data as a validation set to reduce overfitting and ease the selection of the best model in AI development. While synthetic data have been used for augmenting the training set, we find that synthetic data can also significantly diversify the validation set, offering marked advantages in domains like healthcare, where data are typically limited, sensitive, and from out-domain sources (i.e., hospitals). In this study, we illustrate the effectiveness of synthetic data for early cancer detection in computed tomography (CT) volumes, where synthetic tumors are generated and superimposed onto healthy organs, thereby creating an extensive dataset for rigorous validation. Using synthetic data as validation can improve AI robustness in both in-domain and out-domain test sets. Furthermore, we establish a new continual learning framework that continuously trains AI models on a stream of out-domain data with synthetic tumors. The AI model trained and validated in dynamically expanding synthetic data can consistently outperform models trained and validated exclusively on real-world data. Specifically, the DSC score for liver tumor segmentation improves from 26.7% (95% CI: 22.6%-30.9%) to 34.5% (30.8%-38.2%) when evaluated on an in-domain dataset and from 31.1% (26.0%-36.2%) to 35.4% (32.1%-38.7%) on an out-domain dataset. Importantly, the performance gain is particularly significant in identifying very tiny liver tumors (radius < 5mm) in CT volumes, with Sensitivity improving from 33.1% to 55.4% on an in-domain dataset and 33.9% to 52.3% on an out-domain dataset, justifying the efficacy in early detection of cancer. The application of synthetic data, from both training and validation perspectives, underlines a promising avenue to enhance AI robustness when dealing with data from varying domains.

Simultaneous multi-index quantification, segmentation, and uncertainty estimation of liver tumors on multi-modality non-contrast magnetic resonance imaging (NCMRI) are crucial for accurate diagnosis. However, existing methods lack an effective mechanism for multi-modality NCMRI fusion and accurate boundary information capture, making these tasks challenging. To address these issues, this paper proposes a unified framework, namely edge-aware multi-task network (EaMtNet), to associate multi-index quantification, segmentation, and uncertainty of liver tumors on the multi-modality NCMRI. The EaMtNet employs two parallel CNN encoders and the Sobel filters to extract local features and edge maps, respectively. The newly designed edge-aware feature aggregation module (EaFA) is used for feature fusion and selection, making the network edge-aware by capturing long-range dependency between feature and edge maps. Multi-tasking leverages prediction discrepancy to estimate uncertainty and improve segmentation and quantification performance. Extensive experiments are performed on multi-modality NCMRI with 250 clinical subjects. The proposed model outperforms the state-of-the-art by a large margin, achieving a dice similarity coefficient of 90.01$\pm$1.23 and a mean absolute error of 2.72$\pm$0.58 mm for MD. The results demonstrate the potential of EaMtNet as a reliable clinical-aided tool for medical image analysis.

Real-world medical image segmentation has tremendous long-tailed complexity of objects, among which tail conditions correlate with relatively rare diseases and are clinically significant. A trustworthy medical AI algorithm should demonstrate its effectiveness on tail conditions to avoid clinically dangerous damage in these out-of-distribution (OOD) cases. In this paper, we adopt the concept of object queries in Mask Transformers to formulate semantic segmentation as a soft cluster assignment. The queries fit the feature-level cluster centers of inliers during training. Therefore, when performing inference on a medical image in real-world scenarios, the similarity between pixels and the queries detects and localizes OOD regions. We term this OOD localization as MaxQuery. Furthermore, the foregrounds of real-world medical images, whether OOD objects or inliers, are lesions. The difference between them is less than that between the foreground and background, possibly misleading the object queries to focus redundantly on the background. Thus, we propose a query-distribution (QD) loss to enforce clear boundaries between segmentation targets and other regions at the query level, improving the inlier segmentation and OOD indication. Our proposed framework is tested on two real-world segmentation tasks, i.e., segmentation of pancreatic and liver tumors, outperforming previous state-of-the-art algorithms by an average of 7.39% on AUROC, 14.69% on AUPR, and 13.79% on FPR95 for OOD localization. On the other hand, our framework improves the performance of inlier segmentation by an average of 5.27% DSC when compared with the leading baseline nnUNet.

We demonstrate that AI models can accurately segment liver tumors without the need for manual annotation by using synthetic tumors in CT scans. Our synthetic tumors have two intriguing advantages: (I) realistic in shape and texture, which even medical professionals can confuse with real tumors; (II) effective for training AI models, which can perform liver tumor segmentation similarly to the model trained on real tumors -- this result is exciting because no existing work, using synthetic tumors only, has thus far reached a similar or even close performance to real tumors. This result also implies that manual efforts for annotating tumors voxel by voxel (which took years to create) can be significantly reduced in the future. Moreover, our synthetic tumors can automatically generate many examples of small (or even tiny) synthetic tumors and have the potential to improve the success rate of detecting small liver tumors, which is critical for detecting the early stages of cancer. In addition to enriching the training data, our synthesizing strategy also enables us to rigorously assess the AI robustness.

Background samples provide key contextual information for segmenting regions of interest (ROIs). However, they always cover a diverse set of structures, causing difficulties for the segmentation model to learn good decision boundaries with high sensitivity and precision. The issue concerns the highly heterogeneous nature of the background class, resulting in multi-modal distributions. Empirically, we find that neural networks trained with heterogeneous background struggle to map the corresponding contextual samples to compact clusters in feature space. As a result, the distribution over background logit activations may shift across the decision boundary, leading to systematic over-segmentation across different datasets and tasks. In this study, we propose context label learning (CoLab) to improve the context representations by decomposing the background class into several subclasses. Specifically, we train an auxiliary network as a task generator, along with the primary segmentation model, to automatically generate context labels that positively affect the ROI segmentation accuracy. Extensive experiments are conducted on several challenging segmentation tasks and datasets. The results demonstrate that CoLab can guide the segmentation model to map the logits of background samples away from the decision boundary, resulting in significantly improved segmentation accuracy. Code is available.

We develop a novel strategy to generate synthetic tumors. Unlike existing works, the tumors generated by our strategy have two intriguing advantages: (1) realistic in shape and texture, which even medical professionals can confuse with real tumors; (2) effective for AI model training, which can perform liver tumor segmentation similarly to a model trained on real tumors - this result is unprecedented because no existing work, using synthetic tumors only, has thus far reached a similar or even close performance to the model trained on real tumors. This result also implies that manual efforts for developing per-voxel annotation of tumors (which took years to create) can be considerably reduced for training AI models in the future. Moreover, our synthetic tumors have the potential to improve the success rate of small tumor detection by automatically generating enormous examples of small (or tiny) synthetic tumors.

The liver is one of the most critical metabolic organs in vertebrates due to its vital functions in the human body, such as detoxification of the blood from waste products and medications. Liver diseases due to liver tumors are one of the most common mortality reasons around the globe. Hence, detecting liver tumors in the early stages of tumor development is highly required as a critical part of medical treatment. Many imaging modalities can be used as aiding tools to detect liver tumors. Computed tomography (CT) is the most used imaging modality for soft tissue organs such as the liver. This is because it is an invasive modality that can be captured relatively quickly. This paper proposed an efficient automatic liver segmentation framework to detect and segment the liver out of CT abdomen scans using the 3D CNN DeepMedic network model. Segmenting the liver region accurately and then using the segmented liver region as input to tumors segmentation method is adopted by many studies as it reduces the false rates resulted from segmenting abdomen organs as tumors. The proposed 3D CNN DeepMedic model has two pathways of input rather than one pathway, as in the original 3D CNN model. In this paper, the network was supplied with multiple abdomen CT versions, which helped improve the segmentation quality. The proposed model achieved 94.36%, 94.57%, 91.86%, and 93.14% for accuracy, sensitivity, specificity, and Dice similarity score, respectively. The experimental results indicate the applicability of the proposed method.