Prostate cancer represents a major threat to health. Early detection is vital in reducing the mortality rate among prostate cancer patients. One approach involves using multi-modality (CT, MRI, US, etc.) computer-aided diagnosis (CAD) systems for the prostate region. However, prostate segmentation is challenging due to imperfections in the images and the prostate's complex tissue structure. The advent of precision medicine and a significant increase in clinical capacity have spurred the need for various data-driven tasks in the field of medical imaging. Recently, numerous machine learning and data mining tools have been integrated into various medical areas, including image segmentation. This article proposes a new classification method that differentiates supervision types, either in number or kind, during the training phase. Subsequently, we conducted a survey on artificial intelligence (AI)-based automatic prostate segmentation methods, examining the advantages and limitations of each. Additionally, we introduce variants of evaluation metrics for the verification and performance assessment of the segmentation method and summarize the current challenges. Finally, future research directions and development trends are discussed, reflecting the outcomes of our literature survey, suggesting high-precision detection and treatment of prostate cancer as a promising avenue.

Healthcare data is often split into medium/small-sized collections across multiple hospitals and access to it is encumbered by privacy regulations. This brings difficulties to use them for the development of machine learning and deep learning models, which are known to be data-hungry. One way to overcome this limitation is to use collaborative learning (CL) methods, which allow hospitals to work collaboratively to solve a task, without the need to explicitly share local data. In this paper, we address a prostate segmentation problem from MRI in a collaborative scenario by comparing two different approaches: federated learning (FL) and consensus-based methods (CBM). To the best of our knowledge, this is the first work in which CBM, such as label fusion techniques, are used to solve a problem of collaborative learning. In this setting, CBM combine predictions from locally trained models to obtain a federated strong learner with ideally improved robustness and predictive variance properties. Our experiments show that, in the considered practical scenario, CBMs provide equal or better results than FL, while being highly cost-effective. Our results demonstrate that the consensus paradigm may represent a valid alternative to FL for typical training tasks in medical imaging.

Medical image data are often limited due to the expensive acquisition and annotation process. Hence, training a deep-learning model with only raw data can easily lead to overfitting. One solution to this problem is to augment the raw data with various transformations, improving the model's ability to generalize to new data. However, manually configuring a generic augmentation combination and parameters for different datasets is non-trivial due to inconsistent acquisition approaches and data distributions. Therefore, automatic data augmentation is proposed to learn favorable augmentation strategies for different datasets while incurring large GPU overhead. To this end, we present a novel method, called Dynamic Data Augmentation (DDAug), which is efficient and has negligible computation cost. Our DDAug develops a hierarchical tree structure to represent various augmentations and utilizes an efficient Monte-Carlo tree searching algorithm to update, prune, and sample the tree. As a result, the augmentation pipeline can be optimized for each dataset automatically. Experiments on multiple Prostate MRI datasets show that our method outperforms the current state-of-the-art data augmentation strategies.

This study focuses on comparing deep learning methods for the segmentation and quantification of uncertainty in prostate segmentation from MRI images. The aim is to improve the workflow of prostate cancer detection and diagnosis. Seven different U-Net-based architectures, augmented with Monte-Carlo dropout, are evaluated for automatic segmentation of the central zone, peripheral zone, transition zone, and tumor, with uncertainty estimation. The top-performing model in this study is the Attention R2U-Net, achieving a mean Intersection over Union (IoU) of 76.3% 0.003 and Dice Similarity Coefficient (DSC) of 85% 0.003 for segmenting all zones. Additionally, Attention R2U-Net exhibits the lowest uncertainty values, particularly in the boundaries of the transition zone and tumor, when compared to the other models.

Despite recent progress in enhancing the privacy of federated learning (FL) via differential privacy (DP), the trade-off of DP between privacy protection and performance is still underexplored for real-world medical scenario. In this paper, we propose to optimize the trade-off under the context of client-level DP, which focuses on privacy during communications. However, FL for medical imaging involves typically much fewer participants (hospitals) than other domains (e.g., mobile devices), thus ensuring clients be differentially private is much more challenging. To tackle this problem, we propose an adaptive intermediary strategy to improve performance without harming privacy. Specifically, we theoretically find splitting clients into sub-clients, which serve as intermediaries between hospitals and the server, can mitigate the noises introduced by DP without harming privacy. Our proposed approach is empirically evaluated on both classification and segmentation tasks using two public datasets, and its effectiveness is demonstrated with significant performance improvements and comprehensive analytical studies.

Micro-ultrasound (micro-US) is a novel 29-MHz ultrasound technique that provides 3-4 times higher resolution than traditional ultrasound, delivering comparable accuracy for diagnosing prostate cancer to MRI but at a lower cost. Accurate prostate segmentation is crucial for prostate volume measurement, cancer diagnosis, prostate biopsy, and treatment planning. However, prostate segmentation on microUS is challenging due to artifacts and indistinct borders between the prostate, bladder, and urethra in the midline. This paper presents MicroSegNet, a multi-scale annotation-guided transformer UNet model designed specifically to tackle these challenges. During the training process, MicroSegNet focuses more on regions that are hard to segment (hard regions), characterized by discrepancies between expert and non-expert annotations. We achieve this by proposing an annotation-guided binary cross entropy (AG-BCE) loss that assigns a larger weight to prediction errors in hard regions and a lower weight to prediction errors in easy regions. The AG-BCE loss was seamlessly integrated into the training process through the utilization of multi-scale deep supervision, enabling MicroSegNet to capture global contextual dependencies and local information at various scales. We trained our model using micro-US images from 55 patients, followed by evaluation on 20 patients. Our MicroSegNet model achieved a Dice coefficient of 0.942 and a Hausdorff distance of 2.11 mm, outperforming several state-of-the-art segmentation methods, as well as three human annotators with different experience levels. We will make our code and dataset publicly available to promote transparency and collaboration in research.

Early diagnosis of prostate cancer significantly improves a patient's 5-year survival rate. Biopsy of small prostate cancers is improved with image-guided biopsy. MRI-ultrasound fusion-guided biopsy is sensitive to smaller tumors but is underutilized due to the high cost of MRI and fusion equipment. Micro-ultrasound (micro-US), a novel high-resolution ultrasound technology, provides a cost-effective alternative to MRI while delivering comparable diagnostic accuracy. However, the interpretation of micro-US is challenging due to subtle gray scale changes indicating cancer vs normal tissue. This challenge can be addressed by training urologists with a large dataset of micro-US images containing the ground truth cancer outlines. Such a dataset can be mapped from surgical specimens (histopathology) onto micro-US images via image registration. In this paper, we present a semi-automated pipeline for registering in vivo micro-US images with ex vivo whole-mount histopathology images. Our pipeline begins with the reconstruction of pseudo-whole-mount histopathology images and a 3-dimensional (3D) micro-US volume. Each pseudo-whole-mount histopathology image is then registered with the corresponding axial micro-US slice using a two-stage approach that estimates an affine transformation followed by a deformable transformation. We evaluated our registration pipeline using micro-US and histopathology images from 18 patients who underwent radical prostatectomy. The results showed a Dice coefficient of 0.94 and a landmark error of 2.7 mm, indicating the accuracy of our registration pipeline. This proof-of-concept study demonstrates the feasibility of accurately aligning micro-US and histopathology images. To promote transparency and collaboration in research, we will make our code and dataset publicly available.

Deep learning advanced to one of the most important technologies in almost all medical fields. Especially in areas, related to medical imaging it plays a big role. However, in interventional radiotherapy (brachytherapy) deep learning is still in an early phase. In this review, first, we investigated and scrutinised the role of deep learning in all processes of interventional radiotherapy and directly related fields. Additionally we summarised the most recent developments. To reproduce results of deep learning algorithms both source code and training data must be available. Therefore, a second focus of this work was on the analysis of the availability of open source, open data and open models. In our analysis, we were able to show that deep learning plays already a major role in some areas of interventional radiotherapy, but is still hardly presented in others. Nevertheless, its impact is increasing with the years, partly self-propelled but also influenced by closely related fields. Open source, data and models are growing in number but are still scarce and unevenly distributed among different research groups. The reluctance in publishing code, data and models limits reproducibility and restricts evaluation to mono-institutional datasets. Summarised, deep learning will change positively the workflow of interventional radiotherapy but there is room for improvement when it comes to reproducible results and standardised evaluation methods.

Prostate cancer was the third most common cancer in 2020 internationally, coming after breast cancer and lung cancer. Furthermore, in recent years prostate cancer has shown an increasing trend. According to clinical experience, if this problem is detected and treated early, there can be a high chance of survival for the patient. One task that helps diagnose prostate cancer is prostate segmentation from magnetic resonance imaging. Manual segmentation performed by clinical experts has its drawbacks such as: the high time and concentration required from observers; and inter- and intra-observer variability. This is why in recent years automatic approaches to segment a prostate based on convolutional neural networks have emerged. Many of them have novel proposed architectures. In this paper I make an exhaustive study of several deep learning models by adjusting them to the task of prostate prediction. I do not use novel architectures, but focus my work more on how to train the networks. My approach is based on a ResNext101 3D encoder and a Unet3D decoder. I provide a study of the importance of resolutions in resampling data, something that no one else has done before.

Creating large scale high-quality annotations is a known challenge in medical imaging. In this work, based on the CycleGAN algorithm, we propose leveraging annotations from one modality to be useful in other modalities. More specifically, the proposed algorithm creates highly realistic synthetic CT images (SynCT) from prostate MR images using unpaired data sets. By using SynCT images (without segmentation labels) and MR images (with segmentation labels available), we have trained a deep segmentation network for precise delineation of prostate from real CT scans. For the generator in our CycleGAN, the cycle consistency term is used to guarantee that SynCT shares the identical manually-drawn, high-quality masks originally delineated on MR images. Further, we introduce a cost function based on structural similarity index (SSIM) to improve the anatomical similarity between real and synthetic images. For segmentation followed by the SynCT generation from CycleGAN, automatic delineation is achieved through a 2.5D Residual U-Net. Quantitative evaluation demonstrates comparable segmentation results between our SynCT and radiologist drawn masks for real CT images, solving an important problem in medical image segmentation field when ground truth annotations are not available for the modality of interest.