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    Item type:Publication, Access status: with files ,
    Computer-aided diagnosis of maxillary sinus anomalies : validation and clinical correlation
    Objective: Computer aided diagnostics (CAD) systems can automate the differentiation of maxillary sinus (MS) with and without opacification, simplifying the typically laborious process and aiding in clinical insight discovery within large cohorts. Methods: This study uses Hamburg City Health Study (HCHS) a large, prospective, long-term, population-based cohort study of participants between 45 and 74 years of age. We develop a CAD system using an ensemble of 3D Convolutional Neural Network (CNN) to analyze cranial MRIs, distinguishing MS with opacifications (polyps, cysts, mucosal thickening) from MS without opacifications. The system is used to find correlations of participants with and without MS opacifications with clinical data (smoking, alcohol, BMI, asthma, bronchitis, sex, age, leukocyte count, C-reactive protein, allergies). Results: The evaluation metrics of CAD system (Area Under Receiver Operator Characteristic: 0.95, sensitivity: 0.85, specificity: 0.90) demonstrated the effectiveness of our approach. MS with opacification group exhibited higher alcohol consumption, higher BMI, higher incidence of intrinsic asthma and extrinsic asthma. Male sex had higher prevalence of MS opacifications. Participants with MS opacifications had higher incidence of hay fever and house dust allergy but lower incidence of bee/wasp venom allergy. Conclusion: The study demonstrates a 3D CNN's ability to distinguish MS with and without opacifications, improving automated diagnosis and aiding in correlating clinical data in population studies. Level of Evidence: 3 Laryngoscope, 134:3927–3934, 2024.
    Publicationtype: Journal Article
      20  63
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    Item type:Publication, Access status: with files ,
    Self-supervised learning for classifying paranasal anomalies in the maxillary sinus
    Purpose: Paranasal anomalies, frequently identified in routine radiological screenings, exhibit diverse morphological characteristics. Due to the diversity of anomalies, supervised learning methods require large labelled dataset exhibiting diverse anomaly morphology. Self-supervised learning (SSL) can be used to learn representations from unlabelled data. However, there are no SSL methods designed for the downstream task of classifying paranasal anomalies in the maxillary sinus (MS). Methods: Our approach uses a 3D convolutional autoencoder (CAE) trained in an unsupervised anomaly detection (UAD) framework. Initially, we train the 3D CAE to reduce reconstruction errors when reconstructing normal maxillary sinus (MS) image. Then, this CAE is applied to an unlabelled dataset to generate coarse anomaly locations by creating residual MS images. Following this, a 3D convolutional neural network (CNN) reconstructs these residual images, which forms our SSL task. Lastly, we fine-tune the encoder part of the 3D CNN on a labelled dataset of normal and anomalous MS images. Results: The proposed SSL technique exhibits superior performance compared to existing generic self-supervised methods, especially in scenarios with limited annotated data. When trained on just 10% of the annotated dataset, our method achieves an area under the precision-recall curve (AUPRC) of 0.79 for the downstream classification task. This performance surpasses other methods, with BYOL attaining an AUPRC of 0.75, SimSiam at 0.74, SimCLR at 0.73 and masked autoencoding using SparK at 0.75. Conclusion: A self-supervised learning approach that inherently focuses on localizing paranasal anomalies proves to be advantageous, particularly when the subsequent task involves differentiating normal from anomalous maxillary sinuses. Access our code at https://github.com/mtec-tuhh/self-supervised-paranasal-anomaly.
    Publicationtype: Journal Article
      14  59
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    Item type:Publication,
    Convolutional transformer network for paranasal anomaly classification in the maxillary sinus
    Large-scale population studies have examined the detection of sinus opacities in cranial MRIs. Deep learning methods, specifically 3D convolutional neural networks (CNNs), have been used to classify these anomalies. However, CNNs have limitations in capturing long-range dependencies across the low and high level features, potentially reducing performance. To address this, we propose an end-to-end pipeline using a novel deep learning network called ConTra-Net. ConTra-Net combines the strengths of CNNs and self-attention mechanisms of transformers to classify paranasal anomalies in the maxillary sinuses. Our approach outperforms 3D CNNs and 3D Vision Transformer (ViT), with relative improvements in F1 score of 11.68% and 53.5%, respectively. Our pipeline with ConTra-Net could serve as an alternative to reduce misdiagnosis rates in classifying paranasal anomalies.
    Publicationtype: Conference Paper
      26
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    Item type:Publication, Access status: with files ,
    Multiple instance ensembling for paranasal anomaly classification in the maxillary sinus
    Purpose : Paranasal anomalies are commonly discovered during routine radiological screenings and can present with a wide range of morphological features. This diversity can make it difficult for convolutional neural networks (CNNs) to accurately classify these anomalies, especially when working with limited datasets. Additionally, current approaches to paranasal anomaly classification are constrained to identifying a single anomaly at a time. These challenges necessitate the need for further research and development in this area. Methods : We investigate the feasibility of using a 3D convolutional neural network (CNN) to classify healthy maxillary sinuses (MS) and MS with polyps or cysts. The task of accurately localizing the relevant MS volume within larger head and neck Magnetic Resonance Imaging (MRI) scans can be difficult, but we develop a strategy which includes the use of a novel sampling technique that not only effectively localizes the relevant MS volume, but also increases the size of the training dataset and improves classification results. Additionally, we employ a Multiple Instance Ensembling (MIE) prediction method to further boost classification performance. Results : With sampling and MIE, we observe that there is consistent improvement in classification performance of all 3D ResNet and 3D DenseNet architecture with an average AUPRC percentage increase of 21.86 ± 11.92% and 4.27 ± 5.04% by sampling and 28.86 ± 12.80% and 9.85 ± 4.02% by sampling and MIE, respectively. Conclusion : Sampling and MIE can be effective techniques to improve the generalizability of CNNs for paranasal anomaly classification. We demonstrate the feasibility of classifying anomalies in the MS. We propose a data enlarging strategy through sampling alongside a novel MIE strategy that proves to be beneficial for paranasal anomaly classification in the MS.
    Publicationtype: Journal Article
    Scopus© Citations 2  27  104
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    Item type:Publication,
    Analysing the feasibility of an automated AI-based classifier for detecting paranasal anomalies in the maxillary sinus
    Large scale population studies have been performed to analyse the rate of finding sinus opacities in cranial MRIs. It is of interest whether there are findings requiring clarification. Using AI-based methods can automate the detection of the sinus opacities and reduce the workload of clinicians. In this work, a method for AI-based classification was developed in order to automatically recognise paranasal sinus opacities
    Publicationtype: Journal Article
      12
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    Item type:Publication,
    Machbarkeitsanalyse eines automatisierten KI-basierten Klassifikationssystems zur Erkennung von Kieferhöhlenbefunden.
    Studien zeigen eine erhöhte Inzidenz von Verschattungen der Nasennebenhöhlen im cMRT ohne entsprechende Symptomatik. Dabei ist es von Interesse, ob abklärungsbedürftigte Befunde vorliegen. Der Einsatz von KI-basierten Methoden kann die Erkennung von Verschattungen automatisieren und dadurch die Arbeitsbelastung von ärzten reduzieren. In dieser Arbeit wurde eine Methode zur KI-basierten Klassifikation von Kieferhöhlenverschattungen entwickelt
    Publicationtype: Journal Article
      7
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    Item type:Publication,
    Unsupervised Anomaly Detection of Paranasal Anomalies in the Maxillary Sinus
    Deep learning (DL) algorithms can be used to automate paranasal anomaly detection from Magnetic Resonance Imaging (MRI). However, previous works relied on supervised learning techniques to distinguish between normal and abnormal samples. This method limits the type of anomalies that can be classified as the anomalies need to be present in the training data. Further, many data points from normal and anomaly class are needed for the model to achieve satisfactory classification performance. However, experienced clinicians can segregate between normal samples (healthy maxillary sinus) and anomalous samples (anomalous maxillary sinus) after looking at a few normal samples. We mimic the clinicians ability by learning the distribution of healthy maxillary sinuses using a 3D convolutional auto-encoder (cAE) and its variant, a 3D variational autoencoder (VAE) architecture and evaluate cAE and VAE for this task. Concretely, we pose the paranasal anomaly detection as an unsupervised anomaly detection problem. Thereby, we are able to reduce the labelling effort of the clinicians as we only use healthy samples during training. Additionally, we can classify any type of anomaly that differs from the training distribution. We train our 3D cAE and VAE to learn a latent representation of healthy maxillary sinus volumes using L1 reconstruction loss. During inference, we use the reconstruction error to classify between normal and anomalous maxillary sinuses. We extract sub-volumes from larger head and neck MRIs and analyse the effect of different fields of view on the detection performance. Finally, we report which anomalies are easiest and hardest to classify using our approach. Our results demonstrate the feasibility of unsupervised detection of paranasal anomalies from MRIs with an AUPRC of 85% and 80% for cAE and VAE, respectively.
    Publicationtype: Conference Paper
      25
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    Item type:Publication,
    Supervised Contrastive Learning to Classify Paranasal Anomalies in the Maxillary Sinus
    Using deep learning techniques, anomalies in the paranasal sinus system can be detected automatically in MRI images and can be further analyzed and classified based on their volume, shape and other parameters like local contrast. However due to limited training data, traditional supervised learning methods often fail to generalize. Existing deep learning methods in paranasal anomaly classification have been used to diagnose at most one anomaly. In our work, we consider three anomalies. Specifically, we employ a 3D CNN to separate maxillary sinus volumes without anomaly from maxillary sinus volumes with anomaly. To learn robust representations from a small labelled dataset, we propose a novel learning paradigm that combines contrastive loss and cross-entropy loss. Particularly, we use a supervised contrastive loss that encourages embeddings of maxillary sinus volumes with and without anomaly to form two distinct clusters while the cross-entropy loss encourages the 3D CNN to maintain its discriminative ability. We report that optimising with both losses is advantageous over optimising with only one loss. We also find that our training strategy leads to label efficiency. With our method, a 3D CNN classifier achieves an AUROC of 0.85 ± 0.03 while a 3D CNN classifier optimised with cross-entropy loss achieves an AUROC of 0.66 ± 0.1. Our source code is available at https://github.com/dawnofthedebayan/SupConCEMICCAI₂2.
    Publicationtype: Conference Paper
      74