MHSnet: Multi-head and Spatial Attention Network with False-Positive Reduction for Lung Nodule Detection
Juanyun MaiMinghao WangJiayin ZhengYanbo ShaoZhaoqi DiaoXinliang FuYulong ChenJianyu XiaoJian YouAiru YinYang YangXiangcheng QiuJinsheng TaoBo WangHua Ji
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Abstract:
Mortality from lung cancer has ranked high among cancers for many years. Early detection of lung cancer is critical for disease prevention, cure, and mortality rate reduction. Many existing detection methods on lung nodules can achieve high sensitivity but meanwhile introduce an excessive number of false-positive proposals, which is clinically unpractical. In this paper, we propose the multi-head detection and spatial attention network, shortly MHSnet, to address this crucial false-positive issue. Specifically, we first introduce multi-head detectors and skip connections to capture multi-scale features so as to customize for the variety of nodules in sizes, shapes, and types. Then, inspired by how experienced clinicians screen CT images, we implemented a spatial attention module to enable the network to focus on different regions, which can successfully distinguish nodules from noisy tissues. Finally, we designed a lightweight but effective false-positive reduction module to cut down the number of false-positive proposals, without any constraints on the front network. Compared with the state-of-the-art models, our extensive experimental results show the superiority of this MHSnet not only in the average FROC but also in the false discovery rate (2.64% improvement for the average FROC, 6.39% decrease for the false discovery rate). The false-positive reduction module takes a further step to decrease the false discovery rate by 14.29%, indicating its very promising utility of reducing distracted proposals for the downstream tasks relied on detection results.Keywords:
False positive rate
Nodule (geology)
We propose a novel patient-specific generative approach to simulate the emergence and growth of lung nodules using 3D cellular automata (CA) in computer tomography (CT). Our proposed method can be applied to individual images thus eliminating the need of external images that can contaminate and influence the generative process, a valuable characteristic in the medical domain. Firstly, we employ inpainting to generate pseudo-healthy representations of lung CT scans prior the visible appearance of each lung nodule. Then, for each nodule, we train a 3D CA to simulate nodule growth and progression using the image of that same nodule as a target. After each CA is trained, we generate early versions of each nodule from a single voxel until the growing nodule closely matches the appearance of the original nodule. These synthesized nodules are inserted where the original nodule was located in the pseudo-healthy inpainted versions of the CTs, which provide realistic context to the generated nodule. We utilize the simulated images for data augmentation yielding false positive reduction in a nodule detector. We found statistically significant improvements (p <; 0.001) in the detection of lung nodules.
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A 28-year-old woman with an unremarkable medical history presented with an enlarging nodule that had been growing under her left great toenail for 6 months. The patient monitored the nodule, hoping that it would resolve on its own, but found that it steadily increased in size and began to displace the nail, causing pain. At the time of presentation, the nodule measured approximately 10 mm in diameter, and there was significant (~80°) superior displacement of the nail.
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Acta Derm Venereol 96 © 2016 The Authors. doi: 10.2340/00015555-2396 Journal Compilation © 2016 Acta Dermato-Venereologica. ISSN 0001-5555 A 33-year-old man with a medical history of tenosynovitis of the third finger of his left hand, which had been treated successfully with a local infiltration of glucocorticoids approximately one year previously, was admitted for evaluation of a cutaneous nodule on the same hand. The nodule first appeared 2 months prior to presentation; it had developed rapidly after the patient had injured his palm while travelling through Morocco and cleaned the wound in a river. Physical examination revealed a well-defined, reddish, painful nodule, 2×2 cm, on the palm of his left hand (Fig. 1). No other cutaneous lesions, regional lymphadenopathies or accompanying systemic symptoms were observed.
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Seedlings of Myrica gale were grown aeroponically and inoculated with suspensions prepared from mature nodules of M gale plants or with a homogenized preparation of a pure culture of the actinomycete isolated from Comptonia nodules. Morphological, anatomical, and cytological studies were made of early nodule development in these plants, and comparisons were made with similar stages in Comptonia and Casuarina Root hair infection was followed by prenodule formation in a manner similar to that in Comptonia In M. gale, most nodules originated with one or two primary nodule lobes. Thereafter, secondary nodule lobes formed sparsely and in a precisely ordered sequence. In 3-mo-old seedlings, nodules with up to five nodule lobes were observed, but the majority of nodules at this age were still one-to-three lobed In Comptonia the number of primary nodule lobes is much higher than in M. gale. In M. gale nodule roots developed from many but not all nodule lobes, usually in an ordered sequence.
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直径2cm以下の肝細胞癌で,肝切除前に経カテーテル肝動脈塞栓術を行わなかった6例の肝切除例において,術前超音波像と病理組織所見との対比を行った.組織学的に完全または不完全な隔壁が5例(83.3%),被膜が4例(66.7%)に認められ,超音波所見と良く一致した.すなわち,超音波像でのseptum in nodule, nodule in noduleの所見は,組織学的な線維性の隔壁や隔壁によって分割された各葉の組織学的形態の相違によって生じることを確認した.septum in nodule像は,線維性隔壁への超音波ビームの入射角の違いで高エコーの,または低エコーの隔壁になるものと考えられた.線維性隔壁は連続切片の得られた1例で検討すと,癌の発育過程で穿破された被膜に由来するものであった.この様に結節型肝癌におけるse-ptum in nodule, nodule in noduleの各US像は細小肝細胞癌の臨床診断上極めて有用な所見である.
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In this case report, we present a pleomorphic adenoma that presented as a hard nodule on the upper lip in a man in his 30s. Differential diagnosis is necessary, as there are multiple causes of a nodule in the lip. The nodule was excised extracapsularly and a histopathological examination was performed. Although the tumor was found to be benign, there is a risk of late malignant conversion, which underscores the importance of prompt treatment.
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The benign or malignant nature of a cold nodule in the thyroid can never be definitely assessed before surgery. All cold nodules that show no tendency to regress must be resected. The nodule is resected with surrounding healthy tissue and immediately examined in freezen sections. Out of 108 cases of simple resection of the nodule only one diagnosis of carcinoma was missed at the operation. That patient was reoperated two weeks later with curative intention.
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