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J K Mandal, S Misra, J S Banerjee and S Nayak (eds.), Application of Machine Intelligence in Engineering
Doi: 10.4324/9781003269793-15
132 2nd Global Conference on Artificial Intelligence and Applications (GCAIA 2021)
the conventional machine learning algorithms discussed in Sect. 2. Then, Sect. 3, 4 and 5
[3], because deep learning learns from enormous covers the application, algorithms and hardware
amount of image examples Similar to human perspective. In Sect. 6, we discuss the analysis
learning and it might take much less time, and recommendation to the research questions
as it solely depends on curated data and the set in the introduction. Finally, the conclusion
corresponding metadata rather than the domain of this work is presented in Sect. 7.
expertise, which usually takes years to develop
[4]. As the traditional AI requires predefined II. APPLICATION PERSPECTIVE
features and have shown plateauing performance
over recent years, and with the current success Deep learning techniques are increasingly
of deep learning in image research, it is expected being used to enhance clinical practice, and the
that the field of deep learning will further number of examples is long and growing every
dominate the image research in radiology. day. In our paper The research articles that were
collected are classified by imaging modality:
In this work, we present a comprehensive survey
magnetic resonance imaging, computed
to assist researchers in the area of deep learning
tomography, positron emission tomography
applications in medical imaging. This work
and single-photon emission tomography,
complements the existing work and contributes
radiography, ultrasound and histology.
towards providing the complete background
1) Magnetic resonance imaging: Magnetic
on the application of deep learning in Medical
resonance imaging (MRI) is a medical
imaging. The objective of this survey is set to
imaging technique used in the field
answer multiple research questions concerning
of radiology to produce images of the
deep learning in medical imaging. these research
anatomy and physiological processes of
questions are:
the body. From image acquisition to image
• Application perspective: What are the
retrieval, from segmentation to disease
main applications that use DL tools in
prediction, deep learning has been applied
Medical imaging?
to every step of complete workflows.
• Deep learning perspective: What are the
Generally deep learning has two levels
DL algorithms and tools used for Medical
of application in Magnetic resonance
imaging and the available Datasets? This
imaging workflow, the first one is the
question is to analyse the most commonly
Lower levels of Magnetic resonance
used algorithms and frameworks in Medical
imaging measurement techniques
imaging Application.
ranging from MR image capture and
• Hardware perspective: What are the
signal treatment to MR imprinting,
trade-offs when using different hardware
denoising and super-resolution, and
platforms for AI acceleration? This
image generation, because, has typically
question is to study and compare available
been focused on segmentation and
hardware implementation options based on
classification of reconstructed magnitude
standard figures of merit.
images. Reconstruction Research on CNN
The rest of the paper is organized as follows: and RNN-based image reconstruction
literature review covering related work is methods is rapidly increasing [6]–[9].
Deep Learning In Medical Imaging: A Review 133
demand for low-cost handheld devices by people who do not have extensive
is increasing [20]. Transducers are expertise in computer vision techniques.
becoming miniaturized, which allows, The process of developing new integrated,
for example, intra-corporeal imaging biologically and clinically uniform
for interventional applications. At the disease categories to identify patients
same time there is a strong movement at risk of progression, and to modify
towards 3D imaging, [21] and the use of current paradigms for the treatment and
high-framerate imaging schemes; both prevention of kidney disease, are central
accompanied by dramatically increasing to the application of these new tools by
data rates that pose a heavy burden the development of machine learning
on the probesystem communication approaches for extracting information
and subsequent image reconstruction from image data, enables the interrogation
algorithms. Current systems offer a of tissues in a way that was not previously
multitude of advanced applications and possible [24].
methods, including shear wave elasticity In pathology, DL has been used for the
imaging, ultra-sensitive Doppler, and detection, annotation, segmentation,
ultrasound localiza-tion microscopy for registration, processing and classification
super-resolution microvascular imaging. of WSIs (whole slide image). For
We can find that [22] is a good article mammography and breast histopathology
to give the reader a broad understanding images we can take an overview present
of the possible impact of deep learning the recent state-of-the-art deep learning
approaches on many aspects of based CAD systems developed is
ultrasound imaging, and this paper [23] presented in [25]. This paper presents an
will be useful for researchers who focus overview of different deep learning based
on the ultrasound CAD system, this study approaches used for mammography and
divided the ultrasound CAD system into breast histology and proposes a bridge
two categories. One is the traditional between these two fields employing deep
ultrasound CAD system which employed learning concepts.
the manmade feature and the other is the Deep-learning-based holographic
deep learning ultrasound CAD system. phase recovery, image enhancement/
4) Histology: The emergence of digital reconstruction and cross-modality
pathology-an image-based environment image transformations have profound
for acquiring, managing, and interpreting and broad implications in the field of
pathological information supported digital holography and coherent imaging
by computational techniques for data systems [26].
extraction and analysis-is changing the
pathology ecosystem. In particular, by
III. ALGORITHMS AND DATA
virtue of our new ability to generate and
maintain digital libraries, the field of
PERSPECTIVE
computer vision can now be effectively In this section, an analysis for the collected
applied to histopathology material research papers from algorithm perspective
Deep Learning In Medical Imaging: A Review 135
is presented in order to state the most used so health care data are highly heterogeneous,
deep learning algorithms in different medical ambiguous, noisy and incomplete that why
imaging applications we also present some Training a good deep learning model with such
available datasets. massive and variegate data sets is challenging.
Data Parallelism is a way to distribute
1) Medical Imaging Data
computing across different machines in a way
Publishing in academic journals without sharing that data is split across different machines and
data/annotations/models is more marketing than some computation is performed locally in each
science. Matthew Lungren MD: Co-Director machine using the whole model, but only for
Stanford AIMI Interventional Radiologist. part of the full data-set. Depending on how these
Deep learning refers to a set of highly intensive parameters are updated, we have two paradigms
computational models. One typical example is for parameter update Synchronous update and
fully connected multi-layer neural networks, Asynchronous update [27]. In [28], They aim to
where tons of network parameters need to be experimentally Measuring the Effects of Data
estimated properly. The basis to achieve this Parallelism on Neural Network Training. One
goal is the availability of huge amount of data. important thing from this paper is that The effect
In fact, while there are no hard guidelines about of the dataset on the maximum useful batch
the minimum number of training documents, a size tends to be weaker than the effects of the
general rule of thumb is to have at least about model and the learning algorithm, and does not
10 the number of samples as parameters in consistently depend on the size of the dataset.
the network. This is also one of the reasons Data parallelism [29] is one of the most
why deep learning is so successful in domains common parallelization approach In multi-GPU
where huge amount of data can be easily platforms, When deployed, all GPUs have a
collected (e.g. computer vision, speech, natural full copy of the DNN model and run a subset
language). However, health care is a different of the training data. Data parallelism incurs
domain; in fact, we only have approximately excessive inter-GPU communication overhead,
7.8 billion people all over the world (as per as the weights updated on each GPU must be
September 2021), with a great part not having synchronized. These communication overheads
access to primary health care. Consequently, increase as the model size increases, severely
we cannot get as many patients as we need to hindering the scalability of data parallelism
train a comprehensive deep learning model. [30]–[35].
Furthermore, understanding diseases and their
variability is much more complicated than other 2) Algorithmis
tasks, such as image or speech recognition. As a
We describe a few deep learning methods in
result, the amount of medical data that is needed
this section.
to train an successful and robust deep learning
model would be much more comparing with a) Convolutional neural networks their
other media, from a big data perspective. extensions
Health care data is not similar to other domains Automatic medical imaging analysis is crucial
where the data are clean and well-structured, to modern medicine. Diagnosis based on
136 2nd Global Conference on Artificial Intelligence and Applications (GCAIA 2021)
deep learning methods, GAN modeling is [46] they proposes multi-stage setup to applies
an unsupervised learning task that involves GANs for intravascular US (IVUS) simulation.
automatically discovering and learning
[47] elucidates that using the GAN training
regularities in the input data; in this manner, the
strategy in CNNs enhances not only the
model can be used for generating or producing
performance of semantic segmentation methods
new examples that could have been drawn from
but also makes the performance of non-semantic
the original data set.
segmentation methods closer to semantic ones.
Generative adversarial networks Models have [48] Highlights the excellent performance of
carved open many exciting ways to handle well GANs in the segmentation of normalized or
known and challenging medical image, analysis equalized patches of brain tumors. [49] The
problems such as data simulation, detection, give us a framework named SegAN framework.
classification, medical image denoising, They display that pixel-dependencies are
reconstruction or segmentation. Kazeminia learned better by using an adversarial loss in
et al. [42], give us a broad overview of recent addition to a multi-scale, pixel-wise losses
literature on GANs for medical applications and using the U-Net as the generator architecture
also the shortcomings and opportunities of the of a GAN. But One challenge with most of
proposed methods are thoroughly discussed, the supervised segmentation methods is the
and potential future work is elaborated. One performance degradation on unseen images.
more great thing from this paper is that all [50] Demonstrate an adversarial framework to
essential details such as the underlying method, address this problem for unsupervised domain
datasets, and performance are tabulated is done adaptation in brain lesion segmentation. For
in An interactive visualization. the segmentation of bony structures in brain
images, [44] synthesize CT images from MRI
CT imaging puts the patient at risk of cell damage
images using GANs and then use both of
and cancer because of radiation exposure that
them as the input to a segmentation network
why the synthesis of CT images from MR
called Deep-supGAN, optimized with five
acquisitions is very important and practically
different losses. For multi-class classification
the acquisition of CT images is required in
of brain tumors, [51] proposes combining the
many clinical settings. [43] Successfully utilizes
cGAN and MGAN, where class labels define
CycleGANs to transform 2D MR images to
conditions.
CT images without the need for explicit, co
registered data pairs. Interestingly, their training
led to even better results as the mapping is IV. HARDWARE PERSPECTIVE
not affected by co-registration artifacts. In
Apparent recent advances in the advancement
[44] they map 3D MR data of the head to its
of computer vision algorithms are not only due
CT counterpart to facilitate the segmentation
to deep learning technologies and large-scale
of craniomaxillofacial bony structures using
datasets, but also relying on the major leaps
conditional GANs.
of hardware acceleration that gives powerful
In [45] they proposes a 3D voxel locations parallel computing architectures to make the
for synthesizing 2D freehand ultrasound (US) efficient training and inference of large-scale,
images of a fetus phantom using cGAN. In complex and multi-layered neural networks.
138 2nd Global Conference on Artificial Intelligence and Applications (GCAIA 2021)
This section discusses the hardware platform images will come from very different sources
can be used in the application of deep learning and, thus the networks must be trained as
in medical imaging field (figure 1). Hardware independently as possible from the acquisition
accelerators’ papers are categorized from source [54].
hardware perspective to provide useful
The use of Cloud TPUs for high-resolution 3D
comparisons.
imaging is a promising way to get better results.
Huot et al. [55], They developed a novel approach
to wavefield modeling using TensorFlow on
Cloud TPUs by adapting a numerical scheme to
exploit the TPU architecture, using higher-order
stencils to leverage its efficient matrix operation
and using the dedicated high-bandwidth, low-
latency, interchip interconnected network of
the TPU Pod for the halo exchange. Faster
computation allows faster decision making
Fig. 1 Summary of the Hardware Platform can
be used in the Application of Deep Learning in in workflows involving high-resolution
Medical Imaging Field medical imaging. Additionally, this work
demonstrated how TensorFlow on Cloud TPU
Hardware selection is about determining the can be used to accelerate conventional scientific
technical specifications for a proposed deep simulation problems. The development of TPU-
learning model. The critical metrics to consider implementation frameworks will potentially
in hardware selection are the size of the dataset allow users to program TPUs with simple and
and the complexity of the model. Deep learning easy-to-read code.
models can be trained on CPUs, GPUs, or TPUs
on cloud platforms, which can leverage deep There is two Important notes from [56], First,
learning-oriented devices [5]. TPU is well adapted to large-batch learning, as
systolic networks are very effective in increasing
1) Tensor Processing Units (TPU): The TPU is throughput. Their experiments show that large
a Cloud TPU instance to which we were given batch size is the key to higher TPU over GPU
academic access in February 2018. Its system speedup. Secondly All CNNs perform better
architecture includes a Cloud Engine VM, on TPU. TPU is the best platform for large
a Cloud TPU server, Google Cloud storage, CNNs due to batch size because it is always the
and a Cloud TPU board [52]. Each TPU card key to better TPU speed over GPU for CNNs,
contains four TPU packages (the default TPU which would suggest that the TPU architecture
Cloud configuration) [53]. is highly optimized for the spatial reusability
Reducing training times is an important characteristics of CNNs.
requirement in this scenario, and Google TPUs 2) GPU: Driven by the rapidly increasing
are currently one of the most powerful resources computational complexities of medical imaging,
available to train and carry out predictions processing time now limits the development of
for cloud-based segmentation. In an Another advanced technologies in medical and clinical
important aspect, in a cloud-based service, applications. Initially designed for parallel data
Deep Learning In Medical Imaging: A Review 139
costs is streaming data architecture that collects have been covered while at the neuron level,
and analyzes comprehensive and up-to-date the optimizations of convolutional and fully
health data. In fact Real-time analysis of patient connected layers have been detailed and
data during medical procedures can supply compared. All the different degrees of freedom
vital diagnostic feedback that significantly offered by FPGAs (custom data types, local
improves chances of success. Frameworks like data streams, dedicated processors, etc.) are
deep neural networks are expected to perform exploited by the presented methods. Moreover,
computations within strict time restrictions algorithmic and datapath optimizations can
for real-time performance With fast sensor a should be jointly implemented, resulting in
processing [63]. additive hardware performance gains.
Although GPUs have been shown to achieve
high throughput, they are widely used for V. CONCLUSION AND
hardware acceleration of DNNs, they are often FUTURE WORK
not favored for power/energy constrained
applications, such as IoT devices, due to In this paper, we present a Review study of
their high power consumption. Hence, DNN the application of deep learning in medical
acceleration requires an alternative solution imaging. The paper covers deep learning
based on low-power FPGAs [60]. application in medical imaging research over
the period between 2016 and 2020. The main
FPGA, and with the offer of great flexibility to objective of our Review is to answer three
accommodate the recent DNN models that are research questions addressing the subject from
featured with increased sparsity and compact three angles, namely application perspective, AI
network structures, allows us to implement algorithms and tools perspective, and hardware
irregular parallelism, customized data type platform perspective.
and application-specific hardware architecture.
Further, FPGA can be reprogrammed after We are confident about the future of deep
manufacturing for desired functions and learning in medical imaging. It is by no means an
applications. Owing to these attractive features, inevitability that deep learning will completely
a massive number of FPGA-based accelerators revolutionize these fields, but given the speed
have been proposed for both HPC data centers at which the field is developing. We have
[64] and embedded applications [65]. highlighted many challenges beyond improving
training and prediction accuracy, such as
In actual practice, a DNN model is frequently preserving patient privacy and interpreting
trained or refined on a high-performance models. Ongoing research has begun to address
computing platform such as a GPU, while these issues and has shown that they are not
FPGA acceleration is implemented for DNN insurmountable.
inference to process given input data based on
the pre-trained DNN model. In [66], A number In this research study we have highlighted the
of methods and tools have been compared that role of deep learning in the applications of
aim at porting Convolutional Neural Networks medical imaging. In the literature, several survey
onto FPGAs. At the network level, approximate and overview paper’s have been developed
computing and datapath optimization methods to address the application of deep learning in
Deep Learning In Medical Imaging: A Review 141
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[10] Yang G, Yu S, Dong H, Slabaugh G, Dragotti
PL, Ye X, et al. DAGAN: Deep de-aliasing
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