Abstract
Liver cancer is the third leading cause of cancer death in the world, where the hepatocellular carcinoma (HCC) is the most common case in primary liver cancer. In general diagnosis, accurate prediction of HCC grades is of great help to the subsequent treatment to improve the survival rate. Rather than to straightly predict HCC grades from images, it will be more interpretable in clinic to first predict the symptoms and then obtain the HCC grades from the Liver Imaging Reporting and Data System (LI-RADS). Accordingly, we propose a two-stage method for automatically predicting HCC grades according to multiphasic magnetic resonance imaging (MRI). The first stage uses multi-instance learning (MIL) to classify the LI-RADS symptoms while the second stage resorts LI-RADS to grade from the predicted symptoms. Since our method provides more diagnostic basis besides the grading results, it is more interpretable and closer to the clinical process. Experimental results on a dataset with 439 patients indicate that our two-stage method is more accurate than the straight HCC grading approach.
Keywords
- Hepatocellular carcinoma
- Multiphasic MRI
- LI-RADS
- Multi-instance learning
This work is mainly completed under the collaboration of Z. Qiu and Y. Pan.
Z. Qiu and Y. Pan—Contribute equally.
This is a preview of subscription content, access via your institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Sung, H., et al.: Global cancer statistics 2020: GLOBOCAN 2020 estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 71, 209–249 (2021)
El-Serag, H.B., Rudolph, K.L.: Hepatocellular carcinoma: epidemiology and molecular carcinogenesis. Gastroenterology 132(7), 2557–2576 (2007)
Liu, Z., et al.: The trends in incidence of primary liver cancer caused by specific etiologies: results from the global burden of disease study 2016 and implications for liver cancer prevention. J. Hepatol. 70(4), 674–683 (2019)
Mulé, S., et al.: Multiphase liver MRI for identifying the macrotrabecular-massive subtype of hepatocellular carcinoma. Radiology 295(3), 562–571 (2020)
Block, K.T., Uecker, M., Frahm, J.: Undersampled radial MRI with multiple coils. Iterative image reconstruction using a total variation constraint. Magn. Reson. Med. 57(6), 1086–1098 (2007)
American College of Radiology: Liver imaging reporting and data system version 2018. https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/LI-RADS/
Chernyak, V., et al.: Liver imaging reporting and data system (LI-RADS) version 2018: imaging of hepatocellular carcinoma in at-risk patients. Radiology 289(3), 816–830 (2018)
Wu, Y., et al.: Deep learning LI-RADS grading system based on contrast enhanced multiphase MRI for differentiation between LR-3 and LR-4/LR-5 liver tumors. Ann. Trans. Med. 8(11), 701 (2020)
Li, X., Chen, H., Qi, X., Dou, Q., Fu, C.W., Heng, P.A.: H-DenseUNet: hybrid densely connected UNet for liver and tumor segmentation from CT volumes. IEEE Trans. Med. Imaging 37(12), 2663–2674 (2018)
Kawka, M., Dawidziuk, A., Jiao, L.R., Gall, T.M.H.: Artificial intelligence in the detection, characterisation and prediction of hepatocellular carcinoma: a narrative review. Transl. Gastroenterol. Hepatol. (2020)
Hamm, C.A., et al.: Deep learning for liver tumor diagnosis part i: development of a convolutional neural network classifier for multi-phasic MRI. Eur. Radiol. 29(7), 3338–3347 (2019)
Yamashita, R., et al.: Deep convolutional neural network applied to the liver imaging reporting and data system (LI-RADS) version 2014 category classification: a pilot study. Abdom. Radiol. 45(1), 24–35 (2020)
Frid-Adar, M., Diamant, I., Klang, E., Amitai, M., Goldberger, J., Greenspan, H.: Gan-based synthetic medical image augmentation for increased CNN performance in liver lesion classification. Neurocomputing 321, 321–331 (2018)
Liang, D., et al.: Residual convolutional neural networks with global and local pathways for classification of focal liver lesions. In: Geng, X., Kang, B.-H. (eds.) PRICAI 2018. LNCS (LNAI), vol. 11012, pp. 617–628. Springer, Cham (2018). https://doi.org/10.1007/978-3-319-97304-3_47
Yasaka, K., Akai, H., Abe, O., Kiryu, S.: Deep learning with convolutional neural network for differentiation of liver masses at dynamic contrast-enhanced CT: a preliminary study. Radiology 286(3), 887–896 (2018)
Trivizakis, E., et al.: Extending 2-D convolutional neural networks to 3-D for advancing deep learning cancer classification with application to MRI liver tumor differentiation. IEEE J. Biomed. Health Inform. 23(3), 923–930 (2018)
Zhen, S., et al.: Deep learning for accurate diagnosis of liver tumor based on magnetic resonance imaging and clinical data. Front. Oncol. 10, 680 (2020)
Wu, J., Yu, Y., Huang, C., Yu, K.: Deep multiple instance learning for image classification and auto-annotation. In: Proceedings of the IEEE Conference on Computer Vision and Pattern Recognition, pp. 3460–3469 (2015)
He, K., Zhang, X., Ren, S., Sun, J.: Deep residual learning for image recognition. In: Proceedings of the IEEE Conference on Computer Vision and Pattern Recognition, pp. 770–778 (2016)
Ilse, M., Tomczak, J., Welling, M.: Attention-based deep multiple instance learning. In: International Conference on Machine Learning, pp. 2127–2136. PMLR (2018)
Lin, T.Y., Goyal, P., Girshick, R., He, K., Dollár, P.: Focal loss for dense object detection. In: Proceedings of the IEEE International Conference on Computer Vision, pp. 2980–2988 (2017)
Kermany, D.S., et al.: Identifying medical diagnoses and treatable diseases by image-based deep learning. Cell 172(5), 1122–1131 (2018)
Deng, J., Dong, W., Socher, R., Li, L.J., Li, K., Fei-Fei, L.: ImageNet: a large-scale hierarchical image database. In: IEEE Conference on Computer Vision and Pattern Recognition 2009, pp. 248–255. IEEE (2009)
Loshchilov, I., Hutter, F.: SGDR: stochastic gradient descent with warm restarts. arXiv preprint arXiv:1608.03983 (2016)
Acknowledgments
This work was supported in part by the National Natural Science Foundation of China under Grants 61771397, in part by the CAAI-Huawei MindSpore Open Fund under Grants CAAIXSJLJJ-2020-005B, and in part by the China Postdoctoral Science Foundation under Grants BX2021333.
Author information
Authors and Affiliations
Corresponding authors
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 Springer Nature Switzerland AG
About this paper
Cite this paper
Qiu, Z., Pan, Y., Wei, J., Wu, D., Xia, Y., Shen, D. (2021). Predicting Symptoms from Multiphasic MRI via Multi-instance Attention Learning for Hepatocellular Carcinoma Grading. In: de Bruijne, M., et al. Medical Image Computing and Computer Assisted Intervention – MICCAI 2021. MICCAI 2021. Lecture Notes in Computer Science(), vol 12905. Springer, Cham. https://doi.org/10.1007/978-3-030-87240-3_42
Download citation
DOI: https://doi.org/10.1007/978-3-030-87240-3_42
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-87239-7
Online ISBN: 978-3-030-87240-3
eBook Packages: Computer ScienceComputer Science (R0)
-
Published in cooperation with
http://miccai.org/