Despeckling of clinical ultrasound images using deep residual learning

The Promise of Artificial Intelligence-Assisted Point-of-Care Ultrasonography in Perioperative Care

The role of point-of-care ultrasonography in the perioperative setting has expanded rapidly over recent years. Revolutionizing this technology further is integrating artificial intelligence to assist clinicians in optimizing images, identifying anomalies, performing automated measurements and calculations, and facilitating diagnoses. Artificial intelligence can increase point-of-care ultrasonography efficiency and accuracy, making it an even more valuable point-of-care tool. Given this topic's importance and ever-changing landscape, this review discusses the latest trends to serve as an introduction and update in this area.

AdaRes: A deep learning-based model for ultrasound image denoising: Results of image quality metrics, radiomics, artificial intelligence, and clinical studies

PURPOSE

The quality of ultrasound images is degraded by speckle and Gaussian noises. This study aims to develop a deep-learning (DL)-based filter for ultrasound image denoising.

METHODS

A novel DL-based filter using adaptive residual (AdaRes) learning was proposed. Five image quality metrics (IQMs) and 27 radiomics features were used to evaluate denoising results. The effect of our proposed filter, AdaRes, on four pre-trained convolutional neural network (CNN) classification models and three radiologists was assessed.

RESULTS

AdaRes filter was tested on both natural and ultrasound image databases. IQMs results indicate that AdaRes could remove noises in three different noise levels with the highest performances. In addition, a radiomics study proved that AdaRes did not distort tissue textures and it could preserve most radiomics features. AdaRes could also improve the performance classification using CNNs in different settings. Finally, AdaRes also improved the mean overall performance (AUC) of three radiologists from 0.494 to 0.702 in the classification of benign and malignant lesions.

CONCLUSIONS

AdaRes filtered out noises on ultrasound images more effectively and can be used as an auxiliary preprocessing step in computer-aided diagnosis systems. Radiologists may use it to remove unwanted noises and improve the ultrasound image quality before the interpretation.

Make It Less Complex: Autoencoder for Speckle Noise Removal-Application to Breast and Lung Ultrasound

Ultrasound (US) imaging is used in the diagnosis and monitoring of COVID-19 and breast cancer. The presence of Speckle Noise (SN) is a downside to its usage since it decreases lesion conspicuity. Filters can be used to remove SN, but they involve time-consuming computation and parameter tuning. Several researchers have been developing complex Deep Learning (DL) models (150,000-500,000 parameters) for the removal of simulated added SN, without focusing on the real-world application of removing naturally occurring SN from original US images. Here, a simpler (<30,000 parameters) Convolutional Neural Network Autoencoder (CNN-AE) to remove SN from US images of the breast and lung is proposed. In order to do so, simulated SN was added to such US images, considering four different noise levels (σ = 0.05, 0.1, 0.2, 0.5). The original US images (N = 1227, breast + lung) were given as targets, while the noised US images served as the input. The Structural Similarity Index Measure (SSIM) and Peak Signal-to-Noise Ratio (PSNR) were used to compare the output of the CNN-AE and of the Median and Lee filters with the original US images. The CNN-AE outperformed the use of these classic filters for every noise level. To see how well the model removed naturally occurring SN from the original US images and to test its real-world applicability, a CNN model that differentiates malignant from benign breast lesions was developed. Several inputs were used to train the model (original, CNN-AE denoised, filter denoised, and noised US images). The use of the original US images resulted in the highest Matthews Correlation Coefficient (MCC) and accuracy values, while for sensitivity and negative predicted values, the CNN-AE-denoised US images (for higher σ values) achieved the best results. Our results demonstrate that the application of a simpler DL model for SN removal results in fewer misclassifications of malignant breast lesions in comparison to the use of original US images and the application of the Median filter. This shows that the use of a less-complex model and the focus on clinical practice applicability are relevant and should be considered in future studies.

Tunable image quality control of 3-D ultrasound using switchable CycleGAN

In contrast to 2-D ultrasound (US) for uniaxial plane imaging, a 3-D US imaging system can visualize a volume along three axial planes. This allows for a full view of the anatomy, which is useful for gynecological (GYN) and obstetrical (OB) applications. Unfortunately, the 3-D US has an inherent limitation in resolution compared to the 2-D US. In the case of 3-D US with a 3-D mechanical probe, for example, the image quality is comparable along the beam direction, but significant deterioration in image quality is often observed in the other two axial image planes. To address this, here we propose a novel unsupervised deep learning approach to improve 3-D US image quality. In particular, using unmatched high-quality 2-D US images as a reference, we trained a recently proposed switchable CycleGAN architecture so that every mapping plane in 3-D US can learn the image quality of 2-D US images. Thanks to the switchable architecture, our network can also provide real-time control of image enhancement level based on user preference, which is ideal for a user-centric scanner setup. Extensive experiments with clinical evaluation confirm that our method offers significantly improved image quality as well user-friendly flexibility.

Comparative analysis of wavelet transform filtering systems for noise reduction in ultrasound images

Wavelet transform (WT) is a commonly used method for noise suppression and feature extraction from biomedical images. The selection of WT system settings significantly affects the efficiency of denoising procedure. This comparative study analyzed the efficacy of the proposed WT system on real 292 ultrasound images from several areas of interest. The study investigates the performance of the system for different scaling functions of two basic wavelet bases, Daubechies and Symlets, and their efficiency on images artificially corrupted by three kinds of noise. To evaluate our extensive analysis, we used objective metrics, namely structural similarity index (SSIM), correlation coefficient, mean squared error (MSE), peak signal-to-noise ratio (PSNR) and universal image quality index (Q-index). Moreover, this study includes clinical insights on selected filtration outcomes provided by clinical experts. The results show that the efficiency of the filtration strongly depends on the specific wavelet system setting, type of ultrasound data, and the noise present. The findings presented may provide a useful guideline for researchers, software developers, and clinical professionals to obtain high quality images.

Towards Clinical Application of Artificial Intelligence in Ultrasound Imaging

Artificial intelligence (AI) is being increasingly adopted in medical research and applications. Medical AI devices have continuously been approved by the Food and Drug Administration in the United States and the responsible institutions of other countries. Ultrasound (US) imaging is commonly used in an extensive range of medical fields. However, AI-based US imaging analysis and its clinical implementation have not progressed steadily compared to other medical imaging modalities. The characteristic issues of US imaging owing to its manual operation and acoustic shadows cause difficulties in image quality control. In this review, we would like to introduce the global trends of medical AI research in US imaging from both clinical and basic perspectives. We also discuss US image preprocessing, ingenious algorithms that are suitable for US imaging analysis, AI explainability for obtaining informed consent, the approval process of medical AI devices, and future perspectives towards the clinical application of AI-based US diagnostic support technologies.

Methods for image denoising using convolutional neural network: a review

Image denoising faces significant challenges, arising from the sources of noise. Specifically, Gaussian, impulse, salt, pepper, and speckle noise are complicated sources of noise in imaging. Convolutional neural network (CNN) has increasingly received attention in image denoising task. Several CNN methods for denoising images have been studied. These methods used different datasets for evaluation. In this paper, we offer an elaborate study on different CNN techniques used in image denoising. Different CNN methods for image denoising were categorized and analyzed. Popular datasets used for evaluating CNN image denoising methods were investigated. Several CNN image denoising papers were selected for review and analysis. Motivations and principles of CNN methods were outlined. Some state-of-the-arts CNN image denoising methods were depicted in graphical forms, while other methods were elaborately explained. We proposed a review of image denoising with CNN. Previous and recent papers on image denoising with CNN were selected. Potential challenges and directions for future research were equally fully explicated.

Computer-aided diagnosis system for the classification of multi-class kidney abnormalities in the noisy ultrasound images

BACKGROUND AND OBJECTIVE

The primary causes of kidney failure are chronic and polycystic kidney diseases. Cyst, stone, and tumor development lead to chronic kidney diseases that commonly impair kidney functions. The kidney diseases are asymptomatic and do not show any significant symptoms at its initial stage. Therefore, diagnosing the kidney diseases at their earlier stage is required to prevent the loss of kidney function and kidney failure.

METHODS

This paper proposes a computer-aided diagnosis (CAD) system for detecting multi-class kidney abnormalities from ultrasound images. The presented CAD system uses a pre-trained ResNet-101 model for extracting the features and support vector machine (SVM) classifier for the classification purpose. Ultrasound images usually gets affected by speckle noise that degrades the image quality and performance of the CAD system. Hence, it is necessary to remove speckle noise from the ultrasound images. Therefore, a CAD based system is proposed with the despeckling module using a deep residual learning network (RLN) to reduce speckle noise. Pre-processing of ultrasound images using deep RLN helps to drastically improve the classification performance of the CAD system. The proposed CAD system achieved better prediction results when compared to the existing state-of-the-art methods.

RESULTS

To validate the proposed CAD system performance, the experiments have been carried out in the noisy kidney ultrasound images. The designed system framework achieved the maximum classification accuracy when compared to the existing approaches. The SVM classifier is selected for the CAD system based on performance comparison with various classifiers like K-nearest neighbour, tree, discriminant, Naive Bayes, and linear.

CONCLUSIONS

The proposed CAD system outperforms in classifying the noisy kidney ultrasound images precisely as compared to the existing state-of-the-art methods. Further, the CAD system is evaluated in terms of selectivity and sensitivity scores. The presented CAD system with the pre-processing module would serve as a real-time supporting tool for diagnosing multi-class kidney abnormalities from the ultrasound images.

A denoising and enhancing method framework for 4D ultrasound images of human fetal heart

Background

4D ultrasound images of human fetal heart are important for medical applications such as evaluation of fetal heart function and early diagnosis of congenital heart diseases. However, due to the high noise and low contrast characteristics in fetal ultrasound images, denoising and enhancements are important.

Methods

In this paper, a special method framework for denoising and enhancing is proposed. It consists of a 4D-NLM (non-local means) denoising method for 4D fetal heart ultrasound image sequence, which takes advantage of context similar information in neighboring images to denoise the target image, and an enhancing method called the Adaptive Clipping for Each Histogram Pillar (ACEHP), which is designed to enhance myocardial spaces to distinguish them from blood spaces.

Results

Denoising and enhancing experiments show that 4D-NLM method has better denoising effect than several classical and state-of-the-art methods such as NLM and WNNM. Similarly, ACEHP method can keep noise level low while enhancing myocardial regions better than several classical and state-of-the-art methods such as CLAHE and SVDDWT. Furthermore, in the volume rendering after the combined "4D-NLM+ACEHP" processing, the cardiac lumen is clear and the boundary is neat. The Entropy value that can be achieved by our method framework (4D-NLM+ACEHP) is 4.84.

Conclusions

Our new framework can thus provide important improvements to clinical fetal heart ultrasound images.