中國醫藥大學附設醫院 林仰賢、游家鑫

1. 人工智慧醫學診斷中心
AI Center for Medical Diagnosis
CUDA加速先進影像分析技術與深度學習
於臨床電腦斷層掃瞄肝細胞腫瘤輔助診斷
AI-assisted Diagnosis of Hepatocellular Carcinoma
using CUDA Radiomics and Deep Learning
林仰賢 游家鑫

2. • Background
– Hepatocellular Carcinoma
– Exams and Diagnosis
• Radiomics
– Acceleration
• Unmet Clinical Need
• Deep Learning in Hepatocellular Carcinoma
• Future Works
2
Agenda
GTC Taiwan 2017

3. Hepatocellular Carcinoma (HCC)
• Background
• Material and Methods
– Optical Setup
– Phase Retrieval
• Results
• Conclusion • Radiographic Imaging
– Ultrasound
– Computed Tomography (CT)
– Magnetic Resonance Imaging (MRI)
– Angiography
GTC Taiwan 2017
3
Hepatitis B Virus
Hepatitis C Virus
Alcohol
NASH
Aflatoxin

4. 4
Dynamic CT
Non-enhanced CT Late Arterial Phase Venous PhaseEarly Arterial Phase
• Enhanced Tumor
GTC Taiwan 2017 IRB: CMUH106-REC1-072

5. • Diagnostic algorithm for suspected HCC
5
Diagnostic Criteria
Liver Nodule
< 1cm > 1cm
Repeat US at 3 months
Growing/changing Character Stable
Investigate according to size
4-phase MDCT/dynamic contrast enhanced MRI
Arterial hypervascularity AND venous or
delayed phase washout
Other contrast enhanced study (CT or MRI)
Arterial hypervascularity AND venous or
delayed phase washout
Yes
HCC
No
No
Biopsy
Yes
GTC Taiwan 2017
AASLD practice guideline (2017)

6. 6
Gross Tumor Volume
Transverse Plane Coronal Plane Sagittal Plane 3-D Rendering
• Orthogonal Views
GTC Taiwan 2017

7. 7
Radiomics
Image Acquisition DiagnosisFeature Extraction Neural Network Prediction
GTC Taiwan 2017

8. 8
Acceleration on Radiomics
Feature Extraction
GTC Taiwan 2017
Volume of InterestMethodologies
Morphometrics
LoG Operation
Wavelet Texture
Laws Texture
Gray-level Co-occurrence Matrix
Gray-level size zone
……

9. • Extract more information
• Easy parallelization on GPU
• Improve diagnosis accuracy
• Evaluate disease progression
• Predict patient outcomes
• Data sharing
9
Advantages of Radiomics
GTC Taiwan 2017
CT ImagesFeature ExtractionRadiomics Heat Map

10. 10
Unmet Clinical Needs
GTC Taiwan 2017
Recurrence
Metastasis
Treatment

11. 11
Process and Tools
GTC Taiwan 2017
HCC
Diagnoses
Curative
Treatment
Follow-up
3 - 6 months
Follow-up
2 years
Medical Images Blood Tests
Tools

12. 12
Radiomics and Machine Learning
GTC Taiwan 2017
Medical Image Radiomics Features Classifier
Metastasis Accuracy: 94%(5-Fold)

13. 13
Why we need deep learning
GTC Taiwan 2017
HCC
Diagnoses
Follow-up
3 - 6 months
Curative
Treatment
20 Cases
per day
Less More
Miss Rate 7% 15%
HCC
Recurrence
(within 2 years)
Metastasis
(within 5 years)
After Curative
Treatment 70% 90%

14. 14
Scanning Protocol Difference
GTC Taiwan 2017

15. 15
Augmentation
GTC Taiwan 2017
Scale
Translate Rotate Blur
Contrast Normalization
Origin

16. 16
Deep Neural Network
GTC Taiwan 2017
CONV3D
CONV3D
MaxPool3D
CONV3D
CONV3D
MaxPool3D
CONV3D
CONV3D
MaxPool3D
CONV3D
CONV3D
FC

17. CONV3D
CONV3D
MaxPool3D
CONV3D
CONV3D
MaxPool3D
CONV3D
CONV3D
MaxPool3D
CONV3D
CONV3D
FC
17
Deep Neural Network
GTC Taiwan 2017
MLP
FC

18. 18
NVIDIA DIGITS
GTC Taiwan 2017
256*256 (2D)
GoogLeNet

19. 19
Future works
GTC Taiwan 2017
HCC
Diagnose
Curative
Treatment
Follow-up
3 - 6 months
Follow-up
2 years
Recurrence
Risk Assessment
+

20. GTC Taiwan 2017
Acknowledging
China Medical University
Tzung-Chi Huang, Ph.D.
China Medical University Hospital
Wei-Ching Lin, M.D.
Shih-Neng Yang, M.D.
Chun-Chieh Yeh, M.D.
NVIDIA
Andrew Liu, Ph.D.
Moffitt Cancer Center
Geoffrey G Zhang, Ph.D.
China Medical University Beigang Hospital
Tsung-Jung Ho, M.D.
Chang Bing Show Chwan Memorial Hospital
Kuan-Yung Chen, M.D.
Chih-Yen Tu, M.D.
Chia-Huang Chen, M.D.
Wei-Chih Liao, M.D.

21. Thank you
GTC Taiwan 2017