Early stage diagnosis of laryngeal squamous cell carcinoma (SCC) is of primary importance for lowering patient mortality or after treatment morbidity. Despite the challenges in diagnosis reported in the clinical literature, few efforts have been invested in computer-assisted diagnosis. The objective of this paper is to investigate the use of texture-based machine-learning algorithms for early stage cancerous laryngeal tissue classification. To estimate the classification reliability, a measure of confidence is also exploited. From the endoscopic videos of 33 patients affected by SCC, a well-balanced dataset of 1320 patches, relative to four laryngeal tissue classes, was extracted. With the best performing feature, the achieved median classification recall was 93% [interquartile range (IQR)=6%]. When excluding low-confidence patches, the achieved median recall was increased to 98% (IQR=5%), proving the high reliability of the proposed approach. This research represents an important advancement in the state-of-the-art computer-assisted laryngeal diagnosis, and the results are a promising step toward a helpful endoscope-integrated processing system to support early stage diagnosis.
Stereo-ElectroEncephaloGraphy (SEEG) is a surgical procedure that allows brain exploration of patients affected by focal epilepsy by placing intra-cerebral multi-lead electrodes. The electrode trajectory planning is challenging and time consuming. Various constraints have to be taken into account simultaneously, such as absence of vessels at the electrode Entry Point (EP), where bleeding is more likely to occur. In this paper, we propose a novel framework to help clinicians in defining a safe trajectory and focus our attention on EP. For each electrode, a Maximum Intensity Projection (MIP) image was obtained from Computer Tomography Angiography (CTA) slices of the brain first centimeter measured along the electrode trajectory. A Gaussian Mixture Model (GMM), modified to include neighborhood prior through Markov Random Fields (GMM-MRF), is used to robustly segment vessels and deal with the noisy nature of MIP images. Results are compared with simple GMM and manual global Thresholding (Th) by computing sensitivity, specificity, accuracy and Dice similarity index against manual segmentation performed under the supervision of an expert surgeon. In this work we present a novel framework which can be easily integrated into manual and automatic planner to help surgeon during the planning phase. GMM-MRF qualitatively showed better performance over GMM in reproducing the connected nature of brain vessels also in presence of noise and image intensity drops typical of MIP images. With respect Th, it is a completely automatic method and it is not influenced by inter-subject variability.
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