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Publications

Publications by Miriam Seoane Santos

2025

The Role of Deep Learning in Medical Image Inpainting: A Systematic Review

Authors
Santos, JC; Alexandre, HTP; Santos, MS; Abreu, PH;

Publication
ACM TRANSACTIONS ON COMPUTING FOR HEALTHCARE

Abstract
Image inpainting is a crucial technique in computer vision, particularly for reconstructing corrupted images. In medical imaging, it addresses issues from instrumental errors, artifacts, or human factors. The development of deep learning techniques has revolutionized image inpainting, allowing for the generation of high-level semantic information to ensure structural and textural consistency in restored images. This article presents a comprehensive review of 53 studies on deep image inpainting in medical imaging, analyzing its evolution, impact, and limitations. The findings highlight the significance of deep image inpainting in artifact removal and enhancing the performance of multi-task approaches by localizing and inpainting regions of interest. Furthermore, the study identifies magnetic resonance imaging and computed tomography as the predominant modalities and highlights generative adversarial networks and U-Net as preferred architectures. Future research directions include the development of blind inpainting techniques, the exploration of techniques suitable for 3D/4D images, multiple artifacts, and multi-task applications, and the improvement of architectures.

2024

Enhancing mammography: a comprehensive review of computer methods for improving image quality

Authors
Santos, JC; Santos, MS; Abreu, PH;

Publication
PROGRESS IN BIOMEDICAL ENGINEERING

Abstract
Mammography imaging remains the gold standard for breast cancer detection and diagnosis, but challenges in image quality can lead to misdiagnosis, increased radiation exposure, and higher healthcare costs. This comprehensive review evaluates traditional and machine learning-based techniques for improving mammography image quality, aiming to benefit clinicians and enhance diagnostic accuracy. Our literature search, spanning 2015 - 2024, identified 115 articles focusing on contrast enhancement and noise reduction methods, including histogram equalization, filtering, unsharp masking, fuzzy logic, transform-based techniques, and advanced machine learning approaches. Machine learning, particularly architectures integrating denoising autoencoders with convolutional neural networks, emerged as highly effective in enhancing image quality without compromising detail. The discussion highlights the success of these techniques in improving mammography images' visual quality. However, challenges such as high noise ratios, inconsistent evaluation metrics, and limited open-source datasets persist. Addressing these issues offers opportunities for future research to further advance mammography image enhancement methodologies.

2017

HCC Survival

Authors
Santos, MS; Abreu, PH; García Laencina, PJ; Simão, A; Carvalho, A;

Publication

Abstract

2017

Influence of Data Distribution in Missing Data Imputation

Authors
Santos, MS; Soares, JP; Abreu, PH; Araújo, H; Santos, JAM;

Publication
AIME

Abstract
Dealing with missing data is a crucial step in the preprocessing stage of most data mining projects. Especially in healthcare contexts, addressing this issue is fundamental, since it may result in keeping or loosing critical patient information that can help physicians in their daily clinical practice. Over the years, many researchers have addressed this problem, basing their approach on the implementation of a set of imputation techniques and evaluating their performance in classification tasks. These classic approaches, however, do not consider some intrinsic data information that could be related to the performance of those algorithms, such as features’ distribution. Establishing a correspondence between data distribution and the most proper imputation method avoids the need of repeatedly testing a large set of methods, since it provides a heuristic on the best choice for each feature in the study. The goal of this work is to understand the relationship between data distribution and the performance of well-known imputation techniques, such as Mean, Decision Trees, k-Nearest Neighbours, Self-Organizing Maps and Support Vector Machines imputation. Several publicly available datasets, all complete, were selected attending to several characteristics such as number of distributions, features and instances. Missing values were artificially generated at different percentages and the imputation methods were evaluated in terms of Predictive and Distributional Accuracy. Our findings show that there is a relationship between features’ distribution and algorithms’ performance, although some factors must be taken into account, such as the number of features per distribution and the missing rate at state.

2024

An Interpretable Human-in-the-Loop Process to Improve Medical Image Classification

Authors
Santos, JC; Santos, MS; Abreu, PH;

Publication
ADVANCES IN INTELLIGENT DATA ANALYSIS XXII, PT I, IDA 2024

Abstract
Medical imaging classification improves patient prognoses by providing information on disease assessment, staging, and treatment response. The high demand for medical imaging acquisition requires the development of effective classification methodologies, occupying deep learning technologies, the pool position for this task. However, the major drawback of such techniques relies on their black-box nature which has delayed their use in real-world scenarios. Interpretability methodologies have emerged as a solution for this problem due to their capacity to translate black-box models into clinical understandable information. The most promising interpretability methodologies are concept-based techniques that can understand the predictions of a deep neural network through user-specified concepts. Concept activation regions and concept activation vectors are concept-based implementations that provide global explanations for the prediction of neural networks. The explanations provided allow the identification of the relationships that the network learned and can be used to identify possible errors during training. In this work, concept activation vectors and concept activation regions are used to identify flaws in neural network training and how this weakness can be mitigated in a human-in-the-loop process automatically improving the performance and trustworthiness of the classifier. To reach such a goal, three phases have been defined: training baseline classifiers, applying the concept-based interpretability, and implementing a human-in-the-loop approach to improve classifier performance. Four medical imaging datasets of different modalities are included in this study to prove the generality of the proposed method. The results identified concepts in each dataset that presented flaws in the classifier training and consequently, the human-in-the-loop approach validated by a team of 2 clinicians team achieved a statistically significant improvement.

2023

Bone Metastases Detection in Patients with Breast Cancer: Does Bone Scintigraphy Add Information to PET/CT?

Authors
Santos, JC; Abreu, MH; Santos, MS; Duarte, H; Alpoim, T; Próspero, I; Sousa, S; Abreu, PH;

Publication
ONCOLOGIST

Abstract
This article compares the effectiveness of the PET/CT scan and bone scintigraphy for the detection of bone metastases in patients with breast cancer. Background Positron emission tomography/computed tomography (PET/CT) has become in recent years a tool for breast cancer (BC) staging. However, its accuracy to detect bone metastases is classically considered inferior to bone scintigraphy (BS). The purpose of this work is to compare the effectiveness of bone metastases detection between PET/CT and BS. Materials and Methods Prospective study of 410 female patients treated in a Comprehensive Cancer Center between 2014 and 2020 that performed PET/CT and BS for staging purposes. The image analysis was performed by 2 senior nuclear medicine physicians. The comparison was performed based on accuracy, sensitivity, and specificity on a patient and anatomical region level and was assessed using McNemar's Test. An average ROC was calculated for the anatomical region analysis. Results PET/CT presented higher values of accuracy and sensitivity (98.0% and 93.83%), surpassing BS (95.61% and 81.48%) in detecting bone disease. There was a significant difference in favor of PET/CT (sensitivity 93.83% vs. 81.48%), however, there is no significant difference in eliminating false positives (specificity 99.09% vs. 99.09%). PET/CT presented the highest accuracy and sensitivity values for most of the bone segments, only surpassed by BS for the cranium. There was a significant difference in favor of PET/CT in the upper limb, spine, thorax (sternum) and lower limb (pelvis and sacrum), and in favor of BS in the cranium. The ROC showed that PET/CT has a higher sensitivity and consistency across the bone segments. Conclusion With the correct imaging protocol, PET/CT does not require BS for patients with BC staging.

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