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Publicações

2020

Deep Aesthetic Assessment of Breast Cancer Surgery Outcomes

Autores
Gonçalves, T; Silva, W; Cardoso, J;

Publicação
IFMBE Proceedings

Abstract
Breast cancer is a highly mutable and rapidly evolving disease, with a large worldwide incidence. Even though, it is estimated that approximately 90% of the cases are treatable and curable if detected on early staging and given the best treatment. Nowadays, with the existence of breast cancer routine screening habits, better clinical treatment plans and proper management of the disease, it is possible to treat most cancers with conservative approaches, also known as breast cancer conservative treatments (BCCT). With such a treatment methodology, it is possible to focus on the aesthetic results of the surgery and the patient’s Quality of Life, which may influence BCCT outcomes. In the past, this assessment would be done through subjective methods, where a panel of experts would be needed to perform the assessment; however, with the development of computer vision techniques, objective methods, such as BAT© and BCCT.core, which perform the assessment based on asymmetry measurements, have been used. On the other hand, they still require information given by the user and none of them has been considered the gold standard for this task. Recently, with the advent of deep learning techniques, algorithms capable of improving the performance of traditional methods on the detection of breast fiducial points (required for asymmetry measurements) have been proposed and showed promising results. There is still, however, a large margin for investigation on how to integrate such algorithms in a complete application, capable of performing an end-to-end classification of the BCCT outcomes. Taking this into account, this thesis shows a comparative study between deep convolutional networks for image segmentation and two different quality-driven keypoint detection architectures for the detection of the breast contour. One that uses a deep learning model that has learned to predict the quality (given by the mean squared error) of an array of keypoints, and, based on this quality, applies the backpropagation algorithm, with gradient descent, to improve them; another which uses a deep learning model which was trained with the quality as a regularization method and that used iterative refinement, in each training step, to improve the quality of the keypoints that were fed into the network. Although none of the methods surpasses the current state of the art, they present promising results for the creation of alternative methodologies to address other regression problems in which the learning of the quality metric may be easier. Following the current trend in the field of web development and with the objective of transferring BCCT.core to an online format, a prototype of a web application for the automatic keypoint detection was developed and is presented in this document. Currently, the user may upload an image and automatically detect and/or manipulate its keypoints. This prototype is completely scalable and can be upgraded with new functionalities according to the user’s needs. © 2020, Springer Nature Switzerland AG.

2020

Evolution, current challenges, and future possibilities in the objective assessment of aesthetic outcome of breast cancer locoregional treatment

Autores
Cardoso, JS; Silva, W; Cardoso, MJ;

Publicação
Breast

Abstract
The Breast Cancer overall survival rate has raised impressively in the last 20 years mainly due to improved screening and effectiveness of treatments. This increase in survival paralleled the awareness over the long-lasting impact of the side effects of treatments on patient quality of life, emphasizing the motto “a longer but better life for breast cancer patients”. In breast cancer more strikingly than in other cancers, besides the side effects of systemic treatments, there is the visible impact of surgery and radiotherapy on patients’ body image. This has sparked interest on the development of tools for the aesthetic evaluation of Breast Cancer locoregional treatments, which evolved from manual, subjective approaches to computerized, automated solutions. However, although studied for almost four decades, past solutions were not mature enough to become a standard. Recent advancements in machine learning have inspired trends toward deep-learning-based medical image analysis, also bringing new promises to the field of aesthetic assessment of locoregional treatments. In this paper, a review and discussion of the previous state-of-the-art methods in the field is conducted and the extracted knowledge is used to understand the evolution and current challenges. The aim of this paper is to delve into the current opportunities as well as motivate and guide future research in the aesthetic assessment of Breast Cancer locoregional treatments. © 2019 Elsevier Ltd

2020

A novel approach to keypoint detection for the aesthetic evaluation of breast cancer surgery outcomes

Autores
Gonçalves, T; Silva, W; Cardoso, MJ; Cardoso, JS;

Publicação
Health and Technology

Abstract
The implementation of routine breast cancer screening and better treatment strategies made possible to offer to the majority of women the option of breast conservation instead of a mastectomy. The most important aim of breast cancer conservative treatment (BCCT) is to try to optimize aesthetic outcome and implicitly, quality of life (QoL) without jeopardizing local cancer control and overall survival. As a consequence of the impact aesthetic outcome has on QoL, there has been an effort to try to define an optimal tool capable of performing this type of evaluation. Starting from the classical subjective aesthetic evaluation of BCCT (either by the patient herself or by a group of clinicians through questionnaires) to an objective aesthetic evaluation (where machine learning and computer vision methods are employed), leads to less variability and increasing reproducibility of results. Currently, there are some offline software applications available such as BAT? and BCCT.core, which perform the assessment based on asymmetry measurements that are computed based on semi-automatically annotated keypoints. In the literature, one can find algorithms that attempt to do the completely automatic keypoint annotation with reasonable success. However, these algorithms are very time-consuming. As the course of research goes more and more into the development of web software applications, these time-consuming tasks are not desirable. In this work, we propose a novel approach to the keypoints detection task treating the problem in part as image segmentation. This novel approach can improve both execution-time and results. © 2020, IUPESM and Springer-Verlag GmbH Germany, part of Springer Nature.

2020

Interpretable Biometrics: Should We Rethink How Presentation Attack Detection is Evaluated?

Autores
Sequeira, AF; Silva, W; Pinto, JR; Gonçalves, T; Cardoso, JS;

Publicação
8th International Workshop on Biometrics and Forensics, IWBF 2020, Porto, Portugal, April 29-30, 2020

Abstract
Presentation attack detection (PAD) methods are commonly evaluated using metrics based on the predicted labels. This is a limitation, especially for more elusive methods based on deep learning which can freely learn the most suitable features. Though often being more accurate, these models operate as complex black boxes which makes the inner processes that sustain their predictions still baffling. Interpretability tools are now being used to delve deeper into the operation of machine learning methods, especially artificial networks, to better understand how they reach their decisions. In this paper, we make a case for the integration of interpretability tools in the evaluation of PAD. A simple model for face PAD, based on convolutional neural networks, was implemented and evaluated using both traditional metrics (APCER, BPCER and EER) and interpretability tools (Grad-CAM), using data from the ROSE Youtu video collection. The results show that interpretability tools can capture more completely the intricate behavior of the implemented model, and enable the identification of certain properties that should be verified by a PAD method that is robust, coherent, meaningful, and can adequately generalize to unseen data and attacks. One can conclude that, with further efforts devoted towards higher objectivity in interpretability, this can be the key to obtain deeper and more thorough PAD performance evaluation setups. © 2020 IEEE.

2019

DEEP KEYPOINT DETECTION FOR THE AESTHETIC EVALUATION OF BREAST CANCER SURGERY OUTCOMES

Autores
Silva, W; Castro, E; Cardoso, MJ; Fitzal, F; Cardoso, JS;

Publicação
2019 IEEE 16TH INTERNATIONAL SYMPOSIUM ON BIOMEDICAL IMAGING (ISBI 2019)

Abstract
Breast cancer high survival rate led to an increased interest in the quality of life after treatment, particularly regarding the aesthetic outcome. Currently used aesthetic assessment methods are subjective, which make reproducibility and impartiality impossible. To create an objective method capable of being selected as the gold standard, it is fundamental to detect, in a completely automatic manner, keypoints in photographs of women's torso after being subjected to breast cancer surgeries. This paper proposes a deep and a hybrid model to detect keypoints with high accuracy. Our methods are tested on two datasets, one composed of images with a clean and consistent background and a second one that contains photographs taken under poor lighting and background conditions. The proposed methods represent an improvement in the detection of endpoints, nipples and breast contour for both datasets in terms of average error distance when compared with the current state-of-the-art.