Fractal sets and their applications in medicine

La geometria euclidea risulta spesso inadeguata a descrivere le forme della natura. I Frattali, oggetti interrotti e irregolari, come indica il nome stesso, sono più adatti a rappresentare la forma frastagliata delle linee costiere o altri elementi naturali. Lo strumento necessario per studiare rigorosamente i frattali sono i teoremi riguardanti la misura di Hausdorff, con i quali possono definirsi gli s-sets, dove s è la dimensione di Hausdorff. Se s non è intero, l'insieme in gioco può riconoscersi come frattale e non presenta tangenti e densità in quasi nessun punto. I frattali più classici, come gli insiemi di Cantor, Koch e Sierpinski, presentano anche la proprietà di auto-similarità e la dimensione di similitudine viene a coincidere con quella di Hausdorff. Una tecnica basata sulla dimensione frattale, detta box-counting, interviene in applicazioni bio-mediche e risulta utile per studiare le placche senili di varie specie di mammiferi tra cui l'uomo o anche per distinguere un melanoma maligno da una diversa lesione della cute.

Machine Learning methods for hepatocellular malignancies segmentation and MVI prediction

The aim of this thesis project is to automatically localize HCC tumors in the human liver and subsequently predict if the tumor will undergo microvascular infiltration (MVI), the initial stage of metastasis development. The input data for the work have been partially supplied by Sant'Orsola Hospital and partially downloaded from online medical databases. Two Unet models have been implemented for the automatic segmentation of the livers and the HCC malignancies within it. The segmentation models have been evaluated with the Intersection-over-Union and the Dice Coefficient metrics. The outcomes obtained for the liver automatic segmentation are quite good (IOU = 0.82; DC = 0.35); the outcomes obtained for the tumor automatic segmentation (IOU = 0.35; DC = 0.46) are, instead, affected by some limitations: it can be state that the algorithm is almost always able to detect the location of the tumor, but it tends to underestimate its dimensions. The purpose is to achieve the CT images of the HCC tumors, necessary for features extraction. The 14 Haralick features calculated from the 3D-GLCM, the 120 Radiomic features and the patients' clinical information are collected to build a dataset of 153 features. Now, the goal is to build a model able to discriminate, based on the features given, the tumors that will undergo MVI and those that will not. This task can be seen as a classification problem: each tumor needs to be classified either as “MVI positive” or “MVI negative”. Techniques for features selection are implemented to identify the most descriptive features for the problem at hand and then, a set of classification models are trained and compared. Among all, the models with the best performances (around 80-84% ± 8-15%) result to be the XGBoost Classifier, the SDG Classifier and the Logist Regression models (without penalization and with Lasso, Ridge or Elastic Net penalization).

Bayesian Linear Regression for estimation of the Fractal Dimension of the Cerebral Cortex

The cerebral cortex presents self-similarity in a proper interval of spatial scales, a property typical of natural objects exhibiting fractal geometry. Its complexity therefore can be characterized by the value of its fractal dimension (FD). In the computation of this metric, it has usually been employed a frequentist approach to probability, with point estimator methods yielding only the optimal values of the FD. In our study, we aimed at retrieving a more complete evaluation of the FD by utilizing a Bayesian model for the linear regression analysis of the box-counting algorithm. We used T1-weighted MRI data of 86 healthy subjects (age 44.2 ± 17.1 years, mean ± standard deviation, 48% males) in order to gain insights into the confidence of our measure and investigate the relationship between mean Bayesian FD and age. Our approach yielded a stronger and significant (P < .001) correlation between mean Bayesian FD and age as compared to the previous implementation. Thus, our results make us suppose that the Bayesian FD is a more truthful estimation for the fractal dimension of the cerebral cortex compared to the frequentist FD.

Application of active and transfer learning to wound image segmentation

Wound management is a fundamental task in standard clinical practice. Automated solutions already exist for humans, but there is a lack of applications on wound management for pets. The importance of a precise and efficient wound assessment is helpful to improve diagnosis and to increase the effectiveness of treatment plans for the chronic wounds. The goal of the research was to propose an automated pipeline capable of segmenting natural light-reflected wound images of animals. Two datasets composed by light-reflected images were used in this work: Deepskin dataset, 1564 human wound images obtained during routine dermatological exams, with 145 manual annotated images; Petwound dataset, a set of 290 wound photos of dogs and cats with 0 annotated images. Two implementations of U-Net Convolutioal Neural Network model were proposed for the automated segmentation. Active Semi-Supervised Learning techniques were applied for human-wound images to perform segmentation from 10% of annotated images. Then the same models were trained, via Transfer Learning, adopting an Active Semi- upervised Learning to unlabelled animal-wound images. The combination of the two training strategies proved their effectiveness in generating large amounts of annotated samples (94% of Deepskin, 80% of PetWound) with the minimal human intervention. The correctness of automated segmentation were evaluated by clinical experts at each round of training thus we can assert that the results obtained in this thesis stands as a reliable solution to perform a correct wound image segmentation. The use of Transfer Learning and Active Semi-Supervied Learning allows to minimize labelling effort from clinicians, even requiring no starting manual annotation at all. Moreover the performances of the model with limited number of parameters suggest the implementation of smartphone-based application to this topic, helping the future standardization of light-reflected images as acknowledge medical images.