DATA PROCESSING APPARATUS AND DATA PROCESSING METHOD

Abstract

To enable selection of thresholds applicable to various clinical events for volume data.SOLUTION: A data processing device comprises a determination unit and a processing unit. The determination unit determines at least one threshold according to clinical information specific to a patient. The processing unit performs processing on a medical dataset of the patient using the at least one threshold.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] The embodiments disclosed herein relate to a data processing apparatus and a data processing method. [Background technology]

[0002] For example, it is known to use deep learning algorithms, such as convolutional neural networks, to perform segmentation tasks. For example, deep learning algorithms are used to perform segmentation of voxels of a medical image data volume into two or more classes, each class representing a respective tissue type.

[0003] Typically, deep learning algorithms output probability values: they can output volumetric data as a probability volume that comprises, for each voxel in the image volume, the probability that the voxel belongs to one or more classes.

[0004] Consider the case where the classification task to be performed is a binary classification task, for example classification into two classes, two tissue types. The deep learning algorithm outputs a probability volume comprising a set of probability values. A threshold is then applied to the probability volume to obtain a binary mask. The binary mask includes voxels classified as being in the first class but excludes voxels classified as being in the second class.

[0005] Applying a threshold to a probability volume is a very common method to obtain a binary mask from deep learning algorithms. The probability values ​​in the probability volume are each thresholded to obtain a classification as a first class or a second class of two classes. For example, the threshold may be set to a probability of 0.5. Voxels with a probability value greater than 0.5 are classified as belonging to the first class and are included in the binary mask. All other voxels are classified as belonging to the second class and are excluded from the binary mask.

[0006] Usually, the threshold to be applied to the probability value is selected only once. One common method of threshold selection is to use the midpoint where the probability value is 0.5, as mentioned above. Other methods of threshold selection include using the distance from the optimal classifier on the Receiver Operating Characteristic (ROC) curve, and using Youden's index to select the threshold.

[0007] However, conventional volume data threshold selection methods may not be adaptable to various clinical scenarios. [Prior art documents] [Patent documents]

[0008] [Patent Document 1] US Patent Application Publication No. 2019 / 019286 Summary of the Invention [Problem to be solved by the invention]

[0009] One of the problems that the embodiments disclosed in this specification etc. aim to solve is to realize the selection of a threshold value applicable to various clinical events for volume data. However, the problems solved by the embodiments disclosed in this specification etc. are not limited to the above problem. Problems corresponding to the effects of each configuration shown in the embodiments described later can also be positioned as other problems solved by the embodiments disclosed in this specification etc. [Means for solving the problem]

[0010] A data processing apparatus disclosed in an embodiment includes a determination unit and a processing unit, the determination unit determines at least one threshold value according to clinical information specific to a patient, and the processing unit performs processing on a medical data set of the patient using the at least one threshold value. [Brief description of the drawings]

[0011] [Figure 1] FIG. 1 is a schematic diagram of an apparatus according to an embodiment. [Diagram 2] FIG. 2 is a flow chart outlining a method of an embodiment. [Diagram 3] FIG. 3 is a flow chart that outlines a training method according to an embodiment. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0012] Hereinafter, an apparatus and a method according to the present embodiment will be described with reference to the drawings. In the following embodiments, parts with the same reference numerals perform similar operations, and duplicated descriptions will be omitted as appropriate.

[0013] A data processing apparatus 10 according to an embodiment is illustrated diagrammatically in Fig. 1. The data processing apparatus 10 comprises a computing device 12, in this example a personal computer (PC) or a workstation. The computing device 12 is connected to a scanner 14 via a data store 20.

[0014] The data processing device 10 further comprises one or more display screens 16, and one or more input devices (eg, a computer keyboard, a mouse, or a trackball).

[0015] In this embodiment, the scanner 14 is a Computed Tomography (CT) scanner configured to obtain a volumetric CT scan, such as, for example, a coronary angiogram (CTA) scan. In other embodiments, the scanner 14 may be any scanner configured to perform medical imaging. The scanner 14 is configured to generate image data representative of at least one anatomical region of a patient or other subject.

[0016] Scanner 14 is configured to acquire two-dimensional, three-dimensional, or four-dimensional image data in any imaging modality, for example, scanner 14 may comprise a Magnetic Resonance (MR) scanner, a Computed Tomography (CT) scanner, a Cone Beam CT scanner, an X-ray scanner, or an Ultrasound scanner.

[0017] In this embodiment, the image data set acquired by the scanner 14 is stored in the data store 20 and then provided to the computing device 12. In an alternative embodiment, the image data set is sourced from a remote data store (not shown). The data store 20, or the remote data store, may comprise any form of memory storage. In some embodiments, the data processing device 10 is not coupled to a scanner.

[0018] The computing device 12 comprises a data processing unit 22 for processing of data. The data processing unit 22 comprises a Central Processing Unit (CPU) and a Graphical Processing Unit (GPU). The data processing unit 22 provides processing resources for automatic or semi-automatic processing of the image dataset.

[0019] The data processing unit 22 includes a probability circuit 24, a threshold application circuit 26, and an image rendering circuit 28. The probability circuit 24 is configured to process the data using a deep learning model to obtain a probability volume. The probability circuit 24 is an example of a data output unit. The threshold application circuit 26 is configured to determine at least one threshold according to clinical information specific to a patient, which will be described later, and apply the determined threshold to the probability volume as a medical data set. The threshold application circuit 26 is an example of a determination unit or a processing unit. The image rendering circuit 28 is configured to render an image using the probability to which the threshold has been applied. In this embodiment, the data processing unit 22 further includes a training circuit 29 for training the threshold function. The training circuit 29 is an example of an acquisition unit or a training unit. In other embodiments, these various circuits may be provided on two or more devices. For example, the threshold application circuit 26 may be composed of a first circuit corresponding to the determination unit and a second circuit corresponding to the processing unit. In this case, at least one of the first circuit and the second circuit may be provided in a device capable of communicating with the computing device 12 via a network. The training circuit 29 may also be provided in a device capable of communicating with the computing device 12 via a network.

[0020] In other embodiments, the data processed may not comprise imaging data, for example the data processed may comprise any medical data.

[0021] The probability circuit 24 may be configured to perform any process having a continuously-valued output. In other embodiments, the probability circuit 24 may be configured to perform any process having a multi-valued output, such as an output comprising a set of monotonic discrete values. In further embodiments, the probability circuit 24 may be any process having a multi-valued or continuously-valued output. In some embodiments, the multi-valued or continuously-valued output may not comprise a probability.

[0022] In this embodiment, the probability circuitry 24, threshold application circuitry 26, image rendering circuitry 28, and training circuitry 29 are each implemented in a CPU and / or GPU by a computer program having computer readable instructions executable to perform the method of this embodiment, while in other embodiments various parts thereof may be implemented as one or more Application Specific Integrated Circuits (ASICs) or Field Programmable Gate Arrays (FPGAs).

[0023] Computing device 12 also has other components of a PC, including a hard disk drive, RAM, ROM, a data bus, an operating system including various device drivers, hardware devices including a graphics card, etc. Such components are not shown in FIG.

[0024] The apparatus of Figure 1 is configured to perform a method for processing medical imaging data (data acquired by a medical imaging device) as shown in Figure 2. In other embodiments, the apparatus of Figure 1 may be configured to process any medical data set including medical imaging data.

[0025] 2, at stage 30, the probability circuit 24 acquires a set of volumetric medical imaging data. The set of medical imaging data is acquired by the scanner 14 by scanning an anatomical region of a patient. The set of medical imaging data is then stored in the data store 20 and passed from the data store 20 to the probability circuit 24. In other embodiments, the medical imaging data may be received from any suitable data store or directly from the scanner 14. The set of medical imaging data may comprise any suitable medical imaging data, for example, two-dimensional, three-dimensional, or four-dimensional medical imaging data.

[0026] In the embodiment of FIG. 2, the set of medical imaging data is obtained from a Non-Contrast CT (NCCT) scan of the patient's brain. The patient's brain was scanned because it was suspected that the patient had experienced a stroke. In other embodiments, the medical imaging data may have been obtained by scanning any anatomical region of the patient using any suitable imaging method. In further embodiments, the medical imaging data may have been obtained by optical imaging. For example, the medical imaging data may have been obtained by photography. The medical imaging data may have been obtained by endoscopy. The medical imaging data may have been obtained by microscopy, such as for use in pathology. In other embodiments, any suitable medical data may be used.

[0027] The probability circuit 24 outputs a medical data set as a probability volume consisting of continuous or discrete probabilities, or a medical data set as a step volume consisting of multiple step values, from the medical imaging data. Here, the probability volume consisting of continuous or discrete probabilities is volume data in which each voxel has, for example, a continuous or discrete value between 0 and 1 as a probability, or a continuous or discrete value between 0 and 100 as a probability. Also, the step volume consisting of multiple step values ​​is volume data in which each voxel has multiple step values ​​(for example, each voxel has one of three step values ​​of 1, 2, and 3). In this embodiment, for the sake of concrete explanation, a case in which the probability circuit 24 outputs a medical data set as a probability volume from the medical imaging data is taken as an example. That is, in stage 32, the probability circuit 24 applies a segmentation process to the medical imaging data. Also, applying the segmentation process comprises applying a trained model to the medical imaging data. The trained model is a deep learning model that has been trained to perform a segmentation task. In this embodiment, the deep learning model comprises a convolutional neural network. In other embodiments, any type of deep learning model may be used. In further embodiments, any suitable segmentation process may be used, which may or may not comprise deep learning. In further embodiments, any suitable process that produces a multi-valued or continuously-valued output may be applied.

[0028] The segmentation process performed by the probability circuit 24 also includes determining the probability that a voxel in the medical data set belongs to at least one of the at least one anatomical feature and at least one pathology. The probability circuit 24 outputs the medical data set with the determined probability. That is, the probability circuit 24 outputs a probability volume 34 as a result of the segmentation process. The probability volume 34 is also called a heat map. The probability volume 34 comprises, for each of a set of locations in the medical imaging data, a probability that the tissue at that location belongs to a first class of tissue. For example, the locations may be voxel locations. In this embodiment, the first class of tissue is tissue that exhibits an indication of ischemia. Each probability value is a value between 0 and 1.

[0029] In some embodiments, probability volume 34 may comprise multiple probabilities for each location, such as, for example, a respective probability for each of multiple classes of tissue.

[0030] The probability circuit 24 passes the probability volume 34 to a threshold application circuit 26 .

[0031] At stage 38, the threshold application circuit 26 receives patient information associated with the patient who was scanned to obtain the set of medical imaging data, including patient-specific clinical information.

[0032] In this embodiment, the patient-specific clinical information includes the time from onset of stroke symptoms, which in some circumstances may be approximated as the time since the patient was last perceived to be normal.

[0033] In other embodiments, the patient-specific clinical information may include any information that may be relevant to the probability volume threshold.

[0034] The patient-specific clinical information may also include the patient's medical record or a portion of the patient's medical record. For example, in some embodiments, the patient-specific clinical information may include at least one of demographic information (e.g., age, sex, and / or ethnic affiliation), vital sign information (e.g., blood pressure information), or information about the patient's past or current medical condition (patient's medical condition information). The patient-specific clinical information may also include information about alcohol intake, information about lifestyle factors such as smoking (patient's lifestyle information). The patient-specific clinical information may also include information about current or past medical conditions, and information about current or past diagnoses.

[0035] The patient-specific clinical information may include any information related to the patient, such as intensity values ​​of the pixels (pixel, voxel values) forming the medical imaging data set, as well as information other than the intensity values ​​of the pixels forming the medical imaging data set (extrinsic information, etc.). In some embodiments, the patient-specific clinical information may be found in metadata associated with the set of medical imaging data. For example, the age and sex of the patient may be obtained from a DICOM-compliant data set.

[0036] The patient-specific clinical information may be obtained by any suitable method. In some embodiments, the patient-specific clinical information may be entered by a user. In some embodiments, the patient-specific clinical information is obtained using a machine learning model. The machine learning model is trained to extract the patient-specific clinical information from a dataset, such as, for example, extracting desired items of patient information from a patient's medical record. An example of the model training process is described below with reference to FIG. 3.

[0037] At stage 40, the threshold application circuit 26 determines a threshold based on patient specific clinical information. The threshold is a probability value between 0 and 1. In this embodiment, the patient specific clinical information is time from onset. The threshold application circuit 26 determines the threshold using a threshold function that gives the threshold as a function of time of onset of stroke symptoms. The threshold function 42 is shown in Figure 2.

[0038] The threshold application circuit 26 determines a patient-specific threshold value by inputting a patient-specific time from onset to a threshold function 42 .

[0039] In this embodiment, the threshold function is defined manually.The threshold function is defined using heuristics (clinical knowledge).

[0040] In some embodiments, the threshold function is defined by a linear interpolation between a minimum and a maximum value. Time from onset may be used to determine the amount of interpolation. The threshold function may operate by interpolating between pre-determined values ​​using patient-specific clinical information to determine the interpolation rate. In alternative embodiments, any suitable interpolation function may be used, for example a higher order interpolation function.

[0041] In other embodiments, the threshold function is learned from the data. Learning a threshold function from data is described below with reference to FIG.

[0042] In some embodiments, an approximate threshold value may be determined first, and the threshold value is obtained by modifying the approximate threshold value. For example, the threshold application circuit 26 may use a Receiver Operating Characteristic (ROC) analysis to determine a value for the approximate threshold value. In other embodiments, any suitable method may be used to obtain the approximate threshold value. In some embodiments, a fixed default threshold value may be used as the approximate threshold value.

[0043] In some embodiments, a validity range is established for the threshold before the threshold is determined. For example, a maximum and / or minimum value is used to limit the threshold to ensure that the threshold provides clinically valid results. Taking into account clinical considerations is used to generate the threshold function 42 of this embodiment.

[0044] When acute stroke is suspected, an NCCT scan of the patient's brain is typically obtained. The NCCT scan is used to inform clinical decisions. In particular, the NCCT scan is used to inform decisions about whether tissue plasminogen activator (tPA) should be administered to the patient.

[0045] The decision to administer tPA must be carefully considered: in some circumstances, administration of tPA can result in adverse effects due to bleeding.

[0046] tPA is contraindicated if the time from onset is large (e.g., 4.5 hours). As the time from onset increases, it is expected that the side effects of tPA will begin to outweigh the benefits.

[0047] tPA is contraindicated in cases of large infarction (eg, ASPECTS (Alberta Stroke Programme Early CT Score) score above 7).

[0048] Ischemic infarcts appear on NCCT scans as hypodense signals, which typically become more readily visible with increasing time from onset.

[0049] The sensitivity of detecting visible signs of ischemia on CT modalities ranges from 40% to 60% within 3 hours of onset (Patel et al, “Lack of clinical significance of early ischemic changes on computed tomography in acute stroke”, JAMA. 2001 Dec 12;286(22):2830-8), increasing to 75% within 6 hours for some signs (Broderick, “Recanalization therapies for acute ischemic stroke”, Semin Neurol 1998;18(4):471-484).

[0050] In this embodiment, the desired threshold for the probability volume may be different in different clinical scenarios.

[0051] More time from onset, clinicians want to balance the risk of administering tPA against the likelihood of bleeding. Clinicians generally want a confident prediction so that they can be confident in their decision. Furthermore, it is expected that stronger low-attenuation signals will be obtained over time. Ischemic infarcts will likely have stronger attenuation signals. Thus, more time from onset, a higher threshold is desirable. A higher threshold may be considered to provide more confidence.

[0052] At short times from onset, the clinician cannot be sure that an ischemic stroke has occurred. Typically, the clinician wants some indication that a stroke may be progressing. The clinician wants to rule out stroke mimics. The clinician likely wants to see all possible ischemic areas so that they can make a confident decision. At short times from onset, a large threshold may result in the clinician not seeing any infarction. Therefore, at short times from onset, a lower threshold is preferred. A lower threshold is considered to provide less confidence.

[0053] Once the patient-specific threshold is obtained, the threshold application circuit 26 applies the patient-specific threshold to the probability volume output by the probability circuit 24. The threshold application circuit applies the patient-specific threshold to the probability volume to obtain a binary mask.

[0054] Figure 2 shows different binary masks 44, 46, 48 obtained by applying different thresholds to the same probability volume. The different thresholds are selected to correspond to different times since onset.

[0055] The binary mask 44 corresponds to a time from onset of 1 hour. A low threshold is selected according to the small time from onset. A low threshold results in a large area being classified as ischemic.

[0056] The binary mask 46 corresponds to a time from onset of 2 hours. A higher threshold is selected, resulting in a smaller area being classified as ischemic.

[0057] The binary mask 48 corresponds to a time from onset of 3 hours. The higher the threshold is selected, the smaller the area will be classified as ischemic.

[0058] In the embodiment of Figure 2, the threshold application circuit 26 outputs one threshold value that is used to obtain one binary mask. Different binary masks 44, 46, 48 are shown as different examples corresponding to different threshold values ​​in the method of Figure 2. In other embodiments, the threshold application circuit 26 may output any suitable number of threshold values ​​that are used to obtain any suitable number of binary masks.

[0059] At stage 50, an image is presented to the clinician using the modified thresholds. The image rendering circuitry 28 renders an image from the set of medical imaging data acquired at stage 30. The image is rendered using a binary mask that corresponds to the thresholds output by the threshold application circuitry 26. The rendered image is displayed to the clinician.

[0060] Regions classified as ischemic may be visually distinguished in the rendered image. For example, regions of the brain classified as ischemic may be highlighted using a different color than the rest of the brain. Regions classified as ischemic may be outlined. Regions classified as ischemic may be labeled in the rendered image.

[0061] The image may comprise a heatmap representing the probability values, and the regions that have been determined by applying the threshold may be presented along with the heatmap, e.g., the regions to which the threshold has been applied are overlaid on the heatmap.

[0062] Shortly after onset, the clinician is presented with a large area of ​​tissue that may have signs of ischemia, and the clinician can review this large area for possible signs. At this point, the visible signs of ischemia may be very faint.

[0063] At longer times from onset, clinicians can be shown smaller areas of tissue with greater confidence. At this point, signs of ischemia may be more visible. It is important that clinicians have a high degree of confidence in ischemia if they are considering using tPA.

[0064] At stage 52, the clinician is provided with control of the threshold. The clinician can select any threshold they wish. The image rendering circuitry 28 renders an image from the medical imaging data using the threshold chosen by the clinician. Regions that are classified as ischemic according to the new threshold are visibly distinguished in the rendered image.

[0065] The clinician may select a different threshold value relative to that obtained by the threshold function. The clinician may view all of the information if they wish. For example, the display may show pre-computed values ​​for sensitivity, specificity, and / or other parameters.

[0066] In many cases, the threshold may simply be determined automatically, and the clinician does not need to adjust the threshold. Stage 52 may be considered optional.

[0067] In the above description, reference has generally been made to a clinician, but the method as illustrated in Figure 2 can be used by any user, such as, for example, any physician, radiologist, or researcher.

[0068] By using patient information to select the threshold, different thresholds are applied to each patient. In the case of acute stroke ischemia detection, the time from onset is used to adjust the threshold to match the clinical decision that must be made (in this case, whether to administer tPA or not).

[0069] In some situations, it may be difficult to include patient information as input to a machine learning algorithm, such as a segmentation algorithm. In the embodiment of Figure 2, the step of applying a threshold is used as a secondary stage where patient information is incorporated in combination with the initial segmentation, thus obtaining results that are responsive to patient-specific clinical information.

[0070] The method of Fig. 2 is particularly useful in ischemia, since the signs of ischemia are very subtle in the early stages. In other embodiments, methods similar to the method of Fig. 2 may be applied to signs of other diseases or conditions. For example, the method of Fig. 2 is useful in any segmentation task where patient-specific clinical information influences the algorithm's certainty about the results, the size of the segmentation. The method of Fig. 2 is particularly useful when the boundaries of the target to be segmented are not clearly defined.

[0071] In the embodiment of Figure 2, the threshold function is used to obtain a threshold value based on time of onset. In other embodiments, the threshold function may determine a threshold value based on any suitable patient-specific clinical information. The threshold function may determine a threshold value based on multiple items of patient-specific clinical information, such as time since onset combined with age and gender.

[0072] In some embodiments, the method of Fig. 2 is applied to liver fibrosis segmentation. The patient-specific clinical information used to determine the threshold may include, for example, information about whether the patient has a history of alcohol abuse, or details of the patient's history of alcohol abuse (e.g., duration of alcohol abuse). The information about alcohol abuse is used to partition the probability volume for liver fibrosis segmentation.

[0073] In some embodiments, the method of Figure 2 is applied to segmentation of arterial calcification or arteriosclerosis. The patient-specific clinical information used to determine the threshold may include, for example, the patient's history of smoking (information regarding smoking), information regarding the patient's weight change, and information related to factors associated with the presence of arterial calcification or arteriosclerosis.

[0074] In some embodiments, the method of Figure 2 is applied to visceral fat segmentation. Patient-specific clinical information used to determine the threshold may include, for example, information about the patient's ethnic affiliation.

[0075] In some embodiments, the method of Figure 2 is applied to segmentation of the prostate.Patient-specific clinical information used to determine the threshold may include, for example, information about the patient's age.

[0076] For example, the method of Fig. 2 is applied to the segmentation of anatomical features such as organs, lesions such as cancer tumors, etc. Patient-specific clinical information used in the threshold determination may include, for example, information about the type of cancer, information about the treatment being given to the patient.

[0077] In some circumstances, the tumor may show pseudoresponse or pseudoprogression, where the features seen in the imaging do not match the true changes of the tumor. For example, the pseudoresponse or pseudoprogression may be due to recent treatment. Knowledge of the recent treatment may be used to adjust the threshold, for example, to account for the pseudoresponse or pseudoprogression. Different thresholds or varying thresholds may be used to account for uncertainties in the algorithm. The threshold application circuit 26 processes the medical dataset using the at least one threshold thus determined to generate a medical dataset (e.g., a thresholded image) that includes information on whether at least one of at least one anatomical feature and at least one lesion is present.

[0078] In the embodiment of FIG. 2, an image is displayed to the user. A threshold function is used to obtain a threshold based on the time of onset. The threshold application circuit 26 obtains (determines) multiple thresholds. The threshold application circuit 26 performs a process using multiple thresholds on the patient's medical dataset. For example, the threshold application circuit 26 performs a segmentation process using at least one threshold on the patient's medical dataset and generates a medical dataset for visualizing the results of the segmentation process. For example, in the case of a single threshold, an image is rendered using the medical dataset as a binary mask obtained using the single threshold.

[0079] In other embodiments, multiple thresholds are determined from one medical imaging data set. For example, different thresholds may be applicable for different clinical applications or uses. In some embodiments, the threshold application circuit 26 obtains a range of thresholds around a preferred threshold. In some embodiments, a range of predefined thresholds may be used.

[0080] For example, the threshold application circuit 26 performs segmentation processes corresponding to each of the multiple thresholds on the patient's medical dataset and generates a medical dataset for visualizing each segmentation process. A rendered image using the generated medical dataset displays to a user the regions corresponding to each of the multiple thresholds. The multiple different regions can be visually indicated in one image, for example, by using different colors or patterns. The multiple regions may be indicated as multiple layers. The multiple regions may be indicated like a topographical map with multiple contour lines.

[0081] In some embodiments, the threshold application circuit 26 obtains thresholds corresponding to different confidence levels, and the rendered image visually indicates the confidence gap, for example using a visual indicator such as color or distance between contours.

[0082] In another embodiment, multiple images are rendered, each image showing a region corresponding to a different one of the multiple thresholds. For example, the threshold application circuit 26 obtains (determines) multiple thresholds corresponding to multiple processes. The threshold application circuit 26 performs a segmentation process corresponding to each of the multiple thresholds on a medical dataset of a patient, and generates a medical dataset that visualizes the segmentation process corresponding to each of the multiple processes. The image rendering circuit 28 uses the generated medical dataset to generate multiple rendered images in which the segmentation processes corresponding to the multiple processes are visualized.

[0083] In some embodiments, a user is provided with a screen showing multiple images. The user may also be shown an associated threshold value for each of the multiple images. The user can select which of the images they want to inspect. For example, the user can click on one of the images to enlarge it. By clicking on the image, the user is considered to select one of the multiple threshold values.

[0084] In some embodiments, the threshold application circuit 26 adjusts at least one threshold in response to user input. The threshold application circuit 26 performs a segmentation process or the like on the medical dataset using the thresholds adjusted for the patient's medical dataset. Sliders may also be displayed as an input interface for adjusting at least one threshold. That is, each image is provided with the thresholds used to render that image, and a slider for adjusting each threshold. Adjusting the slider position indicates the effect of adjusting the threshold.

[0085] In some embodiments, the display can use multiple thresholds to provide a visual indication of the degree of uncertainty in the algorithm. Multiple thresholds are used to indicate a range of possible outcomes. Multiple thresholds may be used to indicate outcomes under different assumptions (e.g., outcomes with suspected apparent response or pseudoprogression or outcomes without suspected apparent response or pseudoprogression).

[0086] In some embodiments, thresholds are determined for maximum and minimum values ​​of a clinically useful range of the patient information parameter. The rendered image or images show partitioned regions for the maximum and minimum values. The rendered image or images may also show predicted regions for actual patient-specific values ​​for that parameter, regions for user-selected thresholds. The maximum and minimum regions are visually indicated, for example by dotted outlines.

[0087] Each segmented region in the rendered image may have an associated indicia (e.g., a label or key) indicating the threshold used to obtain that region. Each segmented region may have an associated indicia indicating the patient-specific clinical information (e.g., time of onset) used to obtain that segmented region. Each segmented region may have an associated indicia indicating an estimate for at least one statistical measure for that region, such as, for example, an estimated sensitivity, specificity, etc.

[0088] In some embodiments, multiple items of clinical data are considered in the calculation of the threshold. The calculation is designed so that individual items of data can be ignored. Multiple thresholds may be calculated, each value corresponding to a different combination of clinical information. For example, the calculation of the threshold may take into account age, sex, and smoking history. A first threshold is determined based on the patient's age alone, without taking into account sex and smoking history. A second threshold is determined based on sex alone, without taking into account age or smoking history. A third threshold is determined based on smoking history alone, without taking into account age or sex. Further thresholds may be determined based on different combinations of age, sex, and smoking history. This effectively results in multiple segmentations, one for each possible combination of data.

[0089] Among these options, the most important are segmentation that considers all patient-specific data and segmentation that does not consider any patient-specific data.

[0090] The user may be given the ability to exclude different items of clinical information from consideration. For example, the user may be provided with a checkbox corresponding to each item of data. By checking or unchecking the checkbox, the user can indicate which items of information they want to be considered in determining the threshold and therefore the segmented region. Thus, the user can easily explore the space of different clinical information and how the segmentation changes when that clinical information is or is not considered.

[0091] In some embodiments, a visual indication on the display can inform the user that the medical application uses adapted thresholds based on patient-specific clinical information. The visual indication can inform the user that patient-specific or other information is being used for the thresholds. For example, the visual indication can inform the user that the thresholds are selected based on time of onset. The display can include a warning indication explaining that the displayed results are highly dependent on changes in the thresholds.

[0092] In the embodiment of Figure 2, the threshold function is manually defined. In other embodiments, the threshold function is learned from data. Figure 3 is a flow chart that outlines a method for training the threshold function.

[0093] At stage 60, the training circuitry 29 receives training data. The training data has been collected through real-time use of a medical application having a segmentation process. In the medical application, a clinician may select a threshold value with which to view the results of the segmentation process. It is assumed that clinicians will quite often select a threshold value that they deem more useful. The training circuitry 29 or other circuitry tracks the threshold value that the clinician determines to be most useful when making a decision, along with patient-specific clinical information for the associated case.

[0094] The plurality of training data comprises a plurality of data samples. Each data sample comprises patient-specific clinical information associated with a set of medical imaging data. For example, each of the plurality of training data includes patient-specific clinical information as input data and at least one selected threshold as training data. For example, the patient-specific clinical information may comprise time of onset. Also, each data sample comprises at least one threshold selected by a clinician for use when viewing the set of medical imaging data. In some embodiments, the data sample also comprises the set of medical imaging data. In further embodiments, the data sample comprises data regarding patient outcome. For example, the data sample may comprise information regarding whether tPA was administered to the patient. The data sample may comprise information regarding whether the patient responded well or poorly to administration of tPA.

[0095] The threshold selected by the clinician provides the ground truth for use in training.

[0096] At stage 62, the training circuit 29 trains the threshold function in dependence on the training data. Any suitable method of training the threshold function may be used. In the embodiment of Figure 3, the threshold function is trained to output a threshold value in dependence on time from onset. In further embodiments, the threshold function may be trained to output a threshold value in dependence on additional or alternative patient specific clinical information. In further embodiments, the threshold function may be trained to output a threshold value in dependence on an outcome variable representing a clinical outcome.

[0097] At stage 64, the threshold application circuit 26 uses the trained threshold function to apply thresholds to new probability volumes that do not form part of the training data. The threshold application circuit 26 inputs patient specific clinical information into the trained threshold function. The trained threshold function outputs at least one threshold value.

[0098] In one simple embodiment of stage 62, training circuit 29 plots the selected threshold values ​​against values ​​for one or more items of patient-specific clinical information. Training circuit 29 fits a curve to the resulting plot.

[0099] In more complex embodiments, the training function comprises a machine learning model, for example a convolutional neural network. The training circuit 29 provides the training data as input to the machine learning model. In this case, the output of stage 62 is the trained model. In stage 64, the threshold application circuit 26 applies patient-specific clinical information to the trained model. The trained model outputs at least one threshold.

[0100] In some embodiments, the training data does not include ground truth data. The training circuit 29 trains the threshold function using an unsupervised learning process. In other embodiments, the training data includes some labelling, annotations, but does not include a ground truth threshold. Weak supervision may be used in training the threshold function.

[0101] In the embodiment described above, the segmentation process is applied to medical imaging data acquired by scanning with a scanner.

[0102] In other embodiments, the medical imaging data may comprise any suitable type of medical imaging data. For example, the medical imaging data may be optical data, e.g., from a photograph. The medical imaging data may be pathology data. The medical data may be obtained, for example, from a procedure in which an imaging device is inserted into a patient's body, such as a laparoscopy.

[0103] In further embodiments, a method as described above with reference to Figure 2 may be used to perform any suitable process that generates a multi-valued or continuously-valued output, such as, for example, any suitable machine learning process. The process may not comprise segmentation. The process may comprise processing any suitable data items of a dataset to obtain any multi-valued or continuously-valued output. The output may not be a probability. Any suitable threshold may be applied to the output.

[0104] The method of Figure 2 may be performed using medical data relating to any subject, human or animal. The method of Figure 2 may be used in the detection and / or diagnosis of any suitable disease or condition. For example, the method of Figure 2 may be used to view damage to the heart caused by a heart attack.

[0105] In a further embodiment, the method of Figure 2 is used to perform a thresholding of the output of any suitable process having a multi-valued or continuously-valued output. The process may comprise processing any data item in the data set. The applying of the threshold may be based on any suitable input that does not form part of the data item.

[0106] An embodiment provides a method for processing medical imaging data, the method comprising: applying a segmentation process to the medical imaging data to obtain a continuously-valued segmentation output; determining at least one threshold in response to patient-specific clinical information; and applying the determined at least one threshold to the continuously-valued segmentation output to obtain a thresholded segmentation output.

[0107] One embodiment provides a medical imaging device that includes a segmentation algorithm with a continuous output; specific ranges (thresholds) used to group the algorithm outputs; and threshold calculations that are responsive to patient-specific clinical information.

[0108] The segmentation algorithm may be a convolutional neural network. The threshold calculation may be determined by training a machine learning algorithm (or machine learning model). The machine learning algorithm may be trained to maximize an outcome variable that depends in some way on the algorithm output. Multiple thresholds may be used to group the output into multiple groups.

[0109] Results can be viewed in the medical imaging application. Raw numerical results can also be viewed. Thresholds can be manually adjusted. Grouped results can include continuous value metrics (e.g., heat maps).

[0110] The threshold function works by interpolating between pre-defined values ​​using patient-specific clinical information to determine the interpolation rate.

[0111] The algorithm may be for predicting stroke ischemia. The patient-specific clinical information includes time from onset of stroke.

[0112] Although particular circuits are described herein, in alternative embodiments, one or more functions of those circuits may be provided by a single processing resource or other component. Or, the functions provided by a single circuit may be provided by a combination of two or more processing resources or other components. References to a single circuit encompass multiple components that provide the functions of that circuit, whether or not such multiple components are separate from one another. Also, references to multiple circuits encompass single components that provide the functions of those circuits.

[0113] According to at least the embodiment and modified examples described above, it is possible to realize selection of a threshold value applicable to various clinical phenomena for volume data.

[0114] Although some embodiments have been described, these embodiments are presented as examples and are not intended to limit the scope of the invention. These embodiments can be implemented in various other forms, and various omissions, substitutions, modifications, and combinations of embodiments can be made without departing from the spirit of the invention. These embodiments and their modifications are included in the scope of the invention and its equivalents as described in the claims, as well as in the scope and spirit of the invention. [Explanation of symbols]

[0115] 10 Data Processing Device 12 Computing Equipment 14 Scanner 16 Display Devices 18 Input Devices 20 Data storage unit 22 Data Processing Section 24 Probability Circuit 26 Threshold application circuit 28 Image Rendering Circuit 29 Training Circuit

Claims

1. A determination unit that determines at least one threshold value according to clinical information, the clinical information being information specific to a patient and including a time from the onset of the stroke, from the elapsed time from the onset of the stroke using a trained model based on a threshold function; a processor for performing processing of the at least one threshold value on the patient's medical data set; a data output unit that outputs the medical data set as a probability volume consisting of continuous or discrete probabilities, or the medical data set as a step volume consisting of a plurality of step values, from medical imaging data; The data output unit performs a process for determining a probability or a value that a voxel included in the medical data set belongs to at least one of at least one anatomical feature and at least one lesion; The processing unit executes a process using the at least one threshold value on the medical data set for which the probability or the value has been determined. Data processing device.

2. the processor uses the at least one threshold to generate the medical data set including information indicative of whether at least one of the at least one anatomical feature and the at least one lesion is present.

2. A data processing apparatus according to claim 1.

3. The pathology includes stroke ischemia; 3. A data processing apparatus according to claim 2.

4. The patient-specific clinical information may include at least one of demographic information, age, sex, ethnicity, height, weight, blood pressure information, vital signs information, information regarding the patient's medical condition, information regarding a diagnosis, information regarding a medical procedure, information regarding the patient's lifestyle, information regarding alcohol intake, and information regarding smoking. A data processing device according to any one of claims 1 to 3.

5. The data processing device according to claim 1 , wherein the determination of the threshold value is performed using the learned model obtained by training a machine learning algorithm.

6. The determination unit determines a plurality of the threshold values; The processing unit executes processing using a plurality of the thresholds on the medical data set of the patient. A data processing device according to any one of claims 1 to 5.

7. The processing unit performs a segmentation process using the at least one threshold on the medical data set of the patient, and generates the medical data set that visualizes a result of the segmentation process. A data processing device according to any one of the preceding claims.

8. The processing unit executes a segmentation process corresponding to each of the plurality of thresholds on the medical data set of the patient, and generates the medical data set that visualizes the plurality of segmentation processes.

8. A data processing apparatus according to claim 7.

9. The determination unit determines a plurality of the thresholds corresponding to a plurality of processes; The processing unit executes a segmentation process corresponding to each of the plurality of thresholds on the medical data set of the patient, and generates the medical data set that visualizes the segmentation process corresponding to each of the plurality of processes.

9. A data processing apparatus according to claim 8.

10. The processor adjusts the at least one threshold in response to a user input. A data processing device according to any one of claims 1 to 9.

11. the user input includes at least one of selecting a threshold value, moving a slider to adjust the threshold value, selecting an image from a plurality of images corresponding to a plurality of threshold values, and selecting at least one item of patient-specific clinical information; 11. A data processing apparatus according to claim 10.

12. determining at least one threshold value according to clinical information specific to the patient, the clinical information including the time since the onset of the stroke, from the time since the onset of the stroke using the trained model with a threshold function; performing a process using the at least one threshold on the patient's medical data set; 1. A data processing method comprising: outputting the medical data set as a probability volume of continuous or discrete probabilities or as a graduated volume of graduated values ​​from medical imaging data, the data processing method comprising: performing a process for determining a probability or value of a voxel included in the medical data set belonging to at least one of at least one anatomical feature and at least one pathology; performing a processing using said at least one threshold on said medical data set from which said probability or said value has been determined; The data processing method further comprises:

Images