The use of artificial intelligence, and the deep-learning subtype in particular, has been enabled by the use of labeled big data, along with markedly enhanced computing power and cloud storage, across all sectors. In medicine, this is beginning to have an impact at three levels: for clinicians, predominantly via rapid, accurate image interpretation; for health systems, by improving workflow and the potential for reducing medical errors; and for patients, by enabling them to process their own data to promote health. The current limitations, including bias, privacy and security, and lack of transparency, along with the future directions of these applications will be discussed in this article. Over time, marked improvements in accuracy, productivity, and workflow will likely be actualized, but whether that will be used to improve the patient-doctor relationship or facilitate its erosion remains to be seen.

High-performance medicine: the convergence of human and artificial intelligence

Artificial intelligence (AI) algorithms, particularly deep learning, have demonstrated remarkable progress in image-recognition tasks. Methods ranging from convolutional neural networks to variational autoencoders have found myriad applications in the medical image analysis field, propelling it forward at a rapid pace. Historically, in radiology practice, trained physicians visually assessed medical images for the detection, characterization and monitoring of diseases. AI methods excel at automatically recognizing complex patterns in imaging data and providing quantitative, rather than qualitative, assessments of radiographic characteristics. In this Opinion article, we establish a general understanding of AI methods, particularly those pertaining to image-based tasks. We explore how these methods could impact multiple facets of radiology, with a general focus on applications in oncology, and demonstrate ways in which these methods are advancing the field. Finally, we discuss the challenges facing clinical implementation and provide our perspective on how the domain could be advanced.

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Artificial intelligence in radiology

Current medical imaging technologies allow visualization of tissue anatomy in the human body at resolutions ranging from 100 micrometers to 1 millimeter. These technologies are generally not sensitive enough to detect early-stage tissue abnormalities associated with diseases such as cancer and atherosclerosis, which require micrometer-scale resolution. Here, optical coherence tomography was adapted to allow high-speed visualization of tissue in a living animal with a catheter-endoscope 1 millimeter in diameter. This method, referred to as "optical biopsy," was used to obtain cross-sectional images of the rabbit gastrointestinal and respiratory tracts at 10-micrometer resolution.

In Vivo Endoscopic Optical Biopsy with Optical Coherence Tomography

Drug discovery and development pipelines are long, complex and depend on numerous factors. Machine learning (ML) approaches provide a set of tools that can improve discovery and decision making for well-specified questions with abundant, high-quality data. Opportunities to apply ML occur in all stages of drug discovery. Examples include target validation, identification of prognostic biomarkers and analysis of digital pathology data in clinical trials. Applications have ranged in context and methodology, with some approaches yielding accurate predictions and insights. The challenges of applying ML lie primarily with the lack of interpretability and repeatability of ML-generated results, which may limit their application. In all areas, systematic and comprehensive high-dimensional data still need to be generated. With ongoing efforts to tackle these issues, as well as increasing awareness of the factors needed to validate ML approaches, the application of ML can promote data-driven decision making and has the potential to speed up the process and reduce failure rates in drug discovery and development. Machine learning has been applied to numerous stages in the drug discovery pipeline. Here, Vamathevan and colleagues discuss the most useful techniques and how machine learning can promote data-driven decision making in drug discovery and development. They highlight major hurdles in the field, such as the required data characteristics for applying machine learning, which will need to be solved as machine learning matures.

Applications of machine learning in drug discovery and development.

What has happened in machine learning lately, and what does it mean for the future of medical image analysis? Machine learning has witnessed a tremendous amount of attention over the last few years. The current boom started around 2009 when so-called deep artificial neural networks began outperforming other established models on a number of important benchmarks. Deep neural networks are now the state-of-the-art machine learning models across a variety of areas, from image analysis to natural language processing, and widely deployed in academia and industry. These developments have a huge potential for medical imaging technology, medical data analysis, medical diagnostics and healthcare in general, slowly being realized. We provide a short overview of recent advances and some associated challenges in machine learning applied to medical image processing and image analysis. As this has become a very broad and fast expanding field we will not survey the entire landscape of applications, but put particular focus on deep learning in MRI. 
Our aim is threefold: (i) give a brief introduction to deep learning with pointers to core references; (ii) indicate how deep learning has been applied to the entire MRI processing chain, from acquisition to image retrieval, from segmentation to disease prediction; (iii) provide a starting point for people interested in experimenting and perhaps contributing to the field of machine learning for medical imaging by pointing out good educational resources, state-of-the-art open-source code, and interesting sources of data and problems related medical imaging.

An overview of deep learning in medical imaging focusing on MRI

Image reconstruction is essential for imaging applications across the physical and life sciences, including optical and radar systems, magnetic resonance imaging, X-ray computed tomography, positron emission tomography, ultrasound imaging and radio astronomy. During image acquisition, the sensor encodes an intermediate representation of an object in the sensor domain, which is subsequently reconstructed into an image by an inversion of the encoding function. Image reconstruction is challenging because analytic knowledge of the exact inverse transform may not exist a priori, especially in the presence of sensor non-idealities and noise. Thus, the standard reconstruction approach involves approximating the inverse function with multiple ad hoc stages in a signal processing chain, the composition of which depends on the details of each acquisition strategy, and often requires expert parameter tuning to optimize reconstruction performance. Here we present a unified framework for image reconstruction-automated transform by manifold approximation (AUTOMAP)-which recasts image reconstruction as a data-driven supervised learning task that allows a mapping between the sensor and the image domain to emerge from an appropriate corpus of training data. We implement AUTOMAP with a deep neural network and exhibit its flexibility in learning reconstruction transforms for various magnetic resonance imaging acquisition strategies, using the same network architecture and hyperparameters. We further demonstrate that manifold learning during training results in sparse representations of domain transforms along low-dimensional data manifolds, and observe superior immunity to noise and a reduction in reconstruction artefacts compared with conventional handcrafted reconstruction methods. In addition to improving the reconstruction performance of existing acquisition methodologies, we anticipate that AUTOMAP and other learned reconstruction approaches will accelerate the development of new acquisition strategies across imaging modalities.

Image reconstruction by domain-transform manifold learning

Demonstrate a novel fast method for reconstruction of multi-dimensional MR fingerprinting (MRF) data using deep learning methods.A neural network (NN) is defined using the TensorFlow framework and trained on simulated MRF data computed with the extended phase graph formalism. The NN reconstruction accuracy for noiseless and noisy data is compared to conventional MRF template matching as a function of training data size and is quantified in simulated numerical brain phantom data and International Society for Magnetic Resonance in Medicine/National Institute of Standards and Technology phantom data measured on 1.5T and 3T scanners with an optimized MRF EPI and MRF fast imaging with steady state precession (FISP) sequences with spiral readout. The utility of the method is demonstrated in a healthy subject in vivo at 1.5T.Network training required 10 to 74 minutes; once trained, data reconstruction required approximately 10 ms for the MRF EPI and 76 ms for the MRF FISP sequence. Reconstruction of simulated, noiseless brain data using the NN resulted in a RMS error (RMSE) of 2.6 ms for T1 and 1.9 ms for T2 . The reconstruction error in the presence of noise was less than 10% for both T1 and T2 for SNR greater than 25 dB. Phantom measurements yielded good agreement (R2  = 0.99/0.99 for MRF EPI T1 /T2 and 0.94/0.98 for MRF FISP T1 /T2 ) between the T1 and T2 estimated by the NN and reference values from the International Society for Magnetic Resonance in Medicine/National Institute of Standards and Technology phantom.Reconstruction of MRF data with a NN is accurate, 300- to 5000-fold faster, and more robust to noise and dictionary undersampling than conventional MRF dictionary-matching.

MR fingerprinting Deep RecOnstruction NEtwork (DRONE)

Two lightweight block cipher families, Simon and Speck, have been proposed by researchers from the NSA recently. In this paper, we introduce Simeck, a new family of lightweight block ciphers that combines the good design components from both Simon and Speck, in order to devise even more compact and efficient block ciphers. For Simeck32/64, we can achieve 505 GEs (before the Place and Route phase) and 549 GEs (after the Place and Route phase), with the power consumption of 0.417 \(\mu W\) in CMOS 130 nm ASIC, and 454 GEs (before the Place and Route phase) and 488 GEs (after the Place and Route phase), with the power consumption of 1.292 \(\mu W\) in CMOS 65 nm ASIC. Furthermore, all of the instances of Simeck are smaller than the ones of hardware-optimized cipher Simon in terms of area and power consumption in both CMOS 130 nm and CMOS 65 nm techniques. In addition, we also give the security evaluation of Simeck with respect to many traditional cryptanalysis methods, including differential attacks, linear attacks, impossible differential attacks, meet-in-the-middle attacks, and slide attacks. Overall, all of the instances of Simeck can satisfy the area, power, and throughput requirements in passive RFID tags.

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The Simeck Family of Lightweight Block Ciphers

We introduce an integration of dynamic light scattering (DLS) and optical coherence tomography (OCT) for high-resolution 3D imaging of heterogeneous diffusion and flow. DLS analyzes fluctuations in light scattered by particles to measure diffusion or flow of the particles, and OCT uses coherence gating to collect light only scattered from a small volume for high-resolution structural imaging. Therefore, the integration of DLS and OCT enables high-resolution 3D imaging of diffusion and flow. We derived a theory under the assumption that static and moving particles are mixed within the OCT resolution volume and the moving particles can exhibit either diffusive or translational motion. Based on this theory, we developed a fitting algorithm to estimate dynamic parameters including the axial and transverse velocities and the diffusion coefficient. We validated DLS-OCT measurements of diffusion and flow through numerical simulations and phantom experiments. As an example application, we performed DLS-OCT imaging of the living animal brain, resulting in 3D maps of the absolute and axial velocities, the diffusion coefficient, and the coefficient of determination.

Dynamic light scattering optical coherence tomography

In this article, we present a novel two-scale framework to optimize the structure and the material distribution of an object given its functional specifications. Our approach utilizes multi-material microstructures as low-level building blocks of the object. We start by precomputing the material property gamut—the set of bulk material properties that can be achieved with all material microstructures of a given size. We represent the boundary of this material property gamut using a level set field. Next, we propose an efficient and general topology optimization algorithm that simultaneously computes an optimal object topology and spatially varying material properties constrained by the precomputed gamut. Finally, we map the optimal spatially varying material properties onto the microstructures with the corresponding properties to generate a high-resolution printable structure. We demonstrate the efficacy of our framework by designing, optimizing, and fabricating objects in different material property spaces on the level of a trillion voxels, that is, several orders of magnitude higher than what can be achieved with current systems.

Bo Zhu

Papers

Image reconstruction by domain-transform manifold learning

MR fingerprinting Deep RecOnstruction NEtwork (DRONE)

The Simeck Family of Lightweight Block Ciphers

Dynamic light scattering optical coherence tomography

Two-Scale Topology Optimization with Microstructures