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  1. Al-Shabi M, Shak K, Tan M
    Int J Comput Assist Radiol Surg, 2021 Aug;16(8):1319-1324.
    PMID: 34060010 DOI: 10.1007/s11548-021-02415-z
    PURPOSE: In recent years, Non-Local-based methods have been successfully applied to lung nodule classification. However, these methods offer 2D attention or limited 3D attention to low-resolution feature maps. Moreover, they still depend on a convenient local filter such as convolution as full 3D attention is expensive to compute and requires a big dataset, which might not be available.

    METHODS: We propose to use 3D Axial-Attention, which requires a fraction of the computing power of a regular Non-Local network (i.e., self-attention). Unlike a regular Non-Local network, the 3D Axial-Attention network applies the attention operation to each axis separately. Additionally, we solve the invariant position problem of the Non-Local network by proposing to add 3D positional encoding to shared embeddings.

    RESULTS: We validated the proposed method on 442 benign nodules and 406 malignant nodules, extracted from the public LIDC-IDRI dataset by following a rigorous experimental setup using only nodules annotated by at least three radiologists. Our results show that the 3D Axial-Attention model achieves state-of-the-art performance on all evaluation metrics, including AUC and Accuracy.

    CONCLUSIONS: The proposed model provides full 3D attention, whereby every element (i.e., pixel) in the 3D volume space attends to every other element in the nodule effectively. Thus, the 3D Axial-Attention network can be used in all layers without the need for local filters. The experimental results show the importance of full 3D attention for classifying lung nodules.

  2. Al-Shabi M, Lan BL, Chan WY, Ng KH, Tan M
    Int J Comput Assist Radiol Surg, 2019 Oct;14(10):1815-1819.
    PMID: 31020576 DOI: 10.1007/s11548-019-01981-7
    PURPOSE: Lung nodules have very diverse shapes and sizes, which makes classifying them as benign/malignant a challenging problem. In this paper, we propose a novel method to predict the malignancy of nodules that have the capability to analyze the shape and size of a nodule using a global feature extractor, as well as the density and structure of the nodule using a local feature extractor.

    METHODS: We propose to use Residual Blocks with a 3 × 3 kernel size for local feature extraction and Non-Local Blocks to extract the global features. The Non-Local Block has the ability to extract global features without using a huge number of parameters. The key idea behind the Non-Local Block is to apply matrix multiplications between features on the same feature maps.

    RESULTS: We trained and validated the proposed method on the LIDC-IDRI dataset which contains 1018 computed tomography scans. We followed a rigorous procedure for experimental setup, namely tenfold cross-validation, and ignored the nodules that had been annotated by

  3. Tan M, Al-Shabi M, Chan WY, Thomas L, Rahmat K, Ng KH
    Med Biol Eng Comput, 2021 Feb;59(2):355-367.
    PMID: 33447988 DOI: 10.1007/s11517-021-02313-1
    This study objectively evaluates the similarity between standard full-field digital mammograms and two-dimensional synthesized digital mammograms (2DSM) in a cohort of women undergoing mammography. Under an institutional review board-approved data collection protocol, we retrospectively analyzed 407 women with digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM) examinations performed from September 1, 2014, through February 29, 2016. Both FFDM and 2DSM images were used for the analysis, and 3216 available craniocaudal (CC) and mediolateral oblique (MLO) view mammograms altogether were included in the dataset. We analyzed the mammograms using a fully automated algorithm that computes 152 structural similarity, texture, and mammographic density-based features. We trained and developed two different global mammographic image feature analysis-based breast cancer detection schemes for 2DSM and FFDM images, respectively. The highest structural similarity features were obtained on the coarse Weber Local Descriptor differential excitation texture feature component computed on the CC view images (0.8770) and MLO view images (0.8889). Although the coarse structures are similar, the global mammographic image feature-based cancer detection scheme trained on 2DSM images outperformed the corresponding scheme trained on FFDM images, with area under a receiver operating characteristic curve (AUC) = 0.878 ± 0.034 and 0.756 ± 0.052, respectively. Consequently, further investigation is required to examine whether DBT can replace FFDM as a standalone technique, especially for the development of automated objective-based methods.
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