An Artificial Agent for Anatomical Landmark Detection in Medical Images

Fast and robust detection of anatomical structures or pathologies represents a fundamental task in medical image analysis. Most of the current solutions are however suboptimal and unconstrained by learning an appearance model and exhaustively scanning the space of parameters to detect a specific anatomical structure. In addition, typical feature computation or estimation of meta-parameters related to the appearance model or the search strategy, is based on local criteria or predefined approximation schemes. We propose a new learning method following a fundamentally different paradigm by simultaneously modeling both the object appearance and the parameter search strategy as a unified behavioral task for an artificial agent. The method combines the advantages of behavior learning achieved through reinforcement learning with effective hierarchical feature extraction achieved through deep learning. We show that given only a sequence of annotated images, the agent can automatically and strategically learn optimal paths that converge to the sought anatomical landmark location as opposed to exhaustively scanning the entire solution space. The method significantly outperforms state-of-theart machine learning and deep learning approaches both in terms of accuracy and speed on 2D magnetic resonance images, 2D ultrasound and 3D CT images, achieving average detection errors of 1-2 pixels, while also recognizing the absence of an object from the image.