Federated Voxel Scene Graph for Intracranial Hemorrhage

Intracranial Hemorrhage is a potentially lethal condition whose manifestation is vastly diverse and shifts across clinical centers worldwide. Deep-learning-based solutions are starting to model complex relations between brain structures, but still struggle to generalize. While gathering more diverse data is the most natural approach, privacy regulations often limit the sharing of medical data. We propose the first application of Federated Scene Graph Generation. We show that our models can leverage the increased training data diversity. For Scene Graph Generation, they can recall up to 20% more clinically relevant relations across datasets compared to models trained on a single centralized dataset. Learning structured data representation in a federated setting can open the way to the development of new methods that can leverage this finer information to regularize across clients more effectively.

NCAdapt: Dynamic adaptation with domain-specific Neural Cellular Automata for continual hippocampus segmentation

Continual learning (CL) in medical imaging presents a unique challenge, requiring models to adapt to new domains while retaining previously acquired knowledge. We introduce NCAdapt, a Neural Cellular Automata (NCA) based method designed to address this challenge. NCAdapt features a domain-specific multi-head structure, integrating adaptable convolutional layers into the NCA backbone for each new domain encountered. After initial training, the NCA backbone is frozen, and only the newly added adaptable convolutional layers, consisting of 384 parameters, are trained along with domain-specific NCA convolutions. We evaluate NCAdapt on hippocampus segmentation tasks, benchmarking its performance against Lifelong nnU-Net and U-Net models with state-of-the-art (SOTA) CL methods. Our lightweight approach achieves SOTA performance, underscoring its effectiveness in addressing CL challenges in medical imaging. Upon acceptance, we will make our code base publicly accessible to support reproducibility and foster further advancements in medical CL.

NCA-Morph: Medical Image Registration with Neural Cellular Automata

Medical image registration is a critical process that aligns various patient scans, facilitating tasks like diagnosis, surgical planning, and tracking. Traditional optimization based methods are slow, prompting the use of Deep Learning (DL) techniques, such as VoxelMorph and Transformer-based strategies, for faster results. However, these DL methods often impose significant resource demands. In response to these challenges, we present NCA-Morph, an innovative approach that seamlessly blends DL with a bio-inspired communication and networking approach, enabled by Neural Cellular Automata (NCAs). NCA-Morph not only harnesses the power of DL for efficient image registration but also builds a network of local communications between cells and respective voxels over time, mimicking the interaction observed in living systems. In our extensive experiments, we subject NCA-Morph to evaluations across three distinct 3D registration tasks, encompassing Brain, Prostate and Hippocampus images from both healthy and diseased patients. The results showcase NCA-Morph's ability to achieve state-of-the-art performance. Notably, NCA-Morph distinguishes itself as a lightweight architecture with significantly fewer parameters; 60% and 99.7% less than VoxelMorph and TransMorph. This characteristic positions NCA-Morph as an ideal solution for resource-constrained medical applications, such as primary care settings and operating rooms.

Detection of Intracranial Hemorrhage for Trauma Patients

Whole-body CT is used for multi-trauma patients in the search of any and all injuries. Since an initial assessment needs to be rapid and the search for lesions is done for the whole body, very little time can be allocated for the inspection of a specific anatomy. In particular, intracranial hemorrhages are still missed, especially by clinical students. In this work, we present a Deep Learning approach for highlighting such lesions to improve the diagnostic accuracy. While most works on intracranial hemorrhages perform segmentation, detection only requires bounding boxes for the localization of the bleeding. In this paper, we propose a novel Voxel-Complete IoU (VC-IoU) loss that encourages the network to learn the 3D aspect ratios of bounding boxes and leads to more precise detections. We extensively experiment on brain bleeding detection using a publicly available dataset, and validate it on a private cohort, where we achieve 0.877 AR30, 0.728 AP30, and 0.653 AR30, 0.514 AP30 respectively. These results constitute a relative +5% improvement in Average Recall for both datasets compared to other loss functions. Finally, as there is little data currently publicly available for 3D object detection and as annotation resources are limited in the clinical setting, we evaluate the cost of different annotation methods, as well as the impact of imprecise bounding boxes in the training data on the detection performance.

Voxel Scene Graph for Intracranial Hemorrhage

Patients with Intracranial Hemorrhage (ICH) face a potentially life-threatening condition, and patient-centered individualized treatment remains challenging due to possible clinical complications. Deep-Learning-based methods can efficiently analyze the routinely acquired head CTs to support the clinical decision-making. The majority of early work focuses on the detection and segmentation of ICH, but do not model the complex relations between ICH and adjacent brain structures. In this work, we design a tailored object detection method for ICH, which we unite with segmentation-grounded Scene Graph Generation (SGG) methods to learn a holistic representation of the clinical cerebral scene. To the best of our knowledge, this is the first application of SGG for 3D voxel images. We evaluate our method on two head-CT datasets and demonstrate that our model can recall up to 74% of clinically relevant relations. This work lays the foundation towards SGG for 3D voxel data. The generated Scene Graphs can already provide insights for the clinician, but are also valuable for all downstream tasks as a compact and interpretable representation.

Distribution-Aware Replay for Continual MRI Segmentation

Medical image distributions shift constantly due to changes in patient population and discrepancies in image acquisition. These distribution changes result in performance deterioration; deterioration that continual learning aims to alleviate. However, only adaptation with data rehearsal strategies yields practically desirable performance for medical image segmentation. Such rehearsal violates patient privacy and, as most continual learning approaches, overlooks unexpected changes from out-of-distribution instances. To transcend both of these challenges, we introduce a distribution-aware replay strategy that mitigates forgetting through auto-encoding of features, while simultaneously leveraging the learned distribution of features to detect model failure. We provide empirical corroboration on hippocampus and prostate MRI segmentation.

Unsupervised Training of Neural Cellular Automata on Edge Devices

The disparity in access to machine learning tools for medical imaging across different regions significantly limits the potential for universal healthcare innovation, particularly in remote areas. Our research addresses this issue by implementing Neural Cellular Automata (NCA) training directly on smartphones for accessible X-ray lung segmentation. We confirm the practicality and feasibility of deploying and training these advanced models on five Android devices, improving medical diagnostics accessibility and bridging the tech divide to extend machine learning benefits in medical imaging to low- and middle-income countries (LMICs). We further enhance this approach with an unsupervised adaptation method using the novel Variance-Weighted Segmentation Loss (VWSL), which efficiently learns from unlabeled data by minimizing the variance from multiple NCA predictions. This strategy notably improves model adaptability and performance across diverse medical imaging contexts without the need for extensive computational resources or labeled datasets, effectively lowering the participation threshold. Our methodology, tested on three multisite X-ray datasets -- Padchest, ChestX-ray8, and MIMIC-III -- demonstrates improvements in segmentation Dice accuracy by 0.7 to 2.8%, compared to the classic Med-NCA. Additionally, in extreme cases where no digital copy is available and images must be captured by a phone from an X-ray lightbox or monitor, VWSL enhances Dice accuracy by 5-20%, demonstrating the method's robustness even with suboptimal image sources.

Frequency-Time Diffusion with Neural Cellular Automata

Denoising Diffusion Models (DDMs) have become the leading generative technique for synthesizing high-quality images but are often constrained by their UNet-based architectures that impose certain limitations. In particular, the considerable size of often hundreds of millions of parameters makes them impractical when hardware resources are limited. However, even with powerful hardware, processing images in the gigapixel range is difficult. This is especially true in fields such as microscopy or satellite imaging, where such challenges arise from the limitation to a predefined generative size and the inefficient scaling to larger images. We present two variations of Neural Cellular Automata (NCA)-based DDM methods to address these challenges and jumpstart NCA-based DDMs: Diff-NCA and FourierDiff-NCA. Diff-NCA performs diffusion by using only local features of the underlying distribution, making it suitable for applications where local features are critical. To communicate global knowledge in image space, naive NCA setups require timesteps that increase with the image scale. We solve this bottleneck of current NCA architectures by introducing FourierDiff-NCA, which advances Diff-NCA by adding a Fourier-based diffusion process and combines the frequency-organized Fourier space with the image space. By initiating diffusion in the Fourier domain and finalizing it in the image space, FourierDiff-NCA accelerates global communication. We validate our techniques by using Diff-NCA (208k parameters) to generate high-resolution digital pathology scans at 576x576 resolution and FourierDiff-NCA (887k parameters) to synthesize CelebA images at 64x64, outperforming VNCA and five times bigger UNet-based DDMs. In addition, we demonstrate FourierDiff-NCA's capabilities in super-resolution, OOD image synthesis, and inpainting without additional training.

Continual atlas-based segmentation of prostate MRI

Continual learning (CL) methods designed for natural image classification often fail to reach basic quality standards for medical image segmentation. Atlas-based segmentation, a well-established approach in medical imaging, incorporates domain knowledge on the region of interest, leading to semantically coherent predictions. This is especially promising for CL, as it allows us to leverage structural information and strike an optimal balance between model rigidity and plasticity over time. When combined with privacy-preserving prototypes, this process offers the advantages of rehearsal-based CL without compromising patient privacy. We propose Atlas Replay, an atlas-based segmentation approach that uses prototypes to generate high-quality segmentation masks through image registration that maintain consistency even as the training distribution changes. We explore how our proposed method performs compared to state-of-the-art CL methods in terms of knowledge transferability across seven publicly available prostate segmentation datasets. Prostate segmentation plays a vital role in diagnosing prostate cancer, however, it poses challenges due to substantial anatomical variations, benign structural differences in older age groups, and fluctuating acquisition parameters. Our results show that Atlas Replay is both robust and generalizes well to yet-unseen domains while being able to maintain knowledge, unlike end-to-end segmentation methods. Our code base is available under https://github.com/MECLabTUDA/Atlas-Replay.

From Pointwise to Powerhouse: Initialising Neural Networks with Generative Models

Traditional initialisation methods, e.g. He and Xavier, have been effective in avoiding the problem of vanishing or exploding gradients in neural networks. However, they only use simple pointwise distributions, which model one-dimensional variables. Moreover, they ignore most information about the architecture and disregard past training experiences. These limitations can be overcome by employing generative models for initialisation. In this paper, we introduce two groups of new initialisation methods. First, we locally initialise weight groups by employing variational autoencoders. Secondly, we globally initialise full weight sets by employing graph hypernetworks. We thoroughly evaluate the impact of the employed generative models on state-of-the-art neural networks in terms of accuracy, convergence speed and ensembling. Our results show that global initialisations result in higher accuracy and faster initial convergence speed. However, the implementation through graph hypernetworks leads to diminished ensemble performance on out of distribution data. To counteract, we propose a modification called noise graph hypernetwork, which encourages diversity in the produced ensemble members. Furthermore, our approach might be able to transfer learned knowledge to different image distributions. Our work provides insights into the potential, the trade-offs and possible modifications of these new initialisation methods.