Heatmap Regression for Lesion Detection using Pointwise Annotations

In many clinical contexts, detecting all lesions is imperative for evaluating disease activity. Standard approaches pose lesion detection as a segmentation problem despite the time-consuming nature of acquiring segmentation labels. In this paper, we present a lesion detection method which relies only on point labels. Our model, which is trained via heatmap regression, can detect a variable number of lesions in a probabilistic manner. In fact, our proposed post-processing method offers a reliable way of directly estimating the lesion existence uncertainty. Experimental results on Gad lesion detection show our point-based method performs competitively compared to training on expensive segmentation labels. Finally, our detection model provides a suitable pre-training for segmentation. When fine-tuning on only 17 segmentation samples, we achieve comparable performance to training with the full dataset.

Segmentation-Consistent Probabilistic Lesion Counting

Lesion counts are important indicators of disease severity, patient prognosis, and treatment efficacy, yet counting as a task in medical imaging is often overlooked in favor of segmentation. This work introduces a novel continuously differentiable function that maps lesion segmentation predictions to lesion count probability distributions in a consistent manner. The proposed end-to-end approach--which consists of voxel clustering, lesion-level voxel probability aggregation, and Poisson-binomial counting--is non-parametric and thus offers a robust and consistent way to augment lesion segmentation models with post hoc counting capabilities. Experiments on Gadolinium-enhancing lesion counting demonstrate that our method outputs accurate and well-calibrated count distributions that capture meaningful uncertainty information. They also reveal that our model is suitable for multi-task learning of lesion segmentation, is efficient in low data regimes, and is robust to adversarial attacks.