Uncertainty quantification for White Matter Hyperintensity segmentation detects silent failures and improves automated Fazekas quantification

White Matter Hyperintensities (WMH) are key neuroradiological markers of small vessel disease present in brain MRI. Assessment of WMH is important in research and clinics. However, WMH are challenging to segment due to their high variability in shape, location, size, poorly defined borders, and similar intensity profile to other pathologies (e.g stroke lesions) and artefacts (e.g head motion). In this work, we apply the most effective techniques for uncertainty quantification (UQ) in segmentation to the WMH segmentation task across multiple test-time data distributions. We find a combination of Stochastic Segmentation Networks with Deep Ensembles yields the highest Dice and lowest Absolute Volume Difference % (AVD) score on in-domain and out-of-distribution data. We demonstrate the downstream utility of UQ, proposing a novel method for classification of the clinical Fazekas score using spatial features extracted for WMH segmentation and UQ maps. We show that incorporating WMH uncertainty information improves Fazekas classification performance and calibration, with median class balanced accuracy for classification models with (UQ and spatial WMH features)/(spatial WMH features)/(WMH volume only) of 0.71/0.66/0.60 in the Deep WMH and 0.82/0.77/0.73 in the Periventricular WMH regions respectively. We demonstrate that stochastic UQ techniques with high sample diversity can improve the detection of poor quality segmentations. Finally, we qualitatively analyse the semantic information captured by UQ techniques and demonstrate that uncertainty can highlight areas where there is ambiguity between WMH and stroke lesions, while identifying clusters of small WMH in deep white matter unsegmented by the model.

Sampling-Pattern-Agnostic MRI Reconstruction through Adaptive Consistency Enforcement with Diffusion Model

Magnetic Resonance Imaging (MRI) is a powerful, non-invasive diagnostic tool; however, its clinical applicability is constrained by prolonged acquisition times. Whilst present deep learning-based approaches have demonstrated potential in expediting MRI processes, these methods usually rely on known sampling patterns and exhibit limited generalisability to novel patterns. In the paper, we propose a sampling-pattern-agnostic MRI reconstruction method via a diffusion model through adaptive consistency enforcement. Our approach effectively reconstructs high-fidelity images with varied under-sampled acquisitions, generalising across contrasts and acceleration factors regardless of sampling trajectories. We train and validate across all contrasts in the MICCAI 2024 Cardiac MRI Reconstruction Challenge (CMRxRecon) dataset for the ``Random sampling CMR reconstruction'' task. Evaluation results indicate that our proposed method significantly outperforms baseline methods.

SGSR: Structure-Guided Multi-Contrast MRI Super-Resolution via Spatio-Frequency Co-Query Attention

Magnetic Resonance Imaging (MRI) is a leading diagnostic modality for a wide range of exams, where multiple contrast images are often acquired for characterizing different tissues. However, acquiring high-resolution MRI typically extends scan time, which can introduce motion artifacts. Super-resolution of MRI therefore emerges as a promising approach to mitigate these challenges. Earlier studies have investigated the use of multiple contrasts for MRI super-resolution (MCSR), whereas majority of them did not fully exploit the rich contrast-invariant structural information. To fully utilize such crucial prior knowledge of multi-contrast MRI, in this work, we propose a novel structure-guided MCSR (SGSR) framework based on a new spatio-frequency co-query attention (CQA) mechanism. Specifically, CQA performs attention on features of multiple contrasts with a shared structural query, which is particularly designed to extract, fuse, and refine the common structures from different contrasts. We further propose a novel frequency-domain CQA module in addition to the spatial domain, to enable more fine-grained structural refinement. Extensive experiments on fastMRI knee data and low-field brain MRI show that SGSR outperforms state-of-the-art MCSR methods with statistical significance.

CAR: Contrast-Agnostic Deformable Medical Image Registration with Contrast-Invariant Latent Regularization

Multi-contrast image registration is a challenging task due to the complex intensity relationships between different imaging contrasts. Conventional image registration methods are typically based on iterative optimizations for each input image pair, which is time-consuming and sensitive to contrast variations. While learning-based approaches are much faster during the inference stage, due to generalizability issues, they typically can only be applied to the fixed contrasts observed during the training stage. In this work, we propose a novel contrast-agnostic deformable image registration framework that can be generalized to arbitrary contrast images, without observing them during training. Particularly, we propose a random convolution-based contrast augmentation scheme, which simulates arbitrary contrasts of images over a single image contrast while preserving their inherent structural information. To ensure that the network can learn contrast-invariant representations for facilitating contrast-agnostic registration, we further introduce contrast-invariant latent regularization (CLR) that regularizes representation in latent space through a contrast invariance loss. Experiments show that CAR outperforms the baseline approaches regarding registration accuracy and also possesses better generalization ability to unseen imaging contrasts. Code is available at \url{https://github.com/Yinsong0510/CAR}.

TIP: Tabular-Image Pre-training for Multimodal Classification with Incomplete Data

Images and structured tables are essential parts of real-world databases. Though tabular-image representation learning is promising to create new insights, it remains a challenging task, as tabular data is typically heterogeneous and incomplete, presenting significant modality disparities with images. Earlier works have mainly focused on simple modality fusion strategies in complete data scenarios, without considering the missing data issue, and thus are limited in practice. In this paper, we propose TIP, a novel tabular-image pre-training framework for learning multimodal representations robust to incomplete tabular data. Specifically, TIP investigates a novel self-supervised learning (SSL) strategy, including a masked tabular reconstruction task for tackling data missingness, and image-tabular matching and contrastive learning objectives to capture multimodal information. Moreover, TIP proposes a versatile tabular encoder tailored for incomplete, heterogeneous tabular data and a multimodal interaction module for inter-modality representation learning. Experiments are performed on downstream multimodal classification tasks using both natural and medical image datasets. The results show that TIP outperforms state-of-the-art supervised/SSL image/multimodal algorithms in both complete and incomplete data scenarios. Our code is available at https://github.com/siyi-wind/TIP.

CMRxRecon2024: A Multi-Modality, Multi-View K-Space Dataset Boosting Universal Machine Learning for Accelerated Cardiac MRI

Cardiac magnetic resonance imaging (MRI) has emerged as a clinically gold-standard technique for diagnosing cardiac diseases, thanks to its ability to provide diverse information with multiple modalities and anatomical views. Accelerated cardiac MRI is highly expected to achieve time-efficient and patient-friendly imaging, and then advanced image reconstruction approaches are required to recover high-quality, clinically interpretable images from undersampled measurements. However, the lack of publicly available cardiac MRI k-space dataset in terms of both quantity and diversity has severely hindered substantial technological progress, particularly for data-driven artificial intelligence. Here, we provide a standardized, diverse, and high-quality CMRxRecon2024 dataset to facilitate the technical development, fair evaluation, and clinical transfer of cardiac MRI reconstruction approaches, towards promoting the universal frameworks that enable fast and robust reconstructions across different cardiac MRI protocols in clinical practice. To the best of our knowledge, the CMRxRecon2024 dataset is the largest and most diverse publicly available cardiac k-space dataset. It is acquired from 330 healthy volunteers, covering commonly used modalities, anatomical views, and acquisition trajectories in clinical cardiac MRI workflows. Besides, an open platform with tutorials, benchmarks, and data processing tools is provided to facilitate data usage, advanced method development, and fair performance evaluation.

Neural Ordinary Differential Equation based Sequential Image Registration for Dynamic Characterization

Deformable image registration (DIR) is crucial in medical image analysis, enabling the exploration of biological dynamics such as organ motions and longitudinal changes in imaging. Leveraging Neural Ordinary Differential Equations (ODE) for registration, this extension work discusses how this framework can aid in the characterization of sequential biological processes. Utilizing the Neural ODE's ability to model state derivatives with neural networks, our Neural Ordinary Differential Equation Optimization-based (NODEO) framework considers voxels as particles within a dynamic system, defining deformation fields through the integration of neural differential equations. This method learns dynamics directly from data, bypassing the need for physical priors, making it exceptionally suitable for medical scenarios where such priors are unavailable or inapplicable. Consequently, the framework can discern underlying dynamics and use sequence data to regularize the transformation trajectory. We evaluated our framework on two clinical datasets: one for cardiac motion tracking and another for longitudinal brain MRI analysis. Demonstrating its efficacy in both 2D and 3D imaging scenarios, our framework offers flexibility and model agnosticism, capable of managing image sequences and facilitating label propagation throughout these sequences. This study provides a comprehensive understanding of how the Neural ODE-based framework uniquely benefits the image registration challenge.

The state-of-the-art in Cardiac MRI Reconstruction: Results of the CMRxRecon Challenge in MICCAI 2023

Cardiac MRI, crucial for evaluating heart structure and function, faces limitations like slow imaging and motion artifacts. Undersampling reconstruction, especially data-driven algorithms, has emerged as a promising solution to accelerate scans and enhance imaging performance using highly under-sampled data. Nevertheless, the scarcity of publicly available cardiac k-space datasets and evaluation platform hinder the development of data-driven reconstruction algorithms. To address this issue, we organized the Cardiac MRI Reconstruction Challenge (CMRxRecon) in 2023, in collaboration with the 26th International Conference on MICCAI. CMRxRecon presented an extensive k-space dataset comprising cine and mapping raw data, accompanied by detailed annotations of cardiac anatomical structures. With overwhelming participation, the challenge attracted more than 285 teams and over 600 participants. Among them, 22 teams successfully submitted Docker containers for the testing phase, with 7 teams submitted for both cine and mapping tasks. All teams use deep learning based approaches, indicating that deep learning has predominately become a promising solution for the problem. The first-place winner of both tasks utilizes the E2E-VarNet architecture as backbones. In contrast, U-Net is still the most popular backbone for both multi-coil and single-coil reconstructions. This paper provides a comprehensive overview of the challenge design, presents a summary of the submitted results, reviews the employed methods, and offers an in-depth discussion that aims to inspire future advancements in cardiac MRI reconstruction models. The summary emphasizes the effective strategies observed in Cardiac MRI reconstruction, including backbone architecture, loss function, pre-processing techniques, physical modeling, and model complexity, thereby providing valuable insights for further developments in this field.

Inference Stage Denoising for Undersampled MRI Reconstruction

Reconstruction of magnetic resonance imaging (MRI) data has been positively affected by deep learning. A key challenge remains: to improve generalisation to distribution shifts between the training and testing data. Most approaches aim to address this via inductive design or data augmentation. However, they can be affected by misleading data, e.g. random noise, and cases where the inference stage data do not match assumptions in the modelled shifts. In this work, by employing a conditional hyperparameter network, we eliminate the need of augmentation, yet maintain robust performance under various levels of Gaussian noise. We demonstrate that our model withstands various input noise levels while producing high-definition reconstructions during the test stage. Moreover, we present a hyperparameter sampling strategy that accelerates the convergence of training. Our proposed method achieves the highest accuracy and image quality in all settings compared to baseline methods.

VAE-IF: Deep feature extraction with averaging for unsupervised artifact detection in routine acquired ICU time-series

Artifacts are a common problem in physiological time-series data collected from intensive care units (ICU) and other settings. They affect the quality and reliability of clinical research and patient care. Manual annotation of artifacts is costly and time-consuming, rendering it impractical. Automated methods are desired. Here, we propose a novel unsupervised approach to detect artifacts in clinical-standard minute-by-minute resolution ICU data without any prior labeling or signal-specific knowledge. Our approach combines a variational autoencoder (VAE) and an isolation forest (iForest) model to learn features and identify anomalies in different types of vital signs, such as blood pressure, heart rate, and intracranial pressure. We evaluate our approach on a real-world ICU dataset and compare it with supervised models based on long short-term memory (LSTM) and XGBoost. We show that our approach achieves comparable sensitivity and generalizes well to an external dataset. We also visualize the latent space learned by the VAE and demonstrate its ability to disentangle clean and noisy samples. Our approach offers a promising solution for cleaning ICU data in clinical research and practice without the need for any labels whatsoever.