Gadolinium dose reduction for brain MRI using conditional deep learning

Recently, deep learning (DL)-based methods have been proposed for the computational reduction of gadolinium-based contrast agents (GBCAs) to mitigate adverse side effects while preserving diagnostic value. Currently, the two main challenges for these approaches are the accurate prediction of contrast enhancement and the synthesis of realistic images. In this work, we address both challenges by utilizing the contrast signal encoded in the subtraction images of pre-contrast and post-contrast image pairs. To avoid the synthesis of any noise or artifacts and solely focus on contrast signal extraction and enhancement from low-dose subtraction images, we train our DL model using noise-free standard-dose subtraction images as targets. As a result, our model predicts the contrast enhancement signal only; thereby enabling synthesization of images beyond the standard dose. Furthermore, we adapt the embedding idea of recent diffusion-based models to condition our model on physical parameters affecting the contrast enhancement behavior. We demonstrate the effectiveness of our approach on synthetic and real datasets using various scanners, field strengths, and contrast agents.

Product of Gaussian Mixture Diffusion Models

In this work we tackle the problem of estimating the density $ f_X $ of a random variable $ X $ by successive smoothing, such that the smoothed random variable $ Y $ fulfills the diffusion partial differential equation $ (\partial_t - \Delta_1)f_Y(\,\cdot\,, t) = 0 $ with initial condition $ f_Y(\,\cdot\,, 0) = f_X $. We propose a product-of-experts-type model utilizing Gaussian mixture experts and study configurations that admit an analytic expression for $ f_Y (\,\cdot\,, t) $. In particular, with a focus on image processing, we derive conditions for models acting on filter-, wavelet-, and shearlet responses. Our construction naturally allows the model to be trained simultaneously over the entire diffusion horizon using empirical Bayes. We show numerical results for image denoising where our models are competitive while being tractable, interpretable, and having only a small number of learnable parameters. As a byproduct, our models can be used for reliable noise estimation, allowing blind denoising of images corrupted by heteroscedastic noise.

Faithful Synthesis of Low-dose Contrast-enhanced Brain MRI Scans using Noise-preserving Conditional GANs

Today Gadolinium-based contrast agents (GBCA) are indispensable in Magnetic Resonance Imaging (MRI) for diagnosing various diseases. However, GBCAs are expensive and may accumulate in patients with potential side effects, thus dose-reduction is recommended. Still, it is unclear to which extent the GBCA dose can be reduced while preserving the diagnostic value -- especially in pathological regions. To address this issue, we collected brain MRI scans at numerous non-standard GBCA dosages and developed a conditional GAN model for synthesizing corresponding images at fractional dose levels. Along with the adversarial loss, we advocate a novel content loss function based on the Wasserstein distance of locally paired patch statistics for the faithful preservation of noise. Our numerical experiments show that conditional GANs are suitable for generating images at different GBCA dose levels and can be used to augment datasets for virtual contrast models. Moreover, our model can be transferred to openly available datasets such as BraTS, where non-standard GBCA dosage images do not exist.

Learning Gradually Non-convex Image Priors Using Score Matching

In this paper, we propose a unified framework of denoising score-based models in the context of graduated non-convex energy minimization. We show that for sufficiently large noise variance, the associated negative log density -- the energy -- becomes convex. Consequently, denoising score-based models essentially follow a graduated non-convexity heuristic. We apply this framework to learning generalized Fields of Experts image priors that approximate the joint density of noisy images and their associated variances. These priors can be easily incorporated into existing optimization algorithms for solving inverse problems and naturally implement a fast and robust graduated non-convexity mechanism.

Explicit Diffusion of Gaussian Mixture Model Based Image Priors

In this work we tackle the problem of estimating the density $f_X$ of a random variable $X$ by successive smoothing, such that the smoothed random variable $Y$ fulfills $(\partial_t - \Delta_1)f_Y(\,\cdot\,, t) = 0$, $f_Y(\,\cdot\,, 0) = f_X$. With a focus on image processing, we propose a product/fields of experts model with Gaussian mixture experts that admits an analytic expression for $f_Y (\,\cdot\,, t)$ under an orthogonality constraint on the filters. This construction naturally allows the model to be trained simultaneously over the entire diffusion horizon using empirical Bayes. We show preliminary results on image denoising where our model leads to competitive results while being tractable, interpretable, and having only a small number of learnable parameters. As a byproduct, our model can be used for reliable noise estimation, allowing blind denoising of images corrupted by heteroscedastic noise.

Computed Tomography Reconstruction using Generative Energy-Based Priors

In the past decades, Computed Tomography (CT) has established itself as one of the most important imaging techniques in medicine. Today, the applicability of CT is only limited by the deposited radiation dose, reduction of which manifests in noisy or incomplete measurements. Thus, the need for robust reconstruction algorithms arises. In this work, we learn a parametric regularizer with a global receptive field by maximizing it's likelihood on reference CT data. Due to this unsupervised learning strategy, our trained regularizer truly represents higher-level domain statistics, which we empirically demonstrate by synthesizing CT images. Moreover, this regularizer can easily be applied to different CT reconstruction problems by embedding it in a variational framework, which increases flexibility and interpretability compared to feed-forward learning-based approaches. In addition, the accompanying probabilistic perspective enables experts to explore the full posterior distribution and may quantify uncertainty of the reconstruction approach. We apply the regularizer to limited-angle and few-view CT reconstruction problems, where it outperforms traditional reconstruction algorithms by a large margin.

Bayesian Uncertainty Estimation of Learned Variational MRI Reconstruction

Recent deep learning approaches focus on improving quantitative scores of dedicated benchmarks, and therefore only reduce the observation-related (aleatoric) uncertainty. However, the model-immanent (epistemic) uncertainty is less frequently systematically analyzed. In this work, we introduce a Bayesian variational framework to quantify the epistemic uncertainty. To this end, we solve the linear inverse problem of undersampled MRI reconstruction in a variational setting. The associated energy functional is composed of a data fidelity term and the total deep variation (TDV) as a learned parametric regularizer. To estimate the epistemic uncertainty we draw the parameters of the TDV regularizer from a multivariate Gaussian distribution, whose mean and covariance matrix are learned in a stochastic optimal control problem. In several numerical experiments, we demonstrate that our approach yields competitive results for undersampled MRI reconstruction. Moreover, we can accurately quantify the pixelwise epistemic uncertainty, which can serve radiologists as an additional resource to visualize reconstruction reliability.

Shared Prior Learning of Energy-Based Models for Image Reconstruction

We propose a novel learning-based framework for image reconstruction particularly designed for training without ground truth data, which has three major building blocks: energy-based learning, a patch-based Wasserstein loss functional, and shared prior learning. In energy-based learning, the parameters of an energy functional composed of a learned data fidelity term and a data-driven regularizer are computed in a mean-field optimal control problem. In the absence of ground truth data, we change the loss functional to a patch-based Wasserstein functional, in which local statistics of the output images are compared to uncorrupted reference patches. Finally, in shared prior learning, both aforementioned optimal control problems are optimized simultaneously with shared learned parameters of the regularizer to further enhance unsupervised image reconstruction. We derive several time discretization schemes of the gradient flow and verify their consistency in terms of Mosco convergence. In numerous numerical experiments, we demonstrate that the proposed method generates state-of-the-art results for various image reconstruction applications--even if no ground truth images are available for training.

Accelerating Prostate Diffusion Weighted MRI using Guided Denoising Convolutional Neural Network: Retrospective Feasibility Study

Purpose: To investigate feasibility of accelerating prostate diffusion-weighted imaging (DWI) by reducing the number of acquired averages and denoising the resulting image using a proposed guided denoising convolutional neural network (DnCNN). Materials and Methods: Raw data from the prostate DWI scans were retrospectively gathered (between July 2018 and July 2019) from six single-vendor MRI scanners. 118 data sets were used for training and validation (age: 64.3 +- 8 years) and 37 - for testing (age: 65.1 +- 7.3 years). High b-value diffusion-weighted (hb-DW) data were reconstructed into noisy images using two averages and reference images using all sixteen averages. A conventional DnCNN was modified into a guided DnCNN, which uses the low b-value DWI image as a guidance input. Quantitative and qualitative reader evaluations were performed on the denoised hb-DW images. A cumulative link mixed regression model was used to compare the readers scores. The agreement between the apparent diffusion coefficient (ADC) maps (denoised vs reference) was analyzed using Bland Altman analysis. Results: Compared to the DnCNN, the guided DnCNN produced denoised hb-DW images with higher peak signal-to-noise ratio and structural similarity index and lower normalized mean square error (p < 0.001). Compared to the reference images, the denoised images received higher image quality scores (p < 0.0001). The ADC values based on the denoised hb-DW images were in good agreement with the reference ADC values. Conclusion: Accelerating prostate DWI by reducing the number of acquired averages and denoising the resulting image using the proposed guided DnCNN is technically feasible.

Total Deep Variation: A Stable Regularizer for Inverse Problems

Various problems in computer vision and medical imaging can be cast as inverse problems. A frequent method for solving inverse problems is the variational approach, which amounts to minimizing an energy composed of a data fidelity term and a regularizer. Classically, handcrafted regularizers are used, which are commonly outperformed by state-of-the-art deep learning approaches. In this work, we combine the variational formulation of inverse problems with deep learning by introducing the data-driven general-purpose total deep variation regularizer. In its core, a convolutional neural network extracts local features on multiple scales and in successive blocks. This combination allows for a rigorous mathematical analysis including an optimal control formulation of the training problem in a mean-field setting and a stability analysis with respect to the initial values and the parameters of the regularizer. In addition, we experimentally verify the robustness against adversarial attacks and numerically derive upper bounds for the generalization error. Finally, we achieve state-of-the-art results for numerous imaging tasks.