Ensemble learning of the atrial fiber orientation with physics-informed neural networks

The anisotropic structure of the myocardium is a key determinant of the cardiac function. To date, there is no imaging modality to assess in-vivo the cardiac fiber structure. We recently proposed Fibernet, a method for the automatic identification of the anisotropic conduction -- and thus fibers -- in the atria from local electrical recordings. Fibernet uses cardiac activation as recorded during electroanatomical mappings to infer local conduction properties using physics-informed neural networks. In this work, we extend Fibernet to cope with the uncertainty in the estimated fiber field. Specifically, we use an ensemble of neural networks to produce multiple samples, all fitting the observed data, and compute posterior statistics. We also introduce a methodology to select the best fiber orientation members and define the input of the neural networks directly on the atrial surface. With these improvements, we outperform the previous methodology in terms of fiber orientation error in 8 different atrial anatomies. Currently, our approach can estimate the fiber orientation and conduction velocities in under 7 minutes with quantified uncertainty, which opens the door to its application in clinical practice. We hope the proposed methodology will enable further personalization of cardiac digital twins for precision medicine.

Understanding the dynamics of the frequency bias in neural networks

Recent works have shown that traditional Neural Network (NN) architectures display a marked frequency bias in the learning process. Namely, the NN first learns the low-frequency features before learning the high-frequency ones. In this study, we rigorously develop a partial differential equation (PDE) that unravels the frequency dynamics of the error for a 2-layer NN in the Neural Tangent Kernel regime. Furthermore, using this insight, we explicitly demonstrate how an appropriate choice of distributions for the initialization weights can eliminate or control the frequency bias. We focus our study on the Fourier Features model, an NN where the first layer has sine and cosine activation functions, with frequencies sampled from a prescribed distribution. In this setup, we experimentally validate our theoretical results and compare the NN dynamics to the solution of the PDE using the finite element method. Finally, we empirically show that the same principle extends to multi-layer NNs.

Self-Supervised k-Space Regularization for Motion-Resolved Abdominal MRI Using Neural Implicit k-Space Representation

Neural implicit k-space representations have shown promising results for dynamic MRI at high temporal resolutions. Yet, their exclusive training in k-space limits the application of common image regularization methods to improve the final reconstruction. In this work, we introduce the concept of parallel imaging-inspired self-consistency (PISCO), which we incorporate as novel self-supervised k-space regularization enforcing a consistent neighborhood relationship. At no additional data cost, the proposed regularization significantly improves neural implicit k-space reconstructions on simulated data. Abdominal in-vivo reconstructions using PISCO result in enhanced spatio-temporal image quality compared to state-of-the-art methods. Code is available at https://github.com/vjspi/PISCO-NIK.

Probabilistic learning of the Purkinje network from the electrocardiogram

The identification of the Purkinje conduction system in the heart is a challenging task, yet essential for a correct definition of cardiac digital twins for precision cardiology. Here, we propose a probabilistic approach for identifying the Purkinje network from non-invasive clinical data such as the standard electrocardiogram (ECG). We use cardiac imaging to build an anatomically accurate model of the ventricles; we algorithmically generate a rule-based Purkinje network tailored to the anatomy; we simulate physiological electrocardiograms with a fast model; we identify the geometrical and electrical parameters of the Purkinje-ECG model with Bayesian optimization and approximate Bayesian computation. The proposed approach is inherently probabilistic and generates a population of plausible Purkinje networks, all fitting the ECG within a given tolerance. In this way, we can estimate the uncertainty of the parameters, thus providing reliable predictions. We test our methodology in physiological and pathological scenarios, showing that we are able to accurately recover the ECG with our model. We propagate the uncertainty in the Purkinje network parameters in a simulation of conduction system pacing therapy. Our methodology is a step forward in creation of digital twins from non-invasive data in precision medicine. An open source implementation can be found at http://github.com/fsahli/purkinje-learning

Shape of my heart: Cardiac models through learned signed distance functions

The efficient construction of an anatomical model is one of the major challenges of patient-specific in-silico models of the human heart. Current methods frequently rely on linear statistical models, allowing no advanced topological changes, or requiring medical image segmentation followed by a meshing pipeline, which strongly depends on image resolution, quality, and modality. These approaches are therefore limited in their transferability to other imaging domains. In this work, the cardiac shape is reconstructed by means of three-dimensional deep signed distance functions with Lipschitz regularity. For this purpose, the shapes of cardiac MRI reconstructions are learned from public databases to model the spatial relation of multiple chambers in Cartesian space. We demonstrate that this approach is also capable of reconstructing anatomical models from partial data, such as point clouds from a single ventricle, or modalities different from the trained MRI, such as electroanatomical mapping, and in addition, allows us to generate new anatomical shapes by randomly sampling latent vectors.

Physics-informed neural networks for blood flow inverse problems

Physics-informed neural networks (PINNs) have emerged as a powerful tool for solving inverse problems, especially in cases where no complete information about the system is known and scatter measurements are available. This is especially useful in hemodynamics since the boundary information is often difficult to model, and high-quality blood flow measurements are generally hard to obtain. In this work, we use the PINNs methodology for estimating reduced-order model parameters and the full velocity field from scatter 2D noisy measurements in the ascending aorta. The results show stable and accurate parameter estimations when using the method with simulated data, while the velocity reconstruction shows dependence on the measurement quality and the flow pattern complexity. The method allows for solving clinical-relevant inverse problems in hemodynamics and complex coupled physical systems.

Unsupervised reconstruction of accelerated cardiac cine MRI using Neural Fields

Cardiac cine MRI is the gold standard for cardiac functional assessment, but the inherently slow acquisition process creates the necessity of reconstruction approaches for accelerated undersampled acquisitions. Several regularization approaches that exploit spatial-temporal redundancy have been proposed to reconstruct undersampled cardiac cine MRI. More recently, methods based on supervised deep learning have been also proposed to further accelerate acquisition and reconstruction. However, these techniques rely on usually large dataset for training, which are not always available. In this work, we propose an unsupervised approach based on implicit neural field representations for cardiac cine MRI (so called NF-cMRI). The proposed method was evaluated in in-vivo undersampled golden-angle radial multi-coil acquisitions for undersampling factors of 26x and 52x, achieving good image quality, and comparable spatial and improved temporal depiction than a state-of-the-art reconstruction technique.

WarpPINN: Cine-MR image registration with physics-informed neural networks

Heart failure is typically diagnosed with a global function assessment, such as ejection fraction. However, these metrics have low discriminate power, failing to distinguish different types of this disease. Quantifying local deformations in the form of cardiac strain can provide helpful information, but it remains a challenge. In this work, we introduce WarpPINN, a physics-informed neural network to perform image registration to obtain local metrics of the heart deformation. We apply this method to cine magnetic resonance images to estimate the motion during the cardiac cycle. We inform our neural network of near-incompressibility of cardiac tissue by penalizing the jacobian of the deformation field. The loss function has two components: an intensity-based similarity term between the reference and the warped template images, and a regularizer that represents the hyperelastic behavior of the tissue. The architecture of the neural network allows us to easily compute the strain via automatic differentiation to assess cardiac activity. We use Fourier feature mappings to overcome the spectral bias of neural networks, allowing us to capture discontinuities in the strain field. We test our algorithm on a synthetic example and on a cine-MRI benchmark of 15 healthy volunteers. We outperform current methodologies both landmark tracking and strain estimation. We expect that WarpPINN will enable more precise diagnostics of heart failure based on local deformation information. Source code is available at https://github.com/fsahli/WarpPINN.

$Δ$-PINNs: physics-informed neural networks on complex geometries

Physics-informed neural networks (PINNs) have demonstrated promise in solving forward and inverse problems involving partial differential equations. Despite recent progress on expanding the class of problems that can be tackled by PINNs, most of existing use-cases involve simple geometric domains. To date, there is no clear way to inform PINNs about the topology of the domain where the problem is being solved. In this work, we propose a novel positional encoding mechanism for PINNs based on the eigenfunctions of the Laplace-Beltrami operator. This technique allows to create an input space for the neural network that represents the geometry of a given object. We approximate the eigenfunctions as well as the operators involved in the partial differential equations with finite elements. We extensively test and compare the proposed methodology against traditional PINNs in complex shapes, such as a coil, a heat sink and a bunny, with different physics, such as the Eikonal equation and heat transfer. We also study the sensitivity of our method to the number of eigenfunctions used, as well as the discretization used for the eigenfunctions and the underlying operators. Our results show excellent agreement with the ground truth data in cases where traditional PINNs fail to produce a meaningful solution. We envision this new technique will expand the effectiveness of PINNs to more realistic applications.

Learning cardiac activation maps from 12-lead ECG with multi-fidelity Bayesian optimization on manifolds

We propose a method for identifying an ectopic activation in the heart non-invasively. Ectopic activity in the heart can trigger deadly arrhythmias. The localization of the ectopic foci or earliest activation sites (EASs) is therefore a critical information for cardiologists in deciding the optimal treatment. In this work, we formulate the identification problem as a global optimization problem, by minimizing the mismatch between the ECG predicted by a cardiac model, when paced at a given EAS, and the observed ECG during the ectopic activity. Our cardiac model amounts at solving an anisotropic eikonal equation for cardiac activation and the forward bidomain model in the torso with the lead field approach for computing the ECG. We build a Gaussian process surrogate model of the loss function on the heart surface to perform Bayesian optimization. In this procedure, we iteratively evaluate the loss function following the lower confidence bound criterion, which combines exploring the surface with exploitation of the minimum region. We also extend this framework to incorporate multiple levels of fidelity of the model. We show that our procedure converges to the minimum only after $11.7\pm10.4$ iterations (20 independent runs) for the single-fidelity case and $3.5\pm1.7$ iterations for the multi-fidelity case. We envision that this tool could be applied in real time in a clinical setting to identify potentially dangerous EASs.