TV-based Deep 3D Self Super-Resolution for fMRI

While functional Magnetic Resonance Imaging (fMRI) offers valuable insights into cognitive processes, its inherent spatial limitations pose challenges for detailed analysis of the fine-grained functional architecture of the brain. More specifically, MRI scanner and sequence specifications impose a trade-off between temporal resolution, spatial resolution, signal-to-noise ratio, and scan time. Deep Learning (DL) Super-Resolution (SR) methods have emerged as a promising solution to enhance fMRI resolution, generating high-resolution (HR) images from low-resolution (LR) images typically acquired with lower scanning times. However, most existing SR approaches depend on supervised DL techniques, which require training ground truth (GT) HR data, which is often difficult to acquire and simultaneously sets a bound for how far SR can go. In this paper, we introduce a novel self-supervised DL SR model that combines a DL network with an analytical approach and Total Variation (TV) regularization. Our method eliminates the need for external GT images, achieving competitive performance compared to supervised DL techniques and preserving the functional maps.

Recon-all-clinical: Cortical surface reconstruction and analysis of heterogeneous clinical brain MRI

Surface-based analysis of the cerebral cortex is ubiquitous in human neuroimaging with MRI. It is crucial for cortical registration, parcellation, and thickness estimation. Traditionally, these analyses require high-resolution, isotropic scans with good gray-white matter contrast, typically a 1mm T1-weighted scan. This excludes most clinical MRI scans, which are often anisotropic and lack the necessary T1 contrast. To enable large-scale neuroimaging studies using vast clinical data, we introduce recon-all-clinical, a novel method for cortical reconstruction, registration, parcellation, and thickness estimation in brain MRI scans of any resolution and contrast. Our approach employs a hybrid analysis method that combines a convolutional neural network (CNN) trained with domain randomization to predict signed distance functions (SDFs) and classical geometry processing for accurate surface placement while maintaining topological and geometric constraints. The method does not require retraining for different acquisitions, thus simplifying the analysis of heterogeneous clinical datasets. We tested recon-all-clinical on multiple datasets, including over 19,000 clinical scans. The method consistently produced precise cortical reconstructions and high parcellation accuracy across varied MRI contrasts and resolutions. Cortical thickness estimates are precise enough to capture aging effects independently of MRI contrast, although accuracy varies with slice thickness. Our method is publicly available at https://surfer.nmr.mgh.harvard.edu/fswiki/recon-all-clinical, enabling researchers to perform detailed cortical analysis on the huge amounts of already existing clinical MRI scans. This advancement may be particularly valuable for studying rare diseases and underrepresented populations where research-grade MRI data is scarce.

BraTS-PEDs: Results of the Multi-Consortium International Pediatric Brain Tumor Segmentation Challenge 2023

Pediatric central nervous system tumors are the leading cause of cancer-related deaths in children. The five-year survival rate for high-grade glioma in children is less than 20%. The development of new treatments is dependent upon multi-institutional collaborative clinical trials requiring reproducible and accurate centralized response assessment. We present the results of the BraTS-PEDs 2023 challenge, the first Brain Tumor Segmentation (BraTS) challenge focused on pediatric brain tumors. This challenge utilized data acquired from multiple international consortia dedicated to pediatric neuro-oncology and clinical trials. BraTS-PEDs 2023 aimed to evaluate volumetric segmentation algorithms for pediatric brain gliomas from magnetic resonance imaging using standardized quantitative performance evaluation metrics employed across the BraTS 2023 challenges. The top-performing AI approaches for pediatric tumor analysis included ensembles of nnU-Net and Swin UNETR, Auto3DSeg, or nnU-Net with a self-supervised framework. The BraTSPEDs 2023 challenge fostered collaboration between clinicians (neuro-oncologists, neuroradiologists) and AI/imaging scientists, promoting faster data sharing and the development of automated volumetric analysis techniques. These advancements could significantly benefit clinical trials and improve the care of children with brain tumors.

High-resolution segmentations of the hypothalamus and its subregions for training of segmentation models

Segmentation of brain structures on magnetic resonance imaging (MRI) is a highly relevant neuroimaging topic, as it is a prerequisite for different analyses such as volumetry or shape analysis. Automated segmentation facilitates the study of brain structures in larger cohorts when compared with manual segmentation, which is time-consuming. However, the development of most automated methods relies on large and manually annotated datasets, which limits the generalizability of these methods. Recently, new techniques using synthetic images have emerged, reducing the need for manual annotation. Here we provide HELM, Hypothalamic ex vivo Label Maps, a dataset composed of label maps built from publicly available ultra-high resolution ex vivo MRI from 10 whole hemispheres, which can be used to develop segmentation methods using synthetic data. The label maps are obtained with a combination of manual labels for the hypothalamic regions and automated segmentations for the rest of the brain, and mirrored to simulate entire brains. We also provide the pre-processed ex vivo scans, as this dataset can support future projects to include other structures after these are manually segmented.

Probabilistic Contrastive Learning with Explicit Concentration on the Hypersphere

Self-supervised contrastive learning has predominantly adopted deterministic methods, which are not suited for environments characterized by uncertainty and noise. This paper introduces a new perspective on incorporating uncertainty into contrastive learning by embedding representations within a spherical space, inspired by the von Mises-Fisher distribution (vMF). We introduce an unnormalized form of vMF and leverage the concentration parameter, kappa, as a direct, interpretable measure to quantify uncertainty explicitly. This approach not only provides a probabilistic interpretation of the embedding space but also offers a method to calibrate model confidence against varying levels of data corruption and characteristics. Our empirical results demonstrate that the estimated concentration parameter correlates strongly with the degree of unforeseen data corruption encountered at test time, enables failure analysis, and enhances existing out-of-distribution detection methods.

Analysis of the BraTS 2023 Intracranial Meningioma Segmentation Challenge

We describe the design and results from the BraTS 2023 Intracranial Meningioma Segmentation Challenge. The BraTS Meningioma Challenge differed from prior BraTS Glioma challenges in that it focused on meningiomas, which are typically benign extra-axial tumors with diverse radiologic and anatomical presentation and a propensity for multiplicity. Nine participating teams each developed deep-learning automated segmentation models using image data from the largest multi-institutional systematically expert annotated multilabel multi-sequence meningioma MRI dataset to date, which included 1000 training set cases, 141 validation set cases, and 283 hidden test set cases. Each case included T2, T2/FLAIR, T1, and T1Gd brain MRI sequences with associated tumor compartment labels delineating enhancing tumor, non-enhancing tumor, and surrounding non-enhancing T2/FLAIR hyperintensity. Participant automated segmentation models were evaluated and ranked based on a scoring system evaluating lesion-wise metrics including dice similarity coefficient (DSC) and 95% Hausdorff Distance. The top ranked team had a lesion-wise median dice similarity coefficient (DSC) of 0.976, 0.976, and 0.964 for enhancing tumor, tumor core, and whole tumor, respectively and a corresponding average DSC of 0.899, 0.904, and 0.871, respectively. These results serve as state-of-the-art benchmarks for future pre-operative meningioma automated segmentation algorithms. Additionally, we found that 1286 of 1424 cases (90.3%) had at least 1 compartment voxel abutting the edge of the skull-stripped image edge, which requires further investigation into optimal pre-processing face anonymization steps.

The Brain Tumor Segmentation in Pediatrics (BraTS-PEDs) Challenge: Focus on Pediatrics (CBTN-CONNECT-DIPGR-ASNR-MICCAI BraTS-PEDs)

Pediatric tumors of the central nervous system are the most common cause of cancer-related death in children. The five-year survival rate for high-grade gliomas in children is less than 20%. Due to their rarity, the diagnosis of these entities is often delayed, their treatment is mainly based on historic treatment concepts, and clinical trials require multi-institutional collaborations. Here we present the CBTN-CONNECT-DIPGR-ASNR-MICCAI BraTS-PEDs challenge, focused on pediatric brain tumors with data acquired across multiple international consortia dedicated to pediatric neuro-oncology and clinical trials. The CBTN-CONNECT-DIPGR-ASNR-MICCAI BraTS-PEDs challenge brings together clinicians and AI/imaging scientists to lead to faster development of automated segmentation techniques that could benefit clinical trials, and ultimately the care of children with brain tumors.

Registration by Regression (RbR): a framework for interpretable and flexible atlas registration

In human neuroimaging studies, atlas registration enables mapping MRI scans to a common coordinate frame, which is necessary to aggregate data from multiple subjects. Machine learning registration methods have achieved excellent speed and accuracy but lack interpretability. More recently, keypoint-based methods have been proposed to tackle this issue, but their accuracy is still subpar, particularly when fitting nonlinear transforms. Here we propose Registration by Regression (RbR), a novel atlas registration framework that is highly robust and flexible, conceptually simple, and can be trained with cheaply obtained data. RbR predicts the (x,y,z) atlas coordinates for every voxel of the input scan (i.e., every voxel is a keypoint), and then uses closed-form expressions to quickly fit transforms using a wide array of possible deformation models, including affine and nonlinear (e.g., Bspline, Demons, invertible diffeomorphic models, etc.). Robustness is provided by the large number of voxels informing the registration and can be further increased by robust estimators like RANSAC. Experiments on independent public datasets show that RbR yields more accurate registration than competing keypoint approaches, while providing full control of the deformation model.

P-Count: Persistence-based Counting of White Matter Hyperintensities in Brain MRI

White matter hyperintensities (WMH) are a hallmark of cerebrovascular disease and multiple sclerosis. Automated WMH segmentation methods enable quantitative analysis via estimation of total lesion load, spatial distribution of lesions, and number of lesions (i.e., number of connected components after thresholding), all of which are correlated with patient outcomes. While the two former measures can generally be estimated robustly, the number of lesions is highly sensitive to noise and segmentation mistakes -- even when small connected components are eroded or disregarded. In this article, we present P-Count, an algebraic WMH counting tool based on persistent homology that accounts for the topological features of WM lesions in a robust manner. Using computational geometry, P-Count takes the persistence of connected components into consideration, effectively filtering out the noisy WMH positives, resulting in a more accurate count of true lesions. We validated P-Count on the ISBI2015 longitudinal lesion segmentation dataset, where it produces significantly more accurate results than direct thresholding.

H-SynEx: Using synthetic images and ultra-high resolution ex vivo MRI for hypothalamus subregion segmentation

Purpose: To develop a method for automated segmentation of hypothalamus subregions informed by ultra-high resolution ex vivo magnetic resonance images (MRI), which generalizes across MRI sequences and resolutions without retraining. Materials and Methods: We trained our deep learning method, H-synEx, with synthetic images derived from label maps built from ultra-high resolution ex vivo MRI scans, which enables finer-grained manual segmentation when compared with 1mm isometric in vivo images. We validated this retrospective study using 1535 in vivo images from six datasets and six MRI sequences. The quantitative evaluation used the Dice Coefficient (DC) and Average Hausdorff distance (AVD). Statistical analysis compared hypothalamic subregion volumes in controls, Alzheimer's disease (AD), and behavioral variant frontotemporal dementia (bvFTD) subjects using the area under the curve (AUC) and Wilcoxon rank sum test. Results: H-SynEx can segment the hypothalamus across various MRI sequences, encompassing FLAIR sequences with significant slice spacing (5mm). Using hypothalamic volumes on T1w images to distinguish control from AD and bvFTD patients, we observed AUC values of 0.74 and 0.79 respectively. Additionally, AUC=0.66 was found for volume variation on FLAIR scans when comparing control and non-patients. Conclusion: Our results show that H-SynEx successfully leverages information from ultra-high resolution scans to segment in vivo from different MRI sequences such as T1w, T2w, PD, qT1, FA, and FLAIR. We also found that our automated segmentation was able to discriminate controls versus patients on FLAIR images with 5mm spacing. H-SynEx is openly available at https://github.com/liviamarodrigues/hsynex.