Search Wide, Focus Deep: Automated Fetal Brain Extraction with Sparse Training Data

Automated fetal brain extraction from full-uterus MRI is a challenging task due to variable head sizes, orientations, complex anatomy, and prevalent artifacts. While deep-learning (DL) models trained on synthetic images have been successful in adult brain extraction, adapting these networks for fetal MRI is difficult due to the sparsity of labeled data, leading to increased false-positive predictions. To address this challenge, we propose a test-time strategy that reduces false positives in networks trained on sparse, synthetic labels. The approach uses a breadth-fine search (BFS) to identify a subvolume likely to contain the fetal brain, followed by a deep-focused sliding window (DFS) search to refine the extraction, pooling predictions to minimize false positives. We train models at different window sizes using synthetic images derived from a small number of fetal brain label maps, augmented with random geometric shapes. Each model is trained on diverse head positions and scales, including cases with partial or no brain tissue. Our framework matches state-of-the-art brain extraction methods on clinical HASTE scans of third-trimester fetuses and exceeds them by up to 5\% in terms of Dice in the second trimester as well as EPI scans across both trimesters. Our results demonstrate the utility of a sliding-window approach and combining predictions from several models trained on synthetic images, for improving brain-extraction accuracy by progressively refining regions of interest and minimizing the risk of missing brain mask slices or misidentifying other tissues as brain.

WALINET: A water and lipid identification convolutional Neural Network for nuisance signal removal in 1H MR Spectroscopic Imaging

Purpose. Proton Magnetic Resonance Spectroscopic Imaging (1H-MRSI) provides non-invasive spectral-spatial mapping of metabolism. However, long-standing problems in whole-brain 1H-MRSI are spectral overlap of metabolite peaks with large lipid signal from scalp, and overwhelming water signal that distorts spectra. Fast and effective methods are needed for high-resolution 1H-MRSI to accurately remove lipid and water signals while preserving the metabolite signal. The potential of supervised neural networks for this task remains unexplored, despite their success for other MRSI processing. Methods. We introduce a deep-learning method based on a modified Y-NET network for water and lipid removal in whole-brain 1H-MRSI. The WALINET (WAter and LIpid neural NETwork) was compared to conventional methods such as the state-of-the-art lipid L2 regularization and Hankel-Lanczos singular value decomposition (HLSVD) water suppression. Methods were evaluated on simulated and in-vivo whole-brain MRSI using NMRSE, SNR, CRLB, and FWHM metrics. Results. WALINET is significantly faster and needs 8s for high-resolution whole-brain MRSI, compared to 42 minutes for conventional HLSVD+L2. Quantitative analysis shows WALINET has better performance than HLSVD+L2: 1) more lipid removal with 41% lower NRMSE, 2) better metabolite signal preservation with 71% lower NRMSE in simulated data, 155% higher SNR and 50% lower CRLB in in-vivo data. Metabolic maps obtained by WALINET in healthy subjects and patients show better gray/white-matter contrast with more visible structural details. Conclusions. WALINET has superior performance for nuisance signal removal and metabolite quantification on whole-brain 1H-MRSI compared to conventional state-of-the-art techniques. This represents a new application of deep-learning for MRSI processing, with potential for automated high-throughput workflow.

Deep-ER: Deep Learning ECCENTRIC Reconstruction for fast high-resolution neurometabolic imaging

Introduction: Altered neurometabolism is an important pathological mechanism in many neurological diseases and brain cancer, which can be mapped non-invasively by Magnetic Resonance Spectroscopic Imaging (MRSI). Advanced MRSI using non-cartesian compressed-sense acquisition enables fast high-resolution metabolic imaging but has lengthy reconstruction times that limits throughput and needs expert user interaction. Here, we present a robust and efficient Deep Learning reconstruction to obtain high-quality metabolic maps. Methods: Fast high-resolution whole-brain metabolic imaging was performed at 3.4 mm$^3$ isotropic resolution with acquisition times between 4:11-9:21 min:s using ECCENTRIC pulse sequence on a 7T MRI scanner. Data were acquired in a high-resolution phantom and 27 human participants, including 22 healthy volunteers and 5 glioma patients. A deep neural network using recurring interlaced convolutional layers with joint dual-space feature representation was developed for deep learning ECCENTRIC reconstruction (Deep-ER). 21 subjects were used for training and 6 subjects for testing. Deep-ER performance was compared to conventional iterative Total Generalized Variation reconstruction using image and spectral quality metrics. Results: Deep-ER demonstrated 600-fold faster reconstruction than conventional methods, providing improved spatial-spectral quality and metabolite quantification with 12%-45% (P<0.05) higher signal-to-noise and 8%-50% (P<0.05) smaller Cramer-Rao lower bounds. Metabolic images clearly visualize glioma tumor heterogeneity and boundary. Conclusion: Deep-ER provides efficient and robust reconstruction for sparse-sampled MRSI. The accelerated acquisition-reconstruction MRSI is compatible with high-throughput imaging workflow. It is expected that such improved performance will facilitate basic and clinical MRSI applications.

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.

Boosting Skull-Stripping Performance for Pediatric Brain Images

Skull-stripping is the removal of background and non-brain anatomical features from brain images. While many skull-stripping tools exist, few target pediatric populations. With the emergence of multi-institutional pediatric data acquisition efforts to broaden the understanding of perinatal brain development, it is essential to develop robust and well-tested tools ready for the relevant data processing. However, the broad range of neuroanatomical variation in the developing brain, combined with additional challenges such as high motion levels, as well as shoulder and chest signal in the images, leaves many adult-specific tools ill-suited for pediatric skull-stripping. Building on an existing framework for robust and accurate skull-stripping, we propose developmental SynthStrip (d-SynthStrip), a skull-stripping model tailored to pediatric images. This framework exposes networks to highly variable images synthesized from label maps. Our model substantially outperforms pediatric baselines across scan types and age cohorts. In addition, the <1-minute runtime of our tool compares favorably to the fastest baselines. We distribute our model at https://w3id.org/synthstrip.

SE-Equivariant and Noise-Invariant 3D Motion Tracking in Medical Images

Rigid motion tracking is paramount in many medical imaging applications where movements need to be detected, corrected, or accounted for. Modern strategies rely on convolutional neural networks (CNN) and pose this problem as rigid registration. Yet, CNNs do not exploit natural symmetries in this task, as they are equivariant to translations (their outputs shift with their inputs) but not to rotations. Here we propose EquiTrack, the first method that uses recent steerable SE(3)-equivariant CNNs (E-CNN) for motion tracking. While steerable E-CNNs can extract corresponding features across different poses, testing them on noisy medical images reveals that they do not have enough learning capacity to learn noise invariance. Thus, we introduce a hybrid architecture that pairs a denoiser with an E-CNN to decouple the processing of anatomically irrelevant intensity features from the extraction of equivariant spatial features. Rigid transforms are then estimated in closed-form. EquiTrack outperforms state-of-the-art learning and optimisation methods for motion tracking in adult brain MRI and fetal MRI time series. Our code is available at github.com/BBillot/equitrack.

Anatomy-aware and acquisition-agnostic joint registration with SynthMorph

Affine image registration is a cornerstone of medical-image processing and analysis. While classical algorithms can achieve excellent accuracy, they solve a time-consuming optimization for every new image pair. Deep-learning (DL) methods learn a function that maps an image pair to an output transform. Evaluating the functions is fast, but capturing large transforms can be challenging, and networks tend to struggle if a test-image characteristic shifts from the training domain, such as the contrast or resolution. A majority of affine methods are also agnostic to the anatomy the user wishes to align; the registration will be inaccurate if algorithms consider all structures in the image. We address these shortcomings with a fast, robust, and easy-to-use DL tool for affine and deformable registration of any brain image without preprocessing, right off the MRI scanner. First, we rigorously analyze how competing architectures learn affine transforms across a diverse set of neuroimaging data, aiming to truly capture the behavior of methods in the real world. Second, we leverage a recent strategy to train networks with wildly varying images synthesized from label maps, yielding robust performance across acquisition specifics. Third, we optimize the spatial overlap of select anatomical labels, which enables networks to distinguish between anatomy of interest and irrelevant structures, removing the need for preprocessing that excludes content that would otherwise reduce the accuracy of anatomy-specific registration. We combine the affine model with prior work on deformable registration and test brain-specific registration across a landscape of MRI protocols unseen at training, demonstrating consistent and improved accuracy compared to existing tools. We distribute our code and tool at https://w3id.org/synthmorph, providing a single complete end-to-end solution for registration of brain MRI.

Data Consistent Deep Rigid MRI Motion Correction

Motion artifacts are a pervasive problem in MRI, leading to misdiagnosis or mischaracterization in population-level imaging studies. Current retrospective rigid intra-slice motion correction techniques jointly optimize estimates of the image and the motion parameters. In this paper, we use a deep network to reduce the joint image-motion parameter search to a search over rigid motion parameters alone. Our network produces a reconstruction as a function of two inputs: corrupted k-space data and motion parameters. We train the network using simulated, motion-corrupted k-space data generated from known motion parameters. At test-time, we estimate unknown motion parameters by minimizing a data consistency loss between the motion parameters, the network-based image reconstruction given those parameters, and the acquired measurements. Intra-slice motion correction experiments on simulated and realistic 2D fast spin echo brain MRI achieve high reconstruction fidelity while retaining the benefits of explicit data consistency-based optimization. Our code is publicly available at https://www.github.com/nalinimsingh/neuroMoCo.

Learning the Effect of Registration Hyperparameters with HyperMorph

We introduce HyperMorph, a framework that facilitates efficient hyperparameter tuning in learning-based deformable image registration. Classical registration algorithms perform an iterative pair-wise optimization to compute a deformation field that aligns two images. Recent learning-based approaches leverage large image datasets to learn a function that rapidly estimates a deformation for a given image pair. In both strategies, the accuracy of the resulting spatial correspondences is strongly influenced by the choice of certain hyperparameter values. However, an effective hyperparameter search consumes substantial time and human effort as it often involves training multiple models for different fixed hyperparameter values and may lead to suboptimal registration. We propose an amortized hyperparameter learning strategy to alleviate this burden by learning the impact of hyperparameters on deformation fields. We design a meta network, or hypernetwork, that predicts the parameters of a registration network for input hyperparameters, thereby comprising a single model that generates the optimal deformation field corresponding to given hyperparameter values. This strategy enables fast, high-resolution hyperparameter search at test-time, reducing the inefficiency of traditional approaches while increasing flexibility. We also demonstrate additional benefits of HyperMorph, including enhanced robustness to model initialization and the ability to rapidly identify optimal hyperparameter values specific to a dataset, image contrast, task, or even anatomical region, all without the need to retrain models. We make our code publicly available at http://hypermorph.voxelmorph.net.

SynthStrip: Skull-Stripping for Any Brain Image

The removal of non-brain signal from magnetic resonance imaging (MRI) data, known as skull-stripping, is an integral component of many neuroimage analysis streams. Despite their abundance, popular classical skull-stripping methods are usually tailored to images with specific acquisition properties, namely near-isotropic resolution and T1-weighted (T1w) MRI contrast, which are prevalent in research settings. As a result, existing tools tend to adapt poorly to other image types, such as stacks of thick slices acquired with fast spin-echo (FSE) MRI that are common in the clinic. While learning-based approaches for brain extraction have gained traction in recent years, these methods face a similar burden, as they are only effective for image types seen during the training procedure. To achieve robust skull-stripping across a landscape of protocols, we introduce SynthStrip, a rapid, learning-based brain-extraction tool. By leveraging anatomical segmentations to generate an entirely synthetic training dataset with anatomies, intensity distributions, and artifacts that far exceed the realistic range of medical images, SynthStrip learns to successfully generalize to a variety of real acquired brain images, removing the need for training data with target contrasts. We demonstrate the efficacy of SynthStrip for a diverse set of image acquisitions and resolutions across subject populations, ranging from newborn to adult. We show substantial improvements in accuracy over popular skull-stripping baselines - all with a single trained model. Our method and labeled evaluation data are available at https://w3id.org/synthstrip.