UPCMR: A Universal Prompt-guided Model for Random Sampling Cardiac MRI Reconstruction

Cardiac magnetic resonance imaging (CMR) is vital for diagnosing heart diseases, but long scan time remains a major drawback. To address this, accelerated imaging techniques have been introduced by undersampling k-space, which reduces the quality of the resulting images. Recent deep learning advancements aim to speed up scanning while preserving quality, but adapting to various sampling modes and undersampling factors remains challenging. Therefore, building a universal model is a promising direction. In this work, we introduce UPCMR, a universal unrolled model designed for CMR reconstruction. This model incorporates two kinds of learnable prompts, undersampling-specific prompt and spatial-specific prompt, and integrates them with a UNet structure in each block. Overall, by using the CMRxRecon2024 challenge dataset for training and validation, the UPCMR model highly enhances reconstructed image quality across all random sampling scenarios through an effective training strategy compared to some traditional methods, demonstrating strong adaptability potential for this task.

Efficient MedSAMs: Segment Anything in Medical Images on Laptop

Promptable segmentation foundation models have emerged as a transformative approach to addressing the diverse needs in medical images, but most existing models require expensive computing, posing a big barrier to their adoption in clinical practice. In this work, we organized the first international competition dedicated to promptable medical image segmentation, featuring a large-scale dataset spanning nine common imaging modalities from over 20 different institutions. The top teams developed lightweight segmentation foundation models and implemented an efficient inference pipeline that substantially reduced computational requirements while maintaining state-of-the-art segmentation accuracy. Moreover, the post-challenge phase advanced the algorithms through the design of performance booster and reproducibility tasks, resulting in improved algorithms and validated reproducibility of the winning solution. Furthermore, the best-performing algorithms have been incorporated into the open-source software with a user-friendly interface to facilitate clinical adoption. The data and code are publicly available to foster the further development of medical image segmentation foundation models and pave the way for impactful real-world applications.

MCP-MedSAM: A Powerful Lightweight Medical Segment Anything Model Trained with a Single GPU in Just One Day

Medical image segmentation involves partitioning medical images into meaningful regions, with a focus on identifying anatomical structures or abnormalities. It has broad applications in healthcare, and deep learning methods have enabled significant advancements in automating this process. Recently, the introduction of the Segmentation Anything Model (SAM), the first foundation model for segmentation task, has prompted researchers to adapt it for the medical domain to improve performance across various tasks. However, SAM's large model size and high GPU requirements hinder its scalability and development in the medical domain. To address these challenges, research has increasingly focused on lightweight adaptations of SAM to reduce its parameter count, enabling training with limited GPU resources while maintaining competitive segmentation performance. In this work, we propose MCP-MedSAM, a powerful and lightweight medical SAM model designed to be trainable on a single GPU within one day while delivering superior segmentation performance. Our method was trained and evaluated using a large-scale challenge dataset\footnote{\url{https://www.codabench.org/competitions/1847}\label{comp}}, compared to top-ranking methods on the challenge leaderboard, MCP-MedSAM achieved superior performance while requiring only one day of training on a single GPU. The code is publicly available at \url{https://github.com/dong845/MCP-MedSAM}.

Swin-LiteMedSAM: A Lightweight Box-Based Segment Anything Model for Large-Scale Medical Image Datasets

Medical imaging is essential for the diagnosis and treatment of diseases, with medical image segmentation as a subtask receiving high attention. However, automatic medical image segmentation models are typically task-specific and struggle to handle multiple scenarios, such as different imaging modalities and regions of interest. With the introduction of the Segment Anything Model (SAM), training a universal model for various clinical scenarios has become feasible. Recently, several Medical SAM (MedSAM) methods have been proposed, but these models often rely on heavy image encoders to achieve high performance, which may not be practical for real-world applications due to their high computational demands and slow inference speed. To address this issue, a lightweight version of the MedSAM (LiteMedSAM) can provide a viable solution, achieving high performance while requiring fewer resources and less time. In this work, we introduce Swin-LiteMedSAM, a new variant of LiteMedSAM. This model integrates the tiny Swin Transformer as the image encoder, incorporates multiple types of prompts, including box-based points and scribble generated from a given bounding box, and establishes skip connections between the image encoder and the mask decoder. In the \textit{Segment Anything in Medical Images on Laptop} challenge (CVPR 2024), our approach strikes a good balance between segmentation performance and speed, demonstrating significantly improved overall results across multiple modalities compared to the LiteMedSAM baseline provided by the challenge organizers. Our proposed model achieved a DSC score of \textbf{0.8678} and an NSD score of \textbf{0.8844} on the validation set. On the final test set, it attained a DSC score of \textbf{0.8193} and an NSD score of \textbf{0.8461}, securing fourth place in the challenge.

Improving Uncertainty-Error Correspondence in Deep Bayesian Medical Image Segmentation

Increased usage of automated tools like deep learning in medical image segmentation has alleviated the bottleneck of manual contouring. This has shifted manual labour to quality assessment (QA) of automated contours which involves detecting errors and correcting them. A potential solution to semi-automated QA is to use deep Bayesian uncertainty to recommend potentially erroneous regions, thus reducing time spent on error detection. Previous work has investigated the correspondence between uncertainty and error, however, no work has been done on improving the "utility" of Bayesian uncertainty maps such that it is only present in inaccurate regions and not in the accurate ones. Our work trains the FlipOut model with the Accuracy-vs-Uncertainty (AvU) loss which promotes uncertainty to be present only in inaccurate regions. We apply this method on datasets of two radiotherapy body sites, c.f. head-and-neck CT and prostate MR scans. Uncertainty heatmaps (i.e. predictive entropy) are evaluated against voxel inaccuracies using Receiver Operating Characteristic (ROC) and Precision-Recall (PR) curves. Numerical results show that when compared to the Bayesian baseline the proposed method successfully suppresses uncertainty for accurate voxels, with similar presence of uncertainty for inaccurate voxels. Code to reproduce experiments is available at https://github.com/prerakmody/bayesuncertainty-error-correspondence

Vestibular schwannoma growth prediction from longitudinal MRI by time conditioned neural fields

Vestibular schwannomas (VS) are benign tumors that are generally managed by active surveillance with MRI examination. To further assist clinical decision-making and avoid overtreatment, an accurate prediction of tumor growth based on longitudinal imaging is highly desirable. In this paper, we introduce DeepGrowth, a deep learning method that incorporates neural fields and recurrent neural networks for prospective tumor growth prediction. In the proposed method, each tumor is represented as a signed distance function (SDF) conditioned on a low-dimensional latent code. Unlike previous studies that perform tumor shape prediction directly in the image space, we predict the latent codes instead and then reconstruct future shapes from it. To deal with irregular time intervals, we introduce a time-conditioned recurrent module based on a ConvLSTM and a novel temporal encoding strategy, which enables the proposed model to output varying tumor shapes over time. The experiments on an in-house longitudinal VS dataset showed that the proposed model significantly improved the performance ($\ge 1.6\%$ Dice score and $\ge0.20$ mm 95\% Hausdorff distance), in particular for top 20\% tumors that grow or shrink the most ($\ge 4.6\%$ Dice score and $\ge 0.73$ mm 95\% Hausdorff distance). Our code is available at ~\burl{https://github.com/cyjdswx/DeepGrowth}

CoNeS: Conditional neural fields with shift modulation for multi-sequence MRI translation

Multi-sequence magnetic resonance imaging (MRI) has found wide applications in both modern clinical studies and deep learning research. However, in clinical practice, it frequently occurs that one or more of the MRI sequences are missing due to different image acquisition protocols or contrast agent contraindications of patients, limiting the utilization of deep learning models trained on multi-sequence data. One promising approach is to leverage generative models to synthesize the missing sequences, which can serve as a surrogate acquisition. State-of-the-art methods tackling this problem are based on convolutional neural networks (CNN) which usually suffer from spectral biases, resulting in poor reconstruction of high-frequency fine details. In this paper, we propose Conditional Neural fields with Shift modulation (CoNeS), a model that takes voxel coordinates as input and learns a representation of the target images for multi-sequence MRI translation. The proposed model uses a multi-layer perceptron (MLP) instead of a CNN as the decoder for pixel-to-pixel mapping. Hence, each target image is represented as a neural field that is conditioned on the source image via shift modulation with a learned latent code. Experiments on BraTS 2018 and an in-house clinical dataset of vestibular schwannoma patients showed that the proposed method outperformed state-of-the-art methods for multi-sequence MRI translation both visually and quantitatively. Moreover, we conducted spectral analysis, showing that CoNeS was able to overcome the spectral bias issue common in conventional CNN models. To further evaluate the usage of synthesized images in clinical downstream tasks, we tested a segmentation network using the synthesized images at inference.

Joint optimization of a $β$-VAE for ECG task-specific feature extraction

Electrocardiography is the most common method to investigate the condition of the heart through the observation of cardiac rhythm and electrical activity, for both diagnosis and monitoring purposes. Analysis of electrocardiograms (ECGs) is commonly performed through the investigation of specific patterns, which are visually recognizable by trained physicians and are known to reflect cardiac (dis)function. In this work we study the use of $\beta$-variational autoencoders (VAEs) as an explainable feature extractor, and improve on its predictive capacities by jointly optimizing signal reconstruction and cardiac function prediction. The extracted features are then used for cardiac function prediction using logistic regression. The method is trained and tested on data from 7255 patients, who were treated for acute coronary syndrome at the Leiden University Medical Center between 2010 and 2021. The results show that our method significantly improved prediction and explainability compared to a vanilla $\beta$-VAE, while still yielding similar reconstruction performance.

Local implicit neural representations for multi-sequence MRI translation

In radiological practice, multi-sequence MRI is routinely acquired to characterize anatomy and tissue. However, due to the heterogeneity of imaging protocols and contra-indications to contrast agents, some MRI sequences, e.g. contrast-enhanced T1-weighted image (T1ce), may not be acquired. This creates difficulties for large-scale clinical studies for which heterogeneous datasets are aggregated. Modern deep learning techniques have demonstrated the capability of synthesizing missing sequences from existing sequences, through learning from an extensive multi-sequence MRI dataset. In this paper, we propose a novel MR image translation solution based on local implicit neural representations. We split the available MRI sequences into local patches and assign to each patch a local multi-layer perceptron (MLP) that represents a patch in the T1ce. The parameters of these local MLPs are generated by a hypernetwork based on image features. Experimental results and ablation studies on the BraTS challenge dataset showed that the local MLPs are critical for recovering fine image and tumor details, as they allow for local specialization that is highly important for accurate image translation. Compared to a classical pix2pix model, the proposed method demonstrated visual improvement and significantly improved quantitative scores (MSE 0.86 x 10^-3 vs. 1.02 x 10^-3 and SSIM 94.9 vs 94.3)

Comparing Bayesian Models for Organ Contouring in Headand Neck Radiotherapy

Deep learning models for organ contouring in radiotherapy are poised for clinical usage, but currently, there exist few tools for automated quality assessment (QA) of the predicted contours. Using Bayesian models and their associated uncertainty, one can potentially automate the process of detecting inaccurate predictions. We investigate two Bayesian models for auto-contouring, DropOut and FlipOut, using a quantitative measure - expected calibration error (ECE) and a qualitative measure - region-based accuracy-vs-uncertainty (R-AvU) graphs. It is well understood that a model should have low ECE to be considered trustworthy. However, in a QA context, a model should also have high uncertainty in inaccurate regions and low uncertainty in accurate regions. Such behaviour could direct visual attention of expert users to potentially inaccurate regions, leading to a speed up in the QA process. Using R-AvU graphs, we qualitatively compare the behaviour of different models in accurate and inaccurate regions. Experiments are conducted on the MICCAI2015 Head and Neck Segmentation Challenge and on the DeepMindTCIA CT dataset using three models: DropOut-DICE, Dropout-CE (Cross Entropy) and FlipOut-CE. Quantitative results show that DropOut-DICE has the highest ECE, while Dropout-CE and FlipOut-CE have the lowest ECE. To better understand the difference between DropOut-CE and FlipOut-CE, we use the R-AvU graph which shows that FlipOut-CE has better uncertainty coverage in inaccurate regions than DropOut-CE. Such a combination of quantitative and qualitative metrics explores a new approach that helps to select which model can be deployed as a QA tool in clinical settings.