Rapid patient-specific neural networks for intraoperative X-ray to volume registration

The integration of artificial intelligence in image-guided interventions holds transformative potential, promising to extract 3D geometric and quantitative information from conventional 2D imaging modalities during complex procedures. Achieving this requires the rapid and precise alignment of 2D intraoperative images (e.g., X-ray) with 3D preoperative volumes (e.g., CT, MRI). However, current 2D/3D registration methods fail across the broad spectrum of procedures dependent on X-ray guidance: traditional optimization techniques require custom parameter tuning for each subject, whereas neural networks trained on small datasets do not generalize to new patients or require labor-intensive manual annotations, increasing clinical burden and precluding application to new anatomical targets. To address these challenges, we present xvr, a fully automated framework for training patient-specific neural networks for 2D/3D registration. xvr uses physics-based simulation to generate abundant high-quality training data from a patient's own preoperative volumetric imaging, thereby overcoming the inherently limited ability of supervised models to generalize to new patients and procedures. Furthermore, xvr requires only 5 minutes of training per patient, making it suitable for emergency interventions as well as planned procedures. We perform the largest evaluation of a 2D/3D registration algorithm on real X-ray data to date and find that xvr robustly generalizes across a diverse dataset comprising multiple anatomical structures, imaging modalities, and hospitals. Across surgical tasks, xvr achieves submillimeter-accurate registration at intraoperative speeds, improving upon existing methods by an order of magnitude. xvr is released as open-source software freely available at https://github.com/eigenvivek/xvr.

Spatial regularisation for improved accuracy and interpretability in keypoint-based registration

Unsupervised registration strategies bypass requirements in ground truth transforms or segmentations by optimising similarity metrics between fixed and moved volumes. Among these methods, a recent subclass of approaches based on unsupervised keypoint detection stand out as very promising for interpretability. Specifically, these methods train a network to predict feature maps for fixed and moving images, from which explainable centres of mass are computed to obtain point clouds, that are then aligned in closed-form. However, the features returned by the network often yield spatially diffuse patterns that are hard to interpret, thus undermining the purpose of keypoint-based registration. Here, we propose a three-fold loss to regularise the spatial distribution of the features. First, we use the KL divergence to model features as point spread functions that we interpret as probabilistic keypoints. Then, we sharpen the spatial distributions of these features to increase the precision of the detected landmarks. Finally, we introduce a new repulsive loss across keypoints to encourage spatial diversity. Overall, our loss considerably improves the interpretability of the features, which now correspond to precise and anatomically meaningful landmarks. We demonstrate our three-fold loss in foetal rigid motion tracking and brain MRI affine registration tasks, where it not only outperforms state-of-the-art unsupervised strategies, but also bridges the gap with state-of-the-art supervised methods. Our code is available at https://github.com/BenBillot/spatial_regularisation.

Differentiable Voxel-based X-ray Rendering Improves Sparse-View 3D CBCT Reconstruction

We present DiffVox, a self-supervised framework for Cone-Beam Computed Tomography (CBCT) reconstruction by directly optimizing a voxelgrid representation using physics-based differentiable X-ray rendering. Further, we investigate how the different implementations of the X-ray image formation model in the renderer affect the quality of 3D reconstruction and novel view synthesis. When combined with our regularized voxel-based learning framework, we find that using an exact implementation of the discrete Beer-Lambert law for X-ray attenuation in the renderer outperforms both widely used iterative CBCT reconstruction algorithms and modern neural field approaches, particularly when given only a few input views. As a result, we reconstruct high-fidelity 3D CBCT volumes from fewer X-rays, potentially reducing ionizing radiation exposure and improving diagnostic utility. Our implementation is available at https://github.com/hossein-momeni/DiffVox.

Learning General-Purpose Biomedical Volume Representations using Randomized Synthesis

Current volumetric biomedical foundation models struggle to generalize as public 3D datasets are small and do not cover the broad diversity of medical procedures, conditions, anatomical regions, and imaging protocols. We address this by creating a representation learning method that instead anticipates strong domain shifts at training time itself. We first propose a data engine that synthesizes highly variable training samples that enable generalization to new biomedical contexts. To then train a single 3D network for any voxel-level task, we develop a contrastive learning method that pretrains the network to be stable against nuisance imaging variation simulated by the data engine, a key inductive bias for generalization. This network's features can be used as robust representations of input images for downstream tasks and its weights provide a strong, dataset-agnostic initialization for finetuning on new datasets. As a result, we set new standards across both multimodality registration and few-shot segmentation, a first for any 3D biomedical vision model, all without (pre-)training on any existing dataset of real images.

Calibrating Expressions of Certainty

We present a novel approach to calibrating linguistic expressions of certainty, e.g., "Maybe" and "Likely". Unlike prior work that assigns a single score to each certainty phrase, we model uncertainty as distributions over the simplex to capture their semantics more accurately. To accommodate this new representation of certainty, we generalize existing measures of miscalibration and introduce a novel post-hoc calibration method. Leveraging these tools, we analyze the calibration of both humans (e.g., radiologists) and computational models (e.g., language models) and provide interpretable suggestions to improve their calibration.

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.

UniMo: Universal Motion Correction For Medical Images without Network Retraining

In this paper, we introduce a Universal Motion Correction (UniMo) framework, leveraging deep neural networks to tackle the challenges of motion correction across diverse imaging modalities. Our approach employs advanced neural network architectures with equivariant filters, overcoming the limitations of current models that require iterative inference or retraining for new image modalities. UniMo enables one-time training on a single modality while maintaining high stability and adaptability for inference across multiple unseen image modalities. We developed a joint learning framework that integrates multimodal knowledge from both shape and images that faithfully improve motion correction accuracy despite image appearance variations. UniMo features a geometric deformation augmenter that enhances the robustness of global motion correction by addressing any local deformations whether they are caused by object deformations or geometric distortions, and also generates augmented data to improve the training process. Our experimental results, conducted on various datasets with four different image modalities, demonstrate that UniMo surpasses existing motion correction methods in terms of accuracy. By offering a comprehensive solution to motion correction, UniMo marks a significant advancement in medical imaging, especially in challenging applications with wide ranges of motion, such as fetal imaging. The code for this work is available online, https://github.com/IntelligentImaging/UNIMO/.

Geo-UNet: A Geometrically Constrained Neural Framework for Clinical-Grade Lumen Segmentation in Intravascular Ultrasound

Precisely estimating lumen boundaries in intravascular ultrasound (IVUS) is needed for sizing interventional stents to treat deep vein thrombosis (DVT). Unfortunately, current segmentation networks like the UNet lack the precision needed for clinical adoption in IVUS workflows. This arises due to the difficulty of automatically learning accurate lumen contour from limited training data while accounting for the radial geometry of IVUS imaging. We propose the Geo-UNet framework to address these issues via a design informed by the geometry of the lumen contour segmentation task. We first convert the input data and segmentation targets from Cartesian to polar coordinates. Starting from a convUNet feature extractor, we propose a two-task setup, one for conventional pixel-wise labeling and the other for single boundary lumen-contour localization. We directly combine the two predictions by passing the predicted lumen contour through a new activation (named CDFeLU) to filter out spurious pixel-wise predictions. Our unified loss function carefully balances area-based, distance-based, and contour-based penalties to provide near clinical-grade generalization in unseen patient data. We also introduce a lightweight, inference-time technique to enhance segmentation smoothness. The efficacy of our framework on a venous IVUS dataset is shown against state-of-the-art models.

SpaER: Learning Spatio-temporal Equivariant Representations for Fetal Brain Motion Tracking

In this paper, we introduce SpaER, a pioneering method for fetal motion tracking that leverages equivariant filters and self-attention mechanisms to effectively learn spatio-temporal representations. Different from conventional approaches that statically estimate fetal brain motions from pairs of images, our method dynamically tracks the rigid movement patterns of the fetal head across temporal and spatial dimensions. Specifically, we first develop an equivariant neural network that efficiently learns rigid motion sequences through low-dimensional spatial representations of images. Subsequently, we learn spatio-temporal representations by incorporating time encoding and self-attention neural network layers. This approach allows for the capture of long-term dependencies of fetal brain motion and addresses alignment errors due to contrast changes and severe motion artifacts. Our model also provides a geometric deformation estimation that properly addresses image distortions among all time frames. To the best of our knowledge, our approach is the first to learn spatial-temporal representations via deep neural networks for fetal motion tracking without data augmentation. We validated our model using real fetal echo-planar images with simulated and real motions. Our method carries significant potential value in accurately measuring, tracking, and correcting fetal motion in fetal MRI sequences.

InterNeRF: Scaling Radiance Fields via Parameter Interpolation

Neural Radiance Fields (NeRFs) have unmatched fidelity on large, real-world scenes. A common approach for scaling NeRFs is to partition the scene into regions, each of which is assigned its own parameters. When implemented naively, such an approach is limited by poor test-time scaling and inconsistent appearance and geometry. We instead propose InterNeRF, a novel architecture for rendering a target view using a subset of the model's parameters. Our approach enables out-of-core training and rendering, increasing total model capacity with only a modest increase to training time. We demonstrate significant improvements in multi-room scenes while remaining competitive on standard benchmarks.