ImageFlowNet: Forecasting Multiscale Trajectories of Disease Progression with Irregularly-Sampled Longitudinal Medical Images

The forecasting of disease progression from images is a holy grail for clinical decision making. However, this task is complicated by the inherent high dimensionality, temporal sparsity and sampling irregularity in longitudinal image acquisitions. Existing methods often rely on extracting hand-crafted features and performing time-series analysis in this vector space, leading to a loss of rich spatial information within the images. To overcome these challenges, we introduce ImageFlowNet, a novel framework that learns latent-space flow fields that evolve multiscale representations in joint embedding spaces using neural ODEs and SDEs to model disease progression in the image domain. Notably, ImageFlowNet learns multiscale joint representation spaces by combining cohorts of patients together so that information can be transferred between the patient samples. The dynamics then provide plausible trajectories of progression, with the SDE providing alternative trajectories from the same starting point. We provide theoretical insights that support our formulation of ODEs, and motivate our regularizations involving high-level visual features, latent space organization, and trajectory smoothness. We then demonstrate ImageFlowNet's effectiveness through empirical evaluations on three longitudinal medical image datasets depicting progression in retinal geographic atrophy, multiple sclerosis, and glioblastoma.