HeMIS: Hetero-Modal Image Segmentation

We introduce a deep learning image segmentation framework that is extremely robust to missing imaging modalities. Instead of attempting to impute or synthesize missing data, the proposed approach learns, for each modality, an embedding of the input image into a single latent vector space for which arithmetic operations (such as taking the mean) are well defined. Points in that space, which are averaged over modalities available at inference time, can then be further processed to yield the desired segmentation. As such, any combinatorial subset of available modalities can be provided as input, without having to learn a combinatorial number of imputation models. Evaluated on two neurological MRI datasets (brain tumors and MS lesions), the approach yields state-of-the-art segmentation results when provided with all modalities; moreover, its performance degrades remarkably gracefully when modalities are removed, significantly more so than alternative mean-filling or other synthesis approaches.Comment: Accepted as an oral presentation at MICCAI 201

MyoPS-Net: Myocardial Pathology Segmentation with Flexible Combination of Multi-Sequence CMR Images

Myocardial pathology segmentation (MyoPS) can be a prerequisite for the accurate diagnosis and treatment planning of myocardial infarction. However, achieving this segmentation is challenging, mainly due to the inadequate and indistinct information from an image. In this work, we develop an end-to-end deep neural network, referred to as MyoPS-Net, to flexibly combine five-sequence cardiac magnetic resonance (CMR) images for MyoPS. To extract precise and adequate information, we design an effective yet flexible architecture to extract and fuse cross-modal features. This architecture can tackle different numbers of CMR images and complex combinations of modalities, with output branches targeting specific pathologies. To impose anatomical knowledge on the segmentation results, we first propose a module to regularize myocardium consistency and localize the pathologies, and then introduce an inclusiveness loss to utilize relations between myocardial scars and edema. We evaluated the proposed MyoPS-Net on two datasets, i.e., a private one consisting of 50 paired multi-sequence CMR images and a public one from MICCAI2020 MyoPS Challenge. Experimental results showed that MyoPS-Net could achieve state-of-the-art performance in various scenarios. Note that in practical clinics, the subjects may not have full sequences, such as missing LGE CMR or mapping CMR scans. We therefore conducted extensive experiments to investigate the performance of the proposed method in dealing with such complex combinations of different CMR sequences. Results proved the superiority and generalizability of MyoPS-Net, and more importantly, indicated a practical clinical application

A Survey on Deep Learning in Medical Image Analysis

Deep learning algorithms, in particular convolutional networks, have rapidly become a methodology of choice for analyzing medical images. This paper reviews the major deep learning concepts pertinent to medical image analysis and summarizes over 300 contributions to the field, most of which appeared in the last year. We survey the use of deep learning for image classification, object detection, segmentation, registration, and other tasks and provide concise overviews of studies per application area. Open challenges and directions for future research are discussed.Comment: Revised survey includes expanded discussion section and reworked introductory section on common deep architectures. Added missed papers from before Feb 1st 201

FastSurfer-HypVINN: Automated sub-segmentation of the hypothalamus and adjacent structures on high-resolutional brain MRI

The hypothalamus plays a crucial role in the regulation of a broad range of physiological, behavioural, and cognitive functions. However, despite its importance, only a few small-scale neuroimaging studies have investigated its substructures, likely due to the lack of fully automated segmentation tools to address scalability and reproducibility issues of manual segmentation. While the only previous attempt to automatically sub-segment the hypothalamus with a neural network showed promise for 1.0 mm isotropic T1-weighted (T1w) MRI, there is a need for an automated tool to sub-segment also high-resolutional (HiRes) MR scans, as they are becoming widely available, and include structural detail also from multi-modal MRI. We, therefore, introduce a novel, fast, and fully automated deep learning method named HypVINN for sub-segmentation of the hypothalamus and adjacent structures on 0.8 mm isotropic T1w and T2w brain MR images that is robust to missing modalities. We extensively validate our model with respect to segmentation accuracy, generalizability, in-session test-retest reliability, and sensitivity to replicate hypothalamic volume effects (e.g. sex-differences). The proposed method exhibits high segmentation performance both for standalone T1w images as well as for T1w/T2w image pairs. Even with the additional capability to accept flexible inputs, our model matches or exceeds the performance of state-of-the-art methods with fixed inputs. We, further, demonstrate the generalizability of our method in experiments with 1.0 mm MR scans from both the Rhineland Study and the UK Biobank. Finally, HypVINN can perform the segmentation in less than a minute (GPU) and will be available in the open source FastSurfer neuroimaging software suite, offering a validated, efficient, and scalable solution for evaluating imaging-derived phenotypes of the hypothalamus.Comment: Submitted to Imaging Neuroscienc

Enhancing Modality-Agnostic Representations via Meta-Learning for Brain Tumor Segmentation

In medical vision, different imaging modalities provide complementary information. However, in practice, not all modalities may be available during inference or even training. Previous approaches, e.g., knowledge distillation or image synthesis, often assume the availability of full modalities for all patients during training; this is unrealistic and impractical due to the variability in data collection across sites. We propose a novel approach to learn enhanced modality-agnostic representations by employing a meta-learning strategy in training, even when only limited full modality samples are available. Meta-learning enhances partial modality representations to full modality representations by meta-training on partial modality data and meta-testing on limited full modality samples. Additionally, we co-supervise this feature enrichment by introducing an auxiliary adversarial learning branch. More specifically, a missing modality detector is used as a discriminator to mimic the full modality setting. Our segmentation framework significantly outperforms state-of-the-art brain tumor segmentation techniques in missing modality scenarios.Comment: Accepted in ICCV 202

MMMNA-Net for Overall Survival Time Prediction of Brain Tumor Patients

Overall survival (OS) time is one of the most important evaluation indices for gliomas situations. Multimodal Magnetic Resonance Imaging (MRI) scans play an important role in the study of glioma prognosis OS time. Several deep learning-based methods are proposed for the OS time prediction on multi-modal MRI problems. However, these methods usually fuse multi-modal information at the beginning or at the end of the deep learning networks and lack the fusion of features from different scales. In addition, the fusion at the end of networks always adapts global with global (eg. fully connected after concatenation of global average pooling output) or local with local (eg. bilinear pooling), which loses the information of local with global. In this paper, we propose a novel method for multi-modal OS time prediction of brain tumor patients, which contains an improved nonlocal features fusion module introduced on different scales. Our method obtains a relative 8.76% improvement over the current state-of-art method (0.6989 vs. 0.6426 on accuracy). Extensive testing demonstrates that our method could adapt to situations with missing modalities. The code is available at https://github.com/TangWen920812/mmmna-net.Comment: Accepted EMBC 202

Modality-Agnostic Learning for Medical Image Segmentation Using Multi-modality Self-distillation

Medical image segmentation of tumors and organs at risk is a time-consuming yet critical process in the clinic that utilizes multi-modality imaging (e.g, different acquisitions, data types, and sequences) to increase segmentation precision. In this paper, we propose a novel framework, Modality-Agnostic learning through Multi-modality Self-dist-illation (MAG-MS), to investigate the impact of input modalities on medical image segmentation. MAG-MS distills knowledge from the fusion of multiple modalities and applies it to enhance representation learning for individual modalities. Thus, it provides a versatile and efficient approach to handle limited modalities during testing. Our extensive experiments on benchmark datasets demonstrate the high efficiency of MAG-MS and its superior segmentation performance than current state-of-the-art methods. Furthermore, using MAG-MS, we provide valuable insight and guidance on selecting input modalities for medical image segmentation tasks

Brain tumor segmentation with missing modalities via latent multi-source correlation representation

Multimodal MR images can provide complementary information for accurate brain tumor segmentation. However, it's common to have missing imaging modalities in clinical practice. Since there exists a strong correlation between multi modalities, a novel correlation representation block is proposed to specially discover the latent multi-source correlation. Thanks to the obtained correlation representation, the segmentation becomes more robust in the case of missing modalities. The model parameter estimation module first maps the individual representation produced by each encoder to obtain independent parameters, then, under these parameters, the correlation expression module transforms all the individual representations to form a latent multi-source correlation representation. Finally, the correlation representations across modalities are fused via the attention mechanism into a shared representation to emphasize the most important features for segmentation. We evaluate our model on BraTS 2018 datasets, it outperforms the current state-of-the-art method and produces robust results when one or more modalities are missing.Comment: 9 pages, 6 figures, accepted by MICCAI 202