PC-Reg: A pyramidal prediction–correction approach for large deformation image registration

Deformable image registration plays an important role in medical image analysis. Deep neural networks such as VoxelMorph and TransMorph are fast, but limited to small deformations and face challenges in the presence of large deformations. To tackle large deformations in medical image registration, we propose PC-Reg, a pyramidal Prediction and Correction method for deformable registration, which treats multi-scale registration akin to solving an ordinary differential equation (ODE) across scales. Starting with a zero-initialized deformation at the coarse level, PC-Reg follows the predictor–corrector regime and progressively predicts a residual flow and a correction flow to update the deformation vector field through different scales. The prediction in each scale can be regarded as a single step of ODE integration. PC-Reg can be easily extended to diffeomorphic registration and is able to alleviate the multiscale accumulated upsampling and diffeomorphic integration error. Further, to transfer details from full resolution to low scale, we introduce a distillation loss, where the output is used as the target label for intermediate outputs. Experiments on inter-patient deformable registration show that the proposed method significantly improves registration not only for large but also for small deformations

ModeT: Learning Deformable Image Registration via Motion Decomposition Transformer

The Transformer structures have been widely used in computer vision and have recently made an impact in the area of medical image registration. However, the use of Transformer in most registration networks is straightforward. These networks often merely use the attention mechanism to boost the feature learning as the segmentation networks do, but do not sufficiently design to be adapted for the registration task. In this paper, we propose a novel motion decomposition Transformer (ModeT) to explicitly model multiple motion modalities by fully exploiting the intrinsic capability of the Transformer structure for deformation estimation. The proposed ModeT naturally transforms the multi-head neighborhood attention relationship into the multi-coordinate relationship to model multiple motion modes. Then the competitive weighting module (CWM) fuses multiple deformation sub-fields to generate the resulting deformation field. Extensive experiments on two public brain magnetic resonance imaging (MRI) datasets show that our method outperforms current state-of-the-art registration networks and Transformers, demonstrating the potential of our ModeT for the challenging non-rigid deformation estimation problem. The benchmarks and our code are publicly available at https://github.com/ZAX130/SmileCode.Comment: Early accepted by MICCAI 202

Differently stained whole slide image registration technique with landmark validation

Abstract. One of the most significant features in digital pathology is to compare and fuse successive differently stained tissue sections, also called slides, visually. Doing so, aligning different images to a common frame, ground truth, is required. Current sample scanning tools enable to create images full of informative layers of digitalized tissues, stored with a high resolution into whole slide images. However, there are a limited amount of automatic alignment tools handling large images precisely in acceptable processing time. The idea of this study is to propose a deep learning solution for histopathology image registration. The main focus is on the understanding of landmark validation and the impact of stain augmentation on differently stained histopathology images. Also, the developed registration method is compared with the state-of-the-art algorithms which utilize whole slide images in the field of digital pathology. There are previous studies about histopathology, digital pathology, whole slide imaging and image registration, color staining, data augmentation, and deep learning that are referenced in this study. The goal is to develop a learning-based registration framework specifically for high-resolution histopathology image registration. Different whole slide tissue sample images are used with a resolution of up to 40x magnification. The images are organized into sets of consecutive, differently dyed sections, and the aim is to register the images based on only the visible tissue and ignore the background. Significant structures in the tissue are marked with landmarks. The quality measurements include, for example, the relative target registration error, structural similarity index metric, visual evaluation, landmark-based evaluation, matching points, and image details. These results are comparable and can be used also in the future research and in development of new tools. Moreover, the results are expected to show how the theory and practice are combined in whole slide image registration challenges. DeepHistReg algorithm will be studied to better understand the development of stain color feature augmentation-based image registration tool of this study. Matlab and Aperio ImageScope are the tools to annotate and validate the image, and Python is used to develop the algorithm of this new registration tool. As cancer is globally a serious disease regardless of age or lifestyle, it is important to find ways to develop the systems experts can use while working with patients’ data. There is still a lot to improve in the field of digital pathology and this study is one step toward it.Eri menetelmin värjättyjen virtuaalinäytelasien rekisteröintitekniikka kiintopisteiden validointia hyödyntäen. Tiivistelmä. Yksi tärkeimmistä digitaalipatologian ominaisuuksista on verrata ja fuusioida peräkkäisiä eri menetelmin värjättyjä kudosleikkeitä toisiinsa visuaalisesti. Tällöin keskenään lähes identtiset kuvat kohdistetaan samaan yhteiseen kehykseen, niin sanottuun pohjatotuuteen. Nykyiset näytteiden skannaustyökalut mahdollistavat sellaisten kuvien luonnin, jotka ovat täynnä kerroksittaista tietoa digitalisoiduista näytteistä, tallennettuna erittäin korkean resoluution virtuaalisiin näytelaseihin. Tällä hetkellä on olemassa kuitenkin vain kourallinen automaattisia työkaluja, jotka kykenevät käsittelemään näin valtavia kuvatiedostoja tarkasti hyväksytyin aikarajoin. Tämän työn tarkoituksena on syväoppimista hyväksikäyttäen löytää ratkaisu histopatologisten kuvien rekisteröintiin. Tärkeimpänä osa-alueena on ymmärtää kiintopisteiden validoinnin periaatteet sekä eri väriaineiden augmentoinnin vaikutus. Lisäksi tässä työssä kehitettyä rekisteröintialgoritmia tullaan vertailemaan muihin kirjallisuudessa esitettyihin algoritmeihin, jotka myös hyödyntävät virtuaalinäytelaseja digitaalipatologian saralla. Kirjallisessa osiossa tullaan siteeraamaan aiempia tutkimuksia muun muassa seuraavista aihealueista: histopatologia, digitaalipatologia, virtuaalinäytelasi, kuvantaminen ja rekisteröinti, näytteen värjäys, data-augmentointi sekä syväoppiminen. Tavoitteena on kehittää oppimispohjainen rekisteröintikehys erityisesti korkearesoluutioisille digitalisoiduille histopatologisille kuville. Erilaisissa näytekuvissa tullaan käyttämään jopa 40-kertaista suurennosta. Kuvat kudoksista on järjestetty eri menetelmin värjättyihin peräkkäisiin kuvasarjoihin ja tämän työn päämääränä on rekisteröidä kuvat pohjautuen ainoastaan kudosten näkyviin osuuksiin, jättäen kuvien tausta huomioimatta. Kudosten merkittävimmät rakenteet on merkattu niin sanotuin kiintopistein. Työn laatumittauksina käytetään arvoja, kuten kohteen suhteellinen rekisteröintivirhe (rTRE), rakenteellisen samankaltaisuuindeksin mittari (SSIM), sekä visuaalista arviointia, kiintopisteisiin pohjautuvaa arviointia, yhteensopivuuskohtia, ja kuvatiedoston yksityiskohtia. Nämä arvot ovat verrattavissa myös tulevissa tutkimuksissa ja samaisia arvoja voidaan käyttää uusia työkaluja kehiteltäessä. DeepHistReg metodi toimii pohjana tässä työssä kehitettävälle näytteen värjäyksen parantamiseen pohjautuvalle rekisteröintityökalulle. Matlab ja Aperio ImageScope ovat ohjelmistoja, joita tullaan hyödyntämään tässä työssä kuvien merkitsemiseen ja validointiin. Ohjelmointikielenä käytetään Pythonia. Syöpä on maailmanlaajuisesti vakava sairaus, joka ei katso ikää eikä elämäntyyliä. Siksi on tärkeää löytää uusia keinoja kehittää työkaluja, joita asiantuntijat voivat hyödyntää jokapäiväisessä työssään potilastietojen käsittelyssä. Digitaalipatologian osa-alueella on vielä paljon innovoitavaa ja tämä työ on yksi askel eteenpäin taistelussa syöpäsairauksia vastaan

An unsupervised learning approach to ultrasound strain elastography with spatio-temporal consistency

Quasi-static ultrasound elastography (USE) is an imaging modality that measures deformation (i.e. strain) of tissue in response to an applied mechanical force. In USE, the strain modulus is traditionally obtained by deriving the displacement field estimated between a pair of radio-frequency data. In this work we propose a recurrent network architecture with convolutional long-short-term memory decoder blocks to improve displacement estimation and spatio-temporal continuity between time series ultrasound frames. The network is trained in an unsupervised way, by optimising a similarity metric between the reference and compressed image. Our training loss is also composed of a regularisation term that preserves displacement continuity by directly optimising the strain smoothness, and a temporal continuity term that enforces consistency between successive strain predictions. In addition, we propose an open-access in vivo database for quasi-static USE, which consists of radio-frequency data sequences captured on the arm of a human volunteer. Our results from numerical simulation and in vivo data suggest that our recurrent neural network can account for larger deformations, as compared with two other feed-forward neural networks. In all experiments, our recurrent network outperformed the state-of-the-art for both learning-based and optimisationbased methods, in terms of elastographic signal-to-noise ratio, strain consistency, and image similarity. Finally, our open-source code provides a 3D-slicer visualisation module that can be used to process ultrasound RF frames in real-time, at a rate of up to 20 frames per second, using a standard GPU

Going Deep in Medical Image Analysis: Concepts, Methods, Challenges and Future Directions

Medical Image Analysis is currently experiencing a paradigm shift due to Deep Learning. This technology has recently attracted so much interest of the Medical Imaging community that it led to a specialized conference in `Medical Imaging with Deep Learning' in the year 2018. This article surveys the recent developments in this direction, and provides a critical review of the related major aspects. We organize the reviewed literature according to the underlying Pattern Recognition tasks, and further sub-categorize it following a taxonomy based on human anatomy. This article does not assume prior knowledge of Deep Learning and makes a significant contribution in explaining the core Deep Learning concepts to the non-experts in the Medical community. Unique to this study is the Computer Vision/Machine Learning perspective taken on the advances of Deep Learning in Medical Imaging. This enables us to single out `lack of appropriately annotated large-scale datasets' as the core challenge (among other challenges) in this research direction. We draw on the insights from the sister research fields of Computer Vision, Pattern Recognition and Machine Learning etc.; where the techniques of dealing with such challenges have already matured, to provide promising directions for the Medical Imaging community to fully harness Deep Learning in the future

ADVANCED MOTION MODELS FOR RIGID AND DEFORMABLE REGISTRATION IN IMAGE-GUIDED INTERVENTIONS

Image-guided surgery (IGS) has been a major area of interest in recent decades that continues to transform surgical interventions and enable safer, less invasive procedures. In the preoperative contexts, diagnostic imaging, including computed tomography (CT) and magnetic resonance (MR) imaging, offers a basis for surgical planning (e.g., definition of target, adjacent anatomy, and the surgical path or trajectory to the target). At the intraoperative stage, such preoperative images and the associated planning information are registered to intraoperative coordinates via a navigation system to enable visualization of (tracked) instrumentation relative to preoperative images. A major limitation to such an approach is that motions during surgery, either rigid motions of bones manipulated during orthopaedic surgery or brain soft-tissue deformation in neurosurgery, are not captured, diminishing the accuracy of navigation systems. This dissertation seeks to use intraoperative images (e.g., x-ray fluoroscopy and cone-beam CT) to provide more up-to-date anatomical context that properly reflects the state of the patient during interventions to improve the performance of IGS. Advanced motion models for inter-modality image registration are developed to improve the accuracy of both preoperative planning and intraoperative guidance for applications in orthopaedic pelvic trauma surgery and minimally invasive intracranial neurosurgery. Image registration algorithms are developed with increasing complexity of motion that can be accommodated (single-body rigid, multi-body rigid, and deformable) and increasing complexity of registration models (statistical models, physics-based models, and deep learning-based models). For orthopaedic pelvic trauma surgery, the dissertation includes work encompassing: (i) a series of statistical models to model shape and pose variations of one or more pelvic bones and an atlas of trajectory annotations; (ii) frameworks for automatic segmentation via registration of the statistical models to preoperative CT and planning of fixation trajectories and dislocation / fracture reduction; and (iii) 3D-2D guidance using intraoperative fluoroscopy. For intracranial neurosurgery, the dissertation includes three inter-modality deformable registrations using physic-based Demons and deep learning models for CT-guided and CBCT-guided procedures

Is attention all you need in medical image analysis? A review

Medical imaging is a key component in clinical diagnosis, treatment planning and clinical trial design, accounting for almost 90% of all healthcare data. CNNs achieved performance gains in medical image analysis (MIA) over the last years. CNNs can efficiently model local pixel interactions and be trained on small-scale MI data. The main disadvantage of typical CNN models is that they ignore global pixel relationships within images, which limits their generalisation ability to understand out-of-distribution data with different 'global' information. The recent progress of Artificial Intelligence gave rise to Transformers, which can learn global relationships from data. However, full Transformer models need to be trained on large-scale data and involve tremendous computational complexity. Attention and Transformer compartments (Transf/Attention) which can well maintain properties for modelling global relationships, have been proposed as lighter alternatives of full Transformers. Recently, there is an increasing trend to co-pollinate complementary local-global properties from CNN and Transf/Attention architectures, which led to a new era of hybrid models. The past years have witnessed substantial growth in hybrid CNN-Transf/Attention models across diverse MIA problems. In this systematic review, we survey existing hybrid CNN-Transf/Attention models, review and unravel key architectural designs, analyse breakthroughs, and evaluate current and future opportunities as well as challenges. We also introduced a comprehensive analysis framework on generalisation opportunities of scientific and clinical impact, based on which new data-driven domain generalisation and adaptation methods can be stimulated