Atlas Construction for Measuring the Variability of Complex Anatomical Structures

RÉSUMÉ La recherche sur l'anatomie humaine, en particulier sur le cœur et le cerveau, est d'un intérêt particulier car leurs anomalies entraînent des pathologies qui sont parmi les principales causes de décès dans le monde et engendrent des coûts substantiels. Heureusement, les progrès en imagerie médicale permettent des diagnostics et des traitements autrefois impossibles. En contrepartie, la quantité phénoménale de données produites par ces technologies nécessite le développement d'outils efficaces pour leur traitement. L'objectif de cette thèse est de proposer un ensemble d'outils permettant de normaliser des mesures prélevées sur différents individus, essentiels à l'étude des caractéristiques de structures anatomiques complexes. La normalisation de mesures consiste à rassembler une collection d'images dans une référence commune, aussi appelée construction d'atlas numériques, afin de combiner des mesures provenant de différents patients. Le processus de construction inclut deux étapes principales; la segmentation d'images pour trouver des régions d'intérêts et le recalage d'images afin de déterminer les correspondances entres régions d'intérêts. Les méthodes actuelles de constructions d'atlas peuvent nécessiter des interventions manuelles, souvent fastidieuses, variables, et sont en outre limitées par leurs mécanismes internes. Principalement, le recalage d'images dépend d'une déformation incrémentales d'images sujettes a des minimums locaux. Le recalage n'est ainsi pas optimal lors de grandes déformations et ces limitations requièrent la nécessite de proposer de nouvelles approches pour la construction d'atlas. Les questions de recherche de cette thèse se concentrent donc sur l'automatisation des méthodes actuelles ainsi que sur la capture de déformations complexes de structures anatomiques, en particulier sur le cœur et le cerveau. La méthodologie adoptée a conduit à trois objectifs de recherche spécifiques. Le premier prévoit un nouveau cadre de construction automatise d'atlas afin de créer le premier atlas humain de l'architecture de fibres cardiaques. Le deuxième vise à explorer une nouvelle approche basée sur la correspondance spectrale, nommée FOCUSR, afin de capturer une grande variabilité de formes sur des maillages. Le troisième aboutit finalement à développer une approche fondamentalement différente pour le recalage d'images à fortes déformations, nommée les démons spectraux. Le premier objectif vise plus particulièrement à construire un atlas statistique de l'architecture des fibres cardiaques a partir de 10 cœurs ex vivo humains. Le système développé a mené à deux contributions techniques et une médicale, soit l'amélioration de la segmentation de structures cardiaques et l'automatisation du calcul de forme moyenne, ainsi que notamment la première étude chez l'homme de la variabilité de l'architecture des fibres cardiaques. Pour résumer les principales conclusions, les fibres du cœur humain moyen varient de +- 12 degrés, l'angle d'helix s'étend entre -41 degrés (+- 26 degrés) sur l'épicarde à +66 degrés (+- 15 degrés) sur l'endocarde, tandis que l'angle transverse varie entre +9 degrés (+- 12 degrés) et +34 degrés (+- 29 degrés) à travers le myocarde. Ces résultats sont importants car ces fibres jouent un rôle clef dans diverses fonctions mécaniques et électrophysiologiques du cœur. Le deuxième objectif cherche à capturer une grande variabilité de formes entre structures anatomiques complexes, plus particulièrement entre cortex cérébraux à cause de l'extrême variabilité de ces surfaces et de leur intérêt pour l'étude de fonctions cognitives. La nouvelle méthode de correspondance surfacique, nommée FOCUSR, exploite des représentations spectrales car l'appariement devient plus facile et rapide dans le domaine spectral plutôt que dans l'espace Euclidien classique. Dans sa forme la plus simple, FOCUSR améliore les méthodes spectrales actuelles par un recalage non rigide des représentations spectrales, toutefois, son plein potentiel est atteint en exploitant des données supplémentaires lors de la mise en correspondance. Par exemple, les résultats ont montré que la profondeur des sillons et de la courbure du cortex cérébral améliore significativement la correspondance de surfaces de cerveaux. Enfin, le troisième objectif vise à améliorer le recalage d'images d'organes ayant des fortes variabilités entre individus ou subis de fortes déformations, telles que celles créées par le mouvement cardiaque. La méthodologie amenée par la correspondance spectrale permet d'améliorer les approches conventionnelles de recalage d'images. En effet, les représentations spectrales, capturant des similitudes géométriques globales entre différentes formes, permettent de surmonter les limitations actuelles des méthodes de recalage qui restent guidées par des forces locales. Le nouvel algorithme, nommé démons spectraux, peut ainsi supporter de très grandes déformations locales et complexes entre images, et peut être tout autant adapté a d'autres approches, telle que dans un cadre de recalage conjoint d'images. Il en résulte un cadre complet de construction d'atlas, nommé démons spectraux multijoints, où la forme moyenne est calculée directement lors du processus de recalage plutôt qu'avec une approche séquentielle de recalage et de moyennage. La réalisation de ces trois objectifs spécifiques a permis des avancées dans l'état de l'art au niveau des méthodes de correspondance spectrales et de construction d'atlas, en permettant l'utilisation d'organes présentant une forte variabilité de formes. Dans l'ensemble, les différentes stratégies fournissent de nouvelles contributions sur la façon de trouver et d'exploiter des descripteurs globaux d'images et de surfaces. D'un point de vue global, le développement des objectifs spécifiques établit un lien entre : a) la première série d'outils, mettant en évidence les défis à recaler des images à fortes déformations, b) la deuxième série d'outils, servant à capturer de fortes déformations entre surfaces mais qui ne reste pas directement applicable a des images, et c) la troisième série d'outils, faisant un retour sur le traitement d'images en permettant la construction d'atlas a partir d'images ayant subies de fortes déformations. Il y a cependant plusieurs limitations générales qui méritent d'être investiguées, par exemple, les données partielles (tronquées ou occluses) ne sont pas actuellement prises en charge les nouveaux outils, ou encore, les stratégies algorithmiques utilisées laissent toujours place à l'amélioration. Cette thèse donne de nouvelles perspectives dans les domaines de l'imagerie cardiaque et de la neuroimagerie, toutefois, les nouveaux outils développés sont assez génériques pour être appliqués a tout recalage d'images ou de surfaces. Les recommandations portent sur des recherches supplémentaires qui établissent des liens avec la segmentation à base de graphes, pouvant conduire à un cadre complet de construction d'atlas où la segmentation, le recalage, et le moyennage de formes seraient tous interdépendants. Il est également recommandé de poursuivre la recherche sur la construction de meilleurs modèles électromécaniques cardiaques à partir des résultats de cette thèse. En somme, les nouveaux outils offrent de nouvelles bases de recherche et développement pour la normalisation de formes, ce qui peut potentiellement avoir un impact sur le diagnostic, ainsi que la planification et la pratique d'interventions médicales.----------ABSTRACT Research on human anatomy, in particular on the heart and the brain, is a primary concern for society since their related diseases are among top killers across the globe and have exploding associated costs. Fortunately, recent advances in medical imaging offer new possibilities for diagnostics and treatments. On the other hand, the growth in data produced by these relatively new technologies necessitates the development of efficient tools for processing data. The focus of this thesis is to provide a set of tools for normalizing measurements across individuals in order to study complex anatomical characteristics. The normalization of measurements consists of bringing a collection of images into a common reference, also known as atlas construction, in order to combine measurements made on different individuals. The process of constructing an atlas involves the topics of segmentation, which finds regions of interest in the data (e.g., an organ, a structure), and registration, which finds correspondences between regions of interest. Current frameworks may require tedious and hardly reproducible user interactions, and are additionally limited by their computational schemes, which rely on slow iterative deformations of images, prone to local minima. Image registration is, therefore, not optimal with large deformations. Such limitations indicate the need to research new approaches for atlas construction. The research questions are consequently addressing the problems of automating current frameworks and capturing global and complex deformations between anatomical structures, in particular between human hearts and brains. More precisely, the methodology adopted in the thesis led to three specific research objectives. Briefly, the first step aims at developing a new automated framework for atlas construction in order to build the first human atlas of the cardiac fiber architecture. The second step intends to explore a new approach based on spectral correspondence, named FOCUSR, in order to precisely capture large shape variability. The third step leads, finally, to a fundamentally new approach for image registration with large deformations, named the Spectral Demons algorithm. The first objective aims more specifically at constructing a statistical atlas of the cardiac fiber architecture from a unique human dataset of 10 ex vivo hearts. The developed framework made two technical, and one medical, contributions, that are the improvement of the segmentation of cardiac structures, the automation of the shape averaging process, and more importantly, the first human study on the variability of the cardiac fiber architecture. To summarize the main finding, the fiber orientations in human hearts has been found to vary with about +- 12 degrees, the range of the helix angle spans from -41 degrees (+- 26 degrees) on the epicardium to +66 degrees (+- 15 degrees) on the endocardium, while, the range of the transverse angle spans from +9 degrees (+- 12 degrees) to +34 degrees (+- 29 degrees) across the myocardial wall. These findings are significant in cardiology since the fiber architecture plays a key role in cardiac mechanical functions and in electrophysiology. The second objective intends to capture large shape variability between complex anatomical structures, in particular between cerebral cortices due to their highly convoluted surfaces and their high anatomical and functional variability across individuals. The new method for surface correspondence, named FOCUSR, exploits spectral representations since matching is easier in the spectral domain rather than in the conventional Euclidean space. In its simplest form, FOCUSR improves current spectral approaches by refining spectral representations with a nonrigid alignment; however, its full power is demonstrated when using additional features during matching. For instance, the results showed that sulcal depth and cortical curvature improve significantly the accuracy of cortical surface matching. Finally, the third objective is to improve image registration for organs with a high inter-subject variability or undergoing very large deformations, such as the heart. The new approach brought by the spectral matching technique allows the improvement of conventional image registration methods. Indeed, spectral representations, which capture global geometric similarities and large deformations between different shapes, may be used to overcome a major limitation of current registration methods, which are in fact guided by local forces and restrained to small deformations. The new algorithm, named Spectral Demons, can capture very large and complex deformations between images, and can additionally be adapted to other approaches, such as in a groupwise configuration. This results in a complete framework for atlas construction, named Groupwise Spectral Demons, where the average shape is computed during the registration process rather than in sequential steps. The achievements of these three specific objectives permitted advances in the state-of-the-art of spectral matching methods and of atlas construction, enabling the registration of organs with significant shape variability. Overall, the investigation of these different strategies provides new contributions on how to find and exploit global descriptions of images and surfaces. From a global perspective, these objectives establish a link between: a) the first set of tools, that highlights the challenges in registering images with very large deformations, b) the second set of tools, that captures very large deformations between surfaces but are not applicable to images, and c) the third set of tools, that comes back on processing images and allows a natural construction of atlases from images with very large deformations. There are, however, several general remaining limitations, for instance, partial data (truncated or occluded) is currently not supported by the new tools, or also, the strategy for computing and using spectral representations still leaves room for improvement. This thesis gives new perspectives in cardiac and neuroimaging, yet at the same time, the new tools remain general enough for virtually any application that uses surface or image registration. It is recommended to research additional links with graph-based segmentation methods, which may lead to a complete framework for atlas construction where segmentation, registration and shape averaging are all interlinked. It is also recommended to pursue research on building better cardiac electromechanical models from the findings of this thesis. Nevertheless, the new tools provide new grounds for research and application of shape normalization, which may potentially impact diagnostic, as well as planning and performance of medical interventions

Active learning for medical image segmentation with stochastic batches

The performance of learning-based algorithms improves with the amount of labelled data used for training. Yet, manually annotating data is particularly difficult for medical image segmentation tasks because of the limited expert availability and intensive manual effort required. To reduce manual labelling, active learning (AL) targets the most informative samples from the unlabelled set to annotate and add to the labelled training set. On the one hand, most active learning works have focused on the classification or limited segmentation of natural images, despite active learning being highly desirable in the difficult task of medical image segmentation. On the other hand, uncertainty-based AL approaches notoriously offer sub-optimal batch-query strategies, while diversity-based methods tend to be computationally expensive. Over and above methodological hurdles, random sampling has proven an extremely difficult baseline to outperform when varying learning and sampling conditions. This work aims to take advantage of the diversity and speed offered by random sampling to improve the selection of uncertainty-based AL methods for segmenting medical images. More specifically, we propose to compute uncertainty at the level of batches instead of samples through an original use of stochastic batches (SB) during sampling in AL. Stochastic batch querying is a simple and effective add-on that can be used on top of any uncertainty-based metric. Extensive experiments on two medical image segmentation datasets show that our strategy consistently improves conventional uncertainty-based sampling methods. Our method can hence act as a strong baseline for medical image segmentation. The code is available on: https://github.com/Minimel/StochasticBatchAL.git.Comment: Accepted to Medical Image Analysis, 17 page

The Little W-Net That Could: State-of-the-Art Retinal Vessel Segmentation with Minimalistic Models

The segmentation of the retinal vasculature from eye fundus images represents one of the most fundamental tasks in retinal image analysis. Over recent years, increasingly complex approaches based on sophisticated Convolutional Neural Network architectures have been slowly pushing performance on well-established benchmark datasets. In this paper, we take a step back and analyze the real need of such complexity. Specifically, we demonstrate that a minimalistic version of a standard U-Net with several orders of magnitude less parameters, carefully trained and rigorously evaluated, closely approximates the performance of current best techniques. In addition, we propose a simple extension, dubbed W-Net, which reaches outstanding performance on several popular datasets, still using orders of magnitude less learnable weights than any previously published approach. Furthermore, we provide the most comprehensive cross-dataset performance analysis to date, involving up to 10 different databases. Our analysis demonstrates that the retinal vessel segmentation problem is far from solved when considering test images that differ substantially from the training data, and that this task represents an ideal scenario for the exploration of domain adaptation techniques. In this context, we experiment with a simple self-labeling strategy that allows us to moderately enhance cross-dataset performance, indicating that there is still much room for improvement in this area. Finally, we also test our approach on the Artery/Vein segmentation problem, where we again achieve results well-aligned with the state-of-the-art, at a fraction of the model complexity in recent literature. All the code to reproduce the results in this paper is released

Trust your neighbours: Penalty-based constraints for model calibration

Ensuring reliable confidence scores from deep networks is of pivotal importance in critical decision-making systems, notably in the medical domain. While recent literature on calibrating deep segmentation networks has led to significant progress, their uncertainty is usually modeled by leveraging the information of individual pixels, which disregards the local structure of the object of interest. In particular, only the recent Spatially Varying Label Smoothing (SVLS) approach addresses this issue by softening the pixel label assignments with a discrete spatial Gaussian kernel. In this work, we first present a constrained optimization perspective of SVLS and demonstrate that it enforces an implicit constraint on soft class proportions of surrounding pixels. Furthermore, our analysis shows that SVLS lacks a mechanism to balance the contribution of the constraint with the primary objective, potentially hindering the optimization process. Based on these observations, we propose a principled and simple solution based on equality constraints on the logit values, which enables to control explicitly both the enforced constraint and the weight of the penalty, offering more flexibility. Comprehensive experiments on a variety of well-known segmentation benchmarks demonstrate the superior performance of the proposed approach.Comment: Under revie

Myocardial Infarct Localization using Neighborhood Approximation Forests

International audienceThis paper presents a machine-learning algorithm for the automatic localization of myocardial infarct in the left ventricle. Our method constructs neighbourhood approximation forests, which are trained with previously diagnosed 4D cardiac sequences. We introduce a new set of features that simultaneously exploit information from the shape and motion of the myocardial wall along the cardiac cycle. More precisely, characteristics are extracted from a hyper surface that represents the profile of the myocardial thickness. The method has been tested on a database of 65 cardiac MRI images in order to retrieve the diagnosed infarct area. The results demonstrate the effectiveness of the NAF in predicting the left ventricular infarct location in 7 distinct regions. We evaluated our method by verifying the database ground truth. Followinga new examination of the 4D cardiac images, our algorithm may detect misclassified infarct locations in the database

Spectral Matching - Application to Brain Surfaces

How to analyze complex shapes, such as of the highly folded surface of the brain This talk will show how spectral representations of shapes can benefit neuroimaging. Here, we exploit spectral coordinates derived from the eigenfunctions of the graph Laplacian. Methodologically, we address the inherent instability of spectral shape decompositions. This change of paradigm, exploiting spectral representations, enables an intrinsic processing of brain surfaces. Brain surface matching will be shown as an example.Non UBCUnreviewedAuthor affiliation: ETS Montreal - Inria Sophia AntipolisResearche

Diffeomorphic spectral matching of cortical surfaces

Abstract. Accurate matching of cortical surfaces is necessary in many neuroscience applications. In this context diffeomorphisms are often sought, because they facilitate further statistical analysis and atlas building. Present methods for computing diffeomorphisms are based on optimizing flows or on inflating surfaces to a common template, but they are often computationally expensive. It typically takes several hours on a conventional desktop computer to match a single pair of cortical surfaces having a few hundred thousand vertices. We propose a very fast alternative based on an application of spectral graph theory on a novel association graph. Our symmetric approach can generate a diffeomorphic correspondence map within a few minutes on high-resolution meshes while avoiding the sign and multiplicity ambiguities of conventional spectral matching methods. The eigenfunctions are shared between surfaces and provide a smooth parameterization of surfaces. These properties are exploited to compute differentials on highly folded cortical surfaces. Diffeomorphisms can thus be verified and invalid surface folding detected. Our method is demonstrated to attain a vertex accuracy that is at least as good as that of FreeSurfer and Spherical Demons but in only a fraction of their processing time. As a practical experiment, we construct an unbiased atlas of cortical surfaces with a speed several orders of magnitude faster than current methods.