arXiv subjects

Adrien Depeursinge

Publications and source records attributed to Adrien Depeursinge.

At least 19 recordsLinked to original sources

arXiv2026

HEad and neCK TumOR (HECKTOR) 2025: Benchmark of Segmentation, Diagnosis, and Prognosis in Multimodal PET/CT

Head and neck cancers (HNC) represent a significant global health burden, with accurate tumor delineation being essential for effective radiotherapy planning. The complexity of the oropharyngeal anatomy, combined with the heterogeneous appearance of tumors on imaging, makes manual segmentation time-intensive and subject to inter-observer variability. Beyond segmentation, predicting long-term clinical outcomes, such as recurrence-free survival (RFS), and determining human papillomavirus (HPV) status from noninvasive imaging, remain challenging yet clinically valuable goals. The HECKTOR 2025 challenge addresses these needs by establishing a comprehensive benchmark for automated HNC analysis using multimodal PET/CT imaging and electronic health records. Building on previous editions (2020-2022), this challenge features an expanded multi-institutional dataset comprising over 1,100 patients from 10 centers worldwide. Participants were tasked with three complementary objectives: (1) segmenting primary gross tumor volumes (GTVp) and metastatic lymph nodes (GTVn), (2) predicting recurrence-free survival, and (3) classifying HPV status. The challenge attracted 35 registered teams, with 15 final submissions evaluated on a held-out test set. Top-performing algorithms achieved a mean Dice similarity coefficient of 0.75 for segmentation, a concordance index of 0.66 for survival prediction, and a balanced accuracy of 0.56 for HPV classification. This paper presents a comprehensive analysis of the submitted methodologies, evaluates their performance across different lesion characteristics, and discusses their implications for clinical translation in automated oncology workflows and decision support systems.

cs.CV↗

arXiv2026

Explaining Uncertainty in Multiple Sclerosis Cortical Lesion Segmentation Beyond Prediction Errors

Trustworthy artificial intelligence (AI) is essential in healthcare, particularly for high-stakes tasks like medical image segmentation. Explainable AI and uncertainty quantification significantly enhance AI reliability by addressing key attributes such as robustness, usability, and explainability. Despite extensive technical advances in uncertainty quantification for medical imaging, understanding the clinical informativeness and interpretability of uncertainty remains limited. This study presents an interpretability framework for analyzing lesion-scale predictive uncertainty in cortical lesion segmentation in multiple sclerosis using deep ensembles. The analysis shifts the focus from the uncertainty--error relationship towards clinically relevant medical and engineering factors. Our findings reveal that instance-wise uncertainty is strongly related to lesion size, shape, and cortical involvement. Expert rater feedback confirms that similar factors impede annotator confidence. Evaluations conducted on two datasets (206 patients, almost 2000 lesions) under both in-domain and distribution-shift conditions highlight the utility of the framework in different scenarios.

eess.IV↗

arXiv2026

Instance-level quantitative saliency in multiple sclerosis lesion segmentation

Explainable artificial intelligence (XAI) methods have been proposed to interpret model decisions in classification and, more recently, in semantic segmentation. However, instance-level XAI for semantic segmentation, namely explanations focused on a single object among multiple instances of the same class, remains largely unexplored. Such explanations are particularly important in multi-lesional diseases to understand what drives the detection and contouring of a specific lesion. We propose instance-level explanation maps for semantic segmentation by extending SmoothGrad and Grad-CAM++ to obtain quantitative instance saliency. These methods were applied to the segmentation of white matter lesions (WMLs), a magnetic resonance imaging biomarker in multiple sclerosis. We used 4023 FLAIR and MPRAGE MRI scans from 687 patients collected at the University Hospital of Basel, Switzerland, with WML masks annotated by four expert clinicians. Three deep learning architectures, a 3D U-Net, nnU-Net, and Swin UNETR, were trained and evaluated, achieving normalized Dice scores of 0.71, 0.78, and 0.80, respectively. Instance saliency maps showed that the models relied primarily on FLAIR rather than MPRAGE for WML segmentation, with positive saliency inside lesions and negative saliency in their immediate neighborhood, consistent with clinical practice. Peak saliency values differed significantly across correct and incorrect predictions, suggesting that quantitative instance saliency may help identify segmentation errors. In conclusion, we introduce two architecture-agnostic XAI methods that provide quantitative instance-level explanations for semantic segmentation and support clinically meaningful interpretation of model decisions.

eess.IV↗

arXiv2025

A Multimodal and Multi-centric Head and Neck Cancer Dataset for Segmentation, Diagnosis and Outcome Prediction

We present a publicly available multimodal dataset for head and neck cancer research, comprising 1123 annotated Positron Emission Tomography/Computed Tomography (PET/CT) studies from patients with histologically confirmed disease, acquired from 10 international medical centers. All studies contain co-registered PET/CT scans with varying acquisition protocols, reflecting real-world clinical diversity from a long-term, multi-institution retrospective collection. Primary gross tumor volumes (GTVp) and involved lymph nodes (GTVn) were manually segmented by experienced radiation oncologists and radiologists following established guidelines. We provide anonymized NifTi files, expert-annotated segmentation masks, comprehensive clinical metadata, and radiotherapy dose distributions for a patient subset. The metadata include TNM staging, HPV status, demographics, long-term follow-up outcomes, survival times, censoring indicators, and treatment information. To demonstrate its utility, we benchmark three key clinical tasks: automated tumor segmentation, recurrence-free survival prediction, and HPV status classification, using state-of-the-art deep learning models like UNet, SegResNet, and multimodal prognostic frameworks.

cs.CV↗

arXiv2025

AI-based response assessment and prediction in longitudinal imaging for brain metastases treated with stereotactic radiosurgery

Brain Metastases (BM) are a large contributor to mortality of patients with cancer. They are treated with Stereotactic Radiosurgery (SRS) and monitored with Magnetic Resonance Imaging (MRI) at regular follow-up intervals according to treatment guidelines. Analyzing and quantifying this longitudinal imaging represents an intractable workload for clinicians. As a result, follow-up images are not annotated and merely assessed by observation. Response to treatment in longitudinal imaging is being studied, to better understand growth trajectories and ultimately predict treatment success or toxicity as early as possible. In this study, we implement an automated pipeline to curate a large longitudinal dataset of SRS treatment data, resulting in a cohort of 896 BMs in 177 patients who were monitored for >360 days at approximately two-month intervals at Lausanne University Hospital (CHUV). We use a data-driven clustering to identify characteristic trajectories. In addition, we predict 12 months lesion-level response using classical as well as graph machine learning Graph Machine Learning (GML). Clustering revealed 5 dominant growth trajectories with distinct final response categories. Response prediction reaches up to 0.90 AUC (CI95%=0.88-0.92) using only pre-treatment and first follow-up MRI with gradient boosting. Similarly, robust predictive performance of up to 0.88 AUC (CI95%=0.86-0.90) was obtained using GML, offering more flexibility with a single model for multiple input time-points configurations. Our results suggest potential automation and increased precision for the comprehensive assessment and prediction of BM response to SRS in longitudinal MRI. The proposed pipeline facilitates scalable data curation for the investigation of BM growth patterns, and lays the foundation for clinical decision support systems aiming at optimizing personalized care.

cs.CV↗

arXiv2025

Benchmarking and Explaining Deep Learning Cortical Lesion MRI Segmentation in Multiple Sclerosis

Cortical lesions (CLs) have emerged as valuable biomarkers in multiple sclerosis (MS), offering high diagnostic specificity and prognostic relevance. However, their routine clinical integration remains limited due to subtle magnetic resonance imaging (MRI) appearance, challenges in expert annotation, and a lack of standardized automated methods. We propose a comprehensive multi-centric benchmark of CL detection and segmentation in MRI. A total of 656 MRI scans, including clinical trial and research data from four institutions, were acquired at 3T and 7T using MP2RAGE and MPRAGE sequences with expert-consensus annotations. We rely on the self-configuring nnU-Net framework, designed for medical imaging segmentation, and propose adaptations tailored to the improved CL detection. We evaluated model generalization through out-of-distribution testing, demonstrating strong lesion detection capabilities with an F1-score of 0.64 and 0.5 in and out of the domain, respectively. We also analyze internal model features and model errors for a better understanding of AI decision-making. Our study examines how data variability, lesion ambiguity, and protocol differences impact model performance, offering future recommendations to address these barriers to clinical adoption. To reinforce the reproducibility, the implementation and models will be publicly accessible and ready to use at https://github.com/Medical-Image-Analysis-Laboratory/ and https://doi.org/10.5281/zenodo.15911797.

eess.IV↗

arXiv2025

A Multi-Centric Anthropomorphic 3D CT Phantom-Based Benchmark Dataset for Harmonization

Artificial intelligence (AI) has introduced numerous opportunities for human assistance and task automation in medicine. However, it suffers from poor generalization in the presence of shifts in the data distribution. In the context of AI-based computed tomography (CT) analysis, significant data distribution shifts can be caused by changes in scanner manufacturer, reconstruction technique or dose. AI harmonization techniques can address this problem by reducing distribution shifts caused by various acquisition settings. This paper presents an open-source benchmark dataset containing CT scans of an anthropomorphic phantom acquired with various scanners and settings, which purpose is to foster the development of AI harmonization techniques. Using a phantom allows fixing variations attributed to inter- and intra-patient variations. The dataset includes 1378 image series acquired with 13 scanners from 4 manufacturers across 8 institutions using a harmonized protocol as well as several acquisition doses. Additionally, we present a methodology, baseline results and open-source code to assess image- and feature-level stability and liver tissue classification, promoting the development of AI harmonization strategies.

cs.CV↗

arXiv2024

Structural-Based Uncertainty in Deep Learning Across Anatomical Scales: Analysis in White Matter Lesion Segmentation

This paper explores uncertainty quantification (UQ) as an indicator of the trustworthiness of automated deep-learning (DL) tools in the context of white matter lesion (WML) segmentation from magnetic resonance imaging (MRI) scans of multiple sclerosis (MS) patients. Our study focuses on two principal aspects of uncertainty in structured output segmentation tasks. First, we postulate that a reliable uncertainty measure should indicate predictions likely to be incorrect with high uncertainty values. Second, we investigate the merit of quantifying uncertainty at different anatomical scales (voxel, lesion, or patient). We hypothesize that uncertainty at each scale is related to specific types of errors. Our study aims to confirm this relationship by conducting separate analyses for in-domain and out-of-domain settings. Our primary methodological contributions are (i) the development of novel measures for quantifying uncertainty at lesion and patient scales, derived from structural prediction discrepancies, and (ii) the extension of an error retention curve analysis framework to facilitate the evaluation of UQ performance at both lesion and patient scales. The results from a multi-centric MRI dataset of 444 patients demonstrate that our proposed measures more effectively capture model errors at the lesion and patient scales compared to measures that average voxel-scale uncertainty values. We provide the UQ protocols code at https://github.com/Medical-Image-Analysis-Laboratory/MS_WML_uncs.

cs.CV↗

arXiv2024

Exploiting XAI maps to improve MS lesion segmentation and detection in MRI

To date, several methods have been developed to explain deep learning algorithms for classification tasks. Recently, an adaptation of two of such methods has been proposed to generate instance-level explainable maps in a semantic segmentation scenario, such as multiple sclerosis (MS) lesion segmentation. In the mentioned work, a 3D U-Net was trained and tested for MS lesion segmentation, yielding an F1 score of 0.7006, and a positive predictive value (PPV) of 0.6265. The distribution of values in explainable maps exposed some differences between maps of true and false positive (TP/FP) examples. Inspired by those results, we explore in this paper the use of characteristics of lesion-specific saliency maps to refine segmentation and detection scores. We generate around 21000 maps from as many TP/FP lesions in a batch of 72 patients (training set) and 4868 from the 37 patients in the test set. 93 radiomic features extracted from the first set of maps were used to train a logistic regression model and classify TP versus FP. On the test set, F1 score and PPV were improved by a large margin when compared to the initial model, reaching 0.7450 and 0.7817, with 95% confidence intervals of [0.7358, 0.7547] and [0.7679, 0.7962], respectively. These results suggest that saliency maps can be used to refine prediction scores, boosting a model's performances.

eess.IV↗

arXiv2024

EDUE: Expert Disagreement-Guided One-Pass Uncertainty Estimation for Medical Image Segmentation

Deploying deep learning (DL) models in medical applications relies on predictive performance and other critical factors, such as conveying trustworthy predictive uncertainty. Uncertainty estimation (UE) methods provide potential solutions for evaluating prediction reliability and improving the model confidence calibration. Despite increasing interest in UE, challenges persist, such as the need for explicit methods to capture aleatoric uncertainty and align uncertainty estimates with real-life disagreements among domain experts. This paper proposes an Expert Disagreement-Guided Uncertainty Estimation (EDUE) for medical image segmentation. By leveraging variability in ground-truth annotations from multiple raters, we guide the model during training and incorporate random sampling-based strategies to enhance calibration confidence. Our method achieves 55% and 23% improvement in correlation on average with expert disagreements at the image and pixel levels, respectively, better calibration, and competitive segmentation performance compared to the state-of-the-art deep ensembles, requiring only a single forward pass.

eess.IV↗

arXiv2024

Standardised convolutional filtering for radiomics

The Image Biomarker Standardisation Initiative (IBSI) aims to improve reproducibility of radiomics studies by standardising the computational process of extracting image biomarkers (features) from images. We have previously established reference values for 169 commonly used features, created a standard radiomics image processing scheme, and developed reporting guidelines for radiomic studies. However, several aspects are not standardised. Here we present a complete version of a reference manual on the use of convolutional filters in radiomics and quantitative image analysis. Filters, such as wavelets or Laplacian of Gaussian filters, play an important part in emphasising specific image characteristics such as edges and blobs. Features derived from filter response maps were found to be poorly reproducible. This reference manual provides definitions for convolutional filters, parameters that should be reported, reference feature values, and tests to verify software compliance with the reference standard.

eess.IV↗

arXiv2023

MedShapeNet -- A Large-Scale Dataset of 3D Medical Shapes for Computer Vision

Prior to the deep learning era, shape was commonly used to describe the objects. Nowadays, state-of-the-art (SOTA) algorithms in medical imaging are predominantly diverging from computer vision, where voxel grids, meshes, point clouds, and implicit surface models are used. This is seen from numerous shape-related publications in premier vision conferences as well as the growing popularity of ShapeNet (about 51,300 models) and Princeton ModelNet (127,915 models). For the medical domain, we present a large collection of anatomical shapes (e.g., bones, organs, vessels) and 3D models of surgical instrument, called MedShapeNet, created to facilitate the translation of data-driven vision algorithms to medical applications and to adapt SOTA vision algorithms to medical problems. As a unique feature, we directly model the majority of shapes on the imaging data of real patients. As of today, MedShapeNet includes 23 dataset with more than 100,000 shapes that are paired with annotations (ground truth). Our data is freely accessible via a web interface and a Python application programming interface (API) and can be used for discriminative, reconstructive, and variational benchmarks as well as various applications in virtual, augmented, or mixed reality, and 3D printing. Exemplary, we present use cases in the fields of classification of brain tumors, facial and skull reconstructions, multi-class anatomy completion, education, and 3D printing. In future, we will extend the data and improve the interfaces. The project pages are: https://medshapenet.ikim.nrw/ and https://github.com/Jianningli/medshapenet-feedback

cs.CV↗

arXiv2023

Biomedical image analysis competitions: The state of current participation practice

The number of international benchmarking competitions is steadily increasing in various fields of machine learning (ML) research and practice. So far, however, little is known about the common practice as well as bottlenecks faced by the community in tackling the research questions posed. To shed light on the status quo of algorithm development in the specific field of biomedical imaging analysis, we designed an international survey that was issued to all participants of challenges conducted in conjunction with the IEEE ISBI 2021 and MICCAI 2021 conferences (80 competitions in total). The survey covered participants' expertise and working environments, their chosen strategies, as well as algorithm characteristics. A median of 72% challenge participants took part in the survey. According to our results, knowledge exchange was the primary incentive (70%) for participation, while the reception of prize money played only a minor role (16%). While a median of 80 working hours was spent on method development, a large portion of participants stated that they did not have enough time for method development (32%). 25% perceived the infrastructure to be a bottleneck. Overall, 94% of all solutions were deep learning-based. Of these, 84% were based on standard architectures. 43% of the respondents reported that the data samples (e.g., images) were too large to be processed at once. This was most commonly addressed by patch-based training (69%), downsampling (37%), and solving 3D analysis tasks as a series of 2D tasks. K-fold cross-validation on the training set was performed by only 37% of the participants and only 50% of the participants performed ensembling based on multiple identical models (61%) or heterogeneous models (39%). 48% of the respondents applied postprocessing steps.

cs.CV↗

arXiv2023

Fast refacing of MR images with a generative neural network lowers re-identification risk and preserves volumetric consistency

With the rise of open data, identifiability of individuals based on 3D renderings obtained from routine structural magnetic resonance imaging (MRI) scans of the head has become a growing privacy concern. To protect subject privacy, several algorithms have been developed to de-identify imaging data using blurring, defacing or refacing. Completely removing facial structures provides the best re-identification protection but can significantly impact post-processing steps, like brain morphometry. As an alternative, refacing methods that replace individual facial structures with generic templates have a lower effect on the geometry and intensity distribution of original scans, and are able to provide more consistent post-processing results by the price of higher re-identification risk and computational complexity. In the current study, we propose a novel method for anonymised face generation for defaced 3D T1-weighted scans based on a 3D conditional generative adversarial network. To evaluate the performance of the proposed de-identification tool, a comparative study was conducted between several existing defacing and refacing tools, with two different segmentation algorithms (FAST and Morphobox). The aim was to evaluate (i) impact on brain morphometry reproducibility, (ii) re-identification risk, (iii) balance between (i) and (ii), and (iv) the processing time. The proposed method takes 9 seconds for face generation and is suitable for recovering consistent post-processing results after defacing.

eess.IV↗

arXiv2023

Why is the winner the best?

International benchmarking competitions have become fundamental for the comparative performance assessment of image analysis methods. However, little attention has been given to investigating what can be learnt from these competitions. Do they really generate scientific progress? What are common and successful participation strategies? What makes a solution superior to a competing method? To address this gap in the literature, we performed a multi-center study with all 80 competitions that were conducted in the scope of IEEE ISBI 2021 and MICCAI 2021. Statistical analyses performed based on comprehensive descriptions of the submitted algorithms linked to their rank as well as the underlying participation strategies revealed common characteristics of winning solutions. These typically include the use of multi-task learning (63%) and/or multi-stage pipelines (61%), and a focus on augmentation (100%), image preprocessing (97%), data curation (79%), and postprocessing (66%). The "typical" lead of a winning team is a computer scientist with a doctoral degree, five years of experience in biomedical image analysis, and four years of experience in deep learning. Two core general development strategies stood out for highly-ranked teams: the reflection of the metrics in the method design and the focus on analyzing and handling failure cases. According to the organizers, 43% of the winning algorithms exceeded the state of the art but only 11% completely solved the respective domain problem. The insights of our study could help researchers (1) improve algorithm development strategies when approaching new problems, and (2) focus on open research questions revealed by this work.

cs.CV↗

arXiv2022

Assessing radiomics feature stability with simulated CT acquisitions

Medical imaging quantitative features had once disputable usefulness in clinical studies. Nowadays, advancements in analysis techniques, for instance through machine learning, have enabled quantitative features to be progressively useful in diagnosis and research. Tissue characterisation is improved via the 'radiomics' features, whose extraction can be automated. Despite the advances, stability of quantitative features remains an important open problem. As features can be highly sensitive to variations of acquisition details, it is not trivial to quantify stability and efficiently select stable features. In this work, we develop and validate a Computed Tomography (CT) simulator environment based on the publicly available ASTRA toolbox (www.astra-toolbox.com). We show that the variability, stability and discriminative power of the radiomics features extracted from the virtual phantom images generated by the simulator are similar to those observed in a tandem phantom study. Additionally, we show that the variability is matched between a multi-center phantom study and simulated results. Consequently, we demonstrate that the simulator can be utilised to assess radiomics features' stability and discriminative power.

physics.comp-ph↗

arXiv2022

Overview of the HECKTOR Challenge at MICCAI 2021: Automatic Head and Neck Tumor Segmentation and Outcome Prediction in PET/CT Images

This paper presents an overview of the second edition of the HEad and neCK TumOR (HECKTOR) challenge, organized as a satellite event of the 24th International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI) 2021. The challenge is composed of three tasks related to the automatic analysis of PET/CT images for patients with Head and Neck cancer (H&N), focusing on the oropharynx region. Task 1 is the automatic segmentation of H&N primary Gross Tumor Volume (GTVt) in FDG-PET/CT images. Task 2 is the automatic prediction of Progression Free Survival (PFS) from the same FDG-PET/CT. Finally, Task 3 is the same as Task 2 with ground truth GTVt annotations provided to the participants. The data were collected from six centers for a total of 325 images, split into 224 training and 101 testing cases. The interest in the challenge was highlighted by the important participation with 103 registered teams and 448 result submissions. The best methods obtained a Dice Similarity Coefficient (DSC) of 0.7591 in the first task, and a Concordance index (C-index) of 0.7196 and 0.6978 in Tasks 2 and 3, respectively. In all tasks, simplicity of the approach was found to be key to ensure generalization performance. The comparison of the PFS prediction performance in Tasks 2 and 3 suggests that providing the GTVt contour was not crucial to achieve best results, which indicates that fully automatic methods can be used. This potentially obviates the need for GTVt contouring, opening avenues for reproducible and large scale radiomics studies including thousands potential subjects.

eess.IV↗

arXiv2021

Principled Design and Implementation of Steerable Detectors

We provide a complete pipeline for the detection of patterns of interest in an image. In our approach, the patterns are assumed to be adequately modeled by a known template, and are located at unknown positions and orientations that we aim at retrieving. We propose a continuous-domain additive image model, where the analyzed image is the sum of the patterns to localize and a background with self-similar isotropic power-spectrum. We are then able to compute the optimal filter fulfilling the SNR criterion based on one single template and background pair: it strongly responds to the template while being optimally decoupled from the background model. In addition, we constrain our filter to be steerable, which allows for a fast template detection together with orientation estimation. In practice, the implementation requires to discretize a continuous-domain formulation on polar grids, which is performed using quadratic radial B-splines. We demonstrate the practical usefulness of our method on a variety of template approximation and pattern detection experiments. We show that the detection performance drastically improves when we exploit the statistics of the background via its power-spectrum decay, which we refer to as spectral-shaping. The proposed scheme outperforms state-of-the-art steerable methods by up to 50% of absolute detection performance.

eess.IV↗