arXiv subjects

Alexander Schlaefer

Publications and source records attributed to Alexander Schlaefer.

At least 37 records · Page 2Linked to original sources

arXiv2024

Validating polyp and instrument segmentation methods in colonoscopy through Medico 2020 and MedAI 2021 Challenges

Automatic analysis of colonoscopy images has been an active field of research motivated by the importance of early detection of precancerous polyps. However, detecting polyps during the live examination can be challenging due to various factors such as variation of skills and experience among the endoscopists, lack of attentiveness, and fatigue leading to a high polyp miss-rate. Deep learning has emerged as a promising solution to this challenge as it can assist endoscopists in detecting and classifying overlooked polyps and abnormalities in real time. In addition to the algorithm's accuracy, transparency and interpretability are crucial to explaining the whys and hows of the algorithm's prediction. Further, most algorithms are developed in private data, closed source, or proprietary software, and methods lack reproducibility. Therefore, to promote the development of efficient and transparent methods, we have organized the "Medico automatic polyp segmentation (Medico 2020)" and "MedAI: Transparency in Medical Image Segmentation (MedAI 2021)" competitions. We present a comprehensive summary and analyze each contribution, highlight the strength of the best-performing methods, and discuss the possibility of clinical translations of such methods into the clinic. For the transparency task, a multi-disciplinary team, including expert gastroenterologists, accessed each submission and evaluated the team based on open-source practices, failure case analysis, ablation studies, usability and understandability of evaluations to gain a deeper understanding of the models' credibility for clinical deployment. Through the comprehensive analysis of the challenge, we not only highlight the advancements in polyp and surgical instrument segmentation but also encourage qualitative evaluation for building more transparent and understandable AI-based colonoscopy systems.

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arXiv2024

Self-supervised learning for classifying paranasal anomalies in the maxillary sinus

Purpose: Paranasal anomalies, frequently identified in routine radiological screenings, exhibit diverse morphological characteristics. Due to the diversity of anomalies, supervised learning methods require large labelled dataset exhibiting diverse anomaly morphology. Self-supervised learning (SSL) can be used to learn representations from unlabelled data. However, there are no SSL methods designed for the downstream task of classifying paranasal anomalies in the maxillary sinus (MS). Methods: Our approach uses a 3D Convolutional Autoencoder (CAE) trained in an unsupervised anomaly detection (UAD) framework. Initially, we train the 3D CAE to reduce reconstruction errors when reconstructing normal maxillary sinus (MS) image. Then, this CAE is applied to an unlabelled dataset to generate coarse anomaly locations by creating residual MS images. Following this, a 3D Convolutional Neural Network (CNN) reconstructs these residual images, which forms our SSL task. Lastly, we fine-tune the encoder part of the 3D CNN on a labelled dataset of normal and anomalous MS images. Results: The proposed SSL technique exhibits superior performance compared to existing generic self-supervised methods, especially in scenarios with limited annotated data. When trained on just 10% of the annotated dataset, our method achieves an Area Under the Precision-Recall Curve (AUPRC) of 0.79 for the downstream classification task. This performance surpasses other methods, with BYOL attaining an AUPRC of 0.75, SimSiam at 0.74, SimCLR at 0.73 and Masked Autoencoding using SparK at 0.75. Conclusion: A self-supervised learning approach that inherently focuses on localizing paranasal anomalies proves to be advantageous, particularly when the subsequent task involves differentiating normal from anomalous maxillary sinuses. Access our code at https://github.com/mtec-tuhh/self-supervised-paranasal-anomaly

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arXiv2024

Sliced Online Model Checking for Optimizing the Beam Scheduling Problem in Robotic Radiation Therapy

In robotic radiation therapy, high-energy photon beams from different directions are directed at a target within the patient. Target motion can be tracked by robotic ultrasound and then compensated by synchronous beam motion. However, moving the beams may result in beams passing through the ultrasound transducer or the robot carrying it. While this can be avoided by pausing the beam delivery, the treatment time would increase. Typically, the beams are delivered in an order which minimizes the robot motion and thereby the overall treatment time. However, this order can be changed, i.e., instead of pausing beams, other feasible beam could be delivered. We address this problem of dynamically ordering the beams by applying a model checking paradigm to select feasible beams. Since breathing patterns are complex and change rapidly, any offline model would be too imprecise. Thus, model checking must be conducted online, predicting the patient's current breathing pattern for a short amount of time and checking which beams can be delivered safely. Monitoring the treatment delivery online provides the option to reschedule beams dynamically in order to avoid pausing and hence to reduce treatment time. While human breathing patterns are complex and may change rapidly, we need a model which can be verified quickly and use approximation by a superposition of sine curves. Further, we simplify the 3D breathing motion into separate 1D models. We compensate the simplification by adding noise inside the model itself. In turn, we synchronize between the multiple models representing the different spatial directions, the treatment simulation, and corresponding verification queries. Our preliminary results show a 16.02 % to 37.21 % mean improvement on the idle time compared to a static beam schedule, depending on an additional safety margin. Note that an additional safety margin around the ultrasound robot can decrease idle times but also compromises plan quality by limiting the range of available beam directions. In contrast, the approach using online model checking maintains the plan quality. Further, we compare to a naive machine learning approach that does not achieve its goals while being harder to reason about.

cs.CE↗

arXiv2024

Diffusion Models with Ensembled Structure-Based Anomaly Scoring for Unsupervised Anomaly Detection

Supervised deep learning techniques show promise in medical image analysis. However, they require comprehensive annotated data sets, which poses challenges, particularly for rare diseases. Consequently, unsupervised anomaly detection (UAD) emerges as a viable alternative for pathology segmentation, as only healthy data is required for training. However, recent UAD anomaly scoring functions often focus on intensity only and neglect structural differences, which impedes the segmentation performance. This work investigates the potential of Structural Similarity (SSIM) to bridge this gap. SSIM captures both intensity and structural disparities and can be advantageous over the classical $l1$ error. However, we show that there is more than one optimal kernel size for the SSIM calculation for different pathologies. Therefore, we investigate an adaptive ensembling strategy for various kernel sizes to offer a more pathology-agnostic scoring mechanism. We demonstrate that this ensembling strategy can enhance the performance of DMs and mitigate the sensitivity to different kernel sizes across varying pathologies, highlighting its promise for brain MRI anomaly detection.

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arXiv2024

PolypNextLSTM: A lightweight and fast polyp video segmentation network using ConvNext and ConvLSTM

Commonly employed in polyp segmentation, single image UNet architectures lack the temporal insight clinicians gain from video data in diagnosing polyps. To mirror clinical practices more faithfully, our proposed solution, PolypNextLSTM, leverages video-based deep learning, harnessing temporal information for superior segmentation performance with the least parameter overhead, making it possibly suitable for edge devices. PolypNextLSTM employs a UNet-like structure with ConvNext-Tiny as its backbone, strategically omitting the last two layers to reduce parameter overhead. Our temporal fusion module, a Convolutional Long Short Term Memory (ConvLSTM), effectively exploits temporal features. Our primary novelty lies in PolypNextLSTM, which stands out as the leanest in parameters and the fastest model, surpassing the performance of five state-of-the-art image and video-based deep learning models. The evaluation of the SUN-SEG dataset spans easy-to-detect and hard-to-detect polyp scenarios, along with videos containing challenging artefacts like fast motion and occlusion. Comparison against 5 image-based and 5 video-based models demonstrates PolypNextLSTM's superiority, achieving a Dice score of 0.7898 on the hard-to-detect polyp test set, surpassing image-based PraNet (0.7519) and video-based PNSPlusNet (0.7486). Notably, our model excels in videos featuring complex artefacts such as ghosting and occlusion. PolypNextLSTM, integrating pruned ConvNext-Tiny with ConvLSTM for temporal fusion, not only exhibits superior segmentation performance but also maintains the highest frames per speed among evaluated models. Access code here https://github.com/mtec-tuhh/PolypNextLSTM

cs.CV↗

arXiv2024

Nodule detection and generation on chest X-rays: NODE21 Challenge

Pulmonary nodules may be an early manifestation of lung cancer, the leading cause of cancer-related deaths among both men and women. Numerous studies have established that deep learning methods can yield high-performance levels in the detection of lung nodules in chest X-rays. However, the lack of gold-standard public datasets slows down the progression of the research and prevents benchmarking of methods for this task. To address this, we organized a public research challenge, NODE21, aimed at the detection and generation of lung nodules in chest X-rays. While the detection track assesses state-of-the-art nodule detection systems, the generation track determines the utility of nodule generation algorithms to augment training data and hence improve the performance of the detection systems. This paper summarizes the results of the NODE21 challenge and performs extensive additional experiments to examine the impact of the synthetically generated nodule training images on the detection algorithm performance.

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arXiv2023

Collaborative Robotic Biopsy with Trajectory Guidance and Needle Tip Force Feedback

The diagnostic value of biopsies is highly dependent on the placement of needles. Robotic trajectory guidance has been shown to improve needle positioning, but feedback for real-time navigation is limited. Haptic display of needle tip forces can provide rich feedback for needle navigation by enabling localization of tissue structures along the insertion path. We present a collaborative robotic biopsy system that combines trajectory guidance with kinesthetic feedback to assist the physician in needle placement. The robot aligns the needle while the insertion is performed in collaboration with a medical expert who controls the needle position on site. We present a needle design that senses forces at the needle tip based on optical coherence tomography and machine learning for real-time data processing. Our robotic setup allows operators to sense deep tissue interfaces independent of frictional forces to improve needle placement relative to a desired target structure. We first evaluate needle tip force sensing in ex-vivo tissue in a phantom study. We characterize the tip forces during insertions with constant velocity and demonstrate the ability to detect tissue interfaces in a collaborative user study. Participants are able to detect 91% of ex-vivo tissue interfaces based on needle tip force feedback alone. Finally, we demonstrate that even smaller, deep target structures can be accurately sampled by performing post-mortem in situ biopsies of the pancreas.

cs.RO↗

arXiv2023

Tissue Classification During Needle Insertion Using Self-Supervised Contrastive Learning and Optical Coherence Tomography

Needle positioning is essential for various medical applications such as epidural anaesthesia. Physicians rely on their instincts while navigating the needle in epidural spaces. Thereby, identifying the tissue structures may be helpful to the physician as they can provide additional feedback in the needle insertion process. To this end, we propose a deep neural network that classifies the tissues from the phase and intensity data of complex OCT signals acquired at the needle tip. We investigate the performance of the deep neural network in a limited labelled dataset scenario and propose a novel contrastive pretraining strategy that learns invariant representation for phase and intensity data. We show that with 10% of the training set, our proposed pretraining strategy helps the model achieve an F1 score of 0.84 whereas the model achieves an F1 score of 0.60 without it. Further, we analyse the importance of phase and intensity individually towards tissue classification.

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arXiv2023

Multiple Instance Ensembling For Paranasal Anomaly Classification In The Maxillary Sinus

Paranasal anomalies are commonly discovered during routine radiological screenings and can present with a wide range of morphological features. This diversity can make it difficult for convolutional neural networks (CNNs) to accurately classify these anomalies, especially when working with limited datasets. Additionally, current approaches to paranasal anomaly classification are constrained to identifying a single anomaly at a time. These challenges necessitate the need for further research and development in this area. In this study, we investigate the feasibility of using a 3D convolutional neural network (CNN) to classify healthy maxillary sinuses (MS) and MS with polyps or cysts. The task of accurately identifying the relevant MS volume within larger head and neck Magnetic Resonance Imaging (MRI) scans can be difficult, but we develop a straightforward strategy to tackle this challenge. Our end-to-end solution includes the use of a novel sampling technique that not only effectively localizes the relevant MS volume, but also increases the size of the training dataset and improves classification results. Additionally, we employ a multiple instance ensemble prediction method to further boost classification performance. Finally, we identify the optimal size of MS volumes to achieve the highest possible classification performance on our dataset. With our multiple instance ensemble prediction strategy and sampling strategy, our 3D CNNs achieve an F1 of 0.85 whereas without it, they achieve an F1 of 0.70. We demonstrate the feasibility of classifying anomalies in the MS. We propose a data enlarging strategy alongside a novel ensembling strategy that proves to be beneficial for paranasal anomaly classification in the MS.

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arXiv2023

Patched Diffusion Models for Unsupervised Anomaly Detection in Brain MRI

The use of supervised deep learning techniques to detect pathologies in brain MRI scans can be challenging due to the diversity of brain anatomy and the need for annotated data sets. An alternative approach is to use unsupervised anomaly detection, which only requires sample-level labels of healthy brains to create a reference representation. This reference representation can then be compared to unhealthy brain anatomy in a pixel-wise manner to identify abnormalities. To accomplish this, generative models are needed to create anatomically consistent MRI scans of healthy brains. While recent diffusion models have shown promise in this task, accurately generating the complex structure of the human brain remains a challenge. In this paper, we propose a method that reformulates the generation task of diffusion models as a patch-based estimation of healthy brain anatomy, using spatial context to guide and improve reconstruction. We evaluate our approach on data of tumors and multiple sclerosis lesions and demonstrate a relative improvement of 25.1% compared to existing baselines.

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arXiv2022

Unsupervised Anomaly Detection of Paranasal Anomalies in the Maxillary Sinus

Deep learning (DL) algorithms can be used to automate paranasal anomaly detection from Magnetic Resonance Imaging (MRI). However, previous works relied on supervised learning techniques to distinguish between normal and abnormal samples. This method limits the type of anomalies that can be classified as the anomalies need to be present in the training data. Further, many data points from normal and anomaly class are needed for the model to achieve satisfactory classification performance. However, experienced clinicians can segregate between normal samples (healthy maxillary sinus) and anomalous samples (anomalous maxillary sinus) after looking at a few normal samples. We mimic the clinicians ability by learning the distribution of healthy maxillary sinuses using a 3D convolutional auto-encoder (cAE) and its variant, a 3D variational autoencoder (VAE) architecture and evaluate cAE and VAE for this task. Concretely, we pose the paranasal anomaly detection as an unsupervised anomaly detection problem. Thereby, we are able to reduce the labelling effort of the clinicians as we only use healthy samples during training. Additionally, we can classify any type of anomaly that differs from the training distribution. We train our 3D cAE and VAE to learn a latent representation of healthy maxillary sinus volumes using L1 reconstruction loss. During inference, we use the reconstruction error to classify between normal and anomalous maxillary sinuses. We extract sub-volumes from larger head and neck MRIs and analyse the effect of different fields of view on the detection performance. Finally, we report which anomalies are easiest and hardest to classify using our approach. Our results demonstrate the feasibility of unsupervised detection of paranasal anomalies from MRIs with an AUPRC of 85% and 80% for cAE and VAE, respectively.

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arXiv2022

Supervised Contrastive Learning to Classify Paranasal Anomalies in the Maxillary Sinus

Using deep learning techniques, anomalies in the paranasal sinus system can be detected automatically in MRI images and can be further analyzed and classified based on their volume, shape and other parameters like local contrast. However due to limited training data, traditional supervised learning methods often fail to generalize. Existing deep learning methods in paranasal anomaly classification have been used to diagnose at most one anomaly. In our work, we consider three anomalies. Specifically, we employ a 3D CNN to separate maxillary sinus volumes without anomalies from maxillary sinus volumes with anomalies. To learn robust representations from a small labelled dataset, we propose a novel learning paradigm that combines contrastive loss and cross-entropy loss. Particularly, we use a supervised contrastive loss that encourages embeddings of maxillary sinus volumes with and without anomaly to form two distinct clusters while the cross-entropy loss encourages the 3D CNN to maintain its discriminative ability. We report that optimising with both losses is advantageous over optimising with only one loss. We also find that our training strategy leads to label efficiency. With our method, a 3D CNN classifier achieves an AUROC of 0.85 while a 3D CNN classifier optimised with cross-entropy loss achieves an AUROC of 0.66.

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arXiv2022

Data-Efficient Vision Transformers for Multi-Label Disease Classification on Chest Radiographs

Radiographs are a versatile diagnostic tool for the detection and assessment of pathologies, for treatment planning or for navigation and localization purposes in clinical interventions. However, their interpretation and assessment by radiologists can be tedious and error-prone. Thus, a wide variety of deep learning methods have been proposed to support radiologists interpreting radiographs. Mostly, these approaches rely on convolutional neural networks (CNN) to extract features from images. Especially for the multi-label classification of pathologies on chest radiographs (Chest X-Rays, CXR), CNNs have proven to be well suited. On the Contrary, Vision Transformers (ViTs) have not been applied to this task despite their high classification performance on generic images and interpretable local saliency maps which could add value to clinical interventions. ViTs do not rely on convolutions but on patch-based self-attention and in contrast to CNNs, no prior knowledge of local connectivity is present. While this leads to increased capacity, ViTs typically require an excessive amount of training data which represents a hurdle in the medical domain as high costs are associated with collecting large medical data sets. In this work, we systematically compare the classification performance of ViTs and CNNs for different data set sizes and evaluate more data-efficient ViT variants (DeiT). Our results show that while the performance between ViTs and CNNs is on par with a small benefit for ViTs, DeiTs outperform the former if a reasonably large data set is available for training.

cs.CV↗

arXiv2022

Ultrasound Shear Wave Elasticity Imaging with Spatio-Temporal Deep Learning

Ultrasound shear wave elasticity imaging is a valuable tool for quantifying the elastic properties of tissue. Typically, the shear wave velocity is derived and mapped to an elasticity value, which neglects information such as the shape of the propagating shear wave or push sequence characteristics. We present 3D spatio-temporal CNNs for fast local elasticity estimation from ultrasound data. This approach is based on retrieving elastic properties from shear wave propagation within small local regions. A large training data set is acquired with a robot from homogeneous gelatin phantoms ranging from 17.42 kPa to 126.05 kPa with various push locations. The results show that our approach can estimate elastic properties on a pixelwise basis with a mean absolute error of 5.01+-4.37 kPa. Furthermore, we estimate local elasticity independent of the push location and can even perform accurate estimates inside the push region. For phantoms with embedded inclusions, we report a 53.93% lower MAE (7.50 kPa) and on the background of 85.24% (1.64 kPa) compared to a conventional shear wave method. Overall, our method offers fast local estimations of elastic properties with small spatio-temporal window sizes.

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arXiv2022

Unsupervised Anomaly Detection in 3D Brain MRI using Deep Learning with impured training data

The detection of lesions in magnetic resonance imaging (MRI)-scans of human brains remains challenging, time-consuming and error-prone. Recently, unsupervised anomaly detection (UAD) methods have shown promising results for this task. These methods rely on training data sets that solely contain healthy samples. Compared to supervised approaches, this significantly reduces the need for an extensive amount of labeled training data. However, data labelling remains error-prone. We study how unhealthy samples within the training data affect anomaly detection performance for brain MRI-scans. For our evaluations, we consider three publicly available data sets and use autoencoders (AE) as a well-established baseline method for UAD. We systematically evaluate the effect of impured training data by injecting different quantities of unhealthy samples to our training set of healthy samples from T1-weighted MRI-scans. We evaluate a method to identify falsely labeled samples directly during training based on the reconstruction error of the AE. Our results show that training with impured data decreases the UAD performance notably even with few falsely labeled samples. By performing outlier removal directly during training based on the reconstruction-loss, we demonstrate that falsely labeled data can be detected and removed to mitigate the effect of falsely labeled data. Overall, we highlight the importance of clean data sets for UAD in brain MRI and demonstrate an approach for detecting falsely labeled data directly during training.

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arXiv2022

Modeling R$^3$ Needle Steering in Uppaal

Medical cyber-physical systems are safety-critical, and as such, require ongoing verification of their correct behavior, as system failure during run time may cause severe (or even fatal) personal damage. However, creating a verifiable model often conflicts with other application requirements, most notably regarding data precision and model accuracy, as efficient model checking promotes discrete data (over continuous) and abstract models to reduce the state space. In this paper, we approach the task of medical needle steering in soft tissue around potential obstacles. We design a verifiable model of needle motion (implemented in Uppaal Stratego) and a framework embedding the model for online needle steering. We mitigate the conflict by imposing boundedness on both the data types, reducing from R^3 to Z^3 when needed, and the motion and environment models, reducing the set of allowed local actions and global paths. In experiments, we successfully apply the static model alone, as well as the dynamic framework in scenarios with varying environment complexity and both a virtual and real needle setting, where up to 100% of targets were reached depending on the scenario and needle.

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arXiv2022

Posterior temperature optimized Bayesian models for inverse problems in medical imaging

We present Posterior Temperature Optimized Bayesian Inverse Models (POTOBIM), an unsupervised Bayesian approach to inverse problems in medical imaging using mean-field variational inference with a fully tempered posterior. Bayesian methods exhibit useful properties for approaching inverse tasks, such as tomographic reconstruction or image denoising. A suitable prior distribution introduces regularization, which is needed to solve the ill-posed problem and reduces overfitting the data. In practice, however, this often results in a suboptimal posterior temperature, and the full potential of the Bayesian approach is not being exploited. In POTOBIM, we optimize both the parameters of the prior distribution and the posterior temperature with respect to reconstruction accuracy using Bayesian optimization with Gaussian process regression. Our method is extensively evaluated on four different inverse tasks on a variety of modalities with images from public data sets and we demonstrate that an optimized posterior temperature outperforms both non-Bayesian and Bayesian approaches without temperature optimization. The use of an optimized prior distribution and posterior temperature leads to improved accuracy and uncertainty estimation and we show that it is sufficient to find these hyperparameters per task domain. Well-tempered posteriors yield calibrated uncertainty, which increases the reliability in the predictions. Our source code is publicly available at github.com/Cardio-AI/mfvi-dip-mia.

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arXiv2022

Unsupervised Anomaly Detection in 3D Brain MRI using Deep Learning with Multi-Task Brain Age Prediction

Lesion detection in brain Magnetic Resonance Images (MRIs) remains a challenging task. MRIs are typically read and interpreted by domain experts, which is a tedious and time-consuming process. Recently, unsupervised anomaly detection (UAD) in brain MRI with deep learning has shown promising results to provide a quick, initial assessment. So far, these methods only rely on the visual appearance of healthy brain anatomy for anomaly detection. Another biomarker for abnormal brain development is the deviation between the brain age and the chronological age, which is unexplored in combination with UAD. We propose deep learning for UAD in 3D brain MRI considering additional age information. We analyze the value of age information during training, as an additional anomaly score, and systematically study several architecture concepts. Based on our analysis, we propose a novel deep learning approach for UAD with multi-task age prediction. We use clinical T1-weighted MRIs of 1735 healthy subjects and the publicly available BraTs 2019 data set for our study. Our novel approach significantly improves UAD performance with an AUC of 92.60% compared to an AUC-score of 84.37% using previous approaches without age information.

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