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Bernhard Kainz

Publications and source records attributed to Bernhard Kainz.

At least 91 records · Page 5Linked to original sources

Metrics reloaded: Recommendations for image analysis validation

Increasing evidence shows that flaws in machine learning (ML) algorithm validation are an underestimated global problem. Particularly in automatic biomedical image analysis, chosen performance metrics often do not reflect the domain interest, thus failing to adequately measure scientific progress and hindering translation of ML techniques into practice. To overcome this, our large international expert consortium created Metrics Reloaded, a comprehensive framework guiding researchers in the problem-aware selection of metrics. Following the convergence of ML methodology across application domains, Metrics Reloaded fosters the convergence of validation methodology. The framework was developed in a multi-stage Delphi process and is based on the novel concept of a problem fingerprint - a structured representation of the given problem that captures all aspects that are relevant for metric selection, from the domain interest to the properties of the target structure(s), data set and algorithm output. Based on the problem fingerprint, users are guided through the process of choosing and applying appropriate validation metrics while being made aware of potential pitfalls. Metrics Reloaded targets image analysis problems that can be interpreted as a classification task at image, object or pixel level, namely image-level classification, object detection, semantic segmentation, and instance segmentation tasks. To improve the user experience, we implemented the framework in the Metrics Reloaded online tool, which also provides a point of access to explore weaknesses, strengths and specific recommendations for the most common validation metrics. The broad applicability of our framework across domains is demonstrated by an instantiation for various biological and medical image analysis use cases.

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Feature-Conditioned Cascaded Video Diffusion Models for Precise Echocardiogram Synthesis

Image synthesis is expected to provide value for the translation of machine learning methods into clinical practice. Fundamental problems like model robustness, domain transfer, causal modelling, and operator training become approachable through synthetic data. Especially, heavily operator-dependant modalities like Ultrasound imaging require robust frameworks for image and video generation. So far, video generation has only been possible by providing input data that is as rich as the output data, e.g., image sequence plus conditioning in, video out. However, clinical documentation is usually scarce and only single images are reported and stored, thus retrospective patient-specific analysis or the generation of rich training data becomes impossible with current approaches. In this paper, we extend elucidated diffusion models for video modelling to generate plausible video sequences from single images and arbitrary conditioning with clinical parameters. We explore this idea within the context of echocardiograms by looking into the variation of the Left Ventricle Ejection Fraction, the most essential clinical metric gained from these examinations. We use the publicly available EchoNet-Dynamic dataset for all our experiments. Our image to sequence approach achieves an $R^2$ score of 93%, which is 38 points higher than recently proposed sequence to sequence generation methods. Code and models will be available at: https://github.com/HReynaud/EchoDiffusion.

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Whole-examination AI estimation of fetal biometrics from 20-week ultrasound scans

The current approach to fetal anomaly screening is based on biometric measurements derived from individually selected ultrasound images. In this paper, we introduce a paradigm shift that attains human-level performance in biometric measurement by aggregating automatically extracted biometrics from every frame across an entire scan, with no need for operator intervention. We use a convolutional neural network to classify each frame of an ultrasound video recording. We then measure fetal biometrics in every frame where appropriate anatomy is visible. We use a Bayesian method to estimate the true value of each biometric from a large number of measurements and probabilistically reject outliers. We performed a retrospective experiment on 1457 recordings (comprising 48 million frames) of 20-week ultrasound scans, estimated fetal biometrics in those scans and compared our estimates to the measurements sonographers took during the scan. Our method achieves human-level performance in estimating fetal biometrics and estimates well-calibrated credible intervals in which the true biometric value is expected to lie.

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Trade-offs in Fine-tuned Diffusion Models Between Accuracy and Interpretability

Recent advancements in diffusion models have significantly impacted the trajectory of generative machine learning research, with many adopting the strategy of fine-tuning pre-trained models using domain-specific text-to-image datasets. Notably, this method has been readily employed for medical applications, such as X-ray image synthesis, leveraging the plethora of associated radiology reports. Yet, a prevailing concern is the lack of assurance on whether these models genuinely comprehend their generated content. With the evolution of text-conditional image generation, these models have grown potent enough to facilitate object localization scrutiny. Our research underscores this advancement in the critical realm of medical imaging, emphasizing the crucial role of interpretability. We further unravel a consequential trade-off between image fidelity as gauged by conventional metrics and model interpretability in generative diffusion models. Specifically, the adoption of learnable text encoders when fine-tuning results in diminished interpretability. Our in-depth exploration uncovers the underlying factors responsible for this divergence. Consequently, we present a set of design principles for the development of truly interpretable generative models. Code is available at https://github.com/MischaD/chest-distillation.

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Common Limitations of Image Processing Metrics: A Picture Story

While the importance of automatic image analysis is continuously increasing, recent meta-research revealed major flaws with respect to algorithm validation. Performance metrics are particularly key for meaningful, objective, and transparent performance assessment and validation of the used automatic algorithms, but relatively little attention has been given to the practical pitfalls when using specific metrics for a given image analysis task. These are typically related to (1) the disregard of inherent metric properties, such as the behaviour in the presence of class imbalance or small target structures, (2) the disregard of inherent data set properties, such as the non-independence of the test cases, and (3) the disregard of the actual biomedical domain interest that the metrics should reflect. This living dynamically document has the purpose to illustrate important limitations of performance metrics commonly applied in the field of image analysis. In this context, it focuses on biomedical image analysis problems that can be phrased as image-level classification, semantic segmentation, instance segmentation, or object detection task. The current version is based on a Delphi process on metrics conducted by an international consortium of image analysis experts from more than 60 institutions worldwide.

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Ultra-Resolution Cascaded Diffusion Model for Gigapixel Image Synthesis in Histopathology

Diagnoses from histopathology images rely on information from both high and low resolutions of Whole Slide Images. Ultra-Resolution Cascaded Diffusion Models (URCDMs) allow for the synthesis of high-resolution images that are realistic at all magnification levels, focusing not only on fidelity but also on long-distance spatial coherency. Our model beats existing methods, improving the pFID-50k [2] score by 110.63 to 39.52 pFID-50k. Additionally, a human expert evaluation study was performed, reaching a weighted Mean Absolute Error (MAE) of 0.11 for the Lower Resolution Diffusion Models and a weighted MAE of 0.22 for the URCDM.

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Stochastic Vision Transformers with Wasserstein Distance-Aware Attention

Self-supervised learning is one of the most promising approaches to acquiring knowledge from limited labeled data. Despite the substantial advancements made in recent years, self-supervised models have posed a challenge to practitioners, as they do not readily provide insight into the model's confidence and uncertainty. Tackling this issue is no simple feat, primarily due to the complexity involved in implementing techniques that can make use of the latent representations learned during pre-training without relying on explicit labels. Motivated by this, we introduce a new stochastic vision transformer that integrates uncertainty and distance awareness into self-supervised learning (SSL) pipelines. Instead of the conventional deterministic vector embedding, our novel stochastic vision transformer encodes image patches into elliptical Gaussian distributional embeddings. Notably, the attention matrices of these stochastic representational embeddings are computed using Wasserstein distance-based attention, effectively capitalizing on the distributional nature of these embeddings. Additionally, we propose a regularization term based on Wasserstein distance for both pre-training and fine-tuning processes, thereby incorporating distance awareness into latent representations. We perform extensive experiments across different tasks such as in-distribution generalization, out-of-distribution detection, dataset corruption, semi-supervised settings, and transfer learning to other datasets and tasks. Our proposed method achieves superior accuracy and calibration, surpassing the self-supervised baseline in a wide range of experiments on a variety of datasets.

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Sculpting Efficiency: Pruning Medical Imaging Models for On-Device Inference

Leveraging ML advancements to augment healthcare systems can improve patient outcomes. Yet, uninformed engineering decisions in early-stage research inadvertently hinder the feasibility of such solutions for high-throughput, on-device inference, particularly in settings involving legacy hardware and multi-modal gigapixel images. Through a preliminary case study concerning segmentation in cardiology, we highlight the excess operational complexity in a suboptimally configured ML model from prior work and demonstrate that it can be sculpted away using pruning to meet deployment criteria. Our results show a compression rate of 1148x with minimal loss in quality (~4%) and, at higher rates, achieve faster inference on a CPU than the GPU baseline, stressing the need to consider task complexity and architectural details when using off-the-shelf models. With this, we consider avenues for future research in streamlining workflows for clinical researchers to develop models quicker and better suited for real-world use.

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Exploring the Hyperparameter Space of Image Diffusion Models for Echocardiogram Generation

This work presents an extensive hyperparameter search on Image Diffusion Models for Echocardiogram generation. The objective is to establish foundational benchmarks and provide guidelines within the realm of ultrasound image and video generation. This study builds over the latest advancements, including cutting-edge model architectures and training methodologies. We also examine the distribution shift between real and generated samples and consider potential solutions, crucial to train efficient models on generated data. We determine an Optimal FID score of $0.88$ for our research problem and achieve an FID of $2.60$. This work is aimed at contributing valuable insights and serving as a reference for further developments in the specialized field of ultrasound image and video generation.

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Whole Slide Multiple Instance Learning for Predicting Axillary Lymph Node Metastasis

Breast cancer is a major concern for women's health globally, with axillary lymph node (ALN) metastasis identification being critical for prognosis evaluation and treatment guidance. This paper presents a deep learning (DL) classification pipeline for quantifying clinical information from digital core-needle biopsy (CNB) images, with one step less than existing methods. A publicly available dataset of 1058 patients was used to evaluate the performance of different baseline state-of-the-art (SOTA) DL models in classifying ALN metastatic status based on CNB images. An extensive ablation study of various data augmentation techniques was also conducted. Finally, the manual tumor segmentation and annotation step performed by the pathologists was assessed.

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Confidence-Aware and Self-Supervised Image Anomaly Localisation

Universal anomaly detection still remains a challenging problem in machine learning and medical image analysis. It is possible to learn an expected distribution from a single class of normative samples, e.g., through epistemic uncertainty estimates, auto-encoding models, or from synthetic anomalies in a self-supervised way. The performance of self-supervised anomaly detection approaches is still inferior compared to methods that use examples from known unknown classes to shape the decision boundary. However, outlier exposure methods often do not identify unknown unknowns. Here we discuss an improved self-supervised single-class training strategy that supports the approximation of probabilistic inference with loosen feature locality constraints. We show that up-scaling of gradients with histogram-equalised images is beneficial for recently proposed self-supervision tasks. Our method is integrated into several out-of-distribution (OOD) detection models and we show evidence that our method outperforms the state-of-the-art on various benchmark datasets.

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Foreground-Background Separation through Concept Distillation from Generative Image Foundation Models

Curating datasets for object segmentation is a difficult task. With the advent of large-scale pre-trained generative models, conditional image generation has been given a significant boost in result quality and ease of use. In this paper, we present a novel method that enables the generation of general foreground-background segmentation models from simple textual descriptions, without requiring segmentation labels. We leverage and explore pre-trained latent diffusion models, to automatically generate weak segmentation masks for concepts and objects. The masks are then used to fine-tune the diffusion model on an inpainting task, which enables fine-grained removal of the object, while at the same time providing a synthetic foreground and background dataset. We demonstrate that using this method beats previous methods in both discriminative and generative performance and closes the gap with fully supervised training while requiring no pixel-wise object labels. We show results on the task of segmenting four different objects (humans, dogs, cars, birds) and a use case scenario in medical image analysis. The code is available at https://github.com/MischaD/fobadiffusion.

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LesionMix: A Lesion-Level Data Augmentation Method for Medical Image Segmentation

Data augmentation has become a de facto component of deep learning-based medical image segmentation methods. Most data augmentation techniques used in medical imaging focus on spatial and intensity transformations to improve the diversity of training images. They are often designed at the image level, augmenting the full image, and do not pay attention to specific abnormalities within the image. Here, we present LesionMix, a novel and simple lesion-aware data augmentation method. It performs augmentation at the lesion level, increasing the diversity of lesion shape, location, intensity and load distribution, and allowing both lesion populating and inpainting. Experiments on different modalities and different lesion datasets, including four brain MR lesion datasets and one liver CT lesion dataset, demonstrate that LesionMix achieves promising performance in lesion image segmentation, outperforming several recent Mix-based data augmentation methods. The code will be released at https://github.com/dogabasaran/lesionmix.

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Realistic Data Enrichment for Robust Image Segmentation in Histopathology

Poor performance of quantitative analysis in histopathological Whole Slide Images (WSI) has been a significant obstacle in clinical practice. Annotating large-scale WSIs manually is a demanding and time-consuming task, unlikely to yield the expected results when used for fully supervised learning systems. Rarely observed disease patterns and large differences in object scales are difficult to model through conventional patient intake. Prior methods either fall back to direct disease classification, which only requires learning a few factors per image, or report on average image segmentation performance, which is highly biased towards majority observations. Geometric image augmentation is commonly used to improve robustness for average case predictions and to enrich limited datasets. So far no method provided sampling of a realistic posterior distribution to improve stability, e.g. for the segmentation of imbalanced objects within images. Therefore, we propose a new approach, based on diffusion models, which can enrich an imbalanced dataset with plausible examples from underrepresented groups by conditioning on segmentation maps. Our method can simply expand limited clinical datasets making them suitable to train machine learning pipelines, and provides an interpretable and human-controllable way of generating histopathology images that are indistinguishable from real ones to human experts. We validate our findings on two datasets, one from the public domain and one from a Kidney Transplant study.

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Conditional Temporal Attention Networks for Neonatal Cortical Surface Reconstruction

Cortical surface reconstruction plays a fundamental role in modeling the rapid brain development during the perinatal period. In this work, we propose Conditional Temporal Attention Network (CoTAN), a fast end-to-end framework for diffeomorphic neonatal cortical surface reconstruction. CoTAN predicts multi-resolution stationary velocity fields (SVF) from neonatal brain magnetic resonance images (MRI). Instead of integrating multiple SVFs, CoTAN introduces attention mechanisms to learn a conditional time-varying velocity field (CTVF) by computing the weighted sum of all SVFs at each integration step. The importance of each SVF, which is estimated by learned attention maps, is conditioned on the age of the neonates and varies with the time step of integration. The proposed CTVF defines a diffeomorphic surface deformation, which reduces mesh self-intersection errors effectively. It only requires 0.21 seconds to deform an initial template mesh to cortical white matter and pial surfaces for each brain hemisphere. CoTAN is validated on the Developing Human Connectome Project (dHCP) dataset with 877 3D brain MR images acquired from preterm and term born neonates. Compared to state-of-the-art baselines, CoTAN achieves superior performance with only 0.12mm geometric error and 0.07% self-intersecting faces. The visualization of our attention maps illustrates that CoTAN indeed learns coarse-to-fine surface deformations automatically without intermediate supervision.

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Many tasks make light work: Learning to localise medical anomalies from multiple synthetic tasks

There is a growing interest in single-class modelling and out-of-distribution detection as fully supervised machine learning models cannot reliably identify classes not included in their training. The long tail of infinitely many out-of-distribution classes in real-world scenarios, e.g., for screening, triage, and quality control, means that it is often necessary to train single-class models that represent an expected feature distribution, e.g., from only strictly healthy volunteer data. Conventional supervised machine learning would require the collection of datasets that contain enough samples of all possible diseases in every imaging modality, which is not realistic. Self-supervised learning methods with synthetic anomalies are currently amongst the most promising approaches, alongside generative auto-encoders that analyse the residual reconstruction error. However, all methods suffer from a lack of structured validation, which makes calibration for deployment difficult and dataset-dependant. Our method alleviates this by making use of multiple visually-distinct synthetic anomaly learning tasks for both training and validation. This enables more robust training and generalisation. With our approach we can readily outperform state-of-the-art methods, which we demonstrate on exemplars in brain MRI and chest X-rays. Code is available at https://github.com/matt-baugh/many-tasks-make-light-work .

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Zero-Shot Anomaly Detection with Pre-trained Segmentation Models

This technical report outlines our submission to the zero-shot track of the Visual Anomaly and Novelty Detection (VAND) 2023 Challenge. Building on the performance of the WINCLIP framework, we aim to enhance the system's localization capabilities by integrating zero-shot segmentation models. In addition, we perform foreground instance segmentation which enables the model to focus on the relevant parts of the image, thus allowing the models to better identify small or subtle deviations. Our pipeline requires no external data or information, allowing for it to be directly applied to new datasets. Our team (Variance Vigilance Vanguard) ranked third in the zero-shot track of the VAND challenge, and achieve an average F1-max score of 81.5/24.2 at a sample/pixel level on the VisA dataset.

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Quantifying Sample Anonymity in Score-Based Generative Models with Adversarial Fingerprinting

Recent advances in score-based generative models have led to a huge spike in the development of downstream applications using generative models ranging from data augmentation over image and video generation to anomaly detection. Despite publicly available trained models, their potential to be used for privacy preserving data sharing has not been fully explored yet. Training diffusion models on private data and disseminating the models and weights rather than the raw dataset paves the way for innovative large-scale data-sharing strategies, particularly in healthcare, where safeguarding patients' personal health information is paramount. However, publishing such models without individual consent of, e.g., the patients from whom the data was acquired, necessitates guarantees that identifiable training samples will never be reproduced, thus protecting personal health data and satisfying the requirements of policymakers and regulatory bodies. This paper introduces a method for estimating the upper bound of the probability of reproducing identifiable training images during the sampling process. This is achieved by designing an adversarial approach that searches for anatomic fingerprints, such as medical devices or dermal art, which could potentially be employed to re-identify training images. Our method harnesses the learned score-based model to estimate the probability of the entire subspace of the score function that may be utilized for one-to-one reproduction of training samples. To validate our estimates, we generate anomalies containing a fingerprint and investigate whether generated samples from trained generative models can be uniquely mapped to the original training samples. Overall our results show that privacy-breaching images are reproduced at sampling time if the models were trained without care.

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