arXiv subjects

Christian F. Baumgartner

Publications and source records attributed to Christian F. Baumgartner.

At least 37 records · Page 2Linked to original sources

arXiv2024

Subgroup-Specific Risk-Controlled Dose Estimation in Radiotherapy

Cancer remains a leading cause of death, highlighting the importance of effective radiotherapy (RT). Magnetic resonance-guided linear accelerators (MR-Linacs) enable imaging during RT, allowing for inter-fraction, and perhaps even intra-fraction, adjustments of treatment plans. However, achieving this requires fast and accurate dose calculations. While Monte Carlo simulations offer accuracy, they are computationally intensive. Deep learning frameworks show promise, yet lack uncertainty quantification crucial for high-risk applications like RT. Risk-controlling prediction sets (RCPS) offer model-agnostic uncertainty quantification with mathematical guarantees. However, we show that naive application of RCPS may lead to only certain subgroups such as the image background being risk-controlled. In this work, we extend RCPS to provide prediction intervals with coverage guarantees for multiple subgroups with unknown subgroup membership at test time. We evaluate our algorithm on real clinical planing volumes from five different anatomical regions and show that our novel subgroup RCPS (SG-RCPS) algorithm leads to prediction intervals that jointly control the risk for multiple subgroups. In particular, our method controls the risk of the crucial voxels along the radiation beam significantly better than conventional RCPS.

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arXiv2023

Unsupervised Anomaly Detection using Aggregated Normative Diffusion

Early detection of anomalies in medical images such as brain MRI is highly relevant for diagnosis and treatment of many conditions. Supervised machine learning methods are limited to a small number of pathologies where there is good availability of labeled data. In contrast, unsupervised anomaly detection (UAD) has the potential to identify a broader spectrum of anomalies by spotting deviations from normal patterns. Our research demonstrates that existing state-of-the-art UAD approaches do not generalise well to diverse types of anomalies in realistic multi-modal MR data. To overcome this, we introduce a new UAD method named Aggregated Normative Diffusion (ANDi). ANDi operates by aggregating differences between predicted denoising steps and ground truth backwards transitions in Denoising Diffusion Probabilistic Models (DDPMs) that have been trained on pyramidal Gaussian noise. We validate ANDi against three recent UAD baselines, and across three diverse brain MRI datasets. We show that ANDi, in some cases, substantially surpasses these baselines and shows increased robustness to varying types of anomalies. Particularly in detecting multiple sclerosis (MS) lesions, ANDi achieves improvements of up to 178% in terms of AUPRC.

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arXiv2023

Inherently Interpretable Multi-Label Classification Using Class-Specific Counterfactuals

Interpretability is essential for machine learning algorithms in high-stakes application fields such as medical image analysis. However, high-performing black-box neural networks do not provide explanations for their predictions, which can lead to mistrust and suboptimal human-ML collaboration. Post-hoc explanation techniques, which are widely used in practice, have been shown to suffer from severe conceptual problems. Furthermore, as we show in this paper, current explanation techniques do not perform adequately in the multi-label scenario, in which multiple medical findings may co-occur in a single image. We propose Attri-Net, an inherently interpretable model for multi-label classification. Attri-Net is a powerful classifier that provides transparent, trustworthy, and human-understandable explanations. The model first generates class-specific attribution maps based on counterfactuals to identify which image regions correspond to certain medical findings. Then a simple logistic regression classifier is used to make predictions based solely on these attribution maps. We compare Attri-Net to five post-hoc explanation techniques and one inherently interpretable classifier on three chest X-ray datasets. We find that Attri-Net produces high-quality multi-label explanations consistent with clinical knowledge and has comparable classification performance to state-of-the-art classification models.

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arXiv2023

Right for the Wrong Reason: Can Interpretable ML Techniques Detect Spurious Correlations?

While deep neural network models offer unmatched classification performance, they are prone to learning spurious correlations in the data. Such dependencies on confounding information can be difficult to detect using performance metrics if the test data comes from the same distribution as the training data. Interpretable ML methods such as post-hoc explanations or inherently interpretable classifiers promise to identify faulty model reasoning. However, there is mixed evidence whether many of these techniques are actually able to do so. In this paper, we propose a rigorous evaluation strategy to assess an explanation technique's ability to correctly identify spurious correlations. Using this strategy, we evaluate five post-hoc explanation techniques and one inherently interpretable method for their ability to detect three types of artificially added confounders in a chest x-ray diagnosis task. We find that the post-hoc technique SHAP, as well as the inherently interpretable Attri-Net provide the best performance and can be used to reliably identify faulty model behavior.

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arXiv2023

Uncertainty Estimation and Propagation in Accelerated MRI Reconstruction

MRI reconstruction techniques based on deep learning have led to unprecedented reconstruction quality especially in highly accelerated settings. However, deep learning techniques are also known to fail unexpectedly and hallucinate structures. This is particularly problematic if reconstructions are directly used for downstream tasks such as real-time treatment guidance or automated extraction of clinical paramters (e.g. via segmentation). Well-calibrated uncertainty quantification will be a key ingredient for safe use of this technology in clinical practice. In this paper we propose a novel probabilistic reconstruction technique (PHiRec) building on the idea of conditional hierarchical variational autoencoders. We demonstrate that our proposed method produces high-quality reconstructions as well as uncertainty quantification that is substantially better calibrated than several strong baselines. We furthermore demonstrate how uncertainties arising in the MR econstruction can be propagated to a downstream segmentation task, and show that PHiRec also allows well-calibrated estimation of segmentation uncertainties that originated in the MR reconstruction process.

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arXiv2023

Deep Hypothesis Tests Detect Clinically Relevant Subgroup Shifts in Medical Images

Distribution shifts remain a fundamental problem for the safe application of machine learning systems. If undetected, they may impact the real-world performance of such systems or will at least render original performance claims invalid. In this paper, we focus on the detection of subgroup shifts, a type of distribution shift that can occur when subgroups have a different prevalence during validation compared to the deployment setting. For example, algorithms developed on data from various acquisition settings may be predominantly applied in hospitals with lower quality data acquisition, leading to an inadvertent performance drop. We formulate subgroup shift detection in the framework of statistical hypothesis testing and show that recent state-of-the-art statistical tests can be effectively applied to subgroup shift detection on medical imaging data. We provide synthetic experiments as well as extensive evaluation on clinically meaningful subgroup shifts on histopathology as well as retinal fundus images. We conclude that classifier-based subgroup shift detection tests could be a particularly useful tool for post-market surveillance of deployed ML systems.

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arXiv2023

Studying Therapy Effects and Disease Outcomes in Silico using Artificial Counterfactual Tissue Samples

Understanding the interactions of different cell types inside the immune tumor microenvironment (iTME) is crucial for the development of immunotherapy treatments as well as for predicting their outcomes. Highly multiplexed tissue imaging (HMTI) technologies offer a tool which can capture cell properties of tissue samples by measuring expression of various proteins and storing them in separate image channels. HMTI technologies can be used to gain insights into the iTME and in particular how the iTME differs for different patient outcome groups of interest (e.g., treatment responders vs. non-responders). Understanding the systematic differences in the iTME of different patient outcome groups is crucial for developing better treatments and personalising existing treatments. However, such analyses are inherently limited by the fact that any two tissue samples vary due to a large number of factors unrelated to the outcome. Here, we present CF-HistoGAN, a machine learning framework that employs generative adversarial networks (GANs) to create artificial counterfactual tissue samples that resemble the original tissue samples as closely as possible but capture the characteristics of a different patient outcome group. Specifically, we learn to "translate" HMTI samples from one patient group to create artificial paired samples. We show that this approach allows to directly study the effects of different patient outcomes on the iTMEs of individual tissue samples. We demonstrate that CF-HistoGAN can be employed as an explorative tool for understanding iTME effects on the pixel level. Moreover, we show that our method can be used to identify statistically significant differences in the expression of different proteins between patient groups with greater sensitivity compared to conventional approaches.

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arXiv2023

Multiscale Metamorphic VAE for 3D Brain MRI Synthesis

Generative modeling of 3D brain MRIs presents difficulties in achieving high visual fidelity while ensuring sufficient coverage of the data distribution. In this work, we propose to address this challenge with composable, multiscale morphological transformations in a variational autoencoder (VAE) framework. These transformations are applied to a chosen reference brain image to generate MRI volumes, equipping the model with strong anatomical inductive biases. We structure the VAE latent space in a way such that the model covers the data distribution sufficiently well. We show substantial performance improvements in FID while retaining comparable, or superior, reconstruction quality compared to prior work based on VAEs and generative adversarial networks (GANs).

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arXiv2022

Adversarial Robustness of MR Image Reconstruction under Realistic Perturbations

Deep Learning (DL) methods have shown promising results for solving ill-posed inverse problems such as MR image reconstruction from undersampled $k$-space data. However, these approaches currently have no guarantees for reconstruction quality and the reliability of such algorithms is only poorly understood. Adversarial attacks offer a valuable tool to understand possible failure modes and worst case performance of DL-based reconstruction algorithms. In this paper we describe adversarial attacks on multi-coil $k$-space measurements and evaluate them on the recently proposed E2E-VarNet and a simpler UNet-based model. In contrast to prior work, the attacks are targeted to specifically alter diagnostically relevant regions. Using two realistic attack models (adversarial $k$-space noise and adversarial rotations) we are able to show that current state-of-the-art DL-based reconstruction algorithms are indeed sensitive to such perturbations to a degree where relevant diagnostic information may be lost. Surprisingly, in our experiments the UNet and the more sophisticated E2E-VarNet were similarly sensitive to such attacks. Our findings add further to the evidence that caution must be exercised as DL-based methods move closer to clinical practice.

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arXiv2022

Sampling possible reconstructions of undersampled acquisitions in MR imaging

Undersampling the k-space during MR acquisitions saves time, however results in an ill-posed inversion problem, leading to an infinite set of images as possible solutions. Traditionally, this is tackled as a reconstruction problem by searching for a single "best" image out of this solution set according to some chosen regularization or prior. This approach, however, misses the possibility of other solutions and hence ignores the uncertainty in the inversion process. In this paper, we propose a method that instead returns multiple images which are possible under the acquisition model and the chosen prior to capture the uncertainty in the inversion process. To this end, we introduce a low dimensional latent space and model the posterior distribution of the latent vectors given the acquisition data in k-space, from which we can sample in the latent space and obtain the corresponding images. We use a variational autoencoder for the latent model and the Metropolis adjusted Langevin algorithm for the sampling. We evaluate our method on two datasets; with images from the Human Connectome Project and in-house measured multi-coil images. We compare to five alternative methods. Results indicate that the proposed method produces images that match the measured k-space data better than the alternatives, while showing realistic structural variability. Furthermore, in contrast to the compared methods, the proposed method yields higher uncertainty in the undersampled phase encoding direction, as expected. Keywords: Magnetic Resonance image reconstruction, uncertainty estimation, inverse problems, sampling, MCMC, deep learning, unsupervised learning.

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arXiv2020

Semi-supervised Task-driven Data Augmentation for Medical Image Segmentation

Supervised learning-based segmentation methods typically require a large number of annotated training data to generalize well at test time. In medical applications, curating such datasets is not a favourable option because acquiring a large number of annotated samples from experts is time-consuming and expensive. Consequently, numerous methods have been proposed in the literature for learning with limited annotated examples. Unfortunately, the proposed approaches in the literature have not yet yielded significant gains over random data augmentation for image segmentation, where random augmentations themselves do not yield high accuracy. In this work, we propose a novel task-driven data augmentation method for learning with limited labeled data where the synthetic data generator, is optimized for the segmentation task. The generator of the proposed method models intensity and shape variations using two sets of transformations, as additive intensity transformations and deformation fields. Both transformations are optimized using labeled as well as unlabeled examples in a semi-supervised framework. Our experiments on three medical datasets, namely cardic, prostate and pancreas, show that the proposed approach significantly outperforms standard augmentation and semi-supervised approaches for image segmentation in the limited annotation setting. The code is made publicly available at https://github.com/krishnabits001/task$\_$driven$\_$data$\_$augmentation.

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arXiv2020

Automated quantification of myocardial tissue characteristics from native T1 mapping using neural networks with Bayesian inference for uncertainty-based quality-control

Tissue characterisation with CMR parametric mapping has the potential to detect and quantify both focal and diffuse alterations in myocardial structure not assessable by late gadolinium enhancement. Native T1 mapping in particular has shown promise as a useful biomarker to support diagnostic, therapeutic and prognostic decision-making in ischaemic and non-ischaemic cardiomyopathies. Convolutional neural networks with Bayesian inference are a category of artificial neural networks which model the uncertainty of the network output. This study presents an automated framework for tissue characterisation from native ShMOLLI T1 mapping at 1.5T using a Probabilistic Hierarchical Segmentation (PHiSeg) network. In addition, we use the uncertainty information provided by the PHiSeg network in a novel automated quality control (QC) step to identify uncertain T1 values. The PHiSeg network and QC were validated against manual analysis on a cohort of the UK Biobank containing healthy subjects and chronic cardiomyopathy patients. We used the proposed method to obtain reference T1 ranges for the left ventricular myocardium in healthy subjects as well as common clinical cardiac conditions. T1 values computed from automatic and manual segmentations were highly correlated (r=0.97). Bland-Altman analysis showed good agreement between the automated and manual measurements. The average Dice metric was 0.84 for the left ventricular myocardium. The sensitivity of detection of erroneous outputs was 91%. Finally, T1 values were automatically derived from 14,683 CMR exams from the UK Biobank. The proposed pipeline allows for automatic analysis of myocardial native T1 mapping and includes a QC process to detect potentially erroneous results. T1 reference values were presented for healthy subjects and common clinical cardiac conditions from the largest cohort to date using T1-mapping images.

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arXiv2019

PHiSeg: Capturing Uncertainty in Medical Image Segmentation

Segmentation of anatomical structures and pathologies is inherently ambiguous. For instance, structure borders may not be clearly visible or different experts may have different styles of annotating. The majority of current state-of-the-art methods do not account for such ambiguities but rather learn a single mapping from image to segmentation. In this work, we propose a novel method to model the conditional probability distribution of the segmentations given an input image. We derive a hierarchical probabilistic model, in which separate latent variables are responsible for modelling the segmentation at different resolutions. Inference in this model can be efficiently performed using the variational autoencoder framework. We show that our proposed method can be used to generate significantly more realistic and diverse segmentation samples compared to recent related work, both, when trained with annotations from a single or multiple annotators.

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arXiv2019

A Partially Reversible U-Net for Memory-Efficient Volumetric Image Segmentation

One of the key drawbacks of 3D convolutional neural networks for segmentation is their memory footprint, which necessitates compromises in the network architecture in order to fit into a given memory budget. Motivated by the RevNet for image classification, we propose a partially reversible U-Net architecture that reduces memory consumption substantially. The reversible architecture allows us to exactly recover each layer's outputs from the subsequent layer's ones, eliminating the need to store activations for backpropagation. This alleviates the biggest memory bottleneck and enables very deep (theoretically infinitely deep) 3D architectures. On the BraTS challenge dataset, we demonstrate substantial memory savings. We further show that the freed memory can be used for processing the whole field-of-view (FOV) instead of patches. Increasing network depth led to higher segmentation accuracy while growing the memory footprint only by a very small fraction, thanks to the partially reversible architecture.

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arXiv2018

MR image reconstruction using deep density priors

Algorithms for Magnetic Resonance (MR) image reconstruction from undersampled measurements exploit prior information to compensate for missing k-space data. Deep learning (DL) provides a powerful framework for extracting such information from existing image datasets, through learning, and then using it for reconstruction. Leveraging this, recent methods employed DL to learn mappings from undersampled to fully sampled images using paired datasets, including undersampled and corresponding fully sampled images, integrating prior knowledge implicitly. In this article, we propose an alternative approach that learns the probability distribution of fully sampled MR images using unsupervised DL, specifically Variational Autoencoders (VAE), and use this as an explicit prior term in reconstruction, completely decoupling the encoding operation from the prior. The resulting reconstruction algorithm enjoys a powerful image prior to compensate for missing k-space data without requiring paired datasets for training nor being prone to associated sensitivities, such as deviations in undersampling patterns used in training and test time or coil settings. We evaluated the proposed method with T1 weighted images from a publicly available dataset, multi-coil complex images acquired from healthy volunteers (N=8) and images with white matter lesions. The proposed algorithm, using the VAE prior, produced visually high quality reconstructions and achieved low RMSE values, outperforming most of the alternative methods on the same dataset. On multi-coil complex data, the algorithm yielded accurate magnitude and phase reconstruction results. In the experiments on images with white matter lesions, the method faithfully reconstructed the lesions. Keywords: Reconstruction, MRI, prior probability, machine learning, deep learning, unsupervised learning, density estimation

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arXiv2018

Combining Heterogeneously Labeled Datasets For Training Segmentation Networks

Accurate segmentation of medical images is an important step towards analyzing and tracking disease related morphological alterations in the anatomy. Convolutional neural networks (CNNs) have recently emerged as a powerful tool for many segmentation tasks in medical imaging. The performance of CNNs strongly depends on the size of the training data and combining data from different sources is an effective strategy for obtaining larger training datasets. However, this is often challenged by heterogeneous labeling of the datasets. For instance, one of the dataset may be missing labels or a number of labels may have been combined into a super label. In this work we propose a cost function which allows integration of multiple datasets with heterogeneous label subsets into a joint training. We evaluated the performance of this strategy on thigh MR and a cardiac MR datasets in which we artificially merged labels for half of the data. We found the proposed cost function substantially outperforms a naive masking approach, obtaining results very close to using the full annotations.

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arXiv2018

Learning to Segment Medical Images with Scribble-Supervision Alone

Semantic segmentation of medical images is a crucial step for the quantification of healthy anatomy and diseases alike. The majority of the current state-of-the-art segmentation algorithms are based on deep neural networks and rely on large datasets with full pixel-wise annotations. Producing such annotations can often only be done by medical professionals and requires large amounts of valuable time. Training a medical image segmentation network with weak annotations remains a relatively unexplored topic. In this work we investigate training strategies to learn the parameters of a pixel-wise segmentation network from scribble annotations alone. We evaluate the techniques on public cardiac (ACDC) and prostate (NCI-ISBI) segmentation datasets. We find that the networks trained on scribbles suffer from a remarkably small degradation in Dice of only 2.9% (cardiac) and 4.5% (prostate) with respect to a network trained on full annotations.

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arXiv2018

Visual Feature Attribution using Wasserstein GANs

Attributing the pixels of an input image to a certain category is an important and well-studied problem in computer vision, with applications ranging from weakly supervised localisation to understanding hidden effects in the data. In recent years, approaches based on interpreting a previously trained neural network classifier have become the de facto state-of-the-art and are commonly used on medical as well as natural image datasets. In this paper, we discuss a limitation of these approaches which may lead to only a subset of the category specific features being detected. To address this problem we develop a novel feature attribution technique based on Wasserstein Generative Adversarial Networks (WGAN), which does not suffer from this limitation. We show that our proposed method performs substantially better than the state-of-the-art for visual attribution on a synthetic dataset and on real 3D neuroimaging data from patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). For AD patients the method produces compellingly realistic disease effect maps which are very close to the observed effects.

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