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Daniel Rueckert

Publications and source records attributed to Daniel Rueckert.

At least 109 records · Page 6Linked to original sources

Towards Cardiac MRI Foundation Models: Comprehensive Visual-Tabular Representations for Whole-Heart Assessment and Beyond

Cardiac magnetic resonance imaging is the gold standard for non-invasive cardiac assessment, offering rich spatio-temporal views of the cardiac anatomy and physiology. Patient-level health factors, such as demographics, metabolic, and lifestyle, are known to substantially influence cardiovascular health and disease risk, yet remain uncaptured by CMR alone. To holistically understand cardiac health and to enable the best possible interpretation of an individual's disease risk, CMR and patient-level factors must be jointly exploited within an integrated framework. Recent multi-modal approaches have begun to bridge this gap, yet they often rely on limited spatio-temporal data and focus on isolated clinical tasks, thereby hindering the development of a comprehensive representation for cardiac health evaluation. To overcome these limitations, we introduce ViTa, a step toward foundation models that delivers a comprehensive representation of the heart and a precise interpretation of individual disease risk. Leveraging data from 42,000 UK Biobank participants, ViTa integrates 3D+T cine stacks from short-axis and long-axis views, enabling a complete capture of the cardiac cycle. These imaging data are then fused with detailed tabular patient-level factors, enabling context-aware insights. This multi-modal paradigm supports a wide spectrum of downstream tasks, including cardiac phenotype and physiological feature prediction, segmentation, and classification of cardiac and metabolic diseases within a single unified framework. By learning a shared latent representation that bridges rich imaging features and patient context, ViTa moves beyond traditional, task-specific models toward a universal, patient-specific understanding of cardiac health, highlighting its potential to advance clinical utility and scalability in cardiac analysis.

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GReAT: leveraging geometric artery data to improve wall shear stress assessment

Leveraging big data for patient care is promising in many medical fields such as cardiovascular health. For example, hemodynamic biomarkers like wall shear stress could be assessed from patient-specific medical images via machine learning algorithms, bypassing the need for time-intensive computational fluid simulation. However, it is extremely challenging to amass large-enough datasets to effectively train such models. We could address this data scarcity by means of self-supervised pre-training and foundations models given large datasets of geometric artery models. In the context of coronary arteries, leveraging learned representations to improve hemodynamic biomarker assessment has not yet been well studied. In this work, we address this gap by investigating whether a large dataset (8449 shapes) consisting of geometric models of 3D blood vessels can benefit wall shear stress assessment in coronary artery models from a small-scale clinical trial (49 patients). We create a self-supervised target for the 3D blood vessels by computing the heat kernel signature, a quantity obtained via Laplacian eigenvectors, which captures the very essence of the shapes. We show how geometric representations learned from this datasets can boost segmentation of coronary arteries into regions of low, mid and high (time-averaged) wall shear stress even when trained on limited data.

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Addressing Annotation Scarcity in Hyperspectral Brain Image Segmentation with Unsupervised Domain Adaptation

This work presents a novel deep learning framework for segmenting cerebral vasculature in hyperspectral brain images. We address the critical challenge of severe label scarcity, which impedes conventional supervised training. Our approach utilizes a novel unsupervised domain adaptation methodology, using a small, expert-annotated ground truth alongside unlabeled data. Quantitative and qualitative evaluations confirm that our method significantly outperforms existing state-of-the-art approaches, demonstrating the efficacy of domain adaptation for label-scarce biomedical imaging tasks.

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Rule-based Key-Point Extraction for MR-Guided Biomechanical Digital Twins of the Spine

Digital twins offer a powerful framework for subject-specific simulation and clinical decision support, yet their development often hinges on accurate, individualized anatomical modeling. In this work, we present a rule-based approach for subpixel-accurate key-point extraction from MRI, adapted from prior CT-based methods. Our approach incorporates robust image alignment and vertebra-specific orientation estimation to generate anatomically meaningful landmarks that serve as boundary conditions and force application points, like muscle and ligament insertions in biomechanical models. These models enable the simulation of spinal mechanics considering the subject's individual anatomy, and thus support the development of tailored approaches in clinical diagnostics and treatment planning. By leveraging MR imaging, our method is radiation-free and well-suited for large-scale studies and use in underrepresented populations. This work contributes to the digital twin ecosystem by bridging the gap between precise medical image analysis with biomechanical simulation, and aligns with key themes in personalized modeling for healthcare.

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Physics-Informed Joint Multi-TE Super-Resolution with Implicit Neural Representation for Robust Fetal T2 Mapping

T2 mapping in fetal brain MRI has the potential to improve characterization of the developing brain, especially at mid-field (0.55T), where T2 decay is slower. However, this is challenging as fetal MRI acquisition relies on multiple motion-corrupted stacks of thick slices, requiring slice-to-volume reconstruction (SVR) to estimate a high-resolution (HR) 3D volume. Currently, T2 mapping involves repeated acquisitions of these stacks at each echo time (TE), leading to long scan times and high sensitivity to motion. We tackle this challenge with a method that jointly reconstructs data across TEs, addressing severe motion. Our approach combines implicit neural representations with a physics-informed regularization that models T2 decay, enabling information sharing across TEs while preserving anatomical and quantitative T2 fidelity. We demonstrate state-of-the-art performance on simulated fetal brain and in vivo adult datasets with fetal-like motion. We also present the first in vivo fetal T2 mapping results at 0.55T. Our study shows potential for reducing the number of stacks per TE in T2 mapping by leveraging anatomical redundancy.

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Topology Optimization in Medical Image Segmentation with Fast Euler Characteristic

Deep learning-based medical image segmentation techniques have shown promising results when evaluated based on conventional metrics such as the Dice score or Intersection-over-Union. However, these fully automatic methods often fail to meet clinically acceptable accuracy, especially when topological constraints should be observed, e.g., continuous boundaries or closed surfaces. In medical image segmentation, the correctness of a segmentation in terms of the required topological genus sometimes is even more important than the pixel-wise accuracy. Existing topology-aware approaches commonly estimate and constrain the topological structure via the concept of persistent homology (PH). However, these methods are difficult to implement for high dimensional data due to their polynomial computational complexity. To overcome this problem, we propose a novel and fast approach for topology-aware segmentation based on the Euler Characteristic ($χ$). First, we propose a fast formulation for $χ$ computation in both 2D and 3D. The scalar $χ$ error between the prediction and ground-truth serves as the topological evaluation metric. Then we estimate the spatial topology correctness of any segmentation network via a so-called topological violation map, i.e., a detailed map that highlights regions with $χ$ errors. Finally, the segmentation results from the arbitrary network are refined based on the topological violation maps by a topology-aware correction network. Our experiments are conducted on both 2D and 3D datasets and show that our method can significantly improve topological correctness while preserving pixel-wise segmentation accuracy.

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Whole-body Representation Learning For Competing Preclinical Disease Risk Assessment

Reliable preclinical disease risk assessment is essential to move public healthcare from reactive treatment to proactive identification and prevention. However, image-based risk prediction algorithms often consider one condition at a time and depend on hand-crafted features obtained through segmentation tools. We propose a whole-body self-supervised representation learning method for the preclinical disease risk assessment under a competing risk modeling. This approach outperforms whole-body radiomics in multiple diseases, including cardiovascular disease (CVD), type 2 diabetes (T2D), chronic obstructive pulmonary disease (COPD), and chronic kidney disease (CKD). Simulating a preclinical screening scenario and subsequently combining with cardiac MRI, it sharpens further the prediction for CVD subgroups: ischemic heart disease (IHD), hypertensive diseases (HD), and stroke. The results indicate the translational potential of whole-body representations as a standalone screening modality and as part of a multi-modal framework within clinical workflows for early personalized risk stratification. The code is available at https://github.com/yayapa/WBRLforCR/

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A Lightweight Optimization Framework for Estimating 3D Brain Tumor Infiltration

Glioblastoma, the most aggressive primary brain tumor, poses a severe clinical challenge due to its diffuse microscopic infiltration, which remains largely undetected on standard MRI. As a result, current radiotherapy planning employs a uniform 15 mm margin around the resection cavity, failing to capture patient-specific tumor spread. Tumor growth modeling offers a promising approach to reveal this hidden infiltration. However, methods based on partial differential equations or physics-informed neural networks tend to be computationally intensive or overly constrained, limiting their clinical adaptability to individual patients. In this work, we propose a lightweight, rapid, and robust optimization framework that estimates the 3D tumor concentration by fitting it to MRI tumor segmentations while enforcing a smooth concentration landscape. This approach achieves superior tumor recurrence prediction on 192 brain tumor patients across two public datasets, outperforming state-of-the-art baselines while reducing runtime from 30 minutes to less than one minute. Furthermore, we demonstrate the framework's versatility and adaptability by showing its ability to seamlessly integrate additional imaging modalities or physical constraints.

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Reconstruct or Generate: Exploring the Spectrum of Generative Modeling for Cardiac MRI

In medical imaging, generative models are increasingly relied upon for two distinct but equally critical tasks: reconstruction, where the goal is to restore medical imaging (usually inverse problems like inpainting or superresolution), and generation, where synthetic data is created to augment datasets or carry out counterfactual analysis. Despite shared architecture and learning frameworks, they prioritize different goals: generation seeks high perceptual quality and diversity, while reconstruction focuses on data fidelity and faithfulness. In this work, we introduce a "generative model zoo" and systematically analyze how modern latent diffusion models and autoregressive models navigate the reconstruction-generation spectrum. We benchmark a suite of generative models across representative cardiac medical imaging tasks, focusing on image inpainting with varying masking ratios and sampling strategies, as well as unconditional image generation. Our findings show that diffusion models offer superior perceptual quality for unconditional generation but tend to hallucinate as masking ratios increase, whereas autoregressive models maintain stable perceptual performance across masking levels, albeit with generally lower fidelity.

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Physics-Informed Implicit Neural Representations for Joint B0 Estimation and Echo Planar Imaging

Echo Planar Imaging (EPI) is widely used for its rapid acquisition but suffers from severe geometric distortions due to B0 inhomogeneities, particularly along the phase encoding direction. Existing methods follow a two-step process: reconstructing blip-up/down EPI images, then estimating B0, which can introduce error accumulation and reduce correction accuracy. This is especially problematic in high B0 regions, where distortions align along the same axis, making them harder to disentangle. In this work, we propose a novel approach that integrates Implicit Neural Representations (INRs) with a physics-informed correction model to jointly estimate B0 inhomogeneities and reconstruct distortion-free images from rotated-view EPI acquisitions. INRs offer a flexible, continuous representation that inherently captures complex spatial variations without requiring predefined grid-based field maps. By leveraging this property, our method dynamically adapts to subject-specific B0 variations and improves robustness across different imaging conditions. Experimental results on 180 slices of brain images from three subjects demonstrate that our approach outperforms traditional methods in terms of reconstruction quality and field estimation accuracy.

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From Fiber Tracts to Tumor Spread: Biophysical Modeling of Butterfly Glioma Growth Using Diffusion Tensor Imaging

Butterfly tumors are a distinct class of gliomas that span the corpus callosum, producing a characteristic butterfly-shaped appearance on MRI. The distinctive growth pattern of these tumors highlights how white matter fibers and structural connectivity influence brain tumor cell migration. To investigate this relation, we applied biophysical tumor growth models to a large patient cohort, systematically comparing models that incorporate fiber tract information with those that do not. Our results demonstrate that including fiber orientation data significantly improves model accuracy, particularly for a subset of butterfly tumors. These findings highlight the critical role of white matter architecture in tumor spread and suggest that integrating fiber tract information can enhance the precision of radiotherapy target volume delineation.

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How Far Have Medical Vision-Language Models Come? A Comprehensive Benchmarking Study

Vision-Language Models (VLMs) trained on web-scale corpora excel at natural image tasks and are increasingly repurposed for healthcare; however, their competence in medical tasks remains underexplored. We present a comprehensive evaluation of open-source general-purpose and medically specialised VLMs, ranging from 3B to 72B parameters, across eight benchmarks: MedXpert, OmniMedVQA, PMC-VQA, PathVQA, MMMU, SLAKE, and VQA-RAD. To observe model performance across different aspects, we first separate it into understanding and reasoning components. Three salient findings emerge. First, large general-purpose models already match or surpass medical-specific counterparts on several benchmarks, demonstrating strong zero-shot transfer from natural to medical images. Second, reasoning performance is consistently lower than understanding, highlighting a critical barrier to safe decision support. Third, performance varies widely across benchmarks, reflecting differences in task design, annotation quality, and knowledge demands. No model yet reaches the reliability threshold for clinical deployment, underscoring the need for stronger multimodal alignment and more rigorous, fine-grained evaluation protocols.

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BrainLesion Suite: A Flexible and User-Friendly Framework for Modular Brain Lesion Image Analysis

BrainLesion Suite is a versatile toolkit for building modular brain lesion image analysis pipelines in Python. Following Pythonic principles, BrainLesion Suite is designed to provide a 'brainless' development experience, minimizing cognitive effort and streamlining the creation of complex workflows for clinical and scientific practice. At its core is an adaptable preprocessing module that performs co-registration, atlas registration, and optional skull-stripping and defacing on arbitrary multi-modal input images. BrainLesion Suite leverages algorithms from the BraTS challenge to synthesize missing modalities, inpaint lesions, and generate pathology-specific tumor segmentations. BrainLesion Suite also enables quantifying segmentation model performance, with tools such as panoptica to compute lesion-wise metrics. Although BrainLesion Suite was originally developed for image analysis pipelines of brain lesions such as glioma, metastasis, and multiple sclerosis, it can be adapted for other biomedical image analysis applications. The individual BrainLesion Suite packages and tutorials are accessible on GitHub.

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ISLES'24 -- A Real-World Longitudinal Multimodal Stroke Dataset

Stroke remains a leading cause of global morbidity and mortality, imposing a heavy socioeconomic burden. Advances in endovascular reperfusion therapy and CT and MR imaging for treatment guidance have significantly improved patient outcomes. Developing machine learning algorithms that can create accurate models of brain function from stroke images for tasks like lesion identification and tissue survival prediction requires large, diverse, and well annotated public datasets. While several high-quality image datasets in stroke exist, they include only single time point data. Data over different time points are essential to accurately identify lesions and predict prognosis. Here, we provide comprehensive longitudinal stroke data, including (sub-)acute CT imaging with angiography and perfusion, follow-up MRI after 2-9 days, and acute and longitudinal clinical data up to a three-month outcome. The dataset also includes vessel occlusion masks from acute CT angiography and delineated infarction masks in follow-up MRI. This multicenter dataset consists of 245 cases and is a solid basis for developing powerful machine-learning algorithms to facilitate clinical decision-making.

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Parametric shape models for vessels learned from segmentations via differentiable voxelization

Vessels are complex structures in the body that have been studied extensively in multiple representations. While voxelization is the most common of them, meshes and parametric models are critical in various applications due to their desirable properties. However, these representations are typically extracted through segmentations and used disjointly from each other. We propose a framework that joins the three representations under differentiable transformations. By leveraging differentiable voxelization, we automatically extract a parametric shape model of the vessels through shape-to-segmentation fitting, where we learn shape parameters from segmentations without the explicit need for ground-truth shape parameters. The vessel is parametrized as centerlines and radii using cubic B-splines, ensuring smoothness and continuity by construction. Meshes are differentiably extracted from the learned shape parameters, resulting in high-fidelity meshes that can be manipulated post-fit. Our method can accurately capture the geometry of complex vessels, as demonstrated by the volumetric fits in experiments on aortas, aneurysms, and brain vessels.

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Diff-Def: Diffusion-Generated Deformation Fields for Conditional Atlases

Anatomical atlases are widely used for population studies and analysis. Conditional atlases target a specific sub-population defined via certain conditions, such as demographics or pathologies, and allow for the investigation of fine-grained anatomical differences like morphological changes associated with ageing or disease. Existing approaches use either registration-based methods that are often unable to handle large anatomical variations or generative adversarial models, which are challenging to train since they can suffer from training instabilities. Instead of generating atlases directly in as intensities, we propose using latent diffusion models to generate deformation fields, which transform a general population atlas into one representing a specific sub-population. Our approach ensures structural integrity, enhances interpretability and avoids hallucinations that may arise during direct image synthesis by generating this deformation field and regularising it using a neighbourhood of images. We compare our method to several state-of-the-art atlas generation methods using brain MR images from the UK Biobank. Our method generates highly realistic atlases with smooth transformations and high anatomical fidelity, outperforming existing baselines. We demonstrate the quality of these atlases through comprehensive evaluations, including quantitative metrics for anatomical accuracy, perceptual similarity, and qualitative analyses displaying the consistency and realism of the generated atlases.

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Redefining spectral unmixing for in-vivo brain tissue analysis from hyperspectral imaging

In this paper, we propose a methodology for extracting molecular tumor biomarkers from hyperspectral imaging (HSI), an emerging technology for intraoperative tissue assessment. To achieve this, we employ spectral unmixing, allowing to decompose the spectral signals recorded by the HSI camera into their constituent molecular components. Traditional unmixing approaches are based on physical models that establish a relationship between tissue molecules and the recorded spectra. However, these methods commonly assume a linear relationship between the spectra and molecular content, which does not capture the whole complexity of light-matter interaction. To address this limitation, we introduce a novel unmixing procedure that allows to take into account non-linear optical effects while preserving the computational benefits of linear spectral unmixing. We validate our methodology on an in-vivo brain tissue HSI dataset and demonstrate that the extracted molecular information leads to superior classification performance.

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CINeMA: Conditional Implicit Neural Multi-Modal Atlas for a Spatio-Temporal Representation of the Perinatal Brain

Magnetic resonance imaging of fetal and neonatal brains reveals rapid neurodevelopment marked by substantial anatomical changes unfolding within days. Studying this critical stage of the developing human brain, therefore, requires accurate brain models-referred to as atlases-of high spatial and temporal resolution. To meet these demands, established traditional atlases and recently proposed deep learning-based methods rely on large and comprehensive datasets. This poses a major challenge for studying brains in the presence of pathologies for which data remains scarce. We address this limitation with CINeMA (Conditional Implicit Neural Multi-Modal Atlas), a novel framework for creating high-resolution, spatio-temporal, multimodal brain atlases, suitable for low-data settings. Unlike established methods, CINeMA operates in latent space, avoiding compute-intensive image registration and reducing atlas construction times from days to minutes. Furthermore, it enables flexible conditioning on anatomical features including GA, birth age, and pathologies like ventriculomegaly (VM) and agenesis of the corpus callosum (ACC). CINeMA supports downstream tasks such as tissue segmentation and age prediction whereas its generative properties enable synthetic data creation and anatomically informed data augmentation. Surpassing state-of-the-art methods in accuracy, efficiency, and versatility, CINeMA represents a powerful tool for advancing brain research. We release the code and atlases at https://github.com/m-dannecker/CINeMA.

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