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Enzo Ferrante

Publications and source records attributed to Enzo Ferrante.

At least 55 records · Page 3Linked to original sources

Unsupervised bias discovery in medical image segmentation

It has recently been shown that deep learning models for anatomical segmentation in medical images can exhibit biases against certain sub-populations defined in terms of protected attributes like sex or ethnicity. In this context, auditing fairness of deep segmentation models becomes crucial. However, such audit process generally requires access to ground-truth segmentation masks for the target population, which may not always be available, especially when going from development to deployment. Here we propose a new method to anticipate model biases in biomedical image segmentation in the absence of ground-truth annotations. Our unsupervised bias discovery method leverages the reverse classification accuracy framework to estimate segmentation quality. Through numerical experiments in synthetic and realistic scenarios we show how our method is able to successfully anticipate fairness issues in the absence of ground-truth labels, constituting a novel and valuable tool in this field.

cs.CV↗

Maximum Entropy on Erroneous Predictions (MEEP): Improving model calibration for medical image segmentation

Modern deep neural networks achieved remarkable progress in medical image segmentation tasks. However, it has recently been observed that they tend to produce overconfident estimates, even in situations of high uncertainty, leading to poorly calibrated and unreliable models. In this work we introduce Maximum Entropy on Erroneous Predictions (MEEP), a training strategy for segmentation networks which selectively penalizes overconfident predictions, focusing only on misclassified pixels. Our method is agnostic to the neural architecture, does not increase model complexity and can be coupled with multiple segmentation loss functions. We benchmark the proposed strategy in two challenging segmentation tasks: white matter hyperintensity lesions in magnetic resonance images (MRI) of the brain, and atrial segmentation in cardiac MRI. The experimental results demonstrate that coupling MEEP with standard segmentation losses leads to improvements not only in terms of model calibration, but also in segmentation quality.

cs.CV↗

Towards unraveling calibration biases in medical image analysis

In recent years the development of artificial intelligence (AI) systems for automated medical image analysis has gained enormous momentum. At the same time, a large body of work has shown that AI systems can systematically and unfairly discriminate against certain populations in various application scenarios. These two facts have motivated the emergence of algorithmic fairness studies in this field. Most research on healthcare algorithmic fairness to date has focused on the assessment of biases in terms of classical discrimination metrics such as AUC and accuracy. Potential biases in terms of model calibration, however, have only recently begun to be evaluated. This is especially important when working with clinical decision support systems, as predictive uncertainty is key for health professionals to optimally evaluate and combine multiple sources of information. In this work we study discrimination and calibration biases in models trained for automatic detection of malignant dermatological conditions from skin lesions images. Importantly, we show how several typically employed calibration metrics are systematically biased with respect to sample sizes, and how this can lead to erroneous fairness analysis if not taken into consideration. This is of particular relevance to fairness studies, where data imbalance results in drastic sample size differences between demographic sub-groups, which, if not taken into account, can act as confounders.

eess.IV↗

Unsupervised ensemble-based phenotyping helps enhance the discoverability of genes related to heart morphology

Recent genome-wide association studies (GWAS) have been successful in identifying associations between genetic variants and simple cardiac parameters derived from cardiac magnetic resonance (CMR) images. However, the emergence of big databases including genetic data linked to CMR, facilitates investigation of more nuanced patterns of shape variability. Here, we propose a new framework for gene discovery entitled Unsupervised Phenotype Ensembles (UPE). UPE builds a redundant yet highly expressive representation by pooling a set of phenotypes learned in an unsupervised manner, using deep learning models trained with different hyperparameters. These phenotypes are then analyzed via (GWAS), retaining only highly confident and stable associations across the ensemble. We apply our approach to the UK Biobank database to extract left-ventricular (LV) geometric features from image-derived three-dimensional meshes. We demonstrate that our approach greatly improves the discoverability of genes influencing LV shape, identifying 11 loci with study-wide significance and 8 with suggestive significance. We argue that our approach would enable more extensive discovery of gene associations with image-derived phenotypes for other organs or image modalities.

q-bio.GN↗

Multi-center anatomical segmentation with heterogeneous labels via landmark-based models

Learning anatomical segmentation from heterogeneous labels in multi-center datasets is a common situation encountered in clinical scenarios, where certain anatomical structures are only annotated in images coming from particular medical centers, but not in the full database. Here we first show how state-of-the-art pixel-level segmentation models fail in naively learning this task due to domain memorization issues and conflicting labels. We then propose to adopt HybridGNet, a landmark-based segmentation model which learns the available anatomical structures using graph-based representations. By analyzing the latent space learned by both models, we show that HybridGNet naturally learns more domain-invariant feature representations, and provide empirical evidence in the context of chest X-ray multiclass segmentation. We hope these insights will shed light on the training of deep learning models with heterogeneous labels from public and multi-center datasets.

eess.IV↗

Improving anatomical plausibility in medical image segmentation via hybrid graph neural networks: applications to chest x-ray analysis

Anatomical segmentation is a fundamental task in medical image computing, generally tackled with fully convolutional neural networks which produce dense segmentation masks. These models are often trained with loss functions such as cross-entropy or Dice, which assume pixels to be independent of each other, thus ignoring topological errors and anatomical inconsistencies. We address this limitation by moving from pixel-level to graph representations, which allow to naturally incorporate anatomical constraints by construction. To this end, we introduce HybridGNet, an encoder-decoder neural architecture that leverages standard convolutions for image feature encoding and graph convolutional neural networks (GCNNs) to decode plausible representations of anatomical structures. We also propose a novel image-to-graph skip connection layer which allows localized features to flow from standard convolutional blocks to GCNN blocks, and show that it improves segmentation accuracy. The proposed architecture is extensively evaluated in a variety of domain shift and image occlusion scenarios, and audited considering different types of demographic domain shift. Our comprehensive experimental setup compares HybridGNet with other landmark and pixel-based models for anatomical segmentation in chest x-ray images, and shows that it produces anatomically plausible results in challenging scenarios where other models tend to fail.

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Impact of class imbalance on chest x-ray classifiers: towards better evaluation practices for discrimination and calibration performance

This work aims to analyze standard evaluation practices adopted by the research community when assessing chest x-ray classifiers, particularly focusing on the impact of class imbalance in such appraisals. Our analysis considers a comprehensive definition of model performance, covering not only discriminative performance but also model calibration, a topic of research that has received increasing attention during the last years within the machine learning community. Firstly, we conducted a literature study to analyze common scientific practices and confirmed that: (1) even when dealing with highly imbalanced datasets, the community tends to use metrics that are dominated by the majority class; and (2) it is still uncommon to include calibration studies for chest x-ray classifiers, albeit its importance in the context of healthcare. Secondly, we perform a systematic experiment on two major chest x-ray datasets to explore the behavior of several performance metrics under different class ratios and show that widely adopted metrics can conceal the performance in the minority class. Finally, we recommend the inclusion of complementary metrics to better reflect the system's performance in such scenarios. Our study indicates that current evaluation practices adopted by the research community for chest x-ray computer-aided diagnosis systems may not reflect their performance in real clinical scenarios, and suggest alternatives to improve this situation.

cs.CV↗

Bridging physiological and perceptual views of autism by means of sampling-based Bayesian inference

Theories for autism spectrum disorder (ASD) have been formulated at different levels: ranging from physiological observations to perceptual and behavioral descriptions. Understanding the physiological underpinnings of perceptual traits in ASD remains a significant challenge in the field. Here we show how a recurrent neural circuit model which was optimized to perform sampling-based inference and displays characteristic features of cortical dynamics can help bridge this gap. The model was able to establish a mechanistic link between two descriptive levels for ASD: a physiological level, in terms of inhibitory dysfunction, neural variability and oscillations, and a perceptual level, in terms of hypopriors in Bayesian computations. We took two parallel paths: inducing hypopriors in the probabilistic model, and an inhibitory dysfunction in the network model, which lead to consistent results in terms of the represented posteriors, providing support for the view that both descriptions might constitute two sides of the same coin.

q-bio.NC↗

Domain Generalization via Gradient Surgery

In real-life applications, machine learning models often face scenarios where there is a change in data distribution between training and test domains. When the aim is to make predictions on distributions different from those seen at training, we incur in a domain generalization problem. Methods to address this issue learn a model using data from multiple source domains, and then apply this model to the unseen target domain. Our hypothesis is that when training with multiple domains, conflicting gradients within each mini-batch contain information specific to the individual domains which is irrelevant to the others, including the test domain. If left untouched, such disagreement may degrade generalization performance. In this work, we characterize the conflicting gradients emerging in domain shift scenarios and devise novel gradient agreement strategies based on gradient surgery to alleviate their effect. We validate our approach in image classification tasks with three multi-domain datasets, showing the value of the proposed agreement strategy in enhancing the generalization capability of deep learning models in domain shift scenarios.

cs.LG↗

Hybrid graph convolutional neural networks for landmark-based anatomical segmentation

In this work we address the problem of landmark-based segmentation for anatomical structures. We propose HybridGNet, an encoder-decoder neural architecture which combines standard convolutions for image feature encoding, with graph convolutional neural networks to decode plausible representations of anatomical structures. We benchmark the proposed architecture considering other standard landmark and pixel-based models for anatomical segmentation in chest x-ray images, and found that HybridGNet is more robust to image occlusions. We also show that it can be used to construct landmark-based segmentations from pixel level annotations. Our experimental results suggest that HybridGNet produces accurate and anatomically plausible landmark-based segmentations, by naturally incorporating shape constraints within the decoding process via spectral convolutions.

eess.IV↗

Orthogonal Ensemble Networks for Biomedical Image Segmentation

Despite the astonishing performance of deep-learning based approaches for visual tasks such as semantic segmentation, they are known to produce miscalibrated predictions, which could be harmful for critical decision-making processes. Ensemble learning has shown to not only boost the performance of individual models but also reduce their miscalibration by averaging independent predictions. In this scenario, model diversity has become a key factor, which facilitates individual models converging to different functional solutions. In this work, we introduce Orthogonal Ensemble Networks (OEN), a novel framework to explicitly enforce model diversity by means of orthogonal constraints. The proposed method is based on the hypothesis that inducing orthogonality among the constituents of the ensemble will increase the overall model diversity. We resort to a new pairwise orthogonality constraint which can be used to regularize a sequential ensemble training process, resulting on improved predictive performance and better calibrated model outputs. We benchmark the proposed framework in two challenging brain lesion segmentation tasks --brain tumor and white matter hyper-intensity segmentation in MR images. The experimental results show that our approach produces more robust and well-calibrated ensemble models and can deal with challenging tasks in the context of biomedical image segmentation.

eess.IV↗

Cranial Implant Design via Virtual Craniectomy with Shape Priors

Cranial implant design is a challenging task, whose accuracy is crucial in the context of cranioplasty procedures. This task is usually performed manually by experts using computer-assisted design software. In this work, we propose and evaluate alternative automatic deep learning models for cranial implant reconstruction from CT images. The models are trained and evaluated using the database released by the AutoImplant challenge, and compared to a baseline implemented by the organizers. We employ a simulated virtual craniectomy to train our models using complete skulls, and compare two different approaches trained with this procedure. The first one is a direct estimation method based on the UNet architecture. The second method incorporates shape priors to increase the robustness when dealing with out-of-distribution implant shapes. Our direct estimation method outperforms the baselines provided by the organizers, while the model with shape priors shows superior performance when dealing with out-of-distribution cases. Overall, our methods show promising results in the difficult task of cranial implant design.

eess.IV↗

Unsupervised Domain Adaptation via CycleGAN for White Matter Hyperintensity Segmentation in Multicenter MR Images

Automatic segmentation of white matter hyperintensities in magnetic resonance images is of paramount clinical and research importance. Quantification of these lesions serve as a predictor for risk of stroke, dementia and mortality. During the last years, convolutional neural networks (CNN) specifically tailored for biomedical image segmentation have outperformed all previous techniques in this task. However, they are extremely data-dependent, and maintain a good performance only when data distribution between training and test datasets remains unchanged. When such distribution changes but we still aim at performing the same task, we incur in a domain adaptation problem (e.g. using a different MR machine or different acquisition parameters for training and test data). In this work, we explore the use of cycle-consistent adversarial networks (CycleGAN) to perform unsupervised domain adaptation on multicenter MR images with brain lesions. We aim at learning a mapping function to transform volumetric MR images between domains, which are characterized by different medical centers and MR machines with varying brand, model and configuration parameters. Our experiments show that CycleGAN allows us to reduce the Jensen-Shannon divergence between MR domains, enabling automatic segmentation with CNN models on domains where no labeled data was available.

eess.IV↗

Self-supervised Skull Reconstruction in Brain CT Images with Decompressive Craniectomy

Decompressive craniectomy (DC) is a common surgical procedure consisting of the removal of a portion of the skull that is performed after incidents such as stroke, traumatic brain injury (TBI) or other events that could result in acute subdural hemorrhage and/or increasing intracranial pressure. In these cases, CT scans are obtained to diagnose and assess injuries, or guide a certain therapy and intervention. We propose a deep learning based method to reconstruct the skull defect removed during DC performed after TBI from post-operative CT images. This reconstruction is useful in multiple scenarios, e.g. to support the creation of cranioplasty plates, accurate measurements of bone flap volume and total intracranial volume, important for studies that aim to relate later atrophy to patient outcome. We propose and compare alternative self-supervised methods where an encoder-decoder convolutional neural network (CNN) estimates the missing bone flap on post-operative CTs. The self-supervised learning strategy only requires images with complete skulls and avoids the need for annotated DC images. For evaluation, we employ real and simulated images with DC, comparing the results with other state-of-the-art approaches. The experiments show that the proposed model outperforms current manual methods, enabling reconstruction even in highly challenging cases where big skull defects have been removed during surgery.

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Post-DAE: Anatomically Plausible Segmentation via Post-Processing with Denoising Autoencoders

We introduce Post-DAE, a post-processing method based on denoising autoencoders (DAE) to improve the anatomical plausibility of arbitrary biomedical image segmentation algorithms. Some of the most popular segmentation methods (e.g. based on convolutional neural networks or random forest classifiers) incorporate additional post-processing steps to ensure that the resulting masks fulfill expected connectivity constraints. These methods operate under the hypothesis that contiguous pixels with similar aspect should belong to the same class. Even if valid in general, this assumption does not consider more complex priors like topological restrictions or convexity, which cannot be easily incorporated into these methods. Post-DAE leverages the latest developments in manifold learning via denoising autoencoders. First, we learn a compact and non-linear embedding that represents the space of anatomically plausible segmentations. Then, given a segmentation mask obtained with an arbitrary method, we reconstruct its anatomically plausible version by projecting it onto the learnt manifold. The proposed method is trained using unpaired segmentation mask, what makes it independent of intensity information and image modality. We performed experiments in binary and multi-label segmentation of chest X-ray and cardiac magnetic resonance images. We show how erroneous and noisy segmentation masks can be improved using Post-DAE. With almost no additional computation cost, our method brings erroneous segmentations back to a feasible space.

cs.CV↗

Learning Deformable Registration of Medical Images with Anatomical Constraints

Deformable image registration is a fundamental problem in the field of medical image analysis. During the last years, we have witnessed the advent of deep learning-based image registration methods which achieve state-of-the-art performance, and drastically reduce the required computational time. However, little work has been done regarding how can we encourage our models to produce not only accurate, but also anatomically plausible results, which is still an open question in the field. In this work, we argue that incorporating anatomical priors in the form of global constraints into the learning process of these models, will further improve their performance and boost the realism of the warped images after registration. We learn global non-linear representations of image anatomy using segmentation masks, and employ them to constraint the registration process. The proposed AC-RegNet architecture is evaluated in the context of chest X-ray image registration using three different datasets, where the high anatomical variability makes the task extremely challenging. Our experiments show that the proposed anatomically constrained registration model produces more realistic and accurate results than state-of-the-art methods, demonstrating the potential of this approach.

eess.IV↗

Anatomical Priors for Image Segmentation via Post-Processing with Denoising Autoencoders

Deep convolutional neural networks (CNN) proved to be highly accurate to perform anatomical segmentation of medical images. However, some of the most popular CNN architectures for image segmentation still rely on post-processing strategies (e.g. Conditional Random Fields) to incorporate connectivity constraints into the resulting masks. These post-processing steps are based on the assumption that objects are usually continuous and therefore nearby pixels should be assigned the same object label. Even if it is a valid assumption in general, these methods do not offer a straightforward way to incorporate more complex priors like convexity or arbitrary shape restrictions. In this work we propose Post-DAE, a post-processing method based on denoising autoencoders (DAE) trained using only segmentation masks. We learn a low-dimensional space of anatomically plausible segmentations, and use it as a post-processing step to impose shape constraints on the resulting masks obtained with arbitrary segmentation methods. Our approach is independent of image modality and intensity information since it employs only segmentation masks for training. This enables the use of anatomical segmentations that do not need to be paired with intensity images, making the approach very flexible. Our experimental results on anatomical segmentation of X-ray images show that Post-DAE can improve the quality of noisy and incorrect segmentation masks obtained with a variety of standard methods, by bringing them back to a feasible space, with almost no extra computational time.

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Joint Learning of Brain Lesion and Anatomy Segmentation from Heterogeneous Datasets

Brain lesion and anatomy segmentation in magnetic resonance images are fundamental tasks in neuroimaging research and clinical practice. Given enough training data, convolutional neuronal networks (CNN) proved to outperform all existent techniques in both tasks independently. However, to date, little work has been done regarding simultaneous learning of brain lesion and anatomy segmentation from disjoint datasets. In this work we focus on training a single CNN model to predict brain tissue and lesion segmentations using heterogeneous datasets labeled independently, according to only one of these tasks (a common scenario when using publicly available datasets). We show that label contradiction issues can arise in this case, and propose a novel adaptive cross entropy (ACE) loss function that makes such training possible. We provide quantitative evaluation in two different scenarios, benchmarking the proposed method in comparison with a multi-network approach. Our experiments suggest that ACE loss enables training of single models when standard cross entropy and Dice loss functions tend to fail. Moreover, we show that it is possible to achieve competitive results when comparing with multiple networks trained for independent tasks.

cs.CV↗