arXiv subjects

Georges El Fakhri

Publications and source records attributed to Georges El Fakhri.

At least 55 records · Page 3Linked to original sources

arXiv2022

Structure-aware Unsupervised Tagged-to-Cine MRI Synthesis with Self Disentanglement

Cycle reconstruction regularized adversarial training -- e.g., CycleGAN, DiscoGAN, and DualGAN -- has been widely used for image style transfer with unpaired training data. Several recent works, however, have shown that local distortions are frequent, and structural consistency cannot be guaranteed. Targeting this issue, prior works usually relied on additional segmentation or consistent feature extraction steps that are task-specific. To counter this, this work aims to learn a general add-on structural feature extractor, by explicitly enforcing the structural alignment between an input and its synthesized image. Specifically, we propose a novel input-output image patches self-training scheme to achieve a disentanglement of underlying anatomical structures and imaging modalities. The translator and structure encoder are updated, following an alternating training protocol. In addition, the information w.r.t. imaging modality can be eliminated with an asymmetric adversarial game. We train, validate, and test our network on 1,768, 416, and 1,560 unpaired subject-independent slices of tagged and cine magnetic resonance imaging from a total of twenty healthy subjects, respectively, demonstrating superior performance over competing methods.

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arXiv2022

Variational Inference for Quantifying Inter-observer Variability in Segmentation of Anatomical Structures

Lesions or organ boundaries visible through medical imaging data are often ambiguous, thus resulting in significant variations in multi-reader delineations, i.e., the source of aleatoric uncertainty. In particular, quantifying the inter-observer variability of manual annotations with Magnetic Resonance (MR) Imaging data plays a crucial role in establishing a reference standard for various diagnosis and treatment tasks. Most segmentation methods, however, simply model a mapping from an image to its single segmentation map and do not take the disagreement of annotators into consideration. In order to account for inter-observer variability, without sacrificing accuracy, we propose a novel variational inference framework to model the distribution of plausible segmentation maps, given a specific MR image, which explicitly represents the multi-reader variability. Specifically, we resort to a latent vector to encode the multi-reader variability and counteract the inherent information loss in the imaging data. Then, we apply a variational autoencoder network and optimize its evidence lower bound (ELBO) to efficiently approximate the distribution of the segmentation map, given an MR image. Experimental results, carried out with the QUBIQ brain growth MRI segmentation datasets with seven annotators, demonstrate the effectiveness of our approach.

cs.CV↗

arXiv2022

Self-semantic contour adaptation for cross modality brain tumor segmentation

Unsupervised domain adaptation (UDA) between two significantly disparate domains to learn high-level semantic alignment is a crucial yet challenging task.~To this end, in this work, we propose exploiting low-level edge information to facilitate the adaptation as a precursor task, which has a small cross-domain gap, compared with semantic segmentation.~The precise contour then provides spatial information to guide the semantic adaptation. More specifically, we propose a multi-task framework to learn a contouring adaptation network along with a semantic segmentation adaptation network, which takes both magnetic resonance imaging (MRI) slice and its initial edge map as input.~These two networks are jointly trained with source domain labels, and the feature and edge map level adversarial learning is carried out for cross-domain alignment. In addition, self-entropy minimization is incorporated to further enhance segmentation performance. We evaluated our framework on the BraTS2018 database for cross-modality segmentation of brain tumors, showing the validity and superiority of our approach, compared with competing methods.

cs.CV↗

arXiv2021

Free-breathing 3D Cardiac T1 Mapping with Transmit B1 Correction at 3T

Purpose: To develop a cardiac T1 mapping method for free-breathing 3D T1 mapping of the whole heart at 3T with transmit B1 (B1+) correction Methods: A free-breathing, ECG-gated inversion recovery sequence with spoiled gradient-echo readout was developed and optimized for cardiac T1 mapping at 3T. High-frame rate dynamic images were reconstructed from sparse (k,t)-space data acquired along a stack-of-stars trajectory using a subspace-based method for accelerated imaging. Joint T1 and flip-angle (FA) estimation was performed in T1 mapping to improve its robustness to B1+ inhomogeneity. Subject-specific timing of data acquisition was utilized in the estimation to account for natural heart-rate variations during the imaging experiment. Results: Simulations showed that accuracy and precision of T1 mapping can be improved with joint T1 and FA estimation and optimized ECG-gated SPGR-based IR acquisition scheme. The phantom study showed good agreement between the T1 maps from the proposed method and the reference method. 3D cardiac T1 maps (40 slices) were obtained at a 1.9 mm in-plane and 4.5 mm through-plane spatial resolution from healthy subjects (n=6) with an average imaging time of 14.2 +- 1.6 min (heartbeat rate: 64.2 +- 7.1 bpm), showing myocardial T1 values comparable to those obtained from MOLLI. The proposed method generated B1+ maps with spatially smooth variation showing 21-32% and 11-15% variations across the septal-lateral and inferior-anterior regions of the myocardium in the left ventricle. Conclusion: The proposed method allows free-breathing 3D T1 mapping of the whole-heart with transmit B1 correction in a practical imaging time.

physics.med-ph↗

arXiv2021

Deep learning-based GTV contouring modeling inter- and intra- observer variability in sarcomas

Background and purpose: The delineation of the gross tumor volume (GTV) is a critical step for radiation therapy treatment planning. The delineation procedure is typically performed manually which exposes two major issues: cost and reproducibility. Delineation is a time-consuming process that is subject to inter- and intra-observer variability. While methods have been proposed to predict GTV contours, typical approaches ignore variability and therefore fail to utilize the valuable confidence information offered by multiple contours. Materials and methods: In this work we propose an automatic GTV contouring method for soft-tissue sarcomas from X-ray computed tomography (CT) images, using deep learning by integrating inter- and intra-observer variability in the learned model. Sixty-eight patients with soft tissue and bone sarcomas were considered in this evaluation, all underwent pre-operative CT imaging used to perform GTV delineation. Four radiation oncologists and radiologists performed three contouring trials each for all patients. We quantify variability by defining confidence levels based on the frequency of inclusion of a given voxel into the GTV and use a deep convolutional neural network to learn GTV confidence maps. Results: Results were compared to confidence maps from the four readers as well as ground-truth consensus contours established jointly by all readers. The resulting continuous Dice score between predicted and true confidence maps was 87% and the Hausdorff distance was 14 mm. Conclusion: Results demonstrate the ability of the proposed method to predict accurate contours while utilizing variability and as such it can be used to improve clinical workflow.

physics.med-ph↗

arXiv2021

Adversarial Unsupervised Domain Adaptation with Conditional and Label Shift: Infer, Align and Iterate

In this work, we propose an adversarial unsupervised domain adaptation (UDA) approach with the inherent conditional and label shifts, in which we aim to align the distributions w.r.t. both $p(x|y)$ and $p(y)$. Since the label is inaccessible in the target domain, the conventional adversarial UDA assumes $p(y)$ is invariant across domains, and relies on aligning $p(x)$ as an alternative to the $p(x|y)$ alignment. To address this, we provide a thorough theoretical and empirical analysis of the conventional adversarial UDA methods under both conditional and label shifts, and propose a novel and practical alternative optimization scheme for adversarial UDA. Specifically, we infer the marginal $p(y)$ and align $p(x|y)$ iteratively in the training, and precisely align the posterior $p(y|x)$ in testing. Our experimental results demonstrate its effectiveness on both classification and segmentation UDA, and partial UDA.

cs.CV↗

arXiv2021

Segmentation of Cardiac Structures via Successive Subspace Learning with Saab Transform from Cine MRI

Assessment of cardiovascular disease (CVD) with cine magnetic resonance imaging (MRI) has been used to non-invasively evaluate detailed cardiac structure and function. Accurate segmentation of cardiac structures from cine MRI is a crucial step for early diagnosis and prognosis of CVD, and has been greatly improved with convolutional neural networks (CNN). There, however, are a number of limitations identified in CNN models, such as limited interpretability and high complexity, thus limiting their use in clinical practice. In this work, to address the limitations, we propose a lightweight and interpretable machine learning model, successive subspace learning with the subspace approximation with adjusted bias (Saab) transform, for accurate and efficient segmentation from cine MRI. Specifically, our segmentation framework is comprised of the following steps: (1) sequential expansion of near-to-far neighborhood at different resolutions; (2) channel-wise subspace approximation using the Saab transform for unsupervised dimension reduction; (3) class-wise entropy guided feature selection for supervised dimension reduction; (4) concatenation of features and pixel-wise classification with gradient boost; and (5) conditional random field for post-processing. Experimental results on the ACDC 2017 segmentation database, showed that our framework performed better than state-of-the-art U-Net models with 200$\times$ fewer parameters in delineating the left ventricle, right ventricle, and myocardium, thus showing its potential to be used in clinical practice.

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arXiv2021

Adapting Off-the-Shelf Source Segmenter for Target Medical Image Segmentation

Unsupervised domain adaptation (UDA) aims to transfer knowledge learned from a labeled source domain to an unlabeled and unseen target domain, which is usually trained on data from both domains. Access to the source domain data at the adaptation stage, however, is often limited, due to data storage or privacy issues. To alleviate this, in this work, we target source free UDA for segmentation, and propose to adapt an ``off-the-shelf" segmentation model pre-trained in the source domain to the target domain, with an adaptive batch-wise normalization statistics adaptation framework. Specifically, the domain-specific low-order batch statistics, i.e., mean and variance, are gradually adapted with an exponential momentum decay scheme, while the consistency of domain shareable high-order batch statistics, i.e., scaling and shifting parameters, is explicitly enforced by our optimization objective. The transferability of each channel is adaptively measured first from which to balance the contribution of each channel. Moreover, the proposed source free UDA framework is orthogonal to unsupervised learning methods, e.g., self-entropy minimization, which can thus be simply added on top of our framework. Extensive experiments on the BraTS 2018 database show that our source free UDA framework outperformed existing source-relaxed UDA methods for the cross-subtype UDA segmentation task and yielded comparable results for the cross-modality UDA segmentation task, compared with a supervised UDA methods with the source data.

cs.CV↗

arXiv2021

Generative Self-training for Cross-domain Unsupervised Tagged-to-Cine MRI Synthesis

Self-training based unsupervised domain adaptation (UDA) has shown great potential to address the problem of domain shift, when applying a trained deep learning model in a source domain to unlabeled target domains. However, while the self-training UDA has demonstrated its effectiveness on discriminative tasks, such as classification and segmentation, via the reliable pseudo-label selection based on the softmax discrete histogram, the self-training UDA for generative tasks, such as image synthesis, is not fully investigated. In this work, we propose a novel generative self-training (GST) UDA framework with continuous value prediction and regression objective for cross-domain image synthesis. Specifically, we propose to filter the pseudo-label with an uncertainty mask, and quantify the predictive confidence of generated images with practical variational Bayes learning. The fast test-time adaptation is achieved by a round-based alternative optimization scheme. We validated our framework on the tagged-to-cine magnetic resonance imaging (MRI) synthesis problem, where datasets in the source and target domains were acquired from different scanners or centers. Extensive validations were carried out to verify our framework against popular adversarial training UDA methods. Results show that our GST, with tagged MRI of test subjects in new target domains, improved the synthesis quality by a large margin, compared with the adversarial training UDA methods.

cs.CV↗

arXiv2021

A Deep Joint Sparse Non-negative Matrix Factorization Framework for Identifying the Common and Subject-specific Functional Units of Tongue Motion During Speech

Intelligible speech is produced by creating varying internal local muscle groupings -- i.e., functional units -- that are generated in a systematic and coordinated manner. There are two major challenges in characterizing and analyzing functional units.~First, due to the complex and convoluted nature of tongue structure and function, it is of great importance to develop a method that can accurately decode complex muscle coordination patterns during speech. Second, it is challenging to keep identified functional units across subjects comparable due to their substantial variability. In this work, to address these challenges, we develop a new deep learning framework to identify common and subject-specific functional units of tongue motion during speech.~Our framework hinges on joint deep graph-regularized sparse non-negative matrix factorization (NMF) using motion quantities derived from displacements by tagged Magnetic Resonance Imaging. More specifically, we transform NMF with sparse and graph regularizations into modular architectures akin to deep neural networks by means of unfolding the Iterative Shrinkage-Thresholding Algorithm to learn interpretable building blocks and associated weighting map. We then apply spectral clustering to common and subject-specific weighting maps from which we jointly determine the common and subject-specific functional units. Experiments carried out with simulated datasets show that the proposed method achieved on par or better clustering performance over the comparison methods. Experiments carried out with in vivo tongue motion data show that the proposed method can determine the common and subject-specific functional units with increased interpretability and decreased size variability.

cs.CV↗

arXiv2021

A Unified Conditional Disentanglement Framework for Multimodal Brain MR Image Translation

Multimodal MRI provides complementary and clinically relevant information to probe tissue condition and to characterize various diseases. However, it is often difficult to acquire sufficiently many modalities from the same subject due to limitations in study plans, while quantitative analysis is still demanded. In this work, we propose a unified conditional disentanglement framework to synthesize any arbitrary modality from an input modality. Our framework hinges on a cycle-constrained conditional adversarial training approach, where it can extract a modality-invariant anatomical feature with a modality-agnostic encoder and generate a target modality with a conditioned decoder. We validate our framework on four MRI modalities, including T1-weighted, T1 contrast enhanced, T2-weighted, and FLAIR MRI, from the BraTS'18 database, showing superior performance on synthesis quality over the comparison methods. In addition, we report results from experiments on a tumor segmentation task carried out with synthesized data.

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arXiv2021

Dual-cycle Constrained Bijective VAE-GAN For Tagged-to-Cine Magnetic Resonance Image Synthesis

Tagged magnetic resonance imaging (MRI) is a widely used imaging technique for measuring tissue deformation in moving organs. Due to tagged MRI's intrinsic low anatomical resolution, another matching set of cine MRI with higher resolution is sometimes acquired in the same scanning session to facilitate tissue segmentation, thus adding extra time and cost. To mitigate this, in this work, we propose a novel dual-cycle constrained bijective VAE-GAN approach to carry out tagged-to-cine MR image synthesis. Our method is based on a variational autoencoder backbone with cycle reconstruction constrained adversarial training to yield accurate and realistic cine MR images given tagged MR images. Our framework has been trained, validated, and tested using 1,768, 416, and 1,560 subject-independent paired slices of tagged and cine MRI from twenty healthy subjects, respectively, demonstrating superior performance over the comparison methods. Our method can potentially be used to reduce the extra acquisition time and cost, while maintaining the same workflow for further motion analyses.

eess.IV↗

arXiv2021

VoxelHop: Successive Subspace Learning for ALS Disease Classification Using Structural MRI

Deep learning has great potential for accurate detection and classification of diseases with medical imaging data, but the performance is often limited by the number of training datasets and memory requirements. In addition, many deep learning models are considered a "black-box," thereby often limiting their adoption in clinical applications. To address this, we present a successive subspace learning model, termed VoxelHop, for accurate classification of Amyotrophic Lateral Sclerosis (ALS) using T2-weighted structural MRI data. Compared with popular convolutional neural network (CNN) architectures, VoxelHop has modular and transparent structures with fewer parameters without any backpropagation, so it is well-suited to small dataset size and 3D imaging data. Our VoxelHop has four key components, including (1) sequential expansion of near-to-far neighborhood for multi-channel 3D data; (2) subspace approximation for unsupervised dimension reduction; (3) label-assisted regression for supervised dimension reduction; and (4) concatenation of features and classification between controls and patients. Our experimental results demonstrate that our framework using a total of 20 controls and 26 patients achieves an accuracy of 93.48$\%$ and an AUC score of 0.9394 in differentiating patients from controls, even with a relatively small number of datasets, showing its robustness and effectiveness. Our thorough evaluations also show its validity and superiority to the state-of-the-art 3D CNN classification methods. Our framework can easily be generalized to other classification tasks using different imaging modalities.

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arXiv2021

Subtype-aware Unsupervised Domain Adaptation for Medical Diagnosis

Recent advances in unsupervised domain adaptation (UDA) show that transferable prototypical learning presents a powerful means for class conditional alignment, which encourages the closeness of cross-domain class centroids. However, the cross-domain inner-class compactness and the underlying fine-grained subtype structure remained largely underexplored. In this work, we propose to adaptively carry out the fine-grained subtype-aware alignment by explicitly enforcing the class-wise separation and subtype-wise compactness with intermediate pseudo labels. Our key insight is that the unlabeled subtypes of a class can be divergent to one another with different conditional and label shifts, while inheriting the local proximity within a subtype. The cases of with or without the prior information on subtype numbers are investigated to discover the underlying subtype structure in an online fashion. The proposed subtype-aware dynamic UDA achieves promising results on medical diagnosis tasks.

cs.CV↗

arXiv2020

Motion correction for PET using subspace-based real-time MR imaging in simultaneous PET/MR

Image quality of PET reconstructions is degraded by subject motion occurring during the acquisition. MR-based motion correction approaches have been studied for PET/MR scanners and have been successful at capturing regular motion patterns, when used in conjunction with surrogate signals (e.g. navigators) to detect motion. However, handling irregular respiratory motion and bulk motion remains challenging. In this work, we propose an MR-based motion correction method relying on subspace-based real-time MR imaging to estimate motion fields used to correct PET reconstructions. We take advantage of the low-rank characteristics of dynamic MR images to reconstruct high-resolution MR images at high frame rates from highly undersampled k-space data. Reconstructed dynamic MR images are used to determine motion phases for PET reconstruction and estimate phase-to-phase nonrigid motion fields able to capture complex motion patterns such as irregular respiratory and bulk motion. MR-derived binning and motion fields are used for PET reconstruction to generate motion-corrected PET images. The proposed method was evaluated on in vivo data with irregular motion patterns. MR reconstructions accurately captured motion, outperforming state-of-the-art dynamic MR reconstruction techniques. Evaluation of PET reconstructions demonstrated the benefits of the proposed method over standard methods in terms of motion artifact reduction. The proposed method can improve the image quality of motion-corrected PET reconstructions in clinical applications.

physics.med-ph↗

arXiv2020

MR-Based PET Attenuation Correction using a Combined Ultrashort Echo Time/Multi-Echo Dixon Acquisition

We propose a magnetic resonance (MR)-based method for estimation of continuous linear attenuation coefficients (LAC) in positron emission tomography (PET) using a physical compartmental model and ultrashort echo time (UTE)/multi-echo Dixon (mUTE) acquisitions. Specifically, we propose a three-dimensional (3D) mUTE sequence to acquire signals from water, fat, and short-T2 components (e.g., bones) simultaneously in a single acquisition. The proposed mUTE sequence integrates 3D UTE with multi-echo Dixon acquisitions and uses sparse radial trajectories to accelerate imaging speed. Errors in the radial k-space trajectories are measured using a special k-space trajectory mapping sequence and corrected for image reconstruction. A physical compartmental model is used to fit the measured multi-echo MR signals to obtain fractions of water, fat and bone components for each voxel, which are then used to estimate the continuous LAC map for PET attenuation correction. The performance of the proposed method was evaluated via phantom and in vivo human studies, using LACs from Computed Tomography (CT) as reference. Compared to Dixon- and atlas-based MRAC methods, the proposed method yielded PET images with higher correlation and similarity in relation to the reference. The relative absolute errors of PET activity values reconstructed by the proposed method were below 5% in all of the four lobes (frontal, temporal, parietal, occipital), cerebellum, whole white matter and gray matter regions across all subjects (n=6). The proposed mUTE method can generate subject-specific, continuous LAC map for PET attenuation correction in PET/MR.

physics.med-ph↗

arXiv2018

End-to-end Lung Nodule Detection in Computed Tomography

Computer aided diagnostic (CAD) system is crucial for modern med-ical imaging. But almost all CAD systems operate on reconstructed images, which were optimized for radiologists. Computer vision can capture features that is subtle to human observers, so it is desirable to design a CAD system op-erating on the raw data. In this paper, we proposed a deep-neural-network-based detection system for lung nodule detection in computed tomography (CT). A primal-dual-type deep reconstruction network was applied first to convert the raw data to the image space, followed by a 3-dimensional convolutional neural network (3D-CNN) for the nodule detection. For efficient network training, the deep reconstruction network and the CNN detector was trained sequentially first, then followed by one epoch of end-to-end fine tuning. The method was evaluated on the Lung Image Database Consortium image collection (LIDC-IDRI) with simulated forward projections. With 144 multi-slice fanbeam pro-jections, the proposed end-to-end detector could achieve comparable sensitivity with the reference detector, which was trained and applied on the fully-sampled image data. It also demonstrated superior detection performance compared to detectors trained on the reconstructed images. The proposed method is general and could be expanded to most detection tasks in medical imaging.

cs.CV↗

arXiv2018

A Sparse Non-negative Matrix Factorization Framework for Identifying Functional Units of Tongue Behavior from MRI

Muscle coordination patterns of lingual behaviors are synergies generated by deforming local muscle groups in a variety of ways. Functional units are functional muscle groups of local structural elements within the tongue that compress, expand, and move in a cohesive and consistent manner. Identifying the functional units using tagged-Magnetic Resonance Imaging (MRI) sheds light on the mechanisms of normal and pathological muscle coordination patterns, yielding improvement in surgical planning, treatment, or rehabilitation procedures. Here, to mine this information, we propose a matrix factorization and probabilistic graphical model framework to produce building blocks and their associated weighting map using motion quantities extracted from tagged-MRI. Our tagged-MRI imaging and accurate voxel-level tracking provide previously unavailable internal tongue motion patterns, thus revealing the inner workings of the tongue during speech or other lingual behaviors. We then employ spectral clustering on the weighting map to identify the cohesive regions defined by the tongue motion that may involve multiple or undocumented regions. To evaluate our method, we perform a series of experiments. We first use two-dimensional images and synthetic data to demonstrate the accuracy of our method. We then use three-dimensional synthetic and \textit{in vivo} tongue motion data using protrusion and simple speech tasks to identify subject-specific and data-driven functional units of the tongue in localized regions.

cs.CV↗