arXiv subjects

Gwenolé Quellec

Publications and source records attributed to Gwenolé Quellec.

At least 19 recordsLinked to original sources

arXiv2026

Constrained latent state modeling: A unifying perspective on representation learning under competing constraints

Learning latent representations from temporal, multimodal, and partially observed data requires specifying what information a latent state should retain, discard, and organize. Existing approaches encode these requirements through heterogeneous objectives, making methods difficult to compare and learned representations difficult to interpret. We propose Constrained Latent State Modeling (CLSM), a conceptual framework that characterizes latent states through six complementary properties: predictive sufficiency, minimality, temporal coherence, observation compatibility, invariance to nuisance factors, and structural constraints. CLSM separates these properties from the surrogate objectives used to induce them and from the diagnostics used to evaluate them, and clarifies how combinations of constraints can improve identifiability by restricting the space of admissible representations. We reinterpret major representation-learning families through this common design space and illustrate the framework with a controlled synthetic benchmark. The experiments show how objectives produce distinct latent organizations and empirical trade-offs depending on the prediction target, surrogate formulation, parameterization, and optimization. Companion repository containing the reference implementation, reproducible experiments, documentation, and model cards: https://github.com/gwenole-quellec/clsm

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arXiv2026

Deep Learning for Retinal Degeneration Assessment: A Comprehensive Analysis of the MARIO Challenge

The MARIO challenge, held at MICCAI 2024, focused on advancing the automated detection and monitoring of age-related macular degeneration (AMD) through the analysis of optical coherence tomography (OCT) images. Designed to evaluate algorithmic performance in detecting neovascular activity changes within AMD, the challenge incorporated unique multi-modal datasets. The primary dataset, sourced from Brest, France, was used by participating teams to train and test their models. The final ranking was determined based on performance on this dataset. An auxiliary dataset from Algeria was used post-challenge to evaluate population and device shifts from submitted solutions. Two tasks were involved in the MARIO challenge. The first one was the classification of evolution between two consecutive 2D OCT B-scans. The second one was the prediction of future AMD evolution over three months for patients undergoing anti-vascular endothelial growth factor (VEGF) therapy. Thirty-five teams participated, with the top 12 finalists presenting their methods. This paper outlines the challenge's structure, tasks, data characteristics, and winning methodologies, setting a benchmark for AMD monitoring using OCT, infrared imaging, and clinical data (such as the number of visits, age, gender, etc.). The results of this challenge indicate that artificial intelligence (AI) performs as well as a physician in measuring AMD progression (Task 1) but is not yet able of predicting future evolution (Task 2).

cs.CV↗

arXiv2026

Iterative LLM-based improvement for French Clinical Interview Transcription and Speaker Diarization

Automatic speech recognition for French medical conversations remains challenging, with word error rates often exceeding 30% in spontaneous clinical speech. This study proposes a multi-pass LLM post-processing architecture alternating between Speaker Recognition and Word Recognition passes to improve transcription accuracy and speaker attribution. Ablation studies on two French clinical datasets (suicide prevention telephone counseling and preoperative awake neurosurgery consultations) investigate four design choices: model selection, prompting strategy, pass ordering, and iteration depth. Using Qwen3-Next-80B, Wilcoxon signed-rank tests confirm significant WDER reductions on suicide prevention conversations (p<0.05, n=18), while maintaining stability on awake neurosurgery consultations (n=10), with zero output failures and acceptable computational cost (RTF 0.32), suggesting feasibility for offline clinical deployment, pending validation on larger corpora.

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arXiv2025

Acoustic and Machine Learning Methods for Speech-Based Suicide Risk Assessment: A Systematic Review

Suicide remains a public health challenge, necessitating improved detection methods to facilitate timely intervention and treatment. This systematic review evaluates the role of Artificial Intelligence (AI) and Machine Learning (ML) in assessing suicide risk through acoustic analysis of speech. Following PRISMA guidelines, we analyzed 33 articles selected from PubMed, Cochrane, Scopus, and Web of Science databases. The last search was conducted in February 2025. Risk of bias was assessed using the PROBAST tool. Studies analyzing acoustic features between individuals at risk of suicide (RS) and those not at risk (NRS) were included, while studies lacking acoustic data, a suicide-related focus, or sufficient methodological details were excluded. Sample sizes varied widely and were reported in terms of participants or speech segments, depending on the study. Results were synthesized narratively based on acoustic features and classifier performance. Findings consistently showed significant acoustic feature variations between RS and NRS populations, particularly involving jitter, fundamental frequency (F0), Mel-frequency cepstral coefficients (MFCC), and power spectral density (PSD). Classifier performance varied based on algorithms, modalities, and speech elicitation methods, with multimodal approaches integrating acoustic, linguistic, and metadata features demonstrating superior performance. Among the 29 classifier-based studies, reported AUC values ranged from 0.62 to 0.985 and accuracies from 60% to 99.85%. Most datasets were imbalanced in favor of NRS, and performance metrics were rarely reported separately by group, limiting clear identification of direction of effect.

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arXiv2025

Patch Progression Masked Autoencoder with Fusion CNN Network for Classifying Evolution Between Two Pairs of 2D OCT Slices

Age-related Macular Degeneration (AMD) is a prevalent eye condition affecting visual acuity. Anti-vascular endothelial growth factor (anti-VEGF) treatments have been effective in slowing the progression of neovascular AMD, with better outcomes achieved through timely diagnosis and consistent monitoring. Tracking the progression of neovascular activity in OCT scans of patients with exudative AMD allows for the development of more personalized and effective treatment plans. This was the focus of the Monitoring Age-related Macular Degeneration Progression in Optical Coherence Tomography (MARIO) challenge, in which we participated. In Task 1, which involved classifying the evolution between two pairs of 2D slices from consecutive OCT acquisitions, we employed a fusion CNN network with model ensembling to further enhance the model's performance. For Task 2, which focused on predicting progression over the next three months based on current exam data, we proposed the Patch Progression Masked Autoencoder that generates an OCT for the next exam and then classifies the evolution between the current OCT and the one generated using our solution from Task 1. The results we achieved allowed us to place in the Top 10 for both tasks. Some team members are part of the same organization as the challenge organizers; therefore, we are not eligible to compete for the prize.

cs.CV↗

arXiv2025

Suicide Risk Assessment Using Multimodal Speech Features: A Study on the SW1 Challenge Dataset

The 1st SpeechWellness Challenge conveys the need for speech-based suicide risk assessment in adolescents. This study investigates a multimodal approach for this challenge, integrating automatic transcription with WhisperX, linguistic embeddings from Chinese RoBERTa, and audio embeddings from WavLM. Additionally, handcrafted acoustic features -- including MFCCs, spectral contrast, and pitch-related statistics -- were incorporated. We explored three fusion strategies: early concatenation, modality-specific processing, and weighted attention with mixup regularization. Results show that weighted attention provided the best generalization, achieving 69% accuracy on the development set, though a performance gap between development and test sets highlights generalization challenges. Our findings, strictly tied to the MINI-KID framework, emphasize the importance of refining embedding representations and fusion mechanisms to enhance classification reliability.

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arXiv2025

Deep learning-enabled prediction of surgical errors during cataract surgery: from simulation to real-world application

Real-time prediction of technical errors from cataract surgical videos can be highly beneficial, particularly for telementoring, which involves remote guidance and mentoring through digital platforms. However, the rarity of surgical errors makes their detection and analysis challenging using artificial intelligence. To tackle this issue, we leveraged videos from the EyeSi Surgical cataract surgery simulator to learn to predict errors and transfer the acquired knowledge to real-world surgical contexts. By employing deep learning models, we demonstrated the feasibility of making real-time predictions using simulator data with a very short temporal history, enabling on-the-fly computations. We then transferred these insights to real-world settings through unsupervised domain adaptation, without relying on labeled videos from real surgeries for training, which are limited. This was achieved by aligning video clips from the simulator with real-world footage and pre-training the models using pretext tasks on both simulated and real surgical data. For a 1-second prediction window on the simulator, we achieved an overall AUC of 0.820 for error prediction using 600$\times$600 pixel images, and 0.784 using smaller 299$\times$299 pixel images. In real-world settings, we obtained an AUC of up to 0.663 with domain adaptation, marking an improvement over direct model application without adaptation, which yielded an AUC of 0.578. To our knowledge, this is the first work to address the tasks of learning surgical error prediction on a simulator using video data only and transferring this knowledge to real-world cataract surgery.

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arXiv2025

Context-Aware Vision Language Foundation Models for Ocular Disease Screening in Retinal Images

Foundation models are large-scale versatile systems trained on vast quantities of diverse data to learn generalizable representations. Their adaptability with minimal fine-tuning makes them particularly promising for medical imaging, where data variability and domain shifts are major challenges. Currently, two types of foundation models dominate the literature: self-supervised models and more recent vision-language models. In this study, we advance the application of vision-language foundation (VLF) models for ocular disease screening using the OPHDIAT dataset, which includes nearly 700,000 fundus photographs from a French diabetic retinopathy (DR) screening network. This dataset provides extensive clinical data (patient-specific information such as diabetic health conditions, and treatments), labeled diagnostics, ophthalmologists text-based findings, and multiple retinal images for each examination. Building on the FLAIR model $\unicode{x2013}$ a VLF model for retinal pathology classification $\unicode{x2013}$ we propose novel context-aware VLF models (e.g jointly analyzing multiple images from the same visit or taking advantage of past diagnoses and contextual data) to fully leverage the richness of the OPHDIAT dataset and enhance robustness to domain shifts. Our approaches were evaluated on both in-domain (a testing subset of OPHDIAT) and out-of-domain data (public datasets) to assess their generalization performance. Our model demonstrated improved in-domain performance for DR grading, achieving an area under the curve (AUC) ranging from 0.851 to 0.9999, and generalized well to ocular disease detection on out-of-domain data (AUC: 0.631-0.913).

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arXiv2024

Deep Learning-Based Detection of Referable Diabetic Retinopathy and Macular Edema Using Ultra-Widefield Fundus Imaging

Diabetic retinopathy and diabetic macular edema are significant complications of diabetes that can lead to vision loss. Early detection through ultra-widefield fundus imaging enhances patient outcomes but presents challenges in image quality and analysis scale. This paper introduces deep learning solutions for automated UWF image analysis within the framework of the MICCAI 2024 UWF4DR challenge. We detail methods and results across three tasks: image quality assessment, detection of referable DR, and identification of DME. Employing advanced convolutional neural network architectures such as EfficientNet and ResNet, along with preprocessing and augmentation strategies, our models demonstrate robust performance in these tasks. Results indicate that deep learning can significantly aid in the automated analysis of UWF images, potentially improving the efficiency and accuracy of DR and DME detection in clinical settings.

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arXiv2024

A Systematic Review of Generalization Research in Medical Image Classification

Numerous Deep Learning (DL) classification models have been developed for a large spectrum of medical image analysis applications, which promises to reshape various facets of medical practice. Despite early advances in DL model validation and implementation, which encourage healthcare institutions to adopt them, a fundamental questions remain: how can these models effectively handle domain shift? This question is crucial to limit DL models performance degradation. Medical data are dynamic and prone to domain shift, due to multiple factors. Two main shift types can occur over time: 1) covariate shift mainly arising due to updates to medical equipment and 2) concept shift caused by inter-grader variability. To mitigate the problem of domain shift, existing surveys mainly focus on domain adaptation techniques, with an emphasis on covariate shift. More generally, no work has reviewed the state-of-the-art solutions while focusing on the shift types. This paper aims to explore existing domain generalization methods for DL-based classification models through a systematic review of literature. It proposes a taxonomy based on the shift type they aim to solve. Papers were searched and gathered on Scopus till 10 April 2023, and after the eligibility screening and quality evaluation, 77 articles were identified. Exclusion criteria included: lack of methodological novelty (e.g., reviews, benchmarks), experiments conducted on a single mono-center dataset, or articles not written in English. The results of this paper show that learning based methods are emerging, for both shift types. Finally, we discuss future challenges, including the need for improved evaluation protocols and benchmarks, and envisioned future developments to achieve robust, generalized models for medical image classification.

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arXiv2024

Instant automatic diagnosis of diabetic retinopathy

The purpose of this study is to evaluate the performance of the OphtAI system for the automatic detection of referable diabetic retinopathy (DR) and the automatic assessment of DR severity using color fundus photography. OphtAI relies on ensembles of convolutional neural networks trained to recognize eye laterality, detect referable DR and assess DR severity. The system can either process single images or full examination records. To document the automatic diagnoses, accurate heatmaps are generated. The system was developed and validated using a dataset of 763,848 images from 164,660 screening procedures from the OPHDIAT screening program. For comparison purposes, it was also evaluated in the public Messidor-2 dataset. Referable DR can be detected with an area under the ROC curve of AUC = 0.989 in the Messidor-2 dataset, using the University of Iowa's reference standard (95% CI: 0.984-0.994). This is better than the only AI system authorized by the FDA, evaluated in the exact same conditions (AUC = 0.980). OphtAI can also detect vision-threatening DR with an AUC of 0.997 (95% CI: 0.996-0.998) and proliferative DR with an AUC of 0.997 (95% CI: 0.995-0.999). The system runs in 0.3 seconds using a graphics processing unit and less than 2 seconds without. OphtAI is safer, faster and more comprehensive than the only AI system authorized by the FDA so far. Instant DR diagnosis is now possible, which is expected to streamline DR screening and to give easy access to DR screening to more diabetic patients.

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arXiv2024

A review of deep learning-based information fusion techniques for multimodal medical image classification

Multimodal medical imaging plays a pivotal role in clinical diagnosis and research, as it combines information from various imaging modalities to provide a more comprehensive understanding of the underlying pathology. Recently, deep learning-based multimodal fusion techniques have emerged as powerful tools for improving medical image classification. This review offers a thorough analysis of the developments in deep learning-based multimodal fusion for medical classification tasks. We explore the complementary relationships among prevalent clinical modalities and outline three main fusion schemes for multimodal classification networks: input fusion, intermediate fusion (encompassing single-level fusion, hierarchical fusion, and attention-based fusion), and output fusion. By evaluating the performance of these fusion techniques, we provide insight into the suitability of different network architectures for various multimodal fusion scenarios and application domains. Furthermore, we delve into challenges related to network architecture selection, handling incomplete multimodal data management, and the potential limitations of multimodal fusion. Finally, we spotlight the promising future of Transformer-based multimodal fusion techniques and give recommendations for future research in this rapidly evolving field.

cs.CV↗

arXiv2024

LaTiM: Longitudinal representation learning in continuous-time models to predict disease progression

This work proposes a novel framework for analyzing disease progression using time-aware neural ordinary differential equations (NODE). We introduce a "time-aware head" in a framework trained through self-supervised learning (SSL) to leverage temporal information in latent space for data augmentation. This approach effectively integrates NODEs with SSL, offering significant performance improvements compared to traditional methods that lack explicit temporal integration. We demonstrate the effectiveness of our strategy for diabetic retinopathy progression prediction using the OPHDIAT database. Compared to the baseline, all NODE architectures achieve statistically significant improvements in area under the ROC curve (AUC) and Kappa metrics, highlighting the efficacy of pre-training with SSL-inspired approaches. Additionally, our framework promotes stable training for NODEs, a commonly encountered challenge in time-aware modeling.

cs.LG↗

arXiv2024

Detection of diabetic retinopathy using longitudinal self-supervised learning

Longitudinal imaging is able to capture both static anatomical structures and dynamic changes in disease progression towards earlier and better patient-specific pathology management. However, conventional approaches for detecting diabetic retinopathy (DR) rarely take advantage of longitudinal information to improve DR analysis. In this work, we investigate the benefit of exploiting self-supervised learning with a longitudinal nature for DR diagnosis purposes. We compare different longitudinal self-supervised learning (LSSL) methods to model the disease progression from longitudinal retinal color fundus photographs (CFP) to detect early DR severity changes using a pair of consecutive exams. The experiments were conducted on a longitudinal DR screening dataset with or without those trained encoders (LSSL) acting as a longitudinal pretext task. Results achieve an AUC of 0.875 for the baseline (model trained from scratch) and an AUC of 0.96 (95% CI: 0.9593-0.9655 DeLong test) with a p-value < 2.2e-16 on early fusion using a simple ResNet alike architecture with frozen LSSL weights, suggesting that the LSSL latent space enables to encode the dynamic of DR progression.

cs.CV↗

arXiv2024

L-MAE: Longitudinal masked auto-encoder with time and severity-aware encoding for diabetic retinopathy progression prediction

Pre-training strategies based on self-supervised learning (SSL) have proven to be effective pretext tasks for many downstream tasks in computer vision. Due to the significant disparity between medical and natural images, the application of typical SSL is not straightforward in medical imaging. Additionally, those pretext tasks often lack context, which is critical for computer-aided clinical decision support. In this paper, we developed a longitudinal masked auto-encoder (MAE) based on the well-known Transformer-based MAE. In particular, we explored the importance of time-aware position embedding as well as disease progression-aware masking. Taking into account the time between examinations instead of just scheduling them offers the benefit of capturing temporal changes and trends. The masking strategy, for its part, evolves during follow-up to better capture pathological changes, ensuring a more accurate assessment of disease progression. Using OPHDIAT, a large follow-up screening dataset targeting diabetic retinopathy (DR), we evaluated the pre-trained weights on a longitudinal task, which is to predict the severity label of the next visit within 3 years based on the past time series examinations. Our results demonstrated the relevancy of both time-aware position embedding and masking strategies based on disease progression knowledge. Compared to popular baseline models and standard longitudinal Transformers, these simple yet effective extensions significantly enhance the predictive ability of deep classification models.

cs.CV↗

arXiv2024

DISCOVER: 2-D Multiview Summarization of Optical Coherence Tomography Angiography for Automatic Diabetic Retinopathy Diagnosis

Diabetic Retinopathy (DR), an ocular complication of diabetes, is a leading cause of blindness worldwide. Traditionally, DR is monitored using Color Fundus Photography (CFP), a widespread 2-D imaging modality. However, DR classifications based on CFP have poor predictive power, resulting in suboptimal DR management. Optical Coherence Tomography Angiography (OCTA) is a recent 3-D imaging modality offering enhanced structural and functional information (blood flow) with a wider field of view. This paper investigates automatic DR severity assessment using 3-D OCTA. A straightforward solution to this task is a 3-D neural network classifier. However, 3-D architectures have numerous parameters and typically require many training samples. A lighter solution consists in using 2-D neural network classifiers processing 2-D en-face (or frontal) projections and/or 2-D cross-sectional slices. Such an approach mimics the way ophthalmologists analyze OCTA acquisitions: 1) en-face flow maps are often used to detect avascular zones and neovascularization, and 2) cross-sectional slices are commonly analyzed to detect macular edemas, for instance. However, arbitrary data reduction or selection might result in information loss. Two complementary strategies are thus proposed to optimally summarize OCTA volumes with 2-D images: 1) a parametric en-face projection optimized through deep learning and 2) a cross-sectional slice selection process controlled through gradient-based attribution. The full summarization and DR classification pipeline is trained from end to end. The automatic 2-D summary can be displayed in a viewer or printed in a report to support the decision. We show that the proposed 2-D summarization and classification pipeline outperforms direct 3-D classification with the advantage of improved interpretability.

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arXiv2024

Automated Detection of Myopic Maculopathy in MMAC 2023: Achievements in Classification, Segmentation, and Spherical Equivalent Prediction

Myopic macular degeneration is the most common complication of myopia and the primary cause of vision loss in individuals with pathological myopia. Early detection and prompt treatment are crucial in preventing vision impairment due to myopic maculopathy. This was the focus of the Myopic Maculopathy Analysis Challenge (MMAC), in which we participated. In task 1, classification of myopic maculopathy, we employed the contrastive learning framework, specifically SimCLR, to enhance classification accuracy by effectively capturing enriched features from unlabeled data. This approach not only improved the intrinsic understanding of the data but also elevated the performance of our classification model. For Task 2 (segmentation of myopic maculopathy plus lesions), we have developed independent segmentation models tailored for different lesion segmentation tasks and implemented a test-time augmentation strategy to further enhance the model's performance. As for Task 3 (prediction of spherical equivalent), we have designed a deep regression model based on the data distribution of the dataset and employed an integration strategy to enhance the model's prediction accuracy. The results we obtained are promising and have allowed us to position ourselves in the Top 6 of the classification task, the Top 2 of the segmentation task, and the Top 1 of the prediction task. The code is available at \url{https://github.com/liyihao76/MMAC_LaTIM_Solution}.

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arXiv2023

LMT: Longitudinal Mixing Training, a Framework to Predict Disease Progression from a Single Image

Longitudinal imaging is able to capture both static anatomical structures and dynamic changes in disease progression toward earlier and better patient-specific pathology management. However, conventional approaches rarely take advantage of longitudinal information for detection and prediction purposes, especially for Diabetic Retinopathy (DR). In the past years, Mix-up training and pretext tasks with longitudinal context have effectively enhanced DR classification results and captured disease progression. In the meantime, a novel type of neural network named Neural Ordinary Differential Equation (NODE) has been proposed for solving ordinary differential equations, with a neural network treated as a black box. By definition, NODE is well suited for solving time-related problems. In this paper, we propose to combine these three aspects to detect and predict DR progression. Our framework, Longitudinal Mixing Training (LMT), can be considered both as a regularizer and as a pretext task that encodes the disease progression in the latent space. Additionally, we evaluate the trained model weights on a downstream task with a longitudinal context using standard and longitudinal pretext tasks. We introduce a new way to train time-aware models using $t_{mix}$, a weighted average time between two consecutive examinations. We compare our approach to standard mixing training on DR classification using OPHDIAT a longitudinal retinal Color Fundus Photographs (CFP) dataset. We were able to predict whether an eye would develop a severe DR in the following visit using a single image, with an AUC of 0.798 compared to baseline results of 0.641. Our results indicate that our longitudinal pretext task can learn the progression of DR disease and that introducing $t_{mix}$ augmentation is beneficial for time-aware models.

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