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Ivana Išgum

Publications and source records attributed to Ivana Išgum.

At least 19 recordsLinked to original sources

TG-OT: Topology-guided CCTA-IVUS registration via optimal transport matching

Registering coronary CT angiography (CCTA) and intravascular ultrasound (IVUS) enables comprehensive coronary analysis that neither modality can provide alone, yet their fusion remains challenging due to differences in imaging geometry, resolution, and artifact profiles. Existing methods depend on pre-computed lumen or vessel wall segmentations that are unreliable under IVUS acoustic shadowing from calcifications, limiting their clinical applicability. We propose TG-OT, a fully automatic CCTA-IVUS registration framework that eliminates this dependency by integrating trained feature detectors directly into the registration pipeline. Lightweight CNNs are trained to predict calcifications, bifurcations, and lumen radii on the topological $(θ, z)$ cylinder, encouraging topologically coherent detections without requiring explicit segmentation. Registration is formulated as an optimization over centerline warping parameters, driven by an unbalanced Sinkhorn optimal transport loss on the cylindrical geometry that provides spatially informative gradients even for spatially disjoint predictions, complemented by a lumen matching term. Evaluated on $N{=}47$ paired CCTA-IVUS cases in a 5-fold cross-validation setup, TG-OT achieves strong longitudinal ($\overline{\text{Dice}}_\text{ctl}{=}0.99$), rotational ($\overline{S}_c{=}0.96$), and lumen alignment ($\overline{\text{Dice}}_\text{L}{=}0.69$) without manual interaction or prior segmentation, marking a meaningful step toward clinical integration of automatic CCTA-IVUS fusion.

eess.IV↗

Disentangling Sampling from Training Budget in Class-Imbalanced CT Body Composition Segmentation

Class imbalance is a fundamental challenge in medical image segmentation, where frequent classes typically dominate training at the expense of rare classes. Loss-based approaches mitigate imbalance by reweighting the per-pixel loss within the batch, while sampling strategies control which images enter the batch. Yet neither explicitly controls which classes appear within the batch, leaving rare-class exposure only partially rebalanced. In this work, we adopt episodic sampling from few-shot learning to promote class-balanced batch construction in a fully supervised setting. We decouple episodic sampling from its conventional metric-learning context and evaluate it in body composition segmentation in CT. We compare episodic sampling against random and weighted sampling on nine muscle and adipose tissues, derived from 210 scans of the public SAROS dataset. Training is performed under full- and low-data regimes, with additional comparisons under matched training iteration budgets. Under full-data training, all three strategies performed comparably (mean Dice 0.882 for episodic, 0.878 for random and weighted). Under low-data training, episodic sampling outperformed random and weighted (0.787 vs. 0.758 and 0.762), driven by a 12-fold difference in training iterations. Under matched training budgets, random and weighted overfit earlier, while episodic improved for approximately three times more iterations before plateauing. Our findings identify the training iteration budget as under-recognized confound in sampling strategies, motivating iteration-aware evaluation protocols for small datasets. Furthermore, the residual advantage of episodic sampling is consistent with an implicit regularization effect of class-balanced batches, offering a low-cost, model-agnostic strategy for class-imbalanced medical image segmentation. Code is available at https://github.com/iasonsky/episodic-sampling.

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Dual-Phase Cross-Modal Contrastive Learning for CMR-Guided ECG Representations for Cardiovascular Disease Assessment

Cardiac magnetic resonance imaging (CMR) offers detailed evaluation of cardiac structure and function, but its limited accessibility restricts use to selected patient populations. In contrast, the electrocardiogram (ECG) is ubiquitous and inexpensive, and provides rich information on cardiac electrical activity and rhythm, yet offers limited insight into underlying cardiac structure and mechanical function. To address this, we introduce a contrastive learning framework that improves the extraction of clinically relevant cardiac phenotypes from ECG by learning from paired ECG-CMR data. Our approach aligns ECG representations with 3D CMR volumes at end-diastole (ED) and end-systole (ES), with a dual-phase contrastive loss to anchor each ECG jointly with both cardiac phases in a shared latent space. Unlike prior methods limited to 2D CMR representations with or without a temporal component, our framework models 3D anatomy at both ED and ES phases as distinct latent representations, enabling flexible disentanglement of structural and functional cardiac properties. Using over 34,000 ECG-CMR pairs from the UK Biobank, we demonstrate improved extraction of image-derived phenotypes from ECG, particularly for functional parameters ($\uparrow$ 9.2\%), while improvements in clinical outcome prediction remained modest ($\uparrow$ 0.7\%). This strategy could enable scalable and cost-effective extraction of image-derived traits from ECG. The code for this research is publicly available.

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Synthesis of Late Gadolinium Enhancement Images via Implicit Neural Representations for Cardiac Scar Segmentation

Late gadolinium enhancement (LGE) imaging is the clinical standard for myocardial scar assessment, but limited annotated datasets hinder the development of automated segmentation methods. We propose a novel framework that synthesises both LGE images and their corresponding segmentation masks using implicit neural representations (INRs) combined with denoising diffusion models. Our approach first trains INRs to capture continuous spatial representations of LGE data and associated myocardium and fibrosis masks. These INRs are then compressed into compact latent embeddings, preserving essential anatomical information. A diffusion model operates on this latent space to generate new representations, which are decoded into synthetic LGE images with anatomically consistent segmentation masks. Experiments on 133 cardiac MRI scans suggest that augmenting training data with 200 synthetic volumes contributes to improved fibrosis segmentation performance, with the Dice score showing an increase from 0.509 to 0.524. Our approach provides an annotation-free method to help mitigate data scarcity.The code for this research is publicly available.

cs.CV↗

Fighting MRI Anisotropy: Learning Multiple Cardiac Shapes From a Single Implicit Neural Representation

The anisotropic nature of short-axis (SAX) cardiovascular magnetic resonance imaging (CMRI) limits cardiac shape analysis. To address this, we propose to leverage near-isotropic, higher resolution computed tomography angiography (CTA) data of the heart. We use this data to train a single neural implicit function to jointly represent cardiac shapes from CMRI at any resolution. We evaluate the method for the reconstruction of right ventricle (RV) and myocardium (MYO), where MYO simultaneously models endocardial and epicardial left-ventricle surfaces. Since high-resolution SAX reference segmentations are unavailable, we evaluate performance by extracting a 4-chamber (4CH) slice of RV and MYO from their reconstructed shapes. When compared with the reference 4CH segmentation masks from CMRI, our method achieved a Dice similarity coefficient of 0.91 $\pm$ 0.07 and 0.75 $\pm$ 0.13, and a Hausdorff distance of 6.21 $\pm$ 3.97 mm and 7.53 $\pm$ 5.13 mm for RV and MYO, respectively. Quantitative and qualitative assessment demonstrate the model's ability to reconstruct accurate, smooth and anatomically plausible shapes, supporting improvements in cardiac shape analysis.

cs.CV↗

Neural Implicit 3D Cardiac Shape Reconstruction from Sparse CT Angiography Slices Mimicking 2D Transthoracic Echocardiography Views

Accurate 3D representations of cardiac structures allow quantitative analysis of anatomy and function. In this work, we propose a method for reconstructing complete 3D cardiac shapes from segmentations of sparse planes in CT angiography (CTA) for application in 2D transthoracic echocardiography (TTE). Our method uses a neural implicit function to reconstruct the 3D shape of the cardiac chambers and left-ventricle myocardium from sparse CTA planes. To investigate the feasibility of achieving 3D reconstruction from 2D TTE, we select planes that mimic the standard apical 2D TTE views. During training, a multi-layer perceptron learns shape priors from 3D segmentations of the target structures in CTA. At test time, the network reconstructs 3D cardiac shapes from segmentations of TTE-mimicking CTA planes by jointly optimizing the latent code and the rigid transforms that map the observed planes into 3D space. For each heart, we simulate four realistic apical views, and we compare reconstructed multi-class volumes with the reference CTA volumes. On a held-out set of CTA segmentations, our approach achieves an average Dice coefficient of 0.86 $\pm$ 0.04 across all structures. Our method also achieves markedly lower volume errors than the clinical standard, Simpson's biplane rule: 4.88 $\pm$ 4.26 mL vs. 8.14 $\pm$ 6.04 mL, respectively, for the left ventricle; and 6.40 $\pm$ 7.37 mL vs. 37.76 $\pm$ 22.96 mL, respectively, for the left atrium. This suggests that our approach offers a viable route to more accurate 3D chamber quantification in 2D transthoracic echocardiography.

cs.CV↗

Brain age identification from diffusion MRI synergistically predicts neurodegenerative disease

Estimated brain age from magnetic resonance image (MRI) and its deviation from chronological age can provide early insights into potential neurodegenerative diseases, supporting early detection and implementation of prevention strategies. Diffusion MRI (dMRI) presents an opportunity to build an earlier biomarker for neurodegenerative disease prediction because it captures subtle microstructural changes that precede more perceptible macrostructural changes. However, the coexistence of macro- and micro-structural information in dMRI raises the question of whether current dMRI-based brain age estimation models are leveraging the intended microstructural information or if they inadvertently rely on the macrostructural information. To develop a microstructure-specific brain age, we propose a method for brain age identification from dMRI that mitigates the model's use of macrostructural information by non-rigidly registering all images to a standard template. Imaging data from 13,398 participants across 12 datasets were used for the training and evaluation. We compare our brain age models, trained with and without macrostructural information mitigated, with an architecturally similar T1-weighted (T1w) MRI-based brain age model and two recent, popular, openly available T1w MRI-based brain age models that primarily use macrostructural information. We observe difference between our dMRI-based brain age and T1w MRI-based brain age across stages of neurodegeneration, with dMRI-based brain age being older than T1w MRI-based brain age in participants transitioning from cognitively normal (CN) to mild cognitive impairment (MCI), but younger in participants already diagnosed with Alzheimer's disease (AD). Furthermore, dMRI-based brain age may offer advantages over T1w MRI-based brain age in predicting the transition from CN to MCI up to five years before diagnosis.

cs.CV↗

Temporally Consistent Mitral Annulus Measurements from Sparse Annotations in Echocardiographic Videos

This work presents a novel approach to achieving temporally consistent mitral annulus landmark localization in echocardiography videos using sparse annotations. Our method introduces a self-supervised loss term that enforces temporal consistency between neighboring frames, which smooths the position of landmarks and enhances measurement accuracy over time. Additionally, we incorporate realistic field-of-view augmentations to improve the recognition of missing anatomical landmarks. We evaluate our approach on both a public and private dataset, and demonstrate significant improvements in Mitral Annular Plane Systolic Excursion (MAPSE) calculations and overall landmark tracking stability. The method achieves a mean absolute MAPSE error of 1.81 $\pm$ 0.14 mm, an annulus size error of 2.46 $\pm$ 0.31 mm, and a landmark localization error of 2.48 $\pm$ 0.07 mm. Finally, it achieves a 0.99 ROC-AUC for recognition of missing landmarks.

cs.CV↗

Attenuation artifact detection and severity classification in intracoronary OCT using mixed image representations

In intracoronary optical coherence tomography (OCT), blood residues and gas bubbles cause attenuation artifacts that can obscure critical vessel structures. The presence and severity of these artifacts may warrant re-acquisition, prolonging procedure time and increasing use of contrast agent. Accurate detection of these artifacts can guide targeted re-acquisition, reducing the amount of repeated scans needed to achieve diagnostically viable images. However, the highly heterogeneous appearance of these artifacts poses a challenge for the automated detection of the affected image regions. To enable automatic detection of the attenuation artifacts caused by blood residues and gas bubbles based on their severity, we propose a convolutional neural network that performs classification of the attenuation lines (A-lines) into three classes: no artifact, mild artifact and severe artifact. Our model extracts and merges features from OCT images in both Cartesian and polar coordinates, where each column of the image represents an A-line. Our method detects the presence of attenuation artifacts in OCT frames reaching F-scores of 0.77 and 0.94 for mild and severe artifacts, respectively. The inference time over a full OCT scan is approximately 6 seconds. Our experiments show that analysis of images represented in both Cartesian and polar coordinate systems outperforms the analysis in polar coordinates only, suggesting that these representations contain complementary features. This work lays the foundation for automated artifact assessment and image acquisition guidance in intracoronary OCT imaging.

cs.CV↗

World of Forms: Deformable Geometric Templates for One-Shot Surface Meshing in Coronary CT Angiography

Deep learning-based medical image segmentation and surface mesh generation typically involve a sequential pipeline from image to segmentation to meshes, often requiring large training datasets while making limited use of prior geometric knowledge. This may lead to topological inconsistencies and suboptimal performance in low-data regimes. To address these challenges, we propose a data-efficient deep learning method for direct 3D anatomical object surface meshing using geometric priors. Our approach employs a multi-resolution graph neural network that operates on a prior geometric template which is deformed to fit object boundaries of interest. We show how different templates may be used for the different surface meshing targets, and introduce a novel masked autoencoder pretraining strategy for 3D spherical data. The proposed method outperforms nnUNet in a one-shot setting for segmentation of the pericardium, left ventricle (LV) cavity and the LV myocardium. Similarly, the method outperforms other lumen segmentation operating on multi-planar reformatted images. Results further indicate that mesh quality is on par with or improves upon marching cubes post-processing of voxel mask predictions, while remaining flexible in the choice of mesh triangulation prior, thus paving the way for more accurate and topologically consistent 3D medical object surface meshing.

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ATOMMIC: An Advanced Toolbox for Multitask Medical Imaging Consistency to facilitate Artificial Intelligence applications from acquisition to analysis in Magnetic Resonance Imaging

AI is revolutionizing MRI along the acquisition and processing chain. Advanced AI frameworks have been developed to apply AI in various successive tasks, such as image reconstruction, quantitative parameter map estimation, and image segmentation. Existing frameworks are often designed to perform tasks independently or are focused on specific models or datasets, limiting generalization. We introduce ATOMMIC, an open-source toolbox that streamlines AI applications for accelerated MRI reconstruction and analysis. ATOMMIC implements several tasks using DL networks and enables MultiTask Learning (MTL) to perform related tasks integrated, targeting generalization in the MRI domain. We first review the current state of AI frameworks for MRI through a comprehensive literature search and by parsing 12,479 GitHub repositories. We benchmark 25 DL models on eight publicly available datasets to present distinct applications of ATOMMIC on accelerated MRI reconstruction, image segmentation, quantitative parameter map estimation, and joint accelerated MRI reconstruction and image segmentation utilizing MTL. Our findings demonstrate that ATOMMIC is the only MTL framework with harmonized complex-valued and real-valued data support. Evaluations on single tasks show that physics-based models, which enforce data consistency by leveraging the physical properties of MRI, outperform other models in reconstructing highly accelerated acquisitions. Physics-based models that produce high reconstruction quality can accurately estimate quantitative parameter maps. When high-performing reconstruction models are combined with robust segmentation networks utilizing MTL, performance is improved in both tasks. ATOMMIC facilitates MRI reconstruction and analysis by standardizing workflows, enhancing data interoperability, integrating unique features like MTL, and effectively benchmarking DL models.

physics.med-ph↗

Predicting Age from White Matter Diffusivity with Residual Learning

Imaging findings inconsistent with those expected at specific chronological age ranges may serve as early indicators of neurological disorders and increased mortality risk. Estimation of chronological age, and deviations from expected results, from structural MRI data has become an important task for developing biomarkers that are sensitive to such deviations. Complementary to structural analysis, diffusion tensor imaging (DTI) has proven effective in identifying age-related microstructural changes within the brain white matter, thereby presenting itself as a promising additional modality for brain age prediction. Although early studies have sought to harness DTI's advantages for age estimation, there is no evidence that the success of this prediction is owed to the unique microstructural and diffusivity features that DTI provides, rather than the macrostructural features that are also available in DTI data. Therefore, we seek to develop white-matter-specific age estimation to capture deviations from normal white matter aging. Specifically, we deliberately disregard the macrostructural information when predicting age from DTI scalar images, using two distinct methods. The first method relies on extracting only microstructural features from regions of interest. The second applies 3D residual neural networks (ResNets) to learn features directly from the images, which are non-linearly registered and warped to a template to minimize macrostructural variations. When tested on unseen data, the first method yields mean absolute error (MAE) of 6.11 years for cognitively normal participants and MAE of 6.62 years for cognitively impaired participants, while the second method achieves MAE of 4.69 years for cognitively normal participants and MAE of 4.96 years for cognitively impaired participants. We find that the ResNet model captures subtler, non-macrostructural features for brain age prediction.

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Deep Learning for Automatic Strain Quantification in Arrhythmogenic Right Ventricular Cardiomyopathy

Quantification of cardiac motion with cine Cardiac Magnetic Resonance Imaging (CMRI) is an integral part of arrhythmogenic right ventricular cardiomyopathy (ARVC) diagnosis. Yet, the expert evaluation of motion abnormalities with CMRI is a challenging task. To automatically assess cardiac motion, we register CMRIs from different time points of the cardiac cycle using Implicit Neural Representations (INRs) and perform a biomechanically informed regularization inspired by the myocardial incompressibility assumption. To enhance the registration performance, our method first rectifies the inter-slice misalignment inherent to CMRI by performing a rigid registration guided by the long-axis views, and then increases the through-plane resolution using an unsupervised deep learning super-resolution approach. Finally, we propose to synergically combine information from short-axis and 4-chamber long-axis views, along with an initialization to incorporate information from multiple cardiac time points. Thereafter, to quantify cardiac motion, we calculate global and segmental strain over a cardiac cycle and compute the peak strain. The evaluation of the method is performed on a dataset of cine CMRI scans from 47 ARVC patients and 67 controls. Our results show that inter-slice alignment and generation of super-resolved volumes combined with joint analysis of the two cardiac views, notably improves registration performance. Furthermore, the proposed initialization yields more physiologically plausible registrations. The significant differences in the peak strain, discerned between the ARVC patients and healthy controls suggest that automated motion quantification methods may assist in diagnosis and provide further understanding of disease-specific alterations of cardiac motion.

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Automatic Coronary Artery Plaque Quantification and CAD-RADS Prediction using Mesh Priors

Coronary artery disease (CAD) remains the leading cause of death worldwide. Patients with suspected CAD undergo coronary CT angiography (CCTA) to evaluate the risk of cardiovascular events and determine the treatment. Clinical analysis of coronary arteries in CCTA comprises the identification of atherosclerotic plaque, as well as the grading of any coronary artery stenosis typically obtained through the CAD-Reporting and Data System (CAD-RADS). This requires analysis of the coronary lumen and plaque. While voxel-wise segmentation is a commonly used approach in various segmentation tasks, it does not guarantee topologically plausible shapes. To address this, in this work, we propose to directly infer surface meshes for coronary artery lumen and plaque based on a centerline prior and use it in the downstream task of CAD-RADS scoring. The method is developed and evaluated using a total of 2407 CCTA scans. Our method achieved lesion-wise volume intraclass correlation coefficients of 0.98, 0.79, and 0.85 for calcified, non-calcified, and total plaque volume respectively. Patient-level CAD-RADS categorization was evaluated on a representative hold-out test set of 300 scans, for which the achieved linearly weighted kappa ($κ$) was 0.75. CAD-RADS categorization on the set of 658 scans from another hospital and scanner led to a $κ$ of 0.71. The results demonstrate that direct inference of coronary artery meshes for lumen and plaque is feasible, and allows for the automated prediction of routinely performed CAD-RADS categorization.

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Robust deformable image registration using cycle-consistent implicit representations

Recent works in medical image registration have proposed the use of Implicit Neural Representations, demonstrating performance that rivals state-of-the-art learning-based methods. However, these implicit representations need to be optimized for each new image pair, which is a stochastic process that may fail to converge to a global minimum. To improve robustness, we propose a deformable registration method using pairs of cycle-consistent Implicit Neural Representations: each implicit representation is linked to a second implicit representation that estimates the opposite transformation, causing each network to act as a regularizer for its paired opposite. During inference, we generate multiple deformation estimates by numerically inverting the paired backward transformation and evaluating the consensus of the optimized pair. This consensus improves registration accuracy over using a single representation and results in a robust uncertainty metric that can be used for automatic quality control. We evaluate our method with a 4D lung CT dataset. The proposed cycle-consistent optimization method reduces the optimization failure rate from 2.4% to 0.0% compared to the current state-of-the-art. The proposed inference method improves landmark accuracy by 4.5% and the proposed uncertainty metric detects all instances where the registration method fails to converge to a correct solution. We verify the generalizability of these results to other data using a centerline propagation task in abdominal 4D MRI, where our method achieves a 46% improvement in propagation consistency compared with single-INR registration and demonstrates a strong correlation between the proposed uncertainty metric and registration accuracy.

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Deep Learning-Based Prediction of Fractional Flow Reserve along the Coronary Artery

Functionally significant coronary artery disease (CAD) is caused by plaque buildup in the coronary arteries, potentially leading to narrowing of the arterial lumen, i.e. coronary stenosis, that significantly obstructs blood flow to the myocardium. The current reference for establishing the presence of a functionally significant stenosis is invasive fractional flow reserve (FFR) measurement. To avoid invasive measurements, non-invasive prediction of FFR from coronary CT angiography (CCTA) has emerged. For this, machine learning approaches, characterized by fast inference, are increasingly developed. However, these methods predict a single FFR value per artery i.e. they don't provide information about the stenosis location or treatment strategy. We propose a deep learning-based method to predict the FFR along the artery from CCTA scans. This study includes CCTA images of 110 patients who underwent invasive FFR pullback measurement in 112 arteries. First, a multi planar reconstruction (MPR) of the artery is fed to a variational autoencoder to characterize the artery, i.e. through the lumen area and unsupervised artery encodings. Thereafter, a convolutional neural network (CNN) predicts the FFR along the artery. The CNN is supervised by multiple loss functions, notably a loss function inspired by the Earth Mover's Distance (EMD) to predict the correct location of FFR drops and a histogram-based loss to explicitly supervise the slope of the FFR curve. To train and evaluate our model, eight-fold cross-validation was performed. The resulting FFR curves show good agreement with the reference allowing the distinction between diffuse and focal CAD distributions in most cases. Quantitative evaluation yielded a mean absolute difference in the area under the FFR pullback curve (AUPC) of 1.7. The method may pave the way towards fast, accurate, automatic prediction of FFR along the artery from CCTA.

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Generative Models for Reproducible Coronary Calcium Scoring

Purpose: Coronary artery calcium (CAC) score, i.e. the amount of CAC quantified in CT, is a strong and independent predictor of coronary heart disease (CHD) events. However, CAC scoring suffers from limited interscan reproducibility, which is mainly due to the clinical definition requiring application of a fixed intensity level threshold for segmentation of calcifications. This limitation is especially pronounced in non-ECG-synchronized CT where lesions are more impacted by cardiac motion and partial volume effects. Therefore, we propose a CAC quantification method that does not require a threshold for segmentation of CAC. Approach: Our method utilizes a generative adversarial network where a CT with CAC is decomposed into an image without CAC and an image showing only CAC. The method, using a CycleGAN, was trained using 626 low-dose chest CTs and 514 radiotherapy treatment planning CTs. Interscan reproducibility was compared to clinical calcium scoring in radiotherapy treatment planning CTs of 1,662 patients, each having two scans. Results: A lower relative interscan difference in CAC mass was achieved by the proposed method: 47% compared to 89% manual clinical calcium scoring. The intraclass correlation coefficient of Agatston scores was 0.96 for the proposed method compared to 0.91 for automatic clinical calcium scoring. Conclusions: The increased interscan reproducibility achieved by our method may lead to increased reliability of CHD risk categorization and improved accuracy of CHD event prediction.

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Autoencoding Low-Resolution MRI for Semantically Smooth Interpolation of Anisotropic MRI

High-resolution medical images are beneficial for analysis but their acquisition may not always be feasible. Alternatively, high-resolution images can be created from low-resolution acquisitions using conventional upsampling methods, but such methods cannot exploit high-level contextual information contained in the images. Recently, better performing deep-learning based super-resolution methods have been introduced. However, these methods are limited by their supervised character, i.e. they require high-resolution examples for training. Instead, we propose an unsupervised deep learning semantic interpolation approach that synthesizes new intermediate slices from encoded low-resolution examples. To achieve semantically smooth interpolation in through-plane direction, the method exploits the latent space generated by autoencoders. To generate new intermediate slices, latent space encodings of two spatially adjacent slices are combined using their convex combination. Subsequently, the combined encoding is decoded to an intermediate slice. To constrain the model, a notion of semantic similarity is defined for a given dataset. For this, a new loss is introduced that exploits the spatial relationship between slices of the same volume. During training, an existing in-between slice is generated using a convex combination of its neighboring slice encodings. The method was trained and evaluated using publicly available cardiac cine, neonatal brain and adult brain MRI scans. In all evaluations, the new method produces significantly better results in terms of Structural Similarity Index Measure and Peak Signal-to-Noise Ratio (p< 0.001 using one-sided Wilcoxon signed-rank test) than a cubic B-spline interpolation approach. Given the unsupervised nature of the method, high-resolution training data is not required and hence, the method can be readily applied in clinical settings.

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