arXiv subjects

Jan Egger

Publications and source records attributed to Jan Egger.

At least 55 records · Page 3Linked to original sources

arXiv2023

Classification of lung cancer subtypes on CT images with synthetic pathological priors

The accurate diagnosis on pathological subtypes for lung cancer is of significant importance for the follow-up treatments and prognosis managements. In this paper, we propose self-generating hybrid feature network (SGHF-Net) for accurately classifying lung cancer subtypes on computed tomography (CT) images. Inspired by studies stating that cross-scale associations exist in the image patterns between the same case's CT images and its pathological images, we innovatively developed a pathological feature synthetic module (PFSM), which quantitatively maps cross-modality associations through deep neural networks, to derive the "gold standard" information contained in the corresponding pathological images from CT images. Additionally, we designed a radiological feature extraction module (RFEM) to directly acquire CT image information and integrated it with the pathological priors under an effective feature fusion framework, enabling the entire classification model to generate more indicative and specific pathologically related features and eventually output more accurate predictions. The superiority of the proposed model lies in its ability to self-generate hybrid features that contain multi-modality image information based on a single-modality input. To evaluate the effectiveness, adaptability, and generalization ability of our model, we performed extensive experiments on a large-scale multi-center dataset (i.e., 829 cases from three hospitals) to compare our model and a series of state-of-the-art (SOTA) classification models. The experimental results demonstrated the superiority of our model for lung cancer subtypes classification with significant accuracy improvements in terms of accuracy (ACC), area under the curve (AUC), and F1 score.

eess.IV↗

arXiv2023

k-strip: A novel segmentation algorithm in k-space for the application of skull stripping

Objectives: Present a novel deep learning-based skull stripping algorithm for magnetic resonance imaging (MRI) that works directly in the information rich k-space. Materials and Methods: Using two datasets from different institutions with a total of 36,900 MRI slices, we trained a deep learning-based model to work directly with the complex raw k-space data. Skull stripping performed by HD-BET (Brain Extraction Tool) in the image domain were used as the ground truth. Results: Both datasets were very similar to the ground truth (DICE scores of 92\%-98\% and Hausdorff distances of under 5.5 mm). Results on slices above the eye-region reach DICE scores of up to 99\%, while the accuracy drops in regions around the eyes and below, with partially blurred output. The output of k-strip often smoothed edges at the demarcation to the skull. Binary masks are created with an appropriate threshold. Conclusion: With this proof-of-concept study, we were able to show the feasibility of working in the k-space frequency domain, preserving phase information, with consistent results. Future research should be dedicated to discovering additional ways the k-space can be used for innovative image analysis and further workflows.

eess.IV↗

arXiv2023

FAM: Relative Flatness Aware Minimization

Flatness of the loss curve around a model at hand has been shown to empirically correlate with its generalization ability. Optimizing for flatness has been proposed as early as 1994 by Hochreiter and Schmidthuber, and was followed by more recent successful sharpness-aware optimization techniques. Their widespread adoption in practice, though, is dubious because of the lack of theoretically grounded connection between flatness and generalization, in particular in light of the reparameterization curse - certain reparameterizations of a neural network change most flatness measures but do not change generalization. Recent theoretical work suggests that a particular relative flatness measure can be connected to generalization and solves the reparameterization curse. In this paper, we derive a regularizer based on this relative flatness that is easy to compute, fast, efficient, and works with arbitrary loss functions. It requires computing the Hessian only of a single layer of the network, which makes it applicable to large neural networks, and with it avoids an expensive mapping of the loss surface in the vicinity of the model. In an extensive empirical evaluation we show that this relative flatness aware minimization (FAM) improves generalization in a multitude of applications and models, both in finetuning and standard training. We make the code available at github.

cs.LG↗

arXiv2023

Open-Source Skull Reconstruction with MONAI

We present a deep learning-based approach for skull reconstruction for MONAI, which has been pre-trained on the MUG500+ skull dataset. The implementation follows the MONAI contribution guidelines, hence, it can be easily tried out and used, and extended by MONAI users. The primary goal of this paper lies in the investigation of open-sourcing codes and pre-trained deep learning models under the MONAI framework. Nowadays, open-sourcing software, especially (pre-trained) deep learning models, has become increasingly important. Over the years, medical image analysis experienced a tremendous transformation. Over a decade ago, algorithms had to be implemented and optimized with low-level programming languages, like C or C++, to run in a reasonable time on a desktop PC, which was not as powerful as today's computers. Nowadays, users have high-level scripting languages like Python, and frameworks like PyTorch and TensorFlow, along with a sea of public code repositories at hand. As a result, implementations that had thousands of lines of C or C++ code in the past, can now be scripted with a few lines and in addition executed in a fraction of the time. To put this even on a higher level, the Medical Open Network for Artificial Intelligence (MONAI) framework tailors medical imaging research to an even more convenient process, which can boost and push the whole field. The MONAI framework is a freely available, community-supported, open-source and PyTorch-based framework, that also enables to provide research contributions with pre-trained models to others. Codes and pre-trained weights for skull reconstruction are publicly available at: https://github.com/Project-MONAI/research-contributions/tree/master/SkullRec

eess.IV↗

arXiv2023

AI-based Aortic Vessel Tree Segmentation for Cardiovascular Diseases Treatment: Status Quo

The aortic vessel tree is composed of the aorta and its branching arteries, and plays a key role in supplying the whole body with blood. Aortic diseases, like aneurysms or dissections, can lead to an aortic rupture, whose treatment with open surgery is highly risky. Therefore, patients commonly undergo drug treatment under constant monitoring, which requires regular inspections of the vessels through imaging. The standard imaging modality for diagnosis and monitoring is computed tomography (CT), which can provide a detailed picture of the aorta and its branching vessels if completed with a contrast agent, called CT angiography (CTA). Optimally, the whole aortic vessel tree geometry from consecutive CTAs is overlaid and compared. This allows not only detection of changes in the aorta, but also of its branches, caused by the primary pathology or newly developed. When performed manually, this reconstruction requires slice by slice contouring, which could easily take a whole day for a single aortic vessel tree, and is therefore not feasible in clinical practice. Automatic or semi-automatic vessel tree segmentation algorithms, however, can complete this task in a fraction of the manual execution time and run in parallel to the clinical routine of the clinicians. In this paper, we systematically review computing techniques for the automatic and semi-automatic segmentation of the aortic vessel tree. The review concludes with an in-depth discussion on how close these state-of-the-art approaches are to an application in clinical practice and how active this research field is, taking into account the number of publications, datasets and challenges.

eess.IV↗

arXiv2023

Why is the winner the best?

International benchmarking competitions have become fundamental for the comparative performance assessment of image analysis methods. However, little attention has been given to investigating what can be learnt from these competitions. Do they really generate scientific progress? What are common and successful participation strategies? What makes a solution superior to a competing method? To address this gap in the literature, we performed a multi-center study with all 80 competitions that were conducted in the scope of IEEE ISBI 2021 and MICCAI 2021. Statistical analyses performed based on comprehensive descriptions of the submitted algorithms linked to their rank as well as the underlying participation strategies revealed common characteristics of winning solutions. These typically include the use of multi-task learning (63%) and/or multi-stage pipelines (61%), and a focus on augmentation (100%), image preprocessing (97%), data curation (79%), and postprocessing (66%). The "typical" lead of a winning team is a computer scientist with a doctoral degree, five years of experience in biomedical image analysis, and four years of experience in deep learning. Two core general development strategies stood out for highly-ranked teams: the reflection of the metrics in the method design and the focus on analyzing and handling failure cases. According to the organizers, 43% of the winning algorithms exceeded the state of the art but only 11% completely solved the respective domain problem. The insights of our study could help researchers (1) improve algorithm development strategies when approaching new problems, and (2) focus on open research questions revealed by this work.

cs.CV↗

arXiv2022

'A net for everyone': fully personalized and unsupervised neural networks trained with longitudinal data from a single patient

With the rise in importance of personalized medicine, we trained personalized neural networks to detect tumor progression in longitudinal datasets. The model was evaluated on two datasets with a total of 64 scans from 32 patients diagnosed with glioblastoma multiforme (GBM). Contrast-enhanced T1w sequences of brain magnetic resonance imaging (MRI) images were used in this study. For each patient, we trained their own neural network using just two images from different timepoints. Our approach uses a Wasserstein-GAN (generative adversarial network), an unsupervised network architecture, to map the differences between the two images. Using this map, the change in tumor volume can be evaluated. Due to the combination of data augmentation and the network architecture, co-registration of the two images is not needed. Furthermore, we do not rely on any additional training data, (manual) annotations or pre-training neural networks. The model received an AUC-score of 0.87 for tumor change. We also introduced a modified RANO criteria, for which an accuracy of 66% can be achieved. We show that using data from just one patient can be used to train deep neural networks to monitor tumor change.

cs.LG↗

arXiv2022

Valuing Vicinity: Memory attention framework for context-based semantic segmentation in histopathology

The segmentation of histopathological whole slide images into tumourous and non-tumourous types of tissue is a challenging task that requires the consideration of both local and global spatial contexts to classify tumourous regions precisely. The identification of subtypes of tumour tissue complicates the issue as the sharpness of separation decreases and the pathologist's reasoning is even more guided by spatial context. However, the identification of detailed types of tissue is crucial for providing personalized cancer therapies. Due to the high resolution of whole slide images, existing semantic segmentation methods, restricted to isolated image sections, are incapable of processing context information beyond. To take a step towards better context comprehension, we propose a patch neighbour attention mechanism to query the neighbouring tissue context from a patch embedding memory bank and infuse context embeddings into bottleneck hidden feature maps. Our memory attention framework (MAF) mimics a pathologist's annotation procedure -- zooming out and considering surrounding tissue context. The framework can be integrated into any encoder-decoder segmentation method. We evaluate the MAF on a public breast cancer and an internal kidney cancer data set using famous segmentation models (U-Net, DeeplabV3) and demonstrate the superiority over other context-integrating algorithms -- achieving a substantial improvement of up to $17\%$ on Dice score. The code is publicly available at: https://github.com/tio-ikim/valuing-vicinity

eess.IV↗

arXiv2022

AutoPET Challenge: Combining nn-Unet with Swin UNETR Augmented by Maximum Intensity Projection Classifier

Tumor volume and changes in tumor characteristics over time are important biomarkers for cancer therapy. In this context, FDG-PET/CT scans are routinely used for staging and re-staging of cancer, as the radiolabeled fluorodeoxyglucose is taken up in regions of high metabolism. Unfortunately, these regions with high metabolism are not specific to tumors and can also represent physiological uptake by normal functioning organs, inflammation, or infection, making detailed and reliable tumor segmentation in these scans a demanding task. This gap in research is addressed by the AutoPET challenge, which provides a public data set with FDG-PET/CT scans from 900 patients to encourage further improvement in this field. Our contribution to this challenge is an ensemble of two state-of-the-art segmentation models, the nn-Unet and the Swin UNETR, augmented by a maximum intensity projection classifier that acts like a gating mechanism. If it predicts the existence of lesions, both segmentations are combined by a late fusion approach. Our solution achieves a Dice score of 72.12\% on patients diagnosed with lung cancer, melanoma, and lymphoma in our cross-validation. Code: https://github.com/heiligerl/autopet_submission

eess.IV↗

arXiv2022

Training β-VAE by Aggregating a Learned Gaussian Posterior with a Decoupled Decoder

The reconstruction loss and the Kullback-Leibler divergence (KLD) loss in a variational autoencoder (VAE) often play antagonistic roles, and tuning the weight of the KLD loss in $β$-VAE to achieve a balance between the two losses is a tricky and dataset-specific task. As a result, current practices in VAE training often result in a trade-off between the reconstruction fidelity and the continuity$/$disentanglement of the latent space, if the weight $β$ is not carefully tuned. In this paper, we present intuitions and a careful analysis of the antagonistic mechanism of the two losses, and propose, based on the insights, a simple yet effective two-stage method for training a VAE. Specifically, the method aggregates a learned Gaussian posterior $z \sim q_θ (z|x)$ with a decoder decoupled from the KLD loss, which is trained to learn a new conditional distribution $p_ϕ (x|z)$ of the input data $x$. Experimentally, we show that the aggregated VAE maximally satisfies the Gaussian assumption about the latent space, while still achieves a reconstruction error comparable to when the latent space is only loosely regularized by $\mathcal{N}(\mathbf{0},I)$. The proposed approach does not require hyperparameter (i.e., the KLD weight $β$) tuning given a specific dataset as required in common VAE training practices. We evaluate the method using a medical dataset intended for 3D skull reconstruction and shape completion, and the results indicate promising generative capabilities of the VAE trained using the proposed method. Besides, through guided manipulation of the latent variables, we establish a connection between existing autoencoder (AE)-based approaches and generative approaches, such as VAE, for the shape completion problem. Codes and pre-trained weights are available at https://github.com/Jianningli/skullVAE

cs.CV↗

arXiv2022

The HoloLens in Medicine: A systematic Review and Taxonomy

The HoloLens (Microsoft Corp., Redmond, WA), a head-worn, optically see-through augmented reality display, is the main player in the recent boost in medical augmented reality research. In medical settings, the HoloLens enables the physician to obtain immediate insight into patient information, directly overlaid with their view of the clinical scenario, the medical student to gain a better understanding of complex anatomies or procedures, and even the patient to execute therapeutic tasks with improved, immersive guidance. In this systematic review, we provide a comprehensive overview of the usage of the first-generation HoloLens within the medical domain, from its release in March 2016, until the year of 2021, were attention is shifting towards it's successor, the HoloLens 2. We identified 171 relevant publications through a systematic search of the PubMed and Scopus databases. We analyze these publications in regard to their intended use case, technical methodology for registration and tracking, data sources, visualization as well as validation and evaluation. We find that, although the feasibility of using the HoloLens in various medical scenarios has been shown, increased efforts in the areas of precision, reliability, usability, workflow and perception are necessary to establish AR in clinical practice.

cs.HC↗

arXiv2022

Medical Deep Learning -- A systematic Meta-Review

Deep learning (DL) has remarkably impacted several different scientific disciplines over the last few years. E.g., in image processing and analysis, DL algorithms were able to outperform other cutting-edge methods. Additionally, DL has delivered state-of-the-art results in tasks like autonomous driving, outclassing previous attempts. There are even instances where DL outperformed humans, for example with object recognition and gaming. DL is also showing vast potential in the medical domain. With the collection of large quantities of patient records and data, and a trend towards personalized treatments, there is a great need for automated and reliable processing and analysis of health information. Patient data is not only collected in clinical centers, like hospitals and private practices, but also by mobile healthcare apps or online websites. The abundance of collected patient data and the recent growth in the DL field has resulted in a large increase in research efforts. In Q2/2020, the search engine PubMed returned already over 11,000 results for the search term 'deep learning', and around 90% of these publications are from the last three years. However, even though PubMed represents the largest search engine in the medical field, it does not cover all medical-related publications. Hence, a complete overview of the field of 'medical deep learning' is almost impossible to obtain and acquiring a full overview of medical sub-fields is becoming increasingly more difficult. Nevertheless, several review and survey articles about medical DL have been published within the last few years. They focus, in general, on specific medical scenarios, like the analysis of medical images containing specific pathologies. With these surveys as a foundation, the aim of this article is to provide the first high-level, systematic meta-review of medical DL surveys.

eess.IV↗

arXiv2022

Back to the Roots: Reconstructing Large and Complex Cranial Defects using an Image-based Statistical Shape Model

Designing implants for large and complex cranial defects is a challenging task, even for professional designers. Current efforts on automating the design process focused mainly on convolutional neural networks (CNN), which have produced state-of-the-art results on reconstructing synthetic defects. However, existing CNN-based methods have been difficult to translate to clinical practice in cranioplasty, as their performance on complex and irregular cranial defects remains unsatisfactory. In this paper, a statistical shape model (SSM) built directly on the segmentation masks of the skulls is presented. We evaluate the SSM on several cranial implant design tasks, and the results show that, while the SSM performs suboptimally on synthetic defects compared to CNN-based approaches, it is capable of reconstructing large and complex defects with only minor manual corrections. The quality of the resulting implants is examined and assured by experienced neurosurgeons. In contrast, CNN-based approaches, even with massive data augmentation, fail or produce less-than-satisfactory implants for these cases. Codes are publicly available at https://github.com/Jianningli/ssm

cs.CV↗

arXiv2022

Review of Disentanglement Approaches for Medical Applications -- Towards Solving the Gordian Knot of Generative Models in Healthcare

Deep neural networks are commonly used for medical purposes such as image generation, segmentation, or classification. Besides this, they are often criticized as black boxes as their decision process is often not human interpretable. Encouraging the latent representation of a generative model to be disentangled offers new perspectives of control and interpretability. Understanding the data generation process could help to create artificial medical data sets without violating patient privacy, synthesizing different data modalities, or discovering data generating characteristics. These characteristics might unravel novel relationships that can be related to genetic traits or patient outcomes. In this paper, we give a comprehensive overview of popular generative models, like Generative Adversarial Networks (GANs), Variational Autoencoders (VAEs), and Flow-based Models. Furthermore, we summarize the different notions of disentanglement, review approaches to disentangle latent space representations and metrics to evaluate the degree of disentanglement. After introducing the theoretical frameworks, we give an overview of recent medical applications and discuss the impact and importance of disentanglement approaches for medical applications.

cs.LG↗

arXiv2022

Stochastic Modeling of Inhomogeneities in the Aortic Wall and Uncertainty Quantification using a Bayesian Encoder-Decoder Surrogate

Inhomogeneities in the aortic wall can lead to localized stress accumulations, possibly initiating dissection. In many cases, a dissection results from pathological changes such as fragmentation or loss of elastic fibers. But it has been shown that even the healthy aortic wall has an inherent heterogeneous microstructure. Some parts of the aorta are particularly susceptible to the development of inhomogeneities due to pathological changes, however, the distribution in the aortic wall and the spatial extent, such as size, shape, and type, are difficult to predict. Motivated by this observation, we describe the heterogeneous distribution of elastic fiber degradation in the dissected aortic wall using a stochastic constitutive model. For this purpose, random field realizations, which model the stochastic distribution of degraded elastic fibers, are generated over a non-equidistant grid. The random field then serves as input for a uni-axial extension test of the pathological aortic wall, solved with the finite-element (FE) method. To include the microstructure of the dissected aortic wall, a constitutive model developed in a previous study is applied, which also includes an approach to model the degradation of inter-lamellar elastic fibers. Then to assess the uncertainty in the output stress distribution due to this stochastic constitutive model, a convolutional neural network, specifically a Bayesian encoder-decoder, was used as a surrogate model that maps the random input fields to the output stress distribution obtained from the FE analysis. The results show that the neural network is able to predict the stress distribution of the FE analysis while significantly reducing the computational time. In addition, it provides the probability for exceeding critical stresses within the aortic wall, which could allow for the prediction of delamination or fatal rupture.

stat.ML↗

arXiv2021

MOMO -- Deep Learning-driven classification of external DICOM studies for PACS archivation

Patients regularly continue assessment or treatment in other facilities than they began them in, receiving their previous imaging studies as a CD-ROM and requiring clinical staff at the new hospital to import these studies into their local database. However, between different facilities, standards for nomenclature, contents, or even medical procedures may vary, often requiring human intervention to accurately classify the received studies in the context of the recipient hospital's standards. In this study, the authors present MOMO (MOdality Mapping and Orchestration), a deep learning-based approach to automate this mapping process utilizing metadata substring matching and a neural network ensemble, which is trained to recognize the 76 most common imaging studies across seven different modalities. A retrospective study is performed to measure the accuracy that this algorithm can provide. To this end, a set of 11,934 imaging series with existing labels was retrieved from the local hospital's PACS database to train the neural networks. A set of 843 completely anonymized external studies was hand-labeled to assess the performance of our algorithm. Additionally, an ablation study was performed to measure the performance impact of the network ensemble in the algorithm, and a comparative performance test with a commercial product was conducted. In comparison to a commercial product (96.20% predictive power, 82.86% accuracy, 1.36% minor errors), a neural network ensemble alone performs the classification task with less accuracy (99.05% predictive power, 72.69% accuracy, 10.3% minor errors). However, MOMO outperforms either by a large margin in accuracy and with increased predictive power (99.29% predictive power, 92.71% accuracy, 2.63% minor errors).

cs.LG↗

arXiv2021

Automated cross-sectional view selection in CT angiography of aortic dissections with uncertainty awareness and retrospective clinical annotations

Objective: Surveillance imaging of chronic aortic diseases, such as dissections, relies on obtaining and comparing cross-sectional diameter measurements at predefined aortic landmarks, over time. Due to a lack of robust tools, the orientation of the cross-sectional planes is defined manually by highly trained operators. We show how manual annotations routinely collected in a clinic can be efficiently used to ease this task, despite the presence of a non-negligible interoperator variability in the measurements. Impact: Ill-posed but repetitive imaging tasks can be eased or automated by leveraging imperfect, retrospective clinical annotations. Methodology: In this work, we combine convolutional neural networks and uncertainty quantification methods to predict the orientation of such cross-sectional planes. We use clinical data randomly processed by 11 operators for training, and test on a smaller set processed by 3 independent operators to assess interoperator variability. Results: Our analysis shows that manual selection of cross-sectional planes is characterized by 95% limits of agreement (LOA) of $10.6^\circ$ and $21.4^\circ$ per angle. Our method showed to decrease static error by $3.57^\circ$ ($40.2$%) and $4.11^\circ$ ($32.8$%) against state of the art and LOA by $5.4^\circ$ ($49.0$%) and $16.0^\circ$ ($74.6$%) against manual processing. Conclusion: This suggests that pre-existing annotations can be an inexpensive resource in clinics to ease ill-posed and repetitive tasks like cross-section extraction for surveillance of aortic dissections.

eess.IV↗

arXiv2021

Deep Learning -- A first Meta-Survey of selected Reviews across Scientific Disciplines, their Commonalities, Challenges and Research Impact

Deep learning belongs to the field of artificial intelligence, where machines perform tasks that typically require some kind of human intelligence. Similar to the basic structure of a brain, a deep learning algorithm consists of an artificial neural network, which resembles the biological brain structure. Mimicking the learning process of humans with their senses, deep learning networks are fed with (sensory) data, like texts, images, videos or sounds. These networks outperform the state-of-the-art methods in different tasks and, because of this, the whole field saw an exponential growth during the last years. This growth resulted in way over 10,000 publications per year in the last years. For example, the search engine PubMed alone, which covers only a sub-set of all publications in the medical field, provides already over 11,000 results in Q3 2020 for the search term 'deep learning', and around 90% of these results are from the last three years. Consequently, a complete overview over the field of deep learning is already impossible to obtain and, in the near future, it will potentially become difficult to obtain an overview over a subfield. However, there are several review articles about deep learning, which are focused on specific scientific fields or applications, for example deep learning advances in computer vision or in specific tasks like object detection. With these surveys as a foundation, the aim of this contribution is to provide a first high-level, categorized meta-survey of selected reviews on deep learning across different scientific disciplines. The categories (computer vision, language processing, medical informatics and additional works) have been chosen according to the underlying data sources (image, language, medical, mixed). In addition, we review the common architectures, methods, pros, cons, evaluations, challenges and future directions for every sub-category.

cs.DL↗