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Jelmer M. Wolterink

Publications and source records attributed to Jelmer M. Wolterink.

At least 37 records · Page 2Linked to original sources

LaB-GATr: geometric algebra transformers for large biomedical surface and volume meshes

Many anatomical structures can be described by surface or volume meshes. Machine learning is a promising tool to extract information from these 3D models. However, high-fidelity meshes often contain hundreds of thousands of vertices, which creates unique challenges in building deep neural network architectures. Furthermore, patient-specific meshes may not be canonically aligned which limits the generalisation of machine learning algorithms. We propose LaB-GATr, a transfomer neural network with geometric tokenisation that can effectively learn with large-scale (bio-)medical surface and volume meshes through sequence compression and interpolation. Our method extends the recently proposed geometric algebra transformer (GATr) and thus respects all Euclidean symmetries, i.e. rotation, translation and reflection, effectively mitigating the problem of canonical alignment between patients. LaB-GATr achieves state-of-the-art results on three tasks in cardiovascular hemodynamics modelling and neurodevelopmental phenotype prediction, featuring meshes of up to 200,000 vertices. Our results demonstrate that LaB-GATr is a powerful architecture for learning with high-fidelity meshes which has the potential to enable interesting downstream applications. Our implementation is publicly available.

cs.CV↗

Global Control for Local SO(3)-Equivariant Scale-Invariant Vessel Segmentation

Personalized 3D vascular models can aid in a range of diagnostic, prognostic, and treatment-planning tasks relevant to cardiovascular disease management. Deep learning provides a means to obtain such models automatically from image data. Ideally, a user should have control over the included region in the vascular model. Additionally, the model should be watertight and highly accurate. To this end, we propose a combination of a global controller leveraging voxel mask segmentations to provide boundary conditions for vessels of interest to a local, iterative vessel segmentation model. We introduce the preservation of scale- and rotational symmetries in the local segmentation model, leading to generalisation to vessels of unseen sizes and orientations. Combined with the global controller, this enables flexible 3D vascular model building, without additional retraining. We demonstrate the potential of our method on a dataset containing abdominal aortic aneurysms (AAAs). Our method performs on par with a state-of-the-art segmentation model in the segmentation of AAAs, iliac arteries, and renal arteries, while providing a watertight, smooth surface representation. Moreover, we demonstrate that by adapting the global controller, we can easily extend vessel sections in the 3D model.

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Neural Fields for Continuous Periodic Motion Estimation in 4D Cardiovascular Imaging

Time-resolved three-dimensional flow MRI (4D flow MRI) provides a unique non-invasive solution to visualize and quantify hemodynamics in blood vessels such as the aortic arch. However, most current analysis methods for arterial 4D flow MRI use static artery walls because of the difficulty in obtaining a full cycle segmentation. To overcome this limitation, we propose a neural fields-based method that directly estimates continuous periodic wall deformations throughout the cardiac cycle. For a 3D + time imaging dataset, we optimize an implicit neural representation (INR) that represents a time-dependent velocity vector field (VVF). An ODE solver is used to integrate the VVF into a deformation vector field (DVF), that can deform images, segmentation masks, or meshes over time, thereby visualizing and quantifying local wall motion patterns. To properly reflect the periodic nature of 3D + time cardiovascular data, we impose periodicity in two ways. First, by periodically encoding the time input to the INR, and hence VVF. Second, by regularizing the DVF. We demonstrate the effectiveness of this approach on synthetic data with different periodic patterns, ECG-gated CT, and 4D flow MRI data. The obtained method could be used to improve 4D flow MRI analysis.

cs.CV↗

Mesh Neural Networks for SE(3)-Equivariant Hemodynamics Estimation on the Artery Wall

Computational fluid dynamics (CFD) is a valuable asset for patient-specific cardiovascular-disease diagnosis and prognosis, but its high computational demands hamper its adoption in practice. Machine-learning methods that estimate blood flow in individual patients could accelerate or replace CFD simulation to overcome these limitations. In this work, we consider the estimation of vector-valued quantities on the wall of three-dimensional geometric artery models. We employ group equivariant graph convolution in an end-to-end SE(3)-equivariant neural network that operates directly on triangular surface meshes and makes efficient use of training data. We run experiments on a large dataset of synthetic coronary arteries and find that our method estimates directional wall shear stress (WSS) with an approximation error of 7.6% and normalised mean absolute error (NMAE) of 0.4% while up to two orders of magnitude faster than CFD. Furthermore, we show that our method is powerful enough to accurately predict transient, vector-valued WSS over the cardiac cycle while conditioned on a range of different inflow boundary conditions. These results demonstrate the potential of our proposed method as a plugin replacement for CFD in the personalised prediction of hemodynamic vector and scalar fields.

cs.LG↗

Vestibular schwannoma growth prediction from longitudinal MRI by time conditioned neural fields

Vestibular schwannomas (VS) are benign tumors that are generally managed by active surveillance with MRI examination. To further assist clinical decision-making and avoid overtreatment, an accurate prediction of tumor growth based on longitudinal imaging is highly desirable. In this paper, we introduce DeepGrowth, a deep learning method that incorporates neural fields and recurrent neural networks for prospective tumor growth prediction. In the proposed method, each tumor is represented as a signed distance function (SDF) conditioned on a low-dimensional latent code. Unlike previous studies that perform tumor shape prediction directly in the image space, we predict the latent codes instead and then reconstruct future shapes from it. To deal with irregular time intervals, we introduce a time-conditioned recurrent module based on a ConvLSTM and a novel temporal encoding strategy, which enables the proposed model to output varying tumor shapes over time. The experiments on an in-house longitudinal VS dataset showed that the proposed model significantly improved the performance ($\ge 1.6\%$ Dice score and $\ge0.20$ mm 95\% Hausdorff distance), in particular for top 20\% tumors that grow or shrink the most ($\ge 4.6\%$ Dice score and $\ge 0.73$ mm 95\% Hausdorff distance). Our code is available at ~\burl{https://github.com/cyjdswx/DeepGrowth}

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Neural Fields for 3D Tracking of Anatomy and Surgical Instruments in Monocular Laparoscopic Video Clips

Laparoscopic video tracking primarily focuses on two target types: surgical instruments and anatomy. The former could be used for skill assessment, while the latter is necessary for the projection of virtual overlays. Where instrument and anatomy tracking have often been considered two separate problems, in this paper, we propose a method for joint tracking of all structures simultaneously. Based on a single 2D monocular video clip, we train a neural field to represent a continuous spatiotemporal scene, used to create 3D tracks of all surfaces visible in at least one frame. Due to the small size of instruments, they generally cover a small part of the image only, resulting in decreased tracking accuracy. Therefore, we propose enhanced class weighting to improve the instrument tracks. We evaluate tracking on video clips from laparoscopic cholecystectomies, where we find mean tracking accuracies of 92.4% for anatomical structures and 87.4% for instruments. Additionally, we assess the quality of depth maps obtained from the method's scene reconstructions. We show that these pseudo-depths have comparable quality to a state-of-the-art pre-trained depth estimator. On laparoscopic videos in the SCARED dataset, the method predicts depth with an MAE of 2.9 mm and a relative error of 9.2%. These results show the feasibility of using neural fields for monocular 3D reconstruction of laparoscopic scenes.

cs.CV↗

Brain-Shift: Unsupervised Pseudo-Healthy Brain Synthesis for Novel Biomarker Extraction in Chronic Subdural Hematoma

Chronic subdural hematoma (cSDH) is a common neurological condition characterized by the accumulation of blood between the brain and the dura mater. This accumulation of blood can exert pressure on the brain, potentially leading to fatal outcomes. Treatment options for cSDH are limited to invasive surgery or non-invasive management. Traditionally, the midline shift, hand-measured by experts from an ideal sagittal plane, and the hematoma volume have been the primary metrics for quantifying and analyzing cSDH. However, these approaches do not quantify the local 3D brain deformation caused by cSDH. We propose a novel method using anatomy-aware unsupervised diffeomorphic pseudo-healthy synthesis to generate brain deformation fields. The deformation fields derived from this process are utilized to extract biomarkers that quantify the shift in the brain due to cSDH. We use CT scans of 121 patients for training and validation of our method and find that our metrics allow the identification of patients who require surgery. Our results indicate that automatically obtained brain deformation fields might contain prognostic value for personalized cSDH treatment. Our implementation is available on: github.com/Barisimre/brain-morphing

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CoNeS: Conditional neural fields with shift modulation for multi-sequence MRI translation

Multi-sequence magnetic resonance imaging (MRI) has found wide applications in both modern clinical studies and deep learning research. However, in clinical practice, it frequently occurs that one or more of the MRI sequences are missing due to different image acquisition protocols or contrast agent contraindications of patients, limiting the utilization of deep learning models trained on multi-sequence data. One promising approach is to leverage generative models to synthesize the missing sequences, which can serve as a surrogate acquisition. State-of-the-art methods tackling this problem are based on convolutional neural networks (CNN) which usually suffer from spectral biases, resulting in poor reconstruction of high-frequency fine details. In this paper, we propose Conditional Neural fields with Shift modulation (CoNeS), a model that takes voxel coordinates as input and learns a representation of the target images for multi-sequence MRI translation. The proposed model uses a multi-layer perceptron (MLP) instead of a CNN as the decoder for pixel-to-pixel mapping. Hence, each target image is represented as a neural field that is conditioned on the source image via shift modulation with a learned latent code. Experiments on BraTS 2018 and an in-house clinical dataset of vestibular schwannoma patients showed that the proposed method outperformed state-of-the-art methods for multi-sequence MRI translation both visually and quantitatively. Moreover, we conducted spectral analysis, showing that CoNeS was able to overcome the spectral bias issue common in conventional CNN models. To further evaluate the usage of synthesized images in clinical downstream tasks, we tested a segmentation network using the synthesized images at inference.

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Quantifying white matter hyperintensity and brain volumes in heterogeneous clinical and low-field portable MRI

Brain atrophy and white matter hyperintensity (WMH) are critical neuroimaging features for ascertaining brain injury in cerebrovascular disease and multiple sclerosis. Automated segmentation and quantification is desirable but existing methods require high-resolution MRI with good signal-to-noise ratio (SNR). This precludes application to clinical and low-field portable MRI (pMRI) scans, thus hampering large-scale tracking of atrophy and WMH progression, especially in underserved areas where pMRI has huge potential. Here we present a method that segments white matter hyperintensity and 36 brain regions from scans of any resolution and contrast (including pMRI) without retraining. We show results on eight public datasets and on a private dataset with paired high- and low-field scans (3T and 64mT), where we attain strong correlation between the WMH ($ρ$=.85) and hippocampal volumes (r=.89) estimated at both fields. Our method is publicly available as part of FreeSurfer, at: http://surfer.nmr.mgh.harvard.edu/fswiki/WMH-SynthSeg.

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SIRE: scale-invariant, rotation-equivariant estimation of artery orientations using graph neural networks

Blood vessel orientation as visualized in 3D medical images is an important descriptor of its geometry that can be used for centerline extraction and subsequent segmentation and visualization. Arteries appear at many scales and levels of tortuosity, and determining their exact orientation is challenging. Recent works have used 3D convolutional neural networks (CNNs) for this purpose, but CNNs are sensitive to varying vessel sizes and orientations. We present SIRE: a scale-invariant, rotation-equivariant estimator for local vessel orientation. SIRE is modular and can generalise due to symmetry preservation. SIRE consists of a gauge equivariant mesh CNN (GEM-CNN) operating on multiple nested spherical meshes with different sizes in parallel. The features on each mesh are a projection of image intensities within the corresponding sphere. These features are intrinsic to the sphere and, in combination with the GEM-CNN, lead to SO(3)-equivariance. Approximate scale invariance is achieved by weight sharing and use of a symmetric maximum function to combine multi-scale predictions. Hence, SIRE can be trained with arbitrarily oriented vessels with varying radii to generalise to vessels with a wide range of calibres and tortuosity. We demonstrate the efficacy of SIRE using three datasets containing vessels of varying scales: the vascular model repository (VMR), the ASOCA coronary artery set, and a set of abdominal aortic aneurysms (AAAs). We embed SIRE in a centerline tracker which accurately tracks AAAs, regardless of the data SIRE is trained with. Moreover, SIRE can be used to track coronary arteries, even when trained only with AAAs. In conclusion, by incorporating SO(3) and scale symmetries, SIRE can determine the orientations of vessels outside of the training domain, forming a robust and data-efficient solution to geometric analysis of blood vessels in 3D medical images.

cs.CV↗

Generative modeling of living cells with SO(3)-equivariant implicit neural representations

Data-driven cell tracking and segmentation methods in biomedical imaging require diverse and information-rich training data. In cases where the number of training samples is limited, synthetic computer-generated data sets can be used to improve these methods. This requires the synthesis of cell shapes as well as corresponding microscopy images using generative models. To synthesize realistic living cell shapes, the shape representation used by the generative model should be able to accurately represent fine details and changes in topology, which are common in cells. These requirements are not met by 3D voxel masks, which are restricted in resolution, and polygon meshes, which do not easily model processes like cell growth and mitosis. In this work, we propose to represent living cell shapes as level sets of signed distance functions (SDFs) which are estimated by neural networks. We optimize a fully-connected neural network to provide an implicit representation of the SDF value at any point in a 3D+time domain, conditioned on a learned latent code that is disentangled from the rotation of the cell shape. We demonstrate the effectiveness of this approach on cells that exhibit rapid deformations (Platynereis dumerilii), cells that grow and divide (C. elegans), and cells that have growing and branching filopodial protrusions (A549 human lung carcinoma cells). A quantitative evaluation using shape features and Dice similarity coefficients of real and synthetic cell shapes shows that our model can generate topologically plausible complex cell shapes in 3D+time with high similarity to real living cell shapes. Finally, we show how microscopy images of living cells that correspond to our generated cell shapes can be synthesized using an image-to-image model.

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Local Implicit Neural Representations for Multi-Sequence MRI Translation

In radiological practice, multi-sequence MRI is routinely acquired to characterize anatomy and tissue. However, due to the heterogeneity of imaging protocols and contra-indications to contrast agents, some MRI sequences, e.g. contrast-enhanced T1-weighted image (T1ce), may not be acquired. This creates difficulties for large-scale clinical studies for which heterogeneous datasets are aggregated. Modern deep learning techniques have demonstrated the capability of synthesizing missing sequences from existing sequences, through learning from an extensive multi-sequence MRI dataset. In this paper, we propose a novel MR image translation solution based on local implicit neural representations. We split the available MRI sequences into local patches and assign to each patch a local multi-layer perceptron (MLP) that represents a patch in the T1ce. The parameters of these local MLPs are generated by a hypernetwork based on image features. Experimental results and ablation studies on the BraTS challenge dataset showed that the local MLPs are critical for recovering fine image and tumor details, as they allow for local specialization that is highly important for accurate image translation. Compared to a classical pix2pix model, the proposed method demonstrated visual improvement and significantly improved quantitative scores (MSE 0.86 x 10^-3 vs. 1.02 x 10^-3 and SSIM 94.9 vs 94.3)

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Dynamic Depth-Supervised NeRF for Multi-View RGB-D Operating Room Images

The operating room (OR) is an environment of interest for the development of sensing systems, enabling the detection of people, objects, and their semantic relations. Due to frequent occlusions in the OR, these systems often rely on input from multiple cameras. While increasing the number of cameras generally increases algorithm performance, there are hard limitations to the number and locations of cameras in the OR. Neural Radiance Fields (NeRF) can be used to render synthetic views from arbitrary camera positions, virtually enlarging the number of cameras in the dataset. In this work, we explore the use of NeRF for view synthesis of dynamic scenes in the OR, and we show that regularisation with depth supervision from RGB-D sensor data results in higher image quality. We optimise a dynamic depth-supervised NeRF with up to six synchronised cameras that capture the surgical field in five distinct phases before and during a knee replacement surgery. We qualitatively inspect views rendered by a virtual camera that moves 180 degrees around the surgical field at differing time values. Quantitatively, we evaluate view synthesis from an unseen camera position in terms of PSNR, SSIM and LPIPS for the colour channels and in MAE and error percentage for the estimated depth. We find that NeRFs can be used to generate geometrically consistent views, also from interpolated camera positions and at interpolated time intervals. Views are generated from an unseen camera pose with an average PSNR of 18.2 and a depth estimation error of 2.0%. Our results show the potential of a dynamic NeRF for view synthesis in the OR and stress the relevance of depth supervision in a clinical setting.

cs.CV↗

Uncertainty-based quality assurance of carotid artery wall segmentation in black-blood MRI

The application of deep learning models to large-scale data sets requires means for automatic quality assurance. We have previously developed a fully automatic algorithm for carotid artery wall segmentation in black-blood MRI that we aim to apply to large-scale data sets. This method identifies nested artery walls in 3D patches centered on the carotid artery. In this study, we investigate to what extent the uncertainty in the model predictions for the contour location can serve as a surrogate for error detection and, consequently, automatic quality assurance. We express the quality of automatic segmentations using the Dice similarity coefficient. The uncertainty in the model's prediction is estimated using either Monte Carlo dropout or test-time data augmentation. We found that (1) including uncertainty measurements did not degrade the quality of the segmentations, (2) uncertainty metrics provide a good proxy of the quality of our contours if the center found during the first step is enclosed in the lumen of the carotid artery and (3) they could be used to detect low-quality segmentations at the participant level. This automatic quality assurance tool might enable the application of our model in large-scale data sets.

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SE(3) symmetry lets graph neural networks learn arterial velocity estimation from small datasets

Hemodynamic velocity fields in coronary arteries could be the basis of valuable biomarkers for diagnosis, prognosis and treatment planning in cardiovascular disease. Velocity fields are typically obtained from patient-specific 3D artery models via computational fluid dynamics (CFD). However, CFD simulation requires meticulous setup by experts and is time-intensive, which hinders large-scale acceptance in clinical practice. To address this, we propose graph neural networks (GNN) as an efficient black-box surrogate method to estimate 3D velocity fields mapped to the vertices of tetrahedral meshes of the artery lumen. We train these GNNs on synthetic artery models and CFD-based ground truth velocity fields. Once the GNN is trained, velocity estimates in a new and unseen artery can be obtained with 36-fold speed-up compared to CFD. We demonstrate how to construct an SE(3)-equivariant GNN that is independent of the spatial orientation of the input mesh and show how this reduces the necessary amount of training data compared to a baseline neural network.

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The ACROBAT 2022 Challenge: Automatic Registration Of Breast Cancer Tissue

The alignment of tissue between histopathological whole-slide-images (WSI) is crucial for research and clinical applications. Advances in computing, deep learning, and availability of large WSI datasets have revolutionised WSI analysis. Therefore, the current state-of-the-art in WSI registration is unclear. To address this, we conducted the ACROBAT challenge, based on the largest WSI registration dataset to date, including 4,212 WSIs from 1,152 breast cancer patients. The challenge objective was to align WSIs of tissue that was stained with routine diagnostic immunohistochemistry to its H&E-stained counterpart. We compare the performance of eight WSI registration algorithms, including an investigation of the impact of different WSI properties and clinical covariates. We find that conceptually distinct WSI registration methods can lead to highly accurate registration performances and identify covariates that impact performances across methods. These results establish the current state-of-the-art in WSI registration and guide researchers in selecting and developing methods.

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Implicit Neural Representations for Modeling of Abdominal Aortic Aneurysm Progression

Abdominal aortic aneurysms (AAAs) are progressive dilatations of the abdominal aorta that, if left untreated, can rupture with lethal consequences. Imaging-based patient monitoring is required to select patients eligible for surgical repair. In this work, we present a model based on implicit neural representations (INRs) to model AAA progression. We represent the AAA wall over time as the zero-level set of a signed distance function (SDF), estimated by a multilayer perception that operates on space and time. We optimize this INR using automatically extracted segmentation masks in longitudinal CT data. This network is conditioned on spatiotemporal coordinates and represents the AAA surface at any desired resolution at any moment in time. Using regularization on spatial and temporal gradients of the SDF, we ensure proper interpolation of the AAA shape. We demonstrate the network's ability to produce AAA interpolations with average surface distances ranging between 0.72 and 2.52 mm from images acquired at highly irregular intervals. The results indicate that our model can accurately interpolate AAA shapes over time, with potential clinical value for a more personalised assessment of AAA progression.

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3D Human Pose Estimation in Multi-View Operating Room Videos Using Differentiable Camera Projections

3D human pose estimation in multi-view operating room (OR) videos is a relevant asset for person tracking and action recognition. However, the surgical environment makes it challenging to find poses due to sterile clothing, frequent occlusions, and limited public data. Methods specifically designed for the OR are generally based on the fusion of detected poses in multiple camera views. Typically, a 2D pose estimator such as a convolutional neural network (CNN) detects joint locations. Then, the detected joint locations are projected to 3D and fused over all camera views. However, accurate detection in 2D does not guarantee accurate localisation in 3D space. In this work, we propose to directly optimise for localisation in 3D by training 2D CNNs end-to-end based on a 3D loss that is backpropagated through each camera's projection parameters. Using videos from the MVOR dataset, we show that this end-to-end approach outperforms optimisation in 2D space.

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