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Johannes Brandt

Publications and source records attributed to Johannes Brandt.

5 recordsLinked to original sources

Big, Bright, or Invisible: A Frozen-Feature Benchmark of 3D CT Foundation Models

Routine CT interpretation is inherently comprehensive, capturing incidental findings across the entire scan volume. 3D CT foundation models could assist this process by providing generalizable representations of anatomy and pathology. To evaluate their diagnostic breadth, we benchmark ten frozen CT encoders across three cohorts of thoracic CT scans, including an unseen internal clinical dataset, using $k$-nearest neighbors, zero-shot prompting, and linear probing. We find no universal state-of-the-art, with rankings fluctuating significantly depending on the evaluation context. While models combining fine-grained image tokenization with vision-language alignment generally perform best, a lightweight supervised encoder remains highly competitive, demonstrating that explicit labels can effectively substitute for scale. Crucially, rather than model architecture, we observe that the primary determinant of performance is a physical bottleneck: a finding's detectability scales with its contrast against surrounding tissue and its spatial extent. Through controlled within-organ comparisons, we empirically demonstrate that widespread or high-contrast abnormalities, such as devices and effusions, are reliably recovered. Conversely, small, low-contrast focal lesions remain a persistent challenge across all evaluated encoders. We attribute this to the inherent limitations of globally pooled embeddings, suggesting that accurately representing small, low-contrast structures will require region- or lesion-level pretraining.

cs.CV↗

LungEvaty: A Scalable, Open-Source Transformer-based Deep Learning Model for Lung Cancer Risk Prediction in LDCT Screening

Lung cancer risk estimation is gaining increasing importance as more countries introduce population-wide screening programs using low-dose CT (LDCT). As imaging volumes grow, scalable methods that can process entire lung volumes efficiently are essential to tap into the full potential of these large screening datasets. Existing approaches either over-rely on pixel-level annotations, limiting scalability, or analyze the lung in fragments, weakening performance. We present LungEvaty, a fully transformer-based framework for predicting 1-6 year lung cancer risk from a single LDCT scan. The model operates on whole-lung inputs, learning directly from large-scale screening data to capture comprehensive anatomical and pathological cues relevant for malignancy risk. Using only imaging data and no region supervision, LungEvaty matches state-of-the-art performance, refinable by an optional Anatomically Informed Attention Guidance (AIAG) loss that encourages anatomically focused attention. In total, LungEvaty was trained on more than 90,000 CT scans, including over 28,000 for fine-tuning and 6,000 for evaluation. The framework offers a simple, data-efficient, and fully open-source solution that provides an extensible foundation for future research in longitudinal and multimodal lung cancer risk prediction.

cs.CV↗

Interpretable 2D Vision Models for 3D Medical Images

Training Artificial Intelligence (AI) models on 3D images presents unique challenges compared to the 2D case: Firstly, the demand for computational resources is significantly higher, and secondly, the availability of large datasets for pre-training is often limited, impeding training success. This study proposes a simple approach of adapting 2D networks with an intermediate feature representation for processing 3D images. Our method employs attention pooling to learn to assign each slice an importance weight and, by that, obtain a weighted average of all 2D slices. These weights directly quantify the contribution of each slice to the contribution and thus make the model prediction inspectable. We show on all 3D MedMNIST datasets as benchmark and two real-world datasets consisting of several hundred high-resolution CT or MRI scans that our approach performs on par with existing methods. Furthermore, we compare the in-built interpretability of our approach to HiResCam, a state-of-the-art retrospective interpretability approach.

eess.IV↗

Reconciling AI Performance and Data Reconstruction Resilience for Medical Imaging

Artificial Intelligence (AI) models are vulnerable to information leakage of their training data, which can be highly sensitive, for example in medical imaging. Privacy Enhancing Technologies (PETs), such as Differential Privacy (DP), aim to circumvent these susceptibilities. DP is the strongest possible protection for training models while bounding the risks of inferring the inclusion of training samples or reconstructing the original data. DP achieves this by setting a quantifiable privacy budget. Although a lower budget decreases the risk of information leakage, it typically also reduces the performance of such models. This imposes a trade-off between robust performance and stringent privacy. Additionally, the interpretation of a privacy budget remains abstract and challenging to contextualize. In this study, we contrast the performance of AI models at various privacy budgets against both, theoretical risk bounds and empirical success of reconstruction attacks. We show that using very large privacy budgets can render reconstruction attacks impossible, while drops in performance are negligible. We thus conclude that not using DP -- at all -- is negligent when applying AI models to sensitive data. We deem those results to lie a foundation for further debates on striking a balance between privacy risks and model performance.

cs.CR↗

Anatomy-Driven Pathology Detection on Chest X-rays

Pathology detection and delineation enables the automatic interpretation of medical scans such as chest X-rays while providing a high level of explainability to support radiologists in making informed decisions. However, annotating pathology bounding boxes is a time-consuming task such that large public datasets for this purpose are scarce. Current approaches thus use weakly supervised object detection to learn the (rough) localization of pathologies from image-level annotations, which is however limited in performance due to the lack of bounding box supervision. We therefore propose anatomy-driven pathology detection (ADPD), which uses easy-to-annotate bounding boxes of anatomical regions as proxies for pathologies. We study two training approaches: supervised training using anatomy-level pathology labels and multiple instance learning (MIL) with image-level pathology labels. Our results show that our anatomy-level training approach outperforms weakly supervised methods and fully supervised detection with limited training samples, and our MIL approach is competitive with both baseline approaches, therefore demonstrating the potential of our approach.

cs.CV↗