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Jordina Aviles Verdera

Publications and source records attributed to Jordina Aviles Verdera.

14 recordsLinked to original sources

STORK: Spatio-Temporal Observation of uterine contRactions via neural networKs

Uterine contractions in fetal MRI are typically identified manually and discarded, limiting insights into contraction dynamics. We formalize Uterine Contractile Activity Detection (UCAD) as a weakly-supervised learning problem and introduce STORK, a multi-instance learning model trained on dynamic MRI series using only coarse, series-level labels. STORK factorizes 3D spatio-temporal convolutions into parallel branches across temporal hyperplanes to capture coherent tissue motion without the cost of full 4D convolutions. Per-frame embeddings, combining intensity and Demons-estimated displacement fields, are aggregated by a linear mean-pooling head. This ensures that frame-level contraction scores can be recovered post-hoc without frame-level training supervision. Evaluated on around 700 multi-vendor dynamic fetal MRI series, STORK achieves a series-level AUROC of 95.0% and AUPRC of 94.6%, substantially outperforming 3D ResNet and ConvNeXt baselines. Grad-CAM analysis suggests that the model draws on predictive features extending beyond the placenta into the uterine tissue, offering an automated tool for richer phenotyping of uterine behavior.

cs.CV↗

Unsupervised Adversarial Domain Adaptation for Uterine layer Segmentation: From Labeled Cine to Unlabeled Dynamic EPI MRI

Uterine peristalsis is a key physiological phenomenon responsible for various functions across the menstrual cycle, intimately linked to uterine wall microstructure. Alterations in uterine motion and tissue properties are implicated in the etiology of gynecological diseases, yet these processes have been studied in isolation. We introduce a dynamic multi-echo gradient echo EPI framework for simultaneous characterization and correlation of uterine peristaltic activity and time-resolved T2* changes at 0.55T. Inherent susceptibility artifacts, reduced resolution, and burden of manual uterine layer annotation are addressed by an unsupervised adversarial domain adaptation framework, transferring segmentation knowledge from labeled cine MRI to unlabeled dynamic EPI. We implemented Unet-LSTM with multi-scale domain discriminators that exploits temporal layer dynamics. A Dice score of 0.88 and Jaccard index of 0.80 was achieved. Mean T2* values were 108ms, 76ms, and 124ms for the myometrium, junctional zone, and endometrium. A negative correlation between junctional zone area and T2* was observed in 14/39 cases, providing first insights into oxygenation patterns associated with junctional zone contraction and motion, demonstrating feasibility of assessing the interplay between contractility and dynamic T2* changes.

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Panda: Unsupervised Pelvic Anomaly Detection for Real-Time MR Imaging

Female pelvic diseases remain an under researched area characterized by often delayed diagnosis. While pelvic MRI offers superior soft-tissue contrast for diagnosis and image-guided procedures, real-time anomaly detection remains challenging due to physiological motion, tissue deformation, and instrument artifacts. Existing supervised approaches are impractical, as adverse events are rare, heterogeneous, and difficult to annotate. We present a Dinomaly-based unsupervised anomaly detection framework adapted for pelvic MRI that learns normative representations from healthy cases and flags deviations without requiring labels. Our approach leverages a frozen DINOv3 Vision Transformer encoder combined with a noisy MLP bottleneck and Linear Attention decoder to prevent identity mapping while maintaining computational efficiency. Anomalies are localized via per-token cosine distance between encoder and decoder representations, yielding spatial anomaly maps that provide immediate feedback at the scanner to support radiologist decision-making and adaptive protocol adjustment. Evaluated on a curated subset of the Uterine Myoma Dataset, the framework achieves a pixel-level AUROC of 88.06% and high specificity (95.45%) at frame level at 40.5 slices/s, meeting real-time clinical deployment requirements. The spatial anomaly maps and frame-level scores provide immediate, localized feedback at the scanner to support radiologist decision-making and adaptive protocol adjustment during active procedures.

cs.CV↗

Evaluating Synthetic Data Generation for Domain Generalization in Fetal Brain MRI Segmentation

Fetal brain tissue segmentation from magnetic resonance imaging (MRI) is crucial for studying neurodevelopment, but remains challenging due to data heterogeneity and limited annotations. Domain randomization (DR) has recently emerged as a promising strategy for single-source domain generalization by synthesizing training images with randomized artifacts, contrast, and resolution. In this work, we investigate how to maximize the out-of-domain (OOD) generalization of DR-based methods. We evaluate several synthetic data generation strategies for DR, with a particular focus on our recently proposed framework, FetalSynthSeg. We show that simple Gaussian mixture-based intensity modeling outperforms more complex physics-based simulations, and that intensity clustering (subdividing tissue classes based on intensity) improves OOD robustness. Evaluated on 348 fetal subjects from four sites spanning 0.55-3T and both T1w and T2w contrasts, FetalSynthSeg reaches state-of-the-art performance on several FeTA 2024 testing datasets (80-85 Dice score) and, for the first time, offers robust segmentation on modalities other than T2w for fetal brain segmentation (80 Dice on dHCP-T1w dataset). Compared with state-of-the-art methods such as BOUNTI, nnU-Net ensemble, and the FeTA 2024 winner, FetalSynthSeg delivers comparable or superior accuracy while maintaining strong robustness across domain shifts. Our code, model weights, and Docker image ready for easy inference are available at https://hub.docker.com/r/vzalevskyi/fetalsynthseg.

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Female-RHINO: A Real-Time Scanner-Integrated Framework for Automated Quantitative Uterine MRI Analysis and Structured Reporting

Standardized assessment of uterine MRI remains challenging due to anatomical variability, observer dependence, and the lack of workflow-integrated automated analysis tools. This work presents Female-RHINO: (R)eproductive (H)ealth (I)maging A(N)alysis T(O)ol, a real-time AI-assisted framework for automated quantitative uterine MRI analysis and structured reporting during image acquisition. We present an end-to-end system that integrates inline communication with the MRI scanner and deep learning-based analysis to derive quantitative uterine biomarkers from sagittal T2-weighted pelvic MRI. The framework combines segmentation and anatomical landmark detection models trained and evaluated on more than 500 multi-center datasets spanning diverse protocols, vendors, and patient populations. It performs volumetry, detects and quantifies common incidental findings such as fibroids and Nabothian cysts, and extracts six anatomical landmarks for biometric assessment. Results are compiled into a structured clinician-oriented report with integrated visualizations, without manual interaction. Evaluation on independent retrospective and prospective cohorts demonstrated robust performance across varying acquisition settings. Mean Dice similarity coefficients were 0.82 for the uterus and 0.80 for fibroids, with lower but consistent agreement for Nabothian cysts. Landmark detection achieved a mean radial error of 3.7 mm. End-to-end processing was completed in under 70 seconds, enabling availability of results during the ongoing scan. Prospective deployment yielded immediate, standardized, and reproducible analyses supported by inter-observer agreement. The proposed system enables real-time scanner-integrated AI for automated uterine MRI analysis and reporting, with potential to improve standardization, efficiency, and clinical workflow in pelvic imaging.

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Towards contrast- and pathology-agnostic clinical fetal brain MRI segmentation using SynthSeg

Magnetic resonance imaging (MRI) has played a crucial role in fetal neurodevelopmental research. Structural annotations of MR images are an important step for quantitative analysis of the developing human brain, with Deep Learning providing an automated alternative for this otherwise tedious manual process. However, segmentation performances of Convolutional Neural Networks often suffer from domain shift, where the network fails when applied to subjects that deviate from the distribution with which it is trained on. In this work, we aim to train networks capable of automatically segmenting fetal brain MRIs with a wide range of domain shifts pertaining to differences in subject physiology and acquisition environments, in particular shape-based differences commonly observed in pathological cases. We introduce a novel data-driven train-time sampling strategy that seeks to fully exploit the diversity of a given training dataset to enhance the domain generalizability of the trained networks. We adapted our sampler, together with other existing data augmentation techniques, to the SynthSeg framework, a generator that utilizes domain randomization to generate diverse training data. We ran thorough experimentations and ablation studies on a wide range of training/testing data to test the validity of the approaches. Our networks achieved notable improvements in the segmentation quality on testing subjects with intense anatomical abnormalities (p < 1e-4), though at the cost of a slighter decrease in performance in cases with fewer abnormalities. Our work also lays the foundation for future works on creating and adapting data-driven sampling strategies for other training pipelines.

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Real-time MRI-based fetal femur length measurement

Purpose: To develop and evaluate a real-time method for automatic planning and measurement of fetal femur length - an important indicator of antenatal growth - during MRI. While routinely assessed by ultrasound, MRI-based femur length measurements remain challenging due to bone-slice misalignment, fetal motion, and the need for manual assessment. Methods: A low-latency 3D U-Net was trained on 59 scans acquired at 0.55T (gestational age 18-40 weeks) to localise the proximal and distal endpoints of the femur. These coordinates were employed to automatically adapt a 30-second EPI sequence for in-plane femur coverage in real-time. Retrospective evaluation was performed in 72 scans (19-39 weeks, including 19 pathological cases), and real-time testing in 24 cases (17-39 weeks). Automated results were compared with manual expert annotations and, in 57/72 cases, with matched clinical ultrasound measurements. Precision was evaluated against inter-observer variability and analysed across gestational age and maternal BMI. Furthermore, bilateral femur length consistency was evaluated. Results: Retrospective analysis demonstrated a mean endpoint localisation error of 5.5 mm and femur length deviation of 3.0 mm. Among the 49/72 cases with both femora automatically extracted, the left-right difference was 2.8+-2.7 mm. Precision was unaffected by maternal BMI (p>0.05), but correlated with gestational age (p<0.05). Real-time planning and assessment were successful in 22/24 cases, with a mean deviation of 4.2 mm. Conclusions: A real-time, automated method for MRI-based femur length measurement was developed, enabling precise, motion-robust, and operator-independent growth assessment, supporting future large-scale evaluation in growth-compromised pregnancies.

physics.med-ph↗

PUUMA (Placental patch and whole-Uterus dual-branch U-Mamba-based Architecture): Functional MRI Prediction of Gestational Age at Birth and Preterm Risk

Preterm birth is a major cause of mortality and lifelong morbidity in childhood. Its complex and multifactorial origins limit the effectiveness of current clinical predictors and impede optimal care. In this study, a dual-branch deep learning architecture (PUUMA) was developed to predict gestational age (GA) at birth using T2* fetal MRI data from 295 pregnancies, encompassing a heterogeneous and imbalanced population. The model integrates both global whole-uterus and local placental features. Its performance was benchmarked against linear regression using cervical length measurements obtained by experienced clinicians from anatomical MRI and other Deep Learning architectures. The GA at birth predictions were assessed using mean absolute error. Accuracy, sensitivity, and specificity were used to assess preterm classification. Both the fully automated MRI-based pipeline and the cervical length regression achieved comparable mean absolute errors (3 weeks) and good sensitivity (0.67) for detecting preterm birth, despite pronounced class imbalance in the dataset. These results provide a proof of concept for automated prediction of GA at birth from functional MRI, and underscore the value of whole-uterus functional imaging in identifying at-risk pregnancies. Additionally, we demonstrate that manual, high-definition cervical length measurements derived from MRI, not currently routine in clinical practice, offer valuable predictive information. Future work will focus on expanding the cohort size and incorporating additional organ-specific imaging to improve generalisability and predictive performance.

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Scanner-based real-time automated volumetry reporting of the fetus, amniotic fluid, placenta and umbilical cord for fetal MRI at 0.55T

Purpose: This work aims to enable real-time automated intra-uterine volumetric reporting and fetal weight estimation for fetal MRI, deployed directly on the scanner. Methods: A multi-region segmentation nnUNet was trained on 146 bSSFP images of 73 fetal subjects (coronal and axial orientations) for the parcellation of the fetal head, fetal body, placenta, amniotic fluid and umbilical cord from whole uterus bSSFP stacks. A reporting tool was then developed to integrate the segmentation outputs into an automated report, providing volumetric measurements, fetal weight estimations, and z-score visualisations. The complete pipeline was subsequently deployed on a 0.55T MRI scanner, enabling real-time inference and fully automated reporting in the duration of the acquisition. Results: The segmentation pipeline was quantitatively and retrospectively evaluated on 36 stacks of 18 fetal subjects and demonstrated sufficient performance for all labels, with high scores (>0.98) for the fetus, placenta and amniotic fluid, and 0.91 for the umbilical cord. The prospective evaluation of the scanner deployment step was successfully performed on 50 cases, with the regional volumetric reports available directly on the scanner. Conclusions: This work demonstrated the feasibility of multi-regional intra-uterine segmentation, fetal weight estimation and automated reporting in real-time. This study provides a robust baseline solution for the integration of fully automated scanner-based measurements into fetal MRI reports.

physics.med-ph↗

Advances in Automated Fetal Brain MRI Segmentation and Biometry: Insights from the FeTA 2024 Challenge

Accurate fetal brain tissue segmentation and biometric analysis are essential for studying brain development in utero. The FeTA Challenge 2024 advanced automated fetal brain MRI analysis by introducing biometry prediction as a new task alongside tissue segmentation. For the first time, our diverse multi-centric test set included data from a new low-field (0.55T) MRI dataset. Evaluation metrics were also expanded to include the topology-specific Euler characteristic difference (ED). Sixteen teams submitted segmentation methods, most of which performed consistently across both high- and low-field scans. However, longitudinal trends indicate that segmentation accuracy may be reaching a plateau, with results now approaching inter-rater variability. The ED metric uncovered topological differences that were missed by conventional metrics, while the low-field dataset achieved the highest segmentation scores, highlighting the potential of affordable imaging systems when paired with high-quality reconstruction. Seven teams participated in the biometry task, but most methods failed to outperform a simple baseline that predicted measurements based solely on gestational age, underscoring the challenge of extracting reliable biometric estimates from image data alone. Domain shift analysis identified image quality as the most significant factor affecting model generalization, with super-resolution pipelines also playing a substantial role. Other factors, such as gestational age, pathology, and acquisition site, had smaller, though still measurable, effects. Overall, FeTA 2024 offers a comprehensive benchmark for multi-class segmentation and biometry estimation in fetal brain MRI, underscoring the need for data-centric approaches, improved topological evaluation, and greater dataset diversity to enable clinically robust and generalizable AI tools.

cs.CV↗

Real-time fetAl brain and placental T2* mapping at 0.55T low-field MRI (RAT)

Purpose: To provide real-time quantitative organ-specific information - specifically placental and brain T2* - to allow optimization of the MR examination to the individual patient. Methods: A FIRE-based real-time setup segmenting placenta and fetal brain in real-time, performing T2* fitting and analysis and calculation of the centile was implemented. A nn-UNet were trained and tested on 2989 datasets for the fetal brain and a second one trained on 210 datasets for the placenta for automatic segmentation. T2* normal curves were obtained from 106 cases and prospective evaluation was performed on 10 cases between 35 and 39 weeks GA. Results: Quantitative brain and placental T2* maps and centiles were available in all prospective cases within 30 seconds. The robustness of the method was shown with intra-scan repeats (mean difference 1.04+/-12.39 ms for fetal brain and -3.15+/-8.88 ms for placenta) and direct validation with vendor-processed offline results (mean difference 1.62+/-4.33 ms for fetal brain and 0.16+/-6.19 ms for placenta). Discussion and Conclusion: Real-time available organ-specific quantitative information enables more personalized MR examinations, selection of the most pertinent sequences and thus the promise of reduced recalls and specific insights into tissue properties. The here enabled placental T2*, demonstrated in multiple recent studies to be a biomarker sensitive to a range of pregnancy complications, and fetal brain T2* will be explored in further studies in pregnancies with pre-eclampsia, growth restriction as a way of enabling future MR-guided fetal interventions.

physics.med-ph↗

AutOmatic floW planning for fetaL MRI (OWL)

Two subsequent deep learning networks, one localizing the fetal chest and one identifying a set of landmarks on a coronal whole-uterus balanced steady-state free precession scan, were trained on 167 and 71 fetal datasets across field strengths, acquisition parameters, and gestational ages and implemented in a real-time setup. Next, a phase-contrast sequence was modified to use the identified landmarks for planning. The OWL pipeline was evaluated retrospectively in 10 datasets and prospectively in 7 fetal subjects (gestational ages between 36+3 and 39+3 weeks). The prospective cases were additionally manually planned to enable direct comparison both qualitatively, by scoring the planning quality, and quantitatively, by comparing the indexed flow measurements. OWL enabled real-time fully automatic planning of the 2D phase-contrast scans in all but one of the prospective participants. The fetal body localization achieved an overall Dice score of 0.94+-0.05 and the cardiac landmark detection accuracy was 5.77+-2.91 mm for the descending aorta, 4.32+-2.44 mm for the spine, and 4.94+-3.82 mm for the umbilical vein. For the prospective cases, overall planning quality was 2.73/4 for the automated scans, compared to 3.0/4 for manual planning, and the flow quantitative evaluation showed a mean difference of -1.8% (range -14.2% to 14.9%) by comparing the indexed flow measurements obtained from gated automatic and manual acquisitions. Real-time automated planning of 2D phase-contrast MRI was effectively accomplished for 2 major vessels of the fetal vasculature. While demonstrated here on 0.55T, the achieved method has wider implications, and training across multiple field strengths enables generalization. OWL thereby presents an important step towards extending access to this modality beyond specialised centres.

physics.med-ph↗

Fully automated planning for anatomical fetal brain MRI on 0.55T

Purpose: Widening the availability of fetal MRI with fully automatic real-time planning of radiological brain planes on 0.55T MRI. Methods: Deep learning-based detection of key brain landmarks on a whole-uterus EPI scan enables the subsequent fully automatic planning of the radiological single-shot Turbo Spin Echo acquisitions. The landmark detection pipeline was trained on over 120 datasets from varying field strength, echo times and resolutions and quantitatively evaluated. The entire automatic planning solution was tested prospectively in nine fetal subjects between 20 and 37 weeks. Comprehensive evaluation of all steps, the distance between manual and automatic landmarks, the planning quality and the resulting image quality was conducted. Results: Prospective automatic planning was performed in real-time without latency in all subjects. The landmark detection accuracy was 4.21+-2.56 mm for the fetal eyes and 6.47+-3.23 for the cerebellum, planning quality was 2.44/3 (compared to 2.56/3 for manual planning) and diagnostic image quality was 2.14 compared to 2.07 for manual planning. Conclusions: Real-time automatic planning of all three key fetal brain planes was successfully achieved and will pave the way towards simplifying the acquisition of fetal MRI thereby widening the availability of this modality in non-specialist centres.

physics.med-ph↗

An automated pipeline for quantitative T2* fetal body MRI and segmentation at low field

Fetal Magnetic Resonance Imaging at low field strengths is emerging as an exciting direction in perinatal health. Clinical low field (0.55T) scanners are beneficial for fetal imaging due to their reduced susceptibility-induced artefacts, increased T2* values, and wider bore (widening access for the increasingly obese pregnant population). However, the lack of standard automated image processing tools such as segmentation and reconstruction hampers wider clinical use. In this study, we introduce a semi-automatic pipeline using quantitative MRI for the fetal body at low field strength resulting in fast and detailed quantitative T2* relaxometry analysis of all major fetal body organs. Multi-echo dynamic sequences of the fetal body were acquired and reconstructed into a single high-resolution volume using deformable slice-to-volume reconstruction, generating both structural and quantitative T2* 3D volumes. A neural network trained using a semi-supervised approach was created to automatically segment these fetal body 3D volumes into ten different organs (resulting in dice values > 0.74 for 8 out of 10 organs). The T2* values revealed a strong relationship with GA in the lungs, liver, and kidney parenchyma (R^2>0.5). This pipeline was used successfully for a wide range of GAs (17-40 weeks), and is robust to motion artefacts. Low field fetal MRI can be used to perform advanced MRI analysis, and is a viable option for clinical scanning.

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