arXiv subjects

Klaus H. Maier-Hein

Publications and source records attributed to Klaus H. Maier-Hein.

At least 55 records · Page 3Linked to original sources

arXiv2023

SAM.MD: Zero-shot medical image segmentation capabilities of the Segment Anything Model

Foundation models have taken over natural language processing and image generation domains due to the flexibility of prompting. With the recent introduction of the Segment Anything Model (SAM), this prompt-driven paradigm has entered image segmentation with a hitherto unexplored abundance of capabilities. The purpose of this paper is to conduct an initial evaluation of the out-of-the-box zero-shot capabilities of SAM for medical image segmentation, by evaluating its performance on an abdominal CT organ segmentation task, via point or bounding box based prompting. We show that SAM generalizes well to CT data, making it a potential catalyst for the advancement of semi-automatic segmentation tools for clinicians. We believe that this foundation model, while not reaching state-of-the-art segmentation performance in our investigations, can serve as a highly potent starting point for further adaptations of such models to the intricacies of the medical domain. Keywords: medical image segmentation, SAM, foundation models, zero-shot learning

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arXiv2023

Accurate Detection of Mediastinal Lesions with nnDetection

The accurate detection of mediastinal lesions is one of the rarely explored medical object detection problems. In this work, we applied a modified version of the self-configuring method nnDetection to the Mediastinal Lesion Analysis (MELA) Challenge 2022. By incorporating automatically generated pseudo masks, training high capacity models with large patch sizes in a multi GPU setup and an adapted augmentation scheme to reduce localization errors caused by rotations, our method achieved an excellent FROC score of 0.9922 at IoU 0.10 and 0.9880 at IoU 0.3 in our cross-validation experiments. The submitted ensemble ranked third in the competition with a FROC score of 0.9897 on the MELA challenge leaderboard.

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arXiv2023

CRADL: Contrastive Representations for Unsupervised Anomaly Detection and Localization

Unsupervised anomaly detection in medical imaging aims to detect and localize arbitrary anomalies without requiring annotated anomalous data during training. Often, this is achieved by learning a data distribution of normal samples and detecting anomalies as regions in the image which deviate from this distribution. Most current state-of-the-art methods use latent variable generative models operating directly on the images. However, generative models have been shown to mostly capture low-level features, s.a. pixel-intensities, instead of rich semantic features, which also applies to their representations. We circumvent this problem by proposing CRADL whose core idea is to model the distribution of normal samples directly in the low-dimensional representation space of an encoder trained with a contrastive pretext-task. By utilizing the representations of contrastive learning, we aim to fix the over-fixation on low-level features and learn more semantic-rich representations. Our experiments on anomaly detection and localization tasks using three distinct evaluation datasets show that 1) contrastive representations are superior to representations of generative latent variable models and 2) the CRADL framework shows competitive or superior performance to state-of-the-art.

cs.CV↗

arXiv2022

MONAI: An open-source framework for deep learning in healthcare

Artificial Intelligence (AI) is having a tremendous impact across most areas of science. Applications of AI in healthcare have the potential to improve our ability to detect, diagnose, prognose, and intervene on human disease. For AI models to be used clinically, they need to be made safe, reproducible and robust, and the underlying software framework must be aware of the particularities (e.g. geometry, physiology, physics) of medical data being processed. This work introduces MONAI, a freely available, community-supported, and consortium-led PyTorch-based framework for deep learning in healthcare. MONAI extends PyTorch to support medical data, with a particular focus on imaging, and provide purpose-specific AI model architectures, transformations and utilities that streamline the development and deployment of medical AI models. MONAI follows best practices for software-development, providing an easy-to-use, robust, well-documented, and well-tested software framework. MONAI preserves the simple, additive, and compositional approach of its underlying PyTorch libraries. MONAI is being used by and receiving contributions from research, clinical and industrial teams from around the world, who are pursuing applications spanning nearly every aspect of healthcare.

cs.LG↗

arXiv2022

Detailed Annotations of Chest X-Rays via CT Projection for Report Understanding

In clinical radiology reports, doctors capture important information about the patient's health status. They convey their observations from raw medical imaging data about the inner structures of a patient. As such, formulating reports requires medical experts to possess wide-ranging knowledge about anatomical regions with their normal, healthy appearance as well as the ability to recognize abnormalities. This explicit grasp on both the patient's anatomy and their appearance is missing in current medical image-processing systems as annotations are especially difficult to gather. This renders the models to be narrow experts e.g. for identifying specific diseases. In this work, we recover this missing link by adding human anatomy into the mix and enable the association of content in medical reports to their occurrence in associated imagery (medical phrase grounding). To exploit anatomical structures in this scenario, we present a sophisticated automatic pipeline to gather and integrate human bodily structures from computed tomography datasets, which we incorporate in our PAXRay: A Projected dataset for the segmentation of Anatomical structures in X-Ray data. Our evaluation shows that methods that take advantage of anatomical information benefit heavily in visually grounding radiologists' findings, as our anatomical segmentations allow for up to absolute 50% better grounding results on the OpenI dataset as compared to commonly used region proposals. The PAXRay dataset is available at https://constantinseibold.github.io/paxray/.

cs.CV↗

arXiv2022

Extending nnU-Net is all you need

Semantic segmentation is one of the most popular research areas in medical image computing. Perhaps surprisingly, despite its conceptualization dating back to 2018, nnU-Net continues to provide competitive out-of-the-box solutions for a broad variety of segmentation problems and is regularly used as a development framework for challenge-winning algorithms. Here we use nnU-Net to participate in the AMOS2022 challenge, which comes with a unique set of tasks: not only is the dataset one of the largest ever created and boasts 15 target structures, but the competition also requires submitted solutions to handle both MRI and CT scans. Through careful modification of nnU-net's hyperparameters, the addition of residual connections in the encoder and the design of a custom postprocessing strategy, we were able to substantially improve upon the nnU-Net baseline. Our final ensemble achieves Dice scores of 90.13 for Task 1 (CT) and 89.06 for Task 2 (CT+MRI) in a 5-fold cross-validation on the provided training cases.

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arXiv2022

nnDetection: A Self-configuring Method for Medical Object Detection

Simultaneous localisation and categorization of objects in medical images, also referred to as medical object detection, is of high clinical relevance because diagnostic decisions often depend on rating of objects rather than e.g. pixels. For this task, the cumbersome and iterative process of method configuration constitutes a major research bottleneck. Recently, nnU-Net has tackled this challenge for the task of image segmentation with great success. Following nnU-Net's agenda, in this work we systematize and automate the configuration process for medical object detection. The resulting self-configuring method, nnDetection, adapts itself without any manual intervention to arbitrary medical detection problems while achieving results en par with or superior to the state-of-the-art. We demonstrate the effectiveness of nnDetection on two public benchmarks, ADAM and LUNA16, and propose 11 further medical object detection tasks on public data sets for comprehensive method evaluation. Code is at https://github.com/MIC-DKFZ/nnDetection .

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arXiv2021

Band selection for oxygenation estimation with multispectral/hyperspectral imaging

Multispectral imaging provides valuable information on tissue composition such as hemoglobin oxygen saturation. However, the real-time application of this technique in interventional medicine can be challenging due to the long acquisition times needed for large amounts of hyperspectral data with hundreds of bands. While this challenge can partially be addressed by choosing a discriminative subset of bands, the band selection methods proposed to date are mainly restricted by the availability of often hard to obtain reference measurements. We address this bottleneck with a new approach to band selection that leverages highly accurate Monte Carlo (MC) simulations. We hypothesize that a so chosen small subset of bands can reproduce or even improve upon the results of a quasi continuous spectral measurement. We further investigate whether novel domain adaptation techniques can address the inevitable domain shift stemming from the use of simulations. Initial results based on in silico and in vivo experiments suggest that 10-20 bands are sufficient to closely reproduce results from spectral measurements with 101 bands in the 500-700 nm range. The investigated domain adaptation technique, which only requires unlabeled in vivo measurements, yielded better results than the pure in silico band selection method. Overall, our method could guide development of fast multispectral imaging systems suited for interventional use without relying on complex hardware setups or manually labeled data

physics.bio-ph↗

arXiv2021

Continuous-Time Deep Glioma Growth Models

The ability to estimate how a tumor might evolve in the future could have tremendous clinical benefits, from improved treatment decisions to better dose distribution in radiation therapy. Recent work has approached the glioma growth modeling problem via deep learning and variational inference, thus learning growth dynamics entirely from a real patient data distribution. So far, this approach was constrained to predefined image acquisition intervals and sequences of fixed length, which limits its applicability in more realistic scenarios. We overcome these limitations by extending Neural Processes, a class of conditional generative models for stochastic time series, with a hierarchical multi-scale representation encoding including a spatio-temporal attention mechanism. The result is a learned growth model that can be conditioned on an arbitrary number of observations, and that can produce a distribution of temporally consistent growth trajectories on a continuous time axis. On a dataset of 379 patients, the approach successfully captures both global and finer-grained variations in the images, exhibiting superior performance compared to other learned growth models.

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arXiv2021

GP-ConvCNP: Better Generalization for Convolutional Conditional Neural Processes on Time Series Data

Neural Processes (NPs) are a family of conditional generative models that are able to model a distribution over functions, in a way that allows them to perform predictions at test time conditioned on a number of context points. A recent addition to this family, Convolutional Conditional Neural Processes (ConvCNP), have shown remarkable improvement in performance over prior art, but we find that they sometimes struggle to generalize when applied to time series data. In particular, they are not robust to distribution shifts and fail to extrapolate observed patterns into the future. By incorporating a Gaussian Process into the model, we are able to remedy this and at the same time improve performance within distribution. As an added benefit, the Gaussian Process reintroduces the possibility to sample from the model, a key feature of other members in the NP family.

cs.LG↗

arXiv2021

CHAOS Challenge -- Combined (CT-MR) Healthy Abdominal Organ Segmentation

Segmentation of abdominal organs has been a comprehensive, yet unresolved, research field for many years. In the last decade, intensive developments in deep learning (DL) have introduced new state-of-the-art segmentation systems. In order to expand the knowledge on these topics, the CHAOS - Combined (CT-MR) Healthy Abdominal Organ Segmentation challenge has been organized in conjunction with IEEE International Symposium on Biomedical Imaging (ISBI), 2019, in Venice, Italy. CHAOS provides both abdominal CT and MR data from healthy subjects for single and multiple abdominal organ segmentation. Five different but complementary tasks have been designed to analyze the capabilities of current approaches from multiple perspectives. The results are investigated thoroughly, compared with manual annotations and interactive methods. The analysis shows that the performance of DL models for single modality (CT / MR) can show reliable volumetric analysis performance (DICE: 0.98 $\pm$ 0.00 / 0.95 $\pm$ 0.01) but the best MSSD performance remain limited (21.89 $\pm$ 13.94 / 20.85 $\pm$ 10.63 mm). The performances of participating models decrease significantly for cross-modality tasks for the liver (DICE: 0.88 $\pm$ 0.15 MSSD: 36.33 $\pm$ 21.97 mm) and all organs (DICE: 0.85 $\pm$ 0.21 MSSD: 33.17 $\pm$ 38.93 mm). Despite contrary examples on different applications, multi-tasking DL models designed to segment all organs seem to perform worse compared to organ-specific ones (performance drop around 5\%). Besides, such directions of further research for cross-modality segmentation would significantly support real-world clinical applications. Moreover, having more than 1500 participants, another important contribution of the paper is the analysis on shortcomings of challenge organizations such as the effects of multiple submissions and peeking phenomena.

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arXiv2020

nnU-Net for Brain Tumor Segmentation

We apply nnU-Net to the segmentation task of the BraTS 2020 challenge. The unmodified nnU-Net baseline configuration already achieves a respectable result. By incorporating BraTS-specific modifications regarding postprocessing, region-based training, a more aggressive data augmentation as well as several minor modifications to the nnUNet pipeline we are able to improve its segmentation performance substantially. We furthermore re-implement the BraTS ranking scheme to determine which of our nnU-Net variants best fits the requirements imposed by it. Our final ensemble took the first place in the BraTS 2020 competition with Dice scores of 88.95, 85.06 and 82.03 and HD95 values of 8.498,17.337 and 17.805 for whole tumor, tumor core and enhancing tumor, respectively.

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arXiv2020

The state of the art in kidney and kidney tumor segmentation in contrast-enhanced CT imaging: Results of the KiTS19 Challenge

There is a large body of literature linking anatomic and geometric characteristics of kidney tumors to perioperative and oncologic outcomes. Semantic segmentation of these tumors and their host kidneys is a promising tool for quantitatively characterizing these lesions, but its adoption is limited due to the manual effort required to produce high-quality 3D segmentations of these structures. Recently, methods based on deep learning have shown excellent results in automatic 3D segmentation, but they require large datasets for training, and there remains little consensus on which methods perform best. The 2019 Kidney and Kidney Tumor Segmentation challenge (KiTS19) was a competition held in conjunction with the 2019 International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI) which sought to address these issues and stimulate progress on this automatic segmentation problem. A training set of 210 cross sectional CT images with kidney tumors was publicly released with corresponding semantic segmentation masks. 106 teams from five continents used this data to develop automated systems to predict the true segmentation masks on a test set of 90 CT images for which the corresponding ground truth segmentations were kept private. These predictions were scored and ranked according to their average So rensen-Dice coefficient between the kidney and tumor across all 90 cases. The winning team achieved a Dice of 0.974 for kidney and 0.851 for tumor, approaching the inter-annotator performance on kidney (0.983) but falling short on tumor (0.923). This challenge has now entered an "open leaderboard" phase where it serves as a challenging benchmark in 3D semantic segmentation.

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arXiv2020

Robust Medical Instrument Segmentation Challenge 2019

Intraoperative tracking of laparoscopic instruments is often a prerequisite for computer and robotic-assisted interventions. While numerous methods for detecting, segmenting and tracking of medical instruments based on endoscopic video images have been proposed in the literature, key limitations remain to be addressed: Firstly, robustness, that is, the reliable performance of state-of-the-art methods when run on challenging images (e.g. in the presence of blood, smoke or motion artifacts). Secondly, generalization; algorithms trained for a specific intervention in a specific hospital should generalize to other interventions or institutions. In an effort to promote solutions for these limitations, we organized the Robust Medical Instrument Segmentation (ROBUST-MIS) challenge as an international benchmarking competition with a specific focus on the robustness and generalization capabilities of algorithms. For the first time in the field of endoscopic image processing, our challenge included a task on binary segmentation and also addressed multi-instance detection and segmentation. The challenge was based on a surgical data set comprising 10,040 annotated images acquired from a total of 30 surgical procedures from three different types of surgery. The validation of the competing methods for the three tasks (binary segmentation, multi-instance detection and multi-instance segmentation) was performed in three different stages with an increasing domain gap between the training and the test data. The results confirm the initial hypothesis, namely that algorithm performance degrades with an increasing domain gap. While the average detection and segmentation quality of the best-performing algorithms is high, future research should concentrate on detection and segmentation of small, crossing, moving and transparent instrument(s) (parts).

cs.CV↗

arXiv2020

OR-UNet: an Optimized Robust Residual U-Net for Instrument Segmentation in Endoscopic Images

Segmentation of endoscopic images is an essential processing step for computer and robotics-assisted interventions. The Robust-MIS challenge provides the largest dataset of annotated endoscopic images to date, with 5983 manually annotated images. Here we describe OR-UNet, our optimized robust residual 2D U-Net for endoscopic image segmentation. As the name implies, the network makes use of residual connections in the encoder. It is trained with the sum of Dice and cross-entropy loss and deep supervision. During training, extensive data augmentation is used to increase the robustness. In an 8-fold cross-validation on the training images, our model achieved a mean (median) Dice score of 87.41 (94.35). We use the eight models from the cross-validation as an ensemble on the test set.

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arXiv2020

Automated Design of Deep Learning Methods for Biomedical Image Segmentation

Biomedical imaging is a driver of scientific discovery and core component of medical care, currently stimulated by the field of deep learning. While semantic segmentation algorithms enable 3D image analysis and quantification in many applications, the design of respective specialised solutions is non-trivial and highly dependent on dataset properties and hardware conditions. We propose nnU-Net, a deep learning framework that condenses the current domain knowledge and autonomously takes the key decisions required to transfer a basic architecture to different datasets and segmentation tasks. Without manual tuning, nnU-Net surpasses most specialised deep learning pipelines in 19 public international competitions and sets a new state of the art in the majority of the 49 tasks. The results demonstrate a vast hidden potential in the systematic adaptation of deep learning methods to different datasets. We make nnU-Net publicly available as an open-source tool that can effectively be used out-of-the-box, rendering state of the art segmentation accessible to non-experts and catalyzing scientific progress as a framework for automated method design.

cs.CV↗

arXiv2019

A Case for the Score: Identifying Image Anomalies using Variational Autoencoder Gradients

Through training on unlabeled data, anomaly detection has the potential to impact computer-aided diagnosis by outlining suspicious regions. Previous work on deep-learning-based anomaly detection has primarily focused on the reconstruction error. We argue instead, that pixel-wise anomaly ratings derived from a Variational Autoencoder based score approximation yield a theoretically better grounded and more faithful estimate. In our experiments, Variational Autoencoder gradient-based rating outperforms other approaches on unsupervised pixel-wise tumor detection on the BraTS-2017 dataset with a ROC-AUC of 0.94.

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arXiv2019

An attempt at beating the 3D U-Net

The U-Net is arguably the most successful segmentation architecture in the medical domain. Here we apply a 3D U-Net to the 2019 Kidney and Kidney Tumor Segmentation Challenge and attempt to improve upon it by augmenting it with residual and pre-activation residual blocks. Cross-validation results on the training cases suggest only very minor, barely measurable improvements. Due to marginally higher dice scores, the residual 3D U-Net is chosen for test set prediction. With a Composite Dice score of 91.23 on the test set, our method outperformed all 105 competing teams and won the KiTS2019 challenge by a small margin.

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