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Klaus H. Maier-Hein

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

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Combined tract segmentation and orientation mapping for bundle-specific tractography

While the major white matter tracts are of great interest to numerous studies in neuroscience and medicine, their manual dissection in larger cohorts from diffusion MRI tractograms is time-consuming, requires expert knowledge and is hard to reproduce. In previous work we presented tract orientation mapping (TOM) as a novel concept for bundle-specific tractography. It is based on a learned mapping from the original fiber orientation distribution function (FOD) peaks to tract specific peaks, called tract orientation maps. Each tract orientation map represents the voxel-wise principal orientation of one tract. Here, we present an extension of this approach that combines TOM with accurate segmentations of the tract outline and its start and end region. We also introduce a custom probabilistic tracking algorithm that samples from a Gaussian distribution with fixed standard deviation centered on each peak thus enabling more complete trackings on the tract orientation maps than deterministic tracking. These extensions enable the automatic creation of bundle-specific tractograms with previously unseen accuracy. We show for 72 different bundles on high quality, low quality and phantom data that our approach runs faster and produces more accurate bundle-specific tractograms than 7 state of the art benchmark methods while avoiding cumbersome processing steps like whole brain tractography, non-linear registration, clustering or manual dissection. Moreover, we show on 17 datasets that our approach generalizes well to datasets acquired with different scanners and settings as well as with pathologies. The code of our method is openly available at https://github.com/MIC-DKFZ/TractSeg.

cs.CV↗

Reg R-CNN: Lesion Detection and Grading under Noisy Labels

For the task of concurrently detecting and categorizing objects, the medical imaging community commonly adopts methods developed on natural images. Current state-of-the-art object detectors are comprised of two stages: the first stage generates region proposals, the second stage subsequently categorizes them. Unlike in natural images, however, for anatomical structures of interest such as tumors, the appearance in the image (e.g., scale or intensity) links to a malignancy grade that lies on a continuous ordinal scale. While classification models discard this ordinal relation between grades by discretizing the continuous scale to an unordered bag of categories, regression models are trained with distance metrics, which preserve the relation. This advantage becomes all the more important in the setting of label confusions on ambiguous data sets, which is the usual case with medical images. To this end, we propose Reg R-CNN, which replaces the second-stage classification model of a current object detector with a regression model. We show the superiority of our approach on a public data set with 1026 patients and a series of toy experiments. Code will be available at github.com/MIC-DKFZ/RegRCNN.

cs.CV↗

Deep Probabilistic Modeling of Glioma Growth

Existing approaches to modeling the dynamics of brain tumor growth, specifically glioma, employ biologically inspired models of cell diffusion, using image data to estimate the associated parameters. In this work, we propose an alternative approach based on recent advances in probabilistic segmentation and representation learning that implicitly learns growth dynamics directly from data without an underlying explicit model. We present evidence that our approach is able to learn a distribution of plausible future tumor appearances conditioned on past observations of the same tumor.

eess.IV↗

A Hierarchical Probabilistic U-Net for Modeling Multi-Scale Ambiguities

Medical imaging only indirectly measures the molecular identity of the tissue within each voxel, which often produces only ambiguous image evidence for target measures of interest, like semantic segmentation. This diversity and the variations of plausible interpretations are often specific to given image regions and may thus manifest on various scales, spanning all the way from the pixel to the image level. In order to learn a flexible distribution that can account for multiple scales of variations, we propose the Hierarchical Probabilistic U-Net, a segmentation network with a conditional variational auto-encoder (cVAE) that uses a hierarchical latent space decomposition. We show that this model formulation enables sampling and reconstruction of segmenations with high fidelity, i.e. with finely resolved detail, while providing the flexibility to learn complex structured distributions across scales. We demonstrate these abilities on the task of segmenting ambiguous medical scans as well as on instance segmentation of neurobiological and natural images. Our model automatically separates independent factors across scales, an inductive bias that we deem beneficial in structured output prediction tasks beyond segmentation.

cs.CV↗

No New-Net

In this paper we demonstrate the effectiveness of a well trained U-Net in the context of the BraTS 2018 challenge. This endeavour is particularly interesting given that researchers are currently besting each other with architectural modifications that are intended to improve the segmentation performance. We instead focus on the training process arguing that a well trained U-Net is hard to beat. Our baseline U-Net, which has only minor modifications and is trained with a large patch size and a Dice loss function indeed achieved competitive Dice scores on the BraTS2018 validation data. By incorporating additional measures such as region based training, additional training data, a simple postprocessing technique and a combination of loss functions, we obtain Dice scores of 77.88, 87.81 and 80.62, and Hausdorff Distances (95th percentile) of 2.90, 6.03 and 5.08 for the enhancing tumor, whole tumor and tumor core, respectively on the test data. This setup achieved rank two in BraTS2018, with more than 60 teams participating in the challenge.

cs.CV↗

A Probabilistic U-Net for Segmentation of Ambiguous Images

Many real-world vision problems suffer from inherent ambiguities. In clinical applications for example, it might not be clear from a CT scan alone which particular region is cancer tissue. Therefore a group of graders typically produces a set of diverse but plausible segmentations. We consider the task of learning a distribution over segmentations given an input. To this end we propose a generative segmentation model based on a combination of a U-Net with a conditional variational autoencoder that is capable of efficiently producing an unlimited number of plausible hypotheses. We show on a lung abnormalities segmentation task and on a Cityscapes segmentation task that our model reproduces the possible segmentation variants as well as the frequencies with which they occur, doing so significantly better than published approaches. These models could have a high impact in real-world applications, such as being used as clinical decision-making algorithms accounting for multiple plausible semantic segmentation hypotheses to provide possible diagnoses and recommend further actions to resolve the present ambiguities.

cs.CV↗

Context-encoding Variational Autoencoder for Unsupervised Anomaly Detection

Unsupervised learning can leverage large-scale data sources without the need for annotations. In this context, deep learning-based auto encoders have shown great potential in detecting anomalies in medical images. However, state-of-the-art anomaly scores are still based on the reconstruction error, which lacks in two essential parts: it ignores the model-internal representation employed for reconstruction, and it lacks formal assertions and comparability between samples. We address these shortcomings by proposing the Context-encoding Variational Autoencoder (ceVAE) which combines reconstruction- with density-based anomaly scoring. This improves the sample- as well as pixel-wise results. In our experiments on the BraTS-2017 and ISLES-2015 segmentation benchmarks, the ceVAE achieves unsupervised ROC-AUCs of 0.95 and 0.89, respectively, thus outperforming state-of-the-art methods by a considerable margin.

cs.LG↗

Retina U-Net: Embarrassingly Simple Exploitation of Segmentation Supervision for Medical Object Detection

The task of localizing and categorizing objects in medical images often remains formulated as a semantic segmentation problem. This approach, however, only indirectly solves the coarse localization task by predicting pixel-level scores, requiring ad-hoc heuristics when mapping back to object-level scores. State-of-the-art object detectors on the other hand, allow for individual object scoring in an end-to-end fashion, while ironically trading in the ability to exploit the full pixel-wise supervision signal. This can be particularly disadvantageous in the setting of medical image analysis, where data sets are notoriously small. In this paper, we propose Retina U-Net, a simple architecture, which naturally fuses the Retina Net one-stage detector with the U-Net architecture widely used for semantic segmentation in medical images. The proposed architecture recaptures discarded supervision signals by complementing object detection with an auxiliary task in the form of semantic segmentation without introducing the additional complexity of previously proposed two-stage detectors. We evaluate the importance of full segmentation supervision on two medical data sets, provide an in-depth analysis on a series of toy experiments and show how the corresponding performance gain grows in the limit of small data sets. Retina U-Net yields strong detection performance only reached by its more complex two-staged counterparts. Our framework including all methods implemented for operation on 2D and 3D images is available at github.com/pfjaeger/medicaldetectiontoolkit.

cs.CV↗

nnU-Net: Self-adapting Framework for U-Net-Based Medical Image Segmentation

The U-Net was presented in 2015. With its straight-forward and successful architecture it quickly evolved to a commonly used benchmark in medical image segmentation. The adaptation of the U-Net to novel problems, however, comprises several degrees of freedom regarding the exact architecture, preprocessing, training and inference. These choices are not independent of each other and substantially impact the overall performance. The present paper introduces the nnU-Net ('no-new-Net'), which refers to a robust and self-adapting framework on the basis of 2D and 3D vanilla U-Nets. We argue the strong case for taking away superfluous bells and whistles of many proposed network designs and instead focus on the remaining aspects that make out the performance and generalizability of a method. We evaluate the nnU-Net in the context of the Medical Segmentation Decathlon challenge, which measures segmentation performance in ten disciplines comprising distinct entities, image modalities, image geometries and dataset sizes, with no manual adjustments between datasets allowed. At the time of manuscript submission, nnU-Net achieves the highest mean dice scores across all classes and seven phase 1 tasks (except class 1 in BrainTumour) in the online leaderboard of the challenge.

cs.CV↗

TractSeg - Fast and accurate white matter tract segmentation

The individual course of white matter fiber tracts is an important key for analysis of white matter characteristics in healthy and diseased brains. Uniquely, diffusion-weighted MRI tractography in combination with region-based or clustering-based selection of streamlines allows for the in-vivo delineation and analysis of anatomically well known tracts. This, however, currently requires complex, computationally intensive and tedious-to-set-up processing pipelines. TractSeg is a novel convolutional neural network-based approach that directly segments tracts in the field of fiber orientation distribution function (fODF) peaks without requiring tractography, image registration or parcellation. We demonstrate in 105 subjects from the Human Connectome Project that the proposed approach is much faster than existing methods while providing unprecedented accuracy. The code and data are openly available at https://github.com/MIC-DKFZ/TractSeg/ and https://doi.org/10.5281/zenodo.1088277, respectively.

cs.CV↗

Domain Adaptation for Deviating Acquisition Protocols in CNN-based Lesion Classification on Diffusion-Weighted MR Images

End-to-end deep learning improves breast cancer classification on diffusion-weighted MR images (DWI) using a convolutional neural network (CNN) architecture. A limitation of CNN as opposed to previous model-based approaches is the dependence on specific DWI input channels used during training. However, in the context of large-scale application, methods agnostic towards heterogeneous inputs are desirable, due to the high deviation of scanning protocols between clinical sites. We propose model-based domain adaptation to overcome input dependencies and avoid re-training of networks at clinical sites by restoring training inputs from altered input channels given during deployment. We demonstrate the method's significant increase in classification performance and superiority over implicit domain adaptation provided by training-schemes operating on model-parameters instead of raw DWI images.

cs.CV↗

Tract orientation mapping for bundle-specific tractography

While the major white matter tracts are of great interest to numerous studies in neuroscience and medicine, their manual dissection in larger cohorts from diffusion MRI tractograms is time-consuming, requires expert knowledge and is hard to reproduce. Tract orientation mapping (TOM) is a novel concept that facilitates bundle-specific tractography based on a learned mapping from the original fiber orientation distribution function (fODF) peaks to a list of tract orientation maps (also abbr. TOM). Each TOM represents one of the known tracts with each voxel containing no more than one orientation vector. TOMs can act as a prior or even as direct input for tractography. We use an encoder-decoder fully-convolutional neural network architecture to learn the required mapping. In comparison to previous concepts for the reconstruction of specific bundles, the presented one avoids various cumbersome processing steps like whole brain tractography, atlas registration or clustering. We compare it to four state of the art bundle recognition methods on 20 different bundles in a total of 105 subjects from the Human Connectome Project. Results are anatomically convincing even for difficult tracts, while reaching low angular errors, unprecedented runtimes and top accuracy values (Dice). Our code and our data are openly available.

cs.CV↗

Towards whole-body CT Bone Segmentation

Bone segmentation from CT images is a task that has been worked on for decades. It is an important ingredient to several diagnostics or treatment planning approaches and relevant to various diseases. As high-quality manual and semi-automatic bone segmentation is very time-consuming, a reliable and fully automatic approach would be of great interest in many scenarios. In this publication, we propose a UNet inspired architecture to address the task using Deep Learning. We evaluated the approach on whole-body CT scans of patients suffering from multiple myeloma. As the disease decomposes the bone, an accurate segmentation is of utmost importance for the evaluation of bone density, disease staging and localization of focal lesions. The method was evaluated on an in-house data-set of 6000 2D image slices taken from 15 whole-body CT scans, achieving a dice score of 0.96 and an IOU of 0.94.

cs.CV↗

Brain Tumor Segmentation and Radiomics Survival Prediction: Contribution to the BRATS 2017 Challenge

Quantitative analysis of brain tumors is critical for clinical decision making. While manual segmentation is tedious, time consuming and subjective, this task is at the same time very challenging to solve for automatic segmentation methods. In this paper we present our most recent effort on developing a robust segmentation algorithm in the form of a convolutional neural network. Our network architecture was inspired by the popular U-Net and has been carefully modified to maximize brain tumor segmentation performance. We use a dice loss function to cope with class imbalances and use extensive data augmentation to successfully prevent overfitting. Our method beats the current state of the art on BraTS 2015, is one of the leading methods on the BraTS 2017 validation set (dice scores of 0.896, 0.797 and 0.732 for whole tumor, tumor core and enhancing tumor, respectively) and achieves very good Dice scores on the test set (0.858 for whole, 0.775 for core and 0.647 for enhancing tumor). We furthermore take part in the survival prediction subchallenge by training an ensemble of a random forest regressor and multilayer perceptrons on shape features describing the tumor subregions. Our approach achieves 52.6% accuracy, a Spearman correlation coefficient of 0.496 and a mean square error of 209607 on the test set.

cs.CV↗

Automatic Cardiac Disease Assessment on cine-MRI via Time-Series Segmentation and Domain Specific Features

Cardiac magnetic resonance imaging improves on diagnosis of cardiovascular diseases by providing images at high spatiotemporal resolution. Manual evaluation of these time-series, however, is expensive and prone to biased and non-reproducible outcomes. In this paper, we present a method that addresses named limitations by integrating segmentation and disease classification into a fully automatic processing pipeline. We use an ensemble of UNet inspired architectures for segmentation of cardiac structures such as the left and right ventricular cavity (LVC, RVC) and the left ventricular myocardium (LVM) on each time instance of the cardiac cycle. For the classification task, information is extracted from the segmented time-series in form of comprehensive features handcrafted to reflect diagnostic clinical procedures. Based on these features we train an ensemble of heavily regularized multilayer perceptrons (MLP) and a random forest classifier to predict the pathologic target class. We evaluated our method on the ACDC dataset (4 pathology groups, 1 healthy group) and achieve dice scores of 0.945 (LVC), 0.908 (RVC) and 0.905 (LVM) in a cross-validation over the training set (100 cases) and 0.950 (LVC), 0.923 (RVC) and 0.911 (LVM) on the test set (50 cases). We report a classification accuracy of 94% on a training set cross-validation and 92% on the test set. Our results underpin the potential of machine learning methods for accurate, fast and reproducible segmentation and computer-assisted diagnosis (CAD).

cs.CV↗

Revealing Hidden Potentials of the q-Space Signal in Breast Cancer

Mammography screening for early detection of breast lesions currently suffers from high amounts of false positive findings, which result in unnecessary invasive biopsies. Diffusion-weighted MR images (DWI) can help to reduce many of these false-positive findings prior to biopsy. Current approaches estimate tissue properties by means of quantitative parameters taken from generative, biophysical models fit to the q-space encoded signal under certain assumptions regarding noise and spatial homogeneity. This process is prone to fitting instability and partial information loss due to model simplicity. We reveal unexplored potentials of the signal by integrating all data processing components into a convolutional neural network (CNN) architecture that is designed to propagate clinical target information down to the raw input images. This approach enables simultaneous and target-specific optimization of image normalization, signal exploitation, global representation learning and classification. Using a multicentric data set of 222 patients, we demonstrate that our approach significantly improves clinical decision making with respect to the current state of the art.

cs.CV↗

Direct White Matter Bundle Segmentation using Stacked U-Nets

The state-of-the-art method for automatically segmenting white matter bundles in diffusion-weighted MRI is tractography in conjunction with streamline cluster selection. This process involves long chains of processing steps which are not only computationally expensive but also complex to setup and tedious with respect to quality control. Direct bundle segmentation methods treat the task as a traditional image segmentation problem. While they so far did not deliver competitive results, they can potentially mitigate many of the mentioned issues. We present a novel supervised approach for direct tract segmentation that shows major performance gains. It builds upon a stacked U-Net architecture which is trained on manual bundle segmentations from Human Connectome Project subjects. We evaluate our approach \textit{in vivo} as well as \textit{in silico} using the ISMRM 2015 Tractography Challenge phantom dataset. We achieve human segmentation performance and a major performance gain over previous pipelines. We show how the learned spatial priors efficiently guide the segmentation even at lower image qualities with little quality loss.

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