arXiv subjects

Laurence E. Court

Publications and source records attributed to Laurence E. Court.

5 recordsLinked to original sources

arXiv2026

Bias-Aware Conformal Prediction for Metric-Based Imaging Pipelines

Reliable confidence measures of metrics derived from medical imaging reconstruction pipelines would improve the standard of decision-making in many clinical workflows. Conformal Prediction (CP) provides a robust framework for producing calibrated prediction intervals, but standard CP formulations face a critical challenge in the imaging pipeline: common mismatches between image reconstruction objectives and downstream metrics can introduce systematic prediction deviations from ground truth values, known as bias. These biases in turn compromise the efficiency of prediction intervals, which is a problem that has been unexplored in the CP literature. In this study, we formalize the behavior of symmetric (where bounds expand equally in both directions) and asymmetric (where bounds expand unequally) formulations for common non-conformity scores in CP in the presence of bias, and argue that this measurable bias must inform the choice of CP formulation. We theoretically and empirically demonstrate that symmetric intervals are inflated by a factor of two times the magnitude of bias while asymmetric intervals remain unaffected by bias, and provide conditions under which each formulation produces tighter intervals. We empirically validated our theoretical analyses on sparse-view CT reconstruction for downstream radiotherapy planning. Our work enables users of medical imaging pipelines to proactively select optimal CP formulations, thereby improving interval length efficiency for critical downstream metrics.

stat.ML↗

arXiv2025

When are Diffusion Priors Helpful in Sparse Reconstruction? A Study with Sparse-view CT

Diffusion models demonstrate state-of-the-art performance on image generation, and are gaining traction for sparse medical image reconstruction tasks. However, compared to classical reconstruction algorithms relying on simple analytical priors, diffusion models have the dangerous property of producing realistic looking results \emph{even when incorrect}, particularly with few observations. We investigate the utility of diffusion models as priors for image reconstruction by varying the number of observations and comparing their performance to classical priors (sparse and Tikhonov regularization) using pixel-based, structural, and downstream metrics. We make comparisons on low-dose chest wall computed tomography (CT) for fat mass quantification. First, we find that classical priors are superior to diffusion priors when the number of projections is ``sufficient''. Second, we find that diffusion priors can capture a large amount of detail with very few observations, significantly outperforming classical priors. However, they fall short of capturing all details, even with many observations. Finally, we find that the performance of diffusion priors plateau after extremely few ($\approx$10-15) projections. Ultimately, our work highlights potential issues with diffusion-based sparse reconstruction and underscores the importance of further investigation, particularly in high-stakes clinical settings.

physics.med-ph↗

arXiv2023

Evolving Horizons in Radiotherapy Auto-Contouring: Distilling Insights, Embracing Data-Centric Frameworks, and Moving Beyond Geometric Quantification

Deep learning has significantly advanced the potential for automated contouring in radiotherapy planning. In this manuscript, guided by contemporary literature, we underscore three key insights: (1) High-quality training data is essential for auto-contouring algorithms; (2) Auto-contouring models demonstrate commendable performance even with limited medical image data; (3) The quantitative performance of auto-contouring is reaching a plateau. Given these insights, we emphasize the need for the radiotherapy research community to embrace data-centric approaches to further foster clinical adoption of auto-contouring technologies.

physics.med-ph↗

arXiv2023

Deep Learning-Based Dose Prediction for Automated, Individualized Quality Assurance of Head and Neck Radiation Therapy Plans

Purpose: This study aimed to use deep learning-based dose prediction to assess head and neck (HN) plan quality and identify suboptimal plans. Methods: A total of 245 VMAT HN plans were created using RapidPlan knowledge-based planning (KBP). A subset of 112 high-quality plans was selected under the supervision of an HN radiation oncologist. We trained a 3D Dense Dilated U-Net architecture to predict 3-dimensional dose distributions using 3-fold cross-validation on 90 plans. Model inputs included CT images, target prescriptions, and contours for targets and organs at risk (OARs). The model's performance was assessed on the remaining 22 test plans. We then tested the application of the dose prediction model for automated review of plan quality. Dose distributions were predicted on 14 clinical plans. The predicted versus clinical OAR dose metrics were compared to flag OARs with suboptimal normal tissue sparing using a 2 Gy dose difference or 3% dose-volume threshold. OAR flags were compared to manual flags by 3 HN radiation oncologists. Results: The predicted dose distributions were of comparable quality to the KBP plans. The differences between the predicted and KBP-planned D1%, D95%, and D99% across the targets were within -2.53%(SD=1.34%), -0.42%(SD=1.27%), and -0.12%(SD=1.97%), respectively, and the OAR mean and maximum doses were within -0.33Gy(SD=1.40Gy) and -0.96Gy(SD=2.08Gy). For the plan quality assessment study, radiation oncologists flagged 47 OARs for possible plan improvement. There was high interphysician variability; 83% of physician-flagged OARs were flagged by only one of 3 physicians. The comparative dose prediction model flagged 63 OARs, including 30 of 47 physician-flagged OARs. Conclusion: Deep learning can predict high-quality dose distributions, which can be used as comparative dose distributions for automated, individualized assessment of HN plan quality.

physics.med-ph↗

arXiv2022

VerSe: A Vertebrae Labelling and Segmentation Benchmark for Multi-detector CT Images

Vertebral labelling and segmentation are two fundamental tasks in an automated spine processing pipeline. Reliable and accurate processing of spine images is expected to benefit clinical decision-support systems for diagnosis, surgery planning, and population-based analysis on spine and bone health. However, designing automated algorithms for spine processing is challenging predominantly due to considerable variations in anatomy and acquisition protocols and due to a severe shortage of publicly available data. Addressing these limitations, the Large Scale Vertebrae Segmentation Challenge (VerSe) was organised in conjunction with the International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI) in 2019 and 2020, with a call for algorithms towards labelling and segmentation of vertebrae. Two datasets containing a total of 374 multi-detector CT scans from 355 patients were prepared and 4505 vertebrae have individually been annotated at voxel-level by a human-machine hybrid algorithm (https://osf.io/nqjyw/, https://osf.io/t98fz/). A total of 25 algorithms were benchmarked on these datasets. In this work, we present the the results of this evaluation and further investigate the performance-variation at vertebra-level, scan-level, and at different fields-of-view. We also evaluate the generalisability of the approaches to an implicit domain shift in data by evaluating the top performing algorithms of one challenge iteration on data from the other iteration. The principal takeaway from VerSe: the performance of an algorithm in labelling and segmenting a spine scan hinges on its ability to correctly identify vertebrae in cases of rare anatomical variations. The content and code concerning VerSe can be accessed at: https://github.com/anjany/verse.

cs.CV↗