arXiv subjects

M. Jorge Cardoso

Publications and source records attributed to M. Jorge Cardoso.

At least 37 records · Page 2Linked to original sources

arXiv2023

A 3D generative model of pathological multi-modal MR images and segmentations

Generative modelling and synthetic data can be a surrogate for real medical imaging datasets, whose scarcity and difficulty to share can be a nuisance when delivering accurate deep learning models for healthcare applications. In recent years, there has been an increased interest in using these models for data augmentation and synthetic data sharing, using architectures such as generative adversarial networks (GANs) or diffusion models (DMs). Nonetheless, the application of synthetic data to tasks such as 3D magnetic resonance imaging (MRI) segmentation remains limited due to the lack of labels associated with the generated images. Moreover, many of the proposed generative MRI models lack the ability to generate arbitrary modalities due to the absence of explicit contrast conditioning. These limitations prevent the user from adjusting the contrast and content of the images and obtaining more generalisable data for training task-specific models. In this work, we propose brainSPADE3D, a 3D generative model for brain MRI and associated segmentations, where the user can condition on specific pathological phenotypes and contrasts. The proposed joint imaging-segmentation generative model is shown to generate high-fidelity synthetic images and associated segmentations, with the ability to combine pathologies. We demonstrate how the model can alleviate issues with segmentation model performance when unexpected pathologies are present in the data.

eess.IV↗

arXiv2023

InverseSR: 3D Brain MRI Super-Resolution Using a Latent Diffusion Model

High-resolution (HR) MRI scans obtained from research-grade medical centers provide precise information about imaged tissues. However, routine clinical MRI scans are typically in low-resolution (LR) and vary greatly in contrast and spatial resolution due to the adjustments of the scanning parameters to the local needs of the medical center. End-to-end deep learning methods for MRI super-resolution (SR) have been proposed, but they require re-training each time there is a shift in the input distribution. To address this issue, we propose a novel approach that leverages a state-of-the-art 3D brain generative model, the latent diffusion model (LDM) trained on UK BioBank, to increase the resolution of clinical MRI scans. The LDM acts as a generative prior, which has the ability to capture the prior distribution of 3D T1-weighted brain MRI. Based on the architecture of the brain LDM, we find that different methods are suitable for different settings of MRI SR, and thus propose two novel strategies: 1) for SR with more sparsity, we invert through both the decoder of the LDM and also through a deterministic Denoising Diffusion Implicit Models (DDIM), an approach we will call InverseSR(LDM); 2) for SR with less sparsity, we invert only through the LDM decoder, an approach we will call InverseSR(Decoder). These two approaches search different latent spaces in the LDM model to find the optimal latent code to map the given LR MRI into HR. The training process of the generative model is independent of the MRI under-sampling process, ensuring the generalization of our method to many MRI SR problems with different input measurements. We validate our method on over 100 brain T1w MRIs from the IXI dataset. Our method can demonstrate that powerful priors given by LDM can be used for MRI reconstruction.

eess.IV↗

arXiv2023

Generative AI for Medical Imaging: extending the MONAI Framework

Recent advances in generative AI have brought incredible breakthroughs in several areas, including medical imaging. These generative models have tremendous potential not only to help safely share medical data via synthetic datasets but also to perform an array of diverse applications, such as anomaly detection, image-to-image translation, denoising, and MRI reconstruction. However, due to the complexity of these models, their implementation and reproducibility can be difficult. This complexity can hinder progress, act as a use barrier, and dissuade the comparison of new methods with existing works. In this study, we present MONAI Generative Models, a freely available open-source platform that allows researchers and developers to easily train, evaluate, and deploy generative models and related applications. Our platform reproduces state-of-art studies in a standardised way involving different architectures (such as diffusion models, autoregressive transformers, and GANs), and provides pre-trained models for the community. We have implemented these models in a generalisable fashion, illustrating that their results can be extended to 2D or 3D scenarios, including medical images with different modalities (like CT, MRI, and X-Ray data) and from different anatomical areas. Finally, we adopt a modular and extensible approach, ensuring long-term maintainability and the extension of current applications for future features.

eess.IV↗

arXiv2023

Unsupervised 3D out-of-distribution detection with latent diffusion models

Methods for out-of-distribution (OOD) detection that scale to 3D data are crucial components of any real-world clinical deep learning system. Classic denoising diffusion probabilistic models (DDPMs) have been recently proposed as a robust way to perform reconstruction-based OOD detection on 2D datasets, but do not trivially scale to 3D data. In this work, we propose to use Latent Diffusion Models (LDMs), which enable the scaling of DDPMs to high-resolution 3D medical data. We validate the proposed approach on near- and far-OOD datasets and compare it to a recently proposed, 3D-enabled approach using Latent Transformer Models (LTMs). Not only does the proposed LDM-based approach achieve statistically significant better performance, it also shows less sensitivity to the underlying latent representation, more favourable memory scaling, and produces better spatial anomaly maps. Code is available at https://github.com/marksgraham/ddpm-ood

cs.CV↗

arXiv2023

DeepEdit: Deep Editable Learning for Interactive Segmentation of 3D Medical Images

Automatic segmentation of medical images is a key step for diagnostic and interventional tasks. However, achieving this requires large amounts of annotated volumes, which can be tedious and time-consuming task for expert annotators. In this paper, we introduce DeepEdit, a deep learning-based method for volumetric medical image annotation, that allows automatic and semi-automatic segmentation, and click-based refinement. DeepEdit combines the power of two methods: a non-interactive (i.e. automatic segmentation using nnU-Net, UNET or UNETR) and an interactive segmentation method (i.e. DeepGrow), into a single deep learning model. It allows easy integration of uncertainty-based ranking strategies (i.e. aleatoric and epistemic uncertainty computation) and active learning. We propose and implement a method for training DeepEdit by using standard training combined with user interaction simulation. Once trained, DeepEdit allows clinicians to quickly segment their datasets by using the algorithm in auto segmentation mode or by providing clicks via a user interface (i.e. 3D Slicer, OHIF). We show the value of DeepEdit through evaluation on the PROSTATEx dataset for prostate/prostatic lesions and the Multi-Atlas Labeling Beyond the Cranial Vault (BTCV) dataset for abdominal CT segmentation, using state-of-the-art network architectures as baseline for comparison. DeepEdit could reduce the time and effort annotating 3D medical images compared to DeepGrow alone. Source code is available at https://github.com/Project-MONAI/MONAILabel

eess.IV↗

arXiv2023

Current State of Community-Driven Radiological AI Deployment in Medical Imaging

Artificial Intelligence (AI) has become commonplace to solve routine everyday tasks. Because of the exponential growth in medical imaging data volume and complexity, the workload on radiologists is steadily increasing. We project that the gap between the number of imaging exams and the number of expert radiologist readers required to cover this increase will continue to expand, consequently introducing a demand for AI-based tools that improve the efficiency with which radiologists can comfortably interpret these exams. AI has been shown to improve efficiency in medical-image generation, processing, and interpretation, and a variety of such AI models have been developed across research labs worldwide. However, very few of these, if any, find their way into routine clinical use, a discrepancy that reflects the divide between AI research and successful AI translation. To address the barrier to clinical deployment, we have formed MONAI Consortium, an open-source community which is building standards for AI deployment in healthcare institutions, and developing tools and infrastructure to facilitate their implementation. This report represents several years of weekly discussions and hands-on problem solving experience by groups of industry experts and clinicians in the MONAI Consortium. We identify barriers between AI-model development in research labs and subsequent clinical deployment and propose solutions. Our report provides guidance on processes which take an imaging AI model from development to clinical implementation in a healthcare institution. We discuss various AI integration points in a clinical Radiology workflow. We also present a taxonomy of Radiology AI use-cases. Through this report, we intend to educate the stakeholders in healthcare and AI (AI researchers, radiologists, imaging informaticists, and regulators) about cross-disciplinary challenges and possible solutions.

cs.AI↗

arXiv2023

MONAI Label: A framework for AI-assisted Interactive Labeling of 3D Medical Images

The lack of annotated datasets is a major bottleneck for training new task-specific supervised machine learning models, considering that manual annotation is extremely expensive and time-consuming. To address this problem, we present MONAI Label, a free and open-source framework that facilitates the development of applications based on artificial intelligence (AI) models that aim at reducing the time required to annotate radiology datasets. Through MONAI Label, researchers can develop AI annotation applications focusing on their domain of expertise. It allows researchers to readily deploy their apps as services, which can be made available to clinicians via their preferred user interface. Currently, MONAI Label readily supports locally installed (3D Slicer) and web-based (OHIF) frontends and offers two active learning strategies to facilitate and speed up the training of segmentation algorithms. MONAI Label allows researchers to make incremental improvements to their AI-based annotation application by making them available to other researchers and clinicians alike. Additionally, MONAI Label provides sample AI-based interactive and non-interactive labeling applications, that can be used directly off the shelf, as plug-and-play to any given dataset. Significant reduced annotation times using the interactive model can be observed on two public datasets.

cs.HC↗

arXiv2023

Denoising diffusion models for out-of-distribution detection

Out-of-distribution detection is crucial to the safe deployment of machine learning systems. Currently, unsupervised out-of-distribution detection is dominated by generative-based approaches that make use of estimates of the likelihood or other measurements from a generative model. Reconstruction-based methods offer an alternative approach, in which a measure of reconstruction error is used to determine if a sample is out-of-distribution. However, reconstruction-based approaches are less favoured, as they require careful tuning of the model's information bottleneck - such as the size of the latent dimension - to produce good results. In this work, we exploit the view of denoising diffusion probabilistic models (DDPM) as denoising autoencoders where the bottleneck is controlled externally, by means of the amount of noise applied. We propose to use DDPMs to reconstruct an input that has been noised to a range of noise levels, and use the resulting multi-dimensional reconstruction error to classify out-of-distribution inputs. We validate our approach both on standard computer-vision datasets and on higher dimension medical datasets. Our approach outperforms not only reconstruction-based methods, but also state-of-the-art generative-based approaches. Code is available at https://github.com/marksgraham/ddpm-ood.

cs.LG↗

arXiv2023

Cross Attention Transformers for Multi-modal Unsupervised Whole-Body PET Anomaly Detection

Cancer is a highly heterogeneous condition that can occur almost anywhere in the human body. 18F-fluorodeoxyglucose is an imaging modality commonly used to detect cancer due to its high sensitivity and clear visualisation of the pattern of metabolic activity. Nonetheless, as cancer is highly heterogeneous, it is challenging to train general-purpose discriminative cancer detection models, with data availability and disease complexity often cited as a limiting factor. Unsupervised anomaly detection models have been suggested as a putative solution. These models learn a healthy representation of tissue and detect cancer by predicting deviations from the healthy norm, which requires models capable of accurately learning long-range interactions between organs and their imaging patterns with high levels of expressivity. Such characteristics are suitably satisfied by transformers, which have been shown to generate state-of-the-art results in unsupervised anomaly detection by training on normal data. This work expands upon such approaches by introducing multi-modal conditioning of the transformer via cross-attention i.e. supplying anatomical reference from paired CT. Using 294 whole-body PET/CT samples, we show that our anomaly detection method is robust and capable of achieving accurate cancer localization results even in cases where normal training data is unavailable. In addition, we show the efficacy of this approach on out-of-sample data showcasing the generalizability of this approach with limited training data. Lastly, we propose to combine model uncertainty with a new kernel density estimation approach, and show that it provides clinically and statistically significant improvements when compared to the classic residual-based anomaly maps. Overall, a superior performance is demonstrated against leading state-of-the-art alternatives, drawing attention to the potential of these approaches.

eess.IV↗

arXiv2022

Transformer-based normative modelling for anomaly detection of early schizophrenia

Despite the impact of psychiatric disorders on clinical health, early-stage diagnosis remains a challenge. Machine learning studies have shown that classifiers tend to be overly narrow in the diagnosis prediction task. The overlap between conditions leads to high heterogeneity among participants that is not adequately captured by classification models. To address this issue, normative approaches have surged as an alternative method. By using a generative model to learn the distribution of healthy brain data patterns, we can identify the presence of pathologies as deviations or outliers from the distribution learned by the model. In particular, deep generative models showed great results as normative models to identify neurological lesions in the brain. However, unlike most neurological lesions, psychiatric disorders present subtle changes widespread in several brain regions, making these alterations challenging to identify. In this work, we evaluate the performance of transformer-based normative models to detect subtle brain changes expressed in adolescents and young adults. We trained our model on 3D MRI scans of neurotypical individuals (N=1,765). Then, we obtained the likelihood of neurotypical controls and psychiatric patients with early-stage schizophrenia from an independent dataset (N=93) from the Human Connectome Project. Using the predicted likelihood of the scans as a proxy for a normative score, we obtained an AUROC of 0.82 when assessing the difference between controls and individuals with early-stage schizophrenia. Our approach surpassed recent normative methods based on brain age and Gaussian Process, showing the promising use of deep generative models to help in individualised analyses.

cs.LG↗

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

Brain Imaging Generation with Latent Diffusion Models

Deep neural networks have brought remarkable breakthroughs in medical image analysis. However, due to their data-hungry nature, the modest dataset sizes in medical imaging projects might be hindering their full potential. Generating synthetic data provides a promising alternative, allowing to complement training datasets and conducting medical image research at a larger scale. Diffusion models recently have caught the attention of the computer vision community by producing photorealistic synthetic images. In this study, we explore using Latent Diffusion Models to generate synthetic images from high-resolution 3D brain images. We used T1w MRI images from the UK Biobank dataset (N=31,740) to train our models to learn about the probabilistic distribution of brain images, conditioned on covariables, such as age, sex, and brain structure volumes. We found that our models created realistic data, and we could use the conditioning variables to control the data generation effectively. Besides that, we created a synthetic dataset with 100,000 brain images and made it openly available to the scientific community.

eess.IV↗

arXiv2022

Fitting Segmentation Networks on Varying Image Resolutions using Splatting

Data used in image segmentation are not always defined on the same grid. This is particularly true for medical images, where the resolution, field-of-view and orientation can differ across channels and subjects. Images and labels are therefore commonly resampled onto the same grid, as a pre-processing step. However, the resampling operation introduces partial volume effects and blurring, thereby changing the effective resolution and reducing the contrast between structures. In this paper we propose a splat layer, which automatically handles resolution mismatches in the input data. This layer pushes each image onto a mean space where the forward pass is performed. As the splat operator is the adjoint to the resampling operator, the mean-space prediction can be pulled back to the native label space, where the loss function is computed. Thus, the need for explicit resolution adjustment using interpolation is removed. We show on two publicly available datasets, with simulated and real multi-modal magnetic resonance images, that this model improves segmentation results compared to resampling as a pre-processing step.

eess.IV↗

arXiv2022

Solid NURBS Conforming Scaffolding for Isogeometric Analysis

This work introduces a scaffolding framework to compactly parametrise solid structures with conforming NURBS elements for isogeometric analysis. A novel formulation introduces a topological, geometrical and parametric subdivision of the space in a minimal plurality of conforming vectorial elements. These determine a multi-compartmental scaffolding for arbitrary branching patterns. A solid smoothing paradigm is devised for the conforming scaffolding achieving higher than positional geometrical and parametric continuity. Results are shown for synthetic shapes of varying complexity, for modular CAD geometries, for branching structures from tessellated meshes and for organic biological structures from imaging data. Representative simulations demonstrate the validity of the introduced scaffolding framework with scalable performance and groundbreaking applications for isogeometric analysis.

cs.CG↗

arXiv2022

Fast Unsupervised Brain Anomaly Detection and Segmentation with Diffusion Models

Deep generative models have emerged as promising tools for detecting arbitrary anomalies in data, dispensing with the necessity for manual labelling. Recently, autoregressive transformers have achieved state-of-the-art performance for anomaly detection in medical imaging. Nonetheless, these models still have some intrinsic weaknesses, such as requiring images to be modelled as 1D sequences, the accumulation of errors during the sampling process, and the significant inference times associated with transformers. Denoising diffusion probabilistic models are a class of non-autoregressive generative models recently shown to produce excellent samples in computer vision (surpassing Generative Adversarial Networks), and to achieve log-likelihoods that are competitive with transformers while having fast inference times. Diffusion models can be applied to the latent representations learnt by autoencoders, making them easily scalable and great candidates for application to high dimensional data, such as medical images. Here, we propose a method based on diffusion models to detect and segment anomalies in brain imaging. By training the models on healthy data and then exploring its diffusion and reverse steps across its Markov chain, we can identify anomalous areas in the latent space and hence identify anomalies in the pixel space. Our diffusion models achieve competitive performance compared with autoregressive approaches across a series of experiments with 2D CT and MRI data involving synthetic and real pathological lesions with much reduced inference times, making their usage clinically viable.

cs.CV↗

arXiv2021

Deep forecasting of translational impact in medical research

The value of biomedical research--a $1.7 trillion annual investment--is ultimately determined by its downstream, real-world impact. Current objective predictors of impact rest on proxy, reductive metrics of dissemination, such as paper citation rates, whose relation to real-world translation remains unquantified. Here we sought to determine the comparative predictability of future real-world translation--as indexed by inclusion in patents, guidelines or policy documents--from complex models of the abstract-level content of biomedical publications versus citations and publication meta-data alone. We develop a suite of representational and discriminative mathematical models of multi-scale publication data, quantifying predictive performance out-of-sample, ahead-of-time, across major biomedical domains, using the entire corpus of biomedical research captured by Microsoft Academic Graph from 1990 to 2019, encompassing 43.3 million papers across all domains. We show that citations are only moderately predictive of translational impact as judged by inclusion in patents, guidelines, or policy documents. By contrast, high-dimensional models of publication titles, abstracts and metadata exhibit high fidelity (AUROC > 0.9), generalise across time and thematic domain, and transfer to the task of recognising papers of Nobel Laureates. The translational impact of a paper indexed by inclusion in patents, guidelines, or policy documents can be predicted--out-of-sample and ahead-of-time--with substantially higher fidelity from complex models of its abstract-level content than from models of publication meta-data or citation metrics. We argue that content-based models of impact are superior in performance to conventional, citation-based measures, and sustain a stronger evidence-based claim to the objective measurement of translational potential.

cs.DL↗

arXiv2021

A Decoupled Uncertainty Model for MRI Segmentation Quality Estimation

Quality control (QC) of MR images is essential to ensure that downstream analyses such as segmentation can be performed successfully. Currently, QC is predominantly performed visually and subjectively, at significant time and operator cost. We aim to automate the process using a probabilistic network that estimates segmentation uncertainty through a heteroscedastic noise model, providing a measure of task-specific quality. By augmenting training images with k-space artefacts, we propose a novel CNN architecture to decouple sources of uncertainty related to the task and different k-space artefacts in a self-supervised manner. This enables the prediction of separate uncertainties for different types of data degradation. While the uncertainty predictions reflect the presence and severity of artefacts, the network provides more robust and generalisable segmentation predictions given the quality of the data. We show that models trained with artefact augmentation provide informative measures of uncertainty on both simulated artefacts and problematic real-world images identified by human raters, both qualitatively and quantitatively in the form of error bars on volume measurements. Relating artefact uncertainty to segmentation Dice scores, we observe that our uncertainty predictions provide a better estimate of MRI quality from the point of view of the task (gray matter segmentation) compared to commonly used metrics of quality including signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), hence providing a real-time quality metric indicative of segmentation quality.

eess.IV↗

arXiv2021

Distinguishing Healthy Ageing from Dementia: a Biomechanical Simulation of Brain Atrophy using Deep Networks

Biomechanical modeling of tissue deformation can be used to simulate different scenarios of longitudinal brain evolution. In this work,we present a deep learning framework for hyper-elastic strain modelling of brain atrophy, during healthy ageing and in Alzheimer's Disease. The framework directly models the effects of age, disease status, and scan interval to regress regional patterns of atrophy, from which a strain-based model estimates deformations. This model is trained and validated using 3D structural magnetic resonance imaging data from the ADNI cohort. Results show that the framework can estimate realistic deformations, following the known course of Alzheimer's disease, that clearly differentiate between healthy and demented patterns of ageing. This suggests the framework has potential to be incorporated into explainable models of disease, for the exploration of interventions and counterfactual examples.

q-bio.NC↗