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Marc Niethammer

Publications and source records attributed to Marc Niethammer.

At least 37 records · Page 2Linked to original sources

CARES: A Comprehensive Benchmark of Trustworthiness in Medical Vision Language Models

Artificial intelligence has significantly impacted medical applications, particularly with the advent of Medical Large Vision Language Models (Med-LVLMs), sparking optimism for the future of automated and personalized healthcare. However, the trustworthiness of Med-LVLMs remains unverified, posing significant risks for future model deployment. In this paper, we introduce CARES and aim to comprehensively evaluate the Trustworthiness of Med-LVLMs across the medical domain. We assess the trustworthiness of Med-LVLMs across five dimensions, including trustfulness, fairness, safety, privacy, and robustness. CARES comprises about 41K question-answer pairs in both closed and open-ended formats, covering 16 medical image modalities and 27 anatomical regions. Our analysis reveals that the models consistently exhibit concerns regarding trustworthiness, often displaying factual inaccuracies and failing to maintain fairness across different demographic groups. Furthermore, they are vulnerable to attacks and demonstrate a lack of privacy awareness. We publicly release our benchmark and code in https://cares-ai.github.io/.

cs.LG↗

$\texttt{NePhi}$: Neural Deformation Fields for Approximately Diffeomorphic Medical Image Registration

This work proposes NePhi, a generalizable neural deformation model which results in approximately diffeomorphic transformations. In contrast to the predominant voxel-based transformation fields used in learning-based registration approaches, NePhi represents deformations functionally, leading to great flexibility within the design space of memory consumption during training and inference, inference time, registration accuracy, as well as transformation regularity. Specifically, NePhi 1) requires less memory compared to voxel-based learning approaches, 2) improves inference speed by predicting latent codes, compared to current existing neural deformation based registration approaches that \emph{only} rely on optimization, 3) improves accuracy via instance optimization, and 4) shows excellent deformation regularity which is highly desirable for medical image registration. We demonstrate the performance of NePhi on a 2D synthetic dataset as well as for real 3D medical image datasets (e.g., lungs and brains). Our results show that NePhi can match the accuracy of voxel-based representations in a single-resolution registration setting. For multi-resolution registration, our method matches the accuracy of current SOTA learning-based registration approaches with instance optimization while reducing memory requirements by a factor of five. Our code is available at https://github.com/uncbiag/NePhi.

cs.CV↗

Leveraging Near-Field Lighting for Monocular Depth Estimation from Endoscopy Videos

Monocular depth estimation in endoscopy videos can enable assistive and robotic surgery to obtain better coverage of the organ and detection of various health issues. Despite promising progress on mainstream, natural image depth estimation, techniques perform poorly on endoscopy images due to a lack of strong geometric features and challenging illumination effects. In this paper, we utilize the photometric cues, i.e., the light emitted from an endoscope and reflected by the surface, to improve monocular depth estimation. We first create two novel loss functions with supervised and self-supervised variants that utilize a per-pixel shading representation. We then propose a novel depth refinement network (PPSNet) that leverages the same per-pixel shading representation. Finally, we introduce teacher-student transfer learning to produce better depth maps from both synthetic data with supervision and clinical data with self-supervision. We achieve state-of-the-art results on the C3VD dataset while estimating high-quality depth maps from clinical data. Our code, pre-trained models, and supplementary materials can be found on our project page: https://ppsnet.github.io/

cs.CV↗

The Brain Tumor Sequence Registration (BraTS-Reg) Challenge: Establishing Correspondence Between Pre-Operative and Follow-up MRI Scans of Diffuse Glioma Patients

Registration of longitudinal brain MRI scans containing pathologies is challenging due to dramatic changes in tissue appearance. Although there has been progress in developing general-purpose medical image registration techniques, they have not yet attained the requisite precision and reliability for this task, highlighting its inherent complexity. Here we describe the Brain Tumor Sequence Registration (BraTS-Reg) challenge, as the first public benchmark environment for deformable registration algorithms focusing on estimating correspondences between pre-operative and follow-up scans of the same patient diagnosed with a diffuse brain glioma. The BraTS-Reg data comprise de-identified multi-institutional multi-parametric MRI (mpMRI) scans, curated for size and resolution according to a canonical anatomical template, and divided into training, validation, and testing sets. Clinical experts annotated ground truth (GT) landmark points of anatomical locations distinct across the temporal domain. Quantitative evaluation and ranking were based on the Median Euclidean Error (MEE), Robustness, and the determinant of the Jacobian of the displacement field. The top-ranked methodologies yielded similar performance across all evaluation metrics and shared several methodological commonalities, including pre-alignment, deep neural networks, inverse consistency analysis, and test-time instance optimization per-case basis as a post-processing step. The top-ranked method attained the MEE at or below that of the inter-rater variability for approximately 60% of the evaluated landmarks, underscoring the scope for further accuracy and robustness improvements, especially relative to human experts. The aim of BraTS-Reg is to continue to serve as an active resource for research, with the data and online evaluation tools accessible at https://bratsreg.github.io/.

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Rethinking Interactive Image Segmentation with Low Latency, High Quality, and Diverse Prompts

The goal of interactive image segmentation is to delineate specific regions within an image via visual or language prompts. Low-latency and high-quality interactive segmentation with diverse prompts remain challenging for existing specialist and generalist models. Specialist models, with their limited prompts and task-specific designs, experience high latency because the image must be recomputed every time the prompt is updated, due to the joint encoding of image and visual prompts. Generalist models, exemplified by the Segment Anything Model (SAM), have recently excelled in prompt diversity and efficiency, lifting image segmentation to the foundation model era. However, for high-quality segmentations, SAM still lags behind state-of-the-art specialist models despite SAM being trained with x100 more segmentation masks. In this work, we delve deep into the architectural differences between the two types of models. We observe that dense representation and fusion of visual prompts are the key design choices contributing to the high segmentation quality of specialist models. In light of this, we reintroduce this dense design into the generalist models, to facilitate the development of generalist models with high segmentation quality. To densely represent diverse visual prompts, we propose to use a dense map to capture five types: clicks, boxes, polygons, scribbles, and masks. Thus, we propose SegNext, a next-generation interactive segmentation approach offering low latency, high quality, and diverse prompt support. Our method outperforms current state-of-the-art methods on HQSeg-44K and DAVIS, both quantitatively and qualitatively.

cs.CV↗

A Unified Model for Longitudinal Multi-Modal Multi-View Prediction with Missingness

Medical records often consist of different modalities, such as images, text, and tabular information. Integrating all modalities offers a holistic view of a patient's condition, while analyzing them longitudinally provides a better understanding of disease progression. However, real-world longitudinal medical records present challenges: 1) patients may lack some or all of the data for a specific timepoint, and 2) certain modalities or views might be absent for all patients during a particular period. In this work, we introduce a unified model for longitudinal multi-modal multi-view prediction with missingness. Our method allows as many timepoints as desired for input, and aims to leverage all available data, regardless of their availability. We conduct extensive experiments on the knee osteoarthritis dataset from the Osteoarthritis Initiative for pain and Kellgren-Lawrence grade prediction at a future timepoint. We demonstrate the effectiveness of our method by comparing results from our unified model to specific models that use the same modality and view combinations during training and evaluation. We also show the benefit of having extended temporal data and provide post-hoc analysis for a deeper understanding of each modality/view's importance for different tasks.

cs.CV↗

NeuralOCT: Airway OCT Analysis via Neural Fields

Optical coherence tomography (OCT) is a popular modality in ophthalmology and is also used intravascularly. Our interest in this work is OCT in the context of airway abnormalities in infants and children where the high resolution of OCT and the fact that it is radiation-free is important. The goal of airway OCT is to provide accurate estimates of airway geometry (in 2D and 3D) to assess airway abnormalities such as subglottic stenosis. We propose $\texttt{NeuralOCT}$, a learning-based approach to process airway OCT images. Specifically, $\texttt{NeuralOCT}$ extracts 3D geometries from OCT scans by robustly bridging two steps: point cloud extraction via 2D segmentation and 3D reconstruction from point clouds via neural fields. Our experiments show that $\texttt{NeuralOCT}$ produces accurate and robust 3D airway reconstructions with an average A-line error smaller than 70 micrometer. Our code will cbe available on GitHub.

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NAISR: A 3D Neural Additive Model for Interpretable Shape Representation

Deep implicit functions (DIFs) have emerged as a powerful paradigm for many computer vision tasks such as 3D shape reconstruction, generation, registration, completion, editing, and understanding. However, given a set of 3D shapes with associated covariates there is at present no shape representation method which allows to precisely represent the shapes while capturing the individual dependencies on each covariate. Such a method would be of high utility to researchers to discover knowledge hidden in a population of shapes. For scientific shape discovery, we propose a 3D Neural Additive Model for Interpretable Shape Representation ($\texttt{NAISR}$) which describes individual shapes by deforming a shape atlas in accordance to the effect of disentangled covariates. Our approach captures shape population trends and allows for patient-specific predictions through shape transfer. $\texttt{NAISR}$ is the first approach to combine the benefits of deep implicit shape representations with an atlas deforming according to specified covariates. We evaluate $\texttt{NAISR}$ with respect to shape reconstruction, shape disentanglement, shape evolution, and shape transfer on three datasets: 1) $\textit{Starman}$, a simulated 2D shape dataset; 2) the ADNI hippocampus 3D shape dataset; and 3) a pediatric airway 3D shape dataset. Our experiments demonstrate that $\textit{Starman}$ achieves excellent shape reconstruction performance while retaining interpretability. Our code is available at $\href{https://github.com/uncbiag/NAISR}{https://github.com/uncbiag/NAISR}$.

cs.CV↗

Exploring Cycle Consistency Learning in Interactive Volume Segmentation

Automatic medical volume segmentation often lacks clinical accuracy, necessitating further refinement. In this work, we interactively approach medical volume segmentation via two decoupled modules: interaction-to-segmentation and segmentation propagation. Given a medical volume, a user first segments a slice (or several slices) via the interaction module and then propagates the segmentation(s) to the remaining slices. The user may repeat this process multiple times until a sufficiently high volume segmentation quality is achieved. However, due to the lack of human correction during propagation, segmentation errors are prone to accumulate in the intermediate slices and may lead to sub-optimal performance. To alleviate this issue, we propose a simple yet effective cycle consistency loss that regularizes an intermediate segmentation by referencing the accurate segmentation in the starting slice. To this end, we introduce a backward segmentation path that propagates the intermediate segmentation back to the starting slice using the same propagation network. With cycle consistency training, the propagation network is better regularized than in standard forward-only training approaches. Evaluation results on challenging AbdomenCT-1K and OAI-ZIB datasets demonstrate the effectiveness of our method.

cs.CV↗

uniGradICON: A Foundation Model for Medical Image Registration

Conventional medical image registration approaches directly optimize over the parameters of a transformation model. These approaches have been highly successful and are used generically for registrations of different anatomical regions. Recent deep registration networks are incredibly fast and accurate but are only trained for specific tasks. Hence, they are no longer generic registration approaches. We therefore propose uniGradICON, a first step toward a foundation model for registration providing 1) great performance \emph{across} multiple datasets which is not feasible for current learning-based registration methods, 2) zero-shot capabilities for new registration tasks suitable for different acquisitions, anatomical regions, and modalities compared to the training dataset, and 3) a strong initialization for finetuning on out-of-distribution registration tasks. UniGradICON unifies the speed and accuracy benefits of learning-based registration algorithms with the generic applicability of conventional non-deep-learning approaches. We extensively trained and evaluated uniGradICON on twelve different public datasets. Our code and the uniGradICON model are available at https://github.com/uncbiag/uniGradICON.

cs.CV↗

SAME++: A Self-supervised Anatomical eMbeddings Enhanced medical image registration framework using stable sampling and regularized transformation

Image registration is a fundamental medical image analysis task. Ideally, registration should focus on aligning semantically corresponding voxels, i.e., the same anatomical locations. However, existing methods often optimize similarity measures computed directly on intensities or on hand-crafted features, which lack anatomical semantic information. These similarity measures may lead to sub-optimal solutions where large deformations, complex anatomical differences, or cross-modality imagery exist. In this work, we introduce a fast and accurate method for unsupervised 3D medical image registration building on top of a Self-supervised Anatomical eMbedding (SAM) algorithm, which is capable of computing dense anatomical correspondences between two images at the voxel level. We name our approach SAM-Enhanced registration (SAME++), which decomposes image registration into four steps: affine transformation, coarse deformation, deep non-parametric transformation, and instance optimization. Using SAM embeddings, we enhance these steps by finding more coherent correspondence and providing features with better semantic guidance. We extensively evaluated SAME++ using more than 50 labeled organs on three challenging inter-subject registration tasks of different body parts. As a complete registration framework, SAME++ markedly outperforms leading methods by $4.2\%$ - $8.2\%$ in terms of Dice score while being orders of magnitude faster than numerical optimization-based methods. Code is available at \url{https://github.com/alibaba-damo-academy/same}.

cs.CV↗

Joint Depth Prediction and Semantic Segmentation with Multi-View SAM

Multi-task approaches to joint depth and segmentation prediction are well-studied for monocular images. Yet, predictions from a single-view are inherently limited, while multiple views are available in many robotics applications. On the other end of the spectrum, video-based and full 3D methods require numerous frames to perform reconstruction and segmentation. With this work we propose a Multi-View Stereo (MVS) technique for depth prediction that benefits from rich semantic features of the Segment Anything Model (SAM). This enhanced depth prediction, in turn, serves as a prompt to our Transformer-based semantic segmentation decoder. We report the mutual benefit that both tasks enjoy in our quantitative and qualitative studies on the ScanNet dataset. Our approach consistently outperforms single-task MVS and segmentation models, along with multi-task monocular methods.

cs.CV↗

$\texttt{GradICON}$: Approximate Diffeomorphisms via Gradient Inverse Consistency

We present an approach to learning regular spatial transformations between image pairs in the context of medical image registration. Contrary to optimization-based registration techniques and many modern learning-based methods, we do not directly penalize transformation irregularities but instead promote transformation regularity via an inverse consistency penalty. We use a neural network to predict a map between a source and a target image as well as the map when swapping the source and target images. Different from existing approaches, we compose these two resulting maps and regularize deviations of the $\bf{Jacobian}$ of this composition from the identity matrix. This regularizer -- $\texttt{GradICON}$ -- results in much better convergence when training registration models compared to promoting inverse consistency of the composition of maps directly while retaining the desirable implicit regularization effects of the latter. We achieve state-of-the-art registration performance on a variety of real-world medical image datasets using a single set of hyperparameters and a single non-dataset-specific training protocol.

cs.CV↗

Unsupervised Discovery of 3D Hierarchical Structure with Generative Diffusion Features

Inspired by recent findings that generative diffusion models learn semantically meaningful representations, we use them to discover the intrinsic hierarchical structure in biomedical 3D images using unsupervised segmentation. We show that features of diffusion models from different stages of a U-Net-based ladder-like architecture capture different hierarchy levels in 3D biomedical images. We design three losses to train a predictive unsupervised segmentation network that encourages the decomposition of 3D volumes into meaningful nested subvolumes that represent a hierarchy. First, we pretrain 3D diffusion models and use the consistency of their features across subvolumes. Second, we use the visual consistency between subvolumes. Third, we use the invariance to photometric augmentations as a regularizer. Our models achieve better performance than prior unsupervised structure discovery approaches on challenging biologically-inspired synthetic datasets and on a real-world brain tumor MRI dataset.

cs.CV↗

Inverse Consistency by Construction for Multistep Deep Registration

Inverse consistency is a desirable property for image registration. We propose a simple technique to make a neural registration network inverse consistent by construction, as a consequence of its structure, as long as it parameterizes its output transform by a Lie group. We extend this technique to multi-step neural registration by composing many such networks in a way that preserves inverse consistency. This multi-step approach also allows for inverse-consistent coarse to fine registration. We evaluate our technique on synthetic 2-D data and four 3-D medical image registration tasks and obtain excellent registration accuracy while assuring inverse consistency.

cs.CV↗

Self-supervised Landmark Learning with Deformation Reconstruction and Cross-subject Consistency Objectives

A Point Distribution Model (PDM) is the basis of a Statistical Shape Model (SSM) that relies on a set of landmark points to represent a shape and characterize the shape variation. In this work, we present a self-supervised approach to extract landmark points from a given registration model for the PDMs. Based on the assumption that the landmarks are the points that have the most influence on registration, existing works learn a point-based registration model with a small number of points to estimate the landmark points that influence the deformation the most. However, such approaches assume that the deformation can be captured by point-based registration and quality landmarks can be learned solely with the deformation capturing objective. We argue that data with complicated deformations can not easily be modeled with point-based registration when only a limited number of points is used to extract influential landmark points. Further, landmark consistency is not assured in existing approaches In contrast, we propose to extract landmarks based on a given registration model, which is tailored for the target data, so we can obtain more accurate correspondences. Secondly, to establish the anatomical consistency of the predicted landmarks, we introduce a landmark discovery loss to explicitly encourage the model to predict the landmarks that are anatomically consistent across subjects. We conduct experiments on an osteoarthritis progression prediction task and show our method outperforms existing image-based and point-based approaches.

cs.CV↗

Multimodal Understanding Through Correlation Maximization and Minimization

Multimodal learning has mainly focused on learning large models on, and fusing feature representations from, different modalities for better performances on downstream tasks. In this work, we take a detour from this trend and study the intrinsic nature of multimodal data by asking the following questions: 1) Can we learn more structured latent representations of general multimodal data?; and 2) can we intuitively understand, both mathematically and visually, what the latent representations capture? To answer 1), we propose a general and lightweight framework, Multimodal Understanding Through Correlation Maximization and Minimization (MUCMM), that can be incorporated into any large pre-trained network. MUCMM learns both the common and individual representations. The common representations capture what is common between the modalities; the individual representations capture the unique aspect of the modalities. To answer 2), we propose novel scores that summarize the learned common and individual structures and visualize the score gradients with respect to the input, visually discerning what the different representations capture. We further provide mathematical intuitions of the computed gradients in a linear setting, and demonstrate the effectiveness of our approach through a variety of experiments.

cs.CV↗

LiftReg: Limited Angle 2D/3D Deformable Registration

We propose LiftReg, a 2D/3D deformable registration approach. LiftReg is a deep registration framework which is trained using sets of digitally reconstructed radiographs (DRR) and computed tomography (CT) image pairs. By using simulated training data, LiftReg can use a high-quality CT-CT image similarity measure, which helps the network to learn a high-quality deformation space. To further improve registration quality and to address the inherent depth ambiguities of very limited angle acquisitions, we propose to use features extracted from the backprojected 2D images and a statistical deformation model. We test our approach on the DirLab lung registration dataset and show that it outperforms an existing learning-based pairwise registration approach.

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