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Meritxell Bach Cuadra

Publications and source records attributed to Meritxell Bach Cuadra.

At least 37 records · Page 2Linked to original sources

Meta-learning Slice-to-Volume Reconstruction in Fetal Brain MRI using Implicit Neural Representations

High-resolution slice-to-volume reconstruction (SVR) from multiple motion-corrupted low-resolution 2D slices constitutes a critical step in image-based diagnostics of moving subjects, such as fetal brain Magnetic Resonance Imaging (MRI). Existing solutions struggle with image artifacts and severe subject motion or require slice pre-alignment to achieve satisfying reconstruction performance. We propose a novel SVR method to enable fast and accurate MRI reconstruction even in cases of severe image and motion corruption. Our approach performs motion correction, outlier handling, and super-resolution reconstruction with all operations being entirely based on implicit neural representations. The model can be initialized with task-specific priors through fully self-supervised meta-learning on either simulated or real-world data. In extensive experiments including over 480 reconstructions of simulated and clinical MRI brain data from different centers, we prove the utility of our method in cases of severe subject motion and image artifacts. Our results demonstrate improvements in reconstruction quality, especially in the presence of severe motion, compared to state-of-the-art methods, and up to 50% reduction in reconstruction time.

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Advances in Automated Fetal Brain MRI Segmentation and Biometry: Insights from the FeTA 2024 Challenge

Accurate fetal brain tissue segmentation and biometric analysis are essential for studying brain development in utero. The FeTA Challenge 2024 advanced automated fetal brain MRI analysis by introducing biometry prediction as a new task alongside tissue segmentation. For the first time, our diverse multi-centric test set included data from a new low-field (0.55T) MRI dataset. Evaluation metrics were also expanded to include the topology-specific Euler characteristic difference (ED). Sixteen teams submitted segmentation methods, most of which performed consistently across both high- and low-field scans. However, longitudinal trends indicate that segmentation accuracy may be reaching a plateau, with results now approaching inter-rater variability. The ED metric uncovered topological differences that were missed by conventional metrics, while the low-field dataset achieved the highest segmentation scores, highlighting the potential of affordable imaging systems when paired with high-quality reconstruction. Seven teams participated in the biometry task, but most methods failed to outperform a simple baseline that predicted measurements based solely on gestational age, underscoring the challenge of extracting reliable biometric estimates from image data alone. Domain shift analysis identified image quality as the most significant factor affecting model generalization, with super-resolution pipelines also playing a substantial role. Other factors, such as gestational age, pathology, and acquisition site, had smaller, though still measurable, effects. Overall, FeTA 2024 offers a comprehensive benchmark for multi-class segmentation and biometry estimation in fetal brain MRI, underscoring the need for data-centric approaches, improved topological evaluation, and greater dataset diversity to enable clinically robust and generalizable AI tools.

cs.CV↗

Structural-Based Uncertainty in Deep Learning Across Anatomical Scales: Analysis in White Matter Lesion Segmentation

This paper explores uncertainty quantification (UQ) as an indicator of the trustworthiness of automated deep-learning (DL) tools in the context of white matter lesion (WML) segmentation from magnetic resonance imaging (MRI) scans of multiple sclerosis (MS) patients. Our study focuses on two principal aspects of uncertainty in structured output segmentation tasks. First, we postulate that a reliable uncertainty measure should indicate predictions likely to be incorrect with high uncertainty values. Second, we investigate the merit of quantifying uncertainty at different anatomical scales (voxel, lesion, or patient). We hypothesize that uncertainty at each scale is related to specific types of errors. Our study aims to confirm this relationship by conducting separate analyses for in-domain and out-of-domain settings. Our primary methodological contributions are (i) the development of novel measures for quantifying uncertainty at lesion and patient scales, derived from structural prediction discrepancies, and (ii) the extension of an error retention curve analysis framework to facilitate the evaluation of UQ performance at both lesion and patient scales. The results from a multi-centric MRI dataset of 444 patients demonstrate that our proposed measures more effectively capture model errors at the lesion and patient scales compared to measures that average voxel-scale uncertainty values. We provide the UQ protocols code at https://github.com/Medical-Image-Analysis-Laboratory/MS_WML_uncs.

cs.CV↗

Ground-truth effects in learning-based fiber orientation distribution estimation in neonatal brains

Diffusion Magnetic Resonance Imaging (dMRI) is a non-invasive method for depicting brain microstructure in vivo. Fiber orientation distributions (FODs) are mathematical representations extensively used to map white matter fiber configurations. Recently, FOD estimation with deep neural networks has seen growing success, in particular, those of neonates estimated with fewer diffusion measurements. These methods are mostly trained on target FODs reconstructed with multi-shell multi-tissue constrained spherical deconvolution (MSMT-CSD), which might not be the ideal ground truth for developing brains. Here, we investigate this hypothesis by training a state-of-the-art model based on the U-Net architecture on both MSMT-CSD and single-shell three-tissue constrained spherical deconvolution (SS3T-CSD). Our results suggest that SS3T-CSD might be more suited for neonatal brains, given that the ratio between single and multiple fiber-estimated voxels with SS3T-CSD is more realistic compared to MSMT-CSD. Additionally, increasing the number of input gradient directions significantly improves performance with SS3T-CSD over MSMT-CSD. Finally, in an age domain-shift setting, SS3T-CSD maintains robust performance across age groups, indicating its potential for more accurate neonatal brain imaging.

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Cross-Age and Cross-Site Domain Shift Impacts on Deep Learning-Based White Matter Fiber Estimation in Newborn and Baby Brains

Deep learning models have shown great promise in estimating tissue microstructure from limited diffusion magnetic resonance imaging data. However, these models face domain shift challenges when test and train data are from different scanners and protocols, or when the models are applied to data with inherent variations such as the developing brains of infants and children scanned at various ages. Several techniques have been proposed to address some of these challenges, such as data harmonization or domain adaptation in the adult brain. However, those techniques remain unexplored for the estimation of fiber orientation distribution functions in the rapidly developing brains of infants. In this work, we extensively investigate the age effect and domain shift within and across two different cohorts of 201 newborns and 165 babies using the Method of Moments and fine-tuning strategies. Our results show that reduced variations in the microstructural development of babies in comparison to newborns directly impact the deep learning models' cross-age performance. We also demonstrate that a small number of target domain samples can significantly mitigate domain shift problems.

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Exploiting XAI maps to improve MS lesion segmentation and detection in MRI

To date, several methods have been developed to explain deep learning algorithms for classification tasks. Recently, an adaptation of two of such methods has been proposed to generate instance-level explainable maps in a semantic segmentation scenario, such as multiple sclerosis (MS) lesion segmentation. In the mentioned work, a 3D U-Net was trained and tested for MS lesion segmentation, yielding an F1 score of 0.7006, and a positive predictive value (PPV) of 0.6265. The distribution of values in explainable maps exposed some differences between maps of true and false positive (TP/FP) examples. Inspired by those results, we explore in this paper the use of characteristics of lesion-specific saliency maps to refine segmentation and detection scores. We generate around 21000 maps from as many TP/FP lesions in a batch of 72 patients (training set) and 4868 from the 37 patients in the test set. 93 radiomic features extracted from the first set of maps were used to train a logistic regression model and classify TP versus FP. On the test set, F1 score and PPV were improved by a large margin when compared to the initial model, reaching 0.7450 and 0.7817, with 95% confidence intervals of [0.7358, 0.7547] and [0.7679, 0.7962], respectively. These results suggest that saliency maps can be used to refine prediction scores, boosting a model's performances.

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FetMRQC: a robust quality control system for multi-centric fetal brain MRI

Fetal brain MRI is becoming an increasingly relevant complement to neurosonography for perinatal diagnosis, allowing fundamental insights into fetal brain development throughout gestation. However, uncontrolled fetal motion and heterogeneity in acquisition protocols lead to data of variable quality, potentially biasing the outcome of subsequent studies. We present FetMRQC, an open-source machine-learning framework for automated image quality assessment and quality control that is robust to domain shifts induced by the heterogeneity of clinical data. FetMRQC extracts an ensemble of quality metrics from unprocessed anatomical MRI and combines them to predict experts' ratings using random forests. We validate our framework on a pioneeringly large and diverse dataset of more than 1600 manually rated fetal brain T2-weighted images from four clinical centers and 13 different scanners. Our study shows that FetMRQC's predictions generalize well to unseen data while being interpretable. FetMRQC is a step towards more robust fetal brain neuroimaging, which has the potential to shed new insights on the developing human brain.

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In-vivo imaging of the human thalamus: a comprehensive evaluation of structural magnetic resonance imaging approaches for thalamic nuclei differentiation at 7T

The thalamus is a subcortical structure of central importance to brain function, which is organized in smaller nuclei with specialized roles. Despite significant functional and clinical relevance, locating and distinguishing the different thalamic nuclei in vivo, non-invasively, has proved challenging with conventional imaging techniques, such as T$_{1}$ and T$_{2}$-weighted magnetic resonance imaging (MRI). This key limitation has prompted extensive research efforts, and several new candidate MRI sequences for thalamic imaging have been proposed, especially at 7T. However, studies to date have mainly been centered on individual techniques, and often focused on subsets of specific nuclei. It is now critical to evaluate which options are best for which nuclei, and which are globally the most informative. This work addresses these questions through a comprehensive evaluation of thalamic structural imaging techniques in humans at 7T, including several variants of T$_{1}$, T$_{2}$, T$_{2}$* and magnetic susceptibility-based contrasts. All images were obtained from the same participants, to allow direct comparisons without anatomical variability confounds. The different contrasts were qualitatively and quantitatively analyzed with dedicated approaches, referenced to well-established thalamic atlases. Overall, the analyses showed that quantitative susceptibility mapping (QSM) and T$_{1}$-weighted MP2RAGE tuned to maximize gray-to-white matter contrast are currently the most valuable options. The two contrasts display unique, complementary features and, together, enable the distinction of the majority of known nuclei. Likewise, their combined information could provide a powerful input for automatic segmentation approaches. To our knowledge, this study represents the most comprehensive assessment of structural MRI contrasts for thalamic imaging to date.

physics.med-ph↗

Improving cross-domain brain tissue segmentation in fetal MRI with synthetic data

Segmentation of fetal brain tissue from magnetic resonance imaging (MRI) plays a crucial role in the study of in utero neurodevelopment. However, automated tools face substantial domain shift challenges as they must be robust to highly heterogeneous clinical data, often limited in numbers and lacking annotations. Indeed, high variability of the fetal brain morphology, MRI acquisition parameters, and superresolution reconstruction (SR) algorithms adversely affect the model's performance when evaluated out-of-domain. In this work, we introduce FetalSynthSeg, a domain randomization method to segment fetal brain MRI, inspired by SynthSeg. Our results show that models trained solely on synthetic data outperform models trained on real data in out-ofdomain settings, validated on a 120-subject cross-domain dataset. Furthermore, we extend our evaluation to 40 subjects acquired using lowfield (0.55T) MRI and reconstructed with novel SR models, showcasing robustness across different magnetic field strengths and SR algorithms. Leveraging a generative synthetic approach, we tackle the domain shift problem in fetal brain MRI and offer compelling prospects for applications in fields with limited and highly heterogeneous data.

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Multi-Center Fetal Brain Tissue Annotation (FeTA) Challenge 2022 Results

Segmentation is a critical step in analyzing the developing human fetal brain. There have been vast improvements in automatic segmentation methods in the past several years, and the Fetal Brain Tissue Annotation (FeTA) Challenge 2021 helped to establish an excellent standard of fetal brain segmentation. However, FeTA 2021 was a single center study, and the generalizability of algorithms across different imaging centers remains unsolved, limiting real-world clinical applicability. The multi-center FeTA Challenge 2022 focuses on advancing the generalizability of fetal brain segmentation algorithms for magnetic resonance imaging (MRI). In FeTA 2022, the training dataset contained images and corresponding manually annotated multi-class labels from two imaging centers, and the testing data contained images from these two imaging centers as well as two additional unseen centers. The data from different centers varied in many aspects, including scanners used, imaging parameters, and fetal brain super-resolution algorithms applied. 16 teams participated in the challenge, and 17 algorithms were evaluated. Here, a detailed overview and analysis of the challenge results are provided, focusing on the generalizability of the submissions. Both in- and out of domain, the white matter and ventricles were segmented with the highest accuracy, while the most challenging structure remains the cerebral cortex due to anatomical complexity. The FeTA Challenge 2022 was able to successfully evaluate and advance generalizability of multi-class fetal brain tissue segmentation algorithms for MRI and it continues to benchmark new algorithms. The resulting new methods contribute to improving the analysis of brain development in utero.

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FetMRQC: Automated Quality Control for fetal brain MRI

Quality control (QC) has long been considered essential to guarantee the reliability of neuroimaging studies. It is particularly important for fetal brain MRI, where large and unpredictable fetal motion can lead to substantial artifacts in the acquired images. Existing methods for fetal brain quality assessment operate at the \textit{slice} level, and fail to get a comprehensive picture of the quality of an image, that can only be achieved by looking at the \textit{entire} brain volume. In this work, we propose FetMRQC, a machine learning framework for automated image quality assessment tailored to fetal brain MRI, which extracts an ensemble of quality metrics that are then used to predict experts' ratings. Based on the manual ratings of more than 1000 low-resolution stacks acquired across two different institutions, we show that, compared with existing quality metrics, FetMRQC is able to generalize out-of-domain, while being interpretable and data efficient. We also release a novel manual quality rating tool designed to facilitate and optimize quality rating of fetal brain images. Our tool, along with all the code to generate, train and evaluate the model is available at https://github.com/Medical-Image-Analysis-Laboratory/fetal_brain_qc/ .

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Direct segmentation of brain white matter tracts in diffusion MRI

The brain white matter consists of a set of tracts that connect distinct regions of the brain. Segmentation of these tracts is often needed for clinical and research studies. Diffusion-weighted MRI offers unique contrast to delineate these tracts. However, existing segmentation methods rely on intermediate computations such as tractography or estimation of fiber orientation density. These intermediate computations, in turn, entail complex computations that can result in unnecessary errors. Moreover, these intermediate computations often require dense multi-shell measurements that are unavailable in many clinical and research applications. As a result, current methods suffer from low accuracy and poor generalizability. Here, we propose a new deep learning method that segments these tracts directly from the diffusion MRI data, thereby sidestepping the intermediate computation errors. Our experiments show that this method can achieve segmentation accuracy that is on par with the state of the art methods (mean Dice Similarity Coefficient of 0.826). Compared with the state of the art, our method offers far superior generalizability to undersampled data that are typical of clinical studies and to data obtained with different acquisition protocols. Moreover, we propose a new method for detecting inaccurate segmentations and show that it is more accurate than standard methods that are based on estimation uncertainty quantification. The new methods can serve many critically important clinical and scientific applications that require accurate and reliable non-invasive segmentation of white matter tracts.

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Fast refacing of MR images with a generative neural network lowers re-identification risk and preserves volumetric consistency

With the rise of open data, identifiability of individuals based on 3D renderings obtained from routine structural magnetic resonance imaging (MRI) scans of the head has become a growing privacy concern. To protect subject privacy, several algorithms have been developed to de-identify imaging data using blurring, defacing or refacing. Completely removing facial structures provides the best re-identification protection but can significantly impact post-processing steps, like brain morphometry. As an alternative, refacing methods that replace individual facial structures with generic templates have a lower effect on the geometry and intensity distribution of original scans, and are able to provide more consistent post-processing results by the price of higher re-identification risk and computational complexity. In the current study, we propose a novel method for anonymised face generation for defaced 3D T1-weighted scans based on a 3D conditional generative adversarial network. To evaluate the performance of the proposed de-identification tool, a comparative study was conducted between several existing defacing and refacing tools, with two different segmentation algorithms (FAST and Morphobox). The aim was to evaluate (i) impact on brain morphometry reproducibility, (ii) re-identification risk, (iii) balance between (i) and (ii), and (iv) the processing time. The proposed method takes 9 seconds for face generation and is suitable for recovering consistent post-processing results after defacing.

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Robust thalamic nuclei segmentation from T1-weighted MRI

Accurate segmentation of thalamic nuclei, crucial for understanding their role in healthy cognition and in pathologies, is challenging to achieve on standard T1-weighted (T1w) magnetic resonance imaging (MRI) due to poor image contrast. White-matter-nulled (WMn) MRI sequences improve intrathalamic contrast but are not part of clinical protocols or extant databases. Here, we introduce Histogram-based polynomial synthesis (HIPS), a fast preprocessing step that synthesizes WMn-like image contrast from standard T1w MRI using a polynomial approximation. HIPS was incorporated into our Thalamus Optimized Multi-Atlas Segmentation (THOMAS) pipeline, developed and optimized for WMn MRI. HIPS-THOMAS was compared to a convolutional neural network (CNN)-based segmentation method and THOMAS modified for T1w images (T1w-THOMAS). The robustness and accuracy of the three methods were tested across different image contrasts, scanner manufacturers, and field strength. HIPS-synthesized images improved intra-thalamic contrast and thalamic boundaries, and their segmentations yielded significantly better mean Dice, lower percentage of volume error, and lower standard deviations compared to both the CNN method and T1w-THOMAS. Finally, using THOMAS, HIPS-synthesized images were as effective as WMn images for identifying thalamic nuclei atrophy in alcohol use disorders subjects relative to healthy controls, with a higher area under the ROC curve compared to T1w-THOMAS (0.79 vs 0.73).

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Simulation-based parameter optimization for fetal brain MRI super-resolution reconstruction

Tuning the regularization hyperparameter $α$ in inverse problems has been a longstanding problem. This is particularly true in the case of fetal brain magnetic resonance imaging, where an isotropic high-resolution volume is reconstructed from motion-corrupted low-resolution series of two-dimensional thick slices. Indeed, the lack of ground truth images makes challenging the adaptation of $α$ to a given setting of interest in a quantitative manner. In this work, we propose a simulation-based approach to tune $α$ for a given acquisition setting. We focus on the influence of the magnetic field strength and availability of input low-resolution images on the ill-posedness of the problem. Our results show that the optimal $α$, chosen as the one maximizing the similarity with the simulated reference image, significantly improves the super-resolution reconstruction accuracy compared to the generally adopted default regularization values, independently of the selected pipeline. Qualitative validation on clinical data confirms the importance of tuning this parameter to the targeted clinical image setting.

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Tackling Bias in the Dice Similarity Coefficient: Introducing nDSC for White Matter Lesion Segmentation

The development of automatic segmentation techniques for medical imaging tasks requires assessment metrics to fairly judge and rank such approaches on benchmarks. The Dice Similarity Coefficient (DSC) is a popular choice for comparing the agreement between the predicted segmentation against a ground-truth mask. However, the DSC metric has been shown to be biased to the occurrence rate of the positive class in the ground-truth, and hence should be considered in combination with other metrics. This work describes a detailed analysis of the recently proposed normalised Dice Similarity Coefficient (nDSC) for binary segmentation tasks as an adaptation of DSC which scales the precision at a fixed recall rate to tackle this bias. White matter lesion segmentation on magnetic resonance images of multiple sclerosis patients is selected as a case study task to empirically assess the suitability of nDSC. We validate the normalised DSC using two different models across 59 subject scans with a wide range of lesion loads. It is found that the nDSC is less biased than DSC with lesion load on standard white matter lesion segmentation benchmarks measured using standard rank correlation coefficients. An implementation of nDSC is made available at: https://github.com/NataliiaMolch/nDSC .

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Weakly Supervised Learning with Automated Labels from Radiology Reports for Glioma Change Detection

Gliomas are the most frequent primary brain tumors in adults. Glioma change detection aims at finding the relevant parts of the image that change over time. Although Deep Learning (DL) shows promising performances in similar change detection tasks, the creation of large annotated datasets represents a major bottleneck for supervised DL applications in radiology. To overcome this, we propose a combined use of weak labels (imprecise, but fast-to-create annotations) and Transfer Learning (TL). Specifically, we explore inductive TL, where source and target domains are identical, but tasks are different due to a label shift: our target labels are created manually by three radiologists, whereas our source weak labels are generated automatically from radiology reports via NLP. We frame knowledge transfer as hyperparameter optimization, thus avoiding heuristic choices that are frequent in related works. We investigate the relationship between model size and TL, comparing a low-capacity VGG with a higher-capacity ResNeXt model. We evaluate our models on 1693 T2-weighted magnetic resonance imaging difference maps created from 183 patients, by classifying them into stable or unstable according to tumor evolution. The weak labels extracted from radiology reports allowed us to increase dataset size more than 3-fold, and improve VGG classification results from 75% to 82% AUC. Mixed training from scratch led to higher performance than fine-tuning or feature extraction. To assess generalizability, we ran inference on an open dataset (BraTS-2015: 15 patients, 51 difference maps), reaching up to 76% AUC. Overall, results suggest that medical imaging problems may benefit from smaller models and different TL strategies with respect to computer vision datasets, and that report-generated weak labels are effective in improving model performances. Code, in-house dataset and BraTS labels are released.

cs.CV↗

BigBrain-MR: a new digital phantom with anatomically-realistic magnetic resonance properties at 100-μm resolution for magnetic resonance methods development

The benefits, opportunities and growing availability of ultra-high field magnetic resonance imaging (MRI) for humans have prompted an expansion in research and development efforts towards increasingly more advanced high-resolution imaging techniques. To maximize their effectiveness, these efforts need to be supported by powerful computational simulation platforms that can adequately reproduce the biophysical characteristics of MRI, with high spatial resolution. In this work, we have sought to address this need by developing a novel digital phantom with realistic anatomical detail up to 100-um resolution, including multiple MRI properties that affect image generation. This phantom, termed BigBrain-MR, was generated from the publicly available BigBrain histological dataset and lower-resolution in-vivo 7T-MRI data, using a newly-developed image processing framework that allows mapping the general properties of the latter into the fine anatomical scale of the former. Overall, the mapping framework was found to be effective and robust, yielding a diverse range of realistic "in-vivo-like" MRI contrasts and maps at 100-um resolution. BigBrain-MR was then tested in three different imaging applications (motion effects and interpolation, super-resolution imaging, and parallel imaging reconstruction) to investigate its properties, value and validity as a simulation platform. The results consistently showed that BigBrain-MR can closely approximate the behavior of real in-vivo data, more realistically and with more extensive features than a more classic option such as the Shepp-Logan phantom. This novel phantom is therefore deemed a favorable choice to support methodological development in brain MRI, and has been made freely available to the community.

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