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Michelle Espranita Liman

Publications and source records attributed to Michelle Espranita Liman.

4 recordsLinked to original sources

EchoTab: Learning Measurement-Grounded Representations for Echocardiographic Diagnosis through Tabular Reconstruction

Diagnostic information in multi-view medical imaging studies, like echocardiography, is distributed across views, each capturing different aspects of cardiac structure and function. In clinical practice, these views are first interpreted through quantitative measurements, which then support specific diagnoses. However, existing echo representation learning methods do not explicitly model measurements as an intermediate representation between views and diagnosis. As a result, individual measurements are not explicitly represented in a form that downstream diagnostic tasks can selectively use, hindering accurate diagnosis. Inspired by this hierarchical clinical workflow, we introduce EchoTab, a measurement-grounded representation learning framework that represents multi-view echocardiography studies using measurement-specific tokens as an intermediate representation between echo views and diagnosis. Each measurement token selectively attends to the views relevant to its estimation and is trained through tabular reconstruction to predict the corresponding measurement value. The resulting tokens form a factorized echo representation, which encode clinically meaningful structural and functional properties and can be selectively used for downstream diagnosis. Unlike the commonly used contrastive approaches, EchoTab does not require negative samples or large batch sizes. Experiments on two datasets demonstrate that EchoTab learns effective measurement-grounded representations that improve diagnosis classification in multi-view echocardiography and its learned attention aligns with established measurement-view relationships used by cardiologists. Our code is accessible at https://github.com/michelleespranita/EchoTab.

cs.LG↗

NOAH: Learning the Full Patient Journey. A Longitudinal Multimodal Time-Aware Model for Representation and Forecasting

The digitization of healthcare has generated vast, longitudinal, and multimodal patient records over a lifetime, yet fully exploiting these data to represent and predict patient state trajectories remains a critical challenge. Current AI models often struggle to capture the complex, irregular temporal dynamics and inherent stochasticity of real-world multimodal patient data. Existing AI approaches for modeling longitudinal patient records are predominantly discriminative, limited to a few modalities, constrained by closed categorical vocabularies, treating time as a monotonic inductive bias, or they are limited in forecasting future patient states. We introduce NOAH, a time-aware, task-agnostic, generative transformer model representing and forecasting the full multimodal patient journey. NOAH features a novel bidirectional time integration and a variational latent space to capture the continuous evolution of patient states and the stochasticity of clinical trajectories. Built from over 559 million clinical events from 431,000 hospital visits of 299,000 patients across the MIMIC dataset family, NOAH natively processes medical images, time-series and numeric signals, categorical events, as well as structured and unstructured clinical records. NOAH is the first truly holistic generative model in its field, enabling autoregressive forecasting with optional time control, zero-shot classification, and counterfactual intervention simulation. It generates highly informative and predictive patient state representations that demonstrate strong performance in probing for clinical outcomes, 15 ICD chapters, and 29 comorbidities, as well as in time-to-event prediction. Seamlessly handling diverse modalities and complex temporal dynamics, NOAH provides a versatile, task-agnostic, scalable foundation for intelligent predictive systems in personalized clinical care and digital medicine.

cs.LG↗

Echo2ECG: Enhancing ECG Representations with Cardiac Morphology from Multi-View Echos

Electrocardiography (ECG) is a low-cost, widely used modality for diagnosing electrical abnormalities like atrial fibrillation by capturing the heart's electrical activity. However, it cannot directly measure cardiac morphological phenotypes, such as left ventricular ejection fraction (LVEF), which typically require echocardiography (Echo). Predicting these phenotypes from ECG would enable early, accessible health screening. Existing self-supervised methods suffer from a representational mismatch by aligning ECGs to single-view Echos, which only capture local, spatially restricted anatomical snapshots. To address this, we propose Echo2ECG, a multimodal self-supervised learning framework that enriches ECG representations with the heart's morphological structure captured in multi-view Echos. We evaluate Echo2ECG as an ECG feature extractor on two clinically relevant tasks that fundamentally require morphological information: (1) classification of structural cardiac phenotypes across three datasets, and (2) retrieval of Echo studies with similar morphological characteristics using ECG queries. Our extracted ECG representations consistently outperform those of state-of-the-art unimodal and multimodal baselines across both tasks, despite being 18x smaller than the largest baseline. These results demonstrate that Echo2ECG is a robust, powerful ECG feature extractor. Our code is accessible at https://github.com/michelleespranita/Echo2ECG.

cs.LG↗

Diffusion-based Generative Image Outpainting for Recovery of FOV-Truncated CT Images

Field-of-view (FOV) recovery of truncated chest CT scans is crucial for accurate body composition analysis, which involves quantifying skeletal muscle and subcutaneous adipose tissue (SAT) on CT slices. This, in turn, enables disease prognostication. Here, we present a method for recovering truncated CT slices using generative image outpainting. We train a diffusion model and apply it to truncated CT slices generated by simulating a small FOV. Our model reliably recovers the truncated anatomy and outperforms the previous state-of-the-art despite being trained on 87% less data.

eess.IV↗