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P. Ellen Grant

Publications and source records attributed to P. Ellen Grant.

At least 37 records · Page 2Linked to original sources

Consistency Regularization Improves Placenta Segmentation in Fetal EPI MRI Time Series

The placenta plays a crucial role in fetal development. Automated 3D placenta segmentation from fetal EPI MRI holds promise for advancing prenatal care. This paper proposes an effective semi-supervised learning method for improving placenta segmentation in fetal EPI MRI time series. We employ consistency regularization loss that promotes consistency under spatial transformation of the same image and temporal consistency across nearby images in a time series. The experimental results show that the method improves the overall segmentation accuracy and provides better performance for outliers and hard samples. The evaluation also indicates that our method improves the temporal coherency of the prediction, which could lead to more accurate computation of temporal placental biomarkers. This work contributes to the study of the placenta and prenatal clinical decision-making. Code is available at https://github.com/firstmover/cr-seg.

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AnyStar: Domain randomized universal star-convex 3D instance segmentation

Star-convex shapes arise across bio-microscopy and radiology in the form of nuclei, nodules, metastases, and other units. Existing instance segmentation networks for such structures train on densely labeled instances for each dataset, which requires substantial and often impractical manual annotation effort. Further, significant reengineering or finetuning is needed when presented with new datasets and imaging modalities due to changes in contrast, shape, orientation, resolution, and density. We present AnyStar, a domain-randomized generative model that simulates synthetic training data of blob-like objects with randomized appearance, environments, and imaging physics to train general-purpose star-convex instance segmentation networks. As a result, networks trained using our generative model do not require annotated images from unseen datasets. A single network trained on our synthesized data accurately 3D segments C. elegans and P. dumerilii nuclei in fluorescence microscopy, mouse cortical nuclei in micro-CT, zebrafish brain nuclei in EM, and placental cotyledons in human fetal MRI, all without any retraining, finetuning, transfer learning, or domain adaptation. Code is available at https://github.com/neel-dey/AnyStar.

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Computer-Vision Benchmark Segment-Anything Model (SAM) in Medical Images: Accuracy in 12 Datasets

Background: The segment-anything model (SAM), introduced in April 2023, shows promise as a benchmark model and a universal solution to segment various natural images. It comes without previously-required re-training or fine-tuning specific to each new dataset. Purpose: To test SAM's accuracy in various medical image segmentation tasks and investigate potential factors that may affect its accuracy in medical images. Methods: SAM was tested on 12 public medical image segmentation datasets involving 7,451 subjects. The accuracy was measured by the Dice overlap between the algorithm-segmented and ground-truth masks. SAM was compared with five state-of-the-art algorithms specifically designed for medical image segmentation tasks. Associations of SAM's accuracy with six factors were computed, independently and jointly, including segmentation difficulties as measured by segmentation ability score and by Dice overlap in U-Net, image dimension, size of the target region, image modality, and contrast. Results: The Dice overlaps from SAM were significantly lower than the five medical-image-based algorithms in all 12 medical image segmentation datasets, by a margin of 0.1-0.5 and even 0.6-0.7 Dice. SAM-Semantic was significantly associated with medical image segmentation difficulty and the image modality, and SAM-Point and SAM-Box were significantly associated with image segmentation difficulty, image dimension, target region size, and target-vs-background contrast. All these 3 variations of SAM were more accurate in 2D medical images, larger target region sizes, easier cases with a higher Segmentation Ability score and higher U-Net Dice, and higher foreground-background contrast.

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U-Netmer: U-Net meets Transformer for medical image segmentation

The combination of the U-Net based deep learning models and Transformer is a new trend for medical image segmentation. U-Net can extract the detailed local semantic and texture information and Transformer can learn the long-rang dependencies among pixels in the input image. However, directly adapting the Transformer for segmentation has ``token-flatten" problem (flattens the local patches into 1D tokens which losses the interaction among pixels within local patches) and ``scale-sensitivity" problem (uses a fixed scale to split the input image into local patches). Compared to directly combining U-Net and Transformer, we propose a new global-local fashion combination of U-Net and Transformer, named U-Netmer, to solve the two problems. The proposed U-Netmer splits an input image into local patches. The global-context information among local patches is learnt by the self-attention mechanism in Transformer and U-Net segments each local patch instead of flattening into tokens to solve the `token-flatten" problem. The U-Netmer can segment the input image with different patch sizes with the identical structure and the same parameter. Thus, the U-Netmer can be trained with different patch sizes to solve the ``scale-sensitivity" problem. We conduct extensive experiments in 7 public datasets on 7 organs (brain, heart, breast, lung, polyp, pancreas and prostate) and 4 imaging modalities (MRI, CT, ultrasound, and endoscopy) to show that the proposed U-Netmer can be generally applied to improve accuracy of medical image segmentation. These experimental results show that U-Netmer provides state-of-the-art performance compared to baselines and other models. In addition, the discrepancy among the outputs of U-Netmer with different scales is linearly correlated to the segmentation accuracy which can be considered as a confidence score to rank test images by difficulty without ground-truth.

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Time-efficient, High Resolution 3T Whole Brain Quantitative Relaxometry using 3D-QALAS with Wave-CAIPI Readouts

Purpose: Volumetric, high-resolution, quantitative mapping of brain tissue relaxation properties is hindered by long acquisition times and signal-to-noise (SNR) challenges. This study, for the first time, combines the time-efficient wave-CAIPI readouts into the 3D-quantification using an interleaved Look-Locker acquisition sequence with a T2 preparation pulse (3D-QALAS) acquisition scheme, enabling full brain quantitative T1, T2 and proton density (PD) maps at 1.15 mm3 isotropic voxels in only 3 minutes. Methods: Wave-CAIPI readouts were embedded in the standard 3D-QALAS encoding scheme, enabling full brain quantitative parameter maps (T1, T2, and PD) at acceleration factors of R=3x2 with minimum SNR loss due to g-factor penalties. The quantitative parameter maps were estimated using a dictionary-based mapping algorithm incorporating inversion efficiency and B1 field inhomogeneity. The quantitative maps using the accelerated protocol were quantitatively compared against those obtained from conventional 3D-QALAS sequence using GRAPPA acceleration of R=2 in the ISMRM NIST phantom, and ten healthy volunteers. Results: When tested in both the ISMRM/NIST phantom and ten healthy volunteers, the quantitative maps using the accelerated protocol showed excellent agreement against those obtained from conventional 3D-QALAS at RGRAPPA=2. Conclusion: 3D-QALAS enhanced with wave-CAIPI readouts enables time-efficient, full brain quantitative T1, T2, and PD mapping at 1.15 mm3 in 3 minutes at R=3x2 acceleration. When tested on the NIST phantom and ten healthy volunteers, the quantitative maps obtained from the accelerated wave-CAIPI 3D-QALAS protocol showed very similar values to those obtained from the standard 3D-QALAS (R=2) protocol, alluding to the robustness and reliability of the proposed methods.

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Segmentation Ability Map: Interpret deep features for medical image segmentation

Deep convolutional neural networks (CNNs) have been widely used for medical image segmentation. In most studies, only the output layer is exploited to compute the final segmentation results and the hidden representations of the deep learned features have not been well understood. In this paper, we propose a prototype segmentation (ProtoSeg) method to compute a binary segmentation map based on deep features. We measure the segmentation abilities of the features by computing the Dice between the feature segmentation map and ground-truth, named as the segmentation ability score (SA score for short). The corresponding SA score can quantify the segmentation abilities of deep features in different layers and units to understand the deep neural networks for segmentation. In addition, our method can provide a mean SA score which can give a performance estimation of the output on the test images without ground-truth. Finally, we use the proposed ProtoSeg method to compute the segmentation map directly on input images to further understand the segmentation ability of each input image. Results are presented on segmenting tumors in brain MRI, lesions in skin images, COVID-related abnormality in CT images, prostate segmentation in abdominal MRI, and pancreatic mass segmentation in CT images. Our method can provide new insights for interpreting and explainable AI systems for medical image segmentation. Our code is available on: \url{https://github.com/shengfly/ProtoSeg}.

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Automatic Segmentation of the Placenta in BOLD MRI Time Series

Blood oxygen level dependent (BOLD) MRI with maternal hyperoxia can assess oxygen transport within the placenta and has emerged as a promising tool to study placental function. Measuring signal changes over time requires segmenting the placenta in each volume of the time series. Due to the large number of volumes in the BOLD time series, existing studies rely on registration to map all volumes to a manually segmented template. As the placenta can undergo large deformation due to fetal motion, maternal motion, and contractions, this approach often results in a large number of discarded volumes, where the registration approach fails. In this work, we propose a machine learning model based on a U-Net neural network architecture to automatically segment the placenta in BOLD MRI and apply it to segmenting each volume in a time series. We use a boundary-weighted loss function to accurately capture the placental shape. Our model is trained and tested on a cohort of 91 subjects containing healthy fetuses, fetuses with fetal growth restriction, and mothers with high BMI. We achieve a Dice score of 0.83+/-0.04 when matching with ground truth labels and our model performs reliably in segmenting volumes in both normoxic and hyperoxic points in the BOLD time series. Our code and trained model are available at https://github.com/mabulnaga/automatic-placenta-segmentation.

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SVoRT: Iterative Transformer for Slice-to-Volume Registration in Fetal Brain MRI

Volumetric reconstruction of fetal brains from multiple stacks of MR slices, acquired in the presence of almost unpredictable and often severe subject motion, is a challenging task that is highly sensitive to the initialization of slice-to-volume transformations. We propose a novel slice-to-volume registration method using Transformers trained on synthetically transformed data, which model multiple stacks of MR slices as a sequence. With the attention mechanism, our model automatically detects the relevance between slices and predicts the transformation of one slice using information from other slices. We also estimate the underlying 3D volume to assist slice-to-volume registration and update the volume and transformations alternately to improve accuracy. Results on synthetic data show that our method achieves lower registration error and better reconstruction quality compared with existing state-of-the-art methods. Experiments with real-world MRI data are also performed to demonstrate the ability of the proposed model to improve the quality of 3D reconstruction under severe fetal motion.

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Deep Relation Learning for Regression and Its Application to Brain Age Estimation

Most deep learning models for temporal regression directly output the estimation based on single input images, ignoring the relationships between different images. In this paper, we propose deep relation learning for regression, aiming to learn different relations between a pair of input images. Four non-linear relations are considered: "cumulative relation", "relative relation", "maximal relation" and "minimal relation". These four relations are learned simultaneously from one deep neural network which has two parts: feature extraction and relation regression. We use an efficient convolutional neural network to extract deep features from the pair of input images and apply a Transformer for relation learning. The proposed method is evaluated on a merged dataset with 6,049 subjects with ages of 0-97 years using 5-fold cross-validation for the task of brain age estimation. The experimental results have shown that the proposed method achieved a mean absolute error (MAE) of 2.38 years, which is lower than the MAEs of 8 other state-of-the-art algorithms with statistical significance (p$<$0.05) in paired T-test (two-side).

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Volumetric Parameterization of the Placenta to a Flattened Template

We present a volumetric mesh-based algorithm for parameterizing the placenta to a flattened template to enable effective visualization of local anatomy and function. MRI shows potential as a research tool as it provides signals directly related to placental function. However, due to the curved and highly variable in vivo shape of the placenta, interpreting and visualizing these images is difficult. We address interpretation challenges by mapping the placenta so that it resembles the familiar ex vivo shape. We formulate the parameterization as an optimization problem for mapping the placental shape represented by a volumetric mesh to a flattened template. We employ the symmetric Dirichlet energy to control local distortion throughout the volume. Local injectivity in the mapping is enforced by a constrained line search during the gradient descent optimization. We validate our method using a research study of 111 placental shapes extracted from BOLD MRI images. Our mapping achieves sub-voxel accuracy in matching the template while maintaining low distortion throughout the volume. We demonstrate how the resulting flattening of the placenta improves visualization of anatomy and function. Our code is freely available at https://github.com/mabulnaga/placenta-flattening .

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Rapid head-pose detection for automated slice prescription of fetal-brain MRI

In fetal-brain MRI, head-pose changes between prescription and acquisition present a challenge to obtaining the standard sagittal, coronal and axial views essential to clinical assessment. As motion limits acquisitions to thick slices that preclude retrospective resampling, technologists repeat ~55-second stack-of-slices scans (HASTE) with incrementally reoriented field of view numerous times, deducing the head pose from previous stacks. To address this inefficient workflow, we propose a robust head-pose detection algorithm using full-uterus scout scans (EPI) which take ~5 seconds to acquire. Our ~2-second procedure automatically locates the fetal brain and eyes, which we derive from maximally stable extremal regions (MSERs). The success rate of the method exceeds 94% in the third trimester, outperforming a trained technologist by up to 20%. The pipeline may be used to automatically orient the anatomical sequence, removing the need to estimate the head pose from 2D views and reducing delays during which motion can occur.

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Global-Local Transformer for Brain Age Estimation

Deep learning can provide rapid brain age estimation based on brain magnetic resonance imaging (MRI). However, most studies use one neural network to extract the global information from the whole input image, ignoring the local fine-grained details. In this paper, we propose a global-local transformer, which consists of a global-pathway to extract the global-context information from the whole input image and a local-pathway to extract the local fine-grained details from local patches. The fine-grained information from the local patches are fused with the global-context information by the attention mechanism, inspired by the transformer, to estimate the brain age. We evaluate the proposed method on 8 public datasets with 8,379 healthy brain MRIs with the age range of 0-97 years. 6 datasets are used for cross-validation and 2 datasets are used for evaluating the generality. Comparing with other state-of-the-art methods, the proposed global-local transformer reduces the mean absolute error of the estimated ages to 2.70 years and increases the correlation coefficient of the estimated age and the chronological age to 0.9853. In addition, our proposed method provides regional information of which local patches are most informative for brain age estimation. Our source code is available on: \url{https://github.com/shengfly/global-local-transformer}.

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STRESS: Super-Resolution for Dynamic Fetal MRI using Self-Supervised Learning

Fetal motion is unpredictable and rapid on the scale of conventional MR scan times. Therefore, dynamic fetal MRI, which aims at capturing fetal motion and dynamics of fetal function, is limited to fast imaging techniques with compromises in image quality and resolution. Super-resolution for dynamic fetal MRI is still a challenge, especially when multi-oriented stacks of image slices for oversampling are not available and high temporal resolution for recording the dynamics of the fetus or placenta is desired. Further, fetal motion makes it difficult to acquire high-resolution images for supervised learning methods. To address this problem, in this work, we propose STRESS (Spatio-Temporal Resolution Enhancement with Simulated Scans), a self-supervised super-resolution framework for dynamic fetal MRI with interleaved slice acquisitions. Our proposed method simulates an interleaved slice acquisition along the high-resolution axis on the originally acquired data to generate pairs of low- and high-resolution images. Then, it trains a super-resolution network by exploiting both spatial and temporal correlations in the MR time series, which is used to enhance the resolution of the original data. Evaluations on both simulated and in utero data show that our proposed method outperforms other self-supervised super-resolution methods and improves image quality, which is beneficial to other downstream tasks and evaluations.

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Enhanced detection of fetal pose in 3D MRI by Deep Reinforcement Learning with physical structure priors on anatomy

Fetal MRI is heavily constrained by unpredictable and substantial fetal motion that causes image artifacts and limits the set of viable diagnostic image contrasts. Current mitigation of motion artifacts is predominantly performed by fast, single-shot MRI and retrospective motion correction. Estimation of fetal pose in real time during MRI stands to benefit prospective methods to detect and mitigate fetal motion artifacts where inferred fetal motion is combined with online slice prescription with low-latency decision making. Current developments of deep reinforcement learning (DRL), offer a novel approach for fetal landmarks detection. In this task 15 agents are deployed to detect 15 landmarks simultaneously by DRL. The optimization is challenging, and here we propose an improved DRL that incorporates priors on physical structure of the fetal body. First, we use graph communication layers to improve the communication among agents based on a graph where each node represents a fetal-body landmark. Further, additional reward based on the distance between agents and physical structures such as the fetal limbs is used to fully exploit physical structure. Evaluation of this method on a repository of 3-mm resolution in vivo data demonstrates a mean accuracy of landmark estimation within 10 mm of ground truth as 87.3%, and a mean error of 6.9 mm. The proposed DRL for fetal pose landmark search demonstrates a potential clinical utility for online detection of fetal motion that guides real-time mitigation of motion artifacts as well as health diagnosis during MRI of the pregnant mother.

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Semi-Supervised Learning for Fetal Brain MRI Quality Assessment with ROI consistency

Fetal brain MRI is useful for diagnosing brain abnormalities but is challenged by fetal motion. The current protocol for T2-weighted fetal brain MRI is not robust to motion so image volumes are degraded by inter- and intra- slice motion artifacts. Besides, manual annotation for fetal MR image quality assessment are usually time-consuming. Therefore, in this work, a semi-supervised deep learning method that detects slices with artifacts during the brain volume scan is proposed. Our method is based on the mean teacher model, where we not only enforce consistency between student and teacher models on the whole image, but also adopt an ROI consistency loss to guide the network to focus on the brain region. The proposed method is evaluated on a fetal brain MR dataset with 11,223 labeled images and more than 200,000 unlabeled images. Results show that compared with supervised learning, the proposed method can improve model accuracy by about 6\% and outperform other state-of-the-art semi-supervised learning methods. The proposed method is also implemented and evaluated on an MR scanner, which demonstrates the feasibility of online image quality assessment and image reacquisition during fetal MR scans.

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Brain Age Estimation Using LSTM on Children's Brain MRI

Brain age prediction based on children's brain MRI is an important biomarker for brain health and brain development analysis. In this paper, we consider the 3D brain MRI volume as a sequence of 2D images and propose a new framework using the recurrent neural network for brain age estimation. The proposed method is named as 2D-ResNet18+Long short-term memory (LSTM), which consists of four parts: 2D ResNet18 for feature extraction on 2D images, a pooling layer for feature reduction over the sequences, an LSTM layer, and a final regression layer. We apply the proposed method on a public multisite NIH-PD dataset and evaluate generalization on a second multisite dataset, which shows that the proposed 2D-ResNet18+LSTM method provides better results than traditional 3D based neural network for brain age estimation.

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Infant FreeSurfer: An automated segmentation and surface extraction pipeline for T1-weighted neuroimaging data of infants 0-2 years

The development of automated tools for brain morphometric analysis in infants has lagged significantly behind analogous tools for adults. This gap reflects the greater challenges in this domain due to: 1) a smaller-scaled region of interest, 2) increased motion corruption, 3) regional changes in geometry due to heterochronous growth, and 4) regional variations in contrast properties corresponding to ongoing myelination and other maturation processes. Nevertheless, there is a great need for automated image-processing tools to quantify differences between infant groups and other individuals, because aberrant cortical morphologic measurements (including volume, thickness, surface area, and curvature) have been associated with neuropsychiatric, neurologic, and developmental disorders in children. In this paper we present an automated segmentation and surface extraction pipeline designed to accommodate clinical MRI studies of infant brains in a population 0-2 year-olds. The algorithm relies on a single channel of T1-weighted MR images to achieve automated segmentation of cortical and subcortical brain areas, producing volumes of subcortical structures and surface models of the cerebral cortex. We evaluated the algorithm both qualitatively and quantitatively using manually labeled datasets, relevant comparator software solutions cited in the literature, and expert evaluations. The computational tools and atlases described in this paper will be distributed to the research community as part of the FreeSurfer image analysis package.

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Placental Flattening via Volumetric Parameterization

We present a volumetric mesh-based algorithm for flattening the placenta to a canonical template to enable effective visualization of local anatomy and function. Monitoring placental function in vivo promises to support pregnancy assessment and to improve care outcomes. We aim to alleviate visualization and interpretation challenges presented by the shape of the placenta when it is attached to the curved uterine wall. To do so, we flatten the volumetric mesh that captures placental shape to resemble the well-studied ex vivo shape. We formulate our method as a map from the in vivo shape to a flattened template that minimizes the symmetric Dirichlet energy to control distortion throughout the volume. Local injectivity is enforced via constrained line search during gradient descent. We evaluate the proposed method on 28 placenta shapes extracted from MRI images in a clinical study of placental function. We achieve sub-voxel accuracy in mapping the boundary of the placenta to the template while successfully controlling distortion throughout the volume. We illustrate how the resulting mapping of the placenta enhances visualization of placental anatomy and function. Our code is freely available at https://github.com/mabulnaga/placenta-flattening .

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