arXiv subjects

Sven Nebelung

Publications and source records attributed to Sven Nebelung.

44 records · Page 3Linked to original sources

arXiv2023

Transformers for CT Reconstruction From Monoplanar and Biplanar Radiographs

Computed Tomography (CT) scans provide detailed and accurate information of internal structures in the body. They are constructed by sending x-rays through the body from different directions and combining this information into a three-dimensional volume. Such volumes can then be used to diagnose a wide range of conditions and allow for volumetric measurements of organs. In this work, we tackle the problem of reconstructing CT images from biplanar x-rays only. X-rays are widely available and even if the CT reconstructed from these radiographs is not a replacement of a complete CT in the diagnostic setting, it might serve to spare the patients from radiation where a CT is only acquired for rough measurements such as determining organ size. We propose a novel method based on the transformer architecture, by framing the underlying task as a language translation problem. Radiographs and CT images are first embedded into latent quantized codebook vectors using two different autoencoder networks. We then train a GPT model, to reconstruct the codebook vectors of the CT image, conditioned on the codebook vectors of the x-rays and show that this approach leads to realistic looking images. To encourage further research in this direction, we make our code publicly available on GitHub: XXX.

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arXiv2023

Fibroglandular Tissue Segmentation in Breast MRI using Vision Transformers -- A multi-institutional evaluation

Accurate and automatic segmentation of fibroglandular tissue in breast MRI screening is essential for the quantification of breast density and background parenchymal enhancement. In this retrospective study, we developed and evaluated a transformer-based neural network for breast segmentation (TraBS) in multi-institutional MRI data, and compared its performance to the well established convolutional neural network nnUNet. TraBS and nnUNet were trained and tested on 200 internal and 40 external breast MRI examinations using manual segmentations generated by experienced human readers. Segmentation performance was assessed in terms of the Dice score and the average symmetric surface distance. The Dice score for nnUNet was lower than for TraBS on the internal testset (0.909$\pm$0.069 versus 0.916$\pm$0.067, P<0.001) and on the external testset (0.824$\pm$0.144 versus 0.864$\pm$0.081, P=0.004). Moreover, the average symmetric surface distance was higher (=worse) for nnUNet than for TraBS on the internal (0.657$\pm$2.856 versus 0.548$\pm$2.195, P=0.001) and on the external testset (0.727$\pm$0.620 versus 0.584$\pm$0.413, P=0.03). Our study demonstrates that transformer-based networks improve the quality of fibroglandular tissue segmentation in breast MRI compared to convolutional-based models like nnUNet. These findings might help to enhance the accuracy of breast density and parenchymal enhancement quantification in breast MRI screening.

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arXiv2023

Collaborative Training of Medical Artificial Intelligence Models with non-uniform Labels

Due to the rapid advancements in recent years, medical image analysis is largely dominated by deep learning (DL). However, building powerful and robust DL models requires training with large multi-party datasets. While multiple stakeholders have provided publicly available datasets, the ways in which these data are labeled vary widely. For Instance, an institution might provide a dataset of chest radiographs containing labels denoting the presence of pneumonia, while another institution might have a focus on determining the presence of metastases in the lung. Training a single AI model utilizing all these data is not feasible with conventional federated learning (FL). This prompts us to propose an extension to the widespread FL process, namely flexible federated learning (FFL) for collaborative training on such data. Using 695,000 chest radiographs from five institutions from across the globe - each with differing labels - we demonstrate that having heterogeneously labeled datasets, FFL-based training leads to significant performance increase compared to conventional FL training, where only the uniformly annotated images are utilized. We believe that our proposed algorithm could accelerate the process of bringing collaborative training methods from research and simulation phase to the real-world applications in healthcare.

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arXiv2023

Medical Diffusion: Denoising Diffusion Probabilistic Models for 3D Medical Image Generation

Recent advances in computer vision have shown promising results in image generation. Diffusion probabilistic models in particular have generated realistic images from textual input, as demonstrated by DALL-E 2, Imagen and Stable Diffusion. However, their use in medicine, where image data typically comprises three-dimensional volumes, has not been systematically evaluated. Synthetic images may play a crucial role in privacy preserving artificial intelligence and can also be used to augment small datasets. Here we show that diffusion probabilistic models can synthesize high quality medical imaging data, which we show for Magnetic Resonance Images (MRI) and Computed Tomography (CT) images. We provide quantitative measurements of their performance through a reader study with two medical experts who rated the quality of the synthesized images in three categories: Realistic image appearance, anatomical correctness and consistency between slices. Furthermore, we demonstrate that synthetic images can be used in a self-supervised pre-training and improve the performance of breast segmentation models when data is scarce (dice score 0.91 vs. 0.95 without vs. with synthetic data). The code is publicly available on GitHub: https://github.com/FirasGit/medicaldiffusion.

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arXiv2022

Medical Diagnosis with Large Scale Multimodal Transformers: Leveraging Diverse Data for More Accurate Diagnosis

Multimodal deep learning has been used to predict clinical endpoints and diagnoses from clinical routine data. However, these models suffer from scaling issues: they have to learn pairwise interactions between each piece of information in each data type, thereby escalating model complexity beyond manageable scales. This has so far precluded a widespread use of multimodal deep learning. Here, we present a new technical approach of "learnable synergies", in which the model only selects relevant interactions between data modalities and keeps an "internal memory" of relevant data. Our approach is easily scalable and naturally adapts to multimodal data inputs from clinical routine. We demonstrate this approach on three large multimodal datasets from radiology and ophthalmology and show that it outperforms state-of-the-art models in clinically relevant diagnosis tasks. Our new approach is transferable and will allow the application of multimodal deep learning to a broad set of clinically relevant problems.

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arXiv2022

Diffusion Probabilistic Models beat GANs on Medical Images

The success of Deep Learning applications critically depends on the quality and scale of the underlying training data. Generative adversarial networks (GANs) can generate arbitrary large datasets, but diversity and fidelity are limited, which has recently been addressed by denoising diffusion probabilistic models (DDPMs) whose superiority has been demonstrated on natural images. In this study, we propose Medfusion, a conditional latent DDPM for medical images. We compare our DDPM-based model against GAN-based models, which constitute the current state-of-the-art in the medical domain. Medfusion was trained and compared with (i) StyleGan-3 on n=101,442 images from the AIROGS challenge dataset to generate fundoscopies with and without glaucoma, (ii) ProGAN on n=191,027 from the CheXpert dataset to generate radiographs with and without cardiomegaly and (iii) wGAN on n=19,557 images from the CRCMS dataset to generate histopathological images with and without microsatellite stability. In the AIROGS, CRMCS, and CheXpert datasets, Medfusion achieved lower (=better) FID than the GANs (11.63 versus 20.43, 30.03 versus 49.26, and 17.28 versus 84.31). Also, fidelity (precision) and diversity (recall) were higher (=better) for Medfusion in all three datasets. Our study shows that DDPM are a superior alternative to GANs for image synthesis in the medical domain.

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arXiv2022

Image prediction of disease progression by style-based manifold extrapolation

Disease-modifying management aims to prevent deterioration and progression of the disease, not just relieve symptoms. Unfortunately, the development of necessary therapies is often hampered by the failure to recognize the presymptomatic disease and limited understanding of disease development. We present a generic solution for this problem by a methodology that allows the prediction of progression risk and morphology in individuals using a latent extrapolation optimization approach. To this end, we combined a regularized generative adversarial network (GAN) and a latent nearest neighbor algorithm for joint optimization to generate plausible images of future time points. We evaluated our method on osteoarthritis (OA) data from a multi-center longitudinal study (the Osteoarthritis Initiative, OAI). With presymptomatic baseline data, our model is generative and significantly outperforms the end-to-end learning model in discriminating the progressive cohort. Two experiments were performed with seven experienced radiologists. When no synthetic follow-up radiographs were provided, our model performed better than all seven radiologists. In cases where the synthetic follow-ups generated by our model were available, the specificity and sensitivity of all readers in discriminating progressors increased from $72.3\%$ to $88.6\%$ and from $42.1\%$ to $51.6\%$, respectively. Our results open up a new possibility of using model-based morphology and risk prediction to make predictions about future disease occurrence, as demonstrated in the example of OA.

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arXiv2020

Advancing diagnostic performance and clinical usability of neural networks via adversarial training and dual batch normalization

Unmasking the decision-making process of machine learning models is essential for implementing diagnostic support systems in clinical practice. Here, we demonstrate that adversarially trained models can significantly enhance the usability of pathology detection as compared to their standard counterparts. We let six experienced radiologists rate the interpretability of saliency maps in datasets of X-rays, computed tomography, and magnetic resonance imaging scans. Significant improvements were found for our adversarial models, which could be further improved by the application of dual batch normalization. Contrary to previous research on adversarially trained models, we found that the accuracy of such models was equal to standard models when sufficiently large datasets and dual batch norm training were used. To ensure transferability, we additionally validated our results on an external test set of 22,433 X-rays. These findings elucidate that different paths for adversarial and real images are needed during training to achieve state of the art results with superior clinical interpretability.

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