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Tom Vercauteren

Publications and source records attributed to Tom Vercauteren.

At least 73 records · Page 4Linked to original sources

A 3D generative model of pathological multi-modal MR images and segmentations

Generative modelling and synthetic data can be a surrogate for real medical imaging datasets, whose scarcity and difficulty to share can be a nuisance when delivering accurate deep learning models for healthcare applications. In recent years, there has been an increased interest in using these models for data augmentation and synthetic data sharing, using architectures such as generative adversarial networks (GANs) or diffusion models (DMs). Nonetheless, the application of synthetic data to tasks such as 3D magnetic resonance imaging (MRI) segmentation remains limited due to the lack of labels associated with the generated images. Moreover, many of the proposed generative MRI models lack the ability to generate arbitrary modalities due to the absence of explicit contrast conditioning. These limitations prevent the user from adjusting the contrast and content of the images and obtaining more generalisable data for training task-specific models. In this work, we propose brainSPADE3D, a 3D generative model for brain MRI and associated segmentations, where the user can condition on specific pathological phenotypes and contrasts. The proposed joint imaging-segmentation generative model is shown to generate high-fidelity synthetic images and associated segmentations, with the ability to combine pathologies. We demonstrate how the model can alleviate issues with segmentation model performance when unexpected pathologies are present in the data.

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A Clinical Guideline Driven Automated Linear Feature Extraction for Vestibular Schwannoma

Vestibular Schwannoma is a benign brain tumour that grows from one of the balance nerves. Patients may be treated by surgery, radiosurgery or with a conservative "wait-and-scan" strategy. Clinicians typically use manually extracted linear measurements to aid clinical decision making. This work aims to automate and improve this process by using deep learning based segmentation to extract relevant clinical features through computational algorithms. To the best of our knowledge, our study is the first to propose an automated approach to replicate local clinical guidelines. Our deep learning based segmentation provided Dice-scores of 0.8124 +- 0.2343 and 0.8969 +- 0.0521 for extrameatal and whole tumour regions respectively for T2 weighted MRI, whereas 0.8222 +- 0.2108 and 0.9049 +- 0.0646 were obtained for T1 weighted MRI. We propose a novel algorithm to choose and extract the most appropriate maximum linear measurement from the segmented regions based on the size of the extrameatal portion of the tumour. Using this tool, clinicians will be provided with a visual guide and related metrics relating to tumour progression that will function as a clinical decision aid. In this study, we utilize 187 scans obtained from 50 patients referred to a tertiary specialist neurosurgical service in the United Kingdom. The measurements extracted manually by an expert neuroradiologist indicated a significant correlation with the automated measurements (p < 0.0001).

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Long-term Dependency for 3D Reconstruction of Freehand Ultrasound Without External Tracker

Objective: Reconstructing freehand ultrasound in 3D without any external tracker has been a long-standing challenge in ultrasound-assisted procedures. We aim to define new ways of parameterising long-term dependencies, and evaluate the performance. Methods: First, long-term dependency is encoded by transformation positions within a frame sequence. This is achieved by combining a sequence model with a multi-transformation prediction. Second, two dependency factors are proposed, anatomical image content and scanning protocol, for contributing towards accurate reconstruction. Each factor is quantified experimentally by reducing respective training variances. Results: 1) The added long-term dependency up to 400 frames at 20 frames per second (fps) indeed improved reconstruction, with an up to 82.4% lowered accumulated error, compared with the baseline performance. The improvement was found to be dependent on sequence length, transformation interval and scanning protocol and, unexpectedly, not on the use of recurrent networks with long-short term modules; 2) Decreasing either anatomical or protocol variance in training led to poorer reconstruction accuracy. Interestingly, greater performance was gained from representative protocol patterns, than from representative anatomical features. Conclusion: The proposed algorithm uses hyperparameter tuning to effectively utilise long-term dependency. The proposed dependency factors are of practical significance in collecting diverse training data, regulating scanning protocols and developing efficient networks. Significance: The proposed new methodology with publicly available volunteer data and code for parametersing the long-term dependency, experimentally shown to be valid sources of performance improvement, which could potentially lead to better model development and practical optimisation of the reconstruction application.

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Adaptive Multi-scale Online Likelihood Network for AI-assisted Interactive Segmentation

Existing interactive segmentation methods leverage automatic segmentation and user interactions for label refinement, significantly reducing the annotation workload compared to manual annotation. However, these methods lack quick adaptability to ambiguous and noisy data, which is a challenge in CT volumes containing lung lesions from COVID-19 patients. In this work, we propose an adaptive multi-scale online likelihood network (MONet) that adaptively learns in a data-efficient online setting from both an initial automatic segmentation and user interactions providing corrections. We achieve adaptive learning by proposing an adaptive loss that extends the influence of user-provided interaction to neighboring regions with similar features. In addition, we propose a data-efficient probability-guided pruning method that discards uncertain and redundant labels in the initial segmentation to enable efficient online training and inference. Our proposed method was evaluated by an expert in a blinded comparative study on COVID-19 lung lesion annotation task in CT. Our approach achieved 5.86% higher Dice score with 24.67% less perceived NASA-TLX workload score than the state-of-the-art. Source code is available at: https://github.com/masadcv/MONet-MONAILabel

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Unified Brain MR-Ultrasound Synthesis using Multi-Modal Hierarchical Representations

We introduce MHVAE, a deep hierarchical variational auto-encoder (VAE) that synthesizes missing images from various modalities. Extending multi-modal VAEs with a hierarchical latent structure, we introduce a probabilistic formulation for fusing multi-modal images in a common latent representation while having the flexibility to handle incomplete image sets as input. Moreover, adversarial learning is employed to generate sharper images. Extensive experiments are performed on the challenging problem of joint intra-operative ultrasound (iUS) and Magnetic Resonance (MR) synthesis. Our model outperformed multi-modal VAEs, conditional GANs, and the current state-of-the-art unified method (ResViT) for synthesizing missing images, demonstrating the advantage of using a hierarchical latent representation and a principled probabilistic fusion operation. Our code is publicly available \url{https://github.com/ReubenDo/MHVAE}.

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UPL-SFDA: Uncertainty-aware Pseudo Label Guided Source-Free Domain Adaptation for Medical Image Segmentation

Domain Adaptation (DA) is important for deep learning-based medical image segmentation models to deal with testing images from a new target domain. As the source-domain data are usually unavailable when a trained model is deployed at a new center, Source-Free Domain Adaptation (SFDA) is appealing for data and annotation-efficient adaptation to the target domain. However, existing SFDA methods have a limited performance due to lack of sufficient supervision with source-domain images unavailable and target-domain images unlabeled. We propose a novel Uncertainty-aware Pseudo Label guided (UPL) SFDA method for medical image segmentation. Specifically, we propose Target Domain Growing (TDG) to enhance the diversity of predictions in the target domain by duplicating the pre-trained model's prediction head multiple times with perturbations. The different predictions in these duplicated heads are used to obtain pseudo labels for unlabeled target-domain images and their uncertainty to identify reliable pseudo labels. We also propose a Twice Forward pass Supervision (TFS) strategy that uses reliable pseudo labels obtained in one forward pass to supervise predictions in the next forward pass. The adaptation is further regularized by a mean prediction-based entropy minimization term that encourages confident and consistent results in different prediction heads. UPL-SFDA was validated with a multi-site heart MRI segmentation dataset, a cross-modality fetal brain segmentation dataset, and a 3D fetal tissue segmentation dataset. It improved the average Dice by 5.54, 5.01 and 6.89 percentage points for the three tasks compared with the baseline, respectively, and outperformed several state-of-the-art SFDA methods.

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Biomedical image analysis competitions: The state of current participation practice

The number of international benchmarking competitions is steadily increasing in various fields of machine learning (ML) research and practice. So far, however, little is known about the common practice as well as bottlenecks faced by the community in tackling the research questions posed. To shed light on the status quo of algorithm development in the specific field of biomedical imaging analysis, we designed an international survey that was issued to all participants of challenges conducted in conjunction with the IEEE ISBI 2021 and MICCAI 2021 conferences (80 competitions in total). The survey covered participants' expertise and working environments, their chosen strategies, as well as algorithm characteristics. A median of 72% challenge participants took part in the survey. According to our results, knowledge exchange was the primary incentive (70%) for participation, while the reception of prize money played only a minor role (16%). While a median of 80 working hours was spent on method development, a large portion of participants stated that they did not have enough time for method development (32%). 25% perceived the infrastructure to be a bottleneck. Overall, 94% of all solutions were deep learning-based. Of these, 84% were based on standard architectures. 43% of the respondents reported that the data samples (e.g., images) were too large to be processed at once. This was most commonly addressed by patch-based training (69%), downsampling (37%), and solving 3D analysis tasks as a series of 2D tasks. K-fold cross-validation on the training set was performed by only 37% of the participants and only 50% of the participants performed ensembling based on multiple identical models (61%) or heterogeneous models (39%). 48% of the respondents applied postprocessing steps.

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DEEPBEAS3D: Deep Learning and B-Spline Explicit Active Surfaces

Deep learning-based automatic segmentation methods have become state-of-the-art. However, they are often not robust enough for direct clinical application, as domain shifts between training and testing data affect their performance. Failure in automatic segmentation can cause sub-optimal results that require correction. To address these problems, we propose a novel 3D extension of an interactive segmentation framework that represents a segmentation from a convolutional neural network (CNN) as a B-spline explicit active surface (BEAS). BEAS ensures segmentations are smooth in 3D space, increasing anatomical plausibility, while allowing the user to precisely edit the 3D surface. We apply this framework to the task of 3D segmentation of the anal sphincter complex (AS) from transperineal ultrasound (TPUS) images, and compare it to the clinical tool used in the pelvic floor disorder clinic (4D View VOCAL, GE Healthcare; Zipf, Austria). Experimental results show that: 1) the proposed framework gives the user explicit control of the surface contour; 2) the perceived workload calculated via the NASA-TLX index was reduced by 30% compared to VOCAL; and 3) it required 7 0% (170 seconds) less user time than VOCAL (p< 0.00001)

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Privileged Anatomical and Protocol Discrimination in Trackerless 3D Ultrasound Reconstruction

Three-dimensional (3D) freehand ultrasound (US) reconstruction without using any additional external tracking device has seen recent advances with deep neural networks (DNNs). In this paper, we first investigated two identified contributing factors of the learned inter-frame correlation that enable the DNN-based reconstruction: anatomy and protocol. We propose to incorporate the ability to represent these two factors - readily available during training - as the privileged information to improve existing DNN-based methods. This is implemented in a new multi-task method, where the anatomical and protocol discrimination are used as auxiliary tasks. We further develop a differentiable network architecture to optimise the branching location of these auxiliary tasks, which controls the ratio between shared and task-specific network parameters, for maximising the benefits from the two auxiliary tasks. Experimental results, on a dataset with 38 forearms of 19 volunteers acquired with 6 different scanning protocols, show that 1) both anatomical and protocol variances are enabling factors for DNN-based US reconstruction; 2) learning how to discriminate different subjects (anatomical variance) and predefined types of scanning paths (protocol variance) both significantly improve frame prediction accuracy, volume reconstruction overlap, accumulated tracking error and final drift, using the proposed algorithm.

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Deep Homography Prediction for Endoscopic Camera Motion Imitation Learning

In this work, we investigate laparoscopic camera motion automation through imitation learning from retrospective videos of laparoscopic interventions. A novel method is introduced that learns to augment a surgeon's behavior in image space through object motion invariant image registration via homographies. Contrary to existing approaches, no geometric assumptions are made and no depth information is necessary, enabling immediate translation to a robotic setup. Deviating from the dominant approach in the literature which consist of following a surgical tool, we do not handcraft the objective and no priors are imposed on the surgical scene, allowing the method to discover unbiased policies. In this new research field, significant improvements are demonstrated over two baselines on the Cholec80 and HeiChole datasets, showcasing an improvement of 47% over camera motion continuation. The method is further shown to indeed predict camera motion correctly on the public motion classification labels of the AutoLaparo dataset. All code is made accessible on GitHub.

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Synthetic white balancing for intra-operative hyperspectral imaging

Hyperspectral imaging shows promise for surgical applications to non-invasively provide spatially-resolved, spectral information. For calibration purposes, a white reference image of a highly-reflective Lambertian surface should be obtained under the same imaging conditions. Standard white references are not sterilizable, and so are unsuitable for surgical environments. We demonstrate the necessity for in situ white references and address this by proposing a novel, sterile, synthetic reference construction algorithm. The use of references obtained at different distances and lighting conditions to the subject were examined. Spectral and color reconstructions were compared with standard measurements qualitatively and quantitatively, using $ΔE$ and normalised RMSE respectively. The algorithm forms a composite image from a video of a standard sterile ruler, whose imperfect reflectivity is compensated for. The reference is modelled as the product of independent spatial and spectral components, and a scalar factor accounting for gain, exposure, and light intensity. Evaluation of synthetic references against ideal but non-sterile references is performed using the same metrics alongside pixel-by-pixel errors. Finally, intraoperative integration is assessed though cadaveric experiments. Improper white balancing leads to increases in all quantitative and qualitative errors. Synthetic references achieve median pixel-by-pixel errors lower than 6.5% and produce similar reconstructions and errors to an ideal reference. The algorithm integrated well into surgical workflow, achieving median pixel-by-pixel errors of 4.77%, while maintaining good spectral and color reconstruction.

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Deep Reinforcement Learning Based System for Intraoperative Hyperspectral Video Autofocusing

Hyperspectral imaging (HSI) captures a greater level of spectral detail than traditional optical imaging, making it a potentially valuable intraoperative tool when precise tissue differentiation is essential. Hardware limitations of current optical systems used for handheld real-time video HSI result in a limited focal depth, thereby posing usability issues for integration of the technology into the operating room. This work integrates a focus-tunable liquid lens into a video HSI exoscope, and proposes novel video autofocusing methods based on deep reinforcement learning. A first-of-its-kind robotic focal-time scan was performed to create a realistic and reproducible testing dataset. We benchmarked our proposed autofocus algorithm against traditional policies, and found our novel approach to perform significantly ($p<0.05$) better than traditional techniques ($0.070\pm.098$ mean absolute focal error compared to $0.146\pm.148$). In addition, we performed a blinded usability trial by having two neurosurgeons compare the system with different autofocus policies, and found our novel approach to be the most favourable, making our system a desirable addition for intraoperative HSI.

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VideoSum: A Python Library for Surgical Video Summarization

The performance of deep learning (DL) algorithms is heavily influenced by the quantity and the quality of the annotated data. However, in Surgical Data Science, access to it is limited. It is thus unsurprising that substantial research efforts are made to develop methods aiming at mitigating the scarcity of annotated SDS data. In parallel, an increasing number of Computer Assisted Interventions (CAI) datasets are being released, although the scale of these remain limited. On these premises, data curation is becoming a key element of many SDS research endeavors. Surgical video datasets are demanding to curate and would benefit from dedicated support tools. In this work, we propose to summarize surgical videos into storyboards or collages of representative frames to ease visualization, annotation, and processing. Video summarization is well-established for natural images. However, state-of-the-art methods typically rely on models trained on human-made annotations, few methods have been evaluated on surgical videos, and the availability of software packages for the task is limited. We present videosum, an easy-to-use and open-source Python library to generate storyboards from surgical videos that contains a variety of unsupervised methods.

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LoViT: Long Video Transformer for Surgical Phase Recognition

Online surgical phase recognition plays a significant role towards building contextual tools that could quantify performance and oversee the execution of surgical workflows. Current approaches are limited since they train spatial feature extractors using frame-level supervision that could lead to incorrect predictions due to similar frames appearing at different phases, and poorly fuse local and global features due to computational constraints which can affect the analysis of long videos commonly encountered in surgical interventions. In this paper, we present a two-stage method, called Long Video Transformer (LoViT) for fusing short- and long-term temporal information that combines a temporally-rich spatial feature extractor and a multi-scale temporal aggregator consisting of two cascaded L-Trans modules based on self-attention, followed by a G-Informer module based on ProbSparse self-attention for processing global temporal information. The multi-scale temporal head then combines local and global features and classifies surgical phases using phase transition-aware supervision. Our approach outperforms state-of-the-art methods on the Cholec80 and AutoLaparo datasets consistently. Compared to Trans-SVNet, LoViT achieves a 2.4 pp (percentage point) improvement in video-level accuracy on Cholec80 and a 3.1 pp improvement on AutoLaparo. Moreover, it achieves a 5.3 pp improvement in phase-level Jaccard on AutoLaparo and a 1.55 pp improvement on Cholec80. Our results demonstrate the effectiveness of our approach in achieving state-of-the-art performance of surgical phase recognition on two datasets of different surgical procedures and temporal sequencing characteristics whilst introducing mechanisms that cope with long videos.

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blob loss: instance imbalance aware loss functions for semantic segmentation

Deep convolutional neural networks (CNN) have proven to be remarkably effective in semantic segmentation tasks. Most popular loss functions were introduced targeting improved volumetric scores, such as the Dice coefficient (DSC). By design, DSC can tackle class imbalance, however, it does not recognize instance imbalance within a class. As a result, a large foreground instance can dominate minor instances and still produce a satisfactory DSC. Nevertheless, detecting tiny instances is crucial for many applications, such as disease monitoring. For example, it is imperative to locate and surveil small-scale lesions in the follow-up of multiple sclerosis patients. We propose a novel family of loss functions, \emph{blob loss}, primarily aimed at maximizing instance-level detection metrics, such as F1 score and sensitivity. \emph{Blob loss} is designed for semantic segmentation problems where detecting multiple instances matters. We extensively evaluate a DSC-based \emph{blob loss} in five complex 3D semantic segmentation tasks featuring pronounced instance heterogeneity in terms of texture and morphology. Compared to soft Dice loss, we achieve 5% improvement for MS lesions, 3% improvement for liver tumor, and an average 2% improvement for microscopy segmentation tasks considering F1 score.

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DeepEdit: Deep Editable Learning for Interactive Segmentation of 3D Medical Images

Automatic segmentation of medical images is a key step for diagnostic and interventional tasks. However, achieving this requires large amounts of annotated volumes, which can be tedious and time-consuming task for expert annotators. In this paper, we introduce DeepEdit, a deep learning-based method for volumetric medical image annotation, that allows automatic and semi-automatic segmentation, and click-based refinement. DeepEdit combines the power of two methods: a non-interactive (i.e. automatic segmentation using nnU-Net, UNET or UNETR) and an interactive segmentation method (i.e. DeepGrow), into a single deep learning model. It allows easy integration of uncertainty-based ranking strategies (i.e. aleatoric and epistemic uncertainty computation) and active learning. We propose and implement a method for training DeepEdit by using standard training combined with user interaction simulation. Once trained, DeepEdit allows clinicians to quickly segment their datasets by using the algorithm in auto segmentation mode or by providing clicks via a user interface (i.e. 3D Slicer, OHIF). We show the value of DeepEdit through evaluation on the PROSTATEx dataset for prostate/prostatic lesions and the Multi-Atlas Labeling Beyond the Cranial Vault (BTCV) dataset for abdominal CT segmentation, using state-of-the-art network architectures as baseline for comparison. DeepEdit could reduce the time and effort annotating 3D medical images compared to DeepGrow alone. Source code is available at https://github.com/Project-MONAI/MONAILabel

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MONAI Label: A framework for AI-assisted Interactive Labeling of 3D Medical Images

The lack of annotated datasets is a major bottleneck for training new task-specific supervised machine learning models, considering that manual annotation is extremely expensive and time-consuming. To address this problem, we present MONAI Label, a free and open-source framework that facilitates the development of applications based on artificial intelligence (AI) models that aim at reducing the time required to annotate radiology datasets. Through MONAI Label, researchers can develop AI annotation applications focusing on their domain of expertise. It allows researchers to readily deploy their apps as services, which can be made available to clinicians via their preferred user interface. Currently, MONAI Label readily supports locally installed (3D Slicer) and web-based (OHIF) frontends and offers two active learning strategies to facilitate and speed up the training of segmentation algorithms. MONAI Label allows researchers to make incremental improvements to their AI-based annotation application by making them available to other researchers and clinicians alike. Additionally, MONAI Label provides sample AI-based interactive and non-interactive labeling applications, that can be used directly off the shelf, as plug-and-play to any given dataset. Significant reduced annotation times using the interactive model can be observed on two public datasets.

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Hyperspectral Image Segmentation: A Preliminary Study on the Oral and Dental Spectral Image Database (ODSI-DB)

Visual discrimination of clinical tissue types remains challenging, with traditional RGB imaging providing limited contrast for such tasks. Hyperspectral imaging (HSI) is a promising technology providing rich spectral information that can extend far beyond three-channel RGB imaging. Moreover, recently developed snapshot HSI cameras enable real-time imaging with significant potential for clinical applications. Despite this, the investigation into the relative performance of HSI over RGB imaging for semantic segmentation purposes has been limited, particularly in the context of medical imaging. Here we compare the performance of state-of-the-art deep learning image segmentation methods when trained on hyperspectral images, RGB images, hyperspectral pixels (minus spatial context), and RGB pixels (disregarding spatial context). To achieve this, we employ the recently released Oral and Dental Spectral Image Database (ODSI-DB), which consists of 215 manually segmented dental reflectance spectral images with 35 different classes across 30 human subjects. The recent development of snapshot HSI cameras has made real-time clinical HSI a distinct possibility, though successful application requires a comprehensive understanding of the additional information HSI offers. Our work highlights the relative importance of spectral resolution, spectral range, and spatial information to both guide the development of HSI cameras and inform future clinical HSI applications.

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