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Victor Alves

Publications and source records attributed to Victor Alves.

33 records · Page 2Linked to original sources

Subthalamic Nucleus segmentation in high-field Magnetic Resonance data. Is space normalization by template co-registration necessary?

Deep Brain Stimulation (DBS) is one of the most successful methods to diminish late-stage Parkinson's Disease (PD) symptoms. It is a delicate surgical procedure which requires detailed pre-surgical patient's study. High-field Magnetic Resonance Imaging (MRI) has proven its improved capacity of capturing the Subthalamic Nucleus (STN) - the main target of DBS in PD - in greater detail than lower field images. Here, we present a comparison between the performance of two different Deep Learning (DL) automatic segmentation architectures, one based in the registration to a brain template and the other performing the segmentation in in the MRI acquisition native space. The study was based on publicly available high-field 7 Tesla (T) brain MRI datasets of T1-weighted and T2-weighted sequences. nnUNet was used on the segmentation step of both architectures, while the data pre and post-processing pipelines diverged. The evaluation metrics showed that the performance of the segmentation directly in the native space yielded better results for the STN segmentation, despite not showing any advantage over the template-based method for the to other analysed structures: the Red Nucleus (RN) and the Substantia Nigra (SN).

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How we won BraTS 2023 Adult Glioma challenge? Just faking it! Enhanced Synthetic Data Augmentation and Model Ensemble for brain tumour segmentation

Deep Learning is the state-of-the-art technology for segmenting brain tumours. However, this requires a lot of high-quality data, which is difficult to obtain, especially in the medical field. Therefore, our solutions address this problem by using unconventional mechanisms for data augmentation. Generative adversarial networks and registration are used to massively increase the amount of available samples for training three different deep learning models for brain tumour segmentation, the first task of the BraTS2023 challenge. The first model is the standard nnU-Net, the second is the Swin UNETR and the third is the winning solution of the BraTS 2021 Challenge. The entire pipeline is built on the nnU-Net implementation, except for the generation of the synthetic data. The use of convolutional algorithms and transformers is able to fill each other's knowledge gaps. Using the new metric, our best solution achieves the dice results 0.9005, 0.8673, 0.8509 and HD95 14.940, 14.467, 17.699 (whole tumour, tumour core and enhancing tumour) in the validation set.

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Deep Dive into MRI: Exploring Deep Learning Applications in 0.55T and 7T MRI

The development of magnetic resonance imaging (MRI) for medical imaging has provided a leap forward in diagnosis, providing a safe, non-invasive alternative to techniques involving ionising radiation exposure for diagnostic purposes. It was described by Block and Purcel in 1946, and it was not until 1980 that the first clinical application of MRI became available. Since that time the MRI has gone through many advances and has altered the way diagnosing procedures are performed. Due to its ability to improve constantly, MRI has become a commonly used practice among several specialisations in medicine. Particularly starting 0.55T and 7T MRI technologies have pointed out enhanced preservation of image detail and advanced tissue characterisation. This review examines the integration of deep learning (DL) techniques into these MRI modalities, disseminating and exploring the study applications. It highlights how DL contributes to 0.55T and 7T MRI data, showcasing the potential of DL in improving and refining these technologies. The review ends with a brief overview of how MRI technology will evolve in the coming years.

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Treatment And Follow-Up Guidelines For Multiple Brain Metastases: A Systematic Review

Brain metastases are a complication of primary cancer, representing the most common type of brain tumor in adults. The management of multiple brain metastases represents a clinical challenge worldwide in finding the optimal treatment for patients considering various individual aspects. Managing multiple metastases with stereotactic radiosurgery (SRS) is being increasingly used because of quality of life and neurocognitive preservation, which do not present such good outcomes when dealt with whole brain radiation therapy (WBRT). After treatment, analyzing the progression of the disease still represents a clinical issue, since it is difficult to determine a standard schedule for image acquisition. A solution could be the applying artificial intelligence, namely predictive models to forecast the incidence of new metastases in post-treatment images. Although there aren't many works on this subject, this could potentially bennefit medical professionals in early decision of the best treatment approaches.

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FakeNews: GAN-based generation of realistic 3D volumetric data -- A systematic review and taxonomy

With the massive proliferation of data-driven algorithms, such as deep learning-based approaches, the availability of high-quality data is of great interest. Volumetric data is very important in medicine, as it ranges from disease diagnoses to therapy monitoring. When the dataset is sufficient, models can be trained to help doctors with these tasks. Unfortunately, there are scenarios where large amounts of data is unavailable. For example, rare diseases and privacy issues can lead to restricted data availability. In non-medical fields, the high cost of obtaining enough high-quality data can also be a concern. A solution to these problems can be the generation of realistic synthetic data using Generative Adversarial Networks (GANs). The existence of these mechanisms is a good asset, especially in healthcare, as the data must be of good quality, realistic, and without privacy issues. Therefore, most of the publications on volumetric GANs are within the medical domain. In this review, we provide a summary of works that generate realistic volumetric synthetic data using GANs. We therefore outline GAN-based methods in these areas with common architectures, loss functions and evaluation metrics, including their advantages and disadvantages. We present a novel taxonomy, evaluations, challenges, and research opportunities to provide a holistic overview of the current state of volumetric GANs.

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Deep PCCT: Photon Counting Computed Tomography Deep Learning Applications Review

Medical imaging faces challenges such as limited spatial resolution, interference from electronic noise and poor contrast-to-noise ratios. Photon Counting Computed Tomography (PCCT) has emerged as a solution, addressing these issues with its innovative technology. This review delves into the recent developments and applications of PCCT in pre-clinical research, emphasizing its potential to overcome traditional imaging limitations. For example PCCT has demonstrated remarkable efficacy in improving the detection of subtle abnormalities in breast, providing a level of detail previously unattainable. Examining the current literature on PCCT, it presents a comprehensive analysis of the technology, highlighting the main features of scanners and their varied applications. In addition, it explores the integration of deep learning into PCCT, along with the study of radiomic features, presenting successful applications in data processing. While acknowledging these advances, it also discusses the existing challenges in this field, paving the way for future research and improvements in medical imaging technologies. Despite the limited number of articles on this subject, due to the recent integration of PCCT at a clinical level, its potential benefits extend to various diagnostic applications.

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Multilingual Natural Language Processing Model for Radiology Reports -- The Summary is all you need!

The impression section of a radiology report summarizes important radiology findings and plays a critical role in communicating these findings to physicians. However, the preparation of these summaries is time-consuming and error-prone for radiologists. Recently, numerous models for radiology report summarization have been developed. Nevertheless, there is currently no model that can summarize these reports in multiple languages. Such a model could greatly improve future research and the development of Deep Learning models that incorporate data from patients with different ethnic backgrounds. In this study, the generation of radiology impressions in different languages was automated by fine-tuning a model, publicly available, based on a multilingual text-to-text Transformer to summarize findings available in English, Portuguese, and German radiology reports. In a blind test, two board-certified radiologists indicated that for at least 70% of the system-generated summaries, the quality matched or exceeded the corresponding human-written summaries, suggesting substantial clinical reliability. Furthermore, this study showed that the multilingual model outperformed other models that specialized in summarizing radiology reports in only one language, as well as models that were not specifically designed for summarizing radiology reports, such as ChatGPT.

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Open-Source Skull Reconstruction with MONAI

We present a deep learning-based approach for skull reconstruction for MONAI, which has been pre-trained on the MUG500+ skull dataset. The implementation follows the MONAI contribution guidelines, hence, it can be easily tried out and used, and extended by MONAI users. The primary goal of this paper lies in the investigation of open-sourcing codes and pre-trained deep learning models under the MONAI framework. Nowadays, open-sourcing software, especially (pre-trained) deep learning models, has become increasingly important. Over the years, medical image analysis experienced a tremendous transformation. Over a decade ago, algorithms had to be implemented and optimized with low-level programming languages, like C or C++, to run in a reasonable time on a desktop PC, which was not as powerful as today's computers. Nowadays, users have high-level scripting languages like Python, and frameworks like PyTorch and TensorFlow, along with a sea of public code repositories at hand. As a result, implementations that had thousands of lines of C or C++ code in the past, can now be scripted with a few lines and in addition executed in a fraction of the time. To put this even on a higher level, the Medical Open Network for Artificial Intelligence (MONAI) framework tailors medical imaging research to an even more convenient process, which can boost and push the whole field. The MONAI framework is a freely available, community-supported, open-source and PyTorch-based framework, that also enables to provide research contributions with pre-trained models to others. Codes and pre-trained weights for skull reconstruction are publicly available at: https://github.com/Project-MONAI/research-contributions/tree/master/SkullRec

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AutoPET Challenge: Combining nn-Unet with Swin UNETR Augmented by Maximum Intensity Projection Classifier

Tumor volume and changes in tumor characteristics over time are important biomarkers for cancer therapy. In this context, FDG-PET/CT scans are routinely used for staging and re-staging of cancer, as the radiolabeled fluorodeoxyglucose is taken up in regions of high metabolism. Unfortunately, these regions with high metabolism are not specific to tumors and can also represent physiological uptake by normal functioning organs, inflammation, or infection, making detailed and reliable tumor segmentation in these scans a demanding task. This gap in research is addressed by the AutoPET challenge, which provides a public data set with FDG-PET/CT scans from 900 patients to encourage further improvement in this field. Our contribution to this challenge is an ensemble of two state-of-the-art segmentation models, the nn-Unet and the Swin UNETR, augmented by a maximum intensity projection classifier that acts like a gating mechanism. If it predicts the existence of lesions, both segmentations are combined by a late fusion approach. Our solution achieves a Dice score of 72.12\% on patients diagnosed with lung cancer, melanoma, and lymphoma in our cross-validation. Code: https://github.com/heiligerl/autopet_submission

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Generation of Synthetic Rat Brain MRI scans with a 3D Enhanced Alpha-GAN

Translational brain research using Magnetic Resonance Imaging (MRI) is becoming increasingly popular as animal models are an essential part of scientific studies and more ultra-high-field scanners are becoming available. Some disadvantages of MRI are the availability of MRI scanners and the time required for a full scanning session (it usually takes over 30 minutes). Privacy laws and the 3Rs ethics rule also make it difficult to create large datasets for training deep learning models. Generative Adversarial Networks (GANs) can perform data augmentation with higher quality than other techniques. In this work, the alpha-GAN architecture is used to test its ability to produce realistic 3D MRI scans of the rat brain. As far as the authors are aware, this is the first time that a GAN-based approach has been used for data augmentation in preclinical data. The generated scans are evaluated using various qualitative and quantitative metrics. A Turing test conducted by 4 experts has shown that the generated scans can trick almost any expert. The generated scans were also used to evaluate their impact on the performance of an existing deep learning model developed for segmenting the rat brain into white matter, grey matter and cerebrospinal fluid. The models were compared using the Dice score. The best results for whole brain and white matter segmentation were obtained when 174 real scans and 348 synthetic scans were used, with improvements of 0.0172 and 0.0129, respectively. Using 174 real scans and 87 synthetic scans resulted in improvements of 0.0038 and 0.0764 for grey matter and CSF segmentation, respectively. Thus, by using the proposed new normalisation layer and loss functions, it was possible to improve the realism of the generated rat MRI scans and it was shown that using the generated data improved the segmentation model more than using the conventional data augmentation.

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Combining unsupervised and supervised learning for predicting the final stroke lesion

Predicting the final ischaemic stroke lesion provides crucial information regarding the volume of salvageable hypoperfused tissue, which helps physicians in the difficult decision-making process of treatment planning and intervention. Treatment selection is influenced by clinical diagnosis, which requires delineating the stroke lesion, as well as characterising cerebral blood flow dynamics using neuroimaging acquisitions. Nonetheless, predicting the final stroke lesion is an intricate task, due to the variability in lesion size, shape, location and the underlying cerebral haemodynamic processes that occur after the ischaemic stroke takes place. Moreover, since elapsed time between stroke and treatment is related to the loss of brain tissue, assessing and predicting the final stroke lesion needs to be performed in a short period of time, which makes the task even more complex. Therefore, there is a need for automatic methods that predict the final stroke lesion and support physicians in the treatment decision process. We propose a fully automatic deep learning method based on unsupervised and supervised learning to predict the final stroke lesion after 90 days. Our aim is to predict the final stroke lesion location and extent, taking into account the underlying cerebral blood flow dynamics that can influence the prediction. To achieve this, we propose a two-branch Restricted Boltzmann Machine, which provides specialized data-driven features from different sets of standard parametric Magnetic Resonance Imaging maps. These data-driven feature maps are then combined with the parametric Magnetic Resonance Imaging maps, and fed to a Convolutional and Recurrent Neural Network architecture. We evaluated our proposal on the publicly available ISLES 2017 testing dataset, reaching a Dice score of 0.38, Hausdorff Distance of 29.21 mm, and Average Symmetric Surface Distance of 5.52 mm.

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Adaptive feature recombination and recalibration for semantic segmentation with Fully Convolutional Networks

Fully Convolutional Networks have been achieving remarkable results in image semantic segmentation, while being efficient. Such efficiency results from the capability of segmenting several voxels in a single forward pass. So, there is a direct spatial correspondence between a unit in a feature map and the voxel in the same location. In a convolutional layer, the kernel spans over all channels and extracts information from them. We observe that linear recombination of feature maps by increasing the number of channels followed by compression may enhance their discriminative power. Moreover, not all feature maps have the same relevance for the classes being predicted. In order to learn the inter-channel relationships and recalibrate the channels to suppress the less relevant ones, Squeeze and Excitation blocks were proposed in the context of image classification with Convolutional Neural Networks. However, this is not well adapted for segmentation with Fully Convolutional Networks since they segment several objects simultaneously, hence a feature map may contain relevant information only in some locations. In this paper, we propose recombination of features and a spatially adaptive recalibration block that is adapted for semantic segmentation with Fully Convolutional Networks - the SegSE block. Feature maps are recalibrated by considering the cross-channel information together with spatial relevance. Experimental results indicate that Recombination and Recalibration improve the results of a competitive baseline, and generalize across three different problems: brain tumor segmentation, stroke penumbra estimation, and ischemic stroke lesion outcome prediction. The obtained results are competitive or outperform the state of the art in the three applications.

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Automatic brain tumor grading from MRI data using convolutional neural networks and quality assessment

Glioblastoma Multiforme is a high grade, very aggressive, brain tumor, with patients having a poor prognosis. Lower grade gliomas are less aggressive, but they can evolve into higher grade tumors over time. Patient management and treatment can vary considerably with tumor grade, ranging from tumor resection followed by a combined radio- and chemotherapy to a "wait and see" approach. Hence, tumor grading is important for adequate treatment planning and monitoring. The gold standard for tumor grading relies on histopathological diagnosis of biopsy specimens. However, this procedure is invasive, time consuming, and prone to sampling error. Given these disadvantages, automatic tumor grading from widely used MRI protocols would be clinically important, as a way to expedite treatment planning and assessment of tumor evolution. In this paper, we propose to use Convolutional Neural Networks for predicting tumor grade directly from imaging data. In this way, we overcome the need for expert annotations of regions of interest. We evaluate two prediction approaches: from the whole brain, and from an automatically defined tumor region. Finally, we employ interpretability methodologies as a quality assurance stage to check if the method is using image regions indicative of tumor grade for classification.

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Enhancing clinical MRI Perfusion maps with data-driven maps of complementary nature for lesion outcome prediction

Stroke is the second most common cause of death in developed countries, where rapid clinical intervention can have a major impact on a patient's life. To perform the revascularization procedure, the decision making of physicians considers its risks and benefits based on multi-modal MRI and clinical experience. Therefore, automatic prediction of the ischemic stroke lesion outcome has the potential to assist the physician towards a better stroke assessment and information about tissue outcome. Typically, automatic methods consider the information of the standard kinetic models of diffusion and perfusion MRI (e.g. Tmax, TTP, MTT, rCBF, rCBV) to perform lesion outcome prediction. In this work, we propose a deep learning method to fuse this information with an automated data selection of the raw 4D PWI image information, followed by a data-driven deep-learning modeling of the underlying blood flow hemodynamics. We demonstrate the ability of the proposed approach to improve prediction of tissue at risk before therapy, as compared to only using the standard clinical perfusion maps, hence suggesting on the potential benefits of the proposed data-driven raw perfusion data modelling approach.

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Adaptive feature recombination and recalibration for semantic segmentation: application to brain tumor segmentation in MRI

Convolutional neural networks (CNNs) have been successfully used for brain tumor segmentation, specifically, fully convolutional networks (FCNs). FCNs can segment a set of voxels at once, having a direct spatial correspondence between units in feature maps (FMs) at a given location and the corresponding classified voxels. In convolutional layers, FMs are merged to create new FMs, so, channel combination is crucial. However, not all FMs have the same relevance for a given class. Recently, in classification problems, Squeeze-and-Excitation (SE) blocks have been proposed to re-calibrate FMs as a whole, and suppress the less informative ones. However, this is not optimal in FCN due to the spatial correspondence between units and voxels. In this article, we propose feature recombination through linear expansion and compression to create more complex features for semantic segmentation. Additionally, we propose a segmentation SE (SegSE) block for feature recalibration that collects contextual information, while maintaining the spatial meaning. Finally, we evaluate the proposed methods in brain tumor segmentation, using publicly available data.

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