Automated Ventricle Parcellation and Evan's Ratio Computation in Pre- and Post-Surgical Ventriculomegaly

Normal pressure hydrocephalus~(NPH) is a brain disorder associated with enlarged ventricles and multiple cognitive and motor symptoms. The degree of ventricular enlargement can be measured using magnetic resonance images~(MRIs) and characterized quantitatively using the Evan's ratio (ER). Automatic computation of ER is desired to avoid the extra time and variations associated with manual measurements on MRI. Because shunt surgery is often used to treat NPH, it is necessary that this process be robust to image artifacts caused by the shunt and related implants. In this paper, we propose a 3D regions-of-interest aware (ROI-aware) network for segmenting the ventricles. The method achieves state-of-the-art performance on both pre-surgery MRIs and post-surgery MRIs with artifacts. Based on our segmentation results, we also describe an automated approach to compute ER from these results. Experimental results on multiple datasets demonstrate the potential of the proposed method to assist clinicians in the diagnosis and management of NPH.

FastCod: Fast Brain Connectivity in Diffusion Imaging

Connectivity information derived from diffusion-weighted magnetic resonance images~(DW-MRIs) plays an important role in studying human subcortical gray matter structures. However, due to the $O(N^2)$ complexity of computing the connectivity of each voxel to every other voxel (or multiple ROIs), the current practice of extracting connectivity information is highly inefficient. This makes the processing of high-resolution images and population-level analyses very computationally demanding. To address this issue, we propose a more efficient way to extract connectivity information; briefly, we consider two regions/voxels to be connected if a white matter fiber streamline passes through them -- no matter where the streamline originates. We consider the thalamus parcellation task for demonstration purposes; our experiments show that our approach brings a 30 to 120 times speedup over traditional approaches with comparable qualitative parcellation results. We also demonstrate high-resolution connectivity features can be super-resolved from low-resolution DW-MRI in our framework. Together, these two innovations enable higher resolution connectivity analysis from DW-MRI. Our source code is availible at jasonbian97.github.io/fastcod.

A latent space for unsupervised MR image quality control via artifact assessment

Image quality control (IQC) can be used in automated magnetic resonance (MR) image analysis to exclude erroneous results caused by poorly acquired or artifact-laden images. Existing IQC methods for MR imaging generally require human effort to craft meaningful features or label large datasets for supervised training. The involvement of human labor can be burdensome and biased, as labeling MR images based on their quality is a subjective task. In this paper, we propose an automatic IQC method that evaluates the extent of artifacts in MR images without supervision. In particular, we design an artifact encoding network that learns representations of artifacts based on contrastive learning. We then use a normalizing flow to estimate the density of learned representations for unsupervised classification. Our experiments on large-scale multi-cohort MR datasets show that the proposed method accurately detects images with high levels of artifacts, which can inform downstream analysis tasks about potentially flawed data.

Deep Unsupervised Phase-based 3D Incompressible Motion Estimation in Tagged-MRI

Tagged magnetic resonance imaging (MRI) has been used for decades to observe and quantify the detailed motion of deforming tissue. However, this technique faces several challenges such as tag fading, large motion, long computation times, and difficulties in obtaining diffeomorphic incompressible flow fields. To address these issues, this paper presents a novel unsupervised phase-based 3D motion estimation technique for tagged MRI. We introduce two key innovations. First, we apply a sinusoidal transformation to the harmonic phase input, which enables end-to-end training and avoids the need for phase interpolation. Second, we propose a Jacobian determinant-based learning objective to encourage incompressible flow fields for deforming biological tissues. Our method efficiently estimates 3D motion fields that are accurate, dense, and approximately diffeomorphic and incompressible. The efficacy of the method is assessed using human tongue motion during speech, and includes both healthy controls and patients that have undergone glossectomy. We show that the method outperforms existing approaches, and also exhibits improvements in speed, robustness to tag fading, and large tongue motion.

Segmenting thalamic nuclei from manifold projections of multi-contrast MRI

The thalamus is a subcortical gray matter structure that plays a key role in relaying sensory and motor signals within the brain. Its nuclei can atrophy or otherwise be affected by neurological disease and injuries including mild traumatic brain injury. Segmenting both the thalamus and its nuclei is challenging because of the relatively low contrast within and around the thalamus in conventional magnetic resonance (MR) images. This paper explores imaging features to determine key tissue signatures that naturally cluster, from which we can parcellate thalamic nuclei. Tissue contrasts include T1-weighted and T2-weighted images, MR diffusion measurements including FA, mean diffusivity, Knutsson coefficients that represent fiber orientation, and synthetic multi-TI images derived from FGATIR and T1-weighted images. After registration of these contrasts and isolation of the thalamus, we use the uniform manifold approximation and projection (UMAP) method for dimensionality reduction to produce a low-dimensional representation of the data within the thalamus. Manual labeling of the thalamus provides labels for our UMAP embedding from which k nearest neighbors can be used to label new unseen voxels in that same UMAP embedding. N -fold cross-validation of the method reveals comparable performance to state-of-the-art methods for thalamic parcellation.

HACA3: A Unified Approach for Multi-site MR Image Harmonization

The lack of standardization is a prominent issue in magnetic resonance (MR) imaging. This often causes undesired contrast variations due to differences in hardware and acquisition parameters. In recent years, MR harmonization using image synthesis with disentanglement has been proposed to compensate for the undesired contrast variations. Despite the success of existing methods, we argue that three major improvements can be made. First, most existing methods are built upon the assumption that multi-contrast MR images of the same subject share the same anatomy. This assumption is questionable since different MR contrasts are specialized to highlight different anatomical features. Second, these methods often require a fixed set of MR contrasts for training (e.g., both Tw-weighted and T2-weighted images must be available), which limits their applicability. Third, existing methods generally are sensitive to imaging artifacts. In this paper, we present a novel approach, Harmonization with Attention-based Contrast, Anatomy, and Artifact Awareness (HACA3), to address these three issues. We first propose an anatomy fusion module that enables HACA3 to respect the anatomical differences between MR contrasts. HACA3 is also robust to imaging artifacts and can be trained and applied to any set of MR contrasts. Experiments show that HACA3 achieves state-of-the-art performance under multiple image quality metrics. We also demonstrate the applicability of HACA3 on downstream tasks with diverse MR datasets acquired from 21 sites with different field strengths, scanner platforms, and acquisition protocols.

On Finite Difference Jacobian Computation in Deformable Image Registration

Producing spatial transformations that are diffeomorphic has been a central problem in deformable image registration. As a diffeomorphic transformation should have positive Jacobian determinant $|J|$ everywhere, the number of voxels with $|J|<0$ has been used to test for diffeomorphism and also to measure the irregularity of the transformation. For digital transformations, $|J|$ is commonly approximated using central difference, but this strategy can yield positive $|J|$'s for transformations that are clearly not diffeomorphic -- even at the voxel resolution level. To show this, we first investigate the geometric meaning of different finite difference approximations of $|J|$. We show that to determine diffeomorphism for digital images, use of any individual finite difference approximations of $|J|$ is insufficient. We show that for a 2D transformation, four unique finite difference approximations of $|J|$'s must be positive to ensure the entire domain is invertible and free of folding at the pixel level. We also show that in 3D, ten unique finite differences approximations of $|J|$'s are required to be positive. Our proposed digital diffeomorphism criteria solves several errors inherent in the central difference approximation of $|J|$ and accurately detects non-diffeomorphic digital transformations.

Deep filter bank regression for super-resolution of anisotropic MR brain images

In 2D multi-slice magnetic resonance (MR) acquisition, the through-plane signals are typically of lower resolution than the in-plane signals. While contemporary super-resolution (SR) methods aim to recover the underlying high-resolution volume, the estimated high-frequency information is implicit via end-to-end data-driven training rather than being explicitly stated and sought. To address this, we reframe the SR problem statement in terms of perfect reconstruction filter banks, enabling us to identify and directly estimate the missing information. In this work, we propose a two-stage approach to approximate the completion of a perfect reconstruction filter bank corresponding to the anisotropic acquisition of a particular scan. In stage 1, we estimate the missing filters using gradient descent and in stage 2, we use deep networks to learn the mapping from coarse coefficients to detail coefficients. In addition, the proposed formulation does not rely on external training data, circumventing the need for domain shift correction. Under our approach, SR performance is improved particularly in "slice gap" scenarios, likely due to the constrained solution space imposed by the framework.

Deep Learning-based Segmentation of Pleural Effusion From Ultrasound Using Coordinate Convolutions

In many low-to-middle income (LMIC) countries, ultrasound is used for assessment of pleural effusion. Typically, the extent of the effusion is manually measured by a sonographer, leading to significant intra-/inter-observer variability. In this work, we investigate the use of deep learning (DL) to automate the process of pleural effusion segmentation from ultrasound images. On two datasets acquired in a LMIC setting, we achieve median Dice Similarity Coefficients (DSCs) of 0.82 and 0.74 respectively using the nnU-net DL model. We also investigate the use of coordinate convolutions in the DL model and find that this results in a statistically significant improvement in the median DSC on the first dataset to 0.85, with no significant change on the second dataset. This work showcases, for the first time, the potential of DL in automating the process of effusion assessment from ultrasound in LMIC settings where there is often a lack of experienced radiologists to perform such tasks.

Disentangling A Single MR Modality

Disentangling anatomical and contrast information from medical images has gained attention recently, demonstrating benefits for various image analysis tasks. Current methods learn disentangled representations using either paired multi-modal images with the same underlying anatomy or auxiliary labels (e.g., manual delineations) to provide inductive bias for disentanglement. However, these requirements could significantly increase the time and cost in data collection and limit the applicability of these methods when such data are not available. Moreover, these methods generally do not guarantee disentanglement. In this paper, we present a novel framework that learns theoretically and practically superior disentanglement from single modality magnetic resonance images. Moreover, we propose a new information-based metric to quantitatively evaluate disentanglement. Comparisons over existing disentangling methods demonstrate that the proposed method achieves superior performance in both disentanglement and cross-domain image-to-image translation tasks.