Rigid and non-rigid motion compensation in weight-bearing cone-beam CT of the knee using (noisy) inertial measurements

Involuntary subject motion is the main source of artifacts in weight-bearing cone-beam CT of the knee. To achieve image quality for clinical diagnosis, the motion needs to be compensated. We propose to use inertial measurement units (IMUs) attached to the leg for motion estimation. We perform a simulation study using real motion recorded with an optical tracking system. Three IMU-based correction approaches are evaluated, namely rigid motion correction, non-rigid 2D projection deformation and non-rigid 3D dynamic reconstruction. We present an initialization process based on the system geometry. With an IMU noise simulation, we investigate the applicability of the proposed methods in real applications. All proposed IMU-based approaches correct motion at least as good as a state-of-the-art marker-based approach. The structural similarity index and the root mean squared error between motion-free and motion corrected volumes are improved by 24-35% and 78-85%, respectively, compared with the uncorrected case. The noise analysis shows that the noise levels of commercially available IMUs need to be improved by a factor of $10^5$ which is currently only achieved by specialized hardware not robust enough for the application. The presented study confirms the feasibility of this novel approach and defines improvements necessary for a real application.

Enhanced Magnetic Resonance Image Synthesis with Contrast-Aware Generative Adversarial Networks

A Magnetic Resonance Imaging (MRI) exam typically consists of the acquisition of multiple MR pulse sequences, which are required for a reliable diagnosis. Each sequence can be parameterized through multiple acquisition parameters affecting MR image contrast, signal-to-noise ratio, resolution, or scan time. With the rise of generative deep learning models, approaches for the synthesis of MR images are developed to either synthesize additional MR contrasts, generate synthetic data, or augment existing data for AI training. However, current generative approaches for the synthesis of MR images are only trained on images with a specific set of acquisition parameter values, limiting the clinical value of these methods as various sets of acquisition parameter settings are used in clinical practice. Therefore, we trained a generative adversarial network (GAN) to generate synthetic MR knee images conditioned on various acquisition parameters (repetition time, echo time, image orientation). This approach enables us to synthesize MR images with adjustable image contrast. In a visual Turing test, two experts mislabeled 40.5% of real and synthetic MR images, demonstrating that the image quality of the generated synthetic and real MR images is comparable. This work can support radiologists and technologists during the parameterization of MR sequences by previewing the yielded MR contrast, can serve as a valuable tool for radiology training, and can be used for customized data generation to support AI training.

On Mathews Correlation Coefficient and Improved Distance Map Loss for Automatic Glacier Calving Front Segmentation in SAR Imagery

The vast majority of the outlet glaciers and ice streams of the polar ice sheets end in the ocean. Ice mass loss via calving of the glaciers into the ocean has increased over the last few decades. Information on the temporal variability of the calving front position provides fundamental information on the state of the glacier and ice stream, which can be exploited as calibration and validation data to enhance ice dynamics modeling. To identify the calving front position automatically, deep neural network-based semantic segmentation pipelines can be used to delineate the acquired SAR imagery. However, the extreme class imbalance is highly challenging for the accurate calving front segmentation in these images. Therefore, we propose the use of the Mathews correlation coefficient (MCC) as an early stopping criterion because of its symmetrical properties and its invariance towards class imbalance. Moreover, we propose an improvement to the distance map-based binary cross-entropy (BCE) loss function. The distance map adds context to the loss function about the important regions for segmentation and helps accounting for the imbalanced data. Using Mathews correlation coefficient as early stopping demonstrates an average 15% dice coefficient improvement compared to the commonly used BCE. The modified distance map loss further improves the segmentation performance by another 2%. These results are encouraging as they support the effectiveness of the proposed methods for segmentation problems suffering from extreme class imbalances.

Deep Learning compatible Differentiable X-ray Projections for Inverse Rendering

Many minimally invasive interventional procedures still rely on 2D fluoroscopic imaging. Generating a patient-specific 3D model from these X-ray projection data would allow to improve the procedural workflow, e.g. by providing assistance functions such as automatic positioning. To accomplish this, two things are required. First, a statistical human shape model of the human anatomy and second, a differentiable X-ray renderer. In this work, we propose a differentiable renderer by deriving the distance travelled by a ray inside mesh structures to generate a distance map. To demonstrate its functioning, we use it for simulating X-ray images from human shape models. Then we show its application by solving the inverse problem, namely reconstructing 3D models from real 2D fluoroscopy images of the pelvis, which is an ideal anatomical structure for patient registration. This is accomplished by an iterative optimization strategy using gradient descent. With the majority of the pelvis being in the fluoroscopic field of view, we achieve a mean Hausdorff distance of 30 mm between the reconstructed model and the ground truth segmentation.

Learning the Update Operator for 2D/3D Image Registration

Image guidance in minimally invasive interventions is usually provided using live 2D X-ray imaging. To enhance the information available during the intervention, the preoperative volume can be overlaid over the 2D images using 2D/3D image registration. Recently, deep learning-based 2D/3D registration methods have shown promising results by improving computational efficiency and robustness. However, there is still a gap in terms of registration accuracy compared to traditional optimization-based methods. We aim to address this gap by incorporating traditional methods in deep neural networks using known operator learning. As an initial step in this direction, we propose to learn the update step of an iterative 2D/3D registration framework based on the Point-to-Plane Correspondence model. We embed the Point-to-Plane Correspondence model as a known operator in our deep neural network and learn the update step for the iterative registration. We show an improvement of 1.8 times in terms of registration accuracy for the update step prediction compared to learning without the known operator.

SkinScan: Low-Cost 3D-Scanning for Dermatologic Diagnosis and Documentation

The utilization of computational photography becomes increasingly essential in the medical field. Today, imaging techniques for dermatology range from two-dimensional (2D) color imagery with a mobile device to professional clinical imaging systems measuring additional detailed three-dimensional (3D) data. The latter are commonly expensive and not accessible to a broad audience. In this work, we propose a novel system and software framework that relies only on low-cost (and even mobile) commodity devices present in every household to measure detailed 3D information of the human skin with a 3D-gradient-illumination-based method. We believe that our system has great potential for early-stage diagnosis and monitoring of skin diseases, especially in vastly populated or underdeveloped areas.

Learning-Based Patch-Wise Metal Segmentation with Consistency Check

Metal implants that are inserted into the patient's body during trauma interventions cause heavy artifacts in 3D X-ray acquisitions. Metal Artifact Reduction (MAR) methods, whose first step is always a segmentation of the present metal objects, try to remove these artifacts. Thereby, the segmentation is a crucial task which has strong influence on the MAR's outcome. This study proposes and evaluates a learning-based patch-wise segmentation network and a newly proposed Consistency Check as post-processing step. The combination of the learned segmentation and Consistency Check reaches a high segmentation performance with an average IoU score of 0.924 on the test set. Furthermore, the Consistency Check proves the ability to significantly reduce false positive segmentations whilst simultaneously ensuring consistent segmentations.

X-ray Scatter Estimation Using Deep Splines

Algorithmic X-ray scatter compensation is a desirable technique in flat-panel X-ray imaging and cone-beam computed tomography. State-of-the-art U-net based image translation approaches yielded promising results. As there are no physics constraints applied to the output of the U-Net, it cannot be ruled out that it yields spurious results. Unfortunately, those may be misleading in the context of medical imaging. To overcome this problem, we propose to embed B-splines as a known operator into neural networks. This inherently limits their predictions to well-behaved and smooth functions. In a study using synthetic head and thorax data as well as real thorax phantom data, we found that our approach performed on par with U-net when comparing both algorithms based on quantitative performance metrics. However, our approach not only reduces runtime and parameter complexity, but we also found it much more robust to unseen noise levels. While the U-net responded with visible artifacts, our approach preserved the X-ray signal's frequency characteristics.

Synthetic Glacier SAR Image Generation from Arbitrary Masks Using Pix2Pix Algorithm

Supervised machine learning requires a large amount of labeled data to achieve proper test results. However, generating accurately labeled segmentation maps on remote sensing imagery, including images from synthetic aperture radar (SAR), is tedious and highly subjective. In this work, we propose to alleviate the issue of limited training data by generating synthetic SAR images with the pix2pix algorithm. This algorithm uses conditional Generative Adversarial Networks (cGANs) to generate an artificial image while preserving the structure of the input. In our case, the input is a segmentation mask, from which a corresponding synthetic SAR image is generated. We present different models, perform a comparative study and demonstrate that this approach synthesizes convincing glaciers in SAR images with promising qualitative and quantitative results.

Learning to be EXACT, Cell Detection for Asthma on Partially Annotated Whole Slide Images

Asthma is a chronic inflammatory disorder of the lower respiratory tract and naturally occurs in humans and animals including horses. The annotation of an asthma microscopy whole slide image (WSI) is an extremely labour-intensive task due to the hundreds of thousands of cells per WSI. To overcome the limitation of annotating WSI incompletely, we developed a training pipeline which can train a deep learning-based object detection model with partially annotated WSIs and compensate class imbalances on the fly. With this approach we can freely sample from annotated WSIs areas and are not restricted to fully annotated extracted sub-images of the WSI as with classical approaches. We evaluated our pipeline in a cross-validation setup with a fixed training set using a dataset of six equine WSIs of which four are partially annotated and used for training, and two fully annotated WSI are used for validation and testing. Our WSI-based training approach outperformed classical sub-image-based training methods by up to 15\% $mAP$ and yielded human-like performance when compared to the annotations of ten trained pathologists.