Image Quality Assessment for Rigid Motion Compensation

Diagnostic stroke imaging with C-arm cone-beam computed tomography (CBCT) enables reduction of time-to-therapy for endovascular procedures. However, the prolonged acquisition time compared to helical CT increases the likelihood of rigid patient motion. Rigid motion corrupts the geometry alignment assumed during reconstruction, resulting in image blurring or streaking artifacts. To reestablish the geometry, we estimate the motion trajectory by an autofocus method guided by a neural network, which was trained to regress the reprojection error, based on the image information of a reconstructed slice. The network was trained with CBCT scans from 19 patients and evaluated using an additional test patient. It adapts well to unseen motion amplitudes and achieves superior results in a motion estimation benchmark compared to the commonly used entropy-based method.

Learning to Avoid Poor Images: Towards Task-aware C-arm Cone-beam CT Trajectories

Metal artifacts in computed tomography (CT) arise from a mismatch between physics of image formation and idealized assumptions during tomographic reconstruction. These artifacts are particularly strong around metal implants, inhibiting widespread adoption of 3D cone-beam CT (CBCT) despite clear opportunity for intra-operative verification of implant positioning, e.g. in spinal fusion surgery. On synthetic and real data, we demonstrate that much of the artifact can be avoided by acquiring better data for reconstruction in a task-aware and patient-specific manner, and describe the first step towards the envisioned task-aware CBCT protocol. The traditional short-scan CBCT trajectory is planar, with little room for scene-specific adjustment. We extend this trajectory by autonomously adjusting out-of-plane angulation. This enables C-arm source trajectories that are scene-specific in that they avoid acquiring "poor images", characterized by beam hardening, photon starvation, and noise. The recommendation of ideal out-of-plane angulation is performed on-the-fly using a deep convolutional neural network that regresses a detectability-rank derived from imaging physics.

Magnetic Resonance Fingerprinting Reconstruction Using Recurrent Neural Networks

Magnetic Resonance Fingerprinting (MRF) is an imaging technique acquiring unique time signals for different tissues. Although the acquisition is highly accelerated, the reconstruction time remains a problem, as the state-of-the-art template matching compares every signal with a set of possible signals. To overcome this limitation, deep learning based approaches, e.g. Convolutional Neural Networks (CNNs) have been proposed. In this work, we investigate the applicability of Recurrent Neural Networks (RNNs) for this reconstruction problem, as the signals are correlated in time. Compared to previous methods based on CNNs, RNN models yield significantly improved results using in-vivo data.

A Semi-Automated Usability Evaluation Framework for Interactive Image Segmentation Systems

For complex segmentation tasks, the achievable accuracy of fully automated systems is inherently limited. Specifically, when a precise segmentation result is desired for a small amount of given data sets, semi-automatic methods exhibit a clear benefit for the user. The optimization of human computer interaction (HCI) is an essential part of interactive image segmentation. Nevertheless, publications introducing novel interactive segmentation systems (ISS) often lack an objective comparison of HCI aspects. It is demonstrated, that even when the underlying segmentation algorithm is the same throughout interactive prototypes, their user experience may vary substantially. As a result, users prefer simple interfaces as well as a considerable degree of freedom to control each iterative step of the segmentation. In this article, an objective method for the comparison of ISS is proposed, based on extensive user studies. A summative qualitative content analysis is conducted via abstraction of visual and verbal feedback given by the participants. A direct assessment of the segmentation system is executed by the users via the system usability scale (SUS) and AttrakDiff-2 questionnaires. Furthermore, an approximation of the findings regarding usability aspects in those studies is introduced, conducted solely from the system-measurable user actions during their usage of interactive segmentation prototypes. The prediction of all questionnaire results has an average relative error of 8.9%, which is close to the expected precision of the questionnaire results themselves. This automated evaluation scheme may significantly reduce the resources necessary to investigate each variation of a prototype's user interface (UI) features and segmentation methodologies.

Data Consistent Artifact Reduction for Limited Angle Tomography with Deep Learning Prior

Robustness of deep learning methods for limited angle tomography is challenged by two major factors: a) due to insufficient training data the network may not generalize well to unseen data; b) deep learning methods are sensitive to noise. Thus, generating reconstructed images directly from a neural network appears inadequate. We propose to constrain the reconstructed images to be consistent with the measured projection data, while the unmeasured information is complemented by learning based methods. For this purpose, a data consistent artifact reduction (DCAR) method is introduced: First, a prior image is generated from an initial limited angle reconstruction via deep learning as a substitute for missing information. Afterwards, a conventional iterative reconstruction algorithm is applied, integrating the data consistency in the measured angular range and the prior information in the missing angular range. This ensures data integrity in the measured area, while inaccuracies incorporated by the deep learning prior lie only in areas where no information is acquired. The proposed DCAR method achieves significant image quality improvement: for 120-degree cone-beam limited angle tomography more than 10% RMSE reduction in noise-free case and more than 24% RMSE reduction in noisy case compared with a state-of-the-art U-Net based method.

Automated Multi-sequence Cardiac MRI Segmentation Using Supervised Domain Adaptation

Left ventricle segmentation and morphological assessment are essential for improving diagnosis and our understanding of cardiomyopathy, which in turn is imperative for reducing risk of myocardial infarctions in patients. Convolutional neural network (CNN) based methods for cardiac magnetic resonance (CMR) image segmentation rely on supervision with pixel-level annotations, and may not generalize well to images from a different domain. These methods are typically sensitive to variations in imaging protocols and data acquisition. Since annotating multi-sequence CMR images is tedious and subject to inter- and intra-observer variations, developing methods that can automatically adapt from one domain to the target domain is of great interest. In this paper, we propose an approach for domain adaptation in multi-sequence CMR segmentation task using transfer learning that combines multi-source image information. We first train an encoder-decoder CNN on T2-weighted and balanced-Steady State Free Precession (bSSFP) MR images with pixel-level annotation and fine-tune the same network with a limited number of Late Gadolinium Enhanced-MR (LGE-MR) subjects, to adapt the domain features. The domain-adapted network was trained with just four LGE-MR training samples and obtained an average Dice score of $\sim$85.0\% on the test set comprises of 40 LGE-MR subjects. The proposed method significantly outperformed a network without adaptation trained from scratch on the same set of LGE-MR training data.

Deep Generalized Max Pooling

Global pooling layers are an essential part of Convolutional Neural Networks (CNN). They are used to aggregate activations of spatial locations to produce a fixed-size vector in several state-of-the-art CNNs. Global average pooling or global max pooling are commonly used for converting convolutional features of variable size images to a fix-sized embedding. However, both pooling layer types are computed spatially independent: each individual activation map is pooled and thus activations of different locations are pooled together. In contrast, we propose Deep Generalized Max Pooling that balances the contribution of all activations of a spatially coherent region by re-weighting all descriptors so that the impact of frequent and rare ones is equalized. We show that this layer is superior to both average and max pooling on the classification of Latin medieval manuscripts (CLAMM'16, CLAMM'17), as well as writer identification (Historical-WI'17).

Deep Learning-Based Quantification of Pulmonary Hemosiderophages in Cytology Slides

Purpose: Exercise-induced pulmonary hemorrhage (EIPH) is a common syndrome in sport horses with negative impact on performance. Cytology of bronchoalveolar lavage fluid by use of a scoring system is considered the most sensitive diagnostic method. Macrophages are classified depending on the degree of cytoplasmic hemosiderin content. The current gold standard is manual grading, which is however monotonous and time-consuming. Methods: We evaluated state-of-the-art deep learning-based methods for single cell macrophage classification and compared them against the performance of nine cytology experts and evaluated inter- and intra-observer variability. Additionally, we evaluated object detection methods on a novel data set of 17 completely annotated cytology whole slide images (WSI) containing 78,047 hemosiderophages. Resultsf: Our deep learning-based approach reached a concordance of 0.85, partially exceeding human expert concordance (0.68 to 0.86, $\mu$=0.73, $\sigma$ =0.04). Intra-observer variability was high (0.68 to 0.88) and inter-observer concordance was moderate (Fleiss kappa = 0.67). Our object detection approach has a mean average precision of 0.66 over the five classes from the whole slide gigapixel image and a computation time of below two minutes. Conclusion: To mitigate the high inter- and intra-rater variability, we propose our automated object detection pipeline, enabling accurate, reproducible and quick EIPH scoring in WSI.

Multi-task Localization and Segmentation for X-ray Guided Planning in Knee Surgery

X-ray based measurement and guidance are commonly used tools in orthopaedic surgery to facilitate a minimally invasive workflow. Typically, a surgical planning is first performed using knowledge of bone morphology and anatomical landmarks. Information about bone location then serves as a prior for registration during overlay of the planning on intra-operative X-ray images. Performing these steps manually however is prone to intra-rater/inter-rater variability and increases task complexity for the surgeon. To remedy these issues, we propose an automatic framework for planning and subsequent overlay. We evaluate it on the example of femoral drill site planning for medial patellofemoral ligament reconstruction surgery. A deep multi-task stacked hourglass network is trained on 149 conventional lateral X-ray images to jointly localize two femoral landmarks, to predict a region of interest for the posterior femoral cortex tangent line, and to perform semantic segmentation of the femur, patella, tibia, and fibula with adaptive task complexity weighting. On 38 clinical test images the framework achieves a median localization error of 1.50 mm for the femoral drill site and mean IOU scores of 0.99, 0.97, 0.98, and 0.96 for the femur, patella, tibia, and fibula respectively. The demonstrated approach consistently performs surgical planning at expert-level precision without the need for manual correction.