Continual atlas-based segmentation of prostate MRI

Continual learning (CL) methods designed for natural image classification often fail to reach basic quality standards for medical image segmentation. Atlas-based segmentation, a well-established approach in medical imaging, incorporates domain knowledge on the region of interest, leading to semantically coherent predictions. This is especially promising for CL, as it allows us to leverage structural information and strike an optimal balance between model rigidity and plasticity over time. When combined with privacy-preserving prototypes, this process offers the advantages of rehearsal-based CL without compromising patient privacy. We propose Atlas Replay, an atlas-based segmentation approach that uses prototypes to generate high-quality segmentation masks through image registration that maintain consistency even as the training distribution changes. We explore how our proposed method performs compared to state-of-the-art CL methods in terms of knowledge transferability across seven publicly available prostate segmentation datasets. Prostate segmentation plays a vital role in diagnosing prostate cancer, however, it poses challenges due to substantial anatomical variations, benign structural differences in older age groups, and fluctuating acquisition parameters. Our results show that Atlas Replay is both robust and generalizes well to yet-unseen domains while being able to maintain knowledge, unlike end-to-end segmentation methods. Our code base is available under https://github.com/MECLabTUDA/Atlas-Replay.

Efficient Large Scale Medical Image Dataset Preparation for Machine Learning Applications

In the rapidly evolving field of medical imaging, machine learning algorithms have become indispensable for enhancing diagnostic accuracy. However, the effectiveness of these algorithms is contingent upon the availability and organization of high-quality medical imaging datasets. Traditional Digital Imaging and Communications in Medicine (DICOM) data management systems are inadequate for handling the scale and complexity of data required to be facilitated in machine learning algorithms. This paper introduces an innovative data curation tool, developed as part of the Kaapana open-source toolkit, aimed at streamlining the organization, management, and processing of large-scale medical imaging datasets. The tool is specifically tailored to meet the needs of radiologists and machine learning researchers. It incorporates advanced search, auto-annotation and efficient tagging functionalities for improved data curation. Additionally, the tool facilitates quality control and review, enabling researchers to validate image and segmentation quality in large datasets. It also plays a critical role in uncovering potential biases in datasets by aggregating and visualizing metadata, which is essential for developing robust machine learning models. Furthermore, Kaapana is integrated within the Radiological Cooperative Network (RACOON), a pioneering initiative aimed at creating a comprehensive national infrastructure for the aggregation, transmission, and consolidation of radiological data across all university clinics throughout Germany. A supplementary video showcasing the tool's functionalities can be accessed at https://bit.ly/MICCAI-DEMI2023.

Current State of Community-Driven Radiological AI Deployment in Medical Imaging

Artificial Intelligence (AI) has become commonplace to solve routine everyday tasks. Because of the exponential growth in medical imaging data volume and complexity, the workload on radiologists is steadily increasing. We project that the gap between the number of imaging exams and the number of expert radiologist readers required to cover this increase will continue to expand, consequently introducing a demand for AI-based tools that improve the efficiency with which radiologists can comfortably interpret these exams. AI has been shown to improve efficiency in medical-image generation, processing, and interpretation, and a variety of such AI models have been developed across research labs worldwide. However, very few of these, if any, find their way into routine clinical use, a discrepancy that reflects the divide between AI research and successful AI translation. To address the barrier to clinical deployment, we have formed MONAI Consortium, an open-source community which is building standards for AI deployment in healthcare institutions, and developing tools and infrastructure to facilitate their implementation. This report represents several years of weekly discussions and hands-on problem solving experience by groups of industry experts and clinicians in the MONAI Consortium. We identify barriers between AI-model development in research labs and subsequent clinical deployment and propose solutions. Our report provides guidance on processes which take an imaging AI model from development to clinical implementation in a healthcare institution. We discuss various AI integration points in a clinical Radiology workflow. We also present a taxonomy of Radiology AI use-cases. Through this report, we intend to educate the stakeholders in healthcare and AI (AI researchers, radiologists, imaging informaticists, and regulators) about cross-disciplinary challenges and possible solutions.