Mono2D: A Trainable Monogenic Layer for Robust Knee Cartilage Segmentation on Out-of-Distribution 2D Ultrasound Data

Automated knee cartilage segmentation using point-of-care ultrasound devices and deep-learning networks has the potential to enhance the management of knee osteoarthritis. However, segmentation algorithms often struggle with domain shifts caused by variations in ultrasound devices and acquisition parameters, limiting their generalizability. In this paper, we propose Mono2D, a monogenic layer that extracts multi-scale, contrast- and intensity-invariant local phase features using trainable bandpass quadrature filters. This layer mitigates domain shifts, improving generalization to out-of-distribution domains. Mono2D is integrated before the first layer of a segmentation network, and its parameters jointly trained alongside the network's parameters. We evaluated Mono2D on a multi-domain 2D ultrasound knee cartilage dataset for single-source domain generalization (SSDG). Our results demonstrate that Mono2D outperforms other SSDG methods in terms of Dice score and mean average surface distance. To further assess its generalizability, we evaluate Mono2D on a multi-site prostate MRI dataset, where it continues to outperform other SSDG methods, highlighting its potential to improve domain generalization in medical imaging. Nevertheless, further evaluation on diverse datasets is still necessary to assess its clinical utility.

Wireless vs. Traditional Ultrasound Assessed Knee Cartilage Outcomes Utilizing Automated Gain and Normalization Techniques

Advancements in wireless ultrasound technology allow for point of care cartilage imaging, yet validation against traditional ultrasound units remains to be established for knee cartilage outcomes. Therefore, the purpose of our study was to establish the agreement of articular cartilage thickness and echo-intensity measures between traditional and wireless ultrasound units utilizing automatic-gain and normalization techniques. We used traditional and wireless ultrasound to assess the femoral cartilage via transverse suprapatellar scans with the knee in maximum flexion in 71 female NCAA Division I athletes (age: 20.0$\pm$1.3 years, height: 171.7$\pm$8.7 cm, mass: 69.4$\pm$11.0 kg). Wireless ultrasound images (auto-gain and standard gain) were compared to traditional ultrasound images (standard gain) before and after normalization. Ultrasound image pixel values were algebraically scaled to normalize imaging parameter differences between units. Mean thickness and echo-intensity of the global and sub-regions of interest were measured for unnormalized and normalized images. Intraclass correlation coefficients ($ICC_{2,k}$) for absolute agreement, standard error of the measurement, and minimum detectable difference were calculated between the traditional and wireless ultrasound units across both gain parameters and normalization. Cartilage thickness demonstrated good to excellent agreement for all regions ($ICC_{2,k} = 0.83 {\text -} 0.95$) regardless of gain and normalization. However, mean echo-intensity demonstrated poor to moderate agreement in all regions regardless of gain and normalization ($ICC_{2,k} = 0.23 {\text -} 0.68 $). While there was a high level of agreement between units when assessing cartilage thickness, further research in ultrasound beam forming may lead to improvements in agreement of cartilage echo-intensity between ultrasound units.