RegBN: Batch Normalization of Multimodal Data with Regularization

Recent years have witnessed a surge of interest in integrating high-dimensional data captured by multisource sensors, driven by the impressive success of neural networks in the integration of multimodal data. However, the integration of heterogeneous multimodal data poses a significant challenge, as confounding effects and dependencies among such heterogeneous data sources introduce unwanted variability and bias, leading to suboptimal performance of multimodal models. Therefore, it becomes crucial to normalize the low- or high-level features extracted from data modalities before their fusion takes place. This paper introduces a novel approach for the normalization of multimodal data, called RegBN, that incorporates regularization. RegBN uses the Frobenius norm as a regularizer term to address the side effects of confounders and underlying dependencies among different data sources. The proposed method generalizes well across multiple modalities and eliminates the need for learnable parameters, simplifying training and inference. We validate the effectiveness of RegBN on eight databases from five research areas, encompassing diverse modalities such as language, audio, image, video, depth, tabular, and 3D MRI. The proposed method demonstrates broad applicability across different architectures such as multilayer perceptrons, convolutional neural networks, and vision transformers, enabling effective normalization of both low- and high-level features in multimodal neural networks. RegBN is available at \url{https://github.com/mogvision/regbn}.

MedShapeNet -- A Large-Scale Dataset of 3D Medical Shapes for Computer Vision

We present MedShapeNet, a large collection of anatomical shapes (e.g., bones, organs, vessels) and 3D surgical instrument models. Prior to the deep learning era, the broad application of statistical shape models (SSMs) in medical image analysis is evidence that shapes have been commonly used to describe medical data. Nowadays, however, state-of-the-art (SOTA) deep learning algorithms in medical imaging are predominantly voxel-based. In computer vision, on the contrary, shapes (including, voxel occupancy grids, meshes, point clouds and implicit surface models) are preferred data representations in 3D, as seen from the numerous shape-related publications in premier vision conferences, such as the IEEE/CVF Conference on Computer Vision and Pattern Recognition (CVPR), as well as the increasing popularity of ShapeNet (about 51,300 models) and Princeton ModelNet (127,915 models) in computer vision research. MedShapeNet is created as an alternative to these commonly used shape benchmarks to facilitate the translation of data-driven vision algorithms to medical applications, and it extends the opportunities to adapt SOTA vision algorithms to solve critical medical problems. Besides, the majority of the medical shapes in MedShapeNet are modeled directly on the imaging data of real patients, and therefore it complements well existing shape benchmarks comprising of computer-aided design (CAD) models. MedShapeNet currently includes more than 100,000 medical shapes, and provides annotations in the form of paired data. It is therefore also a freely available repository of 3D models for extended reality (virtual reality - VR, augmented reality - AR, mixed reality - MR) and medical 3D printing. This white paper describes in detail the motivations behind MedShapeNet, the shape acquisition procedures, the use cases, as well as the usage of the online shape search portal: https://medshapenet.ikim.nrw/

Meshes Meet Voxels: Abdominal Organ Segmentation via Diffeomorphic Deformations

Abdominal multi-organ segmentation from CT and MRI is an essential prerequisite for surgical planning and computer-aided navigation systems. Three-dimensional numeric representations of abdominal shapes are further important for quantitative and statistical analyses thereof. Existing methods in the field, however, are unable to extract highly accurate 3D representations that are smooth, topologically correct, and match points on a template. In this work, we present UNetFlow, a novel diffeomorphic shape deformation approach for abdominal organs. UNetFlow combines the advantages of voxel-based and mesh-based approaches for 3D shape extraction. Our results demonstrate high accuracy with respect to manually annotated CT data and better topological correctness compared to previous methods. In addition, we show the generalization of UNetFlow to MRI.

HALOS: Hallucination-free Organ Segmentation after Organ Resection Surgery

The wide range of research in deep learning-based medical image segmentation pushed the boundaries in a multitude of applications. A clinically relevant problem that received less attention is the handling of scans with irregular anatomy, e.g., after organ resection. State-of-the-art segmentation models often lead to organ hallucinations, i.e., false-positive predictions of organs, which cannot be alleviated by oversampling or post-processing. Motivated by the increasing need to develop robust deep learning models, we propose HALOS for abdominal organ segmentation in MR images that handles cases after organ resection surgery. To this end, we combine missing organ classification and multi-organ segmentation tasks into a multi-task model, yielding a classification-assisted segmentation pipeline. The segmentation network learns to incorporate knowledge about organ existence via feature fusion modules. Extensive experiments on a small labeled test set and large-scale UK Biobank data demonstrate the effectiveness of our approach in terms of higher segmentation Dice scores and near-to-zero false positive prediction rate.

Don't PANIC: Prototypical Additive Neural Network for Interpretable Classification of Alzheimer's Disease

Alzheimer's disease (AD) has a complex and multifactorial etiology, which requires integrating information about neuroanatomy, genetics, and cerebrospinal fluid biomarkers for accurate diagnosis. Hence, recent deep learning approaches combined image and tabular information to improve diagnostic performance. However, the black-box nature of such neural networks is still a barrier for clinical applications, in which understanding the decision of a heterogeneous model is integral. We propose PANIC, a prototypical additive neural network for interpretable AD classification that integrates 3D image and tabular data. It is interpretable by design and, thus, avoids the need for post-hoc explanations that try to approximate the decision of a network. Our results demonstrate that PANIC achieves state-of-the-art performance in AD classification, while directly providing local and global explanations. Finally, we show that PANIC extracts biologically meaningful signatures of AD, and satisfies a set of desirable desiderata for trustworthy machine learning. Our implementation is available at https://github.com/ai-med/PANIC .

Joint Reconstruction and Parcellation of Cortical Surfaces

The reconstruction of cerebral cortex surfaces from brain MRI scans is instrumental for the analysis of brain morphology and the detection of cortical thinning in neurodegenerative diseases like Alzheimer's disease (AD). Moreover, for a fine-grained analysis of atrophy patterns, the parcellation of the cortical surfaces into individual brain regions is required. For the former task, powerful deep learning approaches, which provide highly accurate brain surfaces of tissue boundaries from input MRI scans in seconds, have recently been proposed. However, these methods do not come with the ability to provide a parcellation of the reconstructed surfaces. Instead, separate brain-parcellation methods have been developed, which typically consider the cortical surfaces as given, often computed beforehand with FreeSurfer. In this work, we propose two options, one based on a graph classification branch and another based on a novel generic 3D reconstruction loss, to augment template-deformation algorithms such that the surface meshes directly come with an atlas-based brain parcellation. By combining both options with two of the latest cortical surface reconstruction algorithms, we attain highly accurate parcellations with a Dice score of 90.2 (graph classification branch) and 90.4 (novel reconstruction loss) together with state-of-the-art surfaces.

Is a PET all you need? A multi-modal study for Alzheimer's disease using 3D CNNs

Alzheimer's Disease (AD) is the most common form of dementia and often difficult to diagnose due to the multifactorial etiology of dementia. Recent works on neuroimaging-based computer-aided diagnosis with deep neural networks (DNNs) showed that fusing structural magnetic resonance images (sMRI) and fluorodeoxyglucose positron emission tomography (FDG-PET) leads to improved accuracy in a study population of healthy controls and subjects with AD. However, this result conflicts with the established clinical knowledge that FDG-PET better captures AD-specific pathologies than sMRI. Therefore, we propose a framework for the systematic evaluation of multi-modal DNNs and critically re-evaluate single- and multi-modal DNNs based on FDG-PET and sMRI for binary healthy vs. AD, and three-way healthy/mild cognitive impairment/AD classification. Our experiments demonstrate that a single-modality network using FDG-PET performs better than MRI (accuracy 0.91 vs 0.87) and does not show improvement when combined. This conforms with the established clinical knowledge on AD biomarkers, but raises questions about the true benefit of multi-modal DNNs. We argue that future work on multi-modal fusion should systematically assess the contribution of individual modalities following our proposed evaluation framework. Finally, we encourage the community to go beyond healthy vs. AD classification and focus on differential diagnosis of dementia, where fusing multi-modal image information conforms with a clinical need.

CASHformer: Cognition Aware SHape Transformer for Longitudinal Analysis

Modeling temporal changes in subcortical structures is crucial for a better understanding of the progression of Alzheimer's disease (AD). Given their flexibility to adapt to heterogeneous sequence lengths, mesh-based transformer architectures have been proposed in the past for predicting hippocampus deformations across time. However, one of the main limitations of transformers is the large amount of trainable parameters, which makes the application on small datasets very challenging. In addition, current methods do not include relevant non-image information that can help to identify AD-related patterns in the progression. To this end, we introduce CASHformer, a transformer-based framework to model longitudinal shape trajectories in AD. CASHformer incorporates the idea of pre-trained transformers as universal compute engines that generalize across a wide range of tasks by freezing most layers during fine-tuning. This reduces the number of parameters by over 90% with respect to the original model and therefore enables the application of large models on small datasets without overfitting. In addition, CASHformer models cognitive decline to reveal AD atrophy patterns in the temporal sequence. Our results show that CASHformer reduces the reconstruction error by 73% compared to previously proposed methods. Moreover, the accuracy of detecting patients progressing to AD increases by 3% with imputing missing longitudinal shape data.

Vox2Cortex: Fast Explicit Reconstruction of Cortical Surfaces from 3D MRI Scans with Geometric Deep Neural Networks

The reconstruction of cortical surfaces from brain magnetic resonance imaging (MRI) scans is essential for quantitative analyses of cortical thickness and sulcal morphology. Although traditional and deep learning-based algorithmic pipelines exist for this purpose, they have two major drawbacks: lengthy runtimes of multiple hours (traditional) or intricate post-processing, such as mesh extraction and topology correction (deep learning-based). In this work, we address both of these issues and propose Vox2Cortex, a deep learning-based algorithm that directly yields topologically correct, three-dimensional meshes of the boundaries of the cortex. Vox2Cortex leverages convolutional and graph convolutional neural networks to deform an initial template to the densely folded geometry of the cortex represented by an input MRI scan. We show in extensive experiments on three brain MRI datasets that our meshes are as accurate as the ones reconstructed by state-of-the-art methods in the field, without the need for time- and resource-intensive post-processing. To accurately reconstruct the tightly folded cortex, we work with meshes containing about 168,000 vertices at test time, scaling deep explicit reconstruction methods to a new level.