Punctate White Matter Lesion Segmentation in Preterm Infants Powered by Counterfactually Generative Learning

Accurate segmentation of punctate white matter lesions (PWMLs) are fundamental for the timely diagnosis and treatment of related developmental disorders. Automated PWMLs segmentation from infant brain MR images is challenging, considering that the lesions are typically small and low-contrast, and the number of lesions may dramatically change across subjects. Existing learning-based methods directly apply general network architectures to this challenging task, which may fail to capture detailed positional information of PWMLs, potentially leading to severe under-segmentations. In this paper, we propose to leverage the idea of counterfactual reasoning coupled with the auxiliary task of brain tissue segmentation to learn fine-grained positional and morphological representations of PWMLs for accurate localization and segmentation. A simple and easy-to-implement deep-learning framework (i.e., DeepPWML) is accordingly designed. It combines the lesion counterfactual map with the tissue probability map to train a lightweight PWML segmentation network, demonstrating state-of-the-art performance on a real-clinical dataset of infant T1w MR images. The code is available at \href{https://github.com/ladderlab-xjtu/DeepPWML}{https://github.com/ladderlab-xjtu/DeepPWML}.

Forensic Histopathological Recognition via a Context-Aware MIL Network Powered by Self-Supervised Contrastive Learning

Forensic pathology is critical in analyzing death manner and time from the microscopic aspect to assist in the establishment of reliable factual bases for criminal investigation. In practice, even the manual differentiation between different postmortem organ tissues is challenging and relies on expertise, considering that changes like putrefaction and autolysis could significantly change typical histopathological appearance. Developing AI-based computational pathology techniques to assist forensic pathologists is practically meaningful, which requires reliable discriminative representation learning to capture tissues' fine-grained postmortem patterns. To this end, we propose a framework called FPath, in which a dedicated self-supervised contrastive learning strategy and a context-aware multiple-instance learning (MIL) block are designed to learn discriminative representations from postmortem histopathological images acquired at varying magnification scales. Our self-supervised learning step leverages multiple complementary contrastive losses and regularization terms to train a double-tier backbone for fine-grained and informative patch/instance embedding. Thereafter, the context-aware MIL adaptively distills from the local instances a holistic bag/image-level representation for the recognition task. On a large-scale database of $19,607$ experimental rat postmortem images and $3,378$ real-world human decedent images, our FPath led to state-of-the-art accuracy and promising cross-domain generalization in recognizing seven different postmortem tissues. The source code will be released on \href{https://github.com/ladderlab-xjtu/forensic_pathology}{https://github.com/ladderlab-xjtu/forensic\_pathology}.

Dual Meta-Learning with Longitudinally Generalized Regularization for One-Shot Brain Tissue Segmentation Across the Human Lifespan

Brain tissue segmentation is essential for neuroscience and clinical studies. However, segmentation on longitudinal data is challenging due to dynamic brain changes across the lifespan. Previous researches mainly focus on self-supervision with regularizations and will lose longitudinal generalization when fine-tuning on a specific age group. In this paper, we propose a dual meta-learning paradigm to learn longitudinally consistent representations and persist when fine-tuning. Specifically, we learn a plug-and-play feature extractor to extract longitudinal-consistent anatomical representations by meta-feature learning and a well-initialized task head for fine-tuning by meta-initialization learning. Besides, two class-aware regularizations are proposed to encourage longitudinal consistency. Experimental results on the iSeg2019 and ADNI datasets demonstrate the effectiveness of our method. Our code is available at https://github.com/ladderlab-xjtu/DuMeta.

NeuroExplainer: Fine-Grained Attention Decoding to Uncover Cortical Development Patterns of Preterm Infants

Deploying reliable deep learning techniques in interdisciplinary applications needs learned models to output accurate and ({even more importantly}) explainable predictions. Existing approaches typically explicate network outputs in a post-hoc fashion, under an implicit assumption that faithful explanations come from accurate predictions/classifications. We have an opposite claim that explanations boost (or even determine) classification. That is, end-to-end learning of explanation factors to augment discriminative representation extraction could be a more intuitive strategy to inversely assure fine-grained explainability, e.g., in those neuroimaging and neuroscience studies with high-dimensional data containing noisy, redundant, and task-irrelevant information. In this paper, we propose such an explainable geometric deep network dubbed as NeuroExplainer, with applications to uncover altered infant cortical development patterns associated with preterm birth. Given fundamental cortical attributes as network input, our NeuroExplainer adopts a hierarchical attention-decoding framework to learn fine-grained attentions and respective discriminative representations to accurately recognize preterm infants from term-born infants at term-equivalent age. NeuroExplainer learns the hierarchical attention-decoding modules under subject-level weak supervision coupled with targeted regularizers deduced from domain knowledge regarding brain development. These prior-guided constraints implicitly maximizes the explainability metrics (i.e., fidelity, sparsity, and stability) in network training, driving the learned network to output detailed explanations and accurate classifications. Experimental results on the public dHCP benchmark suggest that NeuroExplainer led to quantitatively reliable explanation results that are qualitatively consistent with representative neuroimaging studies.

Two-Stream Graph Convolutional Network for Intra-oral Scanner Image Segmentation

Precise segmentation of teeth from intra-oral scanner images is an essential task in computer-aided orthodontic surgical planning. The state-of-the-art deep learning-based methods often simply concatenate the raw geometric attributes (i.e., coordinates and normal vectors) of mesh cells to train a single-stream network for automatic intra-oral scanner image segmentation. However, since different raw attributes reveal completely different geometric information, the naive concatenation of different raw attributes at the (low-level) input stage may bring unnecessary confusion in describing and differentiating between mesh cells, thus hampering the learning of high-level geometric representations for the segmentation task. To address this issue, we design a two-stream graph convolutional network (i.e., TSGCN), which can effectively handle inter-view confusion between different raw attributes to more effectively fuse their complementary information and learn discriminative multi-view geometric representations. Specifically, our TSGCN adopts two input-specific graph-learning streams to extract complementary high-level geometric representations from coordinates and normal vectors, respectively. Then, these single-view representations are further fused by a self-attention module to adaptively balance the contributions of different views in learning more discriminative multi-view representations for accurate and fully automatic tooth segmentation. We have evaluated our TSGCN on a real-patient dataset of dental (mesh) models acquired by 3D intraoral scanners. Experimental results show that our TSGCN significantly outperforms state-of-the-art methods in 3D tooth (surface) segmentation. Github: https://github.com/ZhangLingMing1/TSGCNet.

SkullEngine: A Multi-stage CNN Framework for Collaborative CBCT Image Segmentation and Landmark Detection

We propose a multi-stage coarse-to-fine CNN-based framework, called SkullEngine, for high-resolution segmentation and large-scale landmark detection through a collaborative, integrated, and scalable JSD model and three segmentation and landmark detection refinement models. We evaluated our framework on a clinical dataset consisting of 170 CBCT/CT images for the task of segmenting 2 bones (midface and mandible) and detecting 175 clinically common landmarks on bones, teeth, and soft tissues.

Two-Stage Mesh Deep Learning for Automated Tooth Segmentation and Landmark Localization on 3D Intraoral Scans

Accurately segmenting teeth and identifying the corresponding anatomical landmarks on dental mesh models are essential in computer-aided orthodontic treatment. Manually performing these two tasks is time-consuming, tedious, and, more importantly, highly dependent on orthodontists' experiences due to the abnormality and large-scale variance of patients' teeth. Some machine learning-based methods have been designed and applied in the orthodontic field to automatically segment dental meshes (e.g., intraoral scans). In contrast, the number of studies on tooth landmark localization is still limited. This paper proposes a two-stage framework based on mesh deep learning (called TS-MDL) for joint tooth labeling and landmark identification on raw intraoral scans. Our TS-MDL first adopts an end-to-end \emph{i}MeshSegNet method (i.e., a variant of the existing MeshSegNet with both improved accuracy and efficiency) to label each tooth on the downsampled scan. Guided by the segmentation outputs, our TS-MDL further selects each tooth's region of interest (ROI) on the original mesh to construct a light-weight variant of the pioneering PointNet (i.e., PointNet-Reg) for regressing the corresponding landmark heatmaps. Our TS-MDL was evaluated on a real-clinical dataset, showing promising segmentation and localization performance. Specifically, \emph{i}MeshSegNet in the first stage of TS-MDL reached an averaged Dice similarity coefficient (DSC) at $0.953\pm0.076$, significantly outperforming the original MeshSegNet. In the second stage, PointNet-Reg achieved a mean absolute error (MAE) of $0.623\pm0.718 \, mm$ in distances between the prediction and ground truth for $44$ landmarks, which is superior compared with other networks for landmark detection. All these results suggest the potential usage of our TS-MDL in clinical practices.

A Self-Supervised Deep Framework for Reference Bony Shape Estimation in Orthognathic Surgical Planning

Virtual orthognathic surgical planning involves simulating surgical corrections of jaw deformities on 3D facial bony shape models. Due to the lack of necessary guidance, the planning procedure is highly experience-dependent and the planning results are often suboptimal. A reference facial bony shape model representing normal anatomies can provide an objective guidance to improve planning accuracy. Therefore, we propose a self-supervised deep framework to automatically estimate reference facial bony shape models. Our framework is an end-to-end trainable network, consisting of a simulator and a corrector. In the training stage, the simulator maps jaw deformities of a patient bone to a normal bone to generate a simulated deformed bone. The corrector then restores the simulated deformed bone back to normal. In the inference stage, the trained corrector is applied to generate a patient-specific normal-looking reference bone from a real deformed bone. The proposed framework was evaluated using a clinical dataset and compared with a state-of-the-art method that is based on a supervised point-cloud network. Experimental results show that the estimated shape models given by our approach are clinically acceptable and significantly more accurate than that of the competing method.

TSGCNet: Discriminative Geometric Feature Learning with Two-Stream GraphConvolutional Network for 3D Dental Model Segmentation

The ability to segment teeth precisely from digitized 3D dental models is an essential task in computer-aided orthodontic surgical planning. To date, deep learning based methods have been popularly used to handle this task. State-of-the-art methods directly concatenate the raw attributes of 3D inputs, namely coordinates and normal vectors of mesh cells, to train a single-stream network for fully-automated tooth segmentation. This, however, has the drawback of ignoring the different geometric meanings provided by those raw attributes. This issue might possibly confuse the network in learning discriminative geometric features and result in many isolated false predictions on the dental model. Against this issue, we propose a two-stream graph convolutional network (TSGCNet) to learn multi-view geometric information from different geometric attributes. Our TSGCNet adopts two graph-learning streams, designed in an input-aware fashion, to extract more discriminative high-level geometric representations from coordinates and normal vectors, respectively. These feature representations learned from the designed two different streams are further fused to integrate the multi-view complementary information for the cell-wise dense prediction task. We evaluate our proposed TSGCNet on a real-patient dataset of dental models acquired by 3D intraoral scanners, and experimental results demonstrate that our method significantly outperforms state-of-the-art methods for 3D shape segmentation.

HF-UNet: Learning Hierarchically Inter-Task Relevance in Multi-Task U-Net for Accurate Prostate Segmentation

Accurate segmentation of the prostate is a key step in external beam radiation therapy treatments. In this paper, we tackle the challenging task of prostate segmentation in CT images by a two-stage network with 1) the first stage to fast localize, and 2) the second stage to accurately segment the prostate. To precisely segment the prostate in the second stage, we formulate prostate segmentation into a multi-task learning framework, which includes a main task to segment the prostate, and an auxiliary task to delineate the prostate boundary. Here, the second task is applied to provide additional guidance of unclear prostate boundary in CT images. Besides, the conventional multi-task deep networks typically share most of the parameters (i.e., feature representations) across all tasks, which may limit their data fitting ability, as the specificities of different tasks are inevitably ignored. By contrast, we solve them by a hierarchically-fused U-Net structure, namely HF-UNet. The HF-UNet has two complementary branches for two tasks, with the novel proposed attention-based task consistency learning block to communicate at each level between the two decoding branches. Therefore, HF-UNet endows the ability to learn hierarchically the shared representations for different tasks, and preserve the specificities of learned representations for different tasks simultaneously. We did extensive evaluations of the proposed method on a large planning CT image dataset, including images acquired from 339 patients. The experimental results show HF-UNet outperforms the conventional multi-task network architectures and the state-of-the-art methods.