GP-ConvCNP: Better Generalization for Convolutional Conditional Neural Processes on Time Series Data

Neural Processes (NPs) are a family of conditional generative models that are able to model a distribution over functions, in a way that allows them to perform predictions at test time conditioned on a number of context points. A recent addition to this family, Convolutional Conditional Neural Processes (ConvCNP), have shown remarkable improvement in performance over prior art, but we find that they sometimes struggle to generalize when applied to time series data. In particular, they are not robust to distribution shifts and fail to extrapolate observed patterns into the future. By incorporating a Gaussian Process into the model, we are able to remedy this and at the same time improve performance within distribution. As an added benefit, the Gaussian Process reintroduces the possibility to sample from the model, a key feature of other members in the NP family.

The Medical Segmentation Decathlon

International challenges have become the de facto standard for comparative assessment of image analysis algorithms given a specific task. Segmentation is so far the most widely investigated medical image processing task, but the various segmentation challenges have typically been organized in isolation, such that algorithm development was driven by the need to tackle a single specific clinical problem. We hypothesized that a method capable of performing well on multiple tasks will generalize well to a previously unseen task and potentially outperform a custom-designed solution. To investigate the hypothesis, we organized the Medical Segmentation Decathlon (MSD) - a biomedical image analysis challenge, in which algorithms compete in a multitude of both tasks and modalities. The underlying data set was designed to explore the axis of difficulties typically encountered when dealing with medical images, such as small data sets, unbalanced labels, multi-site data and small objects. The MSD challenge confirmed that algorithms with a consistent good performance on a set of tasks preserved their good average performance on a different set of previously unseen tasks. Moreover, by monitoring the MSD winner for two years, we found that this algorithm continued generalizing well to a wide range of other clinical problems, further confirming our hypothesis. Three main conclusions can be drawn from this study: (1) state-of-the-art image segmentation algorithms are mature, accurate, and generalize well when retrained on unseen tasks; (2) consistent algorithmic performance across multiple tasks is a strong surrogate of algorithmic generalizability; (3) the training of accurate AI segmentation models is now commoditized to non AI experts.

nnDetection: A Self-configuring Method for Medical Object Detection

Simultaneous localisation and categorization of objects in medical images, also referred to as medical object detection, is of high clinical relevance because diagnostic decisions often depend on rating of objects rather than e.g. pixels. For this task, the cumbersome and iterative process of method configuration constitutes a major research bottleneck. Recently, nnU-Net has tackled this challenge for the task of image segmentation with great success. Following nnU-Net's agenda, in this work we systematize and automate the configuration process for medical object detection. The resulting self-configuring method, nnDetection, adapts itself without any manual intervention to arbitrary medical detection problems while achieving results en par with or superior to the state-of-the-art. We demonstrate the effectiveness of nnDetection on two public benchmarks, ADAM and LUNA16, and propose 10 further medical object detection tasks on public data sets for comprehensive method evaluation. Code is at https://github.com/MIC-DKFZ/nnDetection .

Common Limitations of Image Processing Metrics: A Picture Story

While the importance of automatic image analysis is increasing at an enormous pace, recent meta-research revealed major flaws with respect to algorithm validation. Specifically, performance metrics are key for objective, transparent and comparative performance assessment, but relatively little attention has been given to the practical pitfalls when using specific metrics for a given image analysis task. A common mission of several international initiatives is therefore to provide researchers with guidelines and tools to choose the performance metrics in a problem-aware manner. This dynamically updated document has the purpose to illustrate important limitations of performance metrics commonly applied in the field of image analysis. The current version is based on a Delphi process on metrics conducted by an international consortium of image analysis experts.

Are we using appropriate segmentation metrics? Identifying correlates of human expert perception for CNN training beyond rolling the DICE coefficient

In this study, we explore quantitative correlates of qualitative human expert perception. We discover that current quality metrics and loss functions, considered for biomedical image segmentation tasks, correlate moderately with segmentation quality assessment by experts, especially for small yet clinically relevant structures, such as the enhancing tumor in brain glioma. We propose a method employing classical statistics and experimental psychology to create complementary compound loss functions for modern deep learning methods, towards achieving a better fit with human quality assessment. When training a CNN for delineating adult brain tumor in MR images, all four proposed loss candidates outperform the established baselines on the clinically important and hardest to segment enhancing tumor label, while maintaining performance for other label channels.

Studying Robustness of Semantic Segmentation under Domain Shift in cardiac MRI

Cardiac magnetic resonance imaging (cMRI) is an integral part of diagnosis in many heart related diseases. Recently, deep neural networks have demonstrated successful automatic segmentation, thus alleviating the burden of time-consuming manual contouring of cardiac structures. Moreover, frameworks such as nnU-Net provide entirely automatic model configuration to unseen datasets enabling out-of-the-box application even by non-experts. However, current studies commonly neglect the clinically realistic scenario, in which a trained network is applied to data from a different domain such as deviating scanners or imaging protocols. This potentially leads to unexpected performance drops of deep learning models in real life applications. In this work, we systematically study challenges and opportunities of domain transfer across images from multiple clinical centres and scanner vendors. In order to maintain out-of-the-box usability, we build upon a fixed U-Net architecture configured by the nnU-net framework to investigate various data augmentation techniques and batch normalization layers as an easy-to-customize pipeline component and provide general guidelines on how to improve domain generalizability abilities in existing deep learning methods. Our proposed method ranked first at the Multi-Centre, Multi-Vendor & Multi-Disease Cardiac Image Segmentation Challenge (M&Ms).

nnU-Net for Brain Tumor Segmentation

We apply nnU-Net to the segmentation task of the BraTS 2020 challenge. The unmodified nnU-Net baseline configuration already achieves a respectable result. By incorporating BraTS-specific modifications regarding postprocessing, region-based training, a more aggressive data augmentation as well as several minor modifications to the nnUNet pipeline we are able to improve its segmentation performance substantially. We furthermore re-implement the BraTS ranking scheme to determine which of our nnU-Net variants best fits the requirements imposed by it. Our final ensemble took the first place in the BraTS 2020 competition with Dice scores of 88.95, 85.06 and 82.03 and HD95 values of 8.498,17.337 and 17.805 for whole tumor, tumor core and enhancing tumor, respectively.

OR-UNet: an Optimized Robust Residual U-Net for Instrument Segmentation in Endoscopic Images

Segmentation of endoscopic images is an essential processing step for computer and robotics-assisted interventions. The Robust-MIS challenge provides the largest dataset of annotated endoscopic images to date, with 5983 manually annotated images. Here we describe OR-UNet, our optimized robust residual 2D U-Net for endoscopic image segmentation. As the name implies, the network makes use of residual connections in the encoder. It is trained with the sum of Dice and cross-entropy loss and deep supervision. During training, extensive data augmentation is used to increase the robustness. In an 8-fold cross-validation on the training images, our model achieved a mean (median) Dice score of 87.41 (94.35). We use the eight models from the cross-validation as an ensemble on the test set.