The state-of-the-art in Cardiac MRI Reconstruction: Results of the CMRxRecon Challenge in MICCAI 2023

Cardiac MRI, crucial for evaluating heart structure and function, faces limitations like slow imaging and motion artifacts. Undersampling reconstruction, especially data-driven algorithms, has emerged as a promising solution to accelerate scans and enhance imaging performance using highly under-sampled data. Nevertheless, the scarcity of publicly available cardiac k-space datasets and evaluation platform hinder the development of data-driven reconstruction algorithms. To address this issue, we organized the Cardiac MRI Reconstruction Challenge (CMRxRecon) in 2023, in collaboration with the 26th International Conference on MICCAI. CMRxRecon presented an extensive k-space dataset comprising cine and mapping raw data, accompanied by detailed annotations of cardiac anatomical structures. With overwhelming participation, the challenge attracted more than 285 teams and over 600 participants. Among them, 22 teams successfully submitted Docker containers for the testing phase, with 7 teams submitted for both cine and mapping tasks. All teams use deep learning based approaches, indicating that deep learning has predominately become a promising solution for the problem. The first-place winner of both tasks utilizes the E2E-VarNet architecture as backbones. In contrast, U-Net is still the most popular backbone for both multi-coil and single-coil reconstructions. This paper provides a comprehensive overview of the challenge design, presents a summary of the submitted results, reviews the employed methods, and offers an in-depth discussion that aims to inspire future advancements in cardiac MRI reconstruction models. The summary emphasizes the effective strategies observed in Cardiac MRI reconstruction, including backbone architecture, loss function, pre-processing techniques, physical modeling, and model complexity, thereby providing valuable insights for further developments in this field.

Co-Optimization of Environment and Policies for Decentralized Multi-Agent Navigation

This work views the multi-agent system and its surrounding environment as a co-evolving system, where the behavior of one affects the other. The goal is to take both agent actions and environment configurations as decision variables, and optimize these two components in a coordinated manner to improve some measure of interest. Towards this end, we consider the problem of decentralized multi-agent navigation in cluttered environments. By introducing two sub-objectives of multi-agent navigation and environment optimization, we propose an $\textit{agent-environment co-optimization}$ problem and develop a $\textit{coordinated algorithm}$ that alternates between these sub-objectives to search for an optimal synthesis of agent actions and obstacle configurations in the environment; ultimately, improving the navigation performance. Due to the challenge of explicitly modeling the relation between agents, environment and performance, we leverage policy gradient to formulate a model-free learning mechanism within the coordinated framework. A formal convergence analysis shows that our coordinated algorithm tracks the local minimum trajectory of an associated time-varying non-convex optimization problem. Extensive numerical results corroborate theoretical findings and show the benefits of co-optimization over baselines. Interestingly, the results also indicate that optimized environment configurations are able to offer structural guidance that is key to de-conflicting agents in motion.

ContrastDiagnosis: Enhancing Interpretability in Lung Nodule Diagnosis Using Contrastive Learning

With the ongoing development of deep learning, an increasing number of AI models have surpassed the performance levels of human clinical practitioners. However, the prevalence of AI diagnostic products in actual clinical practice remains significantly lower than desired. One crucial reason for this gap is the so-called `black box' nature of AI models. Clinicians' distrust of black box models has directly hindered the clinical deployment of AI products. To address this challenge, we propose ContrastDiagnosis, a straightforward yet effective interpretable diagnosis framework. This framework is designed to introduce inherent transparency and provide extensive post-hoc explainability for deep learning model, making them more suitable for clinical medical diagnosis. ContrastDiagnosis incorporates a contrastive learning mechanism to provide a case-based reasoning diagnostic rationale, enhancing the model's transparency and also offers post-hoc interpretability by highlighting similar areas. High diagnostic accuracy was achieved with AUC of 0.977 while maintain a high transparency and explainability.

MambaMIR: An Arbitrary-Masked Mamba for Joint Medical Image Reconstruction and Uncertainty Estimation

The recent Mamba model has shown remarkable adaptability for visual representation learning, including in medical imaging tasks. This study introduces MambaMIR, a Mamba-based model for medical image reconstruction, as well as its Generative Adversarial Network-based variant, MambaMIR-GAN. Our proposed MambaMIR inherits several advantages, such as linear complexity, global receptive fields, and dynamic weights, from the original Mamba model. The innovated arbitrary-mask mechanism effectively adapt Mamba to our image reconstruction task, providing randomness for subsequent Monte Carlo-based uncertainty estimation. Experiments conducted on various medical image reconstruction tasks, including fast MRI and SVCT, which cover anatomical regions such as the knee, chest, and abdomen, have demonstrated that MambaMIR and MambaMIR-GAN achieve comparable or superior reconstruction results relative to state-of-the-art methods. Additionally, the estimated uncertainty maps offer further insights into the reliability of the reconstruction quality. The code is publicly available at https://github.com/ayanglab/MambaMIR.

Deep Separable Spatiotemporal Learning for Fast Dynamic Cardiac MRI

Dynamic magnetic resonance imaging (MRI) plays an indispensable role in cardiac diagnosis. To enable fast imaging, the k-space data can be undersampled but the image reconstruction poses a great challenge of high-dimensional processing. This challenge leads to necessitate extensive training data in many deep learning reconstruction methods. This work proposes a novel and efficient approach, leveraging a dimension-reduced separable learning scheme that excels even with highly limited training data. We further integrate it with spatiotemporal priors to develop a Deep Separable Spatiotemporal Learning network (DeepSSL), which unrolls an iteration process of a reconstruction model with both temporal low-rankness and spatial sparsity. Intermediate outputs are visualized to provide insights into the network's behavior and enhance its interpretability. Extensive results on cardiac cine datasets show that the proposed DeepSSL is superior to the state-of-the-art methods visually and quantitatively, while reducing the demand for training cases by up to 75%. And its preliminary adaptability to cardiac patients has been verified through experienced radiologists' and cardiologists' blind reader study. Additionally, DeepSSL also benefits for achieving the downstream task of cardiac segmentation with higher accuracy and shows robustness in prospective real-time cardiac MRI.

Make it more specific: A novel uncertainty based airway segmentation application on 3D U-Net and its variants

Each medical segmentation task should be considered with a specific AI algorithm based on its scenario so that the most accurate prediction model can be obtained. The most popular algorithms in medical segmentation, 3D U-Net and its variants, can directly implement the task of lung trachea segmentation, but its failure to consider the special tree-like structure of the trachea suggests that there is much room for improvement in its segmentation accuracy. Therefore, a research gap exists because a great amount of state-of-the-art DL algorithms are vanilla 3D U-Net structures, which do not introduce the various performance-enhancing modules that come with special natural image modality in lung airway segmentation. In this paper, we proposed two different network structures Branch-Level U-Net (B-UNet) and Branch-Level CE-UNet (B-CE-UNet) which are based on U-Net structure and compared the prediction results with the same dataset. Specially, both of the two networks add branch loss and central line loss to learn the feature of fine branch endings of the airways. Uncertainty estimation algorithms are also included to attain confident predictions and thereby, increase the overall trustworthiness of our whole model. In addition, predictions of the lung trachea based on the maximum connectivity rate were calculated and extracted during post-processing for segmentation refinement and pruning.

Assessing the Efficacy of Invisible Watermarks in AI-Generated Medical Images

AI-generated medical images are gaining growing popularity due to their potential to address the data scarcity challenge in the real world. However, the issue of accurate identification of these synthetic images, particularly when they exhibit remarkable realism with their real copies, remains a concern. To mitigate this challenge, image generators such as DALLE and Imagen, have integrated digital watermarks aimed at facilitating the discernment of synthetic images' authenticity. These watermarks are embedded within the image pixels and are invisible to the human eye while remains their detectability. Nevertheless, a comprehensive investigation into the potential impact of these invisible watermarks on the utility of synthetic medical images has been lacking. In this study, we propose the incorporation of invisible watermarks into synthetic medical images and seek to evaluate their efficacy in the context of downstream classification tasks. Our goal is to pave the way for discussions on the viability of such watermarks in boosting the detectability of synthetic medical images, fortifying ethical standards, and safeguarding against data pollution and potential scams.

HAMLET: Graph Transformer Neural Operator for Partial Differential Equations

We present a novel graph transformer framework, HAMLET, designed to address the challenges in solving partial differential equations (PDEs) using neural networks. The framework uses graph transformers with modular input encoders to directly incorporate differential equation information into the solution process. This modularity enhances parameter correspondence control, making HAMLET adaptable to PDEs of arbitrary geometries and varied input formats. Notably, HAMLET scales effectively with increasing data complexity and noise, showcasing its robustness. HAMLET is not just tailored to a single type of physical simulation, but can be applied across various domains. Moreover, it boosts model resilience and performance, especially in scenarios with limited data. We demonstrate, through extensive experiments, that our framework is capable of outperforming current techniques for PDEs.

Data and Physics driven Deep Learning Models for Fast MRI Reconstruction: Fundamentals and Methodologies

Magnetic Resonance Imaging (MRI) is a pivotal clinical diagnostic tool, yet its extended scanning times often compromise patient comfort and image quality, especially in volumetric, temporal and quantitative scans. This review elucidates recent advances in MRI acceleration via data and physics-driven models, leveraging techniques from algorithm unrolling models, enhancement-based models, and plug-and-play models to emergent full spectrum of generative models. We also explore the synergistic integration of data models with physics-based insights, encompassing the advancements in multi-coil hardware accelerations like parallel imaging and simultaneous multi-slice imaging, and the optimization of sampling patterns. We then focus on domain-specific challenges and opportunities, including image redundancy exploitation, image integrity, evaluation metrics, data heterogeneity, and model generalization. This work also discusses potential solutions and future research directions, emphasizing the role of data harmonization, and federated learning for further improving the general applicability and performance of these methods in MRI reconstruction.

Hunting imaging biomarkers in pulmonary fibrosis: Benchmarks of the AIIB23 challenge

Airway-related quantitative imaging biomarkers are crucial for examination, diagnosis, and prognosis in pulmonary diseases. However, the manual delineation of airway trees remains prohibitively time-consuming. While significant efforts have been made towards enhancing airway modelling, current public-available datasets concentrate on lung diseases with moderate morphological variations. The intricate honeycombing patterns present in the lung tissues of fibrotic lung disease patients exacerbate the challenges, often leading to various prediction errors. To address this issue, the 'Airway-Informed Quantitative CT Imaging Biomarker for Fibrotic Lung Disease 2023' (AIIB23) competition was organized in conjunction with the official 2023 International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI). The airway structures were meticulously annotated by three experienced radiologists. Competitors were encouraged to develop automatic airway segmentation models with high robustness and generalization abilities, followed by exploring the most correlated QIB of mortality prediction. A training set of 120 high-resolution computerised tomography (HRCT) scans were publicly released with expert annotations and mortality status. The online validation set incorporated 52 HRCT scans from patients with fibrotic lung disease and the offline test set included 140 cases from fibrosis and COVID-19 patients. The results have shown that the capacity of extracting airway trees from patients with fibrotic lung disease could be enhanced by introducing voxel-wise weighted general union loss and continuity loss. In addition to the competitive image biomarkers for prognosis, a strong airway-derived biomarker (Hazard ratio>1.5, p<0.0001) was revealed for survival prognostication compared with existing clinical measurements, clinician assessment and AI-based biomarkers.