Explainable Image Quality Assessment for Medical Imaging

Medical image quality assessment is an important aspect of image acquisition, as poor-quality images may lead to misdiagnosis. Manual labelling of image quality is a tedious task for population studies and can lead to misleading results. While much research has been done on automated analysis of image quality to address this issue, relatively little work has been done to explain the methodologies. In this work, we propose an explainable image quality assessment system and validate our idea on two different objectives which are foreign object detection on Chest X-Rays (Object-CXR) and Left Ventricular Outflow Tract (LVOT) detection on Cardiac Magnetic Resonance (CMR) volumes. We apply a variety of techniques to measure the faithfulness of the saliency detectors, and our explainable pipeline relies on NormGrad, an algorithm which can efficiently localise image quality issues with saliency maps of the classifier. We compare NormGrad with a range of saliency detection methods and illustrate its superior performance as a result of applying these methodologies for measuring the faithfulness of the saliency detectors. We see that NormGrad has significant gains over other saliency detectors by reaching a repeated Pointing Game score of 0.853 for Object-CXR and 0.611 for LVOT datasets.

Semi-Supervised Segmentation of Multi-vendor and Multi-center Cardiac MRI using Histogram Matching

Automatic segmentation of the heart cavity is an essential task for the diagnosis of cardiac diseases. In this paper, we propose a semi-supervised segmentation setup for leveraging unlabeled data to segment Left-ventricle, Right-ventricle, and Myocardium. We utilize an enhanced version of residual U-Net architecture on a large-scale cardiac MRI dataset. Handling the class imbalanced data issue using dice loss, the enhanced supervised model is able to achieve better dice scores in comparison with a vanilla U-Net model. We applied several augmentation techniques including histogram matching to increase the performance of our model in other domains. Also, we introduce a simple but efficient semi-supervised segmentation method to improve segmentation results without the need for large labeled data. Finally, we applied our method on two benchmark datasets, STACOM2018, and M\&Ms 2020 challenges, to show the potency of the proposed model. The effectiveness of our proposed model is demonstrated by the quantitative results. The model achieves average dice scores of 0.921, 0.926, and 0.891 for Left-ventricle, Right-ventricle, and Myocardium respectively.

Prostate Lesion Estimation using Prostate Masks from Biparametric MRI

Biparametric MRI has emerged as an alternative to multiparametric prostate MRI, which eliminates the need for the potential harms to the patient due to the contrast medium. One major issue with biparametric MRI is difficulty to detect clinically significant prostate cancer (csPCA). Deep learning algorithms have emerged as an alternative solution to detect csPCA in cohort studies. We present a workflow which predicts csPCA on biparametric prostate MRI PI-CAI 2022 Challenge with over 10,000 carefully-curated prostate MRI exams. We propose to to segment the prostate gland first to the central gland (transition + central zone) and the peripheral gland. Then we utilize these predcitions in combination with T2, ADC and DWI images to train an ensemble nnU-Net model. Finally, we utilize clinical indices PSA and ADC intensity distributions of lesion regions to reduce the false positives. Our method achieves top results on open-validation stage with a AUROC of 0.888 and AP of 0.732.

Detecting respiratory motion artefacts for cardiovascular MRIs to ensure high-quality segmentation

While machine learning approaches perform well on their training domain, they generally tend to fail in a real-world application. In cardiovascular magnetic resonance imaging (CMR), respiratory motion represents a major challenge in terms of acquisition quality and therefore subsequent analysis and final diagnosis. We present a workflow which predicts a severity score for respiratory motion in CMR for the CMRxMotion challenge 2022. This is an important tool for technicians to immediately provide feedback on the CMR quality during acquisition, as poor-quality images can directly be re-acquired while the patient is still available in the vicinity. Thus, our method ensures that the acquired CMR holds up to a specific quality standard before it is used for further diagnosis. Therefore, it enables an efficient base for proper diagnosis without having time and cost-intensive re-acquisitions in cases of severe motion artefacts. Combined with our segmentation model, this can help cardiologists and technicians in their daily routine by providing a complete pipeline to guarantee proper quality assessment and genuine segmentations for cardiovascular scans. The code base is available at https://github.com/MECLabTUDA/QA_med_data/tree/dev_QA_CMRxMotion.

Shifted Windows Transformers for Medical Image Quality Assessment

To maintain a standard in a medical imaging study, images should have necessary image quality for potential diagnostic use. Although CNN-based approaches are used to assess the image quality, their performance can still be improved in terms of accuracy. In this work, we approach this problem by using Swin Transformer, which improves the poor-quality image classification performance that causes the degradation in medical image quality. We test our approach on Foreign Object Classification problem on Chest X-Rays (Object-CXR) and Left Ventricular Outflow Tract Classification problem on Cardiac MRI with a four-chamber view (LVOT). While we obtain a classification accuracy of 87.1% and 95.48% on the Object-CXR and LVOT datasets, our experimental results suggest that the use of Swin Transformer improves the Object-CXR classification performance while obtaining a comparable performance for the LVOT dataset. To the best of our knowledge, our study is the first vision transformer application for medical image quality assessment.

A Deep Learning-based Integrated Framework for Quality-aware Undersampled Cine Cardiac MRI Reconstruction and Analysis

Cine cardiac magnetic resonance (CMR) imaging is considered the gold standard for cardiac function evaluation. However, cine CMR acquisition is inherently slow and in recent decades considerable effort has been put into accelerating scan times without compromising image quality or the accuracy of derived results. In this paper, we present a fully-automated, quality-controlled integrated framework for reconstruction, segmentation and downstream analysis of undersampled cine CMR data. The framework enables active acquisition of radial k-space data, in which acquisition can be stopped as soon as acquired data are sufficient to produce high quality reconstructions and segmentations. This results in reduced scan times and automated analysis, enabling robust and accurate estimation of functional biomarkers. To demonstrate the feasibility of the proposed approach, we perform realistic simulations of radial k-space acquisitions on a dataset of subjects from the UK Biobank and present results on in-vivo cine CMR k-space data collected from healthy subjects. The results demonstrate that our method can produce quality-controlled images in a mean scan time reduced from 12 to 4 seconds per slice, and that image quality is sufficient to allow clinically relevant parameters to be automatically estimated to within 5% mean absolute difference.

MyoPS: A Benchmark of Myocardial Pathology Segmentation Combining Three-Sequence Cardiac Magnetic Resonance Images

Assessment of myocardial viability is essential in diagnosis and treatment management of patients suffering from myocardial infarction, and classification of pathology on myocardium is the key to this assessment. This work defines a new task of medical image analysis, i.e., to perform myocardial pathology segmentation (MyoPS) combining three-sequence cardiac magnetic resonance (CMR) images, which was first proposed in the MyoPS challenge, in conjunction with MICCAI 2020. The challenge provided 45 paired and pre-aligned CMR images, allowing algorithms to combine the complementary information from the three CMR sequences for pathology segmentation. In this article, we provide details of the challenge, survey the works from fifteen participants and interpret their methods according to five aspects, i.e., preprocessing, data augmentation, learning strategy, model architecture and post-processing. In addition, we analyze the results with respect to different factors, in order to examine the key obstacles and explore potential of solutions, as well as to provide a benchmark for future research. We conclude that while promising results have been reported, the research is still in the early stage, and more in-depth exploration is needed before a successful application to the clinics. Note that MyoPS data and evaluation tool continue to be publicly available upon registration via its homepage (www.sdspeople.fudan.edu.cn/zhuangxiahai/0/myops20/).

A survey on shape-constraint deep learning for medical image segmentation

Since the advent of U-Net, fully convolutional deep neural networks and its many variants have completely changed the modern landscape of deep learning based medical image segmentation. However, the over dependence of these methods on pixel level classification and regression has been identified early on as a problem. Especially when trained on medical databases with sparse available annotation, these methods are prone to generate segmentation artifacts such as fragmented structures, topological inconsistencies and islands of pixel. These artefacts are especially problematic in medical imaging since segmentation is almost always a pre-processing step for some downstream evaluation. The range of possible downstream evaluations is rather big, for example surgical planning, visualization, shape analysis, prognosis, treatment planning etc. However, one common thread across all these downstream tasks is the demand of anatomical consistency. To ensure the segmentation result is anatomically consistent, approaches based on Markov/ Conditional Random Fields, Statistical Shape Models are becoming increasingly popular over the past 5 years. In this review paper, a broad overview of recent literature on bringing anatomical constraints for medical image segmentation is given, the shortcomings and opportunities of the proposed methods are thoroughly discussed and potential future work is elaborated. We review the most relevant papers published until the submission date. For quick access, important details such as the underlying method, datasets and performance are tabulated.

Channel Attention Networks for Robust MR Fingerprinting Matching

Magnetic Resonance Fingerprinting (MRF) enables simultaneous mapping of multiple tissue parameters such as T1 and T2 relaxation times. The working principle of MRF relies on varying acquisition parameters pseudo-randomly, so that each tissue generates its unique signal evolution during scanning. Even though MRF provides faster scanning, it has disadvantages such as erroneous and slow generation of the corresponding parametric maps, which needs to be improved. Moreover, there is a need for explainable architectures for understanding the guiding signals to generate accurate parametric maps. In this paper, we addressed both of these shortcomings by proposing a novel neural network architecture consisting of a channel-wise attention module and a fully convolutional network. The proposed approach, evaluated over 3 simulated MRF signals, reduces error in the reconstruction of tissue parameters by 8.88% for T1 and 75.44% for T2 with respect to state-of-the-art methods. Another contribution of this study is a new channel selection method: attention-based channel selection. Furthermore, the effect of patch size and temporal frames of MRF signal on channel reduction are analyzed by employing a channel-wise attention.

Transfer Learning for Electricity Price Forecasting

Electricity price forecasting is an essential task for all the deregulated markets of the world. The accurate prediction of the day-ahead electricity prices is an active research field and available data from various markets can be used as an input for forecasting. A collection of models have been proposed for this task, but the fundamental question on how to use the available big data is often neglected. In this paper, we propose to use transfer learning as a tool for utilizing information from other electricity price markets for forecasting. We pre-train a bidirectional Gated Recurrent Units (BGRU) network on source markets and finally do a fine-tuning for the target market. Moreover, we test different ways to use the input data from various markets in the models. Our experiments on five different day-ahead markets indicate that transfer learning improves the performance of electricity price forecasting in a statistically significant manner.