Attri-VAE: attribute-based, disentangled and interpretable representations of medical images with variational autoencoders

Deep learning (DL) methods where interpretability is intrinsically considered as part of the model are required to better understand the relationship of clinical and imaging-based attributes with DL outcomes, thus facilitating their use in reasoning medical decisions. Latent space representations built with variational autoencoders (VAE) do not ensure individual control of data attributes. Attribute-based methods enforcing attribute disentanglement have been proposed in the literature for classical computer vision tasks in benchmark data. In this paper, we propose a VAE approach, the Attri-VAE, that includes an attribute regularization term to associate clinical and medical imaging attributes with different regularized dimensions in the generated latent space, enabling a better disentangled interpretation of the attributes. Furthermore, the generated attention maps explained the attribute encoding in the regularized latent space dimensions. The Attri-VAE approach analyzed healthy and myocardial infarction patients with clinical, cardiac morphology, and radiomics attributes. The proposed model provided an excellent trade-off between reconstruction fidelity, disentanglement, and interpretability, outperforming state-of-the-art VAE approaches according to several quantitative metrics. The resulting latent space allowed the generation of realistic synthetic data in the trajectory between two distinct input samples or along a specific attribute dimension to better interpret changes between different cardiac conditions.

A radiomics approach to analyze cardiac alterations in hypertension

Hypertension is a medical condition that is well-established as a risk factor for many major diseases. For example, it can cause alterations in the cardiac structure and function over time that can lead to heart related morbidity and mortality. However, at the subclinical stage, these changes are subtle and cannot be easily captured using conventional cardiovascular indices calculated from clinical cardiac imaging. In this paper, we describe a radiomics approach for identifying intermediate imaging phenotypes associated with hypertension. The method combines feature selection and machine learning techniques to identify the most subtle as well as complex structural and tissue changes in hypertensive subgroups as compared to healthy individuals. Validation based on a sample of asymptomatic hearts that include both hypertensive and non-hypertensive cases demonstrate that the proposed radiomics model is capable of detecting intensity and textural changes well beyond the capabilities of conventional imaging phenotypes, indicating its potential for improved understanding of the longitudinal effects of hypertension on cardiovascular health and disease.

A Radiomics Approach to Computer-Aided Diagnosis with Cardiac Cine-MRI

Use expert visualization or conventional clinical indices can lack accuracy for borderline classications. Advanced statistical approaches based on eigen-decomposition have been mostly concerned with shape and motion indices. In this paper, we present a new approach to identify CVDs from cine-MRI by estimating large pools of radiomic features (statistical, shape and textural features) encoding relevant changes in anatomical and image characteristics due to CVDs. The calculated cine-MRI radiomic features are assessed using sequential forward feature selection to identify the most relevant ones for given CVD classes (e.g. myocardial infarction, cardiomyopathy, abnormal right ventricle). Finally, advanced machine learning is applied to suitably integrate the selected radiomics for final multi-feature classification based on Support Vector Machines (SVMs). The proposed technique was trained and cross-validated using 100 cine-MRI cases corresponding to five different cardiac classes from the ACDC MICCAI 2017 challenge \footnote{https://www.creatis.insa-lyon.fr/Challenge/acdc/index.html}. All cases were correctly classified in this preliminary study, indicating potential of using large-scale radiomics for MRI-based diagnosis of CVDs.