A Structural Causal Model for MR Images of Multiple Sclerosis

Precision medicine involves answering counterfactual questions such as "Would this patient respond better to treatment A or treatment B?" These types of questions are causal in nature and require the tools of causal inference to be answered, e.g., with a structural causal model (SCM). In this work, we develop an SCM that models the interaction between demographic information, disease covariates, and magnetic resonance (MR) images of the brain for people with multiple sclerosis (MS). Inference in the SCM generates counterfactual images that show what an MR image of the brain would look like when demographic or disease covariates are changed. These images can be used for modeling disease progression or used for downstream image processing tasks where controlling for confounders is necessary.

Validating uncertainty in medical image translation

Medical images are increasingly used as input to deep neural networks to produce quantitative values that aid researchers and clinicians. However, standard deep neural networks do not provide a reliable measure of uncertainty in those quantitative values. Recent work has shown that using dropout during training and testing can provide estimates of uncertainty. In this work, we investigate using dropout to estimate epistemic and aleatoric uncertainty in a CT-to-MR image translation task. We show that both types of uncertainty are captured, as defined, providing confidence in the output uncertainty estimates.

Finding novelty with uncertainty

Medical images are often used to detect and characterize pathology and disease; however, automatically identifying and segmenting pathology in medical images is challenging because the appearance of pathology across diseases varies widely. To address this challenge, we propose a Bayesian deep learning method that learns to translate healthy computed tomography images to magnetic resonance images and simultaneously calculates voxel-wise uncertainty. Since high uncertainty occurs in pathological regions of the image, this uncertainty can be used for unsupervised anomaly segmentation. We show encouraging experimental results on an unsupervised anomaly segmentation task by combining two types of uncertainty into a novel quantity we call scibilic uncertainty.

Evaluating the Impact of Intensity Normalization on MR Image Synthesis

Image synthesis learns a transformation from the intensity features of an input image to yield a different tissue contrast of the output image. This process has been shown to have application in many medical image analysis tasks including imputation, registration, and segmentation. To carry out synthesis, the intensities of the input images are typically scaled--i.e., normalized--both in training to learn the transformation and in testing when applying the transformation, but it is not presently known what type of input scaling is optimal. In this paper, we consider seven different intensity normalization algorithms and three different synthesis methods to evaluate the impact of normalization. Our experiments demonstrate that intensity normalization as a preprocessing step improves the synthesis results across all investigated synthesis algorithms. Furthermore, we show evidence that suggests intensity normalization is vital for successful deep learning-based MR image synthesis.