Pediatric brain and spinal cancers remain the leading cause of cancer-related death in children. Advancements in clinical decision-support in pediatric neuro-oncology utilizing the wealth of radiology imaging data collected through standard care, however, has significantly lagged other domains. Such data is ripe for use with predictive analytics such as artificial intelligence (AI) methods, which require large datasets. To address this unmet need, we provide a multi-institutional, large-scale pediatric dataset of 23,101 multi-parametric MRI exams acquired through routine care for 1,526 brain tumor patients, as part of the Children's Brain Tumor Network. This includes longitudinal MRIs across various cancer diagnoses, with associated patient-level clinical information, digital pathology slides, as well as tissue genotype and omics data. To facilitate downstream analysis, treatment-na\"ive images for 370 subjects were processed and released through the NCI Childhood Cancer Data Initiative via the Cancer Data Service. Through ongoing efforts to continuously build these imaging repositories, our aim is to accelerate discovery and translational AI models with real-world data, to ultimately empower precision medicine for children.
For machine learning-based prognosis and diagnosis of rare diseases, such as pediatric brain tumors, it is necessary to gather medical imaging data from multiple clinical sites that may use different devices and protocols. Deep learning-driven harmonization of radiologic images relies on generative adversarial networks (GANs). However, GANs notoriously generate pseudo structures that do not exist in the original training data, a phenomenon known as "hallucination". To prevent hallucination in medical imaging, such as magnetic resonance images (MRI) of the brain, we propose a one-shot learning method where we utilize neural style transfer for harmonization. At test time, the method uses one image from a clinical site to generate an image that matches the intensity scale of the collaborating sites. Our approach combines learning a feature extractor, neural style transfer, and adaptive instance normalization. We further propose a novel strategy to evaluate the effectiveness of image harmonization approaches with evaluation metrics that both measure image style harmonization and assess the preservation of anatomical structures. Experimental results demonstrate the effectiveness of our method in preserving patient anatomy while adjusting the image intensities to a new clinical site. Our general harmonization model can be used on unseen data from new sites, making it a valuable tool for real-world medical applications and clinical trials.
Self-supervised learning in federated learning paradigm has been gaining a lot of interest both in industry and research due to the collaborative learning capability on unlabeled yet isolated data. However, self-supervised based federated learning strategies suffer from performance degradation due to label scarcity and diverse data distributions, i.e., data heterogeneity. In this paper, we propose the SelfFed framework for Internet of Medical Things (IoMT). Our proposed SelfFed framework works in two phases. The first phase is the pre-training paradigm that performs augmentive modeling using Swin Transformer based encoder in a decentralized manner. The first phase of SelfFed framework helps to overcome the data heterogeneity issue. The second phase is the fine-tuning paradigm that introduces contrastive network and a novel aggregation strategy that is trained on limited labeled data for a target task in a decentralized manner. This fine-tuning stage overcomes the label scarcity problem. We perform our experimental analysis on publicly available medical imaging datasets and show that our proposed SelfFed framework performs better when compared to existing baselines concerning non-independent and identically distributed (IID) data and label scarcity. Our method achieves a maximum improvement of 8.8% and 4.1% on Retina and COVID-FL datasets on non-IID dataset. Further, our proposed method outperforms existing baselines even when trained on a few (10%) labeled instances.
Pediatric tumors of the central nervous system are the most common cause of cancer-related death in children. The five-year survival rate for high-grade gliomas in children is less than 20\%. Due to their rarity, the diagnosis of these entities is often delayed, their treatment is mainly based on historic treatment concepts, and clinical trials require multi-institutional collaborations. The MICCAI Brain Tumor Segmentation (BraTS) Challenge is a landmark community benchmark event with a successful history of 12 years of resource creation for the segmentation and analysis of adult glioma. Here we present the CBTN-CONNECT-DIPGR-ASNR-MICCAI BraTS-PEDs 2023 challenge, which represents the first BraTS challenge focused on pediatric brain tumors with data acquired across multiple international consortia dedicated to pediatric neuro-oncology and clinical trials. The BraTS-PEDs 2023 challenge focuses on benchmarking the development of volumentric segmentation algorithms for pediatric brain glioma through standardized quantitative performance evaluation metrics utilized across the BraTS 2023 cluster of challenges. Models gaining knowledge from the BraTS-PEDs multi-parametric structural MRI (mpMRI) training data will be evaluated on separate validation and unseen test mpMRI dataof high-grade pediatric glioma. The CBTN-CONNECT-DIPGR-ASNR-MICCAI BraTS-PEDs 2023 challenge brings together clinicians and AI/imaging scientists to lead to faster development of automated segmentation techniques that could benefit clinical trials, and ultimately the care of children with brain tumors.
Automated brain tumor segmentation methods are well established, reaching performance levels with clear clinical utility. Most algorithms require four input magnetic resonance imaging (MRI) modalities, typically T1-weighted images with and without contrast enhancement, T2-weighted images, and FLAIR images. However, some of these sequences are often missing in clinical practice, e.g., because of time constraints and/or image artifacts (such as patient motion). Therefore, substituting missing modalities to recover segmentation performance in these scenarios is highly desirable and necessary for the more widespread adoption of such algorithms in clinical routine. In this work, we report the set-up of the Brain MR Image Synthesis Benchmark (BraSyn), organized in conjunction with the Medical Image Computing and Computer-Assisted Intervention (MICCAI) 2023. The objective of the challenge is to benchmark image synthesis methods that realistically synthesize missing MRI modalities given multiple available images to facilitate automated brain tumor segmentation pipelines. The image dataset is multi-modal and diverse, created in collaboration with various hospitals and research institutions.
Meningiomas are the most common primary intracranial tumor in adults and can be associated with significant morbidity and mortality. Radiologists, neurosurgeons, neuro-oncologists, and radiation oncologists rely on multiparametric MRI (mpMRI) for diagnosis, treatment planning, and longitudinal treatment monitoring; yet automated, objective, and quantitative tools for non-invasive assessment of meningiomas on mpMRI are lacking. The BraTS meningioma 2023 challenge will provide a community standard and benchmark for state-of-the-art automated intracranial meningioma segmentation models based on the largest expert annotated multilabel meningioma mpMRI dataset to date. Challenge competitors will develop automated segmentation models to predict three distinct meningioma sub-regions on MRI including enhancing tumor, non-enhancing tumor core, and surrounding nonenhancing T2/FLAIR hyperintensity. Models will be evaluated on separate validation and held-out test datasets using standardized metrics utilized across the BraTS 2023 series of challenges including the Dice similarity coefficient and Hausdorff distance. The models developed during the course of this challenge will aid in incorporation of automated meningioma MRI segmentation into clinical practice, which will ultimately improve care of patients with meningioma.
The number of international benchmarking competitions is steadily increasing in various fields of machine learning (ML) research and practice. So far, however, little is known about the common practice as well as bottlenecks faced by the community in tackling the research questions posed. To shed light on the status quo of algorithm development in the specific field of biomedical imaging analysis, we designed an international survey that was issued to all participants of challenges conducted in conjunction with the IEEE ISBI 2021 and MICCAI 2021 conferences (80 competitions in total). The survey covered participants' expertise and working environments, their chosen strategies, as well as algorithm characteristics. A median of 72% challenge participants took part in the survey. According to our results, knowledge exchange was the primary incentive (70%) for participation, while the reception of prize money played only a minor role (16%). While a median of 80 working hours was spent on method development, a large portion of participants stated that they did not have enough time for method development (32%). 25% perceived the infrastructure to be a bottleneck. Overall, 94% of all solutions were deep learning-based. Of these, 84% were based on standard architectures. 43% of the respondents reported that the data samples (e.g., images) were too large to be processed at once. This was most commonly addressed by patch-based training (69%), downsampling (37%), and solving 3D analysis tasks as a series of 2D tasks. K-fold cross-validation on the training set was performed by only 37% of the participants and only 50% of the participants performed ensembling based on multiple identical models (61%) or heterogeneous models (39%). 48% of the respondents applied postprocessing steps.
Chest X-rays (CXRs) are a widely used imaging modality for the diagnosis and prognosis of lung disease. The image analysis tasks vary. Examples include pathology detection and lung segmentation. There is a large body of work where machine learning algorithms are developed for specific tasks. A significant recent example is Coronavirus disease (covid-19) detection using CXR data. However, the traditional diagnostic tool design methods based on supervised learning are burdened by the need to provide training data annotation, which should be of good quality for better clinical outcomes. Here, we propose an alternative solution, a new self-supervised paradigm, where a general representation from CXRs is learned using a group-masked self-supervised framework. The pre-trained model is then fine-tuned for domain-specific tasks such as covid-19, pneumonia detection, and general health screening. We show that the same pre-training can be used for the lung segmentation task. Our proposed paradigm shows robust performance in multiple downstream tasks which demonstrates the success of the pre-training. Moreover, the performance of the pre-trained models on data with significant drift during test time proves the learning of a better generic representation. The methods are further validated by covid-19 detection in a unique small-scale pediatric data set. The performance gain in accuracy (~25\%) is significant when compared to a supervised transformer-based method. This adds credence to the strength and reliability of our proposed framework and pre-training strategy.
We present a 3D face reconstruction system that aims at recovering the 3D facial geometry of babies from uncalibrated photographs, BabyNet. Since the 3D facial geometry of babies differs substantially from that of adults, baby-specific facial reconstruction systems are needed. BabyNet consists of two stages: 1) a 3D graph convolutional autoencoder learns a latent space of the baby 3D facial shape; and 2) a 2D encoder that maps photographs to the 3D latent space based on representative features extracted using transfer learning. In this way, using the pre-trained 3D decoder, we can recover a 3D face from 2D images. We evaluate BabyNet and show that 1) methods based on adult datasets cannot model the 3D facial geometry of babies, which proves the need for a baby-specific method, and 2) BabyNet outperforms classical model-fitting methods even when a baby-specific 3D morphable model, such as BabyFM, is used.
Designing a registration framework for images that do not share the same probability distribution is a major challenge in modern image analytics yet trivial task for the human visual system (HVS). Discrepancies in probability distributions, also known as \emph{drifts}, can occur due to various reasons including, but not limited to differences in sequences and modalities (e.g., MRI T1-T2 and MRI-CT registration), or acquisition settings (e.g., multisite, inter-subject, or intra-subject registrations). The popular assumption about the working of HVS is that it exploits a communal feature subspace exists between the registering images or fields-of-view that encompasses key drift-invariant features. Mimicking the approach that is potentially adopted by the HVS, herein, we present a representation learning technique of this invariant communal subspace that is shared by registering domains. The proposed communal domain learning (CDL) framework uses a set of hierarchical nonlinear transforms to learn the communal subspace that minimizes the probability differences and maximizes the amount of shared information between the registering domains. Similarity metric and parameter optimization calculations for registration are subsequently performed in the drift-minimized learned communal subspace. This generic registration framework is applied to register multisequence (MR: T1, T2) and multimodal (MR, CT) images. Results demonstrated generic applicability, consistent performance, and statistically significant improvement for both multi-sequence and multi-modal data using the proposed approach ($p$-value$<0.001$; Wilcoxon rank sum test) over baseline methods.