Blood oxygen level dependent (BOLD) MRI with maternal hyperoxia can assess oxygen transport within the placenta and has emerged as a promising tool to study placental function. Measuring signal changes over time requires segmenting the placenta in each volume of the time series. Due to the large number of volumes in the BOLD time series, existing studies rely on registration to map all volumes to a manually segmented template. As the placenta can undergo large deformation due to fetal motion, maternal motion, and contractions, this approach often results in a large number of discarded volumes, where the registration approach fails. In this work, we propose a machine learning model based on a U-Net neural network architecture to automatically segment the placenta in BOLD MRI and apply it to segmenting each volume in a time series. We use a boundary-weighted loss function to accurately capture the placental shape. Our model is trained and tested on a cohort of 91 subjects containing healthy fetuses, fetuses with fetal growth restriction, and mothers with high BMI. We achieve a Dice score of 0.83+/-0.04 when matching with ground truth labels and our model performs reliably in segmenting volumes in both normoxic and hyperoxic points in the BOLD time series. Our code and trained model are available at https://github.com/mabulnaga/automatic-placenta-segmentation.
Volumetric reconstruction of fetal brains from multiple stacks of MR slices, acquired in the presence of almost unpredictable and often severe subject motion, is a challenging task that is highly sensitive to the initialization of slice-to-volume transformations. We propose a novel slice-to-volume registration method using Transformers trained on synthetically transformed data, which model multiple stacks of MR slices as a sequence. With the attention mechanism, our model automatically detects the relevance between slices and predicts the transformation of one slice using information from other slices. We also estimate the underlying 3D volume to assist slice-to-volume registration and update the volume and transformations alternately to improve accuracy. Results on synthetic data show that our method achieves lower registration error and better reconstruction quality compared with existing state-of-the-art methods. Experiments with real-world MRI data are also performed to demonstrate the ability of the proposed model to improve the quality of 3D reconstruction under severe fetal motion.
Implicit neural representations (INRs) have become fast, lightweight tools for storing continuous data, but to date there is no general method for learning directly with INRs as a data representation. We introduce a principled deep learning framework for learning and inference directly with INRs of any type without reverting to grid-based features or operations. Our INR-Nets evaluate INRs on a low discrepancy sequence, enabling quasi-Monte Carlo (QMC) integration throughout the network. We prove INR-Nets are universal approximators on a large class of maps between $L^2$ functions. Additionally, INR-Nets have convergent gradients under the empirical measure, enabling backpropagation. We design INR-Nets as a continuous generalization of discrete networks, enabling them to be initialized with pre-trained models. We demonstrate learning of INR-Nets on classification (INR$\to$label) and segmentation (INR$\to$INR) tasks.
Training a fully convolutional network for semantic segmentation typically requires a large, labeled dataset with little label noise if good generalization is to be guaranteed. For many segmentation problems, however, data with pixel- or voxel-level labeling accuracy are scarce due to the cost of manual labeling. This problem is exacerbated in domains where manual annotation is difficult, resulting in large amounts of variability in the labeling even across domain experts. Therefore, training segmentation networks to generalize better by learning from both labeled and unlabeled images (called semi-supervised learning) is problem of both practical and theoretical interest. However, traditional semi-supervised learning methods for segmentation often necessitate hand-crafting a differentiable regularizer specific to a given segmentation problem, which can be extremely time-consuming. In this work, we propose "supervision by denoising" (SUD), a framework that enables us to supervise segmentation models using their denoised output as targets. SUD unifies temporal ensembling and spatial denoising techniques under a spatio-temporal denoising framework and alternates denoising and network weight update in an optimization framework for semi-supervision. We validate SUD on three tasks-kidney and tumor (3D), and brain (3D) segmentation, and cortical parcellation (2D)-demonstrating a significant improvement in the Dice overlap and the Hausdorff distance of segmentations over supervised-only and temporal ensemble baselines.
Although shape correspondence is a central problem in geometry processing, most methods for this task apply only to two-dimensional surfaces. The neglected task of volumetric correspondence--a natural extension relevant to shapes extracted from simulation, medical imaging, volume rendering, and even improving surface maps of boundary representations--presents unique challenges that do not appear in the two-dimensional case. In this work, we propose a method for mapping between volumes represented as tetrahedral meshes. Our formulation minimizes a distortion energy designed to extract maps symmetrically, i.e., without dependence on the ordering of the source and target domains. We accompany our method with theoretical discussion describing the consequences of this symmetry assumption, leading us to select a symmetrized ARAP energy that favors isometric correspondences. Our final formulation optimizes for near-isometry while matching the boundary. We demonstrate our method on a diverse geometric dataset, producing low-distortion matchings that align to the boundary.
Despite the superior performance of Deep Learning (DL) on numerous segmentation tasks, the DL-based approaches are notoriously overconfident about their prediction with highly polarized label probability. This is often not desirable for many applications with the inherent label ambiguity even in human annotations. This challenge has been addressed by leveraging multiple annotations per image and the segmentation uncertainty. However, multiple per-image annotations are often not available in a real-world application and the uncertainty does not provide full control on segmentation results to users. In this paper, we propose novel methods to improve the segmentation probability estimation without sacrificing performance in a real-world scenario that we have only one ambiguous annotation per image. We marginalize the estimated segmentation probability maps of networks that are encouraged to under-/over-segment with the varying Tversky loss without penalizing balanced segmentation. Moreover, we propose a unified hypernetwork ensemble method to alleviate the computational burden of training multiple networks. Our approaches successfully estimated the segmentation probability maps that reflected the underlying structures and provided the intuitive control on segmentation for the challenging 3D medical image segmentation. Although the main focus of our proposed methods is not to improve the binary segmentation performance, our approaches marginally outperformed the state-of-the-arts. The codes are available at \url{https://github.com/sh4174/HypernetEnsemble}.
We present a volumetric mesh-based algorithm for parameterizing the placenta to a flattened template to enable effective visualization of local anatomy and function. MRI shows potential as a research tool as it provides signals directly related to placental function. However, due to the curved and highly variable in vivo shape of the placenta, interpreting and visualizing these images is difficult. We address interpretation challenges by mapping the placenta so that it resembles the familiar ex vivo shape. We formulate the parameterization as an optimization problem for mapping the placental shape represented by a volumetric mesh to a flattened template. We employ the symmetric Dirichlet energy to control local distortion throughout the volume. Local injectivity in the mapping is enforced by a constrained line search during the gradient descent optimization. We validate our method using a research study of 111 placental shapes extracted from BOLD MRI images. Our mapping achieves sub-voxel accuracy in matching the template while maintaining low distortion throughout the volume. We demonstrate how the resulting flattening of the placenta improves visualization of anatomy and function. Our code is freely available at https://github.com/mabulnaga/placenta-flattening .
Adoption of machine learning models in healthcare requires end users' trust in the system. Models that provide additional supportive evidence for their predictions promise to facilitate adoption. We define consistent evidence to be both compatible and sufficient with respect to model predictions. We propose measures of model inconsistency and regularizers that promote more consistent evidence. We demonstrate our ideas in the context of edema severity grading from chest radiographs. We demonstrate empirically that consistent models provide competitive performance while supporting interpretation.
Image synthesis via Generative Adversarial Networks (GANs) of three-dimensional (3D) medical images has great potential that can be extended to many medical applications, such as, image enhancement and disease progression modeling. However, current GAN technologies for 3D medical image synthesis need to be significantly improved to be readily adapted to real-world medical problems. In this paper, we extend the state-of-the-art StyleGAN2 model, which natively works with two-dimensional images, to enable 3D image synthesis. In addition to the image synthesis, we investigate the controllability and interpretability of the 3D-StyleGAN via style vectors inherited form the original StyleGAN2 that are highly suitable for medical applications: (i) the latent space projection and reconstruction of unseen real images, and (ii) style mixing. We demonstrate the 3D-StyleGAN's performance and feasibility with ~12,000 three-dimensional full brain MR T1 images, although it can be applied to any 3D volumetric images. Furthermore, we explore different configurations of hyperparameters to investigate potential improvement of the image synthesis with larger networks. The codes and pre-trained networks are available online: https://github.com/sh4174/3DStyleGAN.
Fetal motion is unpredictable and rapid on the scale of conventional MR scan times. Therefore, dynamic fetal MRI, which aims at capturing fetal motion and dynamics of fetal function, is limited to fast imaging techniques with compromises in image quality and resolution. Super-resolution for dynamic fetal MRI is still a challenge, especially when multi-oriented stacks of image slices for oversampling are not available and high temporal resolution for recording the dynamics of the fetus or placenta is desired. Further, fetal motion makes it difficult to acquire high-resolution images for supervised learning methods. To address this problem, in this work, we propose STRESS (Spatio-Temporal Resolution Enhancement with Simulated Scans), a self-supervised super-resolution framework for dynamic fetal MRI with interleaved slice acquisitions. Our proposed method simulates an interleaved slice acquisition along the high-resolution axis on the originally acquired data to generate pairs of low- and high-resolution images. Then, it trains a super-resolution network by exploiting both spatial and temporal correlations in the MR time series, which is used to enhance the resolution of the original data. Evaluations on both simulated and in utero data show that our proposed method outperforms other self-supervised super-resolution methods and improves image quality, which is beneficial to other downstream tasks and evaluations.