MaxStyle: Adversarial Style Composition for Robust Medical Image Segmentation

Convolutional neural networks (CNNs) have achieved remarkable segmentation accuracy on benchmark datasets where training and test sets are from the same domain, yet their performance can degrade significantly on unseen domains, which hinders the deployment of CNNs in many clinical scenarios. Most existing works improve model out-of-domain (OOD) robustness by collecting multi-domain datasets for training, which is expensive and may not always be feasible due to privacy and logistical issues. In this work, we focus on improving model robustness using a single-domain dataset only. We propose a novel data augmentation framework called MaxStyle, which maximizes the effectiveness of style augmentation for model OOD performance. It attaches an auxiliary style-augmented image decoder to a segmentation network for robust feature learning and data augmentation. Importantly, MaxStyle augments data with improved image style diversity and hardness, by expanding the style space with noise and searching for the worst-case style composition of latent features via adversarial training. With extensive experiments on multiple public cardiac and prostate MR datasets, we demonstrate that MaxStyle leads to significantly improved out-of-distribution robustness against unseen corruptions as well as common distribution shifts across multiple, different, unseen sites and unknown image sequences under both low- and high-training data settings. The code can be found at https://github.com/cherise215/MaxStyle.

Suggestive Annotation of Brain MR Images with Gradient-guided Sampling

Machine learning has been widely adopted for medical image analysis in recent years given its promising performance in image segmentation and classification tasks. The success of machine learning, in particular supervised learning, depends on the availability of manually annotated datasets. For medical imaging applications, such annotated datasets are not easy to acquire, it takes a substantial amount of time and resource to curate an annotated medical image set. In this paper, we propose an efficient annotation framework for brain MR images that can suggest informative sample images for human experts to annotate. We evaluate the framework on two different brain image analysis tasks, namely brain tumour segmentation and whole brain segmentation. Experiments show that for brain tumour segmentation task on the BraTS 2019 dataset, training a segmentation model with only 7% suggestively annotated image samples can achieve a performance comparable to that of training on the full dataset. For whole brain segmentation on the MALC dataset, training with 42% suggestively annotated image samples can achieve a comparable performance to training on the full dataset. The proposed framework demonstrates a promising way to save manual annotation cost and improve data efficiency in medical imaging applications.

Memory-efficient Segmentation of High-resolution Volumetric MicroCT Images

In recent years, 3D convolutional neural networks have become the dominant approach for volumetric medical image segmentation. However, compared to their 2D counterparts, 3D networks introduce substantially more training parameters and higher requirement for the GPU memory. This has become a major limiting factor for designing and training 3D networks for high-resolution volumetric images. In this work, we propose a novel memory-efficient network architecture for 3D high-resolution image segmentation. The network incorporates both global and local features via a two-stage U-net-based cascaded framework and at the first stage, a memory-efficient U-net (meU-net) is developed. The features learnt at the two stages are connected via post-concatenation, which further improves the information flow. The proposed segmentation method is evaluated on an ultra high-resolution microCT dataset with typically 250 million voxels per volume. Experiments show that it outperforms state-of-the-art 3D segmentation methods in terms of both segmentation accuracy and memory efficiency.

QU-BraTS: MICCAI BraTS 2020 Challenge on Quantifying Uncertainty in Brain Tumor Segmentation -- Analysis of Ranking Metrics and Benchmarking Results

Deep learning (DL) models have provided the state-of-the-art performance in a wide variety of medical imaging benchmarking challenges, including the Brain Tumor Segmentation (BraTS) challenges. However, the task of focal pathology multi-compartment segmentation (e.g., tumor and lesion sub-regions) is particularly challenging, and potential errors hinder the translation of DL models into clinical workflows. Quantifying the reliability of DL model predictions in the form of uncertainties, could enable clinical review of the most uncertain regions, thereby building trust and paving the way towards clinical translation. Recently, a number of uncertainty estimation methods have been introduced for DL medical image segmentation tasks. Developing metrics to evaluate and compare the performance of uncertainty measures will assist the end-user in making more informed decisions. In this study, we explore and evaluate a metric developed during the BraTS 2019-2020 task on uncertainty quantification (QU-BraTS), and designed to assess and rank uncertainty estimates for brain tumor multi-compartment segmentation. This metric (1) rewards uncertainty estimates that produce high confidence in correct assertions, and those that assign low confidence levels at incorrect assertions, and (2) penalizes uncertainty measures that lead to a higher percentages of under-confident correct assertions. We further benchmark the segmentation uncertainties generated by 14 independent participating teams of QU-BraTS 2020, all of which also participated in the main BraTS segmentation task. Overall, our findings confirm the importance and complementary value that uncertainty estimates provide to segmentation algorithms, and hence highlight the need for uncertainty quantification in medical image analyses. Our evaluation code is made publicly available at https://github.com/RagMeh11/QU-BraTS.

Causality-inspired Single-source Domain Generalization for Medical Image Segmentation

Deep learning models usually suffer from domain shift issues, where models trained on one source domain do not generalize well to other unseen domains. In this work, we investigate the single-source domain generalization problem: training a deep network that is robust to unseen domains, under the condition that training data is only available from one source domain, which is common in medical imaging applications. We tackle this problem in the context of cross-domain medical image segmentation. Under this scenario, domain shifts are mainly caused by different acquisition processes. We propose a simple causality-inspired data augmentation approach to expose a segmentation model to synthesized domain-shifted training examples. Specifically, 1) to make the deep model robust to discrepancies in image intensities and textures, we employ a family of randomly-weighted shallow networks. They augment training images using diverse appearance transformations. 2) Further we show that spurious correlations among objects in an image are detrimental to domain robustness. These correlations might be taken by the network as domain-specific clues for making predictions, and they may break on unseen domains. We remove these spurious correlations via causal intervention. This is achieved by resampling the appearances of potentially correlated objects independently. The proposed approach is validated on three cross-domain segmentation tasks: cross-modality (CT-MRI) abdominal image segmentation, cross-sequence (bSSFP-LGE) cardiac MRI segmentation, and cross-center prostate MRI segmentation. The proposed approach yields consistent performance gains compared with competitive methods when tested on unseen domains.

DeepMCAT: Large-Scale Deep Clustering for Medical Image Categorization

In recent years, the research landscape of machine learning in medical imaging has changed drastically from supervised to semi-, weakly- or unsupervised methods. This is mainly due to the fact that ground-truth labels are time-consuming and expensive to obtain manually. Generating labels from patient metadata might be feasible but it suffers from user-originated errors which introduce biases. In this work, we propose an unsupervised approach for automatically clustering and categorizing large-scale medical image datasets, with a focus on cardiac MR images, and without using any labels. We investigated the end-to-end training using both class-balanced and imbalanced large-scale datasets. Our method was able to create clusters with high purity and achieved over 0.99 cluster purity on these datasets. The results demonstrate the potential of the proposed method for categorizing unstructured large medical databases, such as organizing clinical PACS systems in hospitals.

Enhancing MR Image Segmentation with Realistic Adversarial Data Augmentation

The success of neural networks on medical image segmentation tasks typically relies on large labeled datasets for model training. However, acquiring and manually labeling a large medical image set is resource-intensive, expensive, and sometimes impractical due to data sharing and privacy issues. To address this challenge, we propose an adversarial data augmentation approach to improve the efficiency in utilizing training data and to enlarge the dataset via simulated but realistic transformations. Specifically, we present a generic task-driven learning framework, which jointly optimizes a data augmentation model and a segmentation network during training, generating informative examples to enhance network generalizability for the downstream task. The data augmentation model utilizes a set of photometric and geometric image transformations and chains them to simulate realistic complex imaging variations that could exist in magnetic resonance (MR) imaging. The proposed adversarial data augmentation does not rely on generative networks and can be used as a plug-in module in general segmentation networks. It is computationally efficient and applicable for both supervised and semi-supervised learning. We analyze and evaluate the method on two MR image segmentation tasks: cardiac segmentation and prostate segmentation. Results show that the proposed approach can alleviate the need for labeled data while improving model generalization ability, indicating its practical value in medical imaging applications.