Accurate segmentation of punctate white matter lesions (PWMLs) are fundamental for the timely diagnosis and treatment of related developmental disorders. Automated PWMLs segmentation from infant brain MR images is challenging, considering that the lesions are typically small and low-contrast, and the number of lesions may dramatically change across subjects. Existing learning-based methods directly apply general network architectures to this challenging task, which may fail to capture detailed positional information of PWMLs, potentially leading to severe under-segmentations. In this paper, we propose to leverage the idea of counterfactual reasoning coupled with the auxiliary task of brain tissue segmentation to learn fine-grained positional and morphological representations of PWMLs for accurate localization and segmentation. A simple and easy-to-implement deep-learning framework (i.e., DeepPWML) is accordingly designed. It combines the lesion counterfactual map with the tissue probability map to train a lightweight PWML segmentation network, demonstrating state-of-the-art performance on a real-clinical dataset of infant T1w MR images. The code is available at \href{https://github.com/ladderlab-xjtu/DeepPWML}{https://github.com/ladderlab-xjtu/DeepPWML}.
Brain tissue segmentation is essential for neuroscience and clinical studies. However, segmentation on longitudinal data is challenging due to dynamic brain changes across the lifespan. Previous researches mainly focus on self-supervision with regularizations and will lose longitudinal generalization when fine-tuning on a specific age group. In this paper, we propose a dual meta-learning paradigm to learn longitudinally consistent representations and persist when fine-tuning. Specifically, we learn a plug-and-play feature extractor to extract longitudinal-consistent anatomical representations by meta-feature learning and a well-initialized task head for fine-tuning by meta-initialization learning. Besides, two class-aware regularizations are proposed to encourage longitudinal consistency. Experimental results on the iSeg2019 and ADNI datasets demonstrate the effectiveness of our method. Our code is available at https://github.com/ladderlab-xjtu/DuMeta.