arXiv:1710.08354v1 [eess.IV] 23 Oct 2017

The bottleneck of convolutional neural networks (CNN) for medical imaging is the number of annotated data required for training. Manual segmentation is considered to be the “gold-standard”. However, medical imaging datasets with expert manual segmentation are scarce as this step is time-consuming and expensive. We propose in this work the use of what we refer to as silver standard masks for data augmentation in deep-learning-based skull-stripping also known as brain extraction. We generated the silver standard masks using the consensus algorithm Simultaneous Truth and Performance Level Estimation (STAPLE). We evaluated CNN models generated by the silver and gold standard masks. Then, we validated the silver standard masks for CNNs training in one dataset, and showed its generalization to two other datasets. Our results indicated that models generated with silver standard masks are comparable to models generated with gold standard masks and have better generalizability. Moreover, our results also indicate that silver standard masks could be used to augment the input dataset at training stage, reducing the need for manual segmentation at this step.

Full paper here: https://doi.org/10.48550/arXiv.1710.08354

arXiv:1804.04988v1 [cs.CV] 13 Apr 2018

Convolutional neural networks (CNN) for medical imaging are constrained by the number of annotated data required in the training stage. Usually, manual annotation is considered to be the “gold standard”. However, medical imaging datasets that include expert manual segmentation are scarce as this step is time-consuming, and therefore expensive. Moreover, single-rater manual annotation is most often used in data-driven approaches making the network optimal with respect to only that single expert. In this work, we propose a CNN for brain extraction in magnetic resonance (MR) imaging, that is fully trained with what we refer to as silver standard masks. Our method consists of 1) developing a dataset with “silver standard” masks as input, and implementing both 2) a tri-planar method using parallel 2D U-Net-based CNNs (referred to as CONSNet) and 3) an auto-context implementation of CONSNet. The term CONSNet refers to our integrated approach, i.e., training with silver standard masks and using a 2D U-Net-based architecture. Our results showed that we outperformed (i.e., larger Dice coefficients) the current state-of-the-art SS methods. Our use of silver standard masks reduced the cost of manual annotation, decreased inter-intra-rater variability, and avoided CNN segmentation super-specialization towards one specific manual annotation guideline that can occur when gold standard masks are used. Moreover, the usage of silver standard masks greatly enlarges the volume of input annotated data because we can relatively easily generate labels for unlabeled data. In addition, our method has the advantage that, once trained, it takes only a few seconds to process a typical brain image volume using modern hardware, such as a high-end graphics processing unit. In contrast, many of the other competitive methods have processing times in the order of minutes.

Full paper here: https://doi.org/10.48550/arXiv.1804.04988

IEEE Transactions on Medical Imaging, vol. 38, no. 11, pp. 2556-2568, Nov. 2019

Quantification of cerebral white matter hyperintensities (WMH) of presumed vascular origin is of key importance in many neurological research studies. Currently, measurements are often still obtained from manual segmentations on brain MR images, which is a laborious procedure. Automatic WMH segmentation methods exist, but a standardized comparison of the performance of such methods is lacking. We organized a scientific challenge, in which developers could evaluate their method on a standardized multi-center/-scanner image dataset, giving an objective comparison: the WMH Segmentation Challenge (this https URL).
Sixty T1+FLAIR images from three MR scanners were released with manual WMH segmentations for training. A test set of 110 images from five MR scanners was used for evaluation. Segmentation methods had to be containerized and submitted to the challenge organizers. Five evaluation metrics were used to rank the methods: (1) Dice similarity coefficient, (2) modified Hausdorff distance (95th percentile), (3) absolute log-transformed volume difference, (4) sensitivity for detecting individual lesions, and (5) F1-score for individual lesions. Additionally, methods were ranked on their inter-scanner robustness.
Twenty participants submitted their method for evaluation. This paper provides a detailed analysis of the results. In brief, there is a cluster of four methods that rank significantly better than the other methods, with one clear winner. The inter-scanner robustness ranking shows that not all methods generalize to unseen scanners.
The challenge remains open for future submissions and provides a public platform for method evaluation.

Full paper here: https://doi.org/10.48550/arXiv.1904.00682

arXiv:2011.07952v2 [eess.IV] 21 Dec 2021

Deep-learning-based brain magnetic resonance imaging (MRI) reconstruction methods have the potential to accelerate the MRI acquisition process. Nevertheless, the scientific community lacks appropriate benchmarks to assess MRI reconstruction quality of high-resolution brain images, and evaluate how these proposed algorithms will behave in the presence of small, but expected data distribution shifts. The Multi-Coil Magnetic Resonance Image (MC-MRI) Reconstruction Challenge provides a benchmark that aims at addressing these issues, using a large dataset of high-resolution, three-dimensional, T1-weighted MRI scans. The challenge has two primary goals: 1) to compare different MRI reconstruction models on this dataset and 2) to assess the generalizability of these models to data acquired with a different number of receiver coils. In this paper, we describe the challenge experimental design, and summarize the results of a set of baseline and state of the art brain MRI reconstruction models. We provide relevant comparative information on the current MRI reconstruction state-of-the-art and highlight the challenges of obtaining generalizable models that are required prior to broader clinical adoption. The MC-MRI benchmark data, evaluation code and current challenge leaderboard are publicly available. They provide an objective performance assessment for future developments in the field of brain MRI reconstruction.

Full paper here: https://doi.org/10.48550/arXiv.2011.07952

arXiv:2401.17104v1 [eess.IV] 30 Jan 2024

In this article, we train a model using synthetic images derived from label maps built from ultra-high resolution ex vivo MRI. We hypothesize that employing synthetic images will help address various MRI contrasts while constructing the label maps from ex vivo images will provide more details of the hypothalamic anatomy, enhancing the automated segmentation quality. We aim to develop an automated method for hypothalamic subregion segmentation, which is robust against variations in MRI contrast and resolution of the input images – including retrospective clinical data, which often present large slice spacing.

Full paper here: https://doi.org/10.48550/arXiv.2401.17104

Cells, Volume 12, Issue January 2023, 355

Central nervous system (CNS) involvement in childhood-onset systemic lupus erythematosus (cSLE) occurs in more than 50% of patients. Structural magnetic resonance imaging (MRI) has identified global cerebral atrophy, as well as the involvement of the corpus callosum and hippocampus, which is associated with cognitive impairment. In this cross-sectional study we included 71 cSLE (mean age 24.7 years (SD 4.6) patients and a disease duration of 11.8 years (SD 4.8) and two control groups: (1) 49 adult-onset SLE (aSLE) patients (mean age of 33.2 (SD 3.7) with a similar disease duration and (2) 58 healthy control patients (mean age of 29.9 years (DP 4.1)) of a similar age. All of the individuals were evaluated on the day of the MRI scan (Phillips 3T scanner). We reviewed medical charts to obtain the clinical and immunological features and treatment history of the SLE patients. Segmentation of the corpus callosum was performed through an automated segmentation method. Patients with cSLE had a similar mid-sagittal area of the corpus callosum in comparison to the aSLE patients. When compared to the control groups, cSLE and aSLE had a significant reduction in the mid-sagittal area in the posterior region of the corpus callosum. We observed significantly lower FA values and significantly higher MD, RD, and AD values in the total area of the corpus callosum and in the parcels B, C, D, and E in cSLE patients when compared to the aSLE patients. Low complement, the presence of anticardiolipin antibodies, and cognitive impairment were associated with microstructural changes. In conclusion, we observed greater microstructural changes in the corpus callosum in adults with cSLE when compared to those with aSLE. Longitudinal studies are necessary to follow these changes, however they may explain the worse cognitive function and disability observed in adults with cSLE when compared to aSLE.

Full paper here: https://doi.org/10.3390/cells12030355

Clinical Endocrinology, Volume n, Issue 19, December 2022

Full paper here: https://doi.org/10.1111/cen.14868

NeuroImage, Volume 264, Issue 1, December 2022, 119741

The hypothalamus is a small brain structure that plays essential roles in sleep regulation, body temperature control, and metabolic homeostasis. Hypothalamic structural abnormalities have been reported in neuropsychiatric disorders, such as schizophrenia, amyotrophic lateral sclerosis, and Alzheimer’s disease. Although mag- netic resonance (MR) imaging is the standard examination method for evaluating this region, hypothalamic morphological landmarks are unclear, leading to subjec- tivity and high variability during manual segmentation. Due to these limitations, it is common to find contradicting results in the literature regarding hypothalamic volumetry. To the best of our knowledge, only two automated methods are available in the literature for hypothalamus segmentation, the first of which is our previous method based on U-Net. However, both methods present performance losses when predicting images from different datasets than those used in training. Therefore, this project presents a benchmark consisting of a diverse T1-weighted MR image dataset comprising 1381 subjects from IXI, CC359, OASIS, and MiLI (the latter created specifically for this benchmark). All data were provided using automatically generated hypothalamic masks and a subset containing manually annotated masks. As a baseline, a method for fully automated segmentation of the hypothalamus on T1-weighted MR images with a greater generalization ability is presented. The pro- posed method is a teacher-student-based model with two blocks: segmentation and correction, where the second corrects the imperfections of the first block. After using three datasets for training (MiLI, IXI, and CC359), the prediction performance of the model was measured on two test sets: the first was composed of data from IXI, CC359, and MiLI, achieving a Dice coefficient of 0.83; the second was from OASIS, a dataset not used for training, achieving a Dice coefficient of 0.74. The dataset, the baseline model, and all necessary codes to reproduce the experiments are available at https://github.com/MICLab-Unicamp/HypAST and https://sites.google.com/ view/calgary-campinas-dataset/hypothalamus-benchmarking. In addition, a leaderboard will be maintained with predictions for the test set submitted by anyone working on the same task.

Full paper here: https://doi.org/10.1016/j.neuroimage.2022.119741

Yearbook of Medical Informatics, Volume 31, August 2022, 277-295

Objectives: Automated computational segmentation of the lung and its lobes and findings in X-Ray based computed tomography (CT) images is a challenging problem with important applications, including medical research, surgical planning, and diagnostic decision support. With the increase in large imaging cohorts and the need for fast and robust evaluation of normal and abnormal lungs and their lobes, several authors have proposed automated methods for lung assessment on CT images. In this paper we intend to provide a comprehensive summarization of these methods.

Methods: We used a systematic approach to perform an extensive review of automated lung segmentation methods. We chose Scopus, PubMed, and Scopus to conduct our review and included methods that perform segmentation of the lung parenchyma, lobes or internal disease related findings. The review was not limited by date, but rather by only including methods providing quantitative evaluation.

Results: We organized and classified all 234 included articles into various categories according to methodological similarities among them. We provide summarizations of quantitative evaluations, public datasets, evaluation metrics, and overall statistics indicating recent research directions of the field.

Conclusions: We noted the rise of data-driven models in the last decade, especially due to the deep learning trend, increasing the demand for high-quality data annotation. This has instigated an increase of semi-supervised and uncertainty guided works that try to be less dependent on human annotation. In addition, the question of how to evaluate the robustness of data-driven methods remains open, given that evaluations derived from specific datasets are not general.

Full paper here: https://doi.org/10.1055/s-0042-1742517

The Lancet Child & Adolescent Health, Volume 6, Issue 1, August 2022, 571-581

Neuropsychiatric manifestations occur frequently and are challenging to diagnose in childhood-onset systemic lupus erythematosus (SLE). Most patients with childhood-onset SLE have neuropsychiatric events in the first 2 years of disease. 30–70% of patients present with more than one neuropsychiatric event during their disease course, with an average of 2–3 events per person. These symptoms are associated with disability and mortality. Serum, cerebrospinal fluid, and neuroimaging findings have been described in childhood-onset SLE; however, only a few have been validated as biomarkers for diagnosis, monitoring response to treatment, or prognosis. The aim of this Review is to describe the genetic risk, clinical and neuroimaging characteristics, and current treatment strategies of neuropsychiatric manifestations in childhood-onset SLE.

Full paper here: https://doi.org/10.1016/S2352-4642(22)00157-2