In this paper we describe and validate a longitudinal method for whole-brain segmentation of longitudinal MRI scans. It builds upon an existing whole-brain segmentation method that can handle multi-contrast data and robustly analyze images with white matter lesions. This method is here extended with subject-specific latent variables that encourage temporal consistency between its segmentation results, enabling it to better track subtle morphological changes in dozens of neuroanatomical structures and white matter lesions. We validate the proposed method on multiple datasets of control subjects and patients suffering from Alzheimer's disease and multiple sclerosis, and compare its results against those obtained with its original cross-sectional formulation and two benchmark longitudinal methods. The results indicate that the method attains a higher test-retest reliability, while being more sensitive to longitudinal disease effect differences between patient groups. An implementation is publicly available as part of the open-source neuroimaging package FreeSurfer.
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.
Fetal Magnetic Resonance Imaging (MRI) is used in prenatal diagnosis and to assess early brain development. Accurate segmentation of the different brain tissues is a vital step in several brain analysis tasks, such as cortical surface reconstruction and tissue thickness measurements. Fetal MRI scans, however, are prone to motion artifacts that can affect the correctness of both manual and automatic segmentation techniques. In this paper, we propose a novel network structure that can simultaneously generate conditional atlases and predict brain tissue segmentation, called CAS-Net. The conditional atlases provide anatomical priors that can constrain the segmentation connectivity, despite the heterogeneity of intensity values caused by motion or partial volume effects. The proposed method is trained and evaluated on 253 subjects from the developing Human Connectome Project (dHCP). The results demonstrate that the proposed method can generate conditional age-specific atlas with sharp boundary and shape variance. It also segment multi-category brain tissues for fetal MRI with a high overall Dice similarity coefficient (DSC) of $85.2\%$ for the selected 9 tissue labels.
The automatic segmentation of perinatal brain structures in magnetic resonance imaging (MRI) is of utmost importance for the study of brain growth and related complications. While different methods exist for adult and pediatric MRI data, there is a lack for automatic tools for the analysis of perinatal imaging. In this work, a new pipeline for fetal and neonatal segmentation has been developed. We also report the creation of two new fetal atlases, and their use within the pipeline for atlas-based segmentation, based on novel registration methods. The pipeline is also able to extract cortical and pial surfaces and compute features, such as curvature, thickness, sulcal depth, and local gyrification index. Results show that the introduction of the new templates together with our segmentation strategy leads to accurate results when compared to expert annotations, as well as better performances when compared to a reference pipeline (developing Human Connectome Project (dHCP)), for both early and late-onset fetal brains.
Fetal brain segmentation is an important first step for slice-level motion correction and slice-to-volume reconstruction in fetal MRI. Fast and accurate segmentation of the fetal brain on fetal MRI is required to achieve real-time fetal head pose estimation and motion tracking for slice re-acquisition and steering. To address this critical unmet need, in this work we analyzed the speed-accuracy performance of a variety of deep neural network models, and devised a symbolically small convolutional neural network that combines spatial details at high resolution with context features extracted at lower resolutions. We used multiple branches with skip connections to maintain high accuracy while devising a parallel combination of convolution and pooling operations as an input downsampling module to further reduce inference time. We trained our model as well as eight alternative, state-of-the-art networks with manually-labeled fetal brain MRI slices and tested on two sets of normal and challenging test cases. Experimental results show that our network achieved the highest accuracy and lowest inference time among all of the compared state-of-the-art real-time segmentation methods. We achieved average Dice scores of 97.99\% and 84.04\% on the normal and challenging test sets, respectively, with an inference time of 3.36 milliseconds per image on an NVIDIA GeForce RTX 2080 Ti. Code, data, and the trained models are available at https://github.com/bchimagine/real_time_fetal_brain_segmentation.
Ischemic stroke occurs through a blockage of clogged blood vessels supplying blood to the brain. Segmentation of the stroke lesion is vital to improve diagnosis, outcome assessment and treatment planning. In this work, we propose a segmentation model with adversarial learning for ischemic lesion segmentation. We adopt U-Net with skip connection and dropout as segmentation baseline network and a fully connected network (FCN) as discriminator network. Discriminator network consists of 5 convolution layers followed by leaky-ReLU and an upsampling layer to rescale the output to the size of the input map. Training a segmentation network along with an adversarial network can detect and correct higher order inconsistencies between the segmentation maps produced by ground-truth and the Segmentor. We exploit three modalities (CT, DPWI, CBF) of acute computed tomography (CT) perfusion data provided in ISLES 2018 (Ischemic Stroke Lesion Segmentation) for ischemic lesion segmentation. Our model has achieved dice accuracy of 42.10% with the cross-validation of training and 39% with the testing data.
Automatic fetal brain tissue segmentation can enhance the quantitative assessment of brain development at this critical stage. Deep learning methods represent the state of the art in medical image segmentation and have also achieved impressive results in brain segmentation. However, effective training of a deep learning model to perform this task requires a large number of training images to represent the rapid development of the transient fetal brain structures. On the other hand, manual multi-label segmentation of a large number of 3D images is prohibitive. To address this challenge, we segmented 272 training images, covering 19-39 gestational weeks, using an automatic multi-atlas segmentation strategy based on deformable registration and probabilistic atlas fusion, and manually corrected large errors in those segmentations. Since this process generated a large training dataset with noisy segmentations, we developed a novel label smoothing procedure and a loss function to train a deep learning model with smoothed noisy segmentations. Our proposed methods properly account for the uncertainty in tissue boundaries. We evaluated our method on 23 manually-segmented test images of a separate set of fetuses. Results show that our method achieves an average Dice similarity coefficient of 0.893 and 0.916 for the transient structures of younger and older fetuses, respectively. Our method generated results that were significantly more accurate than several state-of-the-art methods including nnU-Net that achieved the closest results to our method. Our trained model can serve as a valuable tool to enhance the accuracy and reproducibility of fetal brain analysis in MRI.
Automatic and reliable quantitative tools for MR brain image analysis are a very valuable resources for both clinical and research environments. In the last years, this field has experienced many advances with successful techniques based on label fusion and more recently deep learning. However, few of them have been specifically designed to provide a dense anatomical labelling at multiscale level and to deal with brain anatomical alterations such as white matter lesions. In this work, we present a fully automatic pipeline (vol2Brain) for whole brain segmentation and analysis which densely labels (N>100) the brain while being robust to the presence of white matter lesions. This new pipeline is an evolution of our previous volBrain pipeline that extends significantly the number of regions that can be analyzed. Our proposed method is based on a fast multiscale multi-atlas label fusion technology with systematic error correction able to provide accurate volumetric information in few minutes. We have deployed our new pipeline within our platform volBrain (www.volbrain.upv.es) which has been already demonstrated to be an efficient and effective manner to share our technology with users worldwide
Domain Adaptation (DA) has recently raised strong interests in the medical imaging community. While a large variety of DA techniques has been proposed for image segmentation, most of these techniques have been validated either on private datasets or on small publicly available datasets. Moreover, these datasets mostly addressed single-class problems. To tackle these limitations, the Cross-Modality Domain Adaptation (crossMoDA) challenge was organised in conjunction with the 24th International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI 2021). CrossMoDA is the first large and multi-class benchmark for unsupervised cross-modality DA. The challenge's goal is to segment two key brain structures involved in the follow-up and treatment planning of vestibular schwannoma (VS): the VS and the cochleas. Currently, the diagnosis and surveillance in patients with VS are performed using contrast-enhanced T1 (ceT1) MRI. However, there is growing interest in using non-contrast sequences such as high-resolution T2 (hrT2) MRI. Therefore, we created an unsupervised cross-modality segmentation benchmark. The training set provides annotated ceT1 (N=105) and unpaired non-annotated hrT2 (N=105). The aim was to automatically perform unilateral VS and bilateral cochlea segmentation on hrT2 as provided in the testing set (N=137). A total of 16 teams submitted their algorithm for the evaluation phase. The level of performance reached by the top-performing teams is strikingly high (best median Dice - VS:88.4%; Cochleas:85.7%) and close to full supervision (median Dice - VS:92.5%; Cochleas:87.7%). All top-performing methods made use of an image-to-image translation approach to transform the source-domain images into pseudo-target-domain images. A segmentation network was then trained using these generated images and the manual annotations provided for the source image.
Leading neuroimaging studies have pushed 3T MRI acquisition resolutions below 1.0 mm for improved structure definition and morphometry. Yet, only few, time-intensive automated image analysis pipelines have been validated for high-resolution (HiRes) settings. Efficient deep learning approaches, on the other hand, rarely support more than one fixed resolution (usually 1.0 mm). Furthermore, the lack of a standard submillimeter resolution as well as limited availability of diverse HiRes data with sufficient coverage of scanner, age, diseases, or genetic variance poses additional, unsolved challenges for training HiRes networks. Incorporating resolution-independence into deep learning-based segmentation, i.e., the ability to segment images at their native resolution across a range of different voxel sizes, promises to overcome these challenges, yet no such approach currently exists. We now fill this gap by introducing a Voxelsize Independent Neural Network (VINN) for resolution-independent segmentation tasks and present FastSurferVINN, which (i) establishes and implements resolution-independence for deep learning as the first method simultaneously supporting 0.7-1.0 mm whole brain segmentation, (ii) significantly outperforms state-of-the-art methods across resolutions, and (iii) mitigates the data imbalance problem present in HiRes datasets. Overall, internal resolution-independence mutually benefits both HiRes and 1.0 mm MRI segmentation. With our rigorously validated FastSurferVINN we distribute a rapid tool for morphometric neuroimage analysis. The VINN architecture, furthermore, represents an efficient resolution-independent segmentation method for wider application
Segmentation of brain magnetic resonance images (MRI) into anatomical regions is a useful task in neuroimaging. Manual annotation is time consuming and expensive, so having a fully automated and general purpose brain segmentation algorithm is highly desirable. To this end, we propose a patched-based label propagation approach based on a generative model with latent variables. Once trained, our Factorisation-based Image Labelling (FIL) model is able to label target images with a variety of image contrasts. We compare the effectiveness of our proposed model against the state-of-the-art using data from the MICCAI 2012 Grand Challenge and Workshop on Multi-Atlas Labeling. As our approach is intended to be general purpose, we also assess how well it can handle domain shift by labelling images of the same subjects acquired with different MR contrasts.
The quantitative assessment of the developing human brain in utero is crucial to fully understand neurodevelopment. Thus, automated multi-tissue fetal brain segmentation algorithms are being developed, which in turn require annotated data to be trained. However, the available annotated fetal brain datasets are limited in number and heterogeneity, hampering domain adaptation strategies for robust segmentation. In this context, we use FaBiAN, a Fetal Brain magnetic resonance Acquisition Numerical phantom, to simulate various realistic magnetic resonance images of the fetal brain along with its class labels. We demonstrate that these multiple synthetic annotated data, generated at no cost and further reconstructed using the target super-resolution technique, can be successfully used for domain adaptation of a deep learning method that segments seven brain tissues. Overall, the accuracy of the segmentation is significantly enhanced, especially in the cortical gray matter, the white matter, the cerebellum, the deep gray matter and the brain stem.
Being able to adequately process and combine data arising from different sites is crucial in neuroimaging, but is difficult, owing to site, sequence and acquisition-parameter dependent biases. It is important therefore to design algorithms that are not only robust to images of differing contrasts, but also be able to generalise well to unseen ones, with a quantifiable measure of uncertainty. In this paper we demonstrate the efficacy of a physics-informed, uncertainty-aware, segmentation network that employs augmentation-time MR simulations and homogeneous batch feature stratification to achieve acquisition invariance. We show that the proposed approach also accurately extrapolates to out-of-distribution sequence samples, providing well calibrated volumetric bounds on these. We demonstrate a significant improvement in terms of coefficients of variation, backed by uncertainty based volumetric validation.
This paper describes our method for our participation in the FeTA challenge2021 (team name: TRABIT). The performance of convolutional neural networks for medical image segmentation is thought to correlate positively with the number of training data. The FeTA challenge does not restrict participants to using only the provided training data but also allows for using other publicly available sources. Yet, open access fetal brain data remains limited. An advantageous strategy could thus be to expand the training data to cover broader perinatal brain imaging sources. Perinatal brain MRIs, other than the FeTA challenge data, that are currently publicly available, span normal and pathological fetal atlases as well as neonatal scans. However, perinatal brain MRIs segmented in different datasets typically come with different annotation protocols. This makes it challenging to combine those datasets to train a deep neural network. We recently proposed a family of loss functions, the label-set loss functions, for partially supervised learning. Label-set loss functions allow to train deep neural networks with partially segmented images, i.e. segmentations in which some classes may be grouped into super-classes. We propose to use label-set loss functions to improve the segmentation performance of a state-of-the-art deep learning pipeline for multi-class fetal brain segmentation by merging several publicly available datasets. To promote generalisability, our approach does not introduce any additional hyper-parameters tuning.
Segmentation of sub-cortical structures from MRI scans is of interest in many neurological diagnosis. Since this is a laborious task machine learning and specifically deep learning (DL) methods have become explored. The structural complexity of the brain demands a large, high quality segmentation dataset to develop good DL-based solutions for sub-cortical structure segmentation. Towards this, we are releasing a set of 114, 1.5 Tesla, T1 MRI scans with manual delineations for 14 sub-cortical structures. The scans in the dataset were acquired from healthy young (21-30 years) subjects ( 58 male and 56 female) and all the structures are manually delineated by experienced radiology experts. Segmentation experiments have been conducted with this dataset and results demonstrate that accurate results can be obtained with deep-learning methods. Our sub-cortical structure segmentation dataset, Indian Brain Segmentation Dataset (IBSD) is made openly available at \url{https://doi.org/10.5281/zenodo.5656776}.
Whole brain segmentation is an important neuroimaging task that segments the whole brain volume into anatomically labeled regions-of-interest. Convolutional neural networks have demonstrated good performance in this task. Existing solutions, usually segment the brain image by classifying the voxels, or labeling the slices or the sub-volumes separately. Their representation learning is based on parts of the whole volume whereas their labeling result is produced by aggregation of partial segmentation. Learning and inference with incomplete information could lead to sub-optimal final segmentation result. To address these issues, we propose to adopt a full volume framework, which feeds the full volume brain image into the segmentation network and directly outputs the segmentation result for the whole brain volume. The framework makes use of complete information in each volume and can be implemented easily. An effective instance in this framework is given subsequently. We adopt the $3$D high-resolution network (HRNet) for learning spatially fine-grained representations and the mixed precision training scheme for memory-efficient training. Extensive experiment results on a publicly available $3$D MRI brain dataset show that our proposed model advances the state-of-the-art methods in terms of segmentation performance. Source code is publicly available at https://github.com/microsoft/VoxHRNet.
Segmenting deep brain structures from magnetic resonance images is important for patient diagnosis, surgical planning, and research. Most current state-of-the-art solutions follow a segmentation-by-registration approach, where subject MRIs are mapped to a template with well-defined segmentations. However, registration-based pipelines are time-consuming, thus, limiting their clinical use. This paper uses deep learning to provide a robust and efficient deep brain segmentation solution. The method consists of a pre-processing step to conform all MRI images to the same orientation, followed by a convolutional neural network using the nnU-Net framework. We use a total of 14 datasets from both research and clinical collections. Of these, seven were used for training and validation and seven were retained for independent testing. We trained the network to segment 30 deep brain structures, as well as a brain mask, using labels generated from a registration-based approach. We evaluated the generalizability of the network by performing a leave-one-dataset-out cross-validation, and extensive testing on external datasets. Furthermore, we assessed cross-domain transportability by evaluating the results separately on different domains. We achieved an average DSC of 0.89 $\pm$ 0.04 on the independent testing datasets when compared to the registration-based gold standard. On our test system, the computation time decreased from 42 minutes for a reference registration-based pipeline to 1 minute. Our proposed method is fast, robust, and generalizes with high reliability. It can be extended to the segmentation of other brain structures. The method is publicly available on GitHub, as well as a pip package for convenient usage.
Multi-spectral optoacoustic tomography (MSOT) is an emerging optical imaging method providing multiplex molecular and functional information from the rodent brain. It can be greatly augmented by magnetic resonance imaging (MRI) that offers excellent soft-tissue contrast and high-resolution brain anatomy. Nevertheless, registration of multi-modal images remains challenging, chiefly due to the entirely different image contrast rendered by these modalities. Previously reported registration algorithms mostly relied on manual user-dependent brain segmentation, which compromised data interpretation and accurate quantification. Here we propose a fully automated registration method for MSOT-MRI multimodal imaging empowered by deep learning. The automated workflow includes neural network-based image segmentation to generate suitable masks, which are subsequently registered using an additional neural network. Performance of the algorithm is showcased with datasets acquired by cross-sectional MSOT and high-field MRI preclinical scanners. The automated registration method is further validated with manual and half-automated registration, demonstrating its robustness and accuracy.
Semantic segmentation of medical images is an essential first step in computer-aided diagnosis systems for many applications. However, given many disparate imaging modalities and inherent variations in the patient data, it is difficult to consistently achieve high accuracy using modern deep neural networks (DNNs). This has led researchers to propose interactive image segmentation techniques where a medical expert can interactively correct the output of a DNN to the desired accuracy. However, these techniques often need separate training data with the associated human interactions, and do not generalize to various diseases, and types of medical images. In this paper, we suggest a novel conditional inference technique for DNNs which takes the intervention by a medical expert as test time constraints and performs inference conditioned upon these constraints. Our technique is generic can be used for medical images from any modality. Unlike other methods, our approach can correct multiple structures simultaneously and add structures missed at initial segmentation. We report an improvement of 13.3, 12.5, 17.8, 10.2, and 12.4 times in user annotation time than full human annotation for the nucleus, multiple cells, liver and tumor, organ, and brain segmentation respectively. We report a time saving of 2.8, 3.0, 1.9, 4.4, and 8.6 fold compared to other interactive segmentation techniques. Our method can be useful to clinicians for diagnosis and post-surgical follow-up with minimal intervention from the medical expert. The source-code and the detailed results are available here [1].
Brain tumor segmentation is a challenging problem in medical image analysis. The endpoint is to generate the salient masks that accurately identify brain tumor regions in an fMRI screening. In this paper, we propose a novel attention gate (AG model) for brain tumor segmentation that utilizes both the edge detecting unit and the attention gated network to highlight and segment the salient regions from fMRI images. This feature enables us to eliminate the necessity of having to explicitly point towards the damaged area(external tissue localization) and classify(classification) as per classical computer vision techniques. AGs can easily be integrated within the deep convolutional neural networks(CNNs). Minimal computional overhead is required while the AGs increase the sensitivity scores significantly. We show that the edge detector along with an attention gated mechanism provide a sufficient enough method for brain segmentation reaching an IOU of 0.78