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A Dual Adversarial Calibration Framework for Automatic Fetal Brain Biometry

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 Added by Lok Hin Lee
 Publication date 2021
and research's language is English




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This paper presents a novel approach to automatic fetal brain biometry motivated by needs in low- and medium- income countries. Specifically, we leverage high-end (HE) ultrasound images to build a biometry solution for low-cost (LC) point-of-care ultrasound images. We propose a novel unsupervised domain adaptation approach to train deep models to be invariant to significant image distribution shift between the image types. Our proposed method, which employs a Dual Adversarial Calibration (DAC) framework, consists of adversarial pathways which enforce model invariance to; i) adversarial perturbations in the feature space derived from LC images, and ii) appearance domain discrepancy. Our Dual Adversarial Calibration method estimates transcerebellar diameter and head circumference on images from low-cost ultrasound devices with a mean absolute error (MAE) of 2.43mm and 1.65mm, compared with 7.28 mm and 5.65 mm respectively for SOTA.



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In fetal Magnetic Resonance Imaging, Super Resolution Reconstruction (SRR) algorithms are becoming popular tools to obtain high-resolution 3D volume reconstructions from low-resolution stacks of 2D slices, acquired at different orientations. To be effective, these algorithms often require accurate segmentation of the region of interest, such as the fetal brain in suspected pathological cases. In the case of Spina Bifida, Ebner, Wang et al. (NeuroImage, 2020) combined their SRR algorithm with a 2-step segmentation pipeline (2D localisation followed by a 2D segmentation network). However, if the localisation step fails, the second network is not able to recover a correct brain mask, thus requiring manual corrections for an effective SRR. In this work, we aim at improving the fetal brain segmentation for SRR in Spina Bifida. We hypothesise that a well-trained single-step UNet can achieve accurate performance, avoiding the need of a 2-step approach. We propose a new tool for fetal brain segmentation called MONAIfbs, which takes advantage of the Medical Open Network for Artificial Intelligence (MONAI) framework. Our network is based on the dynamic UNet (dynUNet), an adaptation of the nnU-Net framework. When compared to the original 2-step approach proposed in Ebner-Wang, and the same Ebner-Wang approach retrained with the expanded dataset available for this work, the dynUNet showed to achieve higher performance using a single step only. It also showed to reduce the number of outliers, as only 28 stacks obtained Dice score less than 0.9, compared to 68 for Ebner-Wang and 53 Ebner-Wang expanded. The proposed dynUNet model thus provides an improvement of the state-of-the-art fetal brain segmentation techniques, reducing the need for manual correction in automated SRR pipelines. Our code and our trained model are made publicly available at https://github.com/gift-surg/MONAIfbs.
Fetal brain magnetic resonance imaging (MRI) offers exquisite images of the developing brain but is not suitable for second-trimester anomaly screening, for which ultrasound (US) is employed. Although expert sonographers are adept at reading US images, MR images which closely resemble anatomical images are much easier for non-experts to interpret. Thus in this paper we propose to generate MR-like images directly from clinical US images. In medical image analysis such a capability is potentially useful as well, for instance for automatic US-MRI registration and fusion. The proposed model is end-to-end trainable and self-supervised without any external annotations. Specifically, based on an assumption that the US and MRI data share a similar anatomical latent space, we first utilise a network to extract the shared latent features, which are then used for MRI synthesis. Since paired data is unavailable for our study (and rare in practice), pixel-level constraints are infeasible to apply. We instead propose to enforce the distributions to be statistically indistinguishable, by adversarial learning in both the image domain and feature space. To regularise the anatomical structures between US and MRI during synthesis, we further propose an adversarial structural constraint. A new cross-modal attention technique is proposed to utilise non-local spatial information, by encouraging multi-modal knowledge fusion and propagation. We extend the approach to consider the case where 3D auxiliary information (e.g., 3D neighbours and a 3D location index) from volumetric data is also available, and show that this improves image synthesis. The proposed approach is evaluated quantitatively and qualitatively with comparison to real fetal MR images and other approaches to synthesis, demonstrating its feasibility of synthesising realistic MR images.
Deep neural networks have increased the accuracy of automatic segmentation, however, their accuracy depends on the availability of a large number of fully segmented images. Methods to train deep neural networks using images for which some, but not all, regions of interest are segmented are necessary to make better use of partially annotated datasets. In this paper, we propose the first axiomatic definition of label-set loss functions that are the loss functions that can handle partially segmented images. We prove that there is one and only one method to convert a classical loss function for fully segmented images into a proper label-set loss function. Our theory also allows us to define the leaf-Dice loss, a label-set generalization of the Dice loss particularly suited for partial supervision with only missing labels. Using the leaf-Dice loss, we set a new state of the art in partially supervised learning for fetal brain 3D MRI segmentation. We achieve a deep neural network able to segment white matter, ventricles, cerebellum, extra-ventricular CSF, cortical gray matter, deep gray matter, brainstem, and corpus callosum based on fetal brain 3D MRI of anatomically normal fetuses or with open spina bifida. Our implementation of the proposed label-set loss functions is available at https://github.com/LucasFidon/label-set-loss-functions
We present a joint graph convolution-image convolution neural network as our submission to the Brain Tumor Segmentation (BraTS) 2021 challenge. We model each brain as a graph composed of distinct image regions, which is initially segmented by a graph neural network (GNN). Subsequently, the tumorous volume identified by the GNN is further refined by a simple (voxel) convolutional neural network (CNN), which produces the final segmentation. This approach captures both global brain feature interactions via the graphical representation and local image details through the use of convolutional filters. We find that the GNN component by itself can effectively identify and segment the brain tumors. The addition of the CNN further improves the median performance of the model by 2 percent across all metrics evaluated. On the validation set, our joint GNN-CNN model achieves mean Dice scores of 0.89, 0.81, 0.73 and mean Hausdorff distances (95th percentile) of 6.8, 12.6, 28.2mm on the whole tumor, core tumor, and enhancing tumor, respectively.
This paper aims to contribute in bench-marking the automatic polyp segmentation problem using generative adversarial networks framework. Perceiving the problem as an image-to-image translation task, conditional generative adversarial networks are utilized to generate masks conditioned by the images as inputs. Both generator and discriminator are convolution neural networks based. The model achieved 0.4382 on Jaccard index and 0.611 as F2 score.

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