Charlotte Robert

Theophraste Henry, Alexandre Carre, Marvin Lerousseau et al.

Brain tumor segmentation is a critical task for patient's disease management. In order to automate and standardize this task, we trained multiple U-net like neural networks, mainly with deep supervision and stochastic weight averaging, on the Multimodal Brain Tumor Segmentation Challenge (BraTS) 2020 training dataset. Two independent ensembles of models from two different training pipelines were trained, and each produced a brain tumor segmentation map. These two labelmaps per patient were then merged, taking into account the performance of each ensemble for specific tumor subregions. Our performance on the online validation dataset with test time augmentation were as follows: Dice of 0.81, 0.91 and 0.85; Hausdorff (95%) of 20.6, 4,3, 5.7 mm for the enhancing tumor, whole tumor and tumor core, respectively. Similarly, our solution achieved a Dice of 0.79, 0.89 and 0.84, as well as Hausdorff (95%) of 20.4, 6.7 and 19.5mm on the final test dataset, ranking us among the top ten teams. More complicated training schemes and neural network architectures were investigated without significant performance gain at the cost of greatly increased training time. Overall, our approach yielded good and balanced performance for each tumor subregion. Our solution is open sourced at https://github.com/lescientifik/open_brats2020.

Théo Estienne, Maria Vakalopoulou, Enzo Battistella et al.

Image registration is one of the most challenging problems in medical image analysis. In the recent years, deep learning based approaches became quite popular, providing fast and performing registration strategies. In this short paper, we summarise our work presented on Learn2Reg challenge 2020. The main contributions of our work rely on (i) a symmetric formulation, predicting the transformations from source to target and from target to source simultaneously, enforcing the trained representations to be similar and (ii) integration of variety of publicly available datasets used both for pretraining and for augmenting segmentation labels. Our method reports a mean dice of $0.64$ for task 3 and $0.85$ for task 4 on the test sets, taking third place on the challenge. Our code and models are publicly available at https://github.com/TheoEst/abdominal_registration and \https://github.com/TheoEst/hippocampus_registration.

Alexandre Cafaro, Amaury Leroy, Guillaume Beldjoudi et al.

We introduce a novel unsupervised approach to reconstructing a 3D volume from only two planar projections that exploits a previous\-ly-captured 3D volume of the patient. Such volume is readily available in many important medical procedures and previous methods already used such a volume. Earlier methods that work by deforming this volume to match the projections typically fail when the number of projections is very low as the alignment becomes underconstrained. We show how to use a generative model of the volume structures to constrain the deformation and obtain a correct estimate. Moreover, our method is not bounded to a specific sensor calibration and can be applied to new calibrations without retraining. We evaluate our approach on a challenging dataset and show it outperforms state-of-the-art methods. As a result, our method could be used in treatment scenarios such as surgery and radiotherapy while drastically reducing patient radiation exposure.

Enzo Battistella, Maria Vakalopoulou, Roger Sun et al.

Precision medicine is a paradigm shift in healthcare relying heavily on genomics data. However, the complexity of biological interactions, the large number of genes as well as the lack of comparisons on the analysis of data, remain a tremendous bottleneck regarding clinical adoption. In this paper, we introduce a novel, automatic and unsupervised framework to discover low-dimensional gene biomarkers. Our method is based on the LP-Stability algorithm, a high dimensional center-based unsupervised clustering algorithm, that offers modularity as concerns metric functions and scalability, while being able to automatically determine the best number of clusters. Our evaluation includes both mathematical and biological criteria. The recovered signature is applied to a variety of biological tasks, including screening of biological pathways and functions, and characterization relevance on tumor types and subtypes. Quantitative comparisons among different distance metrics, commonly used clustering methods and a referential gene signature used in the literature, confirm state of the art performance of our approach. In particular, our signature, that is based on 27 genes, reports at least $30$ times better mathematical significance (average Dunn's Index) and 25% better biological significance (average Enrichment in Protein-Protein Interaction) than those produced by other referential clustering methods. Finally, our signature reports promising results on distinguishing immune inflammatory and immune desert tumors, while reporting a high balanced accuracy of 92% on tumor types classification and averaged balanced accuracy of 68% on tumor subtypes classification, which represents, respectively 7% and 9% higher performance compared to the referential signature.

Spyridon Bakas, Mauricio Reyes, Andras Jakab et al.

Gliomas are the most common primary brain malignancies, with different degrees of aggressiveness, variable prognosis and various heterogeneous histologic sub-regions, i.e., peritumoral edematous/invaded tissue, necrotic core, active and non-enhancing core. This intrinsic heterogeneity is also portrayed in their radio-phenotype, as their sub-regions are depicted by varying intensity profiles disseminated across multi-parametric magnetic resonance imaging (mpMRI) scans, reflecting varying biological properties. Their heterogeneous shape, extent, and location are some of the factors that make these tumors difficult to resect, and in some cases inoperable. The amount of resected tumor is a factor also considered in longitudinal scans, when evaluating the apparent tumor for potential diagnosis of progression. Furthermore, there is mounting evidence that accurate segmentation of the various tumor sub-regions can offer the basis for quantitative image analysis towards prediction of patient overall survival. This study assesses the state-of-the-art machine learning (ML) methods used for brain tumor image analysis in mpMRI scans, during the last seven instances of the International Brain Tumor Segmentation (BraTS) challenge, i.e., 2012-2018. Specifically, we focus on i) evaluating segmentations of the various glioma sub-regions in pre-operative mpMRI scans, ii) assessing potential tumor progression by virtue of longitudinal growth of tumor sub-regions, beyond use of the RECIST/RANO criteria, and iii) predicting the overall survival from pre-operative mpMRI scans of patients that underwent gross total resection. Finally, we investigate the challenge of identifying the best ML algorithms for each of these tasks, considering that apart from being diverse on each instance of the challenge, the multi-institutional mpMRI BraTS dataset has also been a continuously evolving/growing dataset.