Debayan Bhattacharya

Finn Behrendt, Debayan Bhattacharya, Julia Krüger et al.

The use of supervised deep learning techniques to detect pathologies in brain MRI scans can be challenging due to the diversity of brain anatomy and the need for annotated data sets. An alternative approach is to use unsupervised anomaly detection, which only requires sample-level labels of healthy brains to create a reference representation. This reference representation can then be compared to unhealthy brain anatomy in a pixel-wise manner to identify abnormalities. To accomplish this, generative models are needed to create anatomically consistent MRI scans of healthy brains. While recent diffusion models have shown promise in this task, accurately generating the complex structure of the human brain remains a challenge. In this paper, we propose a method that reformulates the generation task of diffusion models as a patch-based estimation of healthy brain anatomy, using spatial context to guide and improve reconstruction. We evaluate our approach on data of tumors and multiple sclerosis lesions and demonstrate a relative improvement of 25.1% compared to existing baselines.

Debayan Bhattacharya, Benjamin Tobias Becker, Finn Behrendt et al.

Using deep learning techniques, anomalies in the paranasal sinus system can be detected automatically in MRI images and can be further analyzed and classified based on their volume, shape and other parameters like local contrast. However due to limited training data, traditional supervised learning methods often fail to generalize. Existing deep learning methods in paranasal anomaly classification have been used to diagnose at most one anomaly. In our work, we consider three anomalies. Specifically, we employ a 3D CNN to separate maxillary sinus volumes without anomalies from maxillary sinus volumes with anomalies. To learn robust representations from a small labelled dataset, we propose a novel learning paradigm that combines contrastive loss and cross-entropy loss. Particularly, we use a supervised contrastive loss that encourages embeddings of maxillary sinus volumes with and without anomaly to form two distinct clusters while the cross-entropy loss encourages the 3D CNN to maintain its discriminative ability. We report that optimising with both losses is advantageous over optimising with only one loss. We also find that our training strategy leads to label efficiency. With our method, a 3D CNN classifier achieves an AUROC of 0.85 while a 3D CNN classifier optimised with cross-entropy loss achieves an AUROC of 0.66.

Finn Behrendt, Debayan Bhattacharya, Robin Mieling et al.

Unsupervised Anomaly Detection (UAD) methods rely on healthy data distributions to identify anomalies as outliers. In brain MRI, a common approach is reconstruction-based UAD, where generative models reconstruct healthy brain MRIs, and anomalies are detected as deviations between input and reconstruction. However, this method is sensitive to imperfect reconstructions, leading to false positives that impede the segmentation. To address this limitation, we construct multiple reconstructions with probabilistic diffusion models. We then analyze the resulting distribution of these reconstructions using the Mahalanobis distance to identify anomalies as outliers. By leveraging information about normal variations and covariance of individual pixels within this distribution, we effectively refine anomaly scoring, leading to improved segmentation. Our experimental results demonstrate substantial performance improvements across various data sets. Specifically, compared to relying solely on single reconstructions, our approach achieves relative improvements of 15.9%, 35.4%, 48.0%, and 4.7% in terms of AUPRC for the BRATS21, ATLAS, MSLUB and WMH data sets, respectively.

Finn Behrendt, Debayan Bhattacharya, Robin Mieling et al.

The application of supervised models to clinical screening tasks is challenging due to the need for annotated data for each considered pathology. Unsupervised Anomaly Detection (UAD) is an alternative approach that aims to identify any anomaly as an outlier from a healthy training distribution. A prevalent strategy for UAD in brain MRI involves using generative models to learn the reconstruction of healthy brain anatomy for a given input image. As these models should fail to reconstruct unhealthy structures, the reconstruction errors indicate anomalies. However, a significant challenge is to balance the accurate reconstruction of healthy anatomy and the undesired replication of abnormal structures. While diffusion models have shown promising results with detailed and accurate reconstructions, they face challenges in preserving intensity characteristics, resulting in false positives. We propose conditioning the denoising process of diffusion models with additional information derived from a latent representation of the input image. We demonstrate that this conditioning allows for accurate and local adaptation to the general input intensity distribution while avoiding the replication of unhealthy structures. We compare the novel approach to different state-of-the-art methods and for different data sets. Our results show substantial improvements in the segmentation performance, with the Dice score improved by 11.9%, 20.0%, and 44.6%, for the BraTS, ATLAS and MSLUB data sets, respectively, while maintaining competitive performance on the WMH data set. Furthermore, our results indicate effective domain adaptation across different MRI acquisitions and simulated contrasts, an important attribute for general anomaly detection methods. The code for our work is available at https://github.com/FinnBehrendt/Conditioned-Diffusion-Models-UAD

Debayan Bhattacharya, Konrad Reuter, Finn Behrendt et al.

Commonly employed in polyp segmentation, single image UNet architectures lack the temporal insight clinicians gain from video data in diagnosing polyps. To mirror clinical practices more faithfully, our proposed solution, PolypNextLSTM, leverages video-based deep learning, harnessing temporal information for superior segmentation performance with the least parameter overhead, making it possibly suitable for edge devices. PolypNextLSTM employs a UNet-like structure with ConvNext-Tiny as its backbone, strategically omitting the last two layers to reduce parameter overhead. Our temporal fusion module, a Convolutional Long Short Term Memory (ConvLSTM), effectively exploits temporal features. Our primary novelty lies in PolypNextLSTM, which stands out as the leanest in parameters and the fastest model, surpassing the performance of five state-of-the-art image and video-based deep learning models. The evaluation of the SUN-SEG dataset spans easy-to-detect and hard-to-detect polyp scenarios, along with videos containing challenging artefacts like fast motion and occlusion. Comparison against 5 image-based and 5 video-based models demonstrates PolypNextLSTM's superiority, achieving a Dice score of 0.7898 on the hard-to-detect polyp test set, surpassing image-based PraNet (0.7519) and video-based PNSPlusNet (0.7486). Notably, our model excels in videos featuring complex artefacts such as ghosting and occlusion. PolypNextLSTM, integrating pruned ConvNext-Tiny with ConvLSTM for temporal fusion, not only exhibits superior segmentation performance but also maintains the highest frames per speed among evaluated models. Access code here https://github.com/mtec-tuhh/PolypNextLSTM

Finn Behrendt, Debayan Bhattacharya, Lennart Maack et al.

Supervised deep learning techniques show promise in medical image analysis. However, they require comprehensive annotated data sets, which poses challenges, particularly for rare diseases. Consequently, unsupervised anomaly detection (UAD) emerges as a viable alternative for pathology segmentation, as only healthy data is required for training. However, recent UAD anomaly scoring functions often focus on intensity only and neglect structural differences, which impedes the segmentation performance. This work investigates the potential of Structural Similarity (SSIM) to bridge this gap. SSIM captures both intensity and structural disparities and can be advantageous over the classical $l1$ error. However, we show that there is more than one optimal kernel size for the SSIM calculation for different pathologies. Therefore, we investigate an adaptive ensembling strategy for various kernel sizes to offer a more pathology-agnostic scoring mechanism. We demonstrate that this ensembling strategy can enhance the performance of DMs and mitigate the sensitivity to different kernel sizes across varying pathologies, highlighting its promise for brain MRI anomaly detection.