Declan P. O'Regan

Siyi Du, Shaoming Zheng, Yinsong Wang et al.

Images and structured tables are essential parts of real-world databases. Though tabular-image representation learning is promising to create new insights, it remains a challenging task, as tabular data is typically heterogeneous and incomplete, presenting significant modality disparities with images. Earlier works have mainly focused on simple modality fusion strategies in complete data scenarios, without considering the missing data issue, and thus are limited in practice. In this paper, we propose TIP, a novel tabular-image pre-training framework for learning multimodal representations robust to incomplete tabular data. Specifically, TIP investigates a novel self-supervised learning (SSL) strategy, including a masked tabular reconstruction task for tackling data missingness, and image-tabular matching and contrastive learning objectives to capture multimodal information. Moreover, TIP proposes a versatile tabular encoder tailored for incomplete, heterogeneous tabular data and a multimodal interaction module for inter-modality representation learning. Experiments are performed on downstream multimodal classification tasks using both natural and medical image datasets. The results show that TIP outperforms state-of-the-art supervised/SSL image/multimodal algorithms in both complete and incomplete data scenarios. Our code is available at https://github.com/siyi-wind/TIP.

Mengyun Qiao, Shuo Wang, Huaqi Qiu et al.

Two key questions in cardiac image analysis are to assess the anatomy and motion of the heart from images; and to understand how they are associated with non-imaging clinical factors such as gender, age and diseases. While the first question can often be addressed by image segmentation and motion tracking algorithms, our capability to model and to answer the second question is still limited. In this work, we propose a novel conditional generative model to describe the 4D spatio-temporal anatomy of the heart and its interaction with non-imaging clinical factors. The clinical factors are integrated as the conditions of the generative modelling, which allows us to investigate how these factors influence the cardiac anatomy. We evaluate the model performance in mainly two tasks, anatomical sequence completion and sequence generation. The model achieves a high performance in anatomical sequence completion, comparable to or outperforming other state-of-the-art generative models. In terms of sequence generation, given clinical conditions, the model can generate realistic synthetic 4D sequential anatomies that share similar distributions with the real data.

Siyi Du, Xinzhe Luo, Declan P. O'Regan et al.

Multimodal deep learning (MDL) has achieved remarkable success across various domains, yet its practical deployment is often hindered by incomplete multimodal data. Existing incomplete MDL methods either discard missing modalities, risking the loss of valuable task-relevant information, or recover them, potentially introducing irrelevant noise, leading to the discarding-imputation dilemma. To address this dilemma, in this paper, we propose DyMo, a new inference-time dynamic modality selection framework that adaptively identifies and integrates reliable recovered modalities, fully exploring task-relevant information beyond the conventional discard-or-impute paradigm. Central to DyMo is a novel selection algorithm that maximizes multimodal task-relevant information for each test sample. Since direct estimation of such information at test time is intractable due to the unknown data distribution, we theoretically establish a connection between information and the task loss, which we compute at inference time as a tractable proxy. Building on this, a novel principled reward function is proposed to guide modality selection. In addition, we design a flexible multimodal network architecture compatible with arbitrary modality combinations, alongside a tailored training strategy for robust representation learning. Extensive experiments on diverse natural and medical image datasets show that DyMo significantly outperforms state-of-the-art incomplete/dynamic MDL methods across various missing-data scenarios. Our code is available at https://github.com//siyi-wind/DyMo.

Siyi Du, Xinzhe Luo, Declan P. O'Regan et al.

Multimodal image-tabular learning is gaining attention, yet it faces challenges due to limited labeled data. While earlier work has applied self-supervised learning (SSL) to unlabeled data, its task-agnostic nature often results in learning suboptimal features for downstream tasks. Semi-supervised learning (SemiSL), which combines labeled and unlabeled data, offers a promising solution. However, existing multimodal SemiSL methods typically focus on unimodal or modality-shared features, ignoring valuable task-relevant modality-specific information, leading to a Modality Information Gap. In this paper, we propose STiL, a novel SemiSL tabular-image framework that addresses this gap by comprehensively exploring task-relevant information. STiL features a new disentangled contrastive consistency module to learn cross-modal invariant representations of shared information while retaining modality-specific information via disentanglement. We also propose a novel consensus-guided pseudo-labeling strategy to generate reliable pseudo-labels based on classifier consensus, along with a new prototype-guided label smoothing technique to refine pseudo-label quality with prototype embeddings, thereby enhancing task-relevant information learning in unlabeled data. Experiments on natural and medical image datasets show that STiL outperforms the state-of-the-art supervised/SSL/SemiSL image/multimodal approaches. Our code is available at https://github.com/siyi-wind/STiL.

Long Chen, Ashiv Patel, Mengyun Qiao et al.

Personalized, accurate prediction of aortic aneurysm progression is essential for timely intervention but remains challenging due to the need to model both subtle local deformations and global anatomical changes within complex 3D geometries. We propose MCMeshGAN, the first multimodal conditional mesh-to-mesh generative adversarial network for 3D aneurysm growth prediction. MCMeshGAN introduces a dual-branch architecture combining a novel local KNN-based convolutional network (KCN) to preserve fine-grained geometric details and a global graph convolutional network (GCN) to capture long-range structural context, overcoming the over-smoothing limitations of deep GCNs. A dedicated condition branch encodes clinical attributes (age, sex) and the target time interval to generate anatomically plausible, temporally controlled predictions, enabling retrospective and prospective modeling. We curated TAAMesh, a new longitudinal thoracic aortic aneurysm mesh dataset consisting of 590 multimodal records (CT scans, 3D meshes, and clinical data) from 208 patients. Extensive experiments demonstrate that MCMeshGAN consistently outperforms state-of-the-art baselines in both geometric accuracy and clinically important diameter estimation. This framework offers a robust step toward clinically deployable, personalized 3D disease trajectory modeling. The source code for MCMeshGAN and the baseline methods is publicly available at https://github.com/ImperialCollegeLondon/MCMeshGAN.

Alexander Thorley, Xi Jia, Hyung Jin Chang et al.

Deterministic approaches using iterative optimisation have been historically successful in diffeomorphic image registration (DiffIR). Although these approaches are highly accurate, they typically carry a significant computational burden. Recent developments in stochastic approaches based on deep learning have achieved sub-second runtimes for DiffIR with competitive registration accuracy, offering a fast alternative to conventional iterative methods. In this paper, we attempt to reduce this difference in speed whilst retaining the performance advantage of iterative approaches in DiffIR. We first propose a simple iterative scheme that functionally composes intermediate non-stationary velocity fields to handle large deformations in images whilst guaranteeing diffeomorphisms in the resultant deformation. We then propose a convex optimisation model that uses a regularisation term of arbitrary order to impose smoothness on these velocity fields and solve this model with a fast algorithm that combines Nesterov gradient descent and the alternating direction method of multipliers (ADMM). Finally, we leverage the computational power of GPU to implement this accelerated ADMM solver on a 3D cardiac MRI dataset, further reducing runtime to less than 2 seconds. In addition to producing strictly diffeomorphic deformations, our methods outperform both state-of-the-art deep learning-based and iterative DiffIR approaches in terms of dice and Hausdorff scores, with speed approaching the inference time of deep learning-based methods.

Nicolo Savioli, Antonio de Marvao, Wenjia Bai et al.

Optimising the analysis of cardiac structure and function requires accurate 3D representations of shape and motion. However, techniques such as cardiac magnetic resonance imaging are conventionally limited to acquiring contiguous cross-sectional slices with low through-plane resolution and potential inter-slice spatial misalignment. Super-resolution in medical imaging aims to increase the resolution of images but is conventionally trained on features from low resolution datasets and does not super-resolve corresponding segmentations. Here we propose a semi-supervised multi-task generative adversarial network (Gemini-GAN) that performs joint super-resolution of the images and their labels using a ground truth of high resolution 3D cines and segmentations, while an unsupervised variational adversarial mixture autoencoder (V-AMA) is used for continuous domain adaptation. Our proposed approach is extensively evaluated on two transnational multi-ethnic populations of 1,331 and 205 adults respectively, delivering an improvement on state of the art methods in terms of Dice index, peak signal to noise ratio, and structural similarity index measure. This framework also exceeds the performance of state of the art generative domain adaptation models on external validation (Dice index 0.81 vs 0.74 for the left ventricle). This demonstrates how joint super-resolution and segmentation, trained on 3D ground-truth data with cross-domain generalization, enables robust precision phenotyping in diverse populations.

Xi Jia, Alexander Thorley, Wei Chen et al.

Data-driven deep learning approaches to image registration can be less accurate than conventional iterative approaches, especially when training data is limited. To address this whilst retaining the fast inference speed of deep learning, we propose VR-Net, a novel cascaded variational network for unsupervised deformable image registration. Using the variable splitting optimization scheme, we first convert the image registration problem, established in a generic variational framework, into two sub-problems, one with a point-wise, closed-form solution while the other one is a denoising problem. We then propose two neural layers (i.e. warping layer and intensity consistency layer) to model the analytical solution and a residual U-Net to formulate the denoising problem (i.e. generalized denoising layer). Finally, we cascade the warping layer, intensity consistency layer, and generalized denoising layer to form the VR-Net. Extensive experiments on three (two 2D and one 3D) cardiac magnetic resonance imaging datasets show that VR-Net outperforms state-of-the-art deep learning methods on registration accuracy, while maintains the fast inference speed of deep learning and the data-efficiency of variational model.

Carlo Biffi, Juan J. Cerrolaza, Giacomo Tarroni et al.

Quantification of anatomical shape changes currently relies on scalar global indexes which are largely insensitive to regional or asymmetric modifications. Accurate assessment of pathology-driven anatomical remodeling is a crucial step for the diagnosis and treatment of many conditions. Deep learning approaches have recently achieved wide success in the analysis of medical images, but they lack interpretability in the feature extraction and decision processes. In this work, we propose a new interpretable deep learning model for shape analysis. In particular, we exploit deep generative networks to model a population of anatomical segmentations through a hierarchy of conditional latent variables. At the highest level of this hierarchy, a two-dimensional latent space is simultaneously optimised to discriminate distinct clinical conditions, enabling the direct visualisation of the classification space. Moreover, the anatomical variability encoded by this discriminative latent space can be visualised in the segmentation space thanks to the generative properties of the model, making the classification task transparent. This approach yielded high accuracy in the categorisation of healthy and remodelled left ventricles when tested on unseen segmentations from our own multi-centre dataset as well as in an external validation set, and on hippocampi from healthy controls and patients with Alzheimer's disease when tested on ADNI data. More importantly, it enabled the visualisation in three-dimensions of both global and regional anatomical features which better discriminate between the conditions under exam. The proposed approach scales effectively to large populations, facilitating high-throughput analysis of normal anatomy and pathology in large-scale studies of volumetric imaging.

Carlo Biffi, Juan J. Cerrolaza, Giacomo Tarroni et al.

Accurate segmentation of heart structures imaged by cardiac MR is key for the quantitative analysis of pathology. High-resolution 3D MR sequences enable whole-heart structural imaging but are time-consuming, expensive to acquire and they often require long breath holds that are not suitable for patients. Consequently, multiplanar breath-hold 2D cine sequences are standard practice but are disadvantaged by lack of whole-heart coverage and low through-plane resolution. To address this, we propose a conditional variational autoencoder architecture able to learn a generative model of 3D high-resolution left ventricular (LV) segmentations which is conditioned on three 2D LV segmentations of one short-axis and two long-axis images. By only employing these three 2D segmentations, our model can efficiently reconstruct the 3D high-resolution LV segmentation of a subject. When evaluated on 400 unseen healthy volunteers, our model yielded an average Dice score of $87.92 \pm 0.15$ and outperformed competing architectures.

Ghalib A. Bello, Timothy J. W. Dawes, Jinming Duan et al.

Motion analysis is used in computer vision to understand the behaviour of moving objects in sequences of images. Optimising the interpretation of dynamic biological systems requires accurate and precise motion tracking as well as efficient representations of high-dimensional motion trajectories so that these can be used for prediction tasks. Here we use image sequences of the heart, acquired using cardiac magnetic resonance imaging, to create time-resolved three-dimensional segmentations using a fully convolutional network trained on anatomical shape priors. This dense motion model formed the input to a supervised denoising autoencoder (4Dsurvival), which is a hybrid network consisting of an autoencoder that learns a task-specific latent code representation trained on observed outcome data, yielding a latent representation optimised for survival prediction. To handle right-censored survival outcomes, our network used a Cox partial likelihood loss function. In a study of 302 patients the predictive accuracy (quantified by Harrell's C-index) was significantly higher (p < .0001) for our model C=0.73 (95$\%$ CI: 0.68 - 0.78) than the human benchmark of C=0.59 (95$\%$ CI: 0.53 - 0.65). This work demonstrates how a complex computer vision task using high-dimensional medical image data can efficiently predict human survival.

Giacomo Tarroni, Ozan Oktay, Wenjia Bai et al.

The effectiveness of a cardiovascular magnetic resonance (CMR) scan depends on the ability of the operator to correctly tune the acquisition parameters to the subject being scanned and on the potential occurrence of imaging artefacts such as cardiac and respiratory motion. In the clinical practice, a quality control step is performed by visual assessment of the acquired images: however, this procedure is strongly operator-dependent, cumbersome and sometimes incompatible with the time constraints in clinical settings and large-scale studies. We propose a fast, fully-automated, learning-based quality control pipeline for CMR images, specifically for short-axis image stacks. Our pipeline performs three important quality checks: 1) heart coverage estimation, 2) inter-slice motion detection, 3) image contrast estimation in the cardiac region. The pipeline uses a hybrid decision forest method - integrating both regression and structured classification models - to extract landmarks as well as probabilistic segmentation maps from both long- and short-axis images as a basis to perform the quality checks. The technique was tested on up to 3000 cases from the UK Biobank as well as on 100 cases from the UK Digital Heart Project, and validated against manual annotations and visual inspections performed by expert interpreters. The results show the capability of the proposed pipeline to correctly detect incomplete or corrupted scans (e.g. on UK Biobank, sensitivity and specificity respectively 88% and 99% for heart coverage estimation, 85% and 95% for motion detection), allowing their exclusion from the analysed dataset or the triggering of a new acquisition.