Philippe Zhang

Philippe Zhang, Pierre-Henri Conze, Mathieu Lamard et al.

Diabetic retinopathy and diabetic macular edema are significant complications of diabetes that can lead to vision loss. Early detection through ultra-widefield fundus imaging enhances patient outcomes but presents challenges in image quality and analysis scale. This paper introduces deep learning solutions for automated UWF image analysis within the framework of the MICCAI 2024 UWF4DR challenge. We detail methods and results across three tasks: image quality assessment, detection of referable DR, and identification of DME. Employing advanced convolutional neural network architectures such as EfficientNet and ResNet, along with preprocessing and augmentation strategies, our models demonstrate robust performance in these tasks. Results indicate that deep learning can significantly aid in the automated analysis of UWF images, potentially improving the efficiency and accuracy of DR and DME detection in clinical settings.

Jieyun Bai, Zihao Zhou, Yitong Tang et al.

A substantial proportion (45\%) of maternal deaths, neonatal deaths, and stillbirths occur during the intrapartum phase, with a particularly high burden in low- and middle-income countries. Intrapartum biometry plays a critical role in monitoring labor progression; however, the routine use of ultrasound in resource-limited settings is hindered by a shortage of trained sonographers. To address this challenge, the Intrapartum Ultrasound Grand Challenge (IUGC), co-hosted with MICCAI 2024, was launched. The IUGC introduces a clinically oriented multi-task automatic measurement framework that integrates standard plane classification, fetal head-pubic symphysis segmentation, and biometry, enabling algorithms to exploit complementary task information for more accurate estimation. Furthermore, the challenge releases the largest multi-center intrapartum ultrasound video dataset to date, comprising 774 videos (68,106 frames) collected from three hospitals, providing a robust foundation for model training and evaluation. In this study, we present a comprehensive overview of the challenge design, review the submissions from eight participating teams, and analyze their methods from five perspectives: preprocessing, data augmentation, learning strategy, model architecture, and post-processing. In addition, we perform a systematic analysis of the benchmark results to identify key bottlenecks, explore potential solutions, and highlight open challenges for future research. Although encouraging performance has been achieved, our findings indicate that the field remains at an early stage, and further in-depth investigation is required before large-scale clinical deployment. All benchmark solutions and the complete dataset have been publicly released to facilitate reproducible research and promote continued advances in automatic intrapartum ultrasound biometry.

Yihao Li, Philippe Zhang, Yubo Tan et al.

Myopic macular degeneration is the most common complication of myopia and the primary cause of vision loss in individuals with pathological myopia. Early detection and prompt treatment are crucial in preventing vision impairment due to myopic maculopathy. This was the focus of the Myopic Maculopathy Analysis Challenge (MMAC), in which we participated. In task 1, classification of myopic maculopathy, we employed the contrastive learning framework, specifically SimCLR, to enhance classification accuracy by effectively capturing enriched features from unlabeled data. This approach not only improved the intrinsic understanding of the data but also elevated the performance of our classification model. For Task 2 (segmentation of myopic maculopathy plus lesions), we have developed independent segmentation models tailored for different lesion segmentation tasks and implemented a test-time augmentation strategy to further enhance the model's performance. As for Task 3 (prediction of spherical equivalent), we have designed a deep regression model based on the data distribution of the dataset and employed an integration strategy to enhance the model's prediction accuracy. The results we obtained are promising and have allowed us to position ourselves in the Top 6 of the classification task, the Top 2 of the segmentation task, and the Top 1 of the prediction task. The code is available at \url{https://github.com/liyihao76/MMAC_LaTIM_Solution}.

Sarah Matta, Mathieu Lamard, Philippe Zhang et al.

Numerous Deep Learning (DL) classification models have been developed for a large spectrum of medical image analysis applications, which promises to reshape various facets of medical practice. Despite early advances in DL model validation and implementation, which encourage healthcare institutions to adopt them, a fundamental questions remain: how can these models effectively handle domain shift? This question is crucial to limit DL models performance degradation. Medical data are dynamic and prone to domain shift, due to multiple factors. Two main shift types can occur over time: 1) covariate shift mainly arising due to updates to medical equipment and 2) concept shift caused by inter-grader variability. To mitigate the problem of domain shift, existing surveys mainly focus on domain adaptation techniques, with an emphasis on covariate shift. More generally, no work has reviewed the state-of-the-art solutions while focusing on the shift types. This paper aims to explore existing domain generalization methods for DL-based classification models through a systematic review of literature. It proposes a taxonomy based on the shift type they aim to solve. Papers were searched and gathered on Scopus till 10 April 2023, and after the eligibility screening and quality evaluation, 77 articles were identified. Exclusion criteria included: lack of methodological novelty (e.g., reviews, benchmarks), experiments conducted on a single mono-center dataset, or articles not written in English. The results of this paper show that learning based methods are emerging, for both shift types. Finally, we discuss future challenges, including the need for improved evaluation protocols and benchmarks, and envisioned future developments to achieve robust, generalized models for medical image classification.

Philippe Zhang, Weili Jiang, Yihao Li et al.

Age-related Macular Degeneration (AMD) is a prevalent eye condition affecting visual acuity. Anti-vascular endothelial growth factor (anti-VEGF) treatments have been effective in slowing the progression of neovascular AMD, with better outcomes achieved through timely diagnosis and consistent monitoring. Tracking the progression of neovascular activity in OCT scans of patients with exudative AMD allows for the development of more personalized and effective treatment plans. This was the focus of the Monitoring Age-related Macular Degeneration Progression in Optical Coherence Tomography (MARIO) challenge, in which we participated. In Task 1, which involved classifying the evolution between two pairs of 2D slices from consecutive OCT acquisitions, we employed a fusion CNN network with model ensembling to further enhance the model's performance. For Task 2, which focused on predicting progression over the next three months based on current exam data, we proposed the Patch Progression Masked Autoencoder that generates an OCT for the next exam and then classifies the evolution between the current OCT and the one generated using our solution from Task 1. The results we achieved allowed us to place in the Top 10 for both tasks. Some team members are part of the same organization as the challenge organizers; therefore, we are not eligible to compete for the prize.

Rachid Zeghlache, Ikram Brahim, Pierre-Henri Conze et al.

The MARIO challenge, held at MICCAI 2024, focused on advancing the automated detection and monitoring of age-related macular degeneration (AMD) through the analysis of optical coherence tomography (OCT) images. Designed to evaluate algorithmic performance in detecting neovascular activity changes within AMD, the challenge incorporated unique multi-modal datasets. The primary dataset, sourced from Brest, France, was used by participating teams to train and test their models. The final ranking was determined based on performance on this dataset. An auxiliary dataset from Algeria was used post-challenge to evaluate population and device shifts from submitted solutions. Two tasks were involved in the MARIO challenge. The first one was the classification of evolution between two consecutive 2D OCT B-scans. The second one was the prediction of future AMD evolution over three months for patients undergoing anti-vascular endothelial growth factor (VEGF) therapy. Thirty-five teams participated, with the top 12 finalists presenting their methods. This paper outlines the challenge's structure, tasks, data characteristics, and winning methodologies, setting a benchmark for AMD monitoring using OCT, infrared imaging, and clinical data (such as the number of visits, age, gender, etc.). The results of this challenge indicate that artificial intelligence (AI) performs as well as a physician in measuring AMD progression (Task 1) but is not yet able of predicting future evolution (Task 2).