Meng Law

Sanuwani Dayarathna, Kh Tohidul Islam, Bohan Zhuang et al.

Magnetic Resonance Imaging (MRI) is instrumental in clinical diagnosis, offering diverse contrasts that provide comprehensive diagnostic information. However, acquiring multiple MRI contrasts is often constrained by high costs, long scanning durations, and patient discomfort. Current synthesis methods, typically focused on single-image contrasts, fall short in capturing the collective nuances across various contrasts. Moreover, existing methods for multi-contrast MRI synthesis often fail to accurately map feature-level information across multiple imaging contrasts. We introduce McCaD (Multi-Contrast MRI Conditioned Adaptive Adversarial Diffusion), a novel framework leveraging an adversarial diffusion model conditioned on multiple contrasts for high-fidelity MRI synthesis. McCaD significantly enhances synthesis accuracy by employing a multi-scale, feature-guided mechanism, incorporating denoising and semantic encoders. An adaptive feature maximization strategy and a spatial feature-attentive loss have been introduced to capture more intrinsic features across multiple contrasts. This facilitates a precise and comprehensive feature-guided denoising process. Extensive experiments on tumor and healthy multi-contrast MRI datasets demonstrated that the McCaD outperforms state-of-the-art baselines quantitively and qualitatively. The code is provided with supplementary materials.

Benjamin Sinclair, Lucy Vivash, Jasmine Moses et al.

Perivascular spaces(PVSs) form a central component of the brainś waste clearance system, the glymphatic system. These structures are visible on MRI images, and their morphology is associated with aging and neurological disease. Manual quantification of PVS is time consuming and subjective. Numerous deep learning methods for PVS segmentation have been developed, however the majority have been developed and evaluated on homogenous datasets and high resolution scans, perhaps limiting their applicability for the wide range of image qualities acquired in clinic and research. In this work we train a nnUNet, a top-performing biomedical image segmentation algorithm, on a heterogenous training sample of manually segmented MRI images of a range of different qualities and resolutions from 6 different datasets. These are compared to publicly available deep learning methods for 3D segmentation of PVS. The resulting model, PINGU (Perivascular space Identification Nnunet for Generalised Usage), achieved voxel and cluster level dice scores of 0.50(SD=0.15), 0.63(0.17) in the white matter(WM), and 0.54(0.11), 0.66(0.17) in the basal ganglia(BG). Performance on data from unseen sites was substantially lower for both PINGU(0.20-0.38(WM, voxel), 0.29-0.58(WM, cluster), 0.22-0.36(BG, voxel), 0.46-0.60(BG, cluster)) and the publicly available algorithms(0.18-0.30(WM, voxel), 0.29-0.38(WM cluster), 0.10-0.20(BG, voxel), 0.15-0.37(BG, cluster)), but PINGU strongly outperformed the publicly available algorithms, particularly in the BG. Finally, training PINGU on manual segmentations from a single site with homogenous scan properties gave marginally lower performances on internal cross-validation, but in some cases gave higher performance on external validation. PINGU stands out as broad-use PVS segmentation tool, with particular strength in the BG, an area of PVS related to vascular disease and pathology.

Zhen Xuen Brandon Low, Rory Zhang, Hang Min et al.

Enlarged perivascular spaces (PVS) are increasingly recognized as biomarkers of cerebral small vessel disease, Alzheimer's disease, stroke, and aging-related neurodegeneration. However, manual segmentation of PVS is time-consuming and subject to moderate inter-rater reliability, while existing automated deep learning models have moderate performance and typically fail to generalize across diverse clinical and research MRI datasets. We adapted MedNeXt-L-k5, a Transformer-inspired 3D encoder-decoder convolutional network, for automated PVS segmentation. Two models were trained: one using a homogeneous dataset of 200 T2-weighted (T2w) MRI scans from the Human Connectome Project-Aging (HCP-Aging) dataset and another using 40 heterogeneous T1-weighted (T1w) MRI volumes from seven studies across six scanners. Model performance was evaluated using internal 5-fold cross validation (5FCV) and leave-one-site-out cross validation (LOSOCV). MedNeXt-L-k5 models trained on the T2w images of the HCP-Aging dataset achieved voxel-level Dice scores of 0.88+/-0.06 (white matter, WM), comparable to the reported inter-rater reliability of that dataset, and the highest yet reported in the literature. The same models trained on the T1w images of the HCP-Aging dataset achieved a substantially lower Dice score of 0.58+/-0.09 (WM). Under LOSOCV, the model had voxel-level Dice scores of 0.38+/-0.16 (WM) and 0.35+/-0.12 (BG), and cluster-level Dice scores of 0.61+/-0.19 (WM) and 0.62+/-0.21 (BG). MedNeXt-L-k5 provides an efficient solution for automated PVS segmentation across diverse T1w and T2w MRI datasets. MedNeXt-L-k5 did not outperform the nnU-Net, indicating that the attention-based mechanisms present in transformer-inspired models to provide global context are not required for high accuracy in PVS segmentation.

Xinyi Wang, Michael Barnett, Frederique Boonstra et al.

Fiber orientation distribution (FOD) is an advanced diffusion MRI modeling technique that represents complex white matter fiber configurations, and a key step for subsequent brain tractography and connectome analysis. Its reliability and accuracy, however, heavily rely on the quality of the MRI acquisition and the subsequent estimation of the FODs at each voxel. Generating reliable FODs from widely available clinical protocols with single-shell and low-angular-resolution acquisitions remains challenging but could potentially be addressed with recent advances in deep learning-based enhancement techniques. Despite advancements, existing methods have predominantly been assessed on healthy subjects, which have proved to be a major hurdle for their clinical adoption. In this work, we validate a newly optimized enhancement framework, FastFOD-Net, across healthy controls and six neurological disorders. This accelerated end-to-end deep learning framework enhancing FODs with superior performance and delivering training/inference efficiency for clinical use ($60\times$ faster comparing to its predecessor). With the most comprehensive clinical evaluation to date, our work demonstrates the potential of FastFOD-Net in accelerating clinical neuroscience research, empowering diffusion MRI analysis for disease differentiation, improving interpretability in connectome applications, and reducing measurement errors to lower sample size requirements. Critically, this work will facilitate the more widespread adoption of, and build clinical trust in, deep learning based methods for diffusion MRI enhancement. Specifically, FastFOD-Net enables robust analysis of real-world, clinical diffusion MRI data, comparable to that achievable with high-quality research acquisitions.

Yunyan Xing, Zongyuan Ge, Rui Zeng et al.

Recent works show that Generative Adversarial Networks (GANs) can be successfully applied to chest X-ray data augmentation for lung disease recognition. However, the implausible and distorted pathology features generated from the less than perfect generator may lead to wrong clinical decisions. Why not keep the original pathology region? We proposed a novel approach that allows our generative model to generate high quality plausible images that contain undistorted pathology areas. The main idea is to design a training scheme based on an image-to-image translation network to introduce variations of new lung features around the pathology ground-truth area. Moreover, our model is able to leverage both annotated disease images and unannotated healthy lung images for the purpose of generation. We demonstrate the effectiveness of our model on two tasks: (i) we invite certified radiologists to assess the quality of the generated synthetic images against real and other state-of-the-art generative models, and (ii) data augmentation to improve the performance of disease localisation.