Anca-Ligia Grosu

Shrajan Bhandary, Zahra Babaiee, Dejan Kostyszyn et al.

Despite the success of convolutional neural networks for 3D medical-image segmentation, the architectures currently used are still not robust enough to the protocols of different scanners, and the variety of image properties they produce. Moreover, access to large-scale datasets with annotated regions of interest is scarce, and obtaining good results is thus difficult. To overcome these challenges, we introduce IB-U-Nets, a novel architecture with inductive bias, inspired by the visual processing in vertebrates. With the 3D U-Net as the base, we add two 3D residual components to the second encoder blocks. They provide an inductive bias, helping U-Nets to segment anatomical structures from 3D images with increased robustness and accuracy. We compared IB-U-Nets with state-of-the-art 3D U-Nets on multiple modalities and organs, such as the prostate and spleen, using the same training and testing pipeline, including data processing, augmentation and cross-validation. Our results demonstrate the superior robustness and accuracy of IB-U-Nets, especially on small datasets, as is typically the case in medical-image analysis. IB-U-Nets source code and models are publicly available.

Shrajan Bhandary, Dejan Kuhn, Zahra Babaiee et al.

Accurate segmentation of prostate tumours from PET images presents a formidable challenge in medical image analysis. Despite considerable work and improvement in delineating organs from CT and MR modalities, the existing standards do not transfer well and produce quality results in PET related tasks. Particularly, contemporary methods fail to accurately consider the intensity-based scaling applied by the physicians during manual annotation of tumour contours. In this paper, we observe that the prostate-localised uptake threshold ranges are beneficial for suppressing outliers. Therefore, we utilize the intensity threshold values, to implement a new custom-feature-clipping normalisation technique. We evaluate multiple, established U-Net variants under different normalisation schemes, using the nnU-Net framework. All models were trained and tested on multiple datasets, obtained with two radioactive tracers: [68-Ga]Ga-PSMA-11 and [18-F]PSMA-1007. Our results show that the U-Net models achieve much better performance when the PET scans are preprocessed with our novel clipping technique.

Nanna E. Wielenberg, Ilinca Popp, Oliver Blanck et al.

Melanoma brain metastases (MBM) are common and spatially heterogeneous lesions, complicating cohort-level analyses due to anatomical variability and differing MRI protocols. We propose a fully differentiable, deep-learning-based deformable registration framework that aligns individual pathological brains to a common atlas while preserving metastatic tissue without requiring lesion masks or preprocessing. Missing anatomical correspondences caused by metastases are handled through a forward-model similarity metric based on distance-transformed anatomical labels, combined with a volume-preserving regularization term to ensure deformation plausibility. Registration performance was evaluated using Dice coefficient (DSC), Hausdorff distance (HD), average symmetric surface distance (ASSD), and Jacobian-based measures. The method was applied to 209 MBM patients from three centres, enabling standardized mapping of metastases to anatomical, arterial, and perfusion atlases. The framework achieved high registration accuracy across datasets (DSC 0.89-0.92, HD 6.79-7.60 mm, ASSD 0.63-0.77 mm) while preserving metastatic volumes. Spatial analysis demonstrated significant over-representation of MBM in the cerebral cortex and putamen, under-representation in white matter, and consistent localization near the gray-white matter junction. No arterial territory showed increased metastasis frequency after volume correction. This approach enables robust atlas registration of pathological brain MRI without lesion masks and supports reproducible multi-centre analyses. Applied to MBM, it confirms and refines known spatial predilections, particularly preferential seeding near the gray-white matter junction and cortical regions. The publicly available implementation facilitates reproducible research and extension to other brain tumours and neurological pathologies.

Shrajan Bhandary, Zahra Babaiee, Dejan Kostyszyn et al.

Despite the great success of convolutional neural networks (CNN) in 3D medical image segmentation tasks, the methods currently in use are still not robust enough to the different protocols utilized by different scanners, and to the variety of image properties or artefacts they produce. To this end, we introduce OOCS-enhanced networks, a novel architecture inspired by the innate nature of visual processing in the vertebrates. With different 3D U-Net variants as the base, we add two 3D residual components to the second encoder blocks: on and off center-surround (OOCS). They generalise the ganglion pathways in the retina to a 3D setting. The use of 2D-OOCS in any standard CNN network complements the feedforward framework with sharp edge-detection inductive biases. The use of 3D-OOCS also helps 3D U-Nets to scrutinise and delineate anatomical structures present in 3D images with increased accuracy.We compared the state-of-the-art 3D U-Nets with their 3D-OOCS extensions and showed the superior accuracy and robustness of the latter in automatic prostate segmentation from 3D Magnetic Resonance Images (MRIs). For a fair comparison, we trained and tested all the investigated 3D U-Nets with the same pipeline, including automatic hyperparameter optimisation and data augmentation.

Tobias Fechter, Sonja Adebahr, Anca-Ligia Grosu et al.

Stereotactic body radiation therapy allows for a precise and accurate dose delivery. Organ motion during treatment bears the risk of undetected high dose healthy tissue exposure. An organ very susceptible to high dose is the oesophagus. Its low contrast on CT and the oblong shape renders motion estimation difficult. We tackle this issue by modern algorithms to measure the oesophageal motion voxel-wise and to estimate motion related dosimetric impact. Oesophageal motion was measured using deformable image registration and 4DCT of 11 internal and 5 public datasets. Current clinical practice of contouring the organ on 3DCT was compared to timely resolved 4DCT contours. The dosimetric impact of the motion was estimated by analysing the trajectory of each voxel in the 4D dose distribution. Finally an organ motion model was built, allowing for easier patient-wise comparisons. Motion analysis showed mean absolute maximal motion amplitudes of 4.55 +/- 1.81 mm left-right, 5.29 +/- 2.67 mm anterior-posterior and 10.78 +/- 5.30 mm superior-inferior. Motion between the cohorts differed significantly. In around 50 % of the cases the dosimetric passing criteria was violated. Contours created on 3DCT did not cover 14 % of the organ for 50 % of the respiratory cycle and the 3D contour is around 38 % smaller than the union of all 4D contours. The motion model revealed that the maximal motion is not limited to the lower part of the organ. Our results showed motion amplitudes higher than most reported values in the literature and that motion is very heterogeneous across patients. Therefore, individual motion information should be considered in contouring and planning.