Nick Lemke

Nick Lemke, Camila González, Anirban Mukhopadhyay et al.

Medical image distributions shift constantly due to changes in patient population and discrepancies in image acquisition. These distribution changes result in performance deterioration; deterioration that continual learning aims to alleviate. However, only adaptation with data rehearsal strategies yields practically desirable performance for medical image segmentation. Such rehearsal violates patient privacy and, as most continual learning approaches, overlooks unexpected changes from out-of-distribution instances. To transcend both of these challenges, we introduce a distribution-aware replay strategy that mitigates forgetting through auto-encoding of features, while simultaneously leveraging the learned distribution of features to detect model failure. We provide empirical corroboration on hippocampus and prostate MRI segmentation.

Nick Lemke, John Kalkhof, Niklas Babendererde et al.

Medical applications demand segmentation of large inputs, like prostate MRIs, pathology slices, or videos of surgery. These inputs should ideally be inferred at once to provide the model with proper spatial or temporal context. When segmenting large inputs, the VRAM consumption of the GPU becomes the bottleneck. Architectures like UNets or Vision Transformers scale very poorly in VRAM consumption, resulting in patch- or frame-wise approaches that compromise global consistency and inference speed. The lightweight Neural Cellular Automaton (NCA) is a bio-inspired model that is by construction size-invariant. However, due to its local-only communication rules, it lacks global knowledge. We propose OctreeNCA by generalizing the neighborhood definition using an octree data structure. Our generalized neighborhood definition enables the efficient traversal of global knowledge. Since deep learning frameworks are mainly developed for large multi-layer networks, their implementation does not fully leverage the advantages of NCAs. We implement an NCA inference function in CUDA that further reduces VRAM demands and increases inference speed. Our OctreeNCA segments high-resolution images and videos quickly while occupying 90% less VRAM than a UNet during evaluation. This allows us to segment 184 Megapixel pathology slices or 1-minute surgical videos at once.

Nick Lemke, Mirko Konstantin, Henry John Krumb et al.

Federated Learning (FL) is enabling collaborative model training across institutions without sharing sensitive patient data. This approach is particularly valuable in low- and middle-income countries (LMICs), where access to trained medical professionals is limited. However, FL adoption in LMICs faces significant barriers, including limited high-performance computing resources and unreliable internet connectivity. To address these challenges, we introduce FedNCA, a novel FL system tailored for medical image segmentation tasks. FedNCA leverages the lightweight Med-NCA architecture, enabling training on low-cost edge devices, such as widely available smartphones, while minimizing communication costs. Additionally, our encryption-ready FedNCA proves to be suitable for compromised network communication. By overcoming infrastructural and security challenges, FedNCA paves the way for inclusive, efficient, lightweight, and encryption-ready medical imaging solutions, fostering equitable healthcare advancements in resource-constrained regions.

Camila Gonzalez, Nick Lemke, Georgios Sakas et al.

Continual learning protocols are attracting increasing attention from the medical imaging community. In continual environments, datasets acquired under different conditions arrive sequentially; and each is only available for a limited period of time. Given the inherent privacy risks associated with medical data, this setup reflects the reality of deployment for deep learning diagnostic radiology systems. Many techniques exist to learn continuously for image classification, and several have been adapted to semantic segmentation. Yet most struggle to accumulate knowledge in a meaningful manner. Instead, they focus on preventing the problem of catastrophic forgetting, even when this reduces model plasticity and thereon burdens the training process. This puts into question whether the additional overhead of knowledge preservation is worth it - particularly for medical image segmentation, where computation requirements are already high - or if maintaining separate models would be a better solution. We propose UNEG, a simple and widely applicable multi-model benchmark that maintains separate segmentation and autoencoder networks for each training stage. The autoencoder is built from the same architecture as the segmentation network, which in our case is a full-resolution nnU-Net, to bypass any additional design decisions. During inference, the reconstruction error is used to select the most appropriate segmenter for each test image. Open this concept, we develop a fair evaluation scheme for different continual learning settings that moves beyond the prevention of catastrophic forgetting. Our results across three regions of interest (prostate, hippocampus, and right ventricle) show that UNEG outperforms several continual learning methods, reinforcing the need for strong baselines in continual learning research.