Luyi Han

Tianyu Zhang, Luyi Han, Anna D'Angelo et al.

Magnetic resonance imaging (MRI) is the most sensitive technique for breast cancer detection among current clinical imaging modalities. Contrast-enhanced MRI (CE-MRI) provides superior differentiation between tumors and invaded healthy tissue, and has become an indispensable technique in the detection and evaluation of cancer. However, the use of gadolinium-based contrast agents (GBCA) to obtain CE-MRI may be associated with nephrogenic systemic fibrosis and may lead to bioaccumulation in the brain, posing a potential risk to human health. Moreover, and likely more important, the use of gadolinium-based contrast agents requires the cannulation of a vein, and the injection of the contrast media which is cumbersome and places a burden on the patient. To reduce the use of contrast agents, diffusion-weighted imaging (DWI) is emerging as a key imaging technique, although currently usually complementing breast CE-MRI. In this study, we develop a multi-sequence fusion network to synthesize CE-MRI based on T1-weighted MRI and DWIs. DWIs with different b-values are fused to efficiently utilize the difference features of DWIs. Rather than proposing a pure data-driven approach, we invent a multi-sequence attention module to obtain refined feature maps, and leverage hierarchical representation information fused at different scales while utilizing the contributions from different sequences from a model-driven approach by introducing the weighted difference module. The results show that the multi-b-value DWI-based fusion model can potentially be used to synthesize CE-MRI, thus theoretically reducing or avoiding the use of GBCA, thereby minimizing the burden to patients. Our code is available at \url{https://github.com/Netherlands-Cancer-Institute/CE-MRI}.

Luyi Han, Tao Tan, Tianyu Zhang et al.

Multi-sequence MRIs can be necessary for reliable diagnosis in clinical practice due to the complimentary information within sequences. However, redundant information exists across sequences, which interferes with mining efficient representations by modern machine learning or deep learning models. To handle various clinical scenarios, we propose a sequence-to-sequence generation framework (Seq2Seq) for imaging-differentiation representation learning. In this study, not only do we propose arbitrary 3D/4D sequence generation within one model to generate any specified target sequence, but also we are able to rank the importance of each sequence based on a new metric estimating the difficulty of a sequence being generated. Furthermore, we also exploit the generation inability of the model to extract regions that contain unique information for each sequence. We conduct extensive experiments using three datasets including a toy dataset of 20,000 simulated subjects, a brain MRI dataset of 1,251 subjects, and a breast MRI dataset of 2,101 subjects, to demonstrate that (1) our proposed Seq2Seq is efficient and lightweight for complex clinical datasets and can achieve excellent image quality; (2) top-ranking sequences can be used to replace complete sequences with non-inferior performance; (3) combining MRI with our imaging-differentiation map leads to better performance in clinical tasks such as glioblastoma MGMT promoter methylation status prediction and breast cancer pathological complete response status prediction. Our code is available at https://github.com/fiy2W/mri_seq2seq.

Luyi Han, Tianyu Zhang, Yunzhi Huang et al.

Multi-sequence MRI is valuable in clinical settings for reliable diagnosis and treatment prognosis, but some sequences may be unusable or missing for various reasons. To address this issue, MRI synthesis is a potential solution. Recent deep learning-based methods have achieved good performance in combining multiple available sequences for missing sequence synthesis. Despite their success, these methods lack the ability to quantify the contributions of different input sequences and estimate the quality of generated images, making it hard to be practical. Hence, we propose an explainable task-specific synthesis network, which adapts weights automatically for specific sequence generation tasks and provides interpretability and reliability from two sides: (1) visualize the contribution of each input sequence in the fusion stage by a trainable task-specific weighted average module; (2) highlight the area the network tried to refine during synthesizing by a task-specific attention module. We conduct experiments on the BraTS2021 dataset of 1251 subjects, and results on arbitrary sequence synthesis indicate that the proposed method achieves better performance than the state-of-the-art methods. Our code is available at \url{https://github.com/fiy2W/mri_seq2seq}.

Matthias Eisenmann, Annika Reinke, Vivienn Weru et al. · utoronto

The number of international benchmarking competitions is steadily increasing in various fields of machine learning (ML) research and practice. So far, however, little is known about the common practice as well as bottlenecks faced by the community in tackling the research questions posed. To shed light on the status quo of algorithm development in the specific field of biomedical imaging analysis, we designed an international survey that was issued to all participants of challenges conducted in conjunction with the IEEE ISBI 2021 and MICCAI 2021 conferences (80 competitions in total). The survey covered participants' expertise and working environments, their chosen strategies, as well as algorithm characteristics. A median of 72% challenge participants took part in the survey. According to our results, knowledge exchange was the primary incentive (70%) for participation, while the reception of prize money played only a minor role (16%). While a median of 80 working hours was spent on method development, a large portion of participants stated that they did not have enough time for method development (32%). 25% perceived the infrastructure to be a bottleneck. Overall, 94% of all solutions were deep learning-based. Of these, 84% were based on standard architectures. 43% of the respondents reported that the data samples (e.g., images) were too large to be processed at once. This was most commonly addressed by patch-based training (69%), downsampling (37%), and solving 3D analysis tasks as a series of 2D tasks. K-fold cross-validation on the training set was performed by only 37% of the participants and only 50% of the participants performed ensembling based on multiple identical models (61%) or heterogeneous models (39%). 48% of the respondents applied postprocessing steps.

Luyi Han, Yunzhi Huang, Tao Tan et al.

Domain adaptation has been widely adopted to transfer styles across multi-vendors and multi-centers, as well as to complement the missing modalities. In this challenge, we proposed an unsupervised domain adaptation framework for cross-modality vestibular schwannoma (VS) and cochlea segmentation and Koos grade prediction. We learn the shared representation from both ceT1 and hrT2 images and recover another modality from the latent representation, and we also utilize proxy tasks of VS segmentation and brain parcellation to restrict the consistency of image structures in domain adaptation. After generating missing modalities, the nnU-Net model is utilized for VS and cochlea segmentation, while a semi-supervised contrastive learning pre-train approach is employed to improve the model performance for Koos grade prediction. On CrossMoDA validation phase Leaderboard, our method received rank 4 in task1 with a mean Dice score of 0.8394 and rank 2 in task2 with Macro-Average Mean Square Error of 0.3941. Our code is available at https://github.com/fiy2W/cmda2022.superpolymerization.

Tianyu Zhang, Tao Tan, Luyi Han et al.

Magnetic resonance imaging (MRI) is highly sensitive for lesion detection in the breasts. Sequences obtained with different settings can capture the specific characteristics of lesions. Such multi-parameter MRI information has been shown to improve radiologist performance in lesion classification, as well as improving the performance of artificial intelligence models in various tasks. However, obtaining multi-parameter MRI makes the examination costly in both financial and time perspectives, and there may be safety concerns for special populations, thus making acquisition of the full spectrum of MRI sequences less durable. In this study, different than naive input fusion or feature concatenation from existing MRI parameters, a novel $\textbf{I}$ntegrated MRI $\textbf{M}$ulti-$\textbf{P}$arameter reinf$\textbf{O}$rcement fusion generato$\textbf{R}$ wi$\textbf{T}$h $\textbf{A}$tte$\textbf{NT}$ion Network (IMPORTANT-Net) is developed to generate missing parameters. First, the parameter reconstruction module is used to encode and restore the existing MRI parameters to obtain the corresponding latent representation information at any scale level. Then the multi-parameter fusion with attention module enables the interaction of the encoded information from different parameters through a set of algorithmic strategies, and applies different weights to the information through the attention mechanism after information fusion to obtain refined representation information. Finally, a reinforcement fusion scheme embedded in a $V^{-}$-shape generation module is used to combine the hierarchical representations to generate the missing MRI parameter. Results showed that our IMPORTANT-Net is capable of generating missing MRI parameters and outperforms comparable state-of-the-art networks. Our code is available at https://github.com/Netherlands-Cancer-Institute/MRI_IMPORTANT_NET.

Xin Wang, Tao Tan, Yuan Gao et al.

Asymmetry is a crucial characteristic of bilateral mammograms (Bi-MG) when abnormalities are developing. It is widely utilized by radiologists for diagnosis. The question of 'what the symmetrical Bi-MG would look like when the asymmetrical abnormalities have been removed ?' has not yet received strong attention in the development of algorithms on mammograms. Addressing this question could provide valuable insights into mammographic anatomy and aid in diagnostic interpretation. Hence, we propose a novel framework, DisAsymNet, which utilizes asymmetrical abnormality transformer guided self-adversarial learning for disentangling abnormalities and symmetric Bi-MG. At the same time, our proposed method is partially guided by randomly synthesized abnormalities. We conduct experiments on three public and one in-house dataset, and demonstrate that our method outperforms existing methods in abnormality classification, segmentation, and localization tasks. Additionally, reconstructed normal mammograms can provide insights toward better interpretable visual cues for clinical diagnosis. The code will be accessible to the public.

Haoran Dou, Ning Bi, Luyi Han et al.

Deep learning-based deformable registration methods have been widely investigated in diverse medical applications. Learning-based deformable registration relies on weighted objective functions trading off registration accuracy and smoothness of the deformation field. Therefore, they inevitably require tuning the hyperparameter for optimal registration performance. Tuning the hyperparameters is highly computationally expensive and introduces undesired dependencies on domain knowledge. In this study, we construct a registration model based on the gradient surgery mechanism, named GSMorph, to achieve a hyperparameter-free balance on multiple losses. In GSMorph, we reformulate the optimization procedure by projecting the gradient of similarity loss orthogonally to the plane associated with the smoothness constraint, rather than additionally introducing a hyperparameter to balance these two competing terms. Furthermore, our method is model-agnostic and can be merged into any deep registration network without introducing extra parameters or slowing down inference. In this study, We compared our method with state-of-the-art (SOTA) deformable registration approaches over two publicly available cardiac MRI datasets. GSMorph proves superior to five SOTA learning-based registration models and two conventional registration techniques, SyN and Demons, on both registration accuracy and smoothness.

Haoran Dou, Luyi Han, Yushuang He et al.

Tumor infiltration of the recurrent laryngeal nerve (RLN) is a contraindication for robotic thyroidectomy and can be difficult to detect via standard laryngoscopy. Ultrasound (US) is a viable alternative for RLN detection due to its safety and ability to provide real-time feedback. However, the tininess of the RLN, with a diameter typically less than 3mm, poses significant challenges to the accurate localization of the RLN. In this work, we propose a knowledge-driven framework for RLN localization, mimicking the standard approach surgeons take to identify the RLN according to its surrounding organs. We construct a prior anatomical model based on the inherent relative spatial relationships between organs. Through Bayesian shape alignment (BSA), we obtain the candidate coordinates of the center of a region of interest (ROI) that encloses the RLN. The ROI allows a decreased field of view for determining the refined centroid of the RLN using a dual-path identification network, based on multi-scale semantic information. Experimental results indicate that the proposed method achieves superior hit rates and substantially smaller distance errors compared with state-of-the-art methods.

Yunzhi Huang, Sahar Ahmad, Luyi Han et al.

Missing scans are inevitable in longitudinal studies due to either subject dropouts or failed scans. In this paper, we propose a deep learning framework to predict missing scans from acquired scans, catering to longitudinal infant studies. Prediction of infant brain MRI is challenging owing to the rapid contrast and structural changes particularly during the first year of life. We introduce a trustworthy metamorphic generative adversarial network (MGAN) for translating infant brain MRI from one time-point to another. MGAN has three key features: (i) Image translation leveraging spatial and frequency information for detail-preserving mapping; (ii) Quality-guided learning strategy that focuses attention on challenging regions. (iii) Multi-scale hybrid loss function that improves translation of tissue contrast and structural details. Experimental results indicate that MGAN outperforms existing GANs by accurately predicting both contrast and anatomical details.

Tianyu Zhang, Xinglong Liang, Jarek van Dijk et al.

Synthesizing high fidelity contrast enhanced MRI is clinically valuable for safer and more efficient breast cancer screening, yet remains challenging due to complex lesion textures and heterogeneous enhancement patterns.

Xin Wang, Tao Tan, Yuan Gao et al.

Precision breast cancer (BC) risk assessment is crucial for developing individualized screening and prevention. Despite the promising potential of recent mammogram (MG) based deep learning models in predicting BC risk, they mostly overlook the 'time-to-future-event' ordering among patients and exhibit limited explorations into how they track history changes in breast tissue, thereby limiting their clinical application. In this work, we propose a novel method, named OA-BreaCR, to precisely model the ordinal relationship of the time to and between BC events while incorporating longitudinal breast tissue changes in a more explainable manner. We validate our method on public EMBED and inhouse datasets, comparing with existing BC risk prediction and time prediction methods. Our ordinal learning method OA-BreaCR outperforms existing methods in both BC risk and time-to-future-event prediction tasks. Additionally, ordinal heatmap visualizations show the model's attention over time. Our findings underscore the importance of interpretable and precise risk assessment for enhancing BC screening and prevention efforts. The code will be accessible to the public.

Luyi Han, Tao Tan, Tianyu Zhang et al.

Adversarial learning helps generative models translate MRI from source to target sequence when lacking paired samples. However, implementing MRI synthesis with adversarial learning in clinical settings is challenging due to training instability and mode collapse. To address this issue, we leverage intermediate sequences to estimate the common latent space among multi-sequence MRI, enabling the reconstruction of distinct sequences from the common latent space. We propose a generative model that compresses discrete representations of each sequence to estimate the Gaussian distribution of vector-quantized common (VQC) latent space between multiple sequences. Moreover, we improve the latent space consistency with contrastive learning and increase model stability by domain augmentation. Experiments using BraTS2021 dataset show that our non-adversarial model outperforms other GAN-based methods, and VQC latent space aids our model to achieve (1) anti-interference ability, which can eliminate the effects of noise, bias fields, and artifacts, and (2) solid semantic representation ability, with the potential of one-shot segmentation. Our code is publicly available.

Luyi Han, Tao Tan, Ritse Mann

The domain adaptation approach has gained significant acceptance in transferring styles across various vendors and centers, along with filling the gaps in modalities. However, multi-center application faces the challenge of the difficulty of domain adaptation due to their intra-domain differences. We focus on introducing a fine-grained unsupervised framework for domain adaptation to facilitate cross-modality segmentation of vestibular schwannoma (VS) and cochlea. We propose to use a vector to control the generator to synthesize a fake image with given features. And then, we can apply various augmentations to the dataset by searching the feature dictionary. The diversity augmentation can increase the performance and robustness of the segmentation model. On the CrossMoDA validation phase Leaderboard, our method received a mean Dice score of 0.765 and 0.836 on VS and cochlea, respectively.

Luyi Han, Tao Tan, Tianyu Zhang et al.

Clinicians compare breast DCE-MRI after neoadjuvant chemotherapy (NAC) with pre-treatment scans to evaluate the response to NAC. Clinical evidence supports that accurate longitudinal deformable registration without deforming treated tumor regions is key to quantifying tumor changes. We propose a conditional pyramid registration network based on unsupervised keypoint detection and selective volume-preserving to quantify changes over time. In this approach, we extract the structural and the abnormal keypoints from DCE-MRI, apply the structural keypoints for the registration algorithm to restrict large deformation, and employ volume-preserving loss based on abnormal keypoints to keep the volume of the tumor unchanged after registration. We use a clinical dataset with 1630 MRI scans from 314 patients treated with NAC. The results demonstrate that our method registers with better performance and better volume preservation of the tumors. Furthermore, a local-global-combining biomarker based on the proposed method achieves high accuracy in pathological complete response (pCR) prediction, indicating that predictive information exists outside tumor regions. The biomarkers could potentially be used to avoid unnecessary surgeries for certain patients. It may be valuable for clinicians and/or computer systems to conduct follow-up tumor segmentation and response prediction on images registered by our method. Our code is available on \url{https://github.com/fiy2W/Treatment-aware-Longitudinal-Registration}.

Xin Wang, Yuan Gao, George Yiasemis et al.

Efficient and explainable breast cancer (BC) risk prediction is critical for large-scale population-based screening. Breast MRI provides functional information for personalized risk assessment. Yet effective modeling remains challenging as fully 3D CNNs capture volumetric context at high computational cost, whereas lightweight 2D CNNs fail to model inter-slice continuity. Importantly, breast MRI modeling for shor- and long-term BC risk stratification remains underexplored. In this study, we propose LoGo-MR, a 2.5D local-global structural modeling framework for five-year BC risk prediction. Aligned with clinical interpretation, our framework first employs neighbor-slice encoding to capture subtle local cues linked to short-term risk. It then integrates transformer-enhanced multiple-instance learning (MIL) to model distributed global patterns related to long-term risk and provide interpretable slice importance. We further apply this framework across axial, sagittal, and coronal planes as LoGo3-MR to capture complementary volumetric information. This multi-plane formulation enables voxel-level risk saliency mapping, which may assist radiologists in localizing risk-relevant regions during breast MRI interpretation. Evaluated on a large breast MRI screening cohort (~7.5K), our method outperforms 2D/3D baselines and existing SOTA MIL methods, achieving AUCs of 0.77-0.69 for 1- to 5-year prediction and improving C-index by ~6% over 3D CNNs. LoGo3-MR further improves overall performance with interpretable localization across three planes, and validation across seven backbones shows consistent gains. These results highlight the clinical potential of efficient MRI-based BC risk stratification for large-scale screening. Code will be released publicly.

Xinglong Liang, Jiaju Huang, Luyi Han et al.

PET-CT lesion segmentation is challenging due to noise sensitivity, small and variable lesion morphology, and interference from physiological high-metabolic signals. Current mainstream approaches follow the practice of one network solving the segmentation of multiple cancer lesions by treating all cancers as a single task. However, this overlooks the unique characteristics of different cancer types. Considering the specificity and similarity of different cancers in terms of metastatic patterns, organ preferences, and FDG uptake intensity, we propose DpDNet, a Dual-Prompt-Driven network that incorporates specific prompts to capture cancer-specific features and common prompts to retain shared knowledge. Additionally, to mitigate information forgetting caused by the early introduction of prompts, prompt-aware heads are employed after the decoder to adaptively handle multiple segmentation tasks. Experiments on a PET-CT dataset with four cancer types show that DpDNet outperforms state-of-the-art models. Finally, based on the segmentation results, we calculated MTV, TLG, and SUVmax for breast cancer survival analysis. The results suggest that DpDNet has the potential to serve as a valuable tool for personalized risk stratification, supporting clinicians in optimizing treatment strategies and improving outcomes. Code is available at https://github.com/XinglongLiang08/DpDNet.

Yaofei Duan, Yuhao Huang, Xin Yang et al.

Deep learning-based diagnostic models often suffer performance drops due to distribution shifts between training (source) and test (target) domains. Collecting and labeling sufficient target domain data for model retraining represents an optimal solution, yet is limited by time and scarce resources. Active learning (AL) offers an efficient approach to reduce annotation costs while maintaining performance, but struggles to handle the challenge posed by distribution variations across different datasets. In this study, we propose a novel unsupervised Active learning framework for Domain Adaptation, named ADAptation, which efficiently selects informative samples from multi-domain data pools under limited annotation budget. As a fundamental step, our method first utilizes the distribution homogenization capabilities of diffusion models to bridge cross-dataset gaps by translating target images into source-domain style. We then introduce two key innovations: (a) a hypersphere-constrained contrastive learning network for compact feature clustering, and (b) a dual-scoring mechanism that quantifies and balances sample uncertainty and representativeness. Extensive experiments on four breast ultrasound datasets (three public and one in-house/multi-center) across five common deep classifiers demonstrate that our method surpasses existing strong AL-based competitors, validating its effectiveness and generalization for clinical domain adaptation. The code is available at the anonymized link: https://github.com/miccai25-966/ADAptation.

Zehui Lin, Luyi Han, Xin Wang et al.

IMPORTANCE: Modern ultrasound systems are universal diagnostic tools capable of imaging the entire body. However, current AI solutions remain fragmented into single-task tools. This critical gap between hardware versatility and software specificity limits workflow integration and clinical utility. OBJECTIVE: To evaluate the diagnostic accuracy, versatility, and efficiency of single general-purpose deep learning models for multi-organ classification and segmentation. DESIGN: The Universal UltraSound Image Challenge 2025 (UUSIC25) involved developing algorithms on 11,644 images aggregated from 12 sources (9 public, 3 private). Evaluation used an independent, multi-center private test set of 2,479 images, including data from a center completely unseen during training to assess generalization. OUTCOMES: Diagnostic performance (Dice Similarity Coefficient [DSC]; Area Under the Receiver Operating Characteristic Curve [AUC]) and computational efficiency (inference time, GPU memory). RESULTS: Of 15 valid algorithms, the top model (SMART) achieved a macro-averaged DSC of 0.854 across 5 segmentation tasks and AUC of 0.766 for binary classification. Models demonstrated high capability in anatomical segmentation (e.g., fetal head DSC: 0.942) but variability in complex diagnostic tasks subject to domain shift. Specifically, in breast cancer molecular subtyping, the top model's performance dropped from an AUC of 0.571 (internal) to 0.508 (unseen external center), highlighting the challenge of generalization. CONCLUSIONS: General-purpose AI models can achieve high accuracy and efficiency across multiple tasks using a single architecture. However, significant performance degradation on unseen data suggests domain generalization is critical for future clinical deployment.

Hao Yang, Xinlong Liang, Zhang Li et al.

Deep learning offers transformative potential in medical imaging, yet its clinical adoption is frequently hampered by challenges such as data scarcity, distribution shifts, and the need for robust task generalization. Prompt-based methodologies have emerged as a pivotal strategy to guide deep learning models, providing flexible, domain-specific adaptations that significantly enhance model performance and adaptability without extensive retraining. This systematic review critically examines the burgeoning landscape of prompt engineering in medical imaging. We dissect diverse prompt modalities, including textual instructions, visual prompts, and learnable embeddings, and analyze their integration for core tasks such as image generation, segmentation, and classification. Our synthesis reveals how these mechanisms improve task-specific outcomes by enhancing accuracy, robustness, and data efficiency and reducing reliance on manual feature engineering while fostering greater model interpretability by making the model's guidance explicit. Despite substantial advancements, we identify persistent challenges, particularly in prompt design optimization, data heterogeneity, and ensuring scalability for clinical deployment. Finally, this review outlines promising future trajectories, including advanced multimodal prompting and robust clinical integration, underscoring the critical role of prompt-driven AI in accelerating the revolution of diagnostics and personalized treatment planning in medicine.

Navodini Wijethilake, Reuben Dorent, Marina Ivory et al.

The cross-Modality Domain Adaptation (crossMoDA) challenge series, initiated in 2021 in conjunction with the International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI), focuses on unsupervised cross-modality segmentation, learning from contrast-enhanced T1 (ceT1) and transferring to T2 MRI. The task is an extreme example of domain shift chosen to serve as a meaningful and illustrative benchmark. From a clinical application perspective, it aims to automate Vestibular Schwannoma (VS) and cochlea segmentation on T2 scans for more cost-effective VS management. Over time, the challenge objectives have evolved to enhance its clinical relevance. The challenge evolved from using single-institutional data and basic segmentation in 2021 to incorporating multi-institutional data and Koos grading in 2022, and by 2023, it included heterogeneous routine data and sub-segmentation of intra- and extra-meatal tumour components. In this work, we report the findings of the 2022 and 2023 editions and perform a retrospective analysis of the challenge progression over the years. The observations from the successive challenge contributions indicate that the number of outliers decreases with an expanding dataset. This is notable since the diversity of scanning protocols of the datasets concurrently increased. The winning approach of the 2023 edition reduced the number of outliers on the 2021 and 2022 testing data, demonstrating how increased data heterogeneity can enhance segmentation performance even on homogeneous data. However, the cochlea Dice score declined in 2023, likely due to the added complexity from tumour sub-annotations affecting overall segmentation performance. While progress is still needed for clinically acceptable VS segmentation, the plateauing performance suggests that a more challenging cross-modal task may better serve future benchmarking.

Alessa Hering, Lasse Hansen, Tony C. W. Mok et al.

Image registration is a fundamental medical image analysis task, and a wide variety of approaches have been proposed. However, only a few studies have comprehensively compared medical image registration approaches on a wide range of clinically relevant tasks. This limits the development of registration methods, the adoption of research advances into practice, and a fair benchmark across competing approaches. The Learn2Reg challenge addresses these limitations by providing a multi-task medical image registration data set for comprehensive characterisation of deformable registration algorithms. A continuous evaluation will be possible at https://learn2reg.grand-challenge.org. Learn2Reg covers a wide range of anatomies (brain, abdomen, and thorax), modalities (ultrasound, CT, MR), availability of annotations, as well as intra- and inter-patient registration evaluation. We established an easily accessible framework for training and validation of 3D registration methods, which enabled the compilation of results of over 65 individual method submissions from more than 20 unique teams. We used a complementary set of metrics, including robustness, accuracy, plausibility, and runtime, enabling unique insight into the current state-of-the-art of medical image registration. This paper describes datasets, tasks, evaluation methods and results of the challenge, as well as results of further analysis of transferability to new datasets, the importance of label supervision, and resulting bias. While no single approach worked best across all tasks, many methodological aspects could be identified that push the performance of medical image registration to new state-of-the-art performance. Furthermore, we demystified the common belief that conventional registration methods have to be much slower than deep-learning-based methods.

Luyi Han, Haoran Dou, Yunzhi Huang et al.

Unsupervised learning strategy is widely adopted by the deformable registration models due to the lack of ground truth of deformation fields. These models typically depend on the intensity-based similarity loss to obtain the learning convergence. Despite the success, such dependence is insufficient. For the deformable registration of mono-modality image, well-aligned two images not only have indistinguishable intensity differences, but also are close in the statistical distribution and the boundary areas. Considering that well-designed loss functions can facilitate a learning model into a desirable convergence, we learn a deformable registration model for T1-weighted MR images by integrating multiple image characteristics via a hybrid loss. Our method registers the OASIS dataset with high accuracy while preserving deformation smoothness.

Luyi Han, Yuanyuan Lyu, Cheng Peng et al.

Clinical evidence has shown that rib-suppressed chest X-rays (CXRs) can improve the reliability of pulmonary disease diagnosis. However, previous approaches on generating rib-suppressed CXR face challenges in preserving details and eliminating rib residues. We hereby propose a GAN-based disentanglement learning framework called Rib Suppression GAN, or RSGAN, to perform rib suppression by utilizing the anatomical knowledge embedded in unpaired computed tomography (CT) images. In this approach, we employ a residual map to characterize the intensity difference between CXR and the corresponding rib-suppressed result. To predict the residual map in CXR domain, we disentangle the image into structure- and contrast-specific features and transfer the rib structural priors from digitally reconstructed radiographs (DRRs) computed by CT. Furthermore, we employ additional adaptive loss to suppress rib residue and preserve more details. We conduct extensive experiments based on 1,673 CT volumes, and four benchmarking CXR datasets, totaling over 120K images, to demonstrate that (i) our proposed RSGAN achieves superior image quality compared to the state-of-the-art rib suppression methods; (ii) combining CXR with our rib-suppressed result leads to better performance in lung disease classification and tuberculosis area detection.