Francesco Galati

Francesco Galati, Daniele Falcetta, Rosa Cortese et al.

We present a semi-supervised domain adaptation framework for brain vessel segmentation from different image modalities. Existing state-of-the-art methods focus on a single modality, despite the wide range of available cerebrovascular imaging techniques. This can lead to significant distribution shifts that negatively impact the generalization across modalities. By relying on annotated angiographies and a limited number of annotated venographies, our framework accomplishes image-to-image translation and semantic segmentation, leveraging a disentangled and semantically rich latent space to represent heterogeneous data and perform image-level adaptation from source to target domains. Moreover, we reduce the typical complexity of cycle-based architectures and minimize the use of adversarial training, which allows us to build an efficient and intuitive model with stable training. We evaluate our method on magnetic resonance angiographies and venographies. While achieving state-of-the-art performance in the source domain, our method attains a Dice score coefficient in the target domain that is only 8.9% lower, highlighting its promising potential for robust cerebrovascular image segmentation across different modalities.

Hava Chaptoukaev, Vincenzo Marcianó, Francesco Galati et al.

Combining multiple modalities carrying complementary information through multimodal learning (MML) has shown considerable benefits for diagnosing multiple pathologies. However, the robustness of multimodal models to missing modalities is often overlooked. Most works assume modality completeness in the input data, while in clinical practice, it is common to have incomplete modalities. Existing solutions that address this issue rely on modality imputation strategies before using supervised learning models. These strategies, however, are complex, computationally costly and can strongly impact subsequent prediction models. Hence, they should be used with parsimony in sensitive applications such as healthcare. We propose HyperMM, an end-to-end framework designed for learning with varying-sized inputs. Specifically, we focus on the task of supervised MML with missing imaging modalities without using imputation before training. We introduce a novel strategy for training a universal feature extractor using a conditional hypernetwork, and propose a permutation-invariant neural network that can handle inputs of varying dimensions to process the extracted features, in a two-phase task-agnostic framework. We experimentally demonstrate the advantages of our method in two tasks: Alzheimer's disease detection and breast cancer classification. We demonstrate that our strategy is robust to high rates of missing data and that its flexibility allows it to handle varying-sized datasets beyond the scenario of missing modalities.

Francesco Galati, Daniele Falcetta, Rosa Cortese et al.

The intricate morphology of brain vessels poses significant challenges for automatic segmentation models, which usually focus on a single imaging modality. However, accurately treating brain-related conditions requires a comprehensive understanding of the cerebrovascular tree, regardless of the specific acquisition procedure. Our framework effectively segments brain arteries and veins in various datasets through image-to-image translation while avoiding domain-specific model design and data harmonization between the source and the target domain. This is accomplished by employing disentanglement techniques to independently manipulate different image properties, allowing them to move from one domain to another in a label-preserving manner. Specifically, we focus on manipulating vessel appearances during adaptation while preserving spatial information, such as shapes and locations, which are crucial for correct segmentation. Our evaluation effectively bridges large and varied domain gaps across medical centers, image modalities, and vessel types. Additionally, we conduct ablation studies on the optimal number of required annotations and other architectural choices. The results highlight our framework's robustness and versatility, demonstrating the potential of domain adaptation methodologies to perform cerebrovascular image segmentation in multiple scenarios accurately. Our code is available at https://github.com/i-vesseg/MultiVesSeg.

Kaiyuan Yang, Fabio Musio, Yihui Ma et al.

The Circle of Willis (CoW) is an important network of arteries connecting major circulations of the brain. Its vascular architecture is believed to affect the risk, severity, and clinical outcome of serious neurovascular diseases. However, characterizing the highly variable CoW anatomy is still a manual and time-consuming expert task. The CoW is usually imaged by two non-invasive angiographic imaging modalities, magnetic resonance angiography (MRA) and computed tomography angiography (CTA), but there exist limited datasets with annotations on CoW anatomy, especially for CTA. Therefore, we organized the TopCoW challenge with the release of an annotated CoW dataset. The TopCoW dataset is the first public dataset with voxel-level annotations for 13 CoW vessel components, enabled by virtual reality technology. It is also the first large dataset using 200 pairs of MRA and CTA from the same patients. As part of the benchmark, we invited submissions worldwide and attracted over 250 registered participants from six continents. The submissions were evaluated on both internal and external test datasets of 226 scans from over five centers. The top performing teams achieved over 90% Dice scores at segmenting the CoW components, over 80% F1 scores at detecting key CoW components, and over 70% balanced accuracy at classifying CoW variants for nearly all test sets. The best algorithms also showed clinical potential in classifying fetal-type posterior cerebral artery and locating aneurysms with CoW anatomy. TopCoW demonstrated the utility and versatility of CoW segmentation algorithms for a wide range of downstream clinical applications with explainability. The annotated datasets and best performing algorithms have been released as public Zenodo records to foster further methodological development and clinical tool building.

Francesco Galati, Maria A. Zuluaga

Deep learning methods have reached state-of-the-art performance in cardiac image segmentation. Currently, the main bottleneck towards their effective translation into clinics requires assuring continuous high model performance and segmentation results. In this work, we present a novel learning framework to monitor the performance of heart segmentation models in the absence of ground truth. Formulated as an anomaly detection problem, the monitoring framework allows deriving surrogate quality measures for a segmentation and allows flagging suspicious results. We propose two different types of quality measures, a global score and a pixel-wise map. We demonstrate their use by reproducing the final rankings of a cardiac segmentation challenge in the absence of ground truth. Results show that our framework is accurate, fast, and scalable, confirming it is a viable option for quality control monitoring in clinical practice and large population studies.