Yvonne W. Lui

Radhika Tibrewala, Tarun Dutt, Angela Tong et al.

The fastMRI brain and knee dataset has enabled significant advances in exploring reconstruction methods for improving speed and image quality for Magnetic Resonance Imaging (MRI) via novel, clinically relevant reconstruction approaches. In this study, we describe the April 2023 expansion of the fastMRI dataset to include biparametric prostate MRI data acquired on a clinical population. The dataset consists of raw k-space and reconstructed images for T2-weighted and diffusion-weighted sequences along with slice-level labels that indicate the presence and grade of prostate cancer. As has been the case with fastMRI, increasing accessibility to raw prostate MRI data will further facilitate research in MR image reconstruction and evaluation with the larger goal of improving the utility of MRI for prostate cancer detection and evaluation. The dataset is available at https://fastmri.med.nyu.edu.

Aakash Kaku, Chaitra V. Hegde, Jeffrey Huang et al.

Quantitative, volumetric analysis of Magnetic Resonance Imaging (MRI) is a fundamental way researchers study the brain in a host of neurological conditions including normal maturation and aging. Despite the availability of open-source brain segmentation software, widespread clinical adoption of volumetric analysis has been hindered due to processing times and reliance on manual corrections. Here, we extend the use of deep learning models from proof-of-concept, as previously reported, to present a comprehensive segmentation of cortical and deep gray matter brain structures matching the standard regions of aseg+aparc included in the commonly used open-source tool, Freesurfer. The work presented here provides a real-life, rapid deep learning-based brain segmentation tool to enable clinical translation as well as research application of quantitative brain segmentation. The advantages of the presented tool include short (~1 minute) processing time and improved segmentation quality. This is the first study to perform quick and accurate segmentation of 102 brain regions based on the surface-based protocol (DMK protocol), widely used by experts in the field. This is also the first work to include an expert reader study to assess the quality of the segmentation obtained using a deep-learning-based model. We show the superior performance of our deep-learning-based models over the traditional segmentation tool, Freesurfer. We refer to the proposed deep learning-based tool as DARTS (DenseUnet-based Automatic Rapid Tool for brain Segmentation). Our tool and trained models are available at https://github.com/NYUMedML/DARTS

Ilias I. Giannakopoulos, Lokesh B Gautham Muthukumar, Yvonne W. Lui et al.

Parallel imaging techniques reduce magnetic resonance imaging (MRI) scan time but image quality degrades as the acceleration factor increases. In clinical practice, conservative acceleration factors are chosen because no mechanism exists to automatically assess the diagnostic quality of undersampled reconstructions. This work introduces a general framework for pixel-wise uncertainty quantification in parallel MRI reconstructions, enabling automatic identification of unreliable regions without access to any ground-truth reference image. Our method integrates conformal quantile regression with image reconstruction methods to estimate statistically rigorous pixel-wise uncertainty intervals. We trained and evaluated our model on Cartesian undersampled brain and knee data obtained from the fastMRI dataset using acceleration factors ranging from 2 to 10. An end-to-end Variational Network was used for image reconstruction. Quantitative experiments demonstrate strong agreement between predicted uncertainty maps and true reconstruction error. Using our method, the corresponding Pearson correlation coefficient was higher than 90% at acceleration levels at and above four-fold; whereas it dropped to less than 70% when the uncertainty was computed using a simpler a heuristic notion (magnitude of the residual). Qualitative examples further show the uncertainty maps based on quantile regression capture the magnitude and spatial distribution of reconstruction errors across acceleration factors, with regions of elevated uncertainty aligning with pathologies and artifacts. The proposed framework enables evaluation of reconstruction quality without access to fully-sampled ground-truth reference images. It represents a step toward adaptive MRI acquisition protocols that may be able to dynamically balance scan time and diagnostic reliability.

Eddy Solomon, Patricia M. Johnson, Zhengguo Tan et al.

This data curation work introduces the first large-scale dataset of radial k-space and DICOM data for breast DCE-MRI acquired in diagnostic breast MRI exams. Our dataset includes case-level labels indicating patient age, menopause status, lesion status (negative, benign, and malignant), and lesion type for each case. The public availability of this dataset and accompanying reconstruction code will support research and development of fast and quantitative breast image reconstruction and machine learning methods.

Ruiyang Zhao, Burhaneddin Yaman, Yuxin Zhang et al.

Improving speed and image quality of Magnetic Resonance Imaging (MRI) via novel reconstruction approaches remains one of the highest impact applications for deep learning in medical imaging. The fastMRI dataset, unique in that it contains large volumes of raw MRI data, has enabled significant advances in accelerating MRI using deep learning-based reconstruction methods. While the impact of the fastMRI dataset on the field of medical imaging is unquestioned, the dataset currently lacks clinical expert pathology annotations, critical to addressing clinically relevant reconstruction frameworks and exploring important questions regarding rendering of specific pathology using such novel approaches. This work introduces fastMRI+, which consists of 16154 subspecialist expert bounding box annotations and 13 study-level labels for 22 different pathology categories on the fastMRI knee dataset, and 7570 subspecialist expert bounding box annotations and 643 study-level labels for 30 different pathology categories for the fastMRI brain dataset. The fastMRI+ dataset is open access and aims to support further research and advancement of medical imaging in MRI reconstruction and beyond.

Matthew J. Muckley, Bruno Riemenschneider, Alireza Radmanesh et al.

Accelerating MRI scans is one of the principal outstanding problems in the MRI research community. Towards this goal, we hosted the second fastMRI competition targeted towards reconstructing MR images with subsampled k-space data. We provided participants with data from 7,299 clinical brain scans (de-identified via a HIPAA-compliant procedure by NYU Langone Health), holding back the fully-sampled data from 894 of these scans for challenge evaluation purposes. In contrast to the 2019 challenge, we focused our radiologist evaluations on pathological assessment in brain images. We also debuted a new Transfer track that required participants to submit models evaluated on MRI scanners from outside the training set. We received 19 submissions from eight different groups. Results showed one team scoring best in both SSIM scores and qualitative radiologist evaluations. We also performed analysis on alternative metrics to mitigate the effects of background noise and collected feedback from the participants to inform future challenges. Lastly, we identify common failure modes across the submissions, highlighting areas of need for future research in the MRI reconstruction community.

Oded Nov, Yindalon Aphinyanaphongs, Yvonne W. Lui et al.

One of the dramatic trends at the intersection of computing and healthcare has been patients' increased access to medical information, ranging from self-tracked physiological data to genetic data, tests, and scans. Increasingly however, patients and clinicians have access to advanced machine learning-based tools for diagnosis, prediction, and recommendation based on large amounts of data, some of it patient-generated. Consequently, just as organizations have had to deal with a "Bring Your Own Device" (BYOD) reality in which employees use their personal devices (phones and tablets) for some aspects of their work, a similar reality of "Bring Your Own Algorithm" (BYOA) is emerging in healthcare with its own challenges and support demands. BYOA is changing patient-clinician interactions and the technologies, skills and workflows related to them. In this paper we argue that: (1) BYOA is changing the patient-clinician relationship and the nature of expert work in healthcare, and (2) better patient-clinician-information-interpretation relationships can be facilitated with solutions that integrate technological and organizational perspectives.

Farah E. Shamout, Yiqiu Shen, Nan Wu et al.

During the coronavirus disease 2019 (COVID-19) pandemic, rapid and accurate triage of patients at the emergency department is critical to inform decision-making. We propose a data-driven approach for automatic prediction of deterioration risk using a deep neural network that learns from chest X-ray images and a gradient boosting model that learns from routine clinical variables. Our AI prognosis system, trained using data from 3,661 patients, achieves an area under the receiver operating characteristic curve (AUC) of 0.786 (95% CI: 0.745-0.830) when predicting deterioration within 96 hours. The deep neural network extracts informative areas of chest X-ray images to assist clinicians in interpreting the predictions and performs comparably to two radiologists in a reader study. In order to verify performance in a real clinical setting, we silently deployed a preliminary version of the deep neural network at New York University Langone Health during the first wave of the pandemic, which produced accurate predictions in real-time. In summary, our findings demonstrate the potential of the proposed system for assisting front-line physicians in the triage of COVID-19 patients.

Tongda Xu, Xiyan Cai, Yao Wang et al.

Mild Traumatic Brain Injury (mTBI) is a significant public health problem. The most troubling symptoms after mTBI are cognitive complaints. Studies show measurable differences between patients with mTBI and healthy controls with respect to tissue microstructure using diffusion MRI. However, it remains unclear which diffusion measures are the most informative with regard to cognitive functions in both the healthy state as well as after injury. In this study, we use diffusion MRI to formulate a predictive model for performance on working memory based on the most relevant MRI features. The key challenge is to identify relevant features over a large feature space with high accuracy in an efficient manner. To tackle this challenge, we propose a novel improvement of the best first search approach with crossover operators inspired by genetic algorithm. Compared against other heuristic feature selection algorithms, the proposed method achieves significantly more accurate predictions and yields clinically interpretable selected features.

Jure Zbontar, Florian Knoll, Anuroop Sriram et al.

Accelerating Magnetic Resonance Imaging (MRI) by taking fewer measurements has the potential to reduce medical costs, minimize stress to patients and make MRI possible in applications where it is currently prohibitively slow or expensive. We introduce the fastMRI dataset, a large-scale collection of both raw MR measurements and clinical MR images, that can be used for training and evaluation of machine-learning approaches to MR image reconstruction. By introducing standardized evaluation criteria and a freely-accessible dataset, our goal is to help the community make rapid advances in the state of the art for MR image reconstruction. We also provide a self-contained introduction to MRI for machine learning researchers with no medical imaging background.

Shervin Minaee, Yao Wang, Alp Aygar et al.

In this work, we propose bag of adversarial features (BAF) for identifying mild traumatic brain injury (MTBI) patients from their diffusion magnetic resonance images (MRI) (obtained within one month of injury) by incorporating unsupervised feature learning techniques. MTBI is a growing public health problem with an estimated incidence of over 1.7 million people annually in US. Diagnosis is based on clinical history and symptoms, and accurate, concrete measures of injury are lacking. Unlike most of previous works, which use hand-crafted features extracted from different parts of brain for MTBI classification, we employ feature learning algorithms to learn more discriminative representation for this task. A major challenge in this field thus far is the relatively small number of subjects available for training. This makes it difficult to use an end-to-end convolutional neural network to directly classify a subject from MR images. To overcome this challenge, we first apply an adversarial auto-encoder (with convolutional structure) to learn patch-level features, from overlapping image patches extracted from different brain regions. We then aggregate these features through a bag-of-word approach. We perform an extensive experimental study on a dataset of 227 subjects (including 109 MTBI patients, and 118 age and sex matched healthy controls), and compare the bag-of-deep-features with several previous approaches. Our experimental results show that the BAF significantly outperforms earlier works relying on the mean values of MR metrics in selected brain regions.

Shervin Minaee, Yao Wang, Anna Choromanska et al.

Mild traumatic brain injury is a growing public health problem with an estimated incidence of over 1.7 million people annually in US. Diagnosis is based on clinical history and symptoms, and accurate, concrete measures of injury are lacking. This work aims to directly use diffusion MR images obtained within one month of trauma to detect injury, by incorporating deep learning techniques. To overcome the challenge due to limited training data, we describe each brain region using the bag of word representation, which specifies the distribution of representative patch patterns. We apply a convolutional auto-encoder to learn the patch-level features, from overlapping image patches extracted from the MR images, to learn features from diffusion MR images of brain using an unsupervised approach. Our experimental results show that the bag of word representation using patch level features learnt by the auto encoder provides similar performance as that using the raw patch patterns, both significantly outperform earlier work relying on the mean values of MR metrics in selected brain regions.

Shervin Minaee, Siyun Wang, Yao Wang et al.

Mild traumatic brain injury (mTBI) is a growing public health problem with an estimated incidence of one million people annually in US. Neurocognitive tests are used to both assess the patient condition and to monitor the patient progress. This work aims to directly use MR images taken shortly after injury to detect whether a patient suffers from mTBI, by incorporating machine learning and computer vision techniques to learn features suitable discriminating between mTBI and normal patients. We focus on 3 regions in brain, and extract multiple patches from them, and use bag-of-visual-word technique to represent each subject as a histogram of representative patterns derived from patches from all training subjects. After extracting the features, we use greedy forward feature selection, to choose a subset of features which achieves highest accuracy. We show through experimental studies that BoW features perform better than the simple mean value features which were used previously.

Shervin Minaee, Yao Wang, Sohae Chung et al.

While diffusion MRI has been extremely promising in the study of MTBI, identifying patients with recent MTBI remains a challenge. The literature is mixed with regard to localizing injury in these patients, however, gray matter such as the thalamus and white matter including the corpus callosum and frontal deep white matter have been repeatedly implicated as areas at high risk for injury. The purpose of this study is to develop a machine learning framework to classify MTBI patients and controls using features derived from multi-shell diffusion MRI in the thalamus, frontal white matter and corpus callosum.