Sebastian Nørgaard Llambias

Sebastian Nørgaard Llambias, Julia Machnio, Asbjørn Munk et al.

Medical image analysis using deep learning frameworks has advanced healthcare by automating complex tasks, but many existing frameworks lack flexibility, modularity, and user-friendliness. To address these challenges, we introduce Yucca, an open-source AI framework available at https://github.com/Sllambias/yucca, designed specifically for medical imaging applications and built on PyTorch and PyTorch Lightning. Yucca features a three-tiered architecture: Functional, Modules, and Pipeline, providing a comprehensive and customizable solution. Evaluated across diverse tasks such as cerebral microbleeds detection, white matter hyperintensity segmentation, and hippocampus segmentation, Yucca achieves state-of-the-art results, demonstrating its robustness and versatility. Yucca offers a powerful, flexible, and user-friendly platform for medical image analysis, inviting community contributions to advance its capabilities and impact.

Asbjørn Munk, Stefano Cerri, Vardan Nersesjan et al.

Clinical deployment of automated brain MRI analysis faces a fundamental challenge: clinical data is heterogeneous and noisy, and high-quality labels are prohibitively costly to obtain. Self-supervised learning (SSL) can address this by leveraging the vast amounts of unlabeled data produced in clinical workflows to train robust \textit{foundation models} that adapt out-of-domain with minimal supervision. However, the development of foundation models for brain MRI has been limited by small pretraining datasets and in-domain benchmarking focused on high-quality, research-grade data. To address this gap, we organized the FOMO25 challenge as a satellite event at MICCAI 2025. FOMO25 provided participants with a large pretraining dataset, FOMO60K, and evaluated models on data sourced directly from clinical workflows in few-shot and out-of-domain settings. Tasks covered infarct classification, meningioma segmentation, and brain age regression, and considered both models trained on FOMO60K (method track) and any data (open track). Nineteen foundation models from sixteen teams were evaluated using a standardized containerized pipeline. Results show that (a) self-supervised pretraining improves generalization on clinical data under domain shift, with the strongest models trained \textit{out-of-domain} surpassing supervised baselines trained \textit{in-domain}. (b) No single pretraining objective benefits all tasks: MAE favors segmentation, hybrid reconstruction-contrastive objectives favor classification, and (c) strong performance was achieved by small pretrained models, and improvements from scaling model size and training duration did not yield reliable benefits.

Sebastian Nørgaard Llambias, Mads Nielsen, Mostafa Mehdipour Ghazi

Deep learning-based models in medical imaging often struggle to generalize effectively to new scans due to data heterogeneity arising from differences in hardware, acquisition parameters, population, and artifacts. This limitation presents a significant challenge in adopting machine learning models for clinical practice. We propose an unsupervised method for robust domain adaptation in brain MRI segmentation by leveraging MRI-specific augmentation techniques. To evaluate the effectiveness of our method, we conduct extensive experiments across diverse datasets, modalities, and segmentation tasks, comparing against the state-of-the-art methods. The results show that our proposed approach achieves high accuracy, exhibits broad applicability, and showcases remarkable robustness against domain shift in various tasks, surpassing the state-of-the-art performance in the majority of cases.

Asbjørn Munk, Stefano Cerri, Jakob Ambsdorf et al.

We present FOMO60K, a large-scale, heterogeneous dataset of 60,529 brain Magnetic Resonance Imaging (MRI) scans from 13,900 sessions and 11,187 subjects, aggregated from 16 publicly available sources. The dataset includes both clinical- and research-grade images, multiple MRI sequences, and a wide range of anatomical and pathological variability, including scans with large brain anomalies. Minimal preprocessing was applied to preserve the original image characteristics while reducing barriers to entry for new users. Accompanying code for self-supervised pretraining and finetuning is provided. FOMO60K is intended to support the development and benchmarking of self-supervised learning methods in medical imaging at scale.

Julia Machnio, Sebastian Nørgaard Llambias, Mads Nielsen et al.

White matter hyperintensities (WMH) are radiological markers of small vessel disease and neurodegeneration, whose accurate segmentation and spatial localization are crucial for diagnosis and monitoring. While multimodal MRI offers complementary contrasts for detecting and contextualizing WM lesions, existing approaches often lack flexibility in handling missing modalities and fail to integrate anatomical localization efficiently. We propose a deep learning framework for WM lesion segmentation and localization that operates directly in native space using single- and multi-modal MRI inputs. Our study evaluates four input configurations: FLAIR-only, T1-only, concatenated FLAIR and T1, and a modality-interchangeable setup. It further introduces a multi-task model for jointly predicting lesion and anatomical region masks to estimate region-wise lesion burden. Experiments conducted on the MICCAI WMH Segmentation Challenge dataset demonstrate that multimodal input significantly improves the segmentation performance, outperforming unimodal models. While the modality-interchangeable setting trades accuracy for robustness, it enables inference in cases with missing modalities. Joint lesion-region segmentation using multi-task learning was less effective than separate models, suggesting representational conflict between tasks. Our findings highlight the utility of multimodal fusion for accurate and robust WMH analysis, and the potential of joint modeling for integrated predictions.