Anna Reithmeir

Anna Reithmeir, Lina Felsner, Rickmer Braren et al.

Physics-inspired regularization is desired for intra-patient image registration since it can effectively capture the biomechanical characteristics of anatomical structures. However, a major challenge lies in the reliance on physical parameters: Parameter estimations vary widely across the literature, and the physical properties themselves are inherently subject-specific. In this work, we introduce a novel data-driven method that leverages hypernetworks to learn the tissue-dependent elasticity parameters of an elastic regularizer. Notably, our approach facilitates the estimation of patient-specific parameters without the need to retrain the network. We evaluate our method on three publicly available 2D and 3D lung CT and cardiac MR datasets. We find that with our proposed subject-specific tissue-dependent regularization, a higher registration quality is achieved across all datasets compared to using a global regularizer. The code is available at https://github.com/compai-lab/2024-miccai-reithmeir.

Fryderyk Kögl, Anna Reithmeir, Vasiliki Sideri-Lampretsa et al.

General vision encoders like DINOv2 and SAM have recently transformed computer vision. Even though they are trained on natural images, such encoder models have excelled in medical imaging, e.g., in classification, segmentation, and registration. However, no in-depth comparison of different state-of-the-art general vision encoders for medical registration is available. In this work, we investigate how well general vision encoder features can be used in the dissimilarity metrics for medical image registration. We explore two encoders that were trained on natural images as well as one that was fine-tuned on medical data. We apply the features within the well-established B-spline FFD registration framework. In extensive experiments on cardiac cine MRI data, we find that using features as additional guidance for conventional metrics improves the registration quality. The code is available at github.com/compai-lab/2024-miccai-koegl.

Inês P. Machado, Anna Reithmeir, Fryderyk Kogl et al.

High-grade serous ovarian carcinoma (HGSOC) is characterised by significant spatial and temporal heterogeneity, typically manifesting at an advanced metastatic stage. A major challenge in treating advanced HGSOC is effectively monitoring localised change in tumour burden across multiple sites during neoadjuvant chemotherapy (NACT) and predicting long-term pathological response and overall patient survival. In this work, we propose a self-supervised deformable image registration algorithm that utilises a general-purpose image encoder for image feature extraction to co-register contrast-enhanced computerised tomography scan images acquired before and after neoadjuvant chemotherapy. This approach addresses challenges posed by highly complex tumour deformations and longitudinal lesion matching during treatment. Localised tumour changes are calculated using the Jacobian determinant maps of the registration deformation at multiple disease sites and their macroscopic areas, including hypo-dense (i.e., cystic/necrotic), hyper-dense (i.e., calcified), and intermediate density (i.e., soft tissue) portions. A series of experiments is conducted to understand the role of a general-purpose image encoder and its application in quantifying change in tumour burden during neoadjuvant chemotherapy in HGSOC. This work is the first to demonstrate the feasibility of a self-supervised image registration approach in quantifying NACT-induced localised tumour changes across the whole disease burden of patients with complex multi-site HGSOC, which could be used as a potential marker for ovarian cancer patient's long-term pathological response and survival.

Anna Reithmeir, Julia A. Schnabel, Veronika A. Zimmer

Medical image registration aims at identifying the spatial deformation between images of the same anatomical region and is fundamental to image-based diagnostics and therapy. To date, the majority of the deep learning-based registration methods employ regularizers that enforce global spatial smoothness, e.g., the diffusion regularizer. However, such regularizers are not tailored to the data and might not be capable of reflecting the complex underlying deformation. In contrast, physics-inspired regularizers promote physically plausible deformations. One such regularizer is the linear elastic regularizer which models the deformation of elastic material. These regularizers are driven by parameters that define the material's physical properties. For biological tissue, a wide range of estimations of such parameters can be found in the literature and it remains an open challenge to identify suitable parameter values for successful registration. To overcome this problem and to incorporate physical properties into learning-based registration, we propose to use a hypernetwork that learns the effect of the physical parameters of a physics-inspired regularizer on the resulting spatial deformation field. In particular, we adapt the HyperMorph framework to learn the effect of the two elasticity parameters of the linear elastic regularizer. Our approach enables the efficient discovery of suitable, data-specific physical parameters at test time.

Xingyu Zhang, Anna Reithmeir, Fryderyk Kögl et al.

Accurate spatial correspondence between medical images is essential for longitudinal analysis, lesion tracking, and image-guided interventions. Medical image registration methods rely on local intensity-based similarity measures, which fail to capture global semantic structure and often yield mismatches in low-contrast or anatomically variable regions. Recent advances in diffusion models suggest that their intermediate representations encode rich geometric and semantic information. We present MedDIFT, a training-free 3D correspondence framework that leverages multi-scale features from a pretrained latent medical diffusion model as voxel descriptors. MedDIFT fuses diffusion activations into rich voxel-wise descriptors and matches them via cosine similarity, with an optional local-search prior. On a publicly available lung CT dataset, MedDIFT shows promising capability in identifying anatomical correspondence without requiring any task-specific model training. Ablation experiments confirm that multi-level feature fusion and modest diffusion noise improve performance. Code is available online.

Josef Mayr, Anna Reithmeir, Maxime Di Folco et al.

Covariance descriptors capture second-order statistics of image features. They have shown strong performance in general computer vision tasks, but remain underexplored in medical imaging. We investigate their effectiveness for both conventional and learning-based medical image classification, with a particular focus on SPDNet, a classification network specifically designed for symmetric positive definite (SPD) matrices. We propose constructing covariance descriptors from features extracted by pre-trained general vision encoders (GVEs) and comparing them with handcrafted descriptors. Two GVEs - DINOv2 and MedSAM - are evaluated across eleven binary and multi-class datasets from the MedMNSIT benchmark. Our results show that covariance descriptors derived from GVE features consistently outperform those derived from handcrafted features. Moreover, SPDNet yields superior performance to state-of-the-art methods when combined with DINOv2 features. Our findings highlight the potential of combining covariance descriptors with powerful pretrained vision encoders for medical image analysis.

Anna Reithmeir, Veronika Spieker, Vasiliki Sideri-Lampretsa et al.

Image registration is fundamental in medical imaging applications, such as disease progression analysis or radiation therapy planning. The primary objective of image registration is to precisely capture the deformation between two or more images, typically achieved by minimizing an optimization problem. Due to its inherent ill-posedness, regularization is a key component in driving the solution toward anatomically meaningful deformations. A wide range of regularization methods has been proposed for both conventional and deep learning-based registration. However, the appropriate application of regularization techniques often depends on the specific registration problem, and no one-fits-all method exists. Despite its importance, regularization is often overlooked or addressed with default approaches, assuming existing methods are sufficient. A comprehensive and structured review remains missing. This review addresses this gap by introducing a novel taxonomy that systematically categorizes the diverse range of proposed regularization methods. It highlights the emerging field of learned regularization, which leverages data-driven techniques to automatically derive deformation properties from the data. Moreover, this review examines the transfer of regularization methods from conventional to learning-based registration, identifies open challenges, and outlines future research directions. By emphasizing the critical role of regularization in image registration, we hope to inspire the research community to reconsider regularization strategies in modern registration algorithms and to explore this rapidly evolving field further.