Gabriel Bernardino

Gabriel Bernardino, Anders Jonsson, Patrick Clarysse et al.

Determining the most appropriate features for machine learning predictive models is challenging regarding performance and feature acquisition costs. In particular, global feature choice is limited given that some features will only benefit a subset of instances. In previous work, we proposed a reinforcement learning approach to sequentially recommend which modality to acquire next to reach the best information/cost ratio, based on the instance-specific information already acquired. We formulated the problem as a Markov Decision Process where the state's dimensionality changes during the episode, avoiding data imputation, contrary to existing works. However, this only allowed processing a small number of features, as all possible combinations of features were considered. Here, we address these limitations with two contributions: 1) we expand our framework to larger datasets with a heuristic-based strategy that focuses on the most promising feature combinations, and 2) we introduce a post-fit regularisation strategy that reduces the number of different feature combinations, leading to compact sequences of decisions. We tested our method on four binary classification datasets (one involving high-dimensional variables), the largest of which had 56 features and 4500 samples. We obtained better performance than state-of-the-art methods, both in terms of accuracy and policy complexity.

Maxime Di Folco, Gabriel Bernardino, Patrick Clarysse et al.

Confidence in the results is a key ingredient to improve the adoption of machine learning methods by clinicians. Uncertainties on the results have been considered in the literature, but mostly those originating from the learning and processing methods. Uncertainty on the data is hardly challenged, as a single sample is often considered representative enough of each subject included in the analysis. In this paper, we propose a representation learning strategy to estimate local uncertainties on a physiological descriptor (here, myocardial deformation) previously obtained from medical images by different definitions or computations. We first use manifold alignment to match the latent representations associated to different high-dimensional input descriptors. Then, we formulate plausible distributions of latent uncertainties, and finally exploit them to reconstruct uncertainties on the input high-dimensional descriptors. We demonstrate its relevance for the quantification of myocardial deformation (strain) from 3D echocardiographic image sequences of the right ventricle, for which a lack of consensus exists in its definition and which directional component to use. We used a database of 100 control subjects with right ventricle overload, for which different types of strain are available at each point of the right ventricle endocardial surface mesh. Our approach quantifies local uncertainties on myocardial deformation from different descriptors defining this physiological concept. Such uncertainties cannot be directly estimated by local statistics on such descriptors, potentially of heterogeneous types. Beyond this controlled illustrative application, our methodology has the potential to be generalized to many other population analyses considering heterogeneous high-dimensional descriptors.

César Díaz-Parga, Marta Nuñez-Garcia, Maria J. Carreira et al.

Being born small carries significant health risks, including increased neonatal mortality and a higher likelihood of future cardiac diseases. Accurate estimation of gestational age is critical for monitoring fetal growth, but traditional methods, such as estimation based on the last menstrual period, are in some situations difficult to obtain. While ultrasound-based approaches offer greater reliability, they rely on manual measurements that introduce variability. This study presents an interpretable deep learning-based method for automated gestational age calculation, leveraging a novel segmentation architecture and distance maps to overcome dataset limitations and the scarcity of segmentation masks. Our approach achieves performance comparable to state-of-the-art models while reducing complexity, making it particularly suitable for resource-constrained settings and with limited annotated data. Furthermore, our results demonstrate that the use of distance maps is particularly suitable for estimating femur endpoints.

Gabriel Bernardino, Oualid Benkarim, María Sanz-de la Garza et al.

Statistical shape analysis is a powerful tool to assess organ morphologies and find shape changes associated to a particular disease. However, imbalance in confounding factors, such as demographics might invalidate the analysis if not taken into consideration. Despite the methodological advances in the field, providing new methods that are able to capture complex and regional shape differences, the relationship between non-imaging information and shape variability has been overlooked. We present a linear statistical shape analysis framework that finds shape differences unassociated to a controlled set of confounding variables. It includes two confounding correction methods: confounding deflation and adjustment. We applied our framework to a cardiac magnetic resonance imaging dataset, consisting of the cardiac ventricles of 89 triathletes and 77 controls, to identify cardiac remodelling due to the practice of endurance exercise. To test robustness to confounders, subsets of this dataset were generated by randomly removing controls with low body mass index, thus introducing imbalance. The analysis of the whole dataset indicates an increase of ventricular volumes and myocardial mass in athletes, which is consistent with the clinical literature. However, when confounders are not taken into consideration no increase of myocardial mass is found. Using the downsampled datasets, we find that confounder adjustment methods are needed to find the real remodelling patterns in imbalanced datasets.

Gabriel Bernardino, Amir Hodzic, Helene Langet et al.

3D echocardiography is an increasingly popular tool for assessing cardiac remodelling in the right ventricle (RV). It allows quantification of the cardiac chambers without any geometric assumptions, which is the main weakness of 2D echocardiography. However, regional quantification of geometry and function is limited by the lower spatial and temporal resolution and the scarcity of identifiable anatomical landmarks. We developed a technique for regionally assessing the 3 relevant RV regions: apical, inlet and outflow. The method's inputs are end-diastolic (ED) and end-systolic (ES) segmented 3D surface models. The method first defines a partition of the ED endocardium using the geodesic distances from each surface point to apex, tricuspid valve and pulmonary valve: the landmarks that define the 3 regions. The ED surface mesh is then tetrahedralised, and the endocardial-defined partition is interpolated in the blood cavity via the Laplace equation. For obtaining an ES partition, the endocardial partition is transported from ED to ES using a commercial image-based tracking, and then interpolated towards the endocardium, similarly to ED, for computing volumes and ejection fraction (EF). We present a full assessment of the method's validity and reproducibility. First, we assess reproducibility under segmentation variability, obtaining intra- and inter- observer errors (4-10% and 10-23% resp.). Finally, we use a synthetic remodelling dataset to identify the situations in which our method is able to correctly determine the region that has remodelled. This dataset is generated by a novel mesh reconstruction method that deforms a reference mesh, locally imposing a given strain, expressed in anatomical coordinates. We show that the parcellation method is adequate for capturing local circumferential and global circumferential and longitudinal RV remodelling.