Mohamed Jarraya

Zhe Wang, Aladine Chetouani, Mohamed Jarraya et al.

Knee OsteoArthritis (KOA) is a widespread musculoskeletal disorder that can severely impact the mobility of older individuals. Insufficient medical data presents a significant obstacle for effectively training models due to the high cost associated with data labelling. Currently, deep learning-based models extensively utilize data augmentation techniques to improve their generalization ability and alleviate overfitting. However, conventional data augmentation techniques are primarily based on the original data and fail to introduce substantial diversity to the dataset. In this paper, we propose a novel approach based on the Vision Transformer (ViT) model with original Selective Shuffled Position Embedding (SSPE) and key-patch exchange strategies to obtain different input sequences as a method of data augmentation for early detection of KOA (KL-0 vs KL-2). More specifically, we fix and shuffle the position embedding of key and non-key patches, respectively. Then, for the target image, we randomly select other candidate images from the training set to exchange their key patches and thus obtain different input sequences. Finally, a hybrid loss function is developed by incorporating multiple loss functions for different types of the sequences. According to the experimental results, the generated data are considered valid as they lead to a notable improvement in the model's classification performance.

Zhe Wang, Aladine Chetouani, Yung Hsin Chen et al.

Knee Osteoarthritis (KOA) is a prevalent musculoskeletal disorder that severely impacts mobility and quality of life, particularly among older adults. Its diagnosis often relies on subjective assessments using the Kellgren-Lawrence (KL) grading system, leading to variability in clinical evaluations. To address these challenges, we propose a confidence-driven deep learning framework for early KOA detection, focusing on distinguishing KL-0 and KL-2 stages. The Siamese-based framework integrates a novel multi-level feature extraction architecture with a hybrid loss strategy. Specifically, multi-level Global Average Pooling (GAP) layers are employed to extract features from varying network depths, ensuring comprehensive feature representation, while the hybrid loss strategy partitions training samples into high-, medium-, and low-confidence subsets. Tailored loss functions are applied to improve model robustness and effectively handle uncertainty in annotations. Experimental results on the Osteoarthritis Initiative (OAI) dataset demonstrate that the proposed framework achieves competitive accuracy, sensitivity, and specificity, comparable to those of expert radiologists. Cohen's kappa values (k > 0.85)) confirm substantial agreement, while McNemar's test (p > 0.05) indicates no statistically significant differences between the model and radiologists. Additionally, Confidence distribution analysis reveals that the model emulates radiologists' decision-making patterns. These findings highlight the potential of the proposed approach to serve as an auxiliary diagnostic tool, enhancing early KOA detection and reducing clinical workload.

Zhe Wang, Aladine Chetouani, Rachid Jennane et al.

Knee Osteoarthritis (KOA) is a common musculoskeletal disorder that significantly affects the mobility of older adults. In the medical domain, images containing temporal data are frequently utilized to study temporal dynamics and statistically monitor disease progression. While deep learning-based generative models for natural images have been widely researched, there are comparatively few methods available for synthesizing temporal knee X-rays. In this work, we introduce a novel deep-learning model designed to synthesize intermediate X-ray images between a specific patient's healthy knee and severe KOA stages. During the testing phase, based on a healthy knee X-ray, the proposed model can produce a continuous and effective sequence of KOA X-ray images with varying degrees of severity. Specifically, we introduce a Diffusion-based Morphing Model by modifying the Denoising Diffusion Probabilistic Model. Our approach integrates diffusion and morphing modules, enabling the model to capture spatial morphing details between source and target knee X-ray images and synthesize intermediate frames along a geodesic path. A hybrid loss consisting of diffusion loss, morphing loss, and supervision loss was employed. We demonstrate that our proposed approach achieves the highest temporal frame synthesis performance, effectively augmenting data for classification models and simulating the progression of KOA.

Zhe Wang, Aladine Chetouani, Mohamed Jarraya et al.

Knee Osteoarthritis (KOA) is a common musculoskeletal condition that significantly affects mobility and quality of life, particularly in elderly populations. However, training deep learning models for early KOA classification is often hampered by the limited availability of annotated medical datasets, owing to the high costs and labour-intensive nature of data labelling. Traditional data augmentation techniques, while useful, rely on simple transformations and fail to introduce sufficient diversity into the dataset. To address these challenges, we propose the Key-Exchange Convolutional Auto-Encoder (KECAE) as an innovative Artificial Intelligence (AI)-based data augmentation strategy for early KOA classification. Our model employs a convolutional autoencoder with a novel key-exchange mechanism that generates synthetic images by selectively exchanging key pathological features between X-ray images, which not only diversifies the dataset but also ensures the clinical validity of the augmented data. A hybrid loss function is introduced to supervise feature learning and reconstruction, integrating multiple components, including reconstruction, supervision, and feature separation losses. Experimental results demonstrate that the KECAE-generated data significantly improve the performance of KOA classification models, with accuracy gains of up to 1.98% across various standard and state-of-the-art architectures. Furthermore, a clinical validation study involving expert radiologists confirms the anatomical plausibility and diagnostic realism of the synthetic outputs. These findings highlight the potential of KECAE as a robust tool for augmenting medical datasets in early KOA detection.

Zhe Wang, Yuhua Ru, Aladine Chetouani et al.

Automated grading of Knee Osteoarthritis (KOA) from radiographs is challenged by significant inter-observer variability and the limited robustness of deep learning models, particularly near critical decision boundaries. To address these limitations, this paper proposes a novel framework, Diffusion-based Counterfactual Augmentation (DCA), which enhances model robustness and interpretability by generating targeted counterfactual examples. The method navigates the latent space of a diffusion model using a Stochastic Differential Equation (SDE), governed by balancing a classifier-informed boundary drive with a manifold constraint. The resulting counterfactuals are then used within a self-corrective learning strategy to improve the classifier by focusing on its specific areas of uncertainty. Extensive experiments on the public Osteoarthritis Initiative (OAI) and Multicenter Osteoarthritis Study (MOST) datasets demonstrate that this approach significantly improves classification accuracy across multiple model architectures. Furthermore, the method provides interpretability by visualizing minimal pathological changes and revealing that the learned latent space topology aligns with clinical knowledge of KOA progression. The DCA framework effectively converts model uncertainty into a robust training signal, offering a promising pathway to developing more accurate and trustworthy automated diagnostic systems. Our code is available at https://github.com/ZWang78/DCA.

Zhe Wang, Yuhua Ru, Aladine Chetouani et al.

Magnetic Resonance Imaging (MRI) at lower field strengths (e.g., 3T) suffers from limited spatial resolution, making it challenging to capture fine anatomical details essential for clinical diagnosis and neuroimaging research. To overcome this limitation, we propose MoEDiff-SR, a Mixture of Experts (MoE)-guided diffusion model for region-adaptive MRI Super-Resolution (SR). Unlike conventional diffusion-based SR models that apply a uniform denoising process across the entire image, MoEDiff-SR dynamically selects specialized denoising experts at a fine-grained token level, ensuring region-specific adaptation and enhanced SR performance. Specifically, our approach first employs a Transformer-based feature extractor to compute multi-scale patch embeddings, capturing both global structural information and local texture details. The extracted feature embeddings are then fed into an MoE gating network, which assigns adaptive weights to multiple diffusion-based denoisers, each specializing in different brain MRI characteristics, such as centrum semiovale, sulcal and gyral cortex, and grey-white matter junction. The final output is produced by aggregating the denoised results from these specialized experts according to dynamically assigned gating probabilities. Experimental results demonstrate that MoEDiff-SR outperforms existing state-of-the-art methods in terms of quantitative image quality metrics, perceptual fidelity, and computational efficiency. Difference maps from each expert further highlight their distinct specializations, confirming the effective region-specific denoising capability and the interpretability of expert contributions. Additionally, clinical evaluation validates its superior diagnostic capability in identifying subtle pathological features, emphasizing its practical relevance in clinical neuroimaging. Our code is available at https://github.com/ZWang78/MoEDiff-SR.

Zhe Wang, Yuhua Ru, Fabian Bauer et al.

Magnetic Resonance Imaging (MRI) offers critical insights into microstructural details, however, the spatial resolution of standard 1.5T imaging systems is often limited. In contrast, 7T MRI provides significantly enhanced spatial resolution, enabling finer visualization of anatomical structures. Though this, the high cost and limited availability of 7T MRI hinder its widespread use in clinical settings. To address this challenge, a novel Super-Resolution (SR) model is proposed to generate 7T-like MRI from standard 1.5T MRI scans. Our approach leverages a diffusion-based architecture, incorporating gradient nonlinearity correction and bias field correction data from 7T imaging as guidance. Moreover, to improve deployability, a progressive distillation strategy is introduced. Specifically, the student model refines the 7T SR task with steps, leveraging feature maps from the inference phase of the teacher model as guidance, aiming to allow the student model to achieve progressively 7T SR performance with a smaller, deployable model size. Experimental results demonstrate that our baseline teacher model achieves state-of-the-art SR performance. The student model, while lightweight, sacrifices minimal performance. Furthermore, the student model is capable of accepting MRI inputs at varying resolutions without the need for retraining, significantly further enhancing deployment flexibility. The clinical relevance of our proposed method is validated using clinical data from Massachusetts General Hospital. Our code is available at https://github.com/ZWang78/SR.

Xingxin He, Yifan Hu, Zhaoye Zhou et al.

Vision foundation models have achieved remarkable progress across various image analysis tasks. In the image segmentation task, foundation models like the Segment Anything Model (SAM) enable generalizable zero-shot segmentation through user-provided prompts. However, SAM primarily trained on natural images, lacks the domain-specific expertise of medical imaging. This limitation poses challenges when applying SAM to medical image segmentation, including the need for extensive fine-tuning on specialized medical datasets and a dependency on manual prompts, which are both labor-intensive and require intervention from medical experts. This work introduces the Few-shot Adaptation of Training-frEe SAM (FATE-SAM), a novel method designed to adapt the advanced Segment Anything Model 2 (SAM2) for 3D medical image segmentation. FATE-SAM reassembles pre-trained modules of SAM2 to enable few-shot adaptation, leveraging a small number of support examples to capture anatomical knowledge and perform prompt-free segmentation, without requiring model fine-tuning. To handle the volumetric nature of medical images, we incorporate a Volumetric Consistency mechanism that enhances spatial coherence across 3D slices. We evaluate FATE-SAM on multiple medical imaging datasets and compare it with supervised learning methods, zero-shot SAM approaches, and fine-tuned medical SAM methods. Results show that FATE-SAM delivers robust and accurate segmentation while eliminating the need for large annotated datasets and expert intervention. FATE-SAM provides a practical, efficient solution for medical image segmentation, making it more accessible for clinical applications.