Boris Mansencal

Reda Abdellah Kamraoui, Boris Mansencal, José V Manjon et al.

The detection of new multiple sclerosis (MS) lesions is an important marker of the evolution of the disease. The applicability of learning-based methods could automate this task efficiently. However, the lack of annotated longitudinal data with new-appearing lesions is a limiting factor for the training of robust and generalizing models. In this work, we describe a deep-learning-based pipeline addressing the challenging task of detecting and segmenting new MS lesions. First, we propose to use transfer-learning from a model trained on a segmentation task using single time-points. Therefore, we exploit knowledge from an easier task and for which more annotated datasets are available. Second, we propose a data synthesis strategy to generate realistic longitudinal time-points with new lesions using single time-point scans. In this way, we pretrain our detection model on large synthetic annotated datasets. Finally, we use a data-augmentation technique designed to simulate data diversity in MRI. By doing that, we increase the size of the available small annotated longitudinal datasets. Our ablation study showed that each contribution lead to an enhancement of the segmentation accuracy. Using the proposed pipeline, we obtained the best score for the segmentation and the detection of new MS lesions in the MSSEG2 MICCAI challenge.

Huy-Dung Nguyen, Michaël Clément, Boris Mansencal et al.

Accurate diagnosis and prognosis of Alzheimer's disease are crucial to develop new therapies and reduce the associated costs. Recently, with the advances of convolutional neural networks, methods have been proposed to automate these two tasks using structural MRI. However, these methods often suffer from lack of interpretability, generalization, and can be limited in terms of performance. In this paper, we propose a novel deep framework designed to overcome these limitations. Our framework consists of two stages. In the first stage, we propose a deep grading model to extract meaningful features. To enhance the robustness of these features against domain shift, we introduce an innovative collective artificial intelligence strategy for training and evaluating steps. In the second stage, we use a graph convolutional neural network to better capture AD signatures. Our experiments based on 2074 subjects show the competitive performance of our deep framework compared to state-of-the-art methods on different datasets for both AD diagnosis and prognosis.

Huy-Dung Nguyen, Michaël Clément, Vincent Planche et al.

Alzheimer's disease and Frontotemporal dementia are common forms of neurodegenerative dementia. Behavioral alterations and cognitive impairments are found in the clinical courses of both diseases and their differential diagnosis is sometimes difficult for physicians. Therefore, an accurate tool dedicated to this diagnostic challenge can be valuable in clinical practice. However, current structural imaging methods mainly focus on the detection of each disease but rarely on their differential diagnosis. In this paper, we propose a deep learning based approach for both problems of disease detection and differential diagnosis. We suggest utilizing two types of biomarkers for this application: structure grading and structure atrophy. First, we propose to train a large ensemble of 3D U-Nets to locally determine the anatomical patterns of healthy people, patients with Alzheimer's disease and patients with Frontotemporal dementia using structural MRI as input. The output of the ensemble is a 2-channel disease's coordinate map able to be transformed into a 3D grading map which is easy to interpret for clinicians. This 2-channel map is coupled with a multi-layer perceptron classifier for different classification tasks. Second, we propose to combine our deep learning framework with a traditional machine learning strategy based on volume to improve the model discriminative capacity and robustness. After both cross-validation and external validation, our experiments based on 3319 MRI demonstrated competitive results of our method compared to the state-of-the-art methods for both disease detection and differential diagnosis.

Huy-Dung Nguyen, Michaël Clément, Boris Mansencal et al.

Age is an important variable to describe the expected brain's anatomy status across the normal aging trajectory. The deviation from that normative aging trajectory may provide some insights into neurological diseases. In neuroimaging, predicted brain age is widely used to analyze different diseases. However, using only the brain age gap information (\ie the difference between the chronological age and the estimated age) can be not enough informative for disease classification problems. In this paper, we propose to extend the notion of global brain age by estimating brain structure ages using structural magnetic resonance imaging. To this end, an ensemble of deep learning models is first used to estimate a 3D aging map (\ie voxel-wise age estimation). Then, a 3D segmentation mask is used to obtain the final brain structure ages. This biomarker can be used in several situations. First, it enables to accurately estimate the brain age for the purpose of anomaly detection at the population level. In this situation, our approach outperforms several state-of-the-art methods. Second, brain structure ages can be used to compute the deviation from the normal aging process of each brain structure. This feature can be used in a multi-disease classification task for an accurate differential diagnosis at the subject level. Finally, the brain structure age deviations of individuals can be visualized, providing some insights about brain abnormality and helping clinicians in real medical contexts.

Sergio Morell-Ortega, Ángela González-Cebrián, Boris Mansencal et al.

Large-scale automated morphometric analysis of brain MRI is limited by the thick-slice, anisotropic acquisitions prevalent in routine clinical practice. Existing generative super-resolution (SR) methods produce visually compelling isotropic volumes but often introduce anatomical hallucinations, systematic volumetric overestimation, and structural distortions that compromise downstream quantitative analysis and diagnostic safety. To address this, we propose CAHAL (Clinically Applicable resolution enHAncement for Low-resolution MRI scans), a hallucination-robust, physics-informed resolution enhancement framework that operates directly in the patient's native acquisition space. CAHAL employs a deterministic bivariate Mixture of Experts (MoE) architecture routing each input through specialised residual 3D U-Net experts conditioned on both volumetric resolution and acquisition anisotropy, two independent descriptors of clinical MRI acquisition. Experts are optimised with a composite loss combining edge-penalised spatial reconstruction, Fourier-domain spectral coherence matching, and a segmentation-guided semantic consistency constraint. Training pairs are generated on-the-fly via physics-based degradation sampled from a large-scale real-world database, ensuring robust generalisation. Validated on T1-weighted and FLAIR sequences against generative baselines, CAHAL achieves state-of-the-art results, improving the best related methods in terms of accuracy and efficiency.

Pierre-Etienne Martin, Jordan Calandre, Boris Mansencal et al.

Sports video analysis is a widespread research topic. Its applications are very diverse, like events detection during a match, video summary, or fine-grained movement analysis of athletes. As part of the MediaEval 2022 benchmarking initiative, this task aims at detecting and classifying subtle movements from sport videos. We focus on recordings of table tennis matches. Conducted since 2019, this task provides a classification challenge from untrimmed videos recorded under natural conditions with known temporal boundaries for each stroke. Since 2021, the task also provides a stroke detection challenge from unannotated, untrimmed videos. This year, the training, validation, and test sets are enhanced to ensure that all strokes are represented in each dataset. The dataset is now similar to the one used in [1, 2]. This research is intended to build tools for coaches and athletes who want to further evaluate their sport performances.

Huy-Dung Nguyen, Michaël Clément, Boris Mansencal et al.

Alzheimer's Disease is the most common cause of dementia. Accurate diagnosis and prognosis of this disease are essential to design an appropriate treatment plan, increasing the life expectancy of the patient. Intense research has been conducted on the use of machine learning to identify Alzheimer's Disease from neuroimaging data, such as structural magnetic resonance imaging. In recent years, advances of deep learning in computer vision suggest a new research direction for this problem. Current deep learning-based approaches in this field, however, have a number of drawbacks, including the interpretability of model decisions, a lack of generalizability information and a lower performance compared to traditional machine learning techniques. In this paper, we design a two-stage framework to overcome these limitations. In the first stage, an ensemble of 125 U-Nets is used to grade the input image, producing a 3D map that reflects the disease severity at voxel-level. This map can help to localize abnormal brain areas caused by the disease. In the second stage, we model a graph per individual using the generated grading map and other information about the subject. We propose to use a graph convolutional neural network classifier for the final classification. As a result, our framework demonstrates comparative performance to the state-of-the-art methods in different datasets for both diagnosis and prognosis. We also demonstrate that the use of a large ensemble of U-Nets offers a better generalization capacity for our framework.

Huy-Dung Nguyen, Michaël Clément, Boris Mansencal et al.

Alzheimer's disease and Frontotemporal dementia are two major types of dementia. Their accurate diagnosis and differentiation is crucial for determining specific intervention and treatment. However, differential diagnosis of these two types of dementia remains difficult at the early stage of disease due to similar patterns of clinical symptoms. Therefore, the automatic classification of multiple types of dementia has an important clinical value. So far, this challenge has not been actively explored. Recent development of deep learning in the field of medical image has demonstrated high performance for various classification tasks. In this paper, we propose to take advantage of two types of biomarkers: structure grading and structure atrophy. To this end, we propose first to train a large ensemble of 3D U-Nets to locally discriminate healthy versus dementia anatomical patterns. The result of these models is an interpretable 3D grading map capable of indicating abnormal brain regions. This map can also be exploited in various classification tasks using graph convolutional neural network. Finally, we propose to combine deep grading and atrophy-based classifications to improve dementia type discrimination. The proposed framework showed competitive performance compared to state-of-the-art methods for different tasks of disease detection and differential diagnosis.

Huy-Dung Nguyen, Michaël Clément, Boris Mansencal et al.

Alzheimer's disease and Frontotemporal dementia are common types of neurodegenerative disorders that present overlapping clinical symptoms, making their differential diagnosis very challenging. Numerous efforts have been done for the diagnosis of each disease but the problem of multi-class differential diagnosis has not been actively explored. In recent years, transformer-based models have demonstrated remarkable success in various computer vision tasks. However, their use in disease diagnostic is uncommon due to the limited amount of 3D medical data given the large size of such models. In this paper, we present a novel 3D transformer-based architecture using a deformable patch location module to improve the differential diagnosis of Alzheimer's disease and Frontotemporal dementia. Moreover, to overcome the problem of data scarcity, we propose an efficient combination of various data augmentation techniques, adapted for training transformer-based models on 3D structural magnetic resonance imaging data. Finally, we propose to combine our transformer-based model with a traditional machine learning model using brain structure volumes to better exploit the available data. Our experiments demonstrate the effectiveness of the proposed approach, showing competitive results compared to state-of-the-art methods. Moreover, the deformable patch locations can be visualized, revealing the most relevant brain regions used to establish the diagnosis of each disease.

José V. Manjón, Sergio Morell-Ortega, Marina Ruiz-Perez et al.

In this paper, we introduce a novel structural holistic Atlas (holiAtlas) of the human brain anatomy based on multimodal and high-resolution MRI that covers several anatomical levels from the organ to the substructure level, using a new densely labelled protocol generated from the fusion of multiple local protocols at different scales. This atlas was constructed by averaging images and segmentations of 75 healthy subjects from the Human Connectome Project database. Specifically, MR images of T1, T2 and WMn (White Matter nulled) contrasts at 0.125 $mm^{3}$ resolution were selected for this project. The images of these 75 subjects were nonlinearly registered and averaged using symmetric group-wise normalisation to construct the atlas. At the finest level, the proposed atlas has 350 different labels derived from 7 distinct delineation protocols. These labels were grouped at multiple scales, offering a coherent and consistent holistic representation of the brain across different levels of detail. This multiscale and multimodal atlas can be used to develop new ultra-high-resolution segmentation methods, potentially improving the early detection of neurological disorders. We make it publicly available to the scientific community.

Pierrick Coupé, Boris Mansencal, Floréal Morandat et al.

INTRODUCTION: Quantification of amyloid plaques (A), neurofibrillary tangles (T2), and neurodegeneration (N) using PET and MRI is critical for Alzheimer's disease (AD) diagnosis and prognosis. Existing pipelines face limitations regarding processing time, variability in tracer types, and challenges in multimodal integration. METHODS: We developed petBrain, a novel end-to-end processing pipeline for amyloid-PET, tau-PET, and structural MRI. It leverages deep learning-based segmentation, standardized biomarker quantification (Centiloid, CenTauR, HAVAs), and simultaneous estimation of A, T2, and N biomarkers. The pipeline is implemented as a web-based platform, requiring no local computational infrastructure or specialized software knowledge. RESULTS: petBrain provides reliable and rapid biomarker quantification, with results comparable to existing pipelines for A and T2. It shows strong concordance with data processed in ADNI databases. The staging and quantification of A/T2/N by petBrain demonstrated good agreement with CSF/plasma biomarkers, clinical status, and cognitive performance. DISCUSSION: petBrain represents a powerful and openly accessible platform for standardized AD biomarker analysis, facilitating applications in clinical research.

Edern Le Bot, Rémi Giraud, Boris Mansencal et al.

This paper introduces a novel method for brain segmentation using only FLAIR MRIs, specifically targeting cases where access to other imaging modalities is limited. By leveraging existing automatic segmentation methods, we train a network to approximate segmentations, typically obtained from T1-weighted MRIs. Our method, called FLAIRBrainSeg, produces segmentations of 132 structures and is robust to multiple sclerosis lesions. Experiments on both in-domain and out-of-domain datasets demonstrate that our method outperforms modality-agnostic approaches based on image synthesis, the only currently available alternative for performing brain parcellation using FLAIR MRI alone. This technique holds promise for scenarios where T1-weighted MRIs are unavailable and offers a valuable alternative for clinicians and researchers in need of reliable anatomical segmentation.

Pierrick Coupé, Boris Mansencal, José V. Manjón et al.

The differential diagnosis of neurodegenerative diseases, characterized by overlapping symptoms, may be challenging. Brain imaging coupled with artificial intelligence has been previously proposed for diagnostic support, but most of these methods have been trained to discriminate only isolated diseases from controls. Here, we develop a novel machine learning framework, named lifespan tree of brain anatomy, dedicated to the differential diagnosis between multiple diseases simultaneously. It integrates the modeling of volume changes for 124 brain structures during the lifespan with non-linear dimensionality reduction and synthetic sampling techniques to create easily interpretable representations of brain anatomy over the course of disease progression. As clinically relevant proof-of-concept applications, we constructed a cognitive lifespan tree of brain anatomy for the differential diagnosis of six causes of neurodegenerative dementia and a motor lifespan tree of brain anatomy for the differential diagnosis of four causes of parkinsonism using 37594 MRI as a training dataset. This original approach enhanced significantly the efficiency of differential diagnosis in the external validation cohort of 1754 cases, outperforming existing state-of-the art machine learning techniques. Lifespan tree holds promise as a valuable tool for differential diagnostic in relevant clinical conditions, especially for diseases still lacking effective biological markers.

Pierre-Etienne Martin, Jordan Calandre, Boris Mansencal et al.

Sports video analysis is a prevalent research topic due to the variety of application areas, ranging from multimedia intelligent devices with user-tailored digests up to analysis of athletes' performance. The Sports Video task is part of the MediaEval 2021 benchmark. This task tackles fine-grained action detection and classification from videos. The focus is on recordings of table tennis games. Running since 2019, the task has offered a classification challenge from untrimmed video recorded in natural conditions with known temporal boundaries for each stroke. This year, the dataset is extended and offers, in addition, a detection challenge from untrimmed videos without annotations. This work aims at creating tools for sports coaches and players in order to analyze sports performance. Movement analysis and player profiling may be built upon such technology to enrich the training experience of athletes and improve their performance.

Reda Abdellah Kamraoui, Vinh-Thong Ta, Thomas Tourdias et al.

Recently, segmentation methods based on Convolutional Neural Networks (CNNs) showed promising performance in automatic Multiple Sclerosis (MS) lesions segmentation. These techniques have even outperformed human experts in controlled evaluation conditions such as Longitudinal MS Lesion Segmentation Challenge (ISBI Challenge). However state-of-the-art approaches trained to perform well on highly-controlled datasets fail to generalize on clinical data from unseen datasets. Instead of proposing another improvement of the segmentation accuracy, we propose a novel method robust to domain shift and performing well on unseen datasets, called DeepLesionBrain (DLB). This generalization property results from three main contributions. First, DLB is based on a large group of compact 3D CNNs. This spatially distributed strategy ensures a robust prediction despite the risk of generalization failure of some individual networks. Second, DLB includes a new image quality data augmentation to reduce dependency to training data specificity (e.g., acquisition protocol). Finally, to learn a more generalizable representation of MS lesions, we propose a hierarchical specialization learning (HSL). HSL is performed by pre-training a generic network over the whole brain, before using its weights as initialization to locally specialized networks. By this end, DLB learns both generic features extracted at global image level and specific features extracted at local image level. DLB generalization was validated in cross-dataset experiments on MSSEG'16, ISBI challenge, and in-house datasets. During experiments, DLB showed higher segmentation accuracy, better segmentation consistency and greater generalization performance compared to state-of-the-art methods. Therefore, DLB offers a robust framework well-suited for clinical practice.

Pierrick Coupé, Boris Mansencal, Michaël Clément et al.

Whole brain segmentation using deep learning (DL) is a very challenging task since the number of anatomical labels is very high compared to the number of available training images. To address this problem, previous DL methods proposed to use a single convolution neural network (CNN) or few independent CNNs. In this paper, we present a novel ensemble method based on a large number of CNNs processing different overlapping brain areas. Inspired by parliamentary decision-making systems, we propose a framework called AssemblyNet, made of two "assemblies" of U-Nets. Such a parliamentary system is capable of dealing with complex decisions, unseen problem and reaching a consensus quickly. AssemblyNet introduces sharing of knowledge among neighboring U-Nets, an "amendment" procedure made by the second assembly at higher-resolution to refine the decision taken by the first one, and a final decision obtained by majority voting. During our validation, AssemblyNet showed competitive performance compared to state-of-the-art methods such as U-Net, Joint label fusion and SLANT. Moreover, we investigated the scan-rescan consistency and the robustness to disease effects of our method. These experiences demonstrated the reliability of AssemblyNet. Finally, we showed the interest of using semi-supervised learning to improve the performance of our method.

Pierrick Coupé, Boris Mansencal, Michaël Clément et al.

Whole brain segmentation using deep learning (DL) is a very challenging task since the number of anatomical labels is very high compared to the number of available training images. To address this problem, previous DL methods proposed to use a global convolution neural network (CNN) or few independent CNNs. In this paper, we present a novel ensemble method based on a large number of CNNs processing different overlapping brain areas. Inspired by parliamentary decision-making systems, we propose a framework called AssemblyNet, made of two "assemblies" of U-Nets. Such a parliamentary system is capable of dealing with complex decisions and reaching a consensus quickly. AssemblyNet introduces sharing of knowledge among neighboring U-Nets, an "amendment" procedure made by the second assembly at higher-resolution to refine the decision taken by the first one, and a final decision obtained by majority voting. When using the same 45 training images, AssemblyNet outperforms global U-Net by 28% in terms of the Dice metric, patch-based joint label fusion by 15% and SLANT-27 by 10%. Finally, AssemblyNet demonstrates high capacity to deal with limited training data to achieve whole brain segmentation in practical training and testing times.