Maximilian Fischer

Robin Peretzke, Marlin Hanstein, Maximilian Fischer et al.

The differentiation between tumor recurrence and radiation-induced contrast enhancements in post-treatment glioblastoma patients remains a major clinical challenge. Existing approaches rely on clinically sparsely available diffusion MRI or do not consider radiation maps, which are gaining increasing interest in the tumor board for this differentiation. We introduce RICE-NET, a multimodal 3D deep learning model that integrates longitudinal MRI data with radiotherapy dose distributions for automated lesion classification using conventional T1-weighted MRI data. Using a cohort of 92 patients, the model achieved an F1 score of 0.92 on an independent test set. During extensive ablation experiments, we quantified the contribution of each timepoint and modality and showed that reliable classification largely depends on the radiation map. Occlusion-based interpretability analyses further confirmed the model's focus on clinically relevant regions. These findings highlight the potential of multimodal deep learning to enhance diagnostic accuracy and support clinical decision-making in neuro-oncology.

Ruining Deng, Tianyuan Yao, Yucheng Tang et al.

Chronic kidney disease (CKD) is a major global health issue, affecting over 10% of the population and causing significant mortality. While kidney biopsy remains the gold standard for CKD diagnosis and treatment, the lack of comprehensive benchmarks for kidney pathology segmentation hinders progress in the field. To address this, we organized the Kidney Pathology Image Segmentation (KPIs) Challenge, introducing a dataset that incorporates preclinical rodent models of CKD with over 10,000 annotated glomeruli from 60+ Periodic Acid Schiff (PAS)-stained whole slide images. The challenge includes two tasks, patch-level segmentation and whole slide image segmentation and detection, evaluated using the Dice Similarity Coefficient (DSC) and F1-score. By encouraging innovative segmentation methods that adapt to diverse CKD models and tissue conditions, the KPIs Challenge aims to advance kidney pathology analysis, establish new benchmarks, and enable precise, large-scale quantification for disease research and diagnosis.

Maximilian Fischer, Peter Neher, Peter Schüffler et al.

Digital pathology offers a groundbreaking opportunity to transform clinical practice in histopathological image analysis, yet faces a significant hurdle: the substantial file sizes of pathological Whole Slide Images (WSI). While current digital pathology solutions rely on lossy JPEG compression to address this issue, lossy compression can introduce color and texture disparities, potentially impacting clinical decision-making. While prior research addresses perceptual image quality and downstream performance independently of each other, we jointly evaluate compression schemes for perceptual and downstream task quality on four different datasets. In addition, we collect an initially uncompressed dataset for an unbiased perceptual evaluation of compression schemes. Our results show that deep learning models fine-tuned for perceptual quality outperform conventional compression schemes like JPEG-XL or WebP for further compression of WSI. However, they exhibit a significant bias towards the compression artifacts present in the training data and struggle to generalize across various compression schemes. We introduce a novel evaluation metric based on feature similarity between original files and compressed files that aligns very well with the actual downstream performance on the compressed WSI. Our metric allows for a general and standardized evaluation of lossy compression schemes and mitigates the requirement to independently assess different downstream tasks. Our study provides novel insights for the assessment of lossy compression schemes for WSI and encourages a unified evaluation of lossy compression schemes to accelerate the clinical uptake of digital pathology.

Rachid Zeghlache, Ikram Brahim, Pierre-Henri Conze et al.

The MARIO challenge, held at MICCAI 2024, focused on advancing the automated detection and monitoring of age-related macular degeneration (AMD) through the analysis of optical coherence tomography (OCT) images. Designed to evaluate algorithmic performance in detecting neovascular activity changes within AMD, the challenge incorporated unique multi-modal datasets. The primary dataset, sourced from Brest, France, was used by participating teams to train and test their models. The final ranking was determined based on performance on this dataset. An auxiliary dataset from Algeria was used post-challenge to evaluate population and device shifts from submitted solutions. Two tasks were involved in the MARIO challenge. The first one was the classification of evolution between two consecutive 2D OCT B-scans. The second one was the prediction of future AMD evolution over three months for patients undergoing anti-vascular endothelial growth factor (VEGF) therapy. Thirty-five teams participated, with the top 12 finalists presenting their methods. This paper outlines the challenge's structure, tasks, data characteristics, and winning methodologies, setting a benchmark for AMD monitoring using OCT, infrared imaging, and clinical data (such as the number of visits, age, gender, etc.). The results of this challenge indicate that artificial intelligence (AI) performs as well as a physician in measuring AMD progression (Task 1) but is not yet able of predicting future evolution (Task 2).

Maximilian Fischer, Florian M. Hauptmann, Robin Peretzke et al.

Although advances in brain surgery techniques have led to fewer postoperative complications requiring Intensive Care Unit (ICU) monitoring, the routine transfer of patients to the ICU remains the clinical standard, despite its high cost. Predictive Gradient Boosted Trees based on clinical data have attempted to optimize ICU admission by identifying key risk factors pre-operatively; however, these approaches overlook valuable imaging data that could enhance prediction accuracy. In this work, we show that multimodal approaches that combine clinical data with imaging data outperform the current clinical data only baseline from 0.29 [F1] to 0.30 [F1], when only pre-operative clinical data is used and from 0.37 [F1] to 0.41 [F1], for pre- and post-operative data. This study demonstrates that effective ICU admission prediction benefits from multimodal data fusion, especially in contexts of severe class imbalance.

Maximilian Fischer, Peter Neher, Tassilo Wald et al.

Processing histopathological Whole Slide Images (WSI) leads to massive storage requirements for clinics worldwide. Even after lossy image compression during image acquisition, additional lossy compression is frequently possible without substantially affecting the performance of deep learning-based (DL) downstream tasks. In this paper, we show that the commonly used JPEG algorithm is not best suited for further compression and we propose Stain Quantized Latent Compression (SQLC ), a novel DL based histopathology data compression approach. SQLC compresses staining and RGB channels before passing it through a compression autoencoder (CAE ) in order to obtain quantized latent representations for maximizing the compression. We show that our approach yields superior performance in a classification downstream task, compared to traditional approaches like JPEG, while image quality metrics like the Multi-Scale Structural Similarity Index (MS-SSIM) is largely preserved. Our method is online available.

Constantin Ulrich, Catherine Knobloch, Julius C. Holzschuh et al.

Despite considerable strides in developing deep learning models for 3D medical image segmentation, the challenge of effectively generalizing across diverse image distributions persists. While domain generalization is acknowledged as vital for robust application in clinical settings, the challenges stemming from training with a limited Field of View (FOV) remain unaddressed. This limitation leads to false predictions when applied to body regions beyond the FOV of the training data. In response to this problem, we propose a novel loss function that penalizes predictions in implausible body regions, applicable in both single-dataset and multi-dataset training schemes. It is realized with a Body Part Regression model that generates axial slice positional scores. Through comprehensive evaluation using a test set featuring varying FOVs, our approach demonstrates remarkable improvements in generalization capabilities. It effectively mitigates false positive tumor predictions up to 85% and significantly enhances overall segmentation performance.