Xuzhe Zhang

Xuzhe Zhang, Yuhao Wu, Elsa Angelini et al.

Robust segmentation is critical for deriving quantitative measures from large-scale, multi-center, and longitudinal medical scans. Manually annotating medical scans, however, is expensive and labor-intensive and may not always be available in every domain. Unsupervised domain adaptation (UDA) is a well-studied technique that alleviates this label-scarcity problem by leveraging available labels from another domain. In this study, we introduce Masked Autoencoding and Pseudo-Labeling Segmentation (MAPSeg), a $\textbf{unified}$ UDA framework with great versatility and superior performance for heterogeneous and volumetric medical image segmentation. To the best of our knowledge, this is the first study that systematically reviews and develops a framework to tackle four different domain shifts in medical image segmentation. More importantly, MAPSeg is the first framework that can be applied to $\textbf{centralized}$, $\textbf{federated}$, and $\textbf{test-time}$ UDA while maintaining comparable performance. We compare MAPSeg with previous state-of-the-art methods on a private infant brain MRI dataset and a public cardiac CT-MRI dataset, and MAPSeg outperforms others by a large margin (10.5 Dice improvement on the private MRI dataset and 5.7 on the public CT-MRI dataset). MAPSeg poses great practical value and can be applied to real-world problems. GitHub: https://github.com/XuzheZ/MAPSeg/.

Vishwanatha M. Rao, Zihan Wan, Soroush Arabshahi et al.

Brain tissue segmentation has demonstrated great utility in quantifying MRI data through Voxel-Based Morphometry and highlighting subtle structural changes associated with various conditions within the brain. However, manual segmentation is highly labor-intensive, and automated approaches have struggled due to properties inherent to MRI acquisition, leaving a great need for an effective segmentation tool. Despite the recent success of deep convolutional neural networks (CNNs) for brain tissue segmentation, many such solutions do not generalize well to new datasets, which is critical for a reliable solution. Transformers have demonstrated success in natural image segmentation and have recently been applied to 3D medical image segmentation tasks due to their ability to capture long-distance relationships in the input where the local receptive fields of CNNs struggle. This study introduces a novel CNN-Transformer hybrid architecture designed for brain tissue segmentation. We validate our model's performance across four multi-site T1w MRI datasets, covering different vendors, field strengths, scan parameters, time points, and neuropsychiatric conditions. In all situations, our model achieved the greatest generality and reliability. Out method is inherently robust and can serve as a valuable tool for brain-related T1w MRI studies. The code for the TABS network is available at: https://github.com/raovish6/TABS.

Xinliu Zhong, Ruiying Liu, Emily S. Nichols et al.

Accurate placental segmentation is essential for quantitative analysis of the placenta. However, this task is particularly challenging in T2*-weighted placental imaging due to: (1) weak and inconsistent boundary contrast across individual echoes; (2) the absence of manual ground truth annotations for all echo times; and (3) motion artifacts across echoes caused by fetal and maternal movement. In this work, we propose a contrast-augmented segmentation framework that leverages complementary information across multi-echo T2*-weighted MRI to learn robust, contrast-invariant representations. Our method integrates: (i) masked autoencoding (MAE) for self-supervised pretraining on unlabeled multi-echo slices; (ii) masked pseudo-labeling (MPL) for unsupervised domain adaptation across echo times; and (iii) global-local collaboration to align fine-grained features with global anatomical context. We further introduce a semantic matching loss to encourage representation consistency across echoes of the same subject. Experiments on a clinical multi-echo placental MRI dataset demonstrate that our approach generalizes effectively across echo times and outperforms both single-echo and naive fusion baselines. To our knowledge, this is the first work to systematically exploit multi-echo T2*-weighted MRI for placental segmentation.

Danielle L. Ferreira, Bruno A. A. Nunes, Xuzhe Zhang et al.

Accurate morphometric assessment of cartilage-such as thickness/volume-via MRI is essential for monitoring knee osteoarthritis. Segmenting cartilage remains challenging and dependent on extensive expert-annotated datasets, which are heavily subjected to inter-reader variability. Recent advancements in Visual Foundational Models (VFM), especially memory-based approaches, offer opportunities for improving generalizability and robustness. This study introduces a deep learning (DL) method for cartilage and meniscus segmentation from 3D MRIs using interactive, memory-based VFMs. To improve spatial awareness and convergence, we incorporated a Hybrid Shuffling Strategy (HSS) during training and applied a segmentation mask propagation technique to enhance annotation efficiency. We trained four AI models-a CNN-based 3D-VNet, two automatic transformer-based models (SaMRI2D and SaMRI3D), and a transformer-based promptable memory-based VFM (SAMRI-2)-on 3D knee MRIs from 270 patients using public and internal datasets and evaluated on 57 external cases, including multi-radiologist annotations and different data acquisitions. Model performance was assessed against reference standards using Dice Score (DSC) and Intersection over Union (IoU), with additional morphometric evaluations to further quantify segmentation accuracy. SAMRI-2 model, trained with HSS, outperformed all other models, achieving an average DSC improvement of 5 points, with a peak improvement of 12 points for tibial cartilage. It also demonstrated the lowest cartilage thickness errors, reducing discrepancies by up to threefold. Notably, SAMRI-2 maintained high performance with as few as three user clicks per volume, reducing annotation effort while ensuring anatomical precision. This memory-based VFM with spatial awareness offers a novel approach for reliable AI-assisted knee MRI segmentation, advancing DL in musculoskeletal imaging.

Xuzhe Zhang, Elsa D. Angelini, Eric A. Hoffman et al.

Robust quantification of pulmonary emphysema on computed tomography (CT) remains challenging for large-scale research studies that involve scans from different scanner types and for translation to clinical scans. Existing studies have explored several directions to tackle this challenge, including density correction, noise filtering, regression, hidden Markov measure field (HMMF) model-based segmentation, and volume-adjusted lung density. Despite some promising results, previous studies either required a tedious workflow or limited opportunities for downstream emphysema subtyping, limiting efficient adaptation on a large-scale study. To alleviate this dilemma, we developed an end-to-end deep learning framework based on an existing HMMF segmentation framework. We first demonstrate that a regular UNet cannot replicate the existing HMMF results because of the lack of scanner priors. We then design a novel domain attention block to fuse image feature with quantitative scanner priors which significantly improves the results.

Xinzi He, Jia Guo, Xuzhe Zhang et al.

Unsupervised learning-based medical image registration approaches have witnessed rapid development in recent years. We propose to revisit a commonly ignored while simple and well-established principle: recursive refinement of deformation vector fields across scales. We introduce a recursive refinement network (RRN) for unsupervised medical image registration, to extract multi-scale features, construct normalized local cost correlation volume and recursively refine volumetric deformation vector fields. RRN achieves state of the art performance for 3D registration of expiratory-inspiratory pairs of CT lung scans. On DirLab COPDGene dataset, RRN returns an average Target Registration Error (TRE) of 0.83 mm, which corresponds to a 13% error reduction from the best result presented in the leaderboard. In addition to comparison with conventional methods, RRN leads to 89% error reduction compared to deep-learning-based peer approaches.

Xuzhe Zhang, Xinzi He, Jia Guo et al.

Magnetic resonance imaging (MRI) noninvasively provides critical information about how human brain structures develop across stages of life. Developmental scientists are particularly interested in the first few years of neurodevelopment. Despite the success of MRI collection and analysis for adults, it is a challenge for researchers to collect high-quality multimodal MRIs from developing infants mainly because of their irregular sleep pattern, limited attention, inability to follow instructions to stay still, and a lack of analysis approaches. These challenges often lead to a significant reduction of usable data. To address this issue, researchers have explored various solutions to replace corrupted scans through synthesizing realistic MRIs. Among them, the convolution neural network (CNN) based generative adversarial network has demonstrated promising results and achieves state-of-the-art performance. However, adversarial training is unstable and may need careful tuning of regularization terms to stabilize the training. In this study, we introduced a novel MRI synthesis framework - Pyramid Transformer Net (PTNet). PTNet consists of transformer layers, skip-connections, and multi-scale pyramid representation. Compared with the most widely used CNN-based conditional GAN models (namely pix2pix and pix2pixHD), our model PTNet shows superior performance in terms of synthesis accuracy and model size. Notably, PTNet does not require any type of adversarial training and can be easily trained using the simple mean squared error loss.