Joseph V. Hajnal

Veronika A. Zimmer, Alberto Gomez, Emily Skelton et al.

Automatic segmentation of the placenta in fetal ultrasound (US) is challenging due to the (i) high diversity of placenta appearance, (ii) the restricted quality in US resulting in highly variable reference annotations, and (iii) the limited field-of-view of US prohibiting whole placenta assessment at late gestation. In this work, we address these three challenges with a multi-task learning approach that combines the classification of placental location (e.g., anterior, posterior) and semantic placenta segmentation in a single convolutional neural network. Through the classification task the model can learn from larger and more diverse datasets while improving the accuracy of the segmentation task in particular in limited training set conditions. With this approach we investigate the variability in annotations from multiple raters and show that our automatic segmentations (Dice of 0.86 for anterior and 0.83 for posterior placentas) achieve human-level performance as compared to intra- and inter-observer variability. Lastly, our approach can deliver whole placenta segmentation using a multi-view US acquisition pipeline consisting of three stages: multi-probe image acquisition, image fusion and image segmentation. This results in high quality segmentation of larger structures such as the placenta in US with reduced image artifacts which are beyond the field-of-view of single probes.

Denis Prokopenko, David F. A. Lloyd, Amedeo Chiribiri et al.

Dynamic fetal heart magnetic resonance imaging (MRI) presents unique challenges due to the fast heart rate of the fetus compared to adult subjects and uncontrolled fetal motion. This requires high temporal and spatial resolutions over a large field of view, in order to encompass surrounding maternal anatomy. In this work, we introduce Dynamic Cardiac Reconstruction Attention Network (DCRA-Net) - a novel deep learning model that employs attention mechanisms in spatial and temporal domains and temporal frequency representation of data to reconstruct the dynamics of the fetal heart from highly accelerated free-running (non-gated) MRI acquisitions. DCRA-Net was trained on retrospectively undersampled complex-valued cardiac MRIs from 42 fetal subjects and separately from 153 adult subjects, and evaluated on data from 14 fetal and 39 adult subjects respectively. Its performance was compared to L+S and k-GIN methods in both fetal and adult cases for an undersampling factor of 8x. The proposed network performed better than the comparators for both fetal and adult data, for both regular lattice and centrally weighted random undersampling. Aliased signals due to the undersampling were comprehensively resolved, and both the spatial details of the heart and its temporal dynamics were recovered with high fidelity. The highest performance was achieved when using lattice undersampling, data consistency and temporal frequency representation, yielding PSNR of 38 for fetal and 35 for adult cases. Our method is publicly available at https://github.com/denproc/DCRA-Net.

Maik Dannecker, Vanessa Kyriakopoulou, Lucilio Cordero-Grande et al.

We introduce a conditional implicit neural atlas (CINA) for spatio-temporal atlas generation from Magnetic Resonance Images (MRI) of the neurotypical and pathological fetal brain, that is fully independent of affine or non-rigid registration. During training, CINA learns a general representation of the fetal brain and encodes subject specific information into latent code. After training, CINA can construct a faithful atlas with tissue probability maps of the fetal brain for any gestational age (GA) and anatomical variation covered within the training domain. Thus, CINA is competent to represent both, neurotypical and pathological brains. Furthermore, a trained CINA model can be fit to brain MRI of unseen subjects via test-time optimization of the latent code. CINA can then produce probabilistic tissue maps tailored to a particular subject. We evaluate our method on a total of 198 T2 weighted MRI of normal and abnormal fetal brains from the dHCP and FeTA datasets. We demonstrate CINA's capability to represent a fetal brain atlas that can be flexibly conditioned on GA and on anatomical variations like ventricular volume or degree of cortical folding, making it a suitable tool for modeling both neurotypical and pathological brains. We quantify the fidelity of our atlas by means of tissue segmentation and age prediction and compare it to an established baseline. CINA demonstrates superior accuracy for neurotypical brains and pathological brains with ventriculomegaly. Moreover, CINA scores a mean absolute error of 0.23 weeks in fetal brain age prediction, further confirming an accurate representation of fetal brain development.

Maik Dannecker, Thomas Sanchez, Meritxell Bach Cuadra et al.

High-resolution slice-to-volume reconstruction (SVR) from multiple motion-corrupted low-resolution 2D slices constitutes a critical step in image-based diagnostics of moving subjects, such as fetal brain Magnetic Resonance Imaging (MRI). Existing solutions struggle with image artifacts and severe subject motion or require slice pre-alignment to achieve satisfying reconstruction performance. We propose a novel SVR method to enable fast and accurate MRI reconstruction even in cases of severe image and motion corruption. Our approach performs motion correction, outlier handling, and super-resolution reconstruction with all operations being entirely based on implicit neural representations. The model can be initialized with task-specific priors through fully self-supervised meta-learning on either simulated or real-world data. In extensive experiments including over 480 reconstructions of simulated and clinical MRI brain data from different centers, we prove the utility of our method in cases of severe subject motion and image artifacts. Our results demonstrate improvements in reconstruction quality, especially in the presence of severe motion, compared to state-of-the-art methods, and up to 50% reduction in reconstruction time.

Johanna P. Müller, Robert Wright, Thomas G. Day et al.

Accurate analysis of prenatal ultrasound (US) is essential for early detection of developmental anomalies. However, operator dependency and technical limitations (e.g. intrinsic artefacts and effects, setting errors) can complicate image interpretation and the assessment of diagnostic uncertainty. We present L-FUSION (Laplacian Fetal US Segmentation with Integrated FoundatiON models), a framework that integrates uncertainty quantification through unsupervised, normative learning and large-scale foundation models for robust segmentation of fetal structures in normal and pathological scans. We propose to utilise the aleatoric logit distributions of Stochastic Segmentation Networks and Laplace approximations with fast Hessian estimations to estimate epistemic uncertainty only from the segmentation head. This enables us to achieve reliable abnormality quantification for instant diagnostic feedback. Combined with an integrated Dropout component, L-FUSION enables reliable differentiation of lesions from normal fetal anatomy with enhanced uncertainty maps and segmentation counterfactuals in US imaging. It improves epistemic and aleatoric uncertainty interpretation and removes the need for manual disease-labelling. Evaluations across multiple datasets show that L-FUSION achieves superior segmentation accuracy and consistent uncertainty quantification, supporting on-site decision-making and offering a scalable solution for advancing fetal ultrasound analysis in clinical settings.

Lucilio Cordero-Grande, Juan Enrique Ortuño-Fisac, Alena Uus et al.

Magnetic resonance imaging of whole fetal body and placenta is limited by different sources of motion affecting the womb. Usual scanning techniques employ single-shot multi-slice sequences where anatomical information in different slices may be subject to different deformations, contrast variations or artifacts. Volumetric reconstruction formulations have been proposed to correct for these factors, but they must accommodate a non-homogeneous and non-isotropic sampling, so regularization becomes necessary. Thus, in this paper we propose a deep generative prior for robust volumetric reconstructions integrated with a diffeomorphic volume to slice registration method. Experiments are performed to validate our contributions and compare with a state of the art method in a cohort of $72$ fetal datasets in the range of $20-36$ weeks gestational age. Results suggest improved image resolution and more accurate prediction of gestational age at scan when comparing to a state of the art reconstruction method. In addition, gestational age prediction results from our volumetric reconstructions compare favourably with existing brain-based approaches, with boosted accuracy when integrating information of organs other than the brain. Namely, a mean absolute error of $0.618$ weeks ($R^2=0.958$) is achieved when combining fetal brain and trunk information.

Jo Schlemper, Jinming Duan, Cheng Ouyang et al.

We present simple reconstruction networks for multi-coil data by extending deep cascade of CNN's and exploiting the data consistency layer. In particular, we propose two variants, where one is inspired by POCSENSE and the other is calibration-less. We show that the proposed approaches are competitive relative to the state of the art both quantitatively and qualitatively.

Jo Schlemper, Ilkay Oksuz, James R. Clough et al.

AUTOMAP is a promising generalized reconstruction approach, however, it is not scalable and hence the practicality is limited. We present dAUTOMAP, a novel way for decomposing the domain transformation of AUTOMAP, making the model scale linearly. We show dAUTOMAP outperforms AUTOMAP with significantly fewer parameters.

Tong Zhang, Laurence H. Jackson, Alena Uus et al.

Accurately estimating and correcting the motion artifacts are crucial for 3D image reconstruction of the abdominal and in-utero magnetic resonance imaging (MRI). The state-of-art methods are based on slice-to-volume registration (SVR) where multiple 2D image stacks are acquired in three orthogonal orientations. In this work, we present a novel reconstruction pipeline that only needs one orientation of 2D MRI scans and can reconstruct the full high-resolution image without masking or registration steps. The framework consists of two main stages: the respiratory motion estimation using a self-supervised recurrent neural network, which learns the respiratory signals that are naturally embedded in the asymmetry relationship of the neighborhood slices and cluster them according to a respiratory state. Then, we train a 3D deconvolutional network for super-resolution (SR) reconstruction of the sparsely selected 2D images using integrated reconstruction and total variation loss. We evaluate the classification accuracy on 5 simulated images and compare our results with the SVR method in adult abdominal and in-utero MRI scans. The results show that the proposed pipeline can accurately estimate the respiratory state and reconstruct 4D SR volumes with better or similar performance to the 3D SVR pipeline with less than 20\% sparsely selected slices. The method has great potential to transform the 4D abdominal and in-utero MRI in clinical practice.

Cheng Ouyang, Jo Schlemper, Carlo Biffi et al.

We look into the robustness of deep learning based MRI reconstruction when tested on unseen contrasts and organs. We then propose to generalize the network by training with large publicly-available natural image datasets with synthesized phase information to achieve high cross-domain reconstruction performance which is competitive with domain-specific training. To explain its generalization mechanism, we have also analyzed patch sets for different training datasets.

Chen Qin, Jo Schlemper, Jose Caballero et al.

Accelerating the data acquisition of dynamic magnetic resonance imaging (MRI) leads to a challenging ill-posed inverse problem, which has received great interest from both the signal processing and machine learning community over the last decades. The key ingredient to the problem is how to exploit the temporal correlation of the MR sequence to resolve the aliasing artefact. Traditionally, such observation led to a formulation of a non-convex optimisation problem, which were solved using iterative algorithms. Recently, however, deep learning based-approaches have gained significant popularity due to its ability to solve general inversion problems. In this work, we propose a unique, novel convolutional recurrent neural network (CRNN) architecture which reconstructs high quality cardiac MR images from highly undersampled k-space data by jointly exploiting the dependencies of the temporal sequences as well as the iterative nature of the traditional optimisation algorithms. In particular, the proposed architecture embeds the structure of the traditional iterative algorithms, efficiently modelling the recurrence of the iterative reconstruction stages by using recurrent hidden connections over such iterations. In addition, spatiotemporal dependencies are simultaneously learnt by exploiting bidirectional recurrent hidden connections across time sequences. The proposed algorithm is able to learn both the temporal dependency and the iterative reconstruction process effectively with only a very small number of parameters, while outperforming current MR reconstruction methods in terms of computational complexity, reconstruction accuracy and speed.

Jo Schlemper, Jose Caballero, Joseph V. Hajnal et al.

Inspired by recent advances in deep learning, we propose a framework for reconstructing dynamic sequences of 2D cardiac magnetic resonance (MR) images from undersampled data using a deep cascade of convolutional neural networks (CNNs) to accelerate the data acquisition process. In particular, we address the case where data is acquired using aggressive Cartesian undersampling. Firstly, we show that when each 2D image frame is reconstructed independently, the proposed method outperforms state-of-the-art 2D compressed sensing approaches such as dictionary learning-based MR image reconstruction, in terms of reconstruction error and reconstruction speed. Secondly, when reconstructing the frames of the sequences jointly, we demonstrate that CNNs can learn spatio-temporal correlations efficiently by combining convolution and data sharing approaches. We show that the proposed method consistently outperforms state-of-the-art methods and is capable of preserving anatomical structure more faithfully up to 11-fold undersampling. Moreover, reconstruction is very fast: each complete dynamic sequence can be reconstructed in less than 10s and, for the 2D case, each image frame can be reconstructed in 23ms, enabling real-time applications.

Jo Schlemper, Jose Caballero, Joseph V. Hajnal et al.

The acquisition of Magnetic Resonance Imaging (MRI) is inherently slow. Inspired by recent advances in deep learning, we propose a framework for reconstructing MR images from undersampled data using a deep cascade of convolutional neural networks to accelerate the data acquisition process. We show that for Cartesian undersampling of 2D cardiac MR images, the proposed method outperforms the state-of-the-art compressed sensing approaches, such as dictionary learning-based MRI (DLMRI) reconstruction, in terms of reconstruction error, perceptual quality and reconstruction speed for both 3-fold and 6-fold undersampling. Compared to DLMRI, the error produced by the method proposed is approximately twice as small, allowing to preserve anatomical structures more faithfully. Using our method, each image can be reconstructed in 23 ms, which is fast enough to enable real-time applications.

Amir Alansary, Bernhard Kainz, Martin Rajchl et al.

In this paper we present a novel method for the correction of motion artifacts that are present in fetal Magnetic Resonance Imaging (MRI) scans of the whole uterus. Contrary to current slice-to-volume registration (SVR) methods, requiring an inflexible anatomical enclosure of a single investigated organ, the proposed patch-to-volume reconstruction (PVR) approach is able to reconstruct a large field of view of non-rigidly deforming structures. It relaxes rigid motion assumptions by introducing a specific amount of redundant information that is exploited with parallelized patch-wise optimization, super-resolution, and automatic outlier rejection. We further describe and provide an efficient parallel implementation of PVR allowing its execution within reasonable time on commercially available graphics processing units (GPU), enabling its use in the clinical practice. We evaluate PVR's computational overhead compared to standard methods and observe improved reconstruction accuracy in presence of affine motion artifacts of approximately 30% compared to conventional SVR in synthetic experiments. Furthermore, we have evaluated our method qualitatively and quantitatively on real fetal MRI data subject to maternal breathing and sudden fetal movements. We evaluate peak-signal-to-noise ratio (PSNR), structural similarity index (SSIM), and cross correlation (CC) with respect to the originally acquired data and provide a method for visual inspection of reconstruction uncertainty. With these experiments we demonstrate successful application of PVR motion compensation to the whole uterus, the human fetus, and the human placenta.

Martin Rajchl, Matthew C. H. Lee, Ozan Oktay et al.

In this paper, we propose DeepCut, a method to obtain pixelwise object segmentations given an image dataset labelled with bounding box annotations. It extends the approach of the well-known GrabCut method to include machine learning by training a neural network classifier from bounding box annotations. We formulate the problem as an energy minimisation problem over a densely-connected conditional random field and iteratively update the training targets to obtain pixelwise object segmentations. Additionally, we propose variants of the DeepCut method and compare those to a naive approach to CNN training under weak supervision. We test its applicability to solve brain and lung segmentation problems on a challenging fetal magnetic resonance dataset and obtain encouraging results in terms of accuracy.