Arjun Desai

Arjun D Desai, Andrew M Schmidt, Elka B Rubin et al.

Magnetic resonance imaging (MRI) is a cornerstone of modern medical imaging. However, long image acquisition times, the need for qualitative expert analysis, and the lack of (and difficulty extracting) quantitative indicators that are sensitive to tissue health have curtailed widespread clinical and research studies. While recent machine learning methods for MRI reconstruction and analysis have shown promise for reducing this burden, these techniques are primarily validated with imperfect image quality metrics, which are discordant with clinically-relevant measures that ultimately hamper clinical deployment and clinician trust. To mitigate this challenge, we present the Stanford Knee MRI with Multi-Task Evaluation (SKM-TEA) dataset, a collection of quantitative knee MRI (qMRI) scans that enables end-to-end, clinically-relevant evaluation of MRI reconstruction and analysis tools. This 1.6TB dataset consists of raw-data measurements of ~25,000 slices (155 patients) of anonymized patient MRI scans, the corresponding scanner-generated DICOM images, manual segmentations of four tissues, and bounding box annotations for sixteen clinically relevant pathologies. We provide a framework for using qMRI parameter maps, along with image reconstructions and dense image labels, for measuring the quality of qMRI biomarker estimates extracted from MRI reconstruction, segmentation, and detection techniques. Finally, we use this framework to benchmark state-of-the-art baselines on this dataset. We hope our SKM-TEA dataset and code can enable a broad spectrum of research for modular image reconstruction and image analysis in a clinically informed manner. Dataset access, code, and benchmarks are available at https://github.com/StanfordMIMI/skm-tea.

Batu Ozturkler, Arda Sahiner, Tolga Ergen et al. · stanford

Unrolled neural networks have recently achieved state-of-the-art accelerated MRI reconstruction. These networks unroll iterative optimization algorithms by alternating between physics-based consistency and neural-network based regularization. However, they require several iterations of a large neural network to handle high-dimensional imaging tasks such as 3D MRI. This limits traditional training algorithms based on backpropagation due to prohibitively large memory and compute requirements for calculating gradients and storing intermediate activations. To address this challenge, we propose Greedy LEarning for Accelerated MRI (GLEAM) reconstruction, an efficient training strategy for high-dimensional imaging settings. GLEAM splits the end-to-end network into decoupled network modules. Each module is optimized in a greedy manner with decoupled gradient updates, reducing the memory footprint during training. We show that the decoupled gradient updates can be performed in parallel on multiple graphical processing units (GPUs) to further reduce training time. We present experiments with 2D and 3D datasets including multi-coil knee, brain, and dynamic cardiac cine MRI. We observe that: i) GLEAM generalizes as well as state-of-the-art memory-efficient baselines such as gradient checkpointing and invertible networks with the same memory footprint, but with 1.3x faster training; ii) for the same memory footprint, GLEAM yields 1.1dB PSNR gain in 2D and 1.8 dB in 3D over end-to-end baselines.

Dave Van Veen, Rogier van der Sluijs, Batu Ozturkler et al. · stanford

We propose using a coordinate network decoder for the task of super-resolution in MRI. The continuous signal representation of coordinate networks enables this approach to be scale-agnostic, i.e. one can train over a continuous range of scales and subsequently query at arbitrary resolutions. Due to the difficulty of performing super-resolution on inherently noisy data, we analyze network behavior under multiple denoising strategies. Lastly we compare this method to a standard convolutional decoder using both quantitative metrics and a radiologist study implemented in Voxel, our newly developed tool for web-based evaluation of medical images.

Louis Blankemeier, Arjun Desai, Juan Manuel Zambrano Chaves et al.

Computed tomography (CT) is routinely used in clinical practice to evaluate a wide variety of medical conditions. While CT scans provide diagnoses, they also offer the ability to extract quantitative body composition metrics to analyze tissue volume and quality. Extracting quantitative body composition measures manually from CT scans is a cumbersome and time-consuming task. Proprietary software has been developed recently to automate this process, but the closed-source nature impedes widespread use. There is a growing need for fully automated body composition software that is more accessible and easier to use, especially for clinicians and researchers who are not experts in medical image processing. To this end, we have built Comp2Comp, an open-source Python package for rapid and automated body composition analysis of CT scans. This package offers models, post-processing heuristics, body composition metrics, automated batching, and polychromatic visualizations. Comp2Comp currently computes body composition measures for bone, skeletal muscle, visceral adipose tissue, and subcutaneous adipose tissue on CT scans of the abdomen. We have created two pipelines for this purpose. The first pipeline computes vertebral measures, as well as muscle and adipose tissue measures, at the T12 - L5 vertebral levels from abdominal CT scans. The second pipeline computes muscle and adipose tissue measures on user-specified 2D axial slices. In this guide, we discuss the architecture of the Comp2Comp pipelines, provide usage instructions, and report internal and external validation results to measure the quality of segmentations and body composition measures. Comp2Comp can be found at https://github.com/StanfordMIMI/Comp2Comp.

Tri Dao, Beidi Chen, Nimit Sohoni et al.

Large neural networks excel in many domains, but they are expensive to train and fine-tune. A popular approach to reduce their compute or memory requirements is to replace dense weight matrices with structured ones (e.g., sparse, low-rank, Fourier transform). These methods have not seen widespread adoption (1) in end-to-end training due to unfavorable efficiency--quality tradeoffs, and (2) in dense-to-sparse fine-tuning due to lack of tractable algorithms to approximate a given dense weight matrix. To address these issues, we propose a class of matrices (Monarch) that is hardware-efficient (they are parameterized as products of two block-diagonal matrices for better hardware utilization) and expressive (they can represent many commonly used transforms). Surprisingly, the problem of approximating a dense weight matrix with a Monarch matrix, though nonconvex, has an analytical optimal solution. These properties of Monarch matrices unlock new ways to train and fine-tune sparse and dense models. We empirically validate that Monarch can achieve favorable accuracy-efficiency tradeoffs in several end-to-end sparse training applications: speeding up ViT and GPT-2 training on ImageNet classification and Wikitext-103 language modeling by 2x with comparable model quality, and reducing the error on PDE solving and MRI reconstruction tasks by 40%. In sparse-to-dense training, with a simple technique called "reverse sparsification," Monarch matrices serve as a useful intermediate representation to speed up GPT-2 pretraining on OpenWebText by 2x without quality drop. The same technique brings 23% faster BERT pretraining than even the very optimized implementation from Nvidia that set the MLPerf 1.1 record. In dense-to-sparse fine-tuning, as a proof-of-concept, our Monarch approximation algorithm speeds up BERT fine-tuning on GLUE by 1.7x with comparable accuracy.

Francesco Santini, Jakob Wasserthal, Abramo Agosti et al.

Purpose: To present and evaluate Dafne (deep anatomical federated network), a freely available decentralized, collaborative deep learning system for the semantic segmentation of radiological images through federated incremental learning. Materials and Methods: Dafne is free software with a client-server architecture. The client side is an advanced user interface that applies the deep learning models stored on the server to the user's data and allows the user to check and refine the prediction. Incremental learning is then performed at the client's side and sent back to the server, where it is integrated into the root model. Dafne was evaluated locally, by assessing the performance gain across model generations on 38 MRI datasets of the lower legs, and through the analysis of real-world usage statistics (n = 639 use-cases). Results: Dafne demonstrated a statistically improvement in the accuracy of semantic segmentation over time (average increase of the Dice Similarity Coefficient by 0.007 points/generation on the local validation set, p < 0.001). Qualitatively, the models showed enhanced performance on various radiologic image types, including those not present in the initial training sets, indicating good model generalizability. Conclusion: Dafne showed improvement in segmentation quality over time, demonstrating potential for learning and generalization.

Jeffrey Dominic, Nandita Bhaskhar, Arjun D. Desai et al.

Although supervised learning has enabled high performance for image segmentation, it requires a large amount of labeled training data, which can be difficult to obtain in the medical imaging field. Self-supervised learning (SSL) methods involving pretext tasks have shown promise in overcoming this requirement by first pretraining models using unlabeled data. In this work, we evaluate the efficacy of two SSL methods (inpainting-based pretext tasks of context prediction and context restoration) for CT and MRI image segmentation in label-limited scenarios, and investigate the effect of implementation design choices for SSL on downstream segmentation performance. We demonstrate that optimally trained and easy-to-implement inpainting-based SSL segmentation models can outperform classically supervised methods for MRI and CT tissue segmentation in label-limited scenarios, for both clinically-relevant metrics and the traditional Dice score.

Beliz Gunel, Arda Sahiner, Arjun D. Desai et al.

Unrolled neural networks have enabled state-of-the-art reconstruction performance and fast inference times for the accelerated magnetic resonance imaging (MRI) reconstruction task. However, these approaches depend on fully-sampled scans as ground truth data which is either costly or not possible to acquire in many clinical medical imaging applications; hence, reducing dependence on data is desirable. In this work, we propose modeling the proximal operators of unrolled neural networks with scale-equivariant convolutional neural networks in order to improve the data-efficiency and robustness to drifts in scale of the images that might stem from the variability of patient anatomies or change in field-of-view across different MRI scanners. Our approach demonstrates strong improvements over the state-of-the-art unrolled neural networks under the same memory constraints both with and without data augmentations on both in-distribution and out-of-distribution scaled images without significantly increasing the train or inference time.

Onat Dalmaz, Arjun D. Desai, Reinhard Heckel et al.

Accelerated MRI reconstruction involves solving an ill-posed inverse problem where noise in acquired data propagates to the reconstructed images. Noise analyses are central to MRI reconstruction for providing an explicit measure of solution fidelity and for guiding the design and deployment of novel reconstruction methods. However, deep learning (DL)-based reconstruction methods have often overlooked noise propagation due to inherent analytical and computational challenges, despite its critical importance. This work proposes a theoretically grounded, memory-efficient technique to calculate voxel-wise variance for quantifying uncertainty due to acquisition noise in accelerated MRI reconstructions. Our approach approximates noise covariance using the DL network's Jacobian, which is intractable to calculate. To circumvent this, we derive an unbiased estimator for the diagonal of this covariance matrix (voxel-wise variance) and introduce a Jacobian sketching technique to efficiently implement it. We evaluate our method on knee and brain MRI datasets for both data- and physics-driven networks trained in supervised and unsupervised manners. Compared to empirical references obtained via Monte Carlo simulations, our technique achieves near-equivalent performance while reducing computational and memory demands by an order of magnitude or more. Furthermore, our method is robust across varying input noise levels, acceleration factors, and diverse undersampling schemes, highlighting its broad applicability. Our work reintroduces accurate and efficient noise analysis as a central tenet of reconstruction algorithms, holding promise to reshape how we evaluate and deploy DL-based MRI. Our code will be made publicly available upon acceptance.

Arjun D Desai, Batu M Ozturkler, Christopher M Sandino et al.

Deep learning (DL) has shown promise for faster, high quality accelerated MRI reconstruction. However, supervised DL methods depend on extensive amounts of fully-sampled (labeled) data and are sensitive to out-of-distribution (OOD) shifts, particularly low signal-to-noise ratio (SNR) acquisitions. To alleviate this challenge, we propose Noise2Recon, a model-agnostic, consistency training method for joint MRI reconstruction and denoising that can use both fully-sampled (labeled) and undersampled (unlabeled) scans in semi-supervised and self-supervised settings. With limited or no labeled training data, Noise2Recon outperforms compressed sensing and deep learning baselines, including supervised networks, augmentation-based training, fine-tuned denoisers, and self-supervised methods, and matches performance of supervised models, which were trained with 14x more fully-sampled scans. Noise2Recon also outperforms all baselines, including state-of-the-art fine-tuning and augmentation techniques, among low-SNR scans and when generalizing to other OOD factors, such as changes in acceleration factors and different datasets. Augmentation extent and loss weighting hyperparameters had negligible impact on Noise2Recon compared to supervised methods, which may indicate increased training stability. Our code is available at https://github.com/ad12/meddlr.

Aviv Bick, Tobias Katsch, Nimit Sohoni et al.

We introduce Llamba, a family of efficient recurrent language models distilled from Llama-3.x into the Mamba architecture. The series includes Llamba-1B, Llamba-3B, and Llamba-8B, which achieve higher inference throughput and handle significantly larger batch sizes than Transformer-based models while maintaining comparable benchmark performance. Furthermore, Llamba demonstrates the effectiveness of cross-architecture distillation using MOHAWK (Bick et al., 2024), achieving these results with less than 0.1% of the training data typically used for models of similar size. To take full advantage of their efficiency, we provide an optimized implementation of Llamba for resource-constrained devices such as smartphones and edge platforms, offering a practical and memory-efficient alternative to Transformers. Overall, Llamba improves the tradeoff between speed, memory efficiency, and performance, making high-quality language models more accessible.

Michael Zhang, Xiaotian Cheng, Daniel Copeland et al.

Open, or non-laparoscopic surgery, represents the vast majority of all operating room procedures, but few tools exist to objectively evaluate these techniques at scale. Current efforts involve human expert-based visual assessment. We leverage advances in computer vision to introduce an automated approach to video analysis of surgical execution. A state-of-the-art convolutional neural network architecture for object detection was used to detect operating hands in open surgery videos. Automated assessment was expanded by combining model predictions with a fast object tracker to enable surgeon-specific hand tracking. To train our model, we used publicly available videos of open surgery from YouTube and annotated these with spatial bounding boxes of operating hands. Our model's spatial detections of operating hands significantly outperforms the detections achieved using pre-existing hand-detection datasets, and allow for insights into intra-operative movement patterns and economy of motion.

Arjun D. Desai, Francesco Caliva, Claudia Iriondo et al.

Purpose: To organize a knee MRI segmentation challenge for characterizing the semantic and clinical efficacy of automatic segmentation methods relevant for monitoring osteoarthritis progression. Methods: A dataset partition consisting of 3D knee MRI from 88 subjects at two timepoints with ground-truth articular (femoral, tibial, patellar) cartilage and meniscus segmentations was standardized. Challenge submissions and a majority-vote ensemble were evaluated using Dice score, average symmetric surface distance, volumetric overlap error, and coefficient of variation on a hold-out test set. Similarities in network segmentations were evaluated using pairwise Dice correlations. Articular cartilage thickness was computed per-scan and longitudinally. Correlation between thickness error and segmentation metrics was measured using Pearson's coefficient. Two empirical upper bounds for ensemble performance were computed using combinations of model outputs that consolidated true positives and true negatives. Results: Six teams (T1-T6) submitted entries for the challenge. No significant differences were observed across all segmentation metrics for all tissues (p=1.0) among the four top-performing networks (T2, T3, T4, T6). Dice correlations between network pairs were high (>0.85). Per-scan thickness errors were negligible among T1-T4 (p=0.99) and longitudinal changes showed minimal bias (<0.03mm). Low correlations (<0.41) were observed between segmentation metrics and thickness error. The majority-vote ensemble was comparable to top performing networks (p=1.0). Empirical upper bound performances were similar for both combinations (p=1.0). Conclusion: Diverse networks learned to segment the knee similarly where high segmentation accuracy did not correlate to cartilage thickness accuracy. Voting ensembles did not outperform individual networks but may help regularize individual models.

Arjun D. Desai, Garry E. Gold, Brian A. Hargreaves et al.

High-fidelity semantic segmentation of magnetic resonance volumes is critical for estimating tissue morphometry and relaxation parameters in both clinical and research applications. While manual segmentation is accepted as the gold-standard, recent advances in deep learning and convolutional neural networks (CNNs) have shown promise for efficient automatic segmentation of soft tissues. However, due to the stochastic nature of deep learning and the multitude of hyperparameters in training networks, predicting network behavior is challenging. In this paper, we quantify the impact of three factors associated with CNN segmentation performance: network architecture, training loss functions, and training data characteristics. We evaluate the impact of these variations on the segmentation of femoral cartilage and propose potential modifications to CNN architectures and training protocols to train these models with confidence.