Christopher M. Sandino

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.

Hsiang-Yun Sherry Chien, Hanlin Goh, Christopher M. Sandino et al.

Decoding information from bio-signals such as EEG, using machine learning has been a challenge due to the small data-sets and difficulty to obtain labels. We propose a reconstruction-based self-supervised learning model, the masked auto-encoder for EEG (MAEEG), for learning EEG representations by learning to reconstruct the masked EEG features using a transformer architecture. We found that MAEEG can learn representations that significantly improve sleep stage classification (~5% accuracy increase) when only a small number of labels are given. We also found that input sample lengths and different ways of masking during reconstruction-based SSL pretraining have a huge effect on downstream model performance. Specifically, learning to reconstruct a larger proportion and more concentrated masked signal results in better performance on sleep classification. Our findings provide insight into how reconstruction-based SSL could help representation learning for EEG.

Christopher Sandino, Sayeri Lala, Geeling Chau et al.

Self-supervised learning (SSL) offers a promising approach for learning electroencephalography (EEG) representations from unlabeled data, reducing the need for expensive annotations for clinical applications like sleep staging and seizure detection. While current EEG SSL methods predominantly use masked reconstruction strategies like masked autoencoders (MAE) that capture local temporal patterns, position prediction pretraining remains underexplored despite its potential to learn long-range dependencies in neural signals. We introduce PAirwise Relative Shift or PARS pretraining, a novel pretext task that predicts relative temporal shifts between randomly sampled EEG window pairs. Unlike reconstruction-based methods that focus on local pattern recovery, PARS encourages encoders to capture relative temporal composition and long-range dependencies inherent in neural signals. Through comprehensive evaluation on various EEG decoding tasks, we demonstrate that PARS-pretrained transformers consistently outperform existing pretraining strategies in label-efficient and transfer learning settings, establishing a new paradigm for self-supervised EEG representation learning.

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.

Joseph Y. Cheng, Feiyu Chen, Christopher Sandino et al.

Compressed sensing in MRI enables high subsampling factors while maintaining diagnostic image quality. This technique enables shortened scan durations and/or improved image resolution. Further, compressed sensing can increase the diagnostic information and value from each scan performed. Overall, compressed sensing has significant clinical impact in improving the diagnostic quality and patient experience for imaging exams. However, a number of challenges exist when moving compressed sensing from research to the clinic. These challenges include hand-crafted image priors, sensitive tuning parameters, and long reconstruction times. Data-driven learning provides a solution to address these challenges. As a result, compressed sensing can have greater clinical impact. In this tutorial, we will review the compressed sensing formulation and outline steps needed to transform this formulation to a deep learning framework. Supplementary open source code in python will be used to demonstrate this approach with open databases. Further, we will discuss considerations in applying data-driven compressed sensing in the clinical setting.

Geeling Chau, Ran Liu, Juri Minxha et al.

New device layouts pose a challenging modeling problem due to the lack of large datasets for each specific layout. Biosignal foundation models offer a plausible solution if they are able to generalize to new layouts effectively. To improve cross-layout transfer, we study how different channel embedding techniques behave when pretraining layouts differ substantially from the downstream decoding layout. We propose Device Passport, a new channel embedding technique that learns experts and mixture models that take each channel's functional activity and metadata as input. This contrasts with prior embedding methods, which typically use only functional information or only metadata to look up learned or fixed positional embeddings. Across controlled subset-transfer experiments and realistic transfer to ear-EEG, Device Passport is competitive overall and improves over the strongest learned baseline in the layout-transfer regimes that motivate this work. These results suggest that channel embedding design is a key consideration when reusing large-scale pretrained biosignal models on new devices.

Ching Fang, Christopher Sandino, Behrooz Mahasseni et al.

Many healthcare applications are inherently multimodal, involving several physiological signals. As sensors for these signals become more common, improving machine learning methods for multimodal healthcare data is crucial. Pretraining foundation models is a promising avenue for success. However, methods for developing foundation models in healthcare are still in early exploration and it is unclear which pretraining strategies are most effective given the diversity of physiological signals. This is partly due to challenges in multimodal health data: obtaining data across many patients is difficult and costly, there is a lot of inter-subject variability, and modalities are often heterogeneously informative across downstream tasks. Here, we explore these challenges in the PhysioNet 2018 dataset. We use a masked autoencoding objective to pretrain a multimodal model. We show that the model learns representations that can be linearly probed for a diverse set of downstream tasks. We hypothesize that cross-modal reconstruction objectives are important for successful multimodal training, as they encourage the model to integrate information across modalities. We demonstrate that modality dropout in the input space improves performance across downstream tasks. We also find that late-fusion models pretrained with contrastive learning objectives are less effective across multiple tasks. Finally, we analyze the model's representations, showing that attention weights become more cross-modal and temporally aligned with our pretraining strategy. The learned embeddings also become more distributed in terms of the modalities encoded by each unit. Overall, our work demonstrates the utility of multimodal foundation models with health data, even across diverse physiological data sources. We further argue that explicit methods for inducing cross-modality may enhance multimodal pretraining strategies.

Sayeri Lala, Hanlin Goh, Christopher Sandino

Sleep staging is a clinically important task for diagnosing various sleep disorders, but remains challenging to deploy at scale because it because it is both labor-intensive and time-consuming. Supervised deep learning-based approaches can automate sleep staging but at the expense of large labeled datasets, which can be unfeasible to procure for various settings, e.g., uncommon sleep disorders. While self-supervised learning (SSL) can mitigate this need, recent studies on SSL for sleep staging have shown performance gains saturate after training with labeled data from only tens of subjects, hence are unable to match peak performance attained with larger datasets. We hypothesize that the rapid saturation stems from applying a sub-optimal pretraining scheme that pretrains only a portion of the architecture, i.e., the feature encoder, but not the temporal encoder; therefore, we propose adopting an architecture that seamlessly couples the feature and temporal encoding and a suitable pretraining scheme that pretrains the entire model. On a sample sleep staging dataset, we find that the proposed scheme offers performance gains that do not saturate with amount of labeled training data (e.g., 3-5\% improvement in balanced sleep staging accuracy across low- to high-labeled data settings), reducing the amount of labeled training data needed for high performance (e.g., by 800 subjects). Based on our findings, we recommend adopting this SSL paradigm for subsequent work on SSL for sleep staging.

Ke Wang, Michael Kellman, Christopher M. Sandino et al.

Deep learning (DL) based unrolled reconstructions have shown state-of-the-art performance for under-sampled magnetic resonance imaging (MRI). Similar to compressed sensing, DL can leverage high-dimensional data (e.g. 3D, 2D+time, 3D+time) to further improve performance. However, network size and depth are currently limited by the GPU memory required for backpropagation. Here we use a memory-efficient learning (MEL) framework which favorably trades off storage with a manageable increase in computation during training. Using MEL with multi-dimensional data, we demonstrate improved image reconstruction performance for in-vivo 3D MRI and 2D+time cardiac cine MRI. MEL uses far less GPU memory while marginally increasing the training time, which enables new applications of DL to high-dimensional MRI.

Jeffrey Ma, Ukash Nakarmi, Cedric Yue Sik Kin et al.

Magnetic Resonance Imaging (MRI) suffers from several artifacts, the most common of which are motion artifacts. These artifacts often yield images that are of non-diagnostic quality. To detect such artifacts, images are prospectively evaluated by experts for their diagnostic quality, which necessitates patient-revisits and rescans whenever non-diagnostic quality scans are encountered. This motivates the need to develop an automated framework capable of accessing medical image quality and detecting diagnostic and non-diagnostic images. In this paper, we explore several convolutional neural network-based frameworks for medical image quality assessment and investigate several challenges therein.

Christopher M. Sandino, Peng Lai, Shreyas S. Vasanawala et al.

A novel neural network architecture, known as DL-ESPIRiT, is proposed to reconstruct rapidly acquired cardiac MRI data without field-of-view limitations which are present in previously proposed deep learning-based reconstruction frameworks. Additionally, a novel convolutional neural network based on separable 3D convolutions is integrated into DL-ESPIRiT to more efficiently learn spatiotemporal priors for dynamic image reconstruction. The network is trained on fully-sampled 2D cardiac cine datasets collected from eleven healthy volunteers with IRB approval. DL-ESPIRiT is compared against a state-of-the-art parallel imaging and compressed sensing method known as $l_1$-ESPIRiT. The reconstruction accuracy of both methods is evaluated on retrospectively undersampled datasets (R=12) with respect to standard image quality metrics as well as automatic deep learning-based segmentations of left ventricular volumes. Feasibility of this approach is demonstrated in reconstructions of prospectively undersampled data which were acquired in a single heartbeat per slice.

Mario O. Malavé, Corey A. Baron, Srivathsan P. Koundinyan et al.

Purpose: To rapidly reconstruct undersampled 3D non-Cartesian image-based navigators (iNAVs) using an unrolled deep learning (DL) model for non-rigid motion correction in coronary magnetic resonance angiography (CMRA). Methods: An unrolled network is trained to reconstruct beat-to-beat 3D iNAVs acquired as part of a CMRA sequence. The unrolled model incorporates a non-uniform FFT operator to perform the data consistency operation, and the regularization term is learned by a convolutional neural network (CNN) based on the proximal gradient descent algorithm. The training set includes 6,000 3D iNAVs acquired from 7 different subjects and 11 scans using a variable-density (VD) cones trajectory. For testing, 3D iNAVs from 4 additional subjects are reconstructed using the unrolled model. To validate reconstruction accuracy, global and localized motion estimates from DL model-based 3D iNAVs are compared with those extracted from 3D iNAVs reconstructed with $\textit{l}_{1}$-ESPIRiT. Then, the high-resolution coronary MRA images motion corrected with autofocusing using the $\textit{l}_{1}$-ESPIRiT and DL model-based 3D iNAVs are assessed for differences. Results: 3D iNAVs reconstructed using the DL model-based approach and conventional $\textit{l}_{1}$-ESPIRiT generate similar global and localized motion estimates and provide equivalent coronary image quality. Reconstruction with the unrolled network completes in a fraction of the time compared to CPU and GPU implementations of $\textit{l}_{1}$-ESPIRiT (20x and 3x speed increases, respectively). Conclusion: We have developed a deep neural network architecture to reconstruct undersampled 3D non-Cartesian VD cones iNAVs. Our approach decreases reconstruction time for 3D iNAVs, while preserving the accuracy of non-rigid motion information offered by them for correction.