Nicola K. Dinsdale

Nicola K Dinsdale, Mark Jenkinson, Ana IL Namburete

The ability to combine data across scanners and studies is vital for neuroimaging, to increase both statistical power and the representation of biological variability. However, combining datasets across sites leads to two challenges: first, an increase in undesirable non-biological variance due to scanner and acquisition differences - the harmonisation problem - and second, data privacy concerns due to the inherently personal nature of medical imaging data, meaning that sharing them across sites may risk violation of privacy laws. To overcome these restrictions, we propose FedHarmony: a harmonisation framework operating in the federated learning paradigm. We show that to remove the scanner-specific effects, we only need to share the mean and standard deviation of the learned features, helping to protect individual subjects' privacy. We demonstrate our approach across a range of realistic data scenarios, using real multi-site data from the ABIDE dataset, thus showing the potential utility of our method for MRI harmonisation across studies. Our code is available at https://github.com/nkdinsdale/FedHarmony.

Nicola K Dinsdale, Mark Jenkinson, Ana IL Namburete

To represent the biological variability of clinical neuroimaging populations, it is vital to be able to combine data across scanners and studies. However, different MRI scanners produce images with different characteristics, resulting in a domain shift known as the `harmonisation problem'. Additionally, neuroimaging data is inherently personal in nature, leading to data privacy concerns when sharing the data. To overcome these barriers, we propose an Unsupervised Source-Free Domain Adaptation (SFDA) method, SFHarmony. Through modelling the imaging features as a Gaussian Mixture Model and minimising an adapted Bhattacharyya distance between the source and target features, we can create a model that performs well for the target data whilst having a shared feature representation across the data domains, without needing access to the source data for adaptation or target labels. We demonstrate the performance of our method on simulated and real domain shifts, showing that the approach is applicable to classification, segmentation and regression tasks, requiring no changes to the algorithm. Our method outperforms existing SFDA approaches across a range of realistic data scenarios, demonstrating the potential utility of our approach for MRI harmonisation and general SFDA problems. Our code is available at \url{https://github.com/nkdinsdale/SFHarmony}.

Linde S. Hesse, Nicola K. Dinsdale, Ana I. L. Namburete

The lack of explainability of deep learning models limits the adoption of such models in clinical practice. Prototype-based models can provide inherent explainable predictions, but these have predominantly been designed for classification tasks, despite many important tasks in medical imaging being continuous regression problems. Therefore, in this work, we present ExPeRT: an explainable prototype-based model specifically designed for regression tasks. Our proposed model makes a sample prediction from the distances to a set of learned prototypes in latent space, using a weighted mean of prototype labels. The distances in latent space are regularized to be relative to label differences, and each of the prototypes can be visualized as a sample from the training set. The image-level distances are further constructed from patch-level distances, in which the patches of both images are structurally matched using optimal transport. This thus provides an example-based explanation with patch-level detail at inference time. We demonstrate our proposed model for brain age prediction on two imaging datasets: adult MR and fetal ultrasound. Our approach achieved state-of-the-art prediction performance while providing insight into the model's reasoning process.

Jieyun Bai, Zihao Zhou, Yitong Tang et al.

A substantial proportion (45\%) of maternal deaths, neonatal deaths, and stillbirths occur during the intrapartum phase, with a particularly high burden in low- and middle-income countries. Intrapartum biometry plays a critical role in monitoring labor progression; however, the routine use of ultrasound in resource-limited settings is hindered by a shortage of trained sonographers. To address this challenge, the Intrapartum Ultrasound Grand Challenge (IUGC), co-hosted with MICCAI 2024, was launched. The IUGC introduces a clinically oriented multi-task automatic measurement framework that integrates standard plane classification, fetal head-pubic symphysis segmentation, and biometry, enabling algorithms to exploit complementary task information for more accurate estimation. Furthermore, the challenge releases the largest multi-center intrapartum ultrasound video dataset to date, comprising 774 videos (68,106 frames) collected from three hospitals, providing a robust foundation for model training and evaluation. In this study, we present a comprehensive overview of the challenge design, review the submissions from eight participating teams, and analyze their methods from five perspectives: preprocessing, data augmentation, learning strategy, model architecture, and post-processing. In addition, we perform a systematic analysis of the benchmark results to identify key bottlenecks, explore potential solutions, and highlight open challenges for future research. Although encouraging performance has been achieved, our findings indicate that the field remains at an early stage, and further in-depth investigation is required before large-scale clinical deployment. All benchmark solutions and the complete dataset have been publicly released to facilitate reproducible research and promote continued advances in automatic intrapartum ultrasound biometry.

Joshua Omolegan, Pak Hei Yeung, Madeleine K. Wyburd et al.

Monitoring the growth of subcortical regions of the fetal brain in ultrasound (US) images can help identify the presence of abnormal development. Manually segmenting these regions is a challenging task, but recent work has shown that it can be automated using deep learning. However, applying pretrained models to unseen freehand US volumes often leads to a degradation of performance due to the vast differences in acquisition and alignment. In this work, we first demonstrate that test time adaptation (TTA) can be used to improve model performance in the presence of both real and simulated domain shifts. We further propose a novel TTA method by incorporating a normative atlas as a prior for anatomy. In the presence of various types of domain shifts, we benchmark the performance of different TTA methods and demonstrate the improvements brought by our proposed approach, which may further facilitate automated monitoring of fetal brain development. Our code is available at https://github.com/joshuaomolegan/TTA-for-3D-Fetal-Subcortical-Segmentation.

Madeleine K. Wyburd, Nicola K. Dinsdale, Ana I. L. Namburete et al.

Accurate topology is key when performing meaningful anatomical segmentations, however, it is often overlooked in traditional deep learning methods. In this work we propose TEDS-Net: a novel segmentation method that guarantees accurate topology. Our method is built upon a continuous diffeomorphic framework, which enforces topology preservation. However, in practice, diffeomorphic fields are represented using a finite number of parameters and sampled using methods such as linear interpolation, violating the theoretical guarantees. We therefore introduce additional modifications to more strictly enforce it. Our network learns how to warp a binary prior, with the desired topological characteristics, to complete the segmentation task. We tested our method on myocardium segmentation from an open-source 2D heart dataset. TEDS-Net preserved topology in 100% of the cases, compared to 90% from the U-Net, without sacrificing on Hausdorff Distance or Dice performance. Code will be made available at: www.github.com/mwyburd/TEDS-Net

Jayroop Ramesh, Nicola K Dinsdale, the INTERGROWTH-21st Consortium et al.

Accurately localizing two-dimensional (2D) ultrasound (US) fetal brain images in the 3D brain, using minimal computational resources, is an important task for automated US analysis of fetal growth and development. We propose an uncertainty-aware deep learning model for automated 3D plane localization in 2D fetal brain images. Specifically, a multi-head network is trained to jointly regress 3D plane pose from 2D images in terms of different geometric transformations. The model explicitly learns to predict uncertainty to allocate higher weight to inputs with low variances across different transformations to improve performance. Our proposed method, QAERTS, demonstrates superior pose estimation accuracy than the state-of-the-art and most of the uncertainty-based approaches, leading to 9% improvement on plane angle (PA) for localization accuracy, and 8% on normalized cross-correlation (NCC) for sampled image quality. QAERTS also demonstrates efficiency, containing 5$\times$ fewer parameters than ensemble-based approach, making it advantageous in resource-constrained settings. In addition, QAERTS proves to be more robust to noise effects observed in freehand US scanning by leveraging rotational discontinuities and explicit output uncertainties.

Hoda Kalabizadeh, Ludovica Griffanti, Pak-Hei Yeung et al.

Deep learning models for medical image segmentation often struggle when deployed across different datasets due to domain shifts - variations in both image appearance, known as style, and population-dependent anatomical characteristics, referred to as content. This paper presents a novel unsupervised domain adaptation framework that directly addresses domain shifts encountered in cross-domain hippocampus segmentation from MRI, with specific emphasis on content variations. Our approach combines efficient style harmonisation through z-normalisation with a bidirectional deformable image registration (DIR) strategy. The DIR network is jointly trained with segmentation and discriminator networks to guide the registration with respect to a region of interest and generate anatomically plausible transformations that align source images to the target domain. We validate our approach through comprehensive evaluations on both a synthetic dataset using Morpho-MNIST (for controlled validation of core principles) and three MRI hippocampus datasets representing populations with varying degrees of atrophy. Across all experiments, our method outperforms existing baselines. For hippocampus segmentation, when transferring from young, healthy populations to clinical dementia patients, our framework achieves up to 15% relative improvement in Dice score compared to standard augmentation methods, with the largest gains observed in scenarios with substantial content shift. These results highlight the efficacy of our approach for accurate hippocampus segmentation across diverse populations.

Jayroop Ramesh, Valentin Bacher, Mark C. Eid et al.

The International Society of Ultrasound advocates Intrapartum Ultrasound (US) Imaging in Obstetrics and Gynecology (ISUOG) to monitor labour progression through changes in fetal head position. Two reliable ultrasound-derived parameters that are used to predict outcomes of instrumental vaginal delivery are the angle of progression (AoP) and head-symphysis distance (HSD). In this work, as part of the Intrapartum Ultrasounds Grand Challenge (IUGC) 2024, we propose an automated fetal biometry measurement pipeline to reduce intra- and inter-observer variability and improve measurement reliability. Our pipeline consists of three key tasks: (i) classification of standard planes (SP) from US videos, (ii) segmentation of fetal head and pubic symphysis from the detected SPs, and (iii) computation of the AoP and HSD from the segmented regions. We perform sparse sampling to mitigate class imbalances and reduce spurious correlations in task (i), and utilize ensemble-based deep learning methods for task (i) and (ii) to enhance generalizability under different US acquisition settings. Finally, to promote robustness in task iii) with respect to the structural fidelity of measurements, we retain the largest connected components and apply ellipse fitting to the segmentations. Our solution achieved ACC: 0.9452, F1: 0.9225, AUC: 0.983, MCC: 0.8361, DSC: 0.918, HD: 19.73, ASD: 5.71, $Δ_{AoP}$: 8.90 and $Δ_{HSD}$: 14.35 across an unseen hold-out set of 4 patients and 224 US frames. The results from the proposed automated pipeline can improve the understanding of labour arrest causes and guide the development of clinical risk stratification tools for efficient and effective prenatal care.

Nicola K Dinsdale, Emma Bluemke, Vaanathi Sundaresan et al.

The combination of deep learning image analysis methods and large-scale imaging datasets offers many opportunities to imaging neuroscience and epidemiology. However, despite the success of deep learning when applied to many neuroimaging tasks, there remain barriers to the clinical translation of large-scale datasets and processing tools. Here, we explore the main challenges and the approaches that have been explored to overcome them. We focus on issues relating to data availability, interpretability, evaluation and logistical challenges, and discuss the challenges we believe are still to be overcome to enable the full success of big data deep learning approaches to be experienced outside of the research field.