Syed Muhammad Anwar

Sunder Ali Khowaja, Kapal Dev, Syed Muhammad Anwar et al.

Self-supervised learning in the federated learning paradigm has been gaining a lot of interest both in industry and research due to the collaborative learning capability on unlabeled yet isolated data. However, self-supervised based federated learning strategies suffer from performance degradation due to label scarcity and diverse data distributions, i.e., data heterogeneity. In this paper, we propose the SelfFed framework for medical images to overcome data heterogeneity and label scarcity issues. The first phase of the SelfFed framework helps to overcome the data heterogeneity issue by leveraging the pre-training paradigm that performs augmentative modeling using Swin Transformer-based encoder in a decentralized manner. The label scarcity issue is addressed by fine-tuning paradigm that introduces a contrastive network and a novel aggregation strategy. We perform our experimental analysis on publicly available medical imaging datasets to show that SelfFed performs better when compared to existing baselines and works. Our method achieves a maximum improvement of 8.8% and 4.1% on Retina and COVID-FL datasets on non-IID datasets. Further, our proposed method outperforms existing baselines even when trained on a few (10%) labeled instances.

Abhijeet Parida, Zhifan Jiang, Syed Muhammad Anwar et al.

For machine learning-based prognosis and diagnosis of rare diseases, such as pediatric brain tumors, it is necessary to gather medical imaging data from multiple clinical sites that may use different devices and protocols. Deep learning-driven harmonization of radiologic images relies on generative adversarial networks (GANs). However, GANs notoriously generate pseudo structures that do not exist in the original training data, a phenomenon known as "hallucination". To prevent hallucination in medical imaging, such as magnetic resonance images (MRI) of the brain, we propose a one-shot learning method where we utilize neural style transfer for harmonization. At test time, the method uses one image from a clinical site to generate an image that matches the intensity scale of the collaborating sites. Our approach combines learning a feature extractor, neural style transfer, and adaptive instance normalization. We further propose a novel strategy to evaluate the effectiveness of image harmonization approaches with evaluation metrics that both measure image style harmonization and assess the preservation of anatomical structures. Experimental results demonstrate the effectiveness of our method in preserving patient anatomy while adjusting the image intensities to a new clinical site. Our general harmonization model can be used on unseen data from new sites, making it a valuable tool for real-world medical applications and clinical trials.

Sara Atito, Syed Muhammad Anwar, Muhammad Awais et al.

The availability of large scale data with high quality ground truth labels is a challenge when developing supervised machine learning solutions for healthcare domain. Although, the amount of digital data in clinical workflows is increasing, most of this data is distributed on clinical sites and protected to ensure patient privacy. Radiological readings and dealing with large-scale clinical data puts a significant burden on the available resources, and this is where machine learning and artificial intelligence play a pivotal role. Magnetic Resonance Imaging (MRI) for musculoskeletal (MSK) diagnosis is one example where the scans have a wealth of information, but require a significant amount of time for reading and labeling. Self-supervised learning (SSL) can be a solution for handling the lack of availability of ground truth labels, but generally requires a large amount of training data during the pretraining stage. Herein, we propose a slice-based self-supervised deep learning framework (SB-SSL), a novel slice-based paradigm for classifying abnormality using knee MRI scans. We show that for a limited number of cases (<1000), our proposed framework is capable to identify anterior cruciate ligament tear with an accuracy of 89.17% and an AUC of 0.954, outperforming state-of-the-art without usage of external data during pretraining. This demonstrates that our proposed framework is suited for SSL in the limited data regime.

Syed Muhammad Anwar, Abhijeet Parida, Sara Atito et al.

Chest X-rays (CXRs) are a widely used imaging modality for the diagnosis and prognosis of lung disease. The image analysis tasks vary. Examples include pathology detection and lung segmentation. There is a large body of work where machine learning algorithms are developed for specific tasks. A significant recent example is Coronavirus disease (covid-19) detection using CXR data. However, the traditional diagnostic tool design methods based on supervised learning are burdened by the need to provide training data annotation, which should be of good quality for better clinical outcomes. Here, we propose an alternative solution, a new self-supervised paradigm, where a general representation from CXRs is learned using a group-masked self-supervised framework. The pre-trained model is then fine-tuned for domain-specific tasks such as covid-19, pneumonia detection, and general health screening. We show that the same pre-training can be used for the lung segmentation task. Our proposed paradigm shows robust performance in multiple downstream tasks which demonstrates the success of the pre-training. Moreover, the performance of the pre-trained models on data with significant drift during test time proves the learning of a better generic representation. The methods are further validated by covid-19 detection in a unique small-scale pediatric data set. The performance gain in accuracy (~25%) is significant when compared to a supervised transformer-based method. This adds credence to the strength and reliability of our proposed framework and pre-training strategy.

Saadat Ullah Khan, Muhammad Majid, Syed Muhammad Anwar

The loss of limb motion arising from damage to the spinal cord is a disability that could effect people while performing their day-to-day activities. The restoration of limb movement would enable people with spinal cord injury to interact with their environment more naturally and this is where a brain-computer interface (BCI) system could be beneficial. The detection of limb movement imagination (MI) could be significant for such a BCI, where the detected MI can guide the computer system. Using MI detection through electroencephalography (EEG), we can recognize the imagination of movement in a user and translate this into a physical movement. In this paper, we utilize pre-trained deep learning (DL) algorithms for the classification of imagined upper limb movements. We use a publicly available EEG dataset with data representing seven classes of limb movements. We compute the spectrograms of the time series EEG signal and use them as an input to the DL model for MI classification. Our novel approach for the classification of upper limb movements using pre-trained DL algorithms and spectrograms has achieved significantly improved results for seven movement classes. When compared with the recently proposed state-of-the-art methods, our algorithm achieved a significant average accuracy of 84.9% for classifying seven movements.

Daniel Capellán-Martín, Zhifan Jiang, Abhijeet Parida et al.

Segmenting brain tumors in multi-parametric magnetic resonance imaging enables performing quantitative analysis in support of clinical trials and personalized patient care. This analysis provides the potential to impact clinical decision-making processes, including diagnosis and prognosis. In 2023, the well-established Brain Tumor Segmentation (BraTS) challenge presented a substantial expansion with eight tasks and 4,500 brain tumor cases. In this paper, we present a deep learning-based ensemble strategy that is evaluated for newly included tumor cases in three tasks: pediatric brain tumors (PED), intracranial meningioma (MEN), and brain metastases (MET). In particular, we ensemble outputs from state-of-the-art nnU-Net and Swin UNETR models on a region-wise basis. Furthermore, we implemented a targeted post-processing strategy based on a cross-validated threshold search to improve the segmentation results for tumor sub-regions. The evaluation of our proposed method on unseen test cases for the three tasks resulted in lesion-wise Dice scores for PED: 0.653, 0.809, 0.826; MEN: 0.876, 0.867, 0.849; and MET: 0.555, 0.6, 0.58; for the enhancing tumor, tumor core, and whole tumor, respectively. Our method was ranked first for PED, third for MEN, and fourth for MET, respectively.

Shanghao Shi, Md Shahedul Haque, Abhijeet Parida et al.

Federated learning (FL) allows participants to collaboratively train machine learning models while keeping their data local, making it ideal for collaborations among healthcare institutions on sensitive data. However, in this paper, we propose a novel privacy attack called MedLeak, which allows a malicious FL server to recover high-quality site-specific private medical data from the client model updates. MedLeak works by introducing an adversarially crafted model during the FL training process. Honest clients, unaware of the insidious changes in the published models, continue to send back their updates as per the standard FL protocol. Leveraging a novel analytical method, MedLeak can efficiently recover private client data from the aggregated parameter updates, eliminating costly optimization. In addition, the scheme relies solely on the aggregated updates, thus rendering secure aggregation protocols ineffective, as they depend on the randomization of intermediate results for security while leaving the final aggregated results unaltered. We implement MedLeak on medical image datasets (MedMNIST, COVIDx CXR-4, and Kaggle Brain Tumor MRI), as well as a medical text dataset (MedAbstract). The results demonstrate that our attack achieves high recovery rates and strong quantitative scores on both image and text datasets. We also thoroughly evaluate MedLeak across different attack parameters, providing insights into key factors that influence attack performance and potential defenses. Furthermore, we demonstrate that the recovered data can support downstream tasks such as disease classification with minimal performance loss. Our findings validate the need for enhanced privacy measures in FL systems, particularly for safeguarding sensitive medical data against powerful model inversion attacks.

Hareem Nisar, Syed Muhammad Anwar, Zhifan Jiang et al.

Large vision language models (VLMs) have progressed incredibly from research to applicability for general-purpose use cases. LLaVA-Med, a pioneering large language and vision assistant for biomedicine, can perform multi-modal biomedical image and data analysis to provide a natural language interface for radiologists. While it is highly generalizable and works with multi-modal data, it is currently limited by well-known challenges that exist in the large language model space. Hallucinations and imprecision in responses can lead to misdiagnosis which currently hinder the clinical adaptability of VLMs. To create precise, user-friendly models in healthcare, we propose D-Rax -- a domain-specific, conversational, radiologic assistance tool that can be used to gain insights about a particular radiologic image. In this study, we enhance the conversational analysis of chest X-ray (CXR) images to support radiological reporting, offering comprehensive insights from medical imaging and aiding in the formulation of accurate diagnosis. D-Rax is achieved by fine-tuning the LLaVA-Med architecture on our curated enhanced instruction-following data, comprising of images, instructions, as well as disease diagnosis and demographic predictions derived from MIMIC-CXR imaging data, CXR-related visual question answer (VQA) pairs, and predictive outcomes from multiple expert AI models. We observe statistically significant improvement in responses when evaluated for both open and close-ended conversations. Leveraging the power of state-of-the-art diagnostic models combined with VLMs, D-Rax empowers clinicians to interact with medical images using natural language, which could potentially streamline their decision-making process, enhance diagnostic accuracy, and conserve their time.

Furqan Shaukat, Syed Muhammad Anwar, Abhijeet Parida et al.

Lung cancer has been one of the major threats to human life for decades. Computer-aided diagnosis can help with early lung nodul detection and facilitate subsequent nodule characterization. Large Visual Language models (VLMs) have been found effective for multiple downstream medical tasks that rely on both imaging and text data. However, lesion level detection and subsequent diagnosis using VLMs have not been explored yet. We propose CADe, for segmenting lung nodules in a zero-shot manner using a variant of the Segment Anything Model called MedSAM. CADe trains on a prompt suite on input computed tomography (CT) scans by using the CLIP text encoder through prefix tuning. We also propose, CADx, a method for the nodule characterization as benign/malignant by making a gallery of radiomic features and aligning image-feature pairs through contrastive learning. Training and validation of CADe and CADx have been done using one of the largest publicly available datasets, called LIDC. To check the generalization ability of the model, it is also evaluated on a challenging dataset, LUNGx. Our experimental results show that the proposed methods achieve a sensitivity of 0.86 compared to 0.76 that of other fully supervised methods.The source code, datasets and pre-processed data can be accessed using the link:

Krithika Iyer, Austin Tapp, Athelia Paulli et al.

Quantifying normative pediatric cranial development and suture ossification is crucial for diagnosing and treating growth-related cephalic disorders. Computed tomography (CT) is widely used to evaluate cranial and sutural deformities; however, its ionizing radiation is contraindicated in children without significant abnormalities. Magnetic resonance imaging (MRI) offers radiation free scans with superior soft tissue contrast, but unlike CT, MRI cannot elucidate cranial sutures, estimate skull bone density, or assess cranial vault growth. This study proposes a deep learning driven pipeline for transforming T1 weighted MRIs of children aged 0.2 to 2 years into synthetic CTs (sCTs), predicting detailed cranial bone segmentation, generating suture probability heatmaps, and deriving direct suture segmentation from the heatmaps. With our in-house pediatric data, sCTs achieved 99% structural similarity and a Frechet inception distance of 1.01 relative to real CTs. Skull segmentation attained an average Dice coefficient of 85% across seven cranial bones, and sutures achieved 80% Dice. Equivalence of skull and suture segmentation between sCTs and real CTs was confirmed using two one sided tests (TOST p < 0.05). To our knowledge, this is the first pediatric cranial CT synthesis framework to enable suture segmentation on sCTs derived from MRI, despite MRI's limited depiction of bone and sutures. By combining robust, domain specific variational autoencoders, our method generates perceptually indistinguishable cranial sCTs from routine pediatric MRIs, bridging critical gaps in non invasive cranial evaluation.

Zhifan Jiang, Daniel Capellán-Martín, Abhijeet Parida et al.

Accurate and automatic segmentation of brain tumors in multi-parametric magnetic resonance imaging (mpMRI) is essential for quantitative measurements, which play an increasingly important role in clinical diagnosis and prognosis. The International Brain Tumor Segmentation (BraTS) Challenge 2024 offers a unique benchmarking opportunity, including various types of brain tumors in both adult and pediatric populations, such as pediatric brain tumors (PED), meningiomas (MEN-RT) and brain metastases (MET), among others. Compared to previous editions, BraTS 2024 has implemented changes to substantially increase clinical relevance, such as refined tumor regions for evaluation. We propose a deep learning-based ensemble approach that integrates state-of-the-art segmentation models. Additionally, we introduce innovative, adaptive pre- and post-processing techniques that employ MRI-based radiomic analyses to differentiate tumor subtypes. Given the heterogeneous nature of the tumors present in the BraTS datasets, this approach enhances the precision and generalizability of segmentation models. On the final testing sets, our method achieved mean lesion-wise Dice similarity coefficients of 0.926, 0.801, and 0.688 for the whole tumor in PED, MEN-RT, and MET, respectively. These results demonstrate the effectiveness of our approach in improving segmentation performance and generalizability for various brain tumor types. The source code of our implementation is available at https://github.com/Precision-Medical-Imaging-Group/HOPE-Segmenter-Kids. Additionally, an open-source web-application is accessible at https://segmenter.hope4kids.io/ which uses the docker container aparida12/brats-peds-2024:v20240913 .

Max Bengtsson, Elif Keles, Gorkem Durak et al.

In this paper, we present a novel approach for segmenting pediatric brain tumors using a deep learning architecture, inspired by expert radiologists' segmentation strategies. Our model delineates four distinct tumor labels and is benchmarked on a held-out PED BraTS 2024 test set (i.e., pediatric brain tumor datasets introduced by BraTS). Furthermore, we evaluate our model's performance against the state-of-the-art (SOTA) model using a new external dataset of 30 patients from CBTN (Children's Brain Tumor Network), labeled in accordance with the PED BraTS 2024 guidelines and 2023 BraTS Adult Glioma dataset. We compare segmentation outcomes with the winning algorithm from the PED BraTS 2023 challenge as the SOTA model. Our proposed algorithm achieved an average Dice score of 0.642 and an HD95 of 73.0 mm on the CBTN test data, outperforming the SOTA model, which achieved a Dice score of 0.626 and an HD95 of 84.0 mm. Moreover, our model exhibits strong generalizability, attaining a 0.877 Dice score in whole tumor segmentation on the BraTS 2023 Adult Glioma dataset, surpassing existing SOTA. Our results indicate that the proposed model is a step towards providing more accurate segmentation for pediatric brain tumors, which is essential for evaluating therapy response and monitoring patient progress. Our source code is available at https://github.com/NUBagciLab/Pediatric-Brain-Tumor-Segmentation-Model.

Dominic LaBella, Ujjwal Baid, Omaditya Khanna et al.

We describe the design and results from the BraTS 2023 Intracranial Meningioma Segmentation Challenge. The BraTS Meningioma Challenge differed from prior BraTS Glioma challenges in that it focused on meningiomas, which are typically benign extra-axial tumors with diverse radiologic and anatomical presentation and a propensity for multiplicity. Nine participating teams each developed deep-learning automated segmentation models using image data from the largest multi-institutional systematically expert annotated multilabel multi-sequence meningioma MRI dataset to date, which included 1000 training set cases, 141 validation set cases, and 283 hidden test set cases. Each case included T2, FLAIR, T1, and T1Gd brain MRI sequences with associated tumor compartment labels delineating enhancing tumor, non-enhancing tumor, and surrounding non-enhancing FLAIR hyperintensity. Participant automated segmentation models were evaluated and ranked based on a scoring system evaluating lesion-wise metrics including dice similarity coefficient (DSC) and 95% Hausdorff Distance. The top ranked team had a lesion-wise median dice similarity coefficient (DSC) of 0.976, 0.976, and 0.964 for enhancing tumor, tumor core, and whole tumor, respectively and a corresponding average DSC of 0.899, 0.904, and 0.871, respectively. These results serve as state-of-the-art benchmarks for future pre-operative meningioma automated segmentation algorithms. Additionally, we found that 1286 of 1424 cases (90.3%) had at least 1 compartment voxel abutting the edge of the skull-stripped image edge, which requires further investigation into optimal pre-processing face anonymization steps.

Abhijeet Parida, Daniel Capellán-Martín, Zhifan Jiang et al.

Gliomas, a kind of brain tumor characterized by high mortality, present substantial diagnostic challenges in low- and middle-income countries, particularly in Sub-Saharan Africa. This paper introduces a novel approach to glioma segmentation using transfer learning to address challenges in resource-limited regions with minimal and low-quality MRI data. We leverage pre-trained deep learning models, nnU-Net and MedNeXt, and apply a stratified fine-tuning strategy using the BraTS2023-Adult-Glioma and BraTS-Africa datasets. Our method exploits radiomic analysis to create stratified training folds, model training on a large brain tumor dataset, and transfer learning to the Sub-Saharan context. A weighted model ensembling strategy and adaptive post-processing are employed to enhance segmentation accuracy. The evaluation of our proposed method on unseen validation cases on the BraTS-Africa 2024 task resulted in lesion-wise mean Dice scores of 0.870, 0.865, and 0.926, for enhancing tumor, tumor core, and whole tumor regions and was ranked first for the challenge. Our approach highlights the ability of integrated machine-learning techniques to bridge the gap between the medical imaging capabilities of resource-limited countries and established developed regions. By tailoring our methods to a target population's specific needs and constraints, we aim to enhance diagnostic capabilities in isolated environments. Our findings underscore the importance of approaches like local data integration and stratification refinement to address healthcare disparities, ensure practical applicability, and enhance impact. A dockerized version of the BraTS-Africa 2024 winning algorithm is available at https://hub.docker.com/r/aparida12/brats-ssa-2024 .

Abhijeet Parida, Daniel Capellan-Martin, Sara Atito et al.

Chest X-Ray (CXR) is a widely used clinical imaging modality and has a pivotal role in the diagnosis and prognosis of various lung and heart related conditions. Conventional automated clinical diagnostic tool design strategies relying on radiology reads and supervised learning, entail the cumbersome requirement of high quality annotated training data. To address this challenge, self-supervised pre-training has proven to outperform supervised pre-training in numerous downstream vision tasks, representing a significant breakthrough in the field. However, medical imaging pre-training significantly differs from pre-training with natural images (e.g., ImageNet) due to unique attributes of clinical images. In this context, we introduce Diverse Concept Modeling (DiCoM), a novel self-supervised training paradigm that leverages a student teacher framework for learning diverse concepts and hence effective representation of the CXR data. Hence, expanding beyond merely modeling a single primary label within an image, instead, effectively harnessing the information from all the concepts inherent in the CXR. The pre-trained model is subsequently fine-tuned to address diverse domain-specific tasks. Our proposed paradigm consistently demonstrates robust performance across multiple downstream tasks on multiple datasets, highlighting the success and generalizability of the pre-training strategy. To establish the efficacy of our methods we analyze both the power of learned representations and the speed of convergence (SoC) of our models. For diverse data and tasks, DiCoM is able to achieve in most cases better results compared to other state-of-the-art pre-training strategies. This when combined with the higher SoC and generalization capabilities positions DiCoM to be established as a foundation model for CXRs, a widely used imaging modality.

Daniel Capellán-Martín, Abhijeet Parida, Juan J. Gómez-Valverde et al.

Tuberculosis (TB) remains a significant global health challenge, with pediatric cases posing a major concern. The World Health Organization (WHO) advocates for chest X-rays (CXRs) for TB screening. However, visual interpretation by radiologists can be subjective, time-consuming and prone to error, especially in pediatric TB. Artificial intelligence (AI)-driven computer-aided detection (CAD) tools, especially those utilizing deep learning, show promise in enhancing lung disease detection. However, challenges include data scarcity and lack of generalizability. In this context, we propose a novel self-supervised paradigm leveraging Vision Transformers (ViT) for improved TB detection in CXR, enabling zero-shot pediatric TB detection. We demonstrate improvements in TB detection performance ($\sim$12.7% and $\sim$13.4% top AUC/AUPR gains in adults and children, respectively) when conducting self-supervised pre-training when compared to fully-supervised (i.e., non pre-trained) ViT models, achieving top performances of 0.959 AUC and 0.962 AUPR in adult TB detection, and 0.697 AUC and 0.607 AUPR in zero-shot pediatric TB detection. As a result, this work demonstrates that self-supervised learning on adult CXRs effectively extends to challenging downstream tasks such as pediatric TB detection, where data are scarce.

Abhijeet Parida, Zhifan Jiang, Roger J. Packer et al.

Image harmonization is an important preprocessing strategy to address domain shifts arising from data acquired using different machines and scanning protocols in medical imaging. However, benchmarking the effectiveness of harmonization techniques has been a challenge due to the lack of widely available standardized datasets with ground truths. In this context, we propose three metrics: two intensity harmonization metrics and one anatomy preservation metric for medical images during harmonization, where no ground truths are required. Through extensive studies on a dataset with available harmonization ground truth, we demonstrate that our metrics are correlated with established image quality assessment metrics. We show how these novel metrics may be applied to real-world scenarios where no harmonization ground truth exists. Additionally, we provide insights into different interpretations of the metric values, shedding light on their significance in the context of the harmonization process. As a result of our findings, we advocate for the adoption of these quantitative harmonization metrics as a standard for benchmarking the performance of image harmonization techniques.

Artur Agaronyan, HyeRan Choo, Marius Linguraru et al.

Rapid advances in 3D model scanning have enabled the mass digitization of dental clay models. However, most clinicians and researchers continue to use manual morphometric analysis methods on these models such as landmarking. This is a significant step in treatment planning for craniomaxillofacial conditions. We aimed to develop and test a geometric deep learning model that would accurately and reliably label landmarks on a complicated and specialized patient population -- infants, as accurately as a human specialist without a large amount of training data. Our developed pipeline demonstrated an accuracy of 94.44% with an absolute mean error of 1.676 +/- 0.959 mm on a set of 100 models acquired from newborn babies with cleft lip and palate. Our proposed pipeline has the potential to serve as a fast, accurate, and reliable quantifier of maxillary arch morphometric features, as well as an integral step towards a future fully automated dental treatment pipeline.

Medha Pappula, Syed Muhammad Anwar

This paper introduces an innovative approach to Attention-deficit/hyperactivity disorder (ADHD) diagnosis by employing deep learning (DL) techniques on electroencephalography (EEG) signals. This method addresses the limitations of current behavior-based diagnostic methods, which often lead to misdiagnosis and gender bias. By utilizing a publicly available EEG dataset and converting the signals into spectrograms, a Resnet-18 convolutional neural network (CNN) architecture was used to extract features for ADHD classification. The model achieved a high precision, recall, and an overall F1 score of 0.9. Feature extraction highlighted significant brain regions (frontopolar, parietal, and occipital lobes) associated with ADHD. These insights guided the creation of a three-part digital diagnostic system, facilitating cost-effective and accessible ADHD screening, especially in school environments. This system enables earlier and more accurate identification of students at risk for ADHD, providing timely support to enhance their developmental outcomes. This study showcases the potential of integrating EEG analysis with DL to enhance ADHD diagnostics, presenting a viable alternative to traditional methods.

Yicheng Leng, Syed Muhammad Anwar, Islem Rekik et al.

Functional Magnetic Resonance Imaging (fMRI) provides useful insights into the brain function both during task or rest. Representing fMRI data using correlation matrices is found to be a reliable method of analyzing the inherent connectivity of the brain in the resting and active states. Graph Neural Networks (GNNs) have been widely used for brain network analysis due to their inherent explainability capability. In this work, we introduce a novel framework using contrastive self-supervised learning graph transformers, incorporating a brain network transformer encoder with random graph alterations. The proposed network leverages both contrastive learning and graph alterations to effectively train the graph transformer for autism detection. Our approach, tested on Autism Brain Imaging Data Exchange (ABIDE) data, demonstrates superior autism detection, achieving an AUROC of 82.6 and an accuracy of 74%, surpassing current state-of-the-art methods.

Muhammad Mohsin Altaf, Saadat Ullah Khan, Muhammad Majd et al.

This paper presents an innovative approach to recognizing personality traits using deep learning (DL) methods applied to electrocardiogram (ECG) signals. Within the framework of detecting the big five personality traits model encompassing extra-version, neuroticism, agreeableness, conscientiousness, and openness, the research explores the potential of ECG-derived spectrograms as informative features. Optimal window sizes for spectrogram generation are determined, and a convolutional neural network (CNN), specifically Resnet-18, and visual transformer (ViT) are employed for feature extraction and personality trait classification. The study utilizes the publicly available ASCERTAIN dataset, which comprises various physiological signals, including ECG recordings, collected from 58 participants during the presentation of video stimuli categorized by valence and arousal levels. The outcomes of this study demonstrate noteworthy performance in personality trait classification, consistently achieving F1-scores exceeding 0.9 across different window sizes and personality traits. These results emphasize the viability of ECG signal spectrograms as a valuable modality for personality trait recognition, with Resnet-18 exhibiting effectiveness in discerning distinct personality traits.

Hongwei Bran Li, Gian Marco Conte, Qingqiao Hu et al.

Automated brain tumor segmentation methods have become well-established and reached performance levels offering clear clinical utility. These methods typically rely on four input magnetic resonance imaging (MRI) modalities: T1-weighted images with and without contrast enhancement, T2-weighted images, and FLAIR images. However, some sequences are often missing in clinical practice due to time constraints or image artifacts, such as patient motion. Consequently, the ability to substitute missing modalities and gain segmentation performance is highly desirable and necessary for the broader adoption of these algorithms in the clinical routine. In this work, we present the establishment of the Brain MR Image Synthesis Benchmark (BraSyn) in conjunction with the Medical Image Computing and Computer-Assisted Intervention (MICCAI) 2023. The primary objective of this challenge is to evaluate image synthesis methods that can realistically generate missing MRI modalities when multiple available images are provided. The ultimate aim is to facilitate automated brain tumor segmentation pipelines. The image dataset used in the benchmark is diverse and multi-modal, created through collaboration with various hospitals and research institutions.

Florian Kofler, Felix Meissen, Felix Steinbauer et al.

A myriad of algorithms for the automatic analysis of brain MR images is available to support clinicians in their decision-making. For brain tumor patients, the image acquisition time series typically starts with an already pathological scan. This poses problems, as many algorithms are designed to analyze healthy brains and provide no guarantee for images featuring lesions. Examples include, but are not limited to, algorithms for brain anatomy parcellation, tissue segmentation, and brain extraction. To solve this dilemma, we introduce the BraTS inpainting challenge. Here, the participants explore inpainting techniques to synthesize healthy brain scans from lesioned ones. The following manuscript contains the task formulation, dataset, and submission procedure. Later, it will be updated to summarize the findings of the challenge. The challenge is organized as part of the ASNR-BraTS MICCAI challenge.

Dominic LaBella, Maruf Adewole, Michelle Alonso-Basanta et al.

Meningiomas are the most common primary intracranial tumor in adults and can be associated with significant morbidity and mortality. Radiologists, neurosurgeons, neuro-oncologists, and radiation oncologists rely on multiparametric MRI (mpMRI) for diagnosis, treatment planning, and longitudinal treatment monitoring; yet automated, objective, and quantitative tools for non-invasive assessment of meningiomas on mpMRI are lacking. The BraTS meningioma 2023 challenge will provide a community standard and benchmark for state-of-the-art automated intracranial meningioma segmentation models based on the largest expert annotated multilabel meningioma mpMRI dataset to date. Challenge competitors will develop automated segmentation models to predict three distinct meningioma sub-regions on MRI including enhancing tumor, non-enhancing tumor core, and surrounding nonenhancing T2/FLAIR hyperintensity. Models will be evaluated on separate validation and held-out test datasets using standardized metrics utilized across the BraTS 2023 series of challenges including the Dice similarity coefficient and Hausdorff distance. The models developed during the course of this challenge will aid in incorporation of automated meningioma MRI segmentation into clinical practice, which will ultimately improve care of patients with meningioma.

Aamir Arsalan, Muhammad Majid, Imran Fareed Nizami et al.

This paper presents a comprehensive review of methods covering significant subjective and objective human stress detection techniques available in the literature. The methods for measuring human stress responses could include subjective questionnaires (developed by psychologists) and objective markers observed using data from wearable and non-wearable sensors. In particular, wearable sensor-based methods commonly use data from electroencephalography, electrocardiogram, galvanic skin response, electromyography, electrodermal activity, heart rate, heart rate variability, and photoplethysmography both individually and in multimodal fusion strategies. Whereas, methods based on non-wearable sensors include strategies such as analyzing pupil dilation and speech, smartphone data, eye movement, body posture, and thermal imaging. Whenever a stressful situation is encountered by an individual, physiological, physical, or behavioral change is induced which help in coping with the challenge at hand. A wide range of studies has attempted to establish a relationship between these stressful situations and the response of human beings by using different kinds of psychological, physiological, physical, and behavioral measures. Inspired by the lack of availability of a definitive verdict about the relationship of human stress with these different kinds of markers, a detailed survey about human stress detection methods is conducted in this paper. In particular, we explore how stress detection methods can benefit from artificial intelligence utilizing relevant data from various sources. This review will prove to be a reference document that would provide guidelines for future research enabling effective detection of human stress conditions.

Maleeha Khalid Khan, Syed Muhammad Anwar

Glaucoma is a severe eye disease that is known to deteriorate optic never fibers, causing cup size to increase, which could result in permanent loss of vision. Glaucoma is the second leading cause of blindness after cataract, but glaucoma being more dangerous as it is not curable. Early diagnoses and treatment of glaucoma can help to slow the progression of glaucoma and its damages. For the detection of glaucoma, the Cup to Disc ratio (CDR) provides significant information. The CDR depends heavily on the accurate segmentation of cup and disc regions. In this paper, we have proposed a modified M-Net with bidirectional convolution long short-term memory (LSTM), based on joint cup and disc segmentation. The proposed network combines features of encoder and decoder, with bidirectional LSTM. Our proposed model segments cup and disc regions based on which the abnormalities in cup to disc ratio can be observed. The proposed model is tested on REFUGE2 data, where our model achieves a dice score of 0.92 for optic disc and an accuracy of 98.99% in segmenting cup and disc regions

Ali Nawaz, Syed Muhammad Anwar, Rehan Liaqat et al.

Alzheimer's disease (AD) is a progressive and incurable neurodegenerative disease which destroys brain cells and causes loss to patient's memory. An early detection can prevent the patient from further damage of the brain cells and hence avoid permanent memory loss. In past few years, various automatic tools and techniques have been proposed for diagnosis of AD. Several methods focus on fast, accurate and early detection of the disease to minimize the loss to patients mental health. Although machine learning and deep learning techniques have significantly improved medical imaging systems for AD by providing diagnostic performance close to human level. But the main problem faced during multi-class classification is the presence of highly correlated features in the brain structure. In this paper, we have proposed a smart and accurate way of diagnosing AD based on a two-dimensional deep convolutional neural network (2D-DCNN) using imbalanced three-dimensional MRI dataset. Experimental results on Alzheimer Disease Neuroimaging Initiative magnetic resonance imaging (MRI) dataset confirms that the proposed 2D-DCNN model is superior in terms of accuracy, efficiency, and robustness. The model classifies MRI into three categories: AD, mild cognitive impairment, and normal control: and has achieved 99.89% classification accuracy with imbalanced classes. The proposed model exhibits noticeable improvement in accuracy as compared to the state-fo-the-art methods.

Harish RaviPrakash, Syed Muhammad Anwar, Ulas Bagci

We propose a novel capsule network based variational encoder architecture, called Bayesian capsules (B-Caps), to modulate the mean and standard deviation of the sampling distribution in the latent space. We hypothesized that this approach can learn a better representation of features in the latent space than traditional approaches. Our hypothesis was tested by using the learned latent variables for image reconstruction task, where for MNIST and Fashion-MNIST datasets, different classes were separated successfully in the latent space using our proposed model. Our experimental results have shown improved reconstruction and classification performances for both datasets adding credence to our hypothesis. We also showed that by increasing the latent space dimension, the proposed B-Caps was able to learn a better representation when compared to the traditional variational auto-encoders (VAE). Hence our results indicate the strength of capsule networks in representation learning which has never been examined under the VAE settings before.

Sobia Yousaf, Syed Muhammad Anwar, Harish RaviPrakash et al.

Surgery planning in patients diagnosed with brain tumor is dependent on their survival prognosis. A poor prognosis might demand for a more aggressive treatment and therapy plan, while a favorable prognosis might enable a less risky surgery plan. Thus, accurate survival prognosis is an important step in treatment planning. Recently, deep learning approaches have been used extensively for brain tumor segmentation followed by the use of deep features for prognosis. However, radiomics-based studies have shown more promise using engineered/hand-crafted features. In this paper, we propose a three-step approach for multi-class survival prognosis. In the first stage, we extract image slices corresponding to tumor regions from multiple magnetic resonance image modalities. We then extract radiomic features from these 2D slices. Finally, we train machine learning classifiers to perform the classification. We evaluate our proposed approach on the publicly available BraTS 2019 data and achieve an accuracy of 76.5% and precision of 74.3% using the random forest classifier, which to the best of our knowledge are the highest reported results yet. Further, we identify the most important features that contribute in improving the prediction.

Samira Masoudi, Syed M. Anwar, Stephanie A. Harmon et al.

Abdominal fat quantification is critical since multiple vital organs are located within this region. Although computed tomography (CT) is a highly sensitive modality to segment body fat, it involves ionizing radiations which makes magnetic resonance imaging (MRI) a preferable alternative for this purpose. Additionally, the superior soft tissue contrast in MRI could lead to more accurate results. Yet, it is highly labor intensive to segment fat in MRI scans. In this study, we propose an algorithm based on deep learning technique(s) to automatically quantify fat tissue from MR images through a cross modality adaptation. Our method does not require supervised labeling of MR scans, instead, we utilize a cycle generative adversarial network (C-GAN) to construct a pipeline that transforms the existing MR scans into their equivalent synthetic CT (s-CT) images where fat segmentation is relatively easier due to the descriptive nature of HU (hounsfield unit) in CT images. The fat segmentation results for MRI scans were evaluated by expert radiologist. Qualitative evaluation of our segmentation results shows average success score of 3.80/5 and 4.54/5 for visceral and subcutaneous fat segmentation in MR images.

Ismail Irmakci, Syed Muhammad Anwar, Drew A. Torigian et al.

The diagnosis, prognosis, and treatment of patients with musculoskeletal (MSK) disorders require radiology imaging (using computed tomography, magnetic resonance imaging(MRI), and ultrasound) and their precise analysis by expert radiologists. Radiology scans can also help assessment of metabolic health, aging, and diabetes. This study presents how machinelearning, specifically deep learning methods, can be used for rapidand accurate image analysis of MRI scans, an unmet clinicalneed in MSK radiology. As a challenging example, we focus on automatic analysis of knee images from MRI scans and study machine learning classification of various abnormalities including meniscus and anterior cruciate ligament tears. Using widely used convolutional neural network (CNN) based architectures, we comparatively evaluated the knee abnormality classification performances of different neural network architectures under limited imaging data regime and compared single and multi-view imaging when classifying the abnormalities. Promising results indicated the potential use of multi-view deep learning based classification of MSK abnormalities in routine clinical assessment.

Syed Muhammad Anwar, Tooba Altaf, Khola Rafique et al.

Artificial intelligence (AI) enabled radiomics has evolved immensely especially in the field of oncology. Radiomics provide assistancein diagnosis of cancer, planning of treatment strategy, and predictionof survival. Radiomics in neuro-oncology has progressed significantly inthe recent past. Deep learning has outperformed conventional machinelearning methods in most image-based applications. Convolutional neu-ral networks (CNNs) have seen some popularity in radiomics, since theydo not require hand-crafted features and can automatically extract fea-tures during the learning process. In this regard, it is observed that CNNbased radiomics could provide state-of-the-art results in neuro-oncology,similar to the recent success of such methods in a wide spectrum ofmedical image analysis applications. Herein we present a review of the most recent best practices and establish the future trends for AI enabled radiomics in neuro-oncology.

Sanay Muhammad Umar Saeed, Syed Muhammad Anwar, Humaira Khalid et al.

Stress research is a rapidly emerging area in thefield of electroencephalography (EEG) based signal processing.The use of EEG as an objective measure for cost effective andpersonalized stress management becomes important in particularsituations such as the non-availability of mental health facilities.In this study, long-term stress is classified using baseline EEGsignal recordings. The labelling for the stress and control groupsis performed using two methods (i) the perceived stress scalescore and (ii) expert evaluation. The frequency domain featuresare extracted from five-channel EEG recordings in addition tothe frontal and temporal alpha and beta asymmetries. The alphaasymmetry is computed from four channels and used as a feature.Feature selection is also performed using a t-test to identifystatistically significant features for both stress and control groups.We found that support vector machine is best suited to classifylong-term human stress when used with alpha asymmetry asa feature. It is observed that expert evaluation based labellingmethod has improved the classification accuracy up to 85.20%.Based on these results, it is concluded that alpha asymmetry maybe used as a potential bio-marker for stress classification, when labels are assigned using expert evaluation.

Aamir Arsalan, Muhammad Majid, Syed Muhammad Anwar et al.

In this paper, we present an experimental study for the classification of perceived human stress using non-invasive physiological signals. These include electroencephalography (EEG), galvanic skin response (GSR), and photoplethysmography (PPG). We conducted experiments consisting of steps including data acquisition, feature extraction, and perceived human stress classification. The physiological data of $28$ participants are acquired in an open eye condition for a duration of three minutes. Four different features are extracted in time domain from EEG, GSR and PPG signals and classification is performed using multiple classifiers including support vector machine, the Naive Bayes, and multi-layer perceptron (MLP). The best classification accuracy of 75% is achieved by using MLP classifier. Our experimental results have shown that our proposed scheme outperforms existing perceived stress classification methods, where no stress inducers are used.

Aasim Raheel, Muhammad Majid, Syed Muhammad Anwar et al.

Tactile enhanced multimedia is generated by synchronizing traditional multimedia clips, to generate hot and cold air effect, with an electric heater and a fan. This objective is to give viewers a more realistic and immersing feel of the multimedia content. The response to this enhanced multimedia content (mulsemedia) is evaluated in terms of the appreciation/emotion by using human brain signals. We observe and record electroencephalography (EEG) data using a commercially available four channel MUSE headband. A total of 21 participants voluntarily participated in this study for EEG recordings. We extract frequency domain features from five different bands of each EEG channel. Four emotions namely: happy, relaxed, sad, and angry are classified using a support vector machine in response to the tactile enhanced multimedia. An increased accuracy of 76:19% is achieved when compared to 63:41% by using the time domain features. Our results show that the selected frequency domain features could be better suited for emotion classification in mulsemedia studies.

Saddam Hussain, Syed Muhammad Anwar, Muhammad Majid

Detection of brain tumor using a segmentation based approach is critical in cases, where survival of a subject depends on an accurate and timely clinical diagnosis. Gliomas are the most commonly found tumors having irregular shape and ambiguous boundaries, making them one of the hardest tumors to detect. The automation of brain tumor segmentation remains a challenging problem mainly due to significant variations in its structure. An automated brain tumor segmentation algorithm using deep convolutional neural network (DCNN) is presented in this paper. A patch based approach along with an inception module is used for training the deep network by extracting two co-centric patches of different sizes from the input images. Recent developments in deep neural networks such as drop-out, batch normalization, non-linear activation and inception module are used to build a new ILinear nexus architecture. The module overcomes the over-fitting problem arising due to scarcity of data using drop-out regularizer. Images are normalized and bias field corrected in the pre-processing step and then extracted patches are passed through a DCNN, which assigns an output label to the central pixel of each patch. Morphological operators are used for post-processing to remove small false positives around the edges. A two-phase weighted training method is introduced and evaluated using BRATS 2013 and BRATS 2015 datasets, where it improves the performance parameters of state-of-the-art techniques under similar settings.

Adnan Qayyum, Syed Muhammad Anwar, Muhammad Awais et al.

With a widespread use of digital imaging data in hospitals, the size of medical image repositories is increasing rapidly. This causes difficulty in managing and querying these large databases leading to the need of content based medical image retrieval (CBMIR) systems. A major challenge in CBMIR systems is the semantic gap that exists between the low level visual information captured by imaging devices and high level semantic information perceived by human. The efficacy of such systems is more crucial in terms of feature representations that can characterize the high-level information completely. In this paper, we propose a framework of deep learning for CBMIR system by using deep Convolutional Neural Network (CNN) that is trained for classification of medical images. An intermodal dataset that contains twenty four classes and five modalities is used to train the network. The learned features and the classification results are used to retrieve medical images. For retrieval, best results are achieved when class based predictions are used. An average classification accuracy of 99.77% and a mean average precision of 0.69 is achieved for retrieval task. The proposed method is best suited to retrieve multimodal medical images for different body organs.