Robert Martí

Marawan Elbatel, Hualiang Wang, Robert Martí et al.

In the medical field, federated learning commonly deals with highly imbalanced datasets, including skin lesions and gastrointestinal images. Existing federated methods under highly imbalanced datasets primarily focus on optimizing a global model without incorporating the intra-class variations that can arise in medical imaging due to different populations, findings, and scanners. In this paper, we study the inter-client intra-class variations with publicly available self-supervised auxiliary networks. Specifically, we find that employing a shared auxiliary pre-trained model, like MoCo-V2, locally on every client yields consistent divergence measurements. Based on these findings, we derive a dynamic balanced model aggregation via self-supervised priors (MAS) to guide the global model optimization. Fed-MAS can be utilized with different local learning methods for effective model aggregation toward a highly robust and unbiased global model. Our code is available at \url{https://github.com/xmed-lab/Fed-MAS}.

Jieyun Bai, Zihao Zhou, Zhanhong Ou et al.

Segmentation of the fetal and maternal structures, particularly intrapartum ultrasound imaging as advocated by the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) for monitoring labor progression, is a crucial first step for quantitative diagnosis and clinical decision-making. This requires specialized analysis by obstetrics professionals, in a task that i) is highly time- and cost-consuming and ii) often yields inconsistent results. The utility of automatic segmentation algorithms for biometry has been proven, though existing results remain suboptimal. To push forward advancements in this area, the Grand Challenge on Pubic Symphysis-Fetal Head Segmentation (PSFHS) was held alongside the 26th International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI 2023). This challenge aimed to enhance the development of automatic segmentation algorithms at an international scale, providing the largest dataset to date with 5,101 intrapartum ultrasound images collected from two ultrasound machines across three hospitals from two institutions. The scientific community's enthusiastic participation led to the selection of the top 8 out of 179 entries from 193 registrants in the initial phase to proceed to the competition's second stage. These algorithms have elevated the state-of-the-art in automatic PSFHS from intrapartum ultrasound images. A thorough analysis of the results pinpointed ongoing challenges in the field and outlined recommendations for future work. The top solutions and the complete dataset remain publicly available, fostering further advancements in automatic segmentation and biometry for intrapartum ultrasound imaging.

Ricardo Montoya-del-Angel, Karla Sam-Millan, Joan C Vilanova et al.

Generative models are used as an alternative data augmentation technique to alleviate the data scarcity problem faced in the medical imaging field. Diffusion models have gathered special attention due to their innovative generation approach, the high quality of the generated images and their relatively less complex training process compared with Generative Adversarial Networks. Still, the implementation of such models in the medical domain remains at early stages. In this work, we propose exploring the use of diffusion models for the generation of high quality full-field digital mammograms using state-of-the-art conditional diffusion pipelines. Additionally, we propose using stable diffusion models for the inpainting of synthetic lesions on healthy mammograms. We introduce MAM-E, a pipeline of generative models for high quality mammography synthesis controlled by a text prompt and capable of generating synthetic lesions on specific regions of the breast. Finally, we provide quantitative and qualitative assessment of the generated images and easy-to-use graphical user interfaces for mammography synthesis.

Marawan Elbatel, Robert Martí, Xiaomeng Li

Representational transfer from publicly available models is a promising technique for improving medical image classification, especially in long-tailed datasets with rare diseases. However, existing methods often overlook the frequency-dependent behavior of these models, thereby limiting their effectiveness in transferring representations and generalizations to rare diseases. In this paper, we propose FoPro-KD, a novel framework that leverages the power of frequency patterns learned from frozen pre-trained models to enhance their transferability and compression, presenting a few unique insights: 1) We demonstrate that leveraging representations from publicly available pre-trained models can substantially improve performance, specifically for rare classes, even when utilizing representations from a smaller pre-trained model. 2) We observe that pre-trained models exhibit frequency preferences, which we explore using our proposed Fourier Prompt Generator (FPG), allowing us to manipulate specific frequencies in the input image, enhancing the discriminative representational transfer. 3) By amplifying or diminishing these frequencies in the input image, we enable Effective Knowledge Distillation (EKD). EKD facilitates the transfer of knowledge from pre-trained models to smaller models. Through extensive experiments in long-tailed gastrointestinal image recognition and skin lesion classification, where rare diseases are prevalent, our FoPro-KD framework outperforms existing methods, enabling more accessible medical models for rare disease classification. Code is available at https://github.com/xmed-lab/FoPro-KD.

Hadeel Awwad, Eloy García, Robert Martí

Breast compression simulation is essential for accurate image registration from 3D modalities to X-ray procedures like mammography. It accounts for tissue shape and position changes due to compression, ensuring precise alignment and improved analysis. Although Finite Element Analysis (FEA) is reliable for approximating soft tissue deformation, it struggles with balancing accuracy and computational efficiency. Recent studies have used data-driven models trained on FEA results to speed up tissue deformation predictions. We propose to explore Physics-based Graph Neural Networks (PhysGNN) for breast compression simulation. PhysGNN has been used for data-driven modelling in other domains, and this work presents the first investigation of their potential in predicting breast deformation during mammographic compression. Unlike conventional data-driven models, PhysGNN, which incorporates mesh structural information and enables inductive learning on unstructured grids, is well-suited for capturing complex breast tissue geometries. Trained on deformations from incremental FEA simulations, PhysGNN's performance is evaluated by comparing predicted nodal displacements with those from finite element (FE) simulations. This deep learning (DL) framework shows promise for accurate, rapid breast deformation approximations, offering enhanced computational efficiency for real-world scenarios.

Melika Pooyan, Hadeel Awwad, Eloy García et al.

Integrating 2D mammography with 3D magnetic resonance imaging (MRI) is crucial for improving breast cancer diagnosis and treatment planning. However, this integration is challenging due to differences in imaging modalities and the need for precise tissue segmentation and alignment. This paper addresses these challenges by enhancing biomechanical breast models in two main aspects: improving tissue identification using nnU-Net segmentation models and evaluating finite element (FE) biomechanical solvers, specifically comparing NiftySim and FEBio. We performed a detailed six-class segmentation of breast MRI data using the nnU-Net architecture, achieving Dice Coefficients of 0.94 for fat, 0.88 for glandular tissue, and 0.87 for pectoral muscle. The overall foreground segmentation reached a mean Dice Coefficient of 0.83 through an ensemble of 2D and 3D U-Net configurations, providing a solid foundation for 3D reconstruction and biomechanical modeling. The segmented data was then used to generate detailed 3D meshes and develop biomechanical models using NiftySim and FEBio, which simulate breast tissue's physical behaviors under compression. Our results include a comparison between NiftySim and FEBio, providing insights into the accuracy and reliability of these simulations in studying breast tissue responses under compression. The findings of this study have the potential to improve the integration of 2D and 3D imaging modalities, thereby enhancing diagnostic accuracy and treatment planning for breast cancer.

Kendall Schmidt, Benjamin Bearce, Ken Chang et al.

The correct interpretation of breast density is important in the assessment of breast cancer risk. AI has been shown capable of accurately predicting breast density, however, due to the differences in imaging characteristics across mammography systems, models built using data from one system do not generalize well to other systems. Though federated learning (FL) has emerged as a way to improve the generalizability of AI without the need to share data, the best way to preserve features from all training data during FL is an active area of research. To explore FL methodology, the breast density classification FL challenge was hosted in partnership with the American College of Radiology, Harvard Medical School's Mass General Brigham, University of Colorado, NVIDIA, and the National Institutes of Health National Cancer Institute. Challenge participants were able to submit docker containers capable of implementing FL on three simulated medical facilities, each containing a unique large mammography dataset. The breast density FL challenge ran from June 15 to September 5, 2022, attracting seven finalists from around the world. The winning FL submission reached a linear kappa score of 0.653 on the challenge test data and 0.413 on an external testing dataset, scoring comparably to a model trained on the same data in a central location.

Basel Alyafi, Oliver Diaz, Joan C Vilanova et al.

Medical image synthesis has gained a great focus recently, especially after the introduction of Generative Adversarial Networks (GANs). GANs have been used widely to provide anatomically-plausible and diverse samples for augmentation and other applications, including segmentation and super resolution. In our previous work, Deep Convolutional GANs were used to generate synthetic mammogram lesions, masses mainly, that could enhance the classification performance in imbalanced datasets. In this new work, a deeper investigation was carried out to explore other aspects of the generated images evaluation, i.e., realism, feature space distribution, and observers studies. t-Stochastic Neighbor Embedding (t-SNE) was used to reduce the dimensionality of real and fake images to enable 2D visualisations. Additionally, two expert radiologists performed a realism-evaluation study. Visualisations showed that the generated images have a similar feature distribution of the real ones, avoiding outliers. Moreover, Receiver Operating Characteristic (ROC) curve showed that the radiologists could not, in many cases, distinguish between synthetic and real lesions, giving 48% and 61% accuracies in a balanced sample set.

Basel Alyafi, Oliver Diaz, Robert Marti

Early detection of breast cancer has a major contribution to curability, and using mammographic images, this can be achieved non-invasively. Supervised deep learning, the dominant CADe tool currently, has played a great role in object detection in computer vision, but it suffers from a limiting property: the need of a large amount of labelled data. This becomes stricter when it comes to medical datasets which require high-cost and time-consuming annotations. Furthermore, medical datasets are usually imbalanced, a condition that often hinders classifiers performance. The aim of this paper is to learn the distribution of the minority class to synthesise new samples in order to improve lesion detection in mammography. Deep Convolutional Generative Adversarial Networks (DCGANs) can efficiently generate breast masses. They are trained on increasing-size subsets of one mammographic dataset and used to generate diverse and realistic breast masses. The effect of including the generated images and/or applying horizontal and vertical flipping is tested in an environment where a 1:10 imbalanced dataset of masses and normal tissue patches is classified by a fully-convolutional network. A maximum of ~ 0:09 improvement of F1 score is reported by using DCGANs along with flipping augmentation over using the original images. We show that DCGANs can be used for synthesising photo-realistic breast mass patches with considerable diversity. It is demonstrated that appending synthetic images in this environment, along with flipping, outperforms the traditional augmentation method of flipping solely, offering faster improvements as a function of the training set size.

Md. Kamrul Hasan, Lavsen Dahal, Prasad N. Samarakoon et al.

Automatic segmentation of skin lesion is considered a crucial step in Computer Aided Diagnosis (CAD) for melanoma diagnosis. Despite its significance, skin lesion segmentation remains a challenging task due to their diverse color, texture, and indistinguishable boundaries and forms an open problem. Through this study, we present a new and automatic semantic segmentation network for robust skin lesion segmentation named Dermoscopic Skin Network (DSNet). In order to reduce the number of parameters to make the network lightweight, we used depth-wise separable convolution in lieu of standard convolution to project the learned discriminating features onto the pixel space at different stages of the encoder. Additionally, we implemented U-Net and Fully Convolutional Network (FCN8s) to compare against the proposed DSNet. We evaluate our proposed model on two publicly available datasets, namely ISIC-2017 and PH2. The obtained mean Intersection over Union (mIoU) is 77.5 % and 87.0 % respectively for ISIC-2017 and PH2 datasets which outperformed the ISIC-2017 challenge winner by 1.0 % with respect to mIoU. Our proposed network also outperformed U-Net and FCN8s respectively by 3.6 % and 6.8 % with respect to mIoU on the ISIC-2017 dataset. Our network for skin lesion segmentation outperforms other methods and can provide better segmented masks on two different test datasets which can lead to better performance in melanoma detection. Our trained model along with the source code and predicted masks are made publicly available.

Joel Vidal, Chyi-Yeu Lin, Robert Martí

The Point Pair Feature (Drost et al. 2010) has been one of the most successful 6D pose estimation method among model-based approaches as an efficient, integrated and compromise alternative to the traditional local and global pipelines. During the last years, several variations of the algorithm have been proposed. Among these extensions, the solution introduced by Hinterstoisser et al. (2016) is a major contribution. This work presents a variation of this PPF method applied to the SIXD Challenge datasets presented at the 3rd International Workshop on Recovering 6D Object Pose held at the ICCV 2017. We report an average recall of 0.77 for all datasets and overall recall of 0.82, 0.67, 0.85, 0.37, 0.97 and 0.96 for hinterstoisser, tless, tudlight, rutgers, tejani and doumanoglou datasets, respectively.