Natasha Lepore

Wenhui Zhu, Peijie Qiu, Xiwen Chen et al.

Over the past few decades, convolutional neural networks (CNNs) have been at the forefront of the detection and tracking of various retinal diseases (RD). Despite their success, the emergence of vision transformers (ViT) in the 2020s has shifted the trajectory of RD model development. The leading-edge performance of ViT-based models in RD can be largely credited to their scalability-their ability to improve as more parameters are added. As a result, ViT-based models tend to outshine traditional CNNs in RD applications, albeit at the cost of increased data and computational demands. ViTs also differ from CNNs in their approach to processing images, working with patches rather than local regions, which can complicate the precise localization of small, variably presented lesions in RD. In our study, we revisited and updated the architecture of a CNN model, specifically MobileNet, to enhance its utility in RD diagnostics. We found that an optimized MobileNet, through selective modifications, can surpass ViT-based models in various RD benchmarks, including diabetic retinopathy grading, detection of multiple fundus diseases, and classification of diabetic macular edema. The code is available at https://github.com/Retinal-Research/NN-MOBILENET

Jianfeng Wu, Yi Su, Wenhui Zhu et al.

Background: Beta-amyloid (A$β$) plaques and tau protein tangles in the brain are the defining 'A' and 'T' hallmarks of Alzheimer's disease (AD), and together with structural atrophy detectable on brain magnetic resonance imaging (MRI) scans as one of the neurodegenerative ('N') biomarkers comprise the ''ATN framework'' of AD. Current methods to detect A$β$/tau pathology include cerebrospinal fluid (CSF; invasive), positron emission tomography (PET; costly and not widely available), and blood-based biomarkers (BBBM; promising but mainly still in development). Objective: To develop a non-invasive and widely available structural MRI-based framework to quantitatively predict the amyloid and tau measurements. Methods: With MRI-based hippocampal multivariate morphometry statistics (MMS) features, we apply our Patch Analysis-based Surface Correntropy-induced Sparse coding and max-pooling (PASCS-MP) method combined with the ridge regression model to individual amyloid/tau measure prediction. Results: We evaluate our framework on amyloid PET/MRI and tau PET/MRI datasets from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Each subject has one pair consisting of a PET image and MRI scan, collected at about the same time. Experimental results suggest that amyloid/tau measurements predicted with our PASCP-MP representations are closer to the real values than the measures derived from other approaches, such as hippocampal surface area, volume, and shape morphometry features based on spherical harmonics (SPHARM). Conclusion: The MMS-based PASCP-MP is an efficient tool that can bridge hippocampal atrophy with amyloid and tau pathology and thus help assess disease burden, progression, and treatment effects.

Wenhui Zhu, Peijie Qiu, Natasha Lepore et al.

Lesion appearance is a crucial clue for medical providers to distinguish referable diabetic retinopathy (rDR) from non-referable DR. Most existing large-scale DR datasets contain only image-level labels rather than pixel-based annotations. This motivates us to develop algorithms to classify rDR and segment lesions via image-level labels. This paper leverages self-supervised equivariant learning and attention-based multi-instance learning (MIL) to tackle this problem. MIL is an effective strategy to differentiate positive and negative instances, helping us discard background regions (negative instances) while localizing lesion regions (positive ones). However, MIL only provides coarse lesion localization and cannot distinguish lesions located across adjacent patches. Conversely, a self-supervised equivariant attention mechanism (SEAM) generates a segmentation-level class activation map (CAM) that can guide patch extraction of lesions more accurately. Our work aims at integrating both methods to improve rDR classification accuracy. We conduct extensive validation experiments on the Eyepacs dataset, achieving an area under the receiver operating characteristic curve (AU ROC) of 0.958, outperforming current state-of-the-art algorithms.

Wenhui Zhu, Xin Li, Xiwen Chen et al.

Recently, Multimodal Large Language Models (MLLMs) have gained significant attention for their remarkable ability to process and analyze non-textual data, such as images, videos, and audio. Notably, several adaptations of general-domain MLLMs to the medical field have been explored, including LLaVA-Med. However, these medical adaptations remain insufficiently advanced in understanding and interpreting retinal images. In contrast, medical experts emphasize the importance of quantitative analyses for disease detection and interpretation. This underscores a gap between general-domain and medical-domain MLLMs: while general-domain MLLMs excel in broad applications, they lack the specialized knowledge necessary for precise diagnostic and interpretative tasks in the medical field. To address these challenges, we introduce \textit{RetinalGPT}, a multimodal conversational assistant for clinically preferred quantitative analysis of retinal images. Specifically, we achieve this by compiling a large retinal image dataset, developing a novel data pipeline, and employing customized visual instruction tuning to enhance both retinal analysis and enrich medical knowledge. In particular, RetinalGPT outperforms MLLM in the generic domain by a large margin in the diagnosis of retinal diseases in 8 benchmark retinal datasets. Beyond disease diagnosis, RetinalGPT features quantitative analyses and lesion localization, representing a pioneering step in leveraging LLMs for an interpretable and end-to-end clinical research framework. The code is available at https://github.com/Retinal-Research/RetinalGPT

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.

Yujian Xiong, Mohammad Farazi, Yanxi Chen et al.

Representation learning on large-scale unstructured volumetric and surface meshes poses significant challenges in neuroimaging, especially when models must incorporate diverse vertex-level morphometric descriptors, such as cortical thickness, curvature, sulcal depth, and myelin content, which carry subtle disease-related signals. Current approaches either ignore these clinically informative features or support only a single mesh topology, restricting their use across imaging pipelines. We introduce a hierarchical transformer framework designed for heterogeneous mesh analysis that operates on spatially adaptive tree partitions constructed from simplicial complexes of arbitrary order. This design accommodates both volumetric and surface discretizations within a single architecture, enabling efficient multi-scale attention without topology-specific modifications. A feature projection module maps variable-length per-vertex clinical descriptors into the spatial hierarchy, separating geometric structure from feature dimensionality and allowing seamless integration of different neuroimaging feature sets. Self-supervised pretraining via masked reconstruction of both coordinates and morphometric channels on large unlabeled cohorts yields a transferable encoder backbone applicable to diverse downstream tasks and mesh modalities. We validate our approach on Alzheimer's disease classification and amyloid burden prediction using volumetric brain meshes from ADNI, as well as focal cortical dysplasia detection on cortical surface meshes from the MELD dataset, achieving state-of-the-art results across all benchmarks.

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.

Jianfeng Wu, Wenhui Zhu, Yi Su et al.

Biomarker-assisted diagnosis and intervention in Alzheimer's disease (AD) may be the key to prevention breakthroughs. One of the hallmarks of AD is the accumulation of tau plaques in the human brain. However, current methods to detect tau pathology are either invasive (lumbar puncture) or quite costly and not widely available (Tau PET). In our previous work, structural MRI-based hippocampal multivariate morphometry statistics (MMS) showed superior performance as an effective neurodegenerative biomarker for preclinical AD and Patch Analysis-based Surface Correntropy-induced Sparse coding and max-pooling (PASCS-MP) has excellent ability to generate low-dimensional representations with strong statistical power for brain amyloid prediction. In this work, we apply this framework together with ridge regression models to predict Tau deposition in Braak12 and Braak34 brain regions separately. We evaluate our framework on 925 subjects from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Each subject has one pair consisting of a PET image and MRI scan which were collected at about the same times. Experimental results suggest that the representations from our MMS and PASCS-MP have stronger predictive power and their predicted Braak12 and Braak34 are closer to the real values compared to the measures derived from other approaches such as hippocampal surface area and volume, and shape morphometry features based on spherical harmonics (SPHARM).