Roberto Di Via

Roberto Di Via, Irina Voiculescu, Francesca Odone et al.

Anatomical landmark detection is a fundamental task in medical image analysis supporting a wide range of diagnostic and interventional workflows. Although recent methods have achieved sub-millimetric localisation, accuracy alone is not sufficient for clinical deployment, requiring reliability and robustness in prediction. Despite its clinical relevance, the impact of representation learning in this context is still underexplored. In this work, we introduce CDPM-align, a multi-scale guidance-aligned conditional diffusion pre-training for anatomical landmark detection. Our experimental setup focuses on a few images and a few annotation regimes. Specifically, we employ three popular heterogeneous small-scale benchmark datasets for representation learning via conditional generative pre-training. Furthermore, we consider low-annotation scenarios for the downstream task of landmark detection, with 10 and 25 annotated images, reflecting realistic trade-offs between clinical effort and resource constraints for annotations. Our results confirm that generative pre-training enables the model to learn a robust representation. This improves both accuracy and uncertainty on the downstream tasks, advancing towards safe and efficient clinical deployment.

Roberto Di Via, Vito Paolo Pastore, Francesca Odone et al.

Many clinical screening decisions are based on angle measurements. In particular, FemoroAcetabular Impingement (FAI) screening relies on angles traditionally measured on X-rays. However, assessing the height and span of the impingement area requires also a 3D view through an MRI scan. The two modalities inform the surgeon on different aspects of the condition. In this work, we conduct a matched-cohort validation study (89 patients, paired MRI/X-ray) using standard heatmap regression architectures to assess cross-modality clinical equivalence. Seen that landmark detection has been proven effective on X-rays, we show that MRI also achieves equivalent localisation and diagnostic accuracy for cam-type impingement. Our method demonstrates clinical feasibility for FAI assessment in coronal views of 3D MRI volumes, opening the possibility for volumetric analysis through placing further landmarks. These results support integrating automated FAI assessment into routine MRI workflows. Code is released at https://github.com/Malga-Vision/Landmarks-Hip-Conditions

Roberto Di Via, Francesca Odone, Vito Paolo Pastore

Deep neural networks have been extensively applied in the medical domain for various tasks, including image classification, segmentation, and landmark detection. However, their application is often hindered by data scarcity, both in terms of available annotations and images. This study introduces a novel application of denoising diffusion probabilistic models (DDPMs) to the landmark detection task, specifically addressing the challenge of limited annotated data in x-ray imaging. Our key innovation lies in leveraging DDPMs for self-supervised pre-training in landmark detection, a previously unexplored approach in this domain. This method enables accurate landmark detection with minimal annotated training data (as few as 50 images), surpassing both ImageNet supervised pre-training and traditional self-supervised techniques across three popular x-ray benchmark datasets. To our knowledge, this work represents the first application of diffusion models for self-supervised learning in landmark detection, which may offer a valuable pre-training approach in few-shot regimes, for mitigating data scarcity.

Massimiliano Ciranni, Vito Paolo Pastore, Roberto Di Via et al.

Deep learning model effectiveness in classification tasks is often challenged by the quality and quantity of training data whenever they are affected by strong spurious correlations between specific attributes and target labels. This results in a form of bias affecting training data, which typically leads to unrecoverable weak generalization in prediction. This paper aims at facing this problem by leveraging bias amplification with generated synthetic data: we introduce Diffusing DeBias (DDB), a novel approach acting as a plug-in for common methods of unsupervised model debiasing exploiting the inherent bias-learning tendency of diffusion models in data generation. Specifically, our approach adopts conditional diffusion models to generate synthetic bias-aligned images, which replace the original training set for learning an effective bias amplifier model that we subsequently incorporate into an end-to-end and a two-step unsupervised debiasing approach. By tackling the fundamental issue of bias-conflicting training samples memorization in learning auxiliary models, typical of this type of techniques, our proposed method beats current state-of-the-art in multiple benchmark datasets, demonstrating its potential as a versatile and effective tool for tackling bias in deep learning models. Code is available at https://github.com/Malga-Vision/DiffusingDeBias

Roberto Di Via, Matteo Santacesaria, Francesca Odone et al.

In recent years, deep learning has emerged as a promising technique for medical image analysis. However, this application domain is likely to suffer from a limited availability of large public datasets and annotations. A common solution to these challenges in deep learning is the usage of a transfer learning framework, typically with a fine-tuning protocol, where a large-scale source dataset is used to pre-train a model, further fine-tuned on the target dataset. In this paper, we present a systematic study analyzing whether the usage of small-scale in-domain x-ray image datasets may provide any improvement for landmark detection over models pre-trained on large natural image datasets only. We focus on the multi-landmark localization task for three datasets, including chest, head, and hand x-ray images. Our results show that using in-domain source datasets brings marginal or no benefit with respect to an ImageNet out-of-domain pre-training. Our findings can provide an indication for the development of robust landmark detection systems in medical images when no large annotated dataset is available.