William Wells

Laurent Chauvin, William Wells, Matthew Toews

This paper proposes to extend local image features in 3D to include invariance to discrete symmetry including inversion of spatial axes and image contrast. A binary feature sign $s \in \{-1,+1\}$ is defined as the sign of the Laplacian operator $\nabla^2$, and used to obtain a descriptor that is invariant to image sign inversion $s \rightarrow -s$ and 3D parity transforms $(x,y,z)\rightarrow(-x,-y,-z)$, i.e. SP-invariant or SP-symmetric. SP-symmetry applies to arbitrary scalar image fields $I: R^3 \rightarrow R^1$ mapping 3D coordinates $(x,y,z) \in R^3$ to scalar intensity $I(x,y,z) \in R^1$, generalizing the well-known charge conjugation and parity symmetry (CP-symmetry) applying to elementary charged particles. Feature orientation is modeled as a set of discrete states corresponding to potential axis reflections, independently of image contrast inversion. Two primary axis vectors are derived from image observations and potentially subject to reflection, and a third axis is an axial vector defined by the right-hand rule. Augmenting local feature properties with sign in addition to standard (location, scale, orientation) geometry leads to descriptors that are invariant to coordinate reflections and intensity contrast inversion. Feature properties are factored in to probabilistic point-based registration as symmetric kernels, based on a model of binary feature correspondence. Experiments using the well-known coherent point drift (CPD) algorithm demonstrate that SIFT-CPD kernels achieve the most accurate and rapid registration of the human brain and CT chest, including multiple MRI modalities of differing intensity contrast, and abnormal local variations such as tumors or occlusions. SIFT-CPD image registration is invariant to global scaling, rotation and translation and image intensity inversions of the input data.

Reuben Dorent, Erickson Torio, Nazim Haouchine et al.

Intraoperative ultrasound (iUS) imaging has the potential to improve surgical outcomes in brain surgery. However, its interpretation is challenging, even for expert neurosurgeons. In this work, we designed the first patient-specific framework that performs brain tumor segmentation in trackerless iUS. To disambiguate ultrasound imaging and adapt to the neurosurgeon's surgical objective, a patient-specific real-time network is trained using synthetic ultrasound data generated by simulating virtual iUS sweep acquisitions in pre-operative MR data. Extensive experiments performed in real ultrasound data demonstrate the effectiveness of the proposed approach, allowing for adapting to the surgeon's definition of surgical targets and outperforming non-patient-specific models, neurosurgeon experts, and high-end tracking systems. Our code is available at: \url{https://github.com/ReubenDo/MHVAE-Seg}.

Geeticka Chauhan, Ruizhi Liao, William Wells et al.

We propose and demonstrate a novel machine learning algorithm that assesses pulmonary edema severity from chest radiographs. While large publicly available datasets of chest radiographs and free-text radiology reports exist, only limited numerical edema severity labels can be extracted from radiology reports. This is a significant challenge in learning such models for image classification. To take advantage of the rich information present in the radiology reports, we develop a neural network model that is trained on both images and free-text to assess pulmonary edema severity from chest radiographs at inference time. Our experimental results suggest that the joint image-text representation learning improves the performance of pulmonary edema assessment compared to a supervised model trained on images only. We also show the use of the text for explaining the image classification by the joint model. To the best of our knowledge, our approach is the first to leverage free-text radiology reports for improving the image model performance in this application. Our code is available at https://github.com/RayRuizhiLiao/joint_chestxray.

Reuben Dorent, Nazim Haouchine, Alexandra Golby et al.

We propose a deep mixture of multimodal hierarchical variational auto-encoders called MMHVAE that synthesizes missing images from observed images in different modalities. MMHVAE's design focuses on tackling four challenges: (i) creating a complex latent representation of multimodal data to generate high-resolution images; (ii) encouraging the variational distributions to estimate the missing information needed for cross-modal image synthesis; (iii) learning to fuse multimodal information in the context of missing data; (iv) leveraging dataset-level information to handle incomplete data sets at training time. Extensive experiments are performed on the challenging problem of pre-operative brain multi-parametric magnetic resonance and intra-operative ultrasound imaging.

Reuben Dorent, Polina Golland, William Wells

Mutual Information (MI) is a fundamental measure of statistical dependence widely used in representation learning. While direct optimization of MI via its definition as a Kullback-Leibler divergence (KLD) is often intractable, many recent methods have instead maximized alternative dependence measures, most notably, the Jensen-Shannon divergence (JSD) between joint and product of marginal distributions via discriminative losses. However, the connection between these surrogate objectives and MI remains poorly understood. In this work, we bridge this gap by deriving a new, tight, and tractable lower bound on KLD as a function of JSD in the general case. By specializing this bound to joint and marginal distributions, we demonstrate that maximizing the JSD-based information increases a guaranteed lower bound on mutual information. Furthermore, we revisit the practical implementation of JSD-based objectives and observe that minimizing the cross-entropy loss of a binary classifier trained to distinguish joint from marginal pairs recovers a known variational lower bound on the JSD. Extensive experiments demonstrate that our lower bound is tight when applied to MI estimation. We compared our lower bound to state-of-the-art neural estimators of variational lower bound across a range of established reference scenarios. Our lower bound estimator consistently provides a stable, low-variance estimate of a tight lower bound on MI. We also demonstrate its practical usefulness in the context of the Information Bottleneck framework. Taken together, our results provide new theoretical justifications and strong empirical evidence for using discriminative learning in MI-based representation learning.

Reuben Dorent, Laura Rigolo, Colin P. Galvin et al.

Accurate intraoperative image guidance is critical for achieving maximal safe resection in brain tumor surgery, yet neuronavigation systems based on preoperative MRI lose accuracy during the procedure due to brain shift. Aligning post-resection intraoperative ultrasound (iUS) with preoperative MRI can restore spatial accuracy by estimating brain shift deformations, but it remains a challenging problem given the large anatomical and topological changes and substantial modality intensity gap. The ReMIND2Reg 2025 Challenge provides the largest public benchmark for this task, built upon the ReMIND dataset. It offers 99 training cases, 5 validation cases, and 10 private test cases comprising paired 3D ceT1 MRI, T2 MRI, and post-resection 3D iUS volumes. Data are provided without annotations for training, while validation and test performance are evaluated on manually annotated anatomical landmarks. Metrics include target registration error (TRE), robustness to worst-case landmark misalignment (TRE30), and runtime. By establishing a standardized evaluation framework for this clinically critical and technically complex problem, ReMIND2Reg aims to accelerate the development of robust, generalizable, and clinically deployable multimodal registration algorithms for image-guided neurosurgery.

Hao He, Fan Zhang, Steve Pieper et al.

The human brain's white matter (WM) structure is of immense interest to the scientific community. Diffusion MRI gives a powerful tool to describe the brain WM structure noninvasively. To potentially enable monitoring of age-related changes and investigation of sex-related brain structure differences on the mapping between the brain connectome and healthy subjects' age and sex, we extract fiber-cluster-based diffusion features and predict sex and age with a novel ensembled neural network classifier. We conduct experiments on the Human Connectome Project (HCP) young adult dataset and show that our model achieves 94.82% accuracy in sex prediction and 2.51 years MAE in age prediction. We also show that the fractional anisotropy (FA) is the most predictive of sex, while the number of fibers is the most predictive of age and the combination of different features can improve the model performance.

Zhe Xu, Jie Luo, Donghuan Lu et al.

In order to tackle the difficulty associated with the ill-posed nature of the image registration problem, regularization is often used to constrain the solution space. For most learning-based registration approaches, the regularization usually has a fixed weight and only constrains the spatial transformation. Such convention has two limitations: (i) Besides the laborious grid search for the optimal fixed weight, the regularization strength of a specific image pair should be associated with the content of the images, thus the "one value fits all" training scheme is not ideal; (ii) Only spatially regularizing the transformation may neglect some informative clues related to the ill-posedness. In this study, we propose a mean-teacher based registration framework, which incorporates an additional temporal consistency regularization term by encouraging the teacher model's prediction to be consistent with that of the student model. More importantly, instead of searching for a fixed weight, the teacher enables automatically adjusting the weights of the spatial regularization and the temporal consistency regularization by taking advantage of the transformation uncertainty and appearance uncertainty. Extensive experiments on the challenging abdominal CT-MRI registration show that our training strategy can promisingly advance the original learning-based method in terms of efficient hyperparameter tuning and a better tradeoff between accuracy and smoothness.

Laurent Chauvin, Kuldeep Kumar, Christian Desrosiers et al.

We propose a novel pairwise distance measure between image keypoint sets, for the purpose of large-scale medical image indexing. Our measure generalizes the Jaccard index to account for soft set equivalence (SSE) between keypoint elements, via an adaptive kernel framework modeling uncertainty in keypoint appearance and geometry. A new kernel is proposed to quantify the variability of keypoint geometry in location and scale. Our distance measure may be estimated between $O(N^2)$ image pairs in $O(N~\log~N)$ operations via keypoint indexing. Experiments report the first results for the task of predicting family relationships from medical images, using 1010 T1-weighted MRI brain volumes of 434 families including monozygotic and dizygotic twins, siblings and half-siblings sharing 100%-25% of their polymorphic genes. Soft set equivalence and the keypoint geometry kernel improve upon standard hard set equivalence (HSE) and appearance kernels alone in predicting family relationships. Monozygotic twin identification is near 100%, and three subjects with uncertain genotyping are automatically paired with their self-reported families, the first reported practical application of image-based family identification. Our distance measure can also be used to predict group categories, sex is predicted with an AUC=0.97. Software is provided for efficient fine-grained curation of large, generic image datasets.

Zhe Xu, Jiangpeng Yan, Jie Luo et al.

The loss function of an unsupervised multimodal image registration framework has two terms, i.e., a metric for similarity measure and regularization. In the deep learning era, researchers proposed many approaches to automatically learn the similarity metric, which has been shown effective in improving registration performance. However, for the regularization term, most existing multimodal registration approaches still use a hand-crafted formula to impose artificial properties on the estimated deformation field. In this work, we propose a unimodal cyclic regularization training pipeline, which learns task-specific prior knowledge from simpler unimodal registration, to constrain the deformation field of multimodal registration. In the experiment of abdominal CT-MR registration, the proposed method yields better results over conventional regularization methods, especially for severely deformed local regions.

Zhe Xu, Jie Luo, Jiangpeng Yan et al.

Deformable image registration between Computed Tomography (CT) images and Magnetic Resonance (MR) imaging is essential for many image-guided therapies. In this paper, we propose a novel translation-based unsupervised deformable image registration method. Distinct from other translation-based methods that attempt to convert the multimodal problem (e.g., CT-to-MR) into a unimodal problem (e.g., MR-to-MR) via image-to-image translation, our method leverages the deformation fields estimated from both: (i) the translated MR image and (ii) the original CT image in a dual-stream fashion, and automatically learns how to fuse them to achieve better registration performance. The multimodal registration network can be effectively trained by computationally efficient similarity metrics without any ground-truth deformation. Our method has been evaluated on two clinical datasets and demonstrates promising results compared to state-of-the-art traditional and learning-based methods.

Jie Luo, Guangshen Ma, Sarah Frisken et al.

With the increasing availability of new image registration approaches, an unbiased evaluation is becoming more needed so that clinicians can choose the most suitable approaches for their applications. Current evaluations typically use landmarks in manually annotated datasets. As a result, the quality of annotations is crucial for unbiased comparisons. Even though most data providers claim to have quality control over their datasets, an objective third-party screening can be reassuring for intended users. In this study, we use the variogram to screen the manually annotated landmarks in two datasets used to benchmark registration in image-guided neurosurgeries. The variogram provides an intuitive 2D representation of the spatial characteristics of annotated landmarks. Using variograms, we identified potentially problematic cases and had them examined by experienced radiologists. We found that (1) a small number of annotations may have fiducial localization errors; (2) the landmark distribution for some cases is not ideal to offer fair comparisons. If unresolved, both findings could incur bias in registration evaluation.

Ruizhi Liao, Jonathan Rubin, Grace Lam et al.

We propose and demonstrate machine learning algorithms to assess the severity of pulmonary edema in chest x-ray images of congestive heart failure patients. Accurate assessment of pulmonary edema in heart failure is critical when making treatment and disposition decisions. Our work is grounded in a large-scale clinical dataset of over 300,000 x-ray images with associated radiology reports. While edema severity labels can be extracted unambiguously from a small fraction of the radiology reports, accurate annotation is challenging in most cases. To take advantage of the unlabeled images, we develop a Bayesian model that includes a variational auto-encoder for learning a latent representation from the entire image set trained jointly with a regressor that employs this representation for predicting pulmonary edema severity. Our experimental results suggest that modeling the distribution of images jointly with the limited labels improves the accuracy of pulmonary edema scoring compared to a strictly supervised approach. To the best of our knowledge, this is the first attempt to employ machine learning algorithms to automatically and quantitatively assess the severity of pulmonary edema in chest x-ray images.

Christian Wachinger, Matthew Toews, Georg Langs et al.

We introduce an approach for image segmentation based on sparse correspondences between keypoints in testing and training images. Keypoints represent automatically identified distinctive image locations, where each keypoint correspondence suggests a transformation between images. We use these correspondences to transfer label maps of entire organs from the training images to the test image. The keypoint transfer algorithm includes three steps: (i) keypoint matching, (ii) voting-based keypoint labeling, and (iii) keypoint-based probabilistic transfer of organ segmentations. We report segmentation results for abdominal organs in whole-body CT and MRI, as well as in contrast-enhanced CT and MRI. Our method offers a speed-up of about three orders of magnitude in comparison to common multi-atlas segmentation, while achieving an accuracy that compares favorably. Moreover, keypoint transfer does not require the registration to an atlas or a training phase. Finally, the method allows for the segmentation of scans with highly variable field-of-view.

Demian Wassermann, Matt Toews, Marc Niethammer et al.

This paper presents a novel mathematical framework for representing uncertainty in large deformation diffeomorphic image registration. The Bayesian posterior distribution over the deformations aligning a moving and a fixed image is approximated via a variational formulation. A stochastic differential equation (SDE) modeling the deformations as the evolution of a time-varying velocity field leads to a prior density over deformations in the form of a Gaussian process. This permits estimating the full posterior distribution in order to represent uncertainty, in contrast to methods in which the posterior is approximated via Monte Carlo sampling or maximized in maximum a-posteriori (MAP) estimation. The frame-work is demonstrated in the case of landmark-based image registration, including simulated data and annotated pre and intra-operative 3D images.