Oliver Blanck

Nanna E. Wielenberg, Ilinca Popp, Oliver Blanck et al.

Melanoma brain metastases (MBM) are common and spatially heterogeneous lesions, complicating cohort-level analyses due to anatomical variability and differing MRI protocols. We propose a fully differentiable, deep-learning-based deformable registration framework that aligns individual pathological brains to a common atlas while preserving metastatic tissue without requiring lesion masks or preprocessing. Missing anatomical correspondences caused by metastases are handled through a forward-model similarity metric based on distance-transformed anatomical labels, combined with a volume-preserving regularization term to ensure deformation plausibility. Registration performance was evaluated using Dice coefficient (DSC), Hausdorff distance (HD), average symmetric surface distance (ASSD), and Jacobian-based measures. The method was applied to 209 MBM patients from three centres, enabling standardized mapping of metastases to anatomical, arterial, and perfusion atlases. The framework achieved high registration accuracy across datasets (DSC 0.89-0.92, HD 6.79-7.60 mm, ASSD 0.63-0.77 mm) while preserving metastatic volumes. Spatial analysis demonstrated significant over-representation of MBM in the cerebral cortex and putamen, under-representation in white matter, and consistent localization near the gray-white matter junction. No arterial territory showed increased metastasis frequency after volume correction. This approach enables robust atlas registration of pathological brain MRI without lesion masks and supports reproducible multi-centre analyses. Applied to MBM, it confirms and refines known spatial predilections, particularly preferential seeding near the gray-white matter junction and cortical regions. The publicly available implementation facilitates reproducible research and extension to other brain tumours and neurological pathologies.

Ciro Benito Raggio, Mathias Krohmer Zabaleta, Nils Skupien et al.

The generation of Synthetic Computed Tomography (sCT) images has become a pivotal methodology in modern clinical practice, particularly in the context of Radiotherapy (RT) treatment planning. The use of sCT enables the calculation of doses, pushing towards Magnetic Resonance Imaging (MRI) guided radiotherapy treatments. Deep learning methods for MRI-to-sCT have shown promising results, but their reliance on single-centre training dataset limits generalisation capabilities to diverse clinical settings. Moreover, creating centralised multi-centre datasets may pose privacy concerns. To address the aforementioned issues, we introduced FedSynthCT-Brain, an approach based on the Federated Learning (FL) paradigm for MRI-to-sCT in brain imaging. This is among the first applications of FL for MRI-to-sCT, employing a cross-silo horizontal FL approach that allows multiple centres to collaboratively train a U-Net-based deep learning model. We validated our method using real multicentre data from four European and American centres, simulating heterogeneous scanner types and acquisition modalities, and tested its performance on an independent dataset from a centre outside the federation. In the case of the unseen centre, the federated model achieved a median Mean Absolute Error (MAE) of $102.0$ HU across 23 patients, with an interquartile range of $96.7-110.5$ HU. The median (interquartile range) for the Structural Similarity Index (SSIM) and the Peak Signal to Noise Ratio (PNSR) were $0.89 (0.86-0.89)$ and $26.58 (25.52-27.42)$, respectively. The analysis of the results showed acceptable performances of the federated approach, thus highlighting the potential of FL to enhance MRI-to-sCT to improve generalisability and advancing safe and equitable clinical applications while fostering collaboration and preserving data privacy.

Ciro Benito Raggio, Lucia Migliorelli, Nils Skupien et al.

Federated Learning (FL) holds the potential to advance equality in health by enabling diverse institutions to collaboratively train deep learning (DL) models, even with limited data. However, the significant resource requirements of FL often exclude centres with limited computational infrastructure, further widening existing healthcare disparities. To address this issue, we propose a Green AI-oriented adaptive layer-freezing strategy designed to reduce energy consumption and computational load while maintaining model performance. We tested our approach using different federated architectures for Magnetic Resonance Imaging (MRI)-to-Computed Tomography (CT) conversion. The proposed adaptive strategy optimises the federated training by selectively freezing the encoder weights based on the monitored relative difference of the encoder weights from round to round. A patience-based mechanism ensures that freezing only occurs when updates remain consistently minimal. The energy consumption and CO2eq emissions of the federation were tracked using the CodeCarbon library. Compared to equivalent non-frozen counterparts, our approach reduced training time, total energy consumption and CO2eq emissions by up to 23%. At the same time, the MRI-to-CT conversion performance was maintained, with only small variations in the Mean Absolute Error (MAE). Notably, for three out of the five evaluated architectures, no statistically significant differences were observed, while two architectures exhibited statistically significant improvements. Our work aligns with a research paradigm that promotes DL-based frameworks meeting clinical requirements while ensuring climatic, social, and economic sustainability. It lays the groundwork for novel FL evaluation frameworks, advancing privacy, equity and, more broadly, justice in AI-driven healthcare.