Ioannis Pappas

Liam Chalcroft, Ruben Lourenço Pereira, Mikael Brudfors et al.

Vision transformers are effective deep learning models for vision tasks, including medical image segmentation. However, they lack efficiency and translational invariance, unlike convolutional neural networks (CNNs). To model long-range interactions in 3D brain lesion segmentation, we propose an all-convolutional transformer block variant of the U-Net architecture. We demonstrate that our model provides the greatest compromise in three factors: performance competitive with the state-of-the-art; parameter efficiency of a CNN; and the favourable inductive biases of a transformer. Our public implementation is available at https://github.com/liamchalcroft/MDUNet .

Maytus Piriyajitakonkij, Sirawaj Itthipuripat, Ian Ballard et al.

In visual decision making, high-level features, such as object categories, have a strong influence on choice. However, the impact of low-level features on behavior is less understood partly due to the high correlation between high- and low-level features in the stimuli presented (e.g., objects of the same category are more likely to share low-level features). To disentangle these effects, we propose a method that de-correlates low- and high-level visual properties in a novel set of stimuli. Our method uses two Convolutional Neural Networks (CNNs) as candidate models of the ventral visual stream: the CORnet-S that has high neural predictivity in high-level, IT-like responses and the VGG-16 that has high neural predictivity in low-level responses. Triplets (root, image1, image2) of stimuli are parametrized by the level of low- and high-level similarity of images extracted from the different layers. These stimuli are then used in a decision-making task where participants are tasked to choose the most similar-to-the-root image. We found that different networks show differing abilities to predict the effects of low-versus-high-level similarity: while CORnet-S outperforms VGG-16 in explaining human choices based on high-level similarity, VGG-16 outperforms CORnet-S in explaining human choices based on low-level similarity. Using Brain-Score, we observed that the behavioral prediction abilities of different layers of these networks qualitatively corresponded to their ability to explain neural activity at different levels of the visual hierarchy. In summary, our algorithm for stimulus set generation enables the study of how different representations in the visual stream affect high-level cognitive behaviors.

Ezequiel de la Rosa, Mauricio Reyes, Sook-Lei Liew et al.

Diffusion-weighted MRI (DWI) is essential for stroke diagnosis, treatment decisions, and prognosis. However, image and disease variability hinder the development of generalizable AI algorithms with clinical value. We address this gap by presenting a novel ensemble algorithm derived from the 2022 Ischemic Stroke Lesion Segmentation (ISLES) challenge. ISLES'22 provided 400 patient scans with ischemic stroke from various medical centers, facilitating the development of a wide range of cutting-edge segmentation algorithms by the research community. Through collaboration with leading teams, we combined top-performing algorithms into an ensemble model that overcomes the limitations of individual solutions. Our ensemble model achieved superior ischemic lesion detection and segmentation accuracy on our internal test set compared to individual algorithms. This accuracy generalized well across diverse image and disease variables. Furthermore, the model excelled in extracting clinical biomarkers. Notably, in a Turing-like test, neuroradiologists consistently preferred the algorithm's segmentations over manual expert efforts, highlighting increased comprehensiveness and precision. Validation using a real-world external dataset (N=1686) confirmed the model's generalizability. The algorithm's outputs also demonstrated strong correlations with clinical scores (admission NIHSS and 90-day mRS) on par with or exceeding expert-derived results, underlining its clinical relevance. This study offers two key findings. First, we present an ensemble algorithm (https://github.com/Tabrisrei/ISLES22_Ensemble) that detects and segments ischemic stroke lesions on DWI across diverse scenarios on par with expert (neuro)radiologists. Second, we show the potential for biomedical challenge outputs to extend beyond the challenge's initial objectives, demonstrating their real-world clinical applicability.

Liam Chalcroft, Ioannis Pappas, Cathy J. Price et al.

Current deep learning-based approaches to lesion segmentation in neuroimaging often depend on high-resolution images and extensive annotated data, limiting clinical applicability. This paper introduces a novel synthetic data framework tailored for stroke lesion segmentation, expanding the SynthSeg methodology to incorporate lesion-specific augmentations that simulate diverse pathological features. Using a modified nnUNet architecture, our approach trains models with label maps from healthy and stroke datasets, facilitating segmentation across both normal and pathological tissue without reliance on specific sequence-based training. Evaluation across in-domain and out-of-domain (OOD) datasets reveals that our method matches state-of-the-art performance within the training domain and significantly outperforms existing methods on OOD data. By minimizing dependence on large annotated datasets and allowing for cross-sequence applicability, our framework holds potential to improve clinical neuroimaging workflows, particularly in stroke pathology. PyTorch training code and weights are publicly available at https://github.com/liamchalcroft/SynthStroke, along with an SPM toolbox featuring a plug-and-play model at https://github.com/liamchalcroft/SynthStrokeSPM.