Shadi Albarqouni

Jean Ogier du Terrail, Samy-Safwan Ayed, Edwige Cyffers et al. · eth-zurich

Federated Learning (FL) is a novel approach enabling several clients holding sensitive data to collaboratively train machine learning models, without centralizing data. The cross-silo FL setting corresponds to the case of few ($2$--$50$) reliable clients, each holding medium to large datasets, and is typically found in applications such as healthcare, finance, or industry. While previous works have proposed representative datasets for cross-device FL, few realistic healthcare cross-silo FL datasets exist, thereby slowing algorithmic research in this critical application. In this work, we propose a novel cross-silo dataset suite focused on healthcare, FLamby (Federated Learning AMple Benchmark of Your cross-silo strategies), to bridge the gap between theory and practice of cross-silo FL. FLamby encompasses 7 healthcare datasets with natural splits, covering multiple tasks, modalities, and data volumes, each accompanied with baseline training code. As an illustration, we additionally benchmark standard FL algorithms on all datasets. Our flexible and modular suite allows researchers to easily download datasets, reproduce results and re-use the different components for their research. FLamby is available at~\url{www.github.com/owkin/flamby}.

Ahmed Ghorbel, Ahmed Aldahdooh, Shadi Albarqouni et al. · eth-zurich

The quality of patient care associated with diagnostic radiology is proportionate to a physician workload. Segmentation is a fundamental limiting precursor to both diagnostic and therapeutic procedures. Advances in machine learning (ML) aim to increase diagnostic efficiency by replacing a single application with generalized algorithms. The goal of unsupervised anomaly detection (UAD) is to identify potential anomalous regions unseen during training, where convolutional neural network (CNN) based autoencoders (AEs) and variational autoencoders (VAEs) are considered a de facto approach for reconstruction based-anomaly segmentation. The restricted receptive field in CNNs limits the CNN to model the global context. Hence, if the anomalous regions cover large parts of the image, the CNN-based AEs are not capable of bringing a semantic understanding of the image. Meanwhile, vision transformers (ViTs) have emerged as a competitive alternative to CNNs. It relies on the self-attention mechanism that can relate image patches to each other. We investigate in this paper Transformer capabilities in building AEs for the reconstruction-based UAD task to reconstruct a coherent and more realistic image. We focus on anomaly segmentation for brain magnetic resonance imaging (MRI) and present five Transformer-based models while enabling segmentation performance comparable to or superior to state-of-the-art (SOTA) models. The source code is made publicly available on GitHub: https://github.com/ahmedgh970/Transformers_Unsupervised_Anomaly_Segmentation.git.

Karim Lekadir, Aasa Feragen, Abdul Joseph Fofanah et al. · eth-zurich

Despite major advances in artificial intelligence (AI) for medicine and healthcare, the deployment and adoption of AI technologies remain limited in real-world clinical practice. In recent years, concerns have been raised about the technical, clinical, ethical and legal risks associated with medical AI. To increase real world adoption, it is essential that medical AI tools are trusted and accepted by patients, clinicians, health organisations and authorities. This work describes the FUTURE-AI guideline as the first international consensus framework for guiding the development and deployment of trustworthy AI tools in healthcare. The FUTURE-AI consortium was founded in 2021 and currently comprises 118 inter-disciplinary experts from 51 countries representing all continents, including AI scientists, clinicians, ethicists, and social scientists. Over a two-year period, the consortium defined guiding principles and best practices for trustworthy AI through an iterative process comprising an in-depth literature review, a modified Delphi survey, and online consensus meetings. The FUTURE-AI framework was established based on 6 guiding principles for trustworthy AI in healthcare, i.e. Fairness, Universality, Traceability, Usability, Robustness and Explainability. Through consensus, a set of 28 best practices were defined, addressing technical, clinical, legal and socio-ethical dimensions. The recommendations cover the entire lifecycle of medical AI, from design, development and validation to regulation, deployment, and monitoring. FUTURE-AI is a risk-informed, assumption-free guideline which provides a structured approach for constructing medical AI tools that will be trusted, deployed and adopted in real-world practice. Researchers are encouraged to take the recommendations into account in proof-of-concept stages to facilitate future translation towards clinical practice of medical AI.

Tobias Bernecker, Annette Peters, Christopher L. Schlett et al. · eth-zurich

Given the high incidence and effective treatment options for liver diseases, they are of great socioeconomic importance. One of the most common methods for analyzing CT and MRI images for diagnosis and follow-up treatment is liver segmentation. Recent advances in deep learning have demonstrated encouraging results for automatic liver segmentation. Despite this, their success depends primarily on the availability of an annotated database, which is often not available because of privacy concerns. Federated Learning has been recently proposed as a solution to alleviate these challenges by training a shared global model on distributed clients without access to their local databases. Nevertheless, Federated Learning does not perform well when it is trained on a high degree of heterogeneity of image data due to multi-modal imaging, such as CT and MRI, and multiple scanner types. To this end, we propose Fednorm and its extension \fednormp, two Federated Learning algorithms that use a modality-based normalization technique. Specifically, Fednorm normalizes the features on a client-level, while Fednorm+ employs the modality information of single slices in the feature normalization. Our methods were validated using 428 patients from six publicly available databases and compared to state-of-the-art Federated Learning algorithms and baseline models in heterogeneous settings (multi-institutional, multi-modal data). The experimental results demonstrate that our methods show an overall acceptable performance, achieve Dice per patient scores up to 0.961, consistently outperform locally trained models, and are on par or slightly better than centralized models.

Duy M. H. Nguyen, Hoang Nguyen, Nghiem T. Diep et al. · eth-zurich

Obtaining large pre-trained models that can be fine-tuned to new tasks with limited annotated samples has remained an open challenge for medical imaging data. While pre-trained deep networks on ImageNet and vision-language foundation models trained on web-scale data are prevailing approaches, their effectiveness on medical tasks is limited due to the significant domain shift between natural and medical images. To bridge this gap, we introduce LVM-Med, the first family of deep networks trained on large-scale medical datasets. We have collected approximately 1.3 million medical images from 55 publicly available datasets, covering a large number of organs and modalities such as CT, MRI, X-ray, and Ultrasound. We benchmark several state-of-the-art self-supervised algorithms on this dataset and propose a novel self-supervised contrastive learning algorithm using a graph-matching formulation. The proposed approach makes three contributions: (i) it integrates prior pair-wise image similarity metrics based on local and global information; (ii) it captures the structural constraints of feature embeddings through a loss function constructed via a combinatorial graph-matching objective; and (iii) it can be trained efficiently end-to-end using modern gradient-estimation techniques for black-box solvers. We thoroughly evaluate the proposed LVM-Med on 15 downstream medical tasks ranging from segmentation and classification to object detection, and both for the in and out-of-distribution settings. LVM-Med empirically outperforms a number of state-of-the-art supervised, self-supervised, and foundation models. For challenging tasks such as Brain Tumor Classification or Diabetic Retinopathy Grading, LVM-Med improves previous vision-language models trained on 1 billion masks by 6-7% while using only a ResNet-50.

Raheleh Salehi, Ario Sadafi, Armin Gruber et al. · eth-zurich

Diagnosing hematological malignancies requires identification and classification of white blood cells in peripheral blood smears. Domain shifts caused by different lab procedures, staining, illumination, and microscope settings hamper the re-usability of recently developed machine learning methods on data collected from different sites. Here, we propose a cross-domain adapted autoencoder to extract features in an unsupervised manner on three different datasets of single white blood cells scanned from peripheral blood smears. The autoencoder is based on an R-CNN architecture allowing it to focus on the relevant white blood cell and eliminate artifacts in the image. To evaluate the quality of the extracted features we use a simple random forest to classify single cells. We show that thanks to the rich features extracted by the autoencoder trained on only one of the datasets, the random forest classifier performs satisfactorily on the unseen datasets, and outperforms published oracle networks in the cross-domain task. Our results suggest the possibility of employing this unsupervised approach in more complicated diagnosis and prognosis tasks without the need to add expensive expert labels to unseen data.

Yiping Jiao, Jeroen van der Laak, Shadi Albarqouni et al. · eth-zurich

We introduce LYSTO, the Lymphocyte Assessment Hackathon, which was held in conjunction with the MICCAI 2019 Conference in Shenzen (China). The competition required participants to automatically assess the number of lymphocytes, in particular T-cells, in histopathological images of colon, breast, and prostate cancer stained with CD3 and CD8 immunohistochemistry. Differently from other challenges setup in medical image analysis, LYSTO participants were solely given a few hours to address this problem. In this paper, we describe the goal and the multi-phase organization of the hackathon; we describe the proposed methods and the on-site results. Additionally, we present post-competition results where we show how the presented methods perform on an independent set of lung cancer slides, which was not part of the initial competition, as well as a comparison on lymphocyte assessment between presented methods and a panel of pathologists. We show that some of the participants were capable to achieve pathologist-level performance at lymphocyte assessment. After the hackathon, LYSTO was left as a lightweight plug-and-play benchmark dataset on grand-challenge website, together with an automatic evaluation platform. LYSTO has supported a number of research in lymphocyte assessment in oncology. LYSTO will be a long-lasting educational challenge for deep learning and digital pathology, it is available at https://lysto.grand-challenge.org/.

Duy M. H. Nguyen, Hoang Nguyen, Mai T. N. Truong et al. · eth-zurich

Collecting large-scale medical datasets with fully annotated samples for training of deep networks is prohibitively expensive, especially for 3D volume data. Recent breakthroughs in self-supervised learning (SSL) offer the ability to overcome the lack of labeled training samples by learning feature representations from unlabeled data. However, most current SSL techniques in the medical field have been designed for either 2D images or 3D volumes. In practice, this restricts the capability to fully leverage unlabeled data from numerous sources, which may include both 2D and 3D data. Additionally, the use of these pre-trained networks is constrained to downstream tasks with compatible data dimensions. In this paper, we propose a novel framework for unsupervised joint learning on 2D and 3D data modalities. Given a set of 2D images or 2D slices extracted from 3D volumes, we construct an SSL task based on a 2D contrastive clustering problem for distinct classes. The 3D volumes are exploited by computing vectored embedding at each slice and then assembling a holistic feature through deformable self-attention mechanisms in Transformer, allowing incorporating long-range dependencies between slices inside 3D volumes. These holistic features are further utilized to define a novel 3D clustering agreement-based SSL task and masking embedding prediction inspired by pre-trained language models. Experiments on downstream tasks, such as 3D brain segmentation, lung nodule detection, 3D heart structures segmentation, and abnormal chest X-ray detection, demonstrate the effectiveness of our joint 2D and 3D SSL approach. We improve plain 2D Deep-ClusterV2 and SwAV by a significant margin and also surpass various modern 2D and 3D SSL approaches.

Agnieszka Tomczak, Aarushi Gupta, Slobodan Ilic et al. · eth-zurich

Generative adversarial networks (GANs) offer an effective solution to the image-to-image translation problem, thereby allowing for new possibilities in medical imaging. They can translate images from one imaging modality to another at a low cost. For unpaired datasets, they rely mostly on cycle loss. Despite its effectiveness in learning the underlying data distribution, it can lead to a discrepancy between input and output data. The purpose of this work is to investigate the hypothesis that we can predict image quality based on its latent representation in the GANs bottleneck. We achieve this by corrupting the latent representation with noise and generating multiple outputs. The degree of differences between them is interpreted as the strength of the representation: the more robust the latent representation, the fewer changes in the output image the corruption causes. Our results demonstrate that our proposed method has the ability to i) predict uncertain parts of synthesized images, and ii) identify samples that may not be reliable for downstream tasks, e.g., liver segmentation task.

Aya Elgebaly, Nikolaos Delopoulos, Juliane Hörner-Rieber et al.

Automated medical image segmentation suffers from high inter-observer variability, particularly in tasks such as lung nodule delineation, where experts often disagree. Existing approaches either collapse this variability into a consensus mask or rely on separate model branches for each annotator. We introduce ProSona, a two-stage framework that learns a continuous latent space of annotation styles, enabling controllable personalization via natural language prompts. A probabilistic U-Net backbone captures diverse expert hypotheses, while a prompt-guided projection mechanism navigates this latent space to generate personalized segmentations. A multi-level contrastive objective aligns textual and visual representations, promoting disentangled and interpretable expert styles. Across the LIDC-IDRI lung nodule and multi-institutional prostate MRI datasets, ProSona reduces the Generalized Energy Distance by 17% and improves mean Dice by more than one point compared with DPersona. These results demonstrate that natural-language prompts can provide flexible, accurate, and interpretable control over personalized medical image segmentation. Our implementation is available online 1 .

Salome Kazeminia, Ario Sadafi, Asya Makhro et al. · eth-zurich

Deep learning-based classification of rare anemia disorders is challenged by the lack of training data and instance-level annotations. Multiple Instance Learning (MIL) has shown to be an effective solution, yet it suffers from low accuracy and limited explainability. Although the inclusion of attention mechanisms has addressed these issues, their effectiveness highly depends on the amount and diversity of cells in the training samples. Consequently, the poor machine learning performance on rare anemia disorder classification from blood samples remains unresolved. In this paper, we propose an interpretable pooling method for MIL to address these limitations. By benefiting from instance-level information of negative bags (i.e., homogeneous benign cells from healthy individuals), our approach increases the contribution of anomalous instances. We show that our strategy outperforms standard MIL classification algorithms and provides a meaningful explanation behind its decisions. Moreover, it can denote anomalous instances of rare blood diseases that are not seen during the training phase.

Tariq Bdair, Hossam Abdelhamid, Nassir Navab et al. · eth-zurich

Self-supervised Learning (SSL) has recently gained much attention due to the high cost and data limitation in the training of supervised learning models. The current paradigm in the SSL is to utilize data augmentation at the input space to create different views of the same images and train a model to maximize the representations between similar images and minimize them for different ones. While this approach achieves state-of-the-art (SOTA) results in various downstream tasks, it still lakes the opportunity to investigate the latent space augmentation. This paper proposes TriMix, a novel concept for SSL that generates virtual embeddings through linear interpolation of the data, thus providing the model with novel representations. Our strategy focuses on training the model to extract the original embeddings from virtual ones, hence, better representation learning. Additionally, we propose a self-consistency term that improves the consistency between the virtual and actual embeddings. We validate TriMix on eight benchmark datasets consisting of natural and medical images with an improvement of 2.71% and 0.41% better than the second-best models for both data types. Further, our approach outperformed the current methods in semi-supervised learning, particularly in low data regimes. Besides, our pre-trained models showed better transfer to other datasets.

Hao Ding, Yuqian Zhang, Tuxun Lu et al.

Surgical data science has seen rapid advancement due to the excellent performance of end-to-end deep neural networks (DNNs) for surgical video analysis. Despite their successes, end-to-end DNNs have been proven susceptible to even minor corruptions, substantially impairing the model's performance. This vulnerability has become a major concern for the translation of cutting-edge technology, especially for high-stakes decision-making in surgical data science. We introduce SegSTRONG-C, a benchmark and challenge in surgical data science dedicated, aiming to better understand model deterioration under unforeseen but plausible non-adversarial corruption and the capabilities of contemporary methods that seek to improve it. Through comprehensive baseline experiments and participating submissions from widespread community engagement, SegSTRONG-C reveals key themes for model failure and identifies promising directions for improving robustness. The performance of challenge winners, achieving an average 0.9394 DSC and 0.9301 NSD across the unreleased test sets with corruption types: bleeding, smoke, and low brightness, shows inspiring improvement of 0.1471 DSC and 0.2584 NSD in average comparing to strongest baseline methods with UNet architecture trained with AutoAugment. In conclusion, the SegSTRONG-C challenge has identified some practical approaches for enhancing model robustness, yet most approaches relied on conventional techniques that have known, and sometimes quite severe, limitations. Looking ahead, we advocate for expanding intellectual diversity and creativity in non-adversarial robustness beyond data augmentation or training scale, calling for new paradigms that enhance universal robustness to corruptions and may enable richer applications in surgical data science.

Roger D. Soberanis-Mukul, Nassir Navab, Shadi Albarqouni

Organ segmentation in CT volumes is an important pre-processing step in many computer assisted intervention and diagnosis methods. In recent years, convolutional neural networks have dominated the state of the art in this task. However, since this problem presents a challenging environment due to high variability in the organ's shape and similarity between tissues, the generation of false negative and false positive regions in the output segmentation is a common issue. Recent works have shown that the uncertainty analysis of the model can provide us with useful information about potential errors in the segmentation. In this context, we proposed a segmentation refinement method based on uncertainty analysis and graph convolutional networks. We employ the uncertainty levels of the convolutional network in a particular input volume to formulate a semi-supervised graph learning problem that is solved by training a graph convolutional network. To test our method we refine the initial output of a 2D U-Net. We validate our framework with the NIH pancreas dataset and the spleen dataset of the medical segmentation decathlon. We show that our method outperforms the state-of-the-art CRF refinement method by improving the dice score by 1% for the pancreas and 2% for spleen, with respect to the original U-Net's prediction. Finally, we perform a sensitivity analysis on the parameters of our proposal and discuss the applicability to other CNN architectures, the results, and current limitations of the model for future work in this research direction. For reproducibility purposes, we make our code publicly available at https://github.com/rodsom22/gcn_refinement.

Amelia Jiménez-Sánchez, Anees Kazi, Shadi Albarqouni et al.

In this paper, we target the problem of fracture classification from clinical X-Ray images towards an automated Computer Aided Diagnosis (CAD) system. Although primarily dealing with an image classification problem, we argue that localizing the fracture in the image is crucial to make good class predictions. Therefore, we propose and thoroughly analyze several schemes for simultaneous fracture localization and classification. We show that using an auxiliary localization task, in general, improves the classification performance. Moreover, it is possible to avoid the need for additional localization annotations thanks to recent advancements in weakly-supervised deep learning approaches. Among such approaches, we investigate and adapt Spatial Transformers (ST), Self-Transfer Learning (STL), and localization from global pooling layers. We provide a detailed quantitative and qualitative validation on a dataset of 1347 femur fractures images and report high accuracy with regard to inter-expert correlation values reported in the literature. Our investigations show that i) lesion localization improves the classification outcome, ii) weakly-supervised methods improve baseline classification without any additional cost, iii) STL guides feature activations and boost performance. We plan to make both the dataset and code available.

Mert Ikinci, Luna Toma, Karin U. Loeffler et al.

Accurate grading of Conjunctival Melanocytic Intraepithelial Lesions (CMIL) is essential for treatment and melanoma prediction but remains difficult due to subtle morphological cues and interrelated diagnostic criteria. We introduce INTERACT-CMIL, a multi-head deep learning framework that jointly predicts five histopathological axes; WHO4, WHO5, horizontal spread, vertical spread, and cytologic atypia, through Shared Feature Learning with Combinatorial Partial Supervision and an Inter-Dependence Loss enforcing cross-task consistency. Trained and evaluated on a newly curated, multi-center dataset of 486 expert-annotated conjunctival biopsy patches from three university hospitals, INTERACT-CMIL achieves consistent improvements over CNN and foundation-model (FM) baselines, with relative macro F1 gains up to 55.1% (WHO4) and 25.0% (vertical spread). The framework provides coherent, interpretable multi-criteria predictions aligned with expert grading, offering a reproducible computational benchmark for CMIL diagnosis and a step toward standardized digital ocular pathology.

Elodie Germani, Ilayda Selin Türk, Fatima Zeineddine et al.

Over the past decades, computer-aided diagnosis tools for breast cancer have been developed to enhance screening procedures, yet their clinical adoption remains challenged by data variability and inherent biases. Although foundation models (FMs) have recently demonstrated impressive generalizability and transfer learning capabilities by leveraging vast and diverse datasets, their performance can be undermined by spurious correlations that arise from variations in image quality, labeling uncertainty, and sensitive patient attributes. In this work, we explore the fairness and bias of FMs for breast mammography classification by leveraging a large pool of datasets from diverse sources-including data from underrepresented regions and an in-house dataset. Our extensive experiments show that while modality-specific pre-training of FMs enhances performance, classifiers trained on features from individual datasets fail to generalize across domains. Aggregating datasets improves overall performance, yet does not fully mitigate biases, leading to significant disparities across under-represented subgroups such as extreme breast densities and age groups. Furthermore, while domain-adaptation strategies can reduce these disparities, they often incur a performance trade-off. In contrast, fairness-aware techniques yield more stable and equitable performance across subgroups. These findings underscore the necessity of incorporating rigorous fairness evaluations and mitigation strategies into FM-based models to foster inclusive and generalizable AI.

Jiajun Zeng, Shadi Albarqouni

Large-scale biomedical vision-language models (VLMs) adapted on high-end imaging (e.g., CT) often fail to transfer to frontline low-end modalities (e.g., radiography), collapsing into modality-specific shortcuts. We propose K-MaT (Knowledge-Anchored Manifold Transport), a prompt-learning framework that transfers decision structures to low-end modalities without requiring low-end training images. K-MaT factorizes prompts, anchors them to clinical text descriptions, and aligns the low-end prompt manifold to the visually-grounded high-end space using Fused Gromov-Wasserstein optimal transport. We evaluate K-MaT on four cross-modal benchmarks, including dermoscopy, mammography to ultrasound, and CT to chest X-ray. K-MaT achieves state-of-the-art results, improving the average harmonic mean of accuracy to 44.1% (from BiomedCoOp's 42.0%) and macro-F1 to 36.2%. Notably, on the challenging breast imaging task, it mitigates the catastrophic forgetting seen in standard methods like CoOp (which drops to 27.0% accuracy on the low-end), preserving robust performance across modalities. Aligning prompt manifolds via optimal transport provides a highly effective route for the zero-shot cross-modal deployment of medical VLMs.

Adea Nesturi, David Dueñas Gaviria, Jiajun Zeng et al.

Deploying medical AI across resource-constrained institutions demands data-efficient learning pipelines that respect patient privacy. Federated Learning (FL) enables collaborative medical AI without centralising data, yet real-world clinical pools are inherently open-set, containing out-of-distribution (OOD) noise such as imaging artifacts and wrong modalities. Standard Active Learning (AL) query strategies mistake this noise for informative samples, wasting scarce annotation budgets. We propose PromptGate, a dynamic VLM-gated framework for Open-Set Federated AL that purifies unlabeled pools before querying. PromptGate introduces a federated Class-Specific Context Optimization: lightweight, learnable prompt vectors that adapt a frozen BiomedCLIP backbone to local clinical domains and aggregate globally via FedAvg -- without sharing patient data. As new annotations arrive, prompts progressively sharpen the ID/OOD boundary, turning the VLM into a dynamic gatekeeper that is strategy-agnostic: a plug-and-play pre-selection module enhancing any downstream AL strategy. Experiments on distributed dermatology and breast imaging benchmarks show that while static VLM prompting degrades to 50% ID purity, PromptGate maintains $>$95% purity with 98% OOD recall.

Malek Al Abed, Sebiha Demir, Anne Groteklaes et al.

Portable ultra-low-field MRI (uLF-MRI, 0.064 T) offers accessible neuroimaging for neonatal care but suffers from low signal-to-noise ratio and poor diagnostic quality compared to high-field (HF) MRI. We propose MRIQT, a 3D conditional diffusion framework for image quality transfer (IQT) from uLF to HF MRI. MRIQT combines realistic K-space degradation for physics-consistent uLF simulation, v-prediction with classifier-free guidance for stable image-to-image generation, and an SNR-weighted 3D perceptual loss for anatomical fidelity. The model denoises from a noised uLF input conditioned on the same scan, leveraging volumetric attention-UNet architecture for structure-preserving translation. Trained on a neonatal cohort with diverse pathologies, MRIQT surpasses recent GAN and CNN baselines in PSNR 15.3% with 1.78% over the state of the art, while physicians rated 85% of its outputs as good quality with clear pathology present. MRIQT enables high-fidelity, diffusion-based enhancement of portable ultra-low-field (uLF) MRI for deliable neonatal brain assessment.

Ario Sadafi, Asya Makhro, Leonid Livshits et al.

Sickle cell disease (SCD) is a severe genetic hemoglobin disorder that results in premature destruction of red blood cells. Assessment of the severity of the disease is a challenging task in clinical routine since the causes of broad variance in SCD manifestation despite the common genetic cause remain unclear. Identification of the biomarkers that would predict the severity grade is of importance for prognosis and assessment of responsiveness of patients to therapy. Detection of the changes in red blood cell (RBC) density through separation of Percoll density gradient could be such marker as it allows to resolve intercellular differences and follow the most damaged dense cells prone to destruction and vaso-occlusion. Quantification of the images obtained from the distribution of RBCs in Percoll gradient and interpretation of the obtained is an important prerequisite for establishment of this approach. Here, we propose a novel approach combining a graph convolutional network, a convolutional neural network, fast Fourier transform, and recursive feature elimination to predict the severity of SCD directly from a Percoll image. Two important but expensive laboratory blood test parameters measurements are used for training the graph convolutional network. To make the model independent from such tests during prediction, the two parameters are estimated by a neural network from the Percoll image directly. On a cohort of 216 subjects, we achieve a prediction performance that is only slightly below an approach where the groundtruth laboratory measurements are used. Our proposed method is the first computational approach for the difficult task of SCD severity prediction. The two-step approach relies solely on inexpensive and simple blood analysis tools and can have a significant impact on the patients' survival in underdeveloped countries where access to medical instruments and doctors is limited

Sarthak Pati, Ujjwal Baid, Maximilian Zenk et al.

This manuscript describes the first challenge on Federated Learning, namely the Federated Tumor Segmentation (FeTS) challenge 2021. International challenges have become the standard for validation of biomedical image analysis methods. However, the actual performance of participating (even the winning) algorithms on "real-world" clinical data often remains unclear, as the data included in challenges are usually acquired in very controlled settings at few institutions. The seemingly obvious solution of just collecting increasingly more data from more institutions in such challenges does not scale well due to privacy and ownership hurdles. Towards alleviating these concerns, we are proposing the FeTS challenge 2021 to cater towards both the development and the evaluation of models for the segmentation of intrinsically heterogeneous (in appearance, shape, and histology) brain tumors, namely gliomas. Specifically, the FeTS 2021 challenge uses clinically acquired, multi-institutional magnetic resonance imaging (MRI) scans from the BraTS 2020 challenge, as well as from various remote independent institutions included in the collaborative network of a real-world federation (https://www.fets.ai/). The goals of the FeTS challenge are directly represented by the two included tasks: 1) the identification of the optimal weight aggregation approach towards the training of a consensus model that has gained knowledge via federated learning from multiple geographically distinct institutions, while their data are always retained within each institution, and 2) the federated evaluation of the generalizability of brain tumor segmentation models "in the wild", i.e. on data from institutional distributions that were not part of the training datasets.

Ario Sadafi, Lucía María Moya Sans, Asya Makhro et al.

Hereditary hemolytic anemias are genetic disorders that affect the shape and density of red blood cells. Genetic tests currently used to diagnose such anemias are expensive and unavailable in the majority of clinical labs. Here, we propose a method for identifying hereditary hemolytic anemias based on a standard biochemistry method, called Percoll gradient, obtained by centrifuging a patient's blood. Our hybrid approach consists on using spatial data-driven features, extracted with a convolutional neural network and spectral handcrafted features obtained from fast Fourier transform. We compare late and early feature fusion with AlexNet and VGG16 architectures. AlexNet with late fusion of spectral features performs better compared to other approaches. We achieved an average F1-score of 88% on different classes suggesting the possibility of diagnosing of hereditary hemolytic anemias from Percoll gradients. Finally, we utilize Grad-CAM to explore the spatial features used for classification.

Cosmin I. Bercea, Benedikt Wiestler, Daniel Rueckert et al.

In recent years, data-driven machine learning (ML) methods have revolutionized the computer vision community by providing novel efficient solutions to many unsolved (medical) image analysis problems. However, due to the increasing privacy concerns and data fragmentation on many different sites, existing medical data are not fully utilized, thus limiting the potential of ML. Federated learning (FL) enables multiple parties to collaboratively train a ML model without exchanging local data. However, data heterogeneity (non-IID) among the distributed clients is yet a challenge. To this end, we propose a novel federated method, denoted Federated Disentanglement (FedDis), to disentangle the parameter space into shape and appearance, and only share the shape parameter with the clients. FedDis is based on the assumption that the anatomical structure in brain MRI images is similar across multiple institutions, and sharing the shape knowledge would be beneficial in anomaly detection. In this paper, we leverage healthy brain scans of 623 subjects from multiple sites with real data (OASIS, ADNI) in a privacy-preserving fashion to learn a model of normal anatomy, that allows to segment abnormal structures. We demonstrate a superior performance of FedDis on real pathological databases containing 109 subjects; two publicly available MS Lesions (MSLUB, MSISBI), and an in-house database with MS and Glioblastoma (MSI and GBI). FedDis achieved an average dice performance of 0.38, outperforming the state-of-the-art (SOTA) auto-encoder by 42% and the SOTA federated method by 11%. Further, we illustrate that FedDis learns a shape embedding that is orthogonal to the appearance and consistent under different intensity augmentations.

Tariq Bdair, Nassir Navab, Shadi Albarqouni

Globally, Skin carcinoma is among the most lethal diseases. Millions of people are diagnosed with this cancer every year. Sill, early detection can decrease the medication cost and mortality rate substantially. The recent improvement in automated cancer classification using deep learning methods has reached a human-level performance requiring a large amount of annotated data assembled in one location, yet, finding such conditions usually is not feasible. Recently, federated learning (FL) has been proposed to train decentralized models in a privacy-preserved fashion depending on labeled data at the client-side, which is usually not available and costly. To address this, we propose \verb!FedPerl!, a semi-supervised federated learning method. Our method is inspired by peer learning from educational psychology and ensemble averaging from committee machines. FedPerl builds communities based on clients' similarities. Then it encourages communities members to learn from each other to generate more accurate pseudo labels for the unlabeled data. We also proposed the peer anonymization (PA) technique to anonymize clients. As a core component of our method, PA is orthogonal to other methods without additional complexity and reduces the communication cost while enhancing performance. Finally, we propose a dynamic peer-learning policy that controls the learning stream to avoid any degradation in the performance, especially for individual clients. Our experimental setup consists of 71,000 skin lesion images collected from 5 publicly available datasets. We test our method in four different scenarios in SSFL. With few annotated data, FedPerl is on par with a state-of-the-art method in skin lesion classification in the standard setup while outperforming SSFLs and the baselines by 1.8% and 15.8%, respectively. Also, it generalizes better to unseen clients while being less sensitive to noisy ones.

Roger D. Soberanis-Mukul, Shadi Albarqouni, Nassir Navab

The diagnosis process of colorectal cancer mainly focuses on the localization and characterization of abnormal growths in the colon tissue known as polyps. Despite recent advances in deep object localization, the localization of polyps remains challenging due to the similarities between tissues, and the high level of artifacts. Recent studies have shown the negative impact of the presence of artifacts in the polyp detection task, and have started to take them into account within the training process. However, the use of prior knowledge related to the spatial interaction of polyps and artifacts has not yet been considered. In this work, we incorporate artifact knowledge in a post-processing step. Our method models this task as an inductive graph representation learning problem, and is composed of training and inference steps. Detected bounding boxes around polyps and artifacts are considered as nodes connected by a defined criterion. The training step generates a node classifier with ground truth bounding boxes. In inference, we use this classifier to analyze a second graph, generated from artifact and polyp predictions given by region proposal networks. We evaluate how the choices in the connectivity and artifacts affect the performance of our method and show that it has the potential to reduce the false positives in the results of a region proposal network.

Yousef Yeganeh, Azade Farshad, Nassir Navab et al.

Federated learning (FL) has been a promising approach in the field of medical imaging in recent years. A critical problem in FL, specifically in medical scenarios is to have a more accurate shared model which is robust to noisy and out-of distribution clients. In this work, we tackle the problem of statistical heterogeneity in data for FL which is highly plausible in medical data where for example the data comes from different sites with different scanner settings. We propose IDA (Inverse Distance Aggregation), a novel adaptive weighting approach for clients based on meta-information which handles unbalanced and non-iid data. We extensively analyze and evaluate our method against the well-known FL approach, Federated Averaging as a baseline.

Ario Sadafi, Asya Makhro, Anna Bogdanova et al.

Red blood cells are highly deformable and present in various shapes. In blood cell disorders, only a subset of all cells is morphologically altered and relevant for the diagnosis. However, manually labeling of all cells is laborious, complicated and introduces inter-expert variability. We propose an attention based multiple instance learning method to classify blood samples of patients suffering from blood cell disorders. Cells are detected using an R-CNN architecture. With the features extracted for each cell, a multiple instance learning method classifies patient samples into one out of four blood cell disorders. The attention mechanism provides a measure of the contribution of each cell to the overall classification and significantly improves the network's classification accuracy as well as its interpretability for the medical expert.

Christoph Baur, Benedikt Wiestler, Shadi Albarqouni et al.

Brain pathologies can vary greatly in size and shape, ranging from few pixels (i.e. MS lesions) to large, space-occupying tumors. Recently proposed Autoencoder-based methods for unsupervised anomaly segmentation in brain MRI have shown promising performance, but face difficulties in modeling distributions with high fidelity, which is crucial for accurate delineation of particularly small lesions. Here, similar to these previous works, we model the distribution of healthy brain MRI to localize pathologies from erroneous reconstructions. However, to achieve improved reconstruction fidelity at higher resolutions, we learn to compress and reconstruct different frequency bands of healthy brain MRI using the laplacian pyramid. In a range of experiments comparing our method to different State-of-the-Art approaches on three different brain MR datasets with MS lesions and tumors, we show improved anomaly segmentation performance and the general capability to obtain much more crisp reconstructions of input data at native resolution. The modeling of the laplacian pyramid further enables the delineation and aggregation of lesions at multiple scales, which allows to effectively cope with different pathologies and lesion sizes using a single model.

Mai Bui, Tolga Birdal, Haowen Deng et al.

We present a multimodal camera relocalization framework that captures ambiguities and uncertainties with continuous mixture models defined on the manifold of camera poses. In highly ambiguous environments, which can easily arise due to symmetries and repetitive structures in the scene, computing one plausible solution (what most state-of-the-art methods currently regress) may not be sufficient. Instead we predict multiple camera pose hypotheses as well as the respective uncertainty for each prediction. Towards this aim, we use Bingham distributions, to model the orientation of the camera pose, and a multivariate Gaussian to model the position, with an end-to-end deep neural network. By incorporating a Winner-Takes-All training scheme, we finally obtain a mixture model that is well suited for explaining ambiguities in the scene, yet does not suffer from mode collapse, a common problem with mixture density networks. We introduce a new dataset specifically designed to foster camera localization research in ambiguous environments and exhaustively evaluate our method on synthetic as well as real data on both ambiguous scenes and on non-ambiguous benchmark datasets. We plan to release our code and dataset under $\href{https://multimodal3dvision.github.io}{multimodal3dvision.github.io}$.

Christoph Baur, Stefan Denner, Benedikt Wiestler et al.

Deep unsupervised representation learning has recently led to new approaches in the field of Unsupervised Anomaly Detection (UAD) in brain MRI. The main principle behind these works is to learn a model of normal anatomy by learning to compress and recover healthy data. This allows to spot abnormal structures from erroneous recoveries of compressed, potentially anomalous samples. The concept is of great interest to the medical image analysis community as it i) relieves from the need of vast amounts of manually segmented training data---a necessity for and pitfall of current supervised Deep Learning---and ii) theoretically allows to detect arbitrary, even rare pathologies which supervised approaches might fail to find. To date, the experimental design of most works hinders a valid comparison, because i) they are evaluated against different datasets and different pathologies, ii) use different image resolutions and iii) different model architectures with varying complexity. The intent of this work is to establish comparability among recent methods by utilizing a single architecture, a single resolution and the same dataset(s). Besides providing a ranking of the methods, we also try to answer questions like i) how many healthy training subjects are needed to model normality and ii) if the reviewed approaches are also sensitive to domain shift. Further, we identify open challenges and provide suggestions for future community efforts and research directions.

Tariq Bdair, Benedikt Wiestler, Nassir Navab et al.

Medical image segmentation is one of the major challenges addressed by machine learning methods. Yet, deep learning methods profoundly depend on a large amount of annotated data, which is time-consuming and costly. Though, semi-supervised learning methods approach this problem by leveraging an abundant amount of unlabeled data along with a small amount of labeled data in the training process. Recently, MixUp regularizer has been successfully introduced to semi-supervised learning methods showing superior performance. MixUp augments the model with new data points through linear interpolation of the data at the input space. We argue that this option is limited. Instead, we propose ROAM, a RandOm lAyer Mixup, which encourages the network to be less confident for interpolated data points at randomly selected space. ROAM generates more data points that have never seen before, and hence it avoids over-fitting and enhances the generalization ability. We conduct extensive experiments to validate our method on three publicly available datasets on whole-brain image segmentation. ROAM achieves state-of-the-art (SOTA) results in fully supervised (89.5%) and semi-supervised (87.0%) settings with a relative improvement of up to 2.40% and 16.50%, respectively for the whole-brain segmentation.

Nicola Rieke, Jonny Hancox, Wenqi Li et al.

Data-driven Machine Learning has emerged as a promising approach for building accurate and robust statistical models from medical data, which is collected in huge volumes by modern healthcare systems. Existing medical data is not fully exploited by ML primarily because it sits in data silos and privacy concerns restrict access to this data. However, without access to sufficient data, ML will be prevented from reaching its full potential and, ultimately, from making the transition from research to clinical practice. This paper considers key factors contributing to this issue, explores how Federated Learning (FL) may provide a solution for the future of digital health and highlights the challenges and considerations that need to be addressed.

Mhd Hasan Sarhan, Nassir Navab, Abouzar Eslami et al.

Learning discriminative powerful representations is a crucial step for machine learning systems. Introducing invariance against arbitrary nuisance or sensitive attributes while performing well on specific tasks is an important problem in representation learning. This is mostly approached by purging the sensitive information from learned representations. In this paper, we propose a novel disentanglement approach to invariant representation problem. We disentangle the meaningful and sensitive representations by enforcing orthogonality constraints as a proxy for independence. We explicitly enforce the meaningful representation to be agnostic to sensitive information by entropy maximization. The proposed approach is evaluated on five publicly available datasets and compared with state of the art methods for learning fairness and invariance achieving the state of the art performance on three datasets and comparable performance on the rest. Further, we perform an ablative study to evaluate the effect of each component.

Maxime Kayser, Roger D. Soberanis-Mukul, Anna-Maria Zvereva et al.

Survival rates for colorectal cancer are higher when polyps are detected at an early stage and can be removed before they develop into malignant tumors. Automated polyp detection, which is dominated by deep learning based methods, seeks to improve early detection of polyps. However, current efforts rely heavily on the size and quality of the training datasets. The quality of these datasets often suffers from various image artifacts that affect the visibility and hence, the detection rate. In this work, we conducted a systematic analysis to gain a better understanding of how artifacts affect automated polyp detection. We look at how six different artifact classes, and their location in an image, affect the performance of a RetinaNet based polyp detection model. We found that, depending on the artifact class, they can either benefit or harm the polyp detector. For instance, bubbles are often misclassified as polyps, while specular reflections inside of a polyp region can improve detection capabilities. We then investigated different strategies, such as a learning without forgetting framework, to leverage artifact knowledge to improve automated polyp detection. Our results show that such models can mitigate some of the harmful effects of artifacts, but require more work to significantly improve polyp detection capabilities.

Agnieszka Tomczack, Nassir Navab, Shadi Albarqouni

Deep Learning sets the state-of-the-art in many challenging tasks showing outstanding performance in a broad range of applications. Despite its success, it still lacks robustness hindering its adoption in medical applications. Modeling uncertainty, through Bayesian Inference and Monte-Carlo dropout, has been successfully introduced for better understanding the underlying deep learning models. Yet, another important source of uncertainty, coming from the inter-observer variability, has not been thoroughly addressed in the literature. In this paper, we introduce labels uncertainty which better suits medical applications and show that modeling such uncertainty together with epistemic uncertainty is of high interest for quality control and referral systems.

Abhijeet Parida, Arianne Tran, Nassir Navab et al.

Semantic segmentation is an import task in the medical field to identify the exact extent and orientation of significant structures like organs and pathology. Deep neural networks can perform this task well by leveraging the information from a large well-labeled data-set. This paper aims to present a method that mitigates the necessity of an extensive well-labeled data-set. This method also addresses semi-supervision by enabling segmentation based on bounding box annotations, avoiding the need for full pixel-level annotations. The network presented consists of a single U-Net based unbranched architecture that generates a few-shot segmentation for an unseen human organ using just 4 example annotations of that specific organ. The network is trained by alternately minimizing the nearest neighbor loss for prototype learning and a weighted cross-entropy loss for segmentation learning to perform a fast 3D segmentation with a median score of 54.64%.

Mohammad Eslami, Solale Tabarestani, Shadi Albarqouni et al.

Chest X-ray radiography is one of the earliest medical imaging technologies and remains one of the most widely-used for diagnosis, screening, and treatment follow up of diseases related to lungs and heart. The literature in this field of research reports many interesting studies dealing with the challenging tasks of bone suppression and organ segmentation but performed separately, limiting any learning that comes with the consolidation of parameters that could optimize both processes. This study, and for the first time, introduces a multitask deep learning model that generates simultaneously the bone-suppressed image and the organ-segmented image, enhancing the accuracy of tasks, minimizing the number of parameters needed by the model and optimizing the processing time, all by exploiting the interplay between the network parameters to benefit the performance of both tasks. The architectural design of this model, which relies on a conditional generative adversarial network, reveals the process on how the well-established pix2pix network (image-to-image network) is modified to fit the need for multitasking and extending it to the new image-to-images architecture. The developed source code of this multitask model is shared publicly on Github as the first attempt for providing the two-task pix2pix extension, a supervised/paired/aligned/registered image-to-images translation which would be useful in many multitask applications. Dilated convolutions are also used to improve the results through a more effective receptive field assessment. The comparison with state-of-the-art algorithms along with ablation study and a demonstration video are provided to evaluate efficacy and gauge the merits of the proposed approach.

Roger D. Soberanis-Mukul, Nassir Navab, Shadi Albarqouni

Organ segmentation in CT volumes is an important pre-processing step in many computer assisted intervention and diagnosis methods. In recent years, convolutional neural networks have dominated the state of the art in this task. However, since this problem presents a challenging environment due to high variability in the organ's shape and similarity between tissues, the generation of false negative and false positive regions in the output segmentation is a common issue. Recent works have shown that the uncertainty analysis of the model can provide us with useful information about potential errors in the segmentation. In this context, we proposed a segmentation refinement method based on uncertainty analysis and graph convolutional networks. We employ the uncertainty levels of the convolutional network in a particular input volume to formulate a semi-supervised graph learning problem that is solved by training a graph convolutional network. To test our method we refine the initial output of a 2D U-Net. We validate our framework with the NIH pancreas dataset and the spleen dataset of the medical segmentation decathlon. We show that our method outperforms the state-of-the art CRF refinement method by improving the dice score by 1% for the pancreas and 2% for spleen, with respect to the original U-Net's prediction. Finally, we discuss the results and current limitations of the model for future work in this research direction. For reproducibility purposes, we make our code publicly available.

Amal Lahiani, Nassir Navab, Shadi Albarqouni et al.

Style transfer is a field with growing interest and use cases in deep learning. Recent work has shown Generative Adversarial Networks(GANs) can be used to create realistic images of virtually stained slide images in digital pathology with clinically validated interpretability. Digital pathology images are typically of extremely high resolution, making tilewise analysis necessary for deep learning applications. It has been shown that image generators with instance normalization can cause a tiling artifact when a large image is reconstructed from the tilewise analysis. We introduce a novel perceptual embedding consistency loss significantly reducing the tiling artifact created in the reconstructed whole slide image (WSI). We validate our results by comparing virtually stained slide images with consecutive real stained tissue slide images. We also demonstrate that our model is more robust to contrast, color and brightness perturbations by running comparative sensitivity analysis tests.

Ashkan Khakzar, Shadi Albarqouni, Nassir Navab

Neural networks are proven to be remarkably successful for classification and diagnosis in medical applications. However, the ambiguity in the decision-making process and the interpretability of the learned features is a matter of concern. In this work, we propose a method for improving the feature interpretability of neural network classifiers. Initially, we propose a baseline convolutional neural network with state of the art performance in terms of accuracy and weakly supervised localization. Subsequently, the loss is modified to integrate robustness to adversarial examples into the training process. In this work, feature interpretability is quantified via evaluating the weakly supervised localization using the ground truth bounding boxes. Interpretability is also visually assessed using class activation maps and saliency maps. The method is applied to NIH ChestX-ray14, the largest publicly available chest x-rays dataset. We demonstrate that the adversarially robust optimization paradigm improves feature interpretability both quantitatively and visually.

Hendrik Burwinkel, Anees Kazi, Gerome Vivar et al.

Recently, Geometric Deep Learning (GDL) has been introduced as a novel and versatile framework for computer-aided disease classification. GDL uses patient meta-information such as age and gender to model patient cohort relations in a graph structure. Concepts from graph signal processing are leveraged to learn the optimal mapping of multi-modal features, e.g. from images to disease classes. Related studies so far have considered image features that are extracted in a pre-processing step. We hypothesize that such an approach prevents the network from optimizing feature representations towards achieving the best performance in the graph network. We propose a new network architecture that exploits an inductive end-to-end learning approach for disease classification, where filters from both the CNN and the graph are trained jointly. We validate this architecture against state-of-the-art inductive graph networks and demonstrate significantly improved classification scores on a modified MNIST toy dataset, as well as comparable classification results with higher stability on a chest X-ray image dataset. Additionally, we explain how the structural information of the graph affects both the image filters and the feature learning.

Mhd Hasan Sarhan, Shadi Albarqouni, Mehmet Yigitsoy et al.

Deep learning techniques are recently being used in fundus image analysis and diabetic retinopathy detection. Microaneurysms are an important indicator of diabetic retinopathy progression. We introduce a two-stage deep learning approach for microaneurysms segmentation using multiple scales of the input with selective sampling and embedding triplet loss. The model first segments on two scales and then the segmentations are refined with a classification model. To enhance the discriminative power of the classification model, we incorporate triplet embedding loss with a selective sampling routine. The model is evaluated quantitatively to assess the segmentation performance and qualitatively to analyze the model predictions. This approach introduces a 30.29% relative improvement over the fully convolutional neural network.

Mhd Hasan Sarhan, Abouzar Eslami, Nassir Navab et al.

Learning Interpretable representation in medical applications is becoming essential for adopting data-driven models into clinical practice. It has been recently shown that learning a disentangled feature representation is important for a more compact and explainable representation of the data. In this paper, we introduce a novel adversarial variational autoencoder with a total correlation constraint to enforce independence on the latent representation while preserving the reconstruction fidelity. Our proposed method is validated on a publicly available dataset showing that the learned disentangled representation is not only interpretable, but also superior to the state-of-the-art methods. We report a relative improvement of 81.50% in terms of disentanglement, 11.60% in clustering, and 2% in supervised classification with a few amounts of labeled data.

Mai Bui, Christoph Baur, Nassir Navab et al.

Despite recent advances on the topic of direct camera pose regression using neural networks, accurately estimating the camera pose of a single RGB image still remains a challenging task. To address this problem, we introduce a novel framework based, in its core, on the idea of implicitly learning the joint distribution of RGB images and their corresponding camera poses using a discriminator network and adversarial learning. Our method allows not only to regress the camera pose from a single image, however, also offers a solely RGB-based solution for camera pose refinement using the discriminator network. Further, we show that our method can effectively be used to optimize the predicted camera poses and thus improve the localization accuracy. To this end, we validate our proposed method on the publicly available 7-Scenes dataset improving upon the results of direct camera pose regression methods.

Anees Kazi, Shayan shekarforoush, S. Arvind krishna et al.

Geometric deep learning provides a principled and versatile manner for the integration of imaging and non-imaging modalities in the medical domain. Graph Convolutional Networks (GCNs) in particular have been explored on a wide variety of problems such as disease prediction, segmentation, and matrix completion by leveraging large, multimodal datasets. In this paper, we introduce a new spectral domain architecture for deep learning on graphs for disease prediction. The novelty lies in defining geometric 'inception modules' which are capable of capturing intra- and inter-graph structural heterogeneity during convolutions. We design filters with different kernel sizes to build our architecture. We show our disease prediction results on two publicly available datasets. Further, we provide insights on the behaviour of regular GCNs and our proposed model under varying input scenarios on simulated data.

Ahmed Ayyad, Yuchen Li, Nassir Navab et al.

Recent progress has shown that few-shot learning can be improved with access to unlabelled data, known as semi-supervised few-shot learning(SS-FSL). We introduce an SS-FSL approach, dubbed as Prototypical Random Walk Networks(PRWN), built on top of Prototypical Networks (PN). We develop a random walk semi-supervised loss that enables the network to learn representations that are compact and well-separated. Our work is related to the very recent development of graph-based approaches for few-shot learning. However, we show that compact and well-separated class representations can be achieved by modeling our prototypical random walk notion without needing additional graph-NN parameters or requiring a transductive setting where a collective test set is provided. Our model outperforms baselines in most benchmarks with significant improvements in some cases. Our model, trained with 40$\%$ of the data as labeled, compares competitively against fully supervised prototypical networks, trained on 100$\%$ of the labels, even outperforming it in the 1-shot mini-Imagenet case with 50.89$\%$ to 49.4$\%$ accuracy. We also show that our loss is resistant to distractors, unlabeled data that does not belong to any of the training classes, and hence reflecting robustness to labeled/unlabeled class distribution mismatch. Associated GitHub page can be found at https://prototypical-random-walk.github.io.

Amelia Jiménez-Sánchez, Anees Kazi, Shadi Albarqouni et al.

We demonstrate the feasibility of a fully automatic computer-aided diagnosis (CAD) tool, based on deep learning, that localizes and classifies proximal femur fractures on X-ray images according to the AO classification. The proposed framework aims to improve patient treatment planning and provide support for the training of trauma surgeon residents. A database of 1347 clinical radiographic studies was collected. Radiologists and trauma surgeons annotated all fractures with bounding boxes, and provided a classification according to the AO standard. The proposed CAD tool for the classification of radiographs into types "A", "B" and "not-fractured", reaches a F1-score of 87% and AUC of 0.95, when classifying fractures versus not-fractured cases it improves up to 94% and 0.98. Prior localization of the fracture results in an improvement with respect to full image classification. 100% of the predicted centers of the region of interest are contained in the manually provided bounding boxes. The system retrieves on average 9 relevant images (from the same class) out of 10 cases. Our CAD scheme localizes, detects and further classifies proximal femur fractures achieving results comparable to expert-level and state-of-the-art performance. Our auxiliary localization model was highly accurate predicting the region of interest in the radiograph. We further investigated several strategies of verification for its adoption into the daily clinical routine. A sensitivity analysis of the size of the ROI and image retrieval as a clinical use case were presented.

Bodo Kaiser, Shadi Albarqouni

We present a detailed description and reference implementation of preprocessing steps necessary to prepare the public Retrospective Image Registration Evaluation (RIRE) dataset for the task of magnetic resonance imaging (MRI) to X-ray computed tomography (CT) translation. Furthermore we describe and implement three state of the art convolutional neural network (CNN) and generative adversarial network (GAN) models where we report statistics and visual results of two of them.

Anees Kazi, S. Arvind krishna, Shayan Shekarforoush et al.

Multi-modal data comprising imaging (MRI, fMRI, PET, etc.) and non-imaging (clinical test, demographics, etc.) data can be collected together and used for disease prediction. Such diverse data gives complementary information about the patientś condition to make an informed diagnosis. A model capable of leveraging the individuality of each multi-modal data is required for better disease prediction. We propose a graph convolution based deep model which takes into account the distinctiveness of each element of the multi-modal data. We incorporate a novel self-attention layer, which weights every element of the demographic data by exploring its relation to the underlying disease. We demonstrate the superiority of our developed technique in terms of computational speed and performance when compared to state-of-the-art methods. Our method outperforms other methods with a significant margin.