Žiga Špiclin

Domen Preložnik, Žiga Špiclin

Inter-scanner variability of magnetic resonance imaging has an adverse impact on the diagnostic and prognostic quality of the scans and necessitates the development of models robust to domain shift inflicted by the unseen scanner data. Review of recent advances in domain adaptation showed that efficacy of strategies involving modifications or constraints on the latent space appears to be contingent upon the level and/or depth of supervision during model training. In this paper, we therefore propose an unsupervised domain adaptation technique based on self-supervised multi-stage unlearning (SSMSU). Building upon the state-of-the-art segmentation framework nnU-Net, we employ deep supervision at deep encoder stages using domain classifier unlearning, applied sequentially across the deep stages to suppress domain-related latent features. Following self-configurable approach of the nnU-Net, the auxiliary feedback loop implements a self-supervised backpropagation schedule for the unlearning process, since continuous unlearning was found to have a detrimental effect on the main segmentation task. Experiments were carried out on four public datasets for benchmarking white-matter lesion segmentation methods. Five benchmark models and/or strategies, covering passive to active unsupervised domain adaptation, were tested. In comparison, the SSMSU demonstrated the advantage of unlearning by enhancing lesion sensitivity and limiting false detections, which resulted in higher overall segmentation quality in terms of segmentation overlap and relative lesion volume error. The proposed model inputs only the FLAIR modality, which simplifies preprocessing pipelines, eliminates the need for inter-modality registration errors and harmonization, which can introduce variability. Source code is available on https://github.com/Pubec/nnunetv2-unlearning.

Vladyslav Zalevskyi, Thomas Sanchez, Misha Kaandorp et al.

Accurate fetal brain tissue segmentation and biometric analysis are essential for studying brain development in utero. The FeTA Challenge 2024 advanced automated fetal brain MRI analysis by introducing biometry prediction as a new task alongside tissue segmentation. For the first time, our diverse multi-centric test set included data from a new low-field (0.55T) MRI dataset. Evaluation metrics were also expanded to include the topology-specific Euler characteristic difference (ED). Sixteen teams submitted segmentation methods, most of which performed consistently across both high- and low-field scans. However, longitudinal trends indicate that segmentation accuracy may be reaching a plateau, with results now approaching inter-rater variability. The ED metric uncovered topological differences that were missed by conventional metrics, while the low-field dataset achieved the highest segmentation scores, highlighting the potential of affordable imaging systems when paired with high-quality reconstruction. Seven teams participated in the biometry task, but most methods failed to outperform a simple baseline that predicted measurements based solely on gestational age, underscoring the challenge of extracting reliable biometric estimates from image data alone. Domain shift analysis identified image quality as the most significant factor affecting model generalization, with super-resolution pipelines also playing a substantial role. Other factors, such as gestational age, pathology, and acquisition site, had smaller, though still measurable, effects. Overall, FeTA 2024 offers a comprehensive benchmark for multi-class segmentation and biometry estimation in fetal brain MRI, underscoring the need for data-centric approaches, improved topological evaluation, and greater dataset diversity to enable clinically robust and generalizable AI tools.

Ema Masterl, Tina Vipotnik Vesnaver, Žiga Špiclin

Fetal brain MRI relies on rapid multi-view 2D slice acquisitions to reduce motion artifacts caused by fetal movement. However, these stacks are typically low resolution, may suffer from motion corruption, and do not adequately capture 3D anatomy. Super-resolution reconstruction (SRR) methods aim to address these limitations by combining slice-to-volume registration and super-resolution techniques to generate high-resolution (HR) 3D volumes. While several SRR methods have been proposed, their comparative performance - particularly in pathological cases - and their influence on downstream volumetric analysis and diagnostic tasks remain underexplored. In this study, we applied three state-of-the-art SRR method - NiftyMIC, SVRTK, and NeSVoR - to 140 fetal brain MRI scans, including both healthy controls (HC) and pathological cases (PC) with ventriculomegaly (VM). Each HR reconstruction was segmented using the BoUNTi algorithm to extract volumes of nine principal brain structures. We evaluated visual quality, SRR success rates, volumetric measurement agreement, and diagnostic classification performance. NeSVoR demonstrated the highest and most consistent reconstruction success rate (>90%) across both HC and PC groups. Although significant differences in volumetric estimates were observed between SRR methods, classification performance for VM was not affected by the choice of SRR method. These findings highlight NeSVoR's robustness and the resilience of diagnostic performance despite SRR-induced volumetric variability.

Hongwei Bran Li, Fernando Navarro, Ivan Ezhov et al.

Uncertainty in medical image segmentation tasks, especially inter-rater variability, arising from differences in interpretations and annotations by various experts, presents a significant challenge in achieving consistent and reliable image segmentation. This variability not only reflects the inherent complexity and subjective nature of medical image interpretation but also directly impacts the development and evaluation of automated segmentation algorithms. Accurately modeling and quantifying this variability is essential for enhancing the robustness and clinical applicability of these algorithms. We report the set-up and summarize the benchmark results of the Quantification of Uncertainties in Biomedical Image Quantification Challenge (QUBIQ), which was organized in conjunction with International Conferences on Medical Image Computing and Computer-Assisted Intervention (MICCAI) 2020 and 2021. The challenge focuses on the uncertainty quantification of medical image segmentation which considers the omnipresence of inter-rater variability in imaging datasets. The large collection of images with multi-rater annotations features various modalities such as MRI and CT; various organs such as the brain, prostate, kidney, and pancreas; and different image dimensions 2D-vs-3D. A total of 24 teams submitted different solutions to the problem, combining various baseline models, Bayesian neural networks, and ensemble model techniques. The obtained results indicate the importance of the ensemble models, as well as the need for further research to develop efficient 3D methods for uncertainty quantification methods in 3D segmentation tasks.

Stefan Denner, Ashkan Khakzar, Moiz Sajid et al.

Segmentation of Multiple Sclerosis (MS) lesions in longitudinal brain MR scans is performed for monitoring the progression of MS lesions. We hypothesize that the spatio-temporal cues in longitudinal data can aid the segmentation algorithm. Therefore, we propose a multi-task learning approach by defining an auxiliary self-supervised task of deformable registration between two time-points to guide the neural network toward learning from spatio-temporal changes. We show the efficacy of our method on a clinical dataset comprised of 70 patients with one follow-up study for each patient. Our results show that spatio-temporal information in longitudinal data is a beneficial cue for improving segmentation. We improve the result of current state-of-the-art by 2.6% in terms of overall score (p<0.05). Code is publicly available.