Pediatric tumors of the central nervous system are the most common cause of cancer-related death in children. The five-year survival rate for high-grade gliomas in children is less than 20%. Due to their rarity, the diagnosis of these entities is often delayed, their treatment is mainly based on historic treatment concepts, and clinical trials require multi-institutional collaborations. Here we present the CBTN-CONNECT-DIPGR-ASNR-MICCAI BraTS-PEDs challenge, focused on pediatric brain tumors with data acquired across multiple international consortia dedicated to pediatric neuro-oncology and clinical trials. The CBTN-CONNECT-DIPGR-ASNR-MICCAI BraTS-PEDs challenge brings together clinicians and AI/imaging scientists to lead to faster development of automated segmentation techniques that could benefit clinical trials, and ultimately the care of children with brain tumors.
In human neuroimaging studies, atlas registration enables mapping MRI scans to a common coordinate frame, which is necessary to aggregate data from multiple subjects. Machine learning registration methods have achieved excellent speed and accuracy but lack interpretability. More recently, keypoint-based methods have been proposed to tackle this issue, but their accuracy is still subpar, particularly when fitting nonlinear transforms. Here we propose Registration by Regression (RbR), a novel atlas registration framework that is highly robust and flexible, conceptually simple, and can be trained with cheaply obtained data. RbR predicts the (x,y,z) atlas coordinates for every voxel of the input scan (i.e., every voxel is a keypoint), and then uses closed-form expressions to quickly fit transforms using a wide array of possible deformation models, including affine and nonlinear (e.g., Bspline, Demons, invertible diffeomorphic models, etc.). Robustness is provided by the large number of voxels informing the registration and can be further increased by robust estimators like RANSAC. Experiments on independent public datasets show that RbR yields more accurate registration than competing keypoint approaches, while providing full control of the deformation model.
White matter hyperintensities (WMH) are a hallmark of cerebrovascular disease and multiple sclerosis. Automated WMH segmentation methods enable quantitative analysis via estimation of total lesion load, spatial distribution of lesions, and number of lesions (i.e., number of connected components after thresholding), all of which are correlated with patient outcomes. While the two former measures can generally be estimated robustly, the number of lesions is highly sensitive to noise and segmentation mistakes -- even when small connected components are eroded or disregarded. In this article, we present P-Count, an algebraic WMH counting tool based on persistent homology that accounts for the topological features of WM lesions in a robust manner. Using computational geometry, P-Count takes the persistence of connected components into consideration, effectively filtering out the noisy WMH positives, resulting in a more accurate count of true lesions. We validated P-Count on the ISBI2015 longitudinal lesion segmentation dataset, where it produces significantly more accurate results than direct thresholding.
Purpose: To develop a method for automated segmentation of hypothalamus subregions informed by ultra-high resolution ex vivo magnetic resonance images (MRI), which generalizes across MRI sequences and resolutions without retraining. Materials and Methods: We trained our deep learning method, H-synEx, with synthetic images derived from label maps built from ultra-high resolution ex vivo MRI scans, which enables finer-grained manual segmentation when compared with 1mm isometric in vivo images. We validated this retrospective study using 1535 in vivo images from six datasets and six MRI sequences. The quantitative evaluation used the Dice Coefficient (DC) and Average Hausdorff distance (AVD). Statistical analysis compared hypothalamic subregion volumes in controls, Alzheimer's disease (AD), and behavioral variant frontotemporal dementia (bvFTD) subjects using the area under the curve (AUC) and Wilcoxon rank sum test. Results: H-SynEx can segment the hypothalamus across various MRI sequences, encompassing FLAIR sequences with significant slice spacing (5mm). Using hypothalamic volumes on T1w images to distinguish control from AD and bvFTD patients, we observed AUC values of 0.74 and 0.79 respectively. Additionally, AUC=0.66 was found for volume variation on FLAIR scans when comparing control and non-patients. Conclusion: Our results show that H-SynEx successfully leverages information from ultra-high resolution scans to segment in vivo from different MRI sequences such as T1w, T2w, PD, qT1, FA, and FLAIR. We also found that our automated segmentation was able to discriminate controls versus patients on FLAIR images with 5mm spacing. H-SynEx is openly available at https://github.com/liviamarodrigues/hsynex.
We present a pipeline for unbiased and robust multimodal registration of neuroimaging modalities with minimal pre-processing. While typical multimodal studies need to use multiple independent processing pipelines, with diverse options and hyperparameters, we propose a single and structured framework to jointly process different image modalities. The use of state-of-the-art learning-based techniques enables fast inferences, which makes the presented method suitable for large-scale and/or multi-cohort datasets with a diverse number of modalities per session. The pipeline currently works with structural MRI, resting state fMRI and amyloid PET images. We show the predictive power of the derived biomarkers using in a case-control study and study the cross-modal relationship between different image modalities. The code can be found in https: //github.com/acasamitjana/JUMP.
Brain atrophy and white matter hyperintensity (WMH) are critical neuroimaging features for ascertaining brain injury in cerebrovascular disease and multiple sclerosis. Automated segmentation and quantification is desirable but existing methods require high-resolution MRI with good signal-to-noise ratio (SNR). This precludes application to clinical and low-field portable MRI (pMRI) scans, thus hampering large-scale tracking of atrophy and WMH progression, especially in underserved areas where pMRI has huge potential. Here we present a method that segments white matter hyperintensity and 36 brain regions from scans of any resolution and contrast (including pMRI) without retraining. We show results on six public datasets and on a private dataset with paired high- and low-field scans (3T and 64mT), where we attain strong correlation between the WMH ($\rho$=.85) and hippocampal volumes (r=.89) estimated at both fields. Our method is publicly available as part of FreeSurfer, at: http://surfer.nmr.mgh.harvard.edu/fswiki/WMH-SynthSeg.
In magnetic resonance imaging (MRI), slice-to-volume reconstruction (SVR) refers to computational reconstruction of an unknown 3D magnetic resonance volume from stacks of 2D slices corrupted by motion. While promising, current SVR methods require multiple slice stacks for accurate 3D reconstruction, leading to long scans and limiting their use in time-sensitive applications such as fetal fMRI. Here, we propose a SVR method that overcomes the shortcomings of previous work and produces state-of-the-art reconstructions in the presence of extreme inter-slice motion. Inspired by the recent success of single-view depth estimation methods, we formulate SVR as a single-stack motion estimation task and train a fully convolutional network to predict a motion stack for a given slice stack, producing a 3D reconstruction as a byproduct of the predicted motion. Extensive experiments on the SVR of adult and fetal brains demonstrate that our fully convolutional method is twice as accurate as previous SVR methods. Our code is available at github.com/seannz/svr.
Recent learning-based approaches have made astonishing advances in calibrated medical imaging like computerized tomography, yet they struggle to generalize in uncalibrated modalities -- notoriously magnetic resonance imaging (MRI), where performance is highly sensitive to the differences in MR contrast, resolution, and orientation between the training and testing data. This prevents broad applicability to the diverse clinical acquisition protocols in the real world. We introduce Brain-ID, a robust feature representation learning strategy for brain imaging, which is contrast-agnostic, and robust to the brain anatomy of each subject regardless of the appearance of acquired images (i.e., deformation, contrast, resolution, orientation, artifacts, etc). Brain-ID is trained entirely on synthetic data, and easily adapts to downstream tasks with our proposed simple one-layer solution. We validate the robustness of Brain-ID features, and evaluate their performance in a variety of downstream applications, including both contrast-independent (anatomy reconstruction/contrast synthesis, brain segmentation), and contrast-dependent (super-resolution, bias field estimation) tasks. Extensive experiments on 6 public datasets demonstrate that Brain-ID achieves state-of-the-art performance in all tasks, and more importantly, preserves its performance when only limited training data is available.
High-resolution fMRI provides a window into the brain's mesoscale organization. Yet, higher spatial resolution increases scan times, to compensate for the low signal and contrast-to-noise ratio. This work introduces a deep learning-based 3D super-resolution (SR) method for fMRI. By incorporating a resolution-agnostic image augmentation framework, our method adapts to varying voxel sizes without retraining. We apply this innovative technique to localize fine-scale motion-selective sites in the early visual areas. Detection of these sites typically requires a resolution higher than 1 mm isotropic, whereas here, we visualize them based on lower resolution (2-3mm isotropic) fMRI data. Remarkably, the super-resolved fMRI is able to recover high-frequency detail of the interdigitated organization of these sites (relative to the color-selective sites), even with training data sourced from different subjects and experimental paradigms -- including non-visual resting-state fMRI, underscoring its robustness and versatility. Quantitative and qualitative results indicate that our method has the potential to enhance the spatial resolution of fMRI, leading to a drastic reduction in acquisition time.
We present USLR, a computational framework for longitudinal registration of brain MRI scans to estimate nonlinear image trajectories that are smooth across time, unbiased to any timepoint, and robust to imaging artefacts. It operates on the Lie algebra parameterisation of spatial transforms (which is compatible with rigid transforms and stationary velocity fields for nonlinear deformation) and takes advantage of log-domain properties to solve the problem using Bayesian inference. USRL estimates rigid and nonlinear registrations that: (i) bring all timepoints to an unbiased subject-specific space; and (i) compute a smooth trajectory across the imaging time-series. We capitalise on learning-based registration algorithms and closed-form expressions for fast inference. A use-case Alzheimer's disease study is used to showcase the benefits of the pipeline in multiple fronts, such as time-consistent image segmentation to reduce intra-subject variability, subject-specific prediction or population analysis using tensor-based morphometry. We demonstrate that such approach improves upon cross-sectional methods in identifying group differences, which can be helpful in detecting more subtle atrophy levels or in reducing sample sizes in clinical trials. The code is publicly available in https://github.com/acasamitjana/uslr