Improving multiple sclerosis lesion segmentation across clinical sites: A federated learning approach with noise-resilient training.

Accurately measuring the evolution of Multiple Sclerosis (MS) with magnetic resonance imaging (MRI) critically informs understanding of disease progression and helps to direct therapeutic strategy. Deep learning models have shown promise for automatically segmenting MS lesions, but the scarcity of accurately annotated data hinders progress in this area. Obtaining sufficient data from a single clinical site is challenging and does not address the heterogeneous need for model robustness. Conversely, the collection of data from multiple sites introduces data privacy concerns and potential label noise due to varying annotation standards. To address this dilemma, we explore the use of the federated learning framework while considering label noise. Our approach enables collaboration among multiple clinical sites without compromising data privacy under a federated learning paradigm that incorporates a noise-robust training strategy based on label correction. Specifically, we introduce a Decoupled Hard Label Correction (DHLC) strategy that considers the imbalanced distribution and fuzzy boundaries of MS lesions, enabling the correction of false annotations based on prediction confidence. We also introduce a Centrally Enhanced Label Correction (CELC) strategy, which leverages the aggregated central model as a correction teacher for all sites, enhancing the reliability of the correction process. Extensive experiments conducted on two multi-site datasets demonstrate the effectiveness and robustness of our proposed methods, indicating their potential for clinical applications in multi-site collaborations to train better deep learning models with lower cost in data collection and annotation.

Cross-domain Fiber Cluster Shape Analysis for Language Performance Cognitive Score Prediction.

Shape plays an important role in computer graphics, offering informative features to convey an object's morphology and functionality. Shape analysis in brain imaging can help interpret structural and functionality correlations of the human brain. In this work, we investigate the shape of the brain's 3D white matter connections and its potential predictive relationship to human cognitive function. We reconstruct brain connections as sequences of 3D points using diffusion magnetic resonance imaging (dMRI) tractography. To describe each connection, we extract 12 shape descriptors in addition to traditional dMRI connectivity and tissue microstructure features. We introduce a novel framework, Shape--fused Fiber Cluster Transformer (SFFormer), that leverages a multi-head cross-attention feature fusion module to predict subject-specific language performance based on dMRI tractography. We assess the performance of the method on a large dataset including 1065 healthy young adults. The results demonstrate that both the transformer-based SFFormer model and its inter/intra feature fusion with shape, microstructure, and connectivity are informative, and together, they improve the prediction of subject-specific language performance scores. Overall, our results indicate that the shape of the brain's connections is predictive of human language function.

High angular diffusion tensor imaging estimation from minimal evenly distributed diffusion gradient directions.

Diffusion-weighted Imaging (DWI) is a non-invasive imaging technique based on Magnetic Resonance Imaging (MRI) principles to measure water diffusivity and reveal details of the underlying brain micro-structure. By fitting a tensor model to quantify the directionality of water diffusion a Diffusion Tensor Image (DTI) can be derived and scalar measures, such as fractional anisotropy (FA), can then be estimated from the DTI to summarise quantitative microstructural information for clinical studies. In particular, FA has been shown to be a useful research metric to identify tissue abnormalities in neurological disease (e.g. decreased anisotropy as a proxy for tissue damage). However, time constraints in clinical practice lead to low angular resolution diffusion imaging (LARDI) acquisitions that can cause inaccurate FA value estimates when compared to those generated from high angular resolution diffusion imaging (HARDI) acquisitions. In this work, we propose High Angular DTI Estimation Network (HADTI-Net) to estimate an enhanced DTI model from LARDI with a set of minimal and evenly distributed diffusion gradient directions. Extensive experiments have been conducted to show the reliability and generalisation of HADTI-Net to generate high angular DTI estimation from any minimal evenly distributed diffusion gradient directions and to explore the feasibility of applying a data-driven method for this task. The code repository of this work and other related works can be found at https://mri-synthesis.github.io/.

Multiple sclerosis lesion segmentation: revisiting weighting mechanisms for federated learning.

Background and introduction: Federated learning (FL) has been widely employed for medical image analysis to facilitate multi-client collaborative learning without sharing raw data. Despite great success, FL's applications remain suboptimal in neuroimage analysis tasks such as lesion segmentation in multiple sclerosis (MS), due to variance in lesion characteristics imparted by different scanners and acquisition parameters. Methods: In this work, we propose the first FL MS lesion segmentation framework via two effective re-weighting mechanisms. Specifically, a learnable weight is assigned to each local node during the aggregation process, based on its segmentation performance. In addition, the segmentation loss function in each client is also re-weighted according to the lesion volume for the data during training. Results: The proposed method has been validated on two FL MS segmentation scenarios using public and clinical datasets. Specifically, the case-wise and voxel-wise Dice score of the proposed method under the first public dataset is 65.20 and 74.30, respectively. On the second in-house dataset, the case-wise and voxel-wise Dice score is 53.66, and 62.31, respectively. Discussions and conclusions: The Comparison experiments on two FL MS segmentation scenarios using public and clinical datasets have demonstrated the effectiveness of the proposed method by significantly outperforming other FL methods. Furthermore, the segmentation performance of FL incorporating our proposed aggregation mechanism can achieve comparable performance to that from centralized training with all the raw data.

Provably Secure and Lightweight Patient Monitoring Protocol for Wireless Body Area Network in IoHT.

As one of the important applications of Internet of Health Things (IoHT) technology in the field of healthcare, wireless body area network (WBAN) has been widely used in medical therapy, and it can not only monitor and record physiological information but also transmit the data collected by sensor devices to the server in time. However, due to the unreliability and vulnerability of wireless network communication, as well as the limited storage and computing resources of sensor nodes in WBAN, a lot of authentication protocols for WBAN have been devised. In 2021, Alzahrani et al. designed an anonymous medical monitoring protocol, which uses lightweight cryptographic primitives for WBAN. However, we find that their protocol is defenseless to off-line identity guessing attacks, known-key attacks, and stolen-verifier attacks and has no perfect forward secrecy. Therefore, a patient monitoring protocol for WBAN in IoHT is proposed. We use security proof under the random oracle model (ROM) and automatic verification tool ProVerif to demonstrate that our protocol is secure. According to comparisons with related protocols, our protocol can achieve both high computational efficiency and security.

Towards bi-directional skip connections in encoder-decoder architectures and beyond.

U-Net, as an encoder-decoder architecture with forward skip connections, has achieved promising results in various medical image analysis tasks. Many recent approaches have also extended U-Net with more complex building blocks, which typically increase the number of network parameters considerably. Such complexity makes the inference stage highly inefficient for clinical applications. Towards an effective yet economic segmentation network design, in this work, we propose backward skip connections that bring decoded features back to the encoder. Our design can be jointly adopted with forward skip connections in any encoder-decoder architecture forming a recurrence structure without introducing extra parameters. With the backward skip connections, we propose a U-Net based network family, namely Bi-directional O-shape networks, which set new benchmarks on multiple public medical imaging segmentation datasets. On the other hand, with the most plain architecture (BiO-Net), network computations inevitably increase along with the pre-set recurrence time. We have thus studied the deficiency bottleneck of such recurrent design and propose a novel two-phase Neural Architecture Search (NAS) algorithm, namely BiX-NAS, to search for the best multi-scale bi-directional skip connections. The ineffective skip connections are then discarded to reduce computational costs and speed up network inference. The finally searched BiX-Net yields the least network complexity and outperforms other state-of-the-art counterparts by large margins. We evaluate our methods on both 2D and 3D segmentation tasks in a total of six datasets. Extensive ablation studies have also been conducted to provide a comprehensive analysis for our proposed methods.

DSNet: A Dual-Stream Framework for Weakly-Supervised Gigapixel Pathology Image Analysis.

We present a novel weakly-supervised framework for classifying whole slide images (WSIs). WSIs, due to their gigapixel resolution, are commonly processed by patch-wise classification with patch-level labels. However, patch-level labels require precise annotations, which is expensive and usually unavailable on clinical data. With image-level labels only, patch-wise classification would be sub-optimal due to inconsistency between the patch appearance and image-level label. To address this issue, we posit that WSI analysis can be effectively conducted by integrating information at both high magnification (local) and low magnification (regional) levels. We auto-encode the visual signals in each patch into a latent embedding vector representing local information, and down-sample the raw WSI to hardware-acceptable thumbnails representing regional information. The WSI label is then predicted with a Dual-Stream Network (DSNet), which takes the transformed local patch embeddings and multi-scale thumbnail images as inputs and can be trained by the image-level label only. Experiments conducted on three large-scale public datasets demonstrate that our method outperforms all recent state-of-the-art weakly-supervised WSI classification methods.

Multiple Sclerosis Lesion Analysis in Brain Magnetic Resonance Images: Techniques and Clinical Applications.

Multiple sclerosis (MS) is a chronic inflammatory and degenerative disease of the central nervous system, characterized by the appearance of focal lesions in the white and gray matter that topographically correlate with an individual patient's neurological symptoms and signs. Magnetic resonance imaging (MRI) provides detailed in-vivo structural information, permitting the quantification and categorization of MS lesions that critically inform disease management. Traditionally, MS lesions have been manually annotated on 2D MRI slices, a process that is inefficient and prone to inter-/intra-observer errors. Recently, automated statistical imaging analysis techniques have been proposed to detect and segment MS lesions based on MRI voxel intensity. However, their effectiveness is limited by the heterogeneity of both MRI data acquisition techniques and the appearance of MS lesions. By learning complex lesion representations directly from images, deep learning techniques have achieved remarkable breakthroughs in the MS lesion segmentation task. Here, we provide a comprehensive review of state-of-the-art automatic statistical and deep-learning MS segmentation methods and discuss current and future clinical applications. Further, we review technical strategies, such as domain adaptation, to enhance MS lesion segmentation in real-world clinical settings.

Stabilization via Event-Triggered Impulsive Control With Constraints for Switched Stochastic Systems.

This article studies the event-triggered impulsive control (ETIC) with constraints for the stabilization of switched stochastic systems (SSSs). An ETIC scheme with constraints is proposed for SSS by designing two levels of events via three indices: 1) a threshold value; 2) a control-free index; and 3) a check period. It is also constrained via a constraint index. Based on the activation probabilities and transition probabilities of subsystems, the stabilizations in terms of the p th moment exponential stability and almost exponential stability are achieved, respectively, by the ETIC with constraints. Moreover, based on the scheme of ETIC with constraints, sampling-based ETIC and random ETIC are proposed, respectively. The stabilization conditions via sampling-based ETIC and random ETIC are also derived. It is shown that the ETIC with constraints is non-Zeno and robust with respect to time delays and can achieve lower impulse frequency than the classic time-based impulsive control and recent ETIC schemes. Finally, two examples are presented to demonstrate the effectiveness of the ETIC with constraints.

Panoptic Feature Fusion Net: A Novel Instance Segmentation Paradigm for Biomedical and Biological Images.

Instance segmentation is an important task for biomedical and biological image analysis. Due to the complicated background components, the high variability of object appearances, numerous overlapping objects, and ambiguous object boundaries, this task still remains challenging. Recently, deep learning based methods have been widely employed to solve these problems and can be categorized into proposal-free and proposal-based methods. However, both proposal-free and proposal-based methods suffer from information loss, as they focus on either global-level semantic or local-level instance features. To tackle this issue, we present a Panoptic Feature Fusion Net (PFFNet) that unifies the semantic and instance features in this work. Specifically, our proposed PFFNet contains a residual attention feature fusion mechanism to incorporate the instance prediction with the semantic features, in order to facilitate the semantic contextual information learning in the instance branch. Then, a mask quality sub-branch is designed to align the confidence score of each object with the quality of the mask prediction. Furthermore, a consistency regularization mechanism is designed between the semantic segmentation tasks in the semantic and instance branches, for the robust learning of both tasks. Extensive experiments demonstrate the effectiveness of our proposed PFFNet, which outperforms several state-of-the-art methods on various biomedical and biological datasets.

PDAM: A Panoptic-Level Feature Alignment Framework for Unsupervised Domain Adaptive Instance Segmentation in Microscopy Images.

In this work, we present an unsupervised domain adaptation (UDA) method, named Panoptic Domain Adaptive Mask R-CNN (PDAM), for unsupervised instance segmentation in microscopy images. Since there currently lack methods particularly for UDA instance segmentation, we first design a Domain Adaptive Mask R-CNN (DAM) as the baseline, with cross-domain feature alignment at the image and instance levels. In addition to the image- and instance-level domain discrepancy, there also exists domain bias at the semantic level in the contextual information. Next, we, therefore, design a semantic segmentation branch with a domain discriminator to bridge the domain gap at the contextual level. By integrating the semantic- and instance-level feature adaptation, our method aligns the cross-domain features at the panoptic level. Third, we propose a task re-weighting mechanism to assign trade-off weights for the detection and segmentation loss functions. The task re-weighting mechanism solves the domain bias issue by alleviating the task learning for some iterations when the features contain source-specific factors. Furthermore, we design a feature similarity maximization mechanism to facilitate instance-level feature adaptation from the perspective of representational learning. Different from the typical feature alignment methods, our feature similarity maximization mechanism separates the domain-invariant and domain-specific features by enlarging their feature distribution dependency. Experimental results on three UDA instance segmentation scenarios with five datasets demonstrate the effectiveness of our proposed PDAM method, which outperforms state-of-the-art UDA methods by a large margin.