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Spatial control methods using additional modules on pretrained diffusion models have gained attention for enabling conditional generation in natural images. These methods guide the generation process with new conditions while leveraging the capabilities of large models. They could be beneficial as training strategies in the context of 3D medical imaging, where training a diffusion model from scratch is challenging due to high computational costs and data scarcity. However, the potential application of spatial control methods with additional modules to 3D medical images has not yet been explored. In this paper, we present a tailored spatial control method for 3D medical images with a novel lightweight module, Volumetric Conditioning Module (VCM). Our VCM employs an asymmetric U-Net architecture to effectively encode complex information from various levels of 3D conditions, providing detailed guidance in image synthesis. To examine the applicability of spatial control methods and the effectiveness of VCM for 3D medical data, we conduct experiments under single- and multimodal conditions scenarios across a wide range of dataset sizes, from extremely small datasets with 10 samples to large datasets with 500 samples. The experimental results show that the VCM is effective for conditional generation and efficient in terms of requiring less training data and computational resources. We further investigate the potential applications for our spatial control method through axial super-resolution for medical images. Our code is available at \url{https://github.com/Ahn-Ssu/VCM}, Comment: 17 pages, 18 figures, accepted @ WACV 2025

Despite significant advancements in automatic brain tumor segmentation methods, their performance is not guaranteed when certain MR sequences are missing. Addressing this issue, it is crucial to synthesize the missing MR images that reflect the unique characteristics of the absent modality with precise tumor representation. Typically, MRI synthesis methods generate partial images rather than full-sized volumes due to computational constraints. This limitation can lead to a lack of comprehensive 3D volumetric information and result in image artifacts during the merging process. In this paper, we propose a two-stage approach that first synthesizes MR images from 2D slices using a novel intensity encoding method and then refines the synthesized MRI. The proposed intensity encoding reduces artifacts when synthesizing MRI on a 2D slice basis. Then, the \textit{Refiner}, which leverages complete 3D volume information, further improves the quality of the synthesized images and enhances their applicability to segmentation methods. Experimental results demonstrate that the intensity encoding effectively minimizes artifacts in the synthesized MRI and improves perceptual quality. Furthermore, using the \textit{Refiner} on synthesized MRI significantly improves brain tumor segmentation results, highlighting the potential of our approach in practical applications., Comment: MICCAI 2024 BraSyn Challenge 1st place

Estimating the poses of both a hand and an object has become an important area of research due to the growing need for advanced vision computing. The primary challenge involves understanding and reconstructing how hands and objects interact, such as contact and physical plausibility. Existing approaches often adopt a graph neural network to incorporate spatial information of hand and object meshes. However, these approaches have not fully exploited the potential of graphs without modification of edges within and between hand- and object-graphs. We propose a graph-based refinement method that incorporates an interaction-aware graph-attention mechanism to account for hand-object interactions. Using edges, we establish connections among closely correlated nodes, both within individual graphs and across different graphs. Experiments demonstrate the effectiveness of our proposed method with notable improvements in the realm of physical plausibility., Comment: 7 pages, Accepted by ICIP 2024

The deformation of the lateral ventricle (LV) shape is widely studied to identify specific morphometric changes associated with diseases. Since LV enlargement is considered a relative change due to brain atrophy, local longitudinal LV deformation can indicate deformation in adjacent brain areas. However, conventional methods for LV shape analysis focus on modeling the solely segmented LV mask. In this work, we propose a novel deep learning-based approach using peripheral area projection, which is the first attempt to analyze LV considering its surrounding areas. Our approach matches the baseline LV mesh by deforming the shape of follow-up LVs, while optimizing the corresponding points of the same adjacent brain area between the baseline and follow-up LVs. Furthermore, we quantitatively evaluated the deformation of the left LV in normal (n=10) and demented subjects (n=10), and we found that each surrounding area (thalamus, caudate, hippocampus, amygdala, and right LV) projected onto the surface of LV shows noticeable differences between normal and demented subjects., Comment: Annual Conference on Medical Image Understanding and Analysis (2024)

Deep learning-based segmentation techniques have shown remarkable performance in brain segmentation, yet their success hinges on the availability of extensive labeled training data. Acquiring such vast datasets, however, poses a significant challenge in many clinical applications. To address this issue, in this work, we propose a novel 3D brain segmentation approach using complementary 2D diffusion models. The core idea behind our approach is to first mine 2D features with semantic information extracted from the 2D diffusion models by taking orthogonal views as input, followed by fusing them into a 3D contextual feature representation. Then, we use these aggregated features to train multi-layer perceptrons to classify the segmentation labels. Our goal is to achieve reliable segmentation quality without requiring complete labels for each individual subject. Our experiments on training in brain subcortical structure segmentation with a dataset from only one subject demonstrate that our approach outperforms state-of-the-art self-supervised learning methods. Further experiments on the minimum requirement of annotation by sparse labeling yield promising results even with only nine slices and a labeled background region., Comment: Extended version of "3D Segmentation of Subcortical Brain Structure with Few Labeled Data using 2D Diffusion Models" (ISMRM 2024 oral)

Multisequence Magnetic Resonance Imaging (MRI) provides a reliable diagnosis in clinical applications through complementary information within sequences. However, in practice, the absence of certain MR sequences is a common problem that can lead to inconsistent analysis results. In this work, we propose a novel unified framework for synthesizing multisequence MR images, called Hybrid Fusion GAN (HF-GAN). We introduce a hybrid fusion encoder designed to ensure the disentangled extraction of complementary and modality-specific information, along with a channel attention-based feature fusion module that integrates the features into a common latent space handling the complexity from combinations of accessible MR sequences. Common feature representations are transformed into a target latent space via the modality infuser to synthesize missing MR sequences. We have performed experiments on multisequence brain MRI datasets from healthy individuals and patients diagnosed with brain tumors. Experimental results show that our method outperforms state-of-the-art methods in both quantitative and qualitative comparisons. In addition, a detailed analysis of our framework demonstrates the superiority of our designed modules and their effectiveness for use in data imputation tasks., Comment: 11 pages, 7 figures

Multimodal Magnetic Resonance (MR) Imaging plays a crucial role in disease diagnosis due to its ability to provide complementary information by analyzing a relationship between multimodal images on the same subject. Acquiring all MR modalities, however, can be expensive, and, during a scanning session, certain MR images may be missed depending on the study protocol. The typical solution would be to synthesize the missing modalities from the acquired images such as using generative adversarial networks (GANs). Yet, GANs constructed with convolutional neural networks (CNNs) are likely to suffer from a lack of global relationships and mechanisms to condition the desired modality. To address this, in this work, we propose a transformer-based modality infuser designed to synthesize multimodal brain MR images. In our method, we extract modality-agnostic features from the encoder and then transform them into modality-specific features using the modality infuser. Furthermore, the modality infuser captures long-range relationships among all brain structures, leading to the generation of more realistic images. We carried out experiments on the BraTS 2018 dataset, translating between four MR modalities, and our experimental results demonstrate the superiority of our proposed method in terms of synthesis quality. In addition, we conducted experiments on a brain tumor segmentation task and different conditioning methods., Comment: 6 pages

Medical segmentation has grown exponentially through the advent of a fully convolutional network (FCN), and we have now reached a turning point through the success of Transformer. However, the different characteristics of the modality have not been fully integrated into Transformer for medical segmentation. In this work, we propose the novel hybrid fusion Transformer (HFTrans) for multisequence MRI image segmentation. We take advantage of the differences among multimodal MRI sequences and utilize the Transformer layers to integrate the features extracted from each modality as well as the features of the early fused modalities. We validate the effectiveness of our hybrid-fusion method in three-dimensional (3D) medical segmentation. Experiments on two public datasets, BraTS2020 and MRBrainS18, show that the proposed method outperforms previous state-of-the-art methods on the task of brain tumor segmentation and brain structure segmentation., Comment: 10 pages, 4 figures

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.

International benchmarking competitions have become fundamental for the comparative performance assessment of image analysis methods. However, little attention has been given to investigating what can be learnt from these competitions. Do they really generate scientific progress? What are common and successful participation strategies? What makes a solution superior to a competing method? To address this gap in the literature, we performed a multi-center study with all 80 competitions that were conducted in the scope of IEEE ISBI 2021 and MICCAI 2021. Statistical analyses performed based on comprehensive descriptions of the submitted algorithms linked to their rank as well as the underlying participation strategies revealed common characteristics of winning solutions. These typically include the use of multi-task learning (63%) and/or multi-stage pipelines (61%), and a focus on augmentation (100%), image preprocessing (97%), data curation (79%), and postprocessing (66%). The "typical" lead of a winning team is a computer scientist with a doctoral degree, five years of experience in biomedical image analysis, and four years of experience in deep learning. Two core general development strategies stood out for highly-ranked teams: the reflection of the metrics in the method design and the focus on analyzing and handling failure cases. According to the organizers, 43% of the winning algorithms exceeded the state of the art but only 11% completely solved the respective domain problem. The insights of our study could help researchers (1) improve algorithm development strategies when approaching new problems, and (2) focus on open research questions revealed by this work., Comment: accepted to CVPR 2023

Obtaining ground truth data in medical imaging has difficulties due to the fact that it requires a lot of annotating time from the experts in the field. Also, when trained with supervised learning, it detects only the cases included in the labels. In real practice, we want to also open to other possibilities than the named cases while examining the medical images. As a solution, the need for anomaly detection that can detect and localize abnormalities by learning the normal characteristics using only normal images is emerging. With medical image data, we can design either 2D or 3D networks of self-supervised learning for anomaly detection task. Although 3D networks, which learns 3D structures of the human body, show good performance in 3D medical image anomaly detection, they cannot be stacked in deeper layers due to memory problems. While 2D networks have advantage in feature detection, they lack 3D context information. In this paper, we develop a method for combining the strength of the 3D network and the strength of the 2D network through joint embedding. We also propose the pretask of self-supervised learning to make it possible for the networks to learn efficiently. Through the experiments, we show that the proposed method achieves better performance in both classification and segmentation tasks compared to the SoTA method., Comment: 14 pages, 11 figures

Studies of virtual try-on (VITON) have been shown their effectiveness in utilizing the generative neural network for virtually exploring fashion products, and some of recent researches of VITON attempted to synthesize human image wearing given multiple types of garments (e.g., top and bottom clothes). However, when replacing the top and bottom clothes of the target human, numerous wearing styles are possible with a certain combination of the clothes. In this paper, we address the problem of variation in wearing style when simultaneously replacing the top and bottom clothes of the model. We introduce Wearing-Guide VITON (i.e., WG-VITON) which utilizes an additional input binary mask to control the wearing styles of the generated image. Our experiments show that WG-VITON effectively generates an image of the model wearing given top and bottom clothes, and create complicated wearing styles such as partly tucking in the top to the bottom, Comment: 5 pages

The density of mitotic figures within tumor tissue is known to be highly correlated with tumor proliferation and thus is an important marker in tumor grading. Recognition of mitotic figures by pathologists is known to be subject to a strong inter-rater bias, which limits the prognostic value. State-of-the-art deep learning methods can support the expert in this assessment but are known to strongly deteriorate when applied in a different clinical environment than was used for training. One decisive component in the underlying domain shift has been identified as the variability caused by using different whole slide scanners. The goal of the MICCAI MIDOG 2021 challenge has been to propose and evaluate methods that counter this domain shift and derive scanner-agnostic mitosis detection algorithms. The challenge used a training set of 200 cases, split across four scanning systems. As a test set, an additional 100 cases split across four scanning systems, including two previously unseen scanners, were given. The best approaches performed on an expert level, with the winning algorithm yielding an F_1 score of 0.748 (CI95: 0.704-0.781). In this paper, we evaluate and compare the approaches that were submitted to the challenge and identify methodological factors contributing to better performance., Comment: 19 pages, 9 figures, summary paper of the 2021 MICCAI MIDOG challenge

We propose a new training scheme for domain generalization in mitotic figure detection. Mitotic figures show different characteristics for each scanner. We consider each scanner as a 'domain' and the image distribution specified for each domain as 'style'. The goal is to train our network to be robust on scanner types by using various 'style' images. To expand the style variance, we transfer a style of the training image into arbitrary styles, by defining a module based on StarGAN. Our model with the proposed training scheme shows positive performance on MIDOG Preliminary Test-Set containing scanners never seen before., Comment: 2 pages, 3 figures