Papers for
clinical imaging teams
Papers whose findings have a practical use for this group, as judged from the abstract. Open a paper to read what it means in practice.
Cardiac MRI segmentation improved for rare single ventricle defects
SV-Cine: Diagnosis-Conditioned Segmentation of Single Ventricle Physiology via Generative Data Augmentation
Abstract: Single Ventricle Physiology (SVP) is a rare subtype of congenital heart disease characterized by the presence of a single functional cardiac ventricle with atypical anatomic configurations that challenge conventional image segmentation approaches. The scarcity of clinical data and the morphological diversity across SVP subtypes make the development of robust segmentation methods particularly difficult. To address these limitations, we propose a cardiac MRI segmentation framework focused on ventricular chambers and myocardium segmentation tailored for SVP. First, we introduce a data augmentation pipeline that generates synthetic 3D cardiac meshes using SDF4CHD and corresponding synthetic cardiac MRI through generative modeling. Second, we introduce SV-Cine, a diagnosis-conditioned adaptation of the foundation model CineMA that incorporates patient-level diagnostic information through Feature-wise Linear Modulation layers, enabling diagnosis-aware feature adaptation during segmentation. We evaluated the framework on an internal cohort with varying SVP subtypes. SV-Cine achieved median Dice scores of 0.89 (IQR: 0.80--0.91) for the left ventricle and 0.72 (IQR: 0.54--0.84) for the right ventricle, outperforming the strongest baseline, nnU-Net, by 0.39 Dice points on right ventricle segmentation. It also yields a median ejection fraction error of 5.55 percentage points (IQR: 3.41--7.69) for the dominant ventricle. Compared with the internal cohort, LV and myocardium segmentation performance was lower for the external cohort; whereas RV Dice scores were comparable for both cohorts. Our findings suggest that a pretrained foundation model can be adapted for highly specialized downstream tasks through usage of diagnosis priors while leveraging anatomic knowledge learned from large-scale MRI datasets during pretraining.
Biomedical image segmentation improved by focusing on uncertain boundaries
Beyond Accuracy: Uncertainty-Guided Boundary Refinement for Reliable Biomedical Image Segmentation
Abstract: Accurate biomedical image segmentation requires not only high global overlap but also reliable delineation of clinically meaningful boundaries. In blood-smear microscopy, cytoplasm and nucleus contours provide the structural basis for downstream morphology analysis; however, deep segmentation models may remain uncertain or overconfident near ambiguous boundary regions even when achieving strong Dice scores. This work proposes a Reliability-Aware Boundary Refinement Network (RABR-Net), a two-stage framework for trustworthy image segmentation. A strong UNet++ EfficientNet-B4 base segmenter first produces initial class probabilities and logits. Predictive entropy, test-time augmentation variance, margin uncertainty, probability gradients, and soft boundary cues are then combined into a boundary-aware reliability representation. This representation guides a gated residual refiner that selectively corrects uncertain boundary pixels while preserving confident regions of the base prediction. The framework is evaluated using overlap accuracy, class-wise Dice, Boundary Dice, HD95/ASSD, calibration, risk--coverage analysis, robustness under image perturbations, qualitative correction maps, and paired statistical testing. On the held-out test set, the proposed method improves Dice from 0.9602 to 0.9614, Boundary Dice from 0.3448 to 0.3611, and HD95 from 3.0354 to 2.8274 compared with the cached base prediction. Statistical analysis confirms significant improvements in Dice, Boundary Dice, and HD95. Qualitative results show that the learned gate concentrates around uncertain cytoplasm and nucleus boundaries, and correction maps confirm localized boundary refinement. Although calibration does not automatically improve after refinement, the proposed framework provides an interpretable and reliability-focused strategy for boundary-sensitive biomedical image segmentation.
Brain pace estimates reveal early brain aging linked to impairment
Brain-PACE: A Deep Siamese MRI Framework for Modelling Longitudinal Brain Acceleration
Abstract: Brain age estimation has become a popular research proxy for assessing brain health and disease, yet longitudinal trajectories of brain ageing are still poorly defined, and clinical use is limited. Building on existing Siamese longitudinal frameworks, we develop Brain-Predicted Age Acceleration (Brain-PACE) to directly estimate the pace of structural brain ageing from paired T1-weighted MRI. Brain-PACE identified accelerated ageing in $42.6$% of participants with mild cognitive impairment. Faster Brain-PACE was associated with greater functional and cognitive impairment (FAQ; $r=0.35$, ADAS13; $r=0.30$, CDR-SB; $r=0.32$) and greater regional tau burden in the posterior cingulate ($r=0.59$), precuneus ($r=0.47$), and entorhinal cortex ($r=0.37$). These associations were stronger than those observed when pace was calculated indirectly from repeated cross-sectional brain age estimates, suggesting that direct longitudinal modelling captures complementary information relevant to ongoing pathological change. Methodologically, Brain-PACE extends the LILAC framework by combining spatial attention with soft label distribution learning and a Cramér distance objective, improving probabilistic performance and reducing prediction bias while providing measures of predictive uncertainty. Together, these findings support Brain-PACE as a complementary longitudinal imaging phenotype with sensitivity to relevant clinical and biological changes in early neurodegeneration.
Transformer improves wireless capsule endoscopy image resolution efficiently
CEM-TUDASR: Computationally efficient multi-modality transformer based unsupervised domain adaptive super-resolution approach
Abstract: Wireless Capsule Endoscopy (WCE) enables non-invasive visualization of the gastrointestinal tract, but its miniaturized optics, sensor limitations, and wireless transmission constraints result in low-resolution images with reduced visibility of diagnostically important structures. This paper proposes CEM-TUDASR, a computationally efficient unsupervised Transformer-based super-resolution framework for WCE image enhancement without paired low-resolution (LR) and high-resolution (HR) training data. A domain-adaptive degradation network synthesizes realistic WCE-like LR images from HR conventional endoscopy images, reducing the domain gap and enabling effective unpaired learning. The SR generator integrates Deep Attention Blocks (DABs) and a Fusion Attention Block (FAB) to capture long-range contextual dependencies and fine local structures while preserving perceptual and structural fidelity. The model is trained on a curated dataset derived from Kvasir Capsule and evaluated on KID and GIANA for cross-dataset generalization. No-reference quality metrics, including BRISQUE, PIQE, NIQE, and the domain-specific EndoQM, show that CEM-TUDASR consistently outperforms existing unsupervised SR methods. Qualitative results further demonstrate improved restoration of mucosal textures, vascular patterns, and clinically relevant anatomical details. Cross-domain experiments on retinal images additionally demonstrate the adaptability of the framework. With only 2.67 million parameters and 169.94 GFLOPs, CEM-TUDASR achieves high-quality reconstruction while maintaining computational efficiency, making it suitable for resource-constrained clinical and embedded endoscopic applications.