In this paper the authors present a new approach for the nonrigid registration of contrast-enhanced breast MRI. A hierarchical transformation model of the motion of the breast has been developed. The global motion of the breast is modeled by an affine transformation while the local breast motion is described by a free-form deformation (FFD) based on B-splines. Normalized mutual information is used as a voxel-based similarity measure which is insensitive to intensity changes as a result of the contrast enhancement. Registration is achieved by minimizing a cost function, which represents a combination of the cost associated with the smoothness of the transformation and the cost associated with the image similarity. The algorithm has been applied to the fully automated registration of three-dimensional (3-D) breast MRI in volunteers and patients. In particular, the authors have compared the results of the proposed nonrigid registration algorithm to those obtained using rigid and affine registration techniques. The results clearly indicate that the nonrigid registration algorithm is much better able to recover the motion and deformation of the breast than rigid or affine registration algorithms.

We propose a novel attention gate (AG) model for medical image analysis that automatically learns to focus on target structures of varying shapes and sizes. Models trained with AGs implicitly learn to suppress irrelevant regions in an input image while highlighting salient features useful for a specific task. This enables us to eliminate the necessity of using explicit external tissue/organ localisation modules when using convolutional neural networks (CNNs). AGs can be easily integrated into standard CNN models such as VGG or U-Net architectures with minimal computational overhead while increasing the model sensitivity and prediction accuracy. The proposed AG models are evaluated on a variety of tasks, including medical image classification and segmentation. For classification, we demonstrate the use case of AGs in scan plane detection for fetal ultrasound screening. We show that the proposed attention mechanism can provide efficient object localisation while improving the overall prediction performance by reducing false positives. For segmentation, the proposed architecture is evaluated on two large 3D CT abdominal datasets with manual annotations for multiple organs. Experimental results show that AG models consistently improve the prediction performance of the base architectures across different datasets and training sizes while preserving computational efficiency. Moreover, AGs guide the model activations to be focused around salient regions, which provides better insights into how model predictions are made. The source code for the proposed AG models is publicly available.

Inspired by recent advances in deep learning, we propose a framework for reconstructing dynamic sequences of 2D cardiac magnetic resonance (MR) images from undersampled data using a deep cascade of convolutional neural networks (CNNs) to accelerate the data acquisition process. In particular, we address the case where data is acquired using aggressive Cartesian undersampling. Firstly, we show that when each 2D image frame is reconstructed independently, the proposed method outperforms state-of-the-art 2D compressed sensing approaches such as dictionary learning-based MR image reconstruction, in terms of reconstruction error and reconstruction speed. Secondly, when reconstructing the frames of the sequences jointly, we demonstrate that CNNs can learn spatio-temporal correlations efficiently by combining convolution and data sharing approaches. We show that the proposed method consistently outperforms state-of-the-art methods and is capable of preserving anatomical structure more faithfully up to 11-fold undersampling. Moreover, reconstruction is very fast: each complete dynamic sequence can be reconstructed in less than 10s and, for the 2D case, each image frame can be reconstructed in 23ms, enabling real-time applications.

Since its renaissance, deep learning (DL) has been widely used in various medical imaging tasks and has achieved remarkable success in many medical imaging applications, thereby propelling us into the so-called artificial intelligence (AI) era. It is known that the success of AI is mostly attributed to the availability of big data with annotations for a single task and the advances in high-performance computing. However, medical imaging presents unique challenges that confront DL approaches. In this survey article, we first present traits of medical imaging, highlight both clinical needs and technical challenges in medical imaging, and describe how emerging trends in DL are addressing these issues. We cover the topics of network architecture, sparse and noisy labels, federating learning, interpretability, uncertainty quantification, and so on. Then, we present several case studies that are commonly found in clinical practice, including digital pathology and chest, brain, cardiovascular, and abdominal imaging. Rather than presenting an exhaustive literature survey, we instead describe some prominent research highlights related to these case study applications. We conclude with a discussion and presentation of promising future directions.