Keerthi Ram

The updated recommendations on diagnostic procedures and treatment pathways for a medical condition are documented as graphical flows in Clinical Practice Guidelines (CPGs). For effective use of the CPGs in helping medical professionals in the treatment decision process, it is necessary to fully capture the guideline knowledge, particularly the contexts and their relationships in the graph. While several existing works have utilized these guidelines to create rule bases for Clinical Decision Support Systems, limited work has been done toward directly capturing the full medical knowledge contained in CPGs. This work proposes an approach to create a contextually enriched, faithful digital representation of National Comprehensive Cancer Network (NCCN) Cancer CPGs in the form of graphs using automated extraction and node & relationship classification. We also implement semantic enrichment of the model by using Large Language Models (LLMs) for node classification, achieving an accuracy of 80.86% and 88.47% with zero-shot learning and few-shot learning, respectively. Additionally, we introduce a methodology for answering natural language questions with constraints to guideline text by leveraging LLMs to extract the relevant subgraph from the guideline knowledge base. By generating natural language answers based on subgraph paths and semantic information, we mitigate the risk of incorrect answers and hallucination associated with LLMs, ensuring factual accuracy in medical domain Question Answering.

Parallel imaging, a fast MRI technique, involves dynamic adjustments based on the configuration i.e. number, positioning, and sensitivity of the coils with respect to the anatomy under study. Conventional deep learning-based image reconstruction models have to be trained or fine-tuned for each configuration, posing a barrier to clinical translation, given the lack of computational resources and machine learning expertise for clinicians to train models at deployment. Joint training on diverse datasets learns a single weight set that might underfit to deviated configurations. We propose, HyperCoil-Recon, a hypernetwork-based coil configuration task-switching network for multi-coil MRI reconstruction that encodes varying configurations of the numbers of coils in a multi-tasking perspective, posing each configuration as a task. The hypernetworks infer and embed task-specific weights into the reconstruction network, 1) effectively utilizing the contextual knowledge of common and varying image features among the various fields-of-view of the coils, and 2) enabling generality to unseen configurations at test time. Experiments reveal that our approach 1) adapts on the fly to various unseen configurations up to 32 coils when trained on lower numbers (i.e. 7 to 11) of randomly varying coils, and to 120 deviated unseen configurations when trained on 18 configurations in a single model, 2) matches the performance of coil configuration-specific models, and 3) outperforms configuration-invariant models with improvement margins of ∼ 1 dB / 0.03 and 0.3 dB / 0.02 in PSNR / SSIM for knee and brain data. Our code is available at https://github.com/sriprabhar/HyperCoil-Recon

Many segmentation networks have been proposed for 3D volumetric segmentation of tumors and organs at risk. Hospitals and clinical institutions seek to accelerate and minimize the efforts of specialists in image segmentation. Still, in case of errors generated by these networks, clinicians would have to manually edit the generated segmentation maps. Given a 3D volume and its putative segmentation map, we propose an approach to identify and measure erroneous regions in the segmentation map. Our method can estimate error at any point or node in a 3D mesh generated from a possibly erroneous volumetric segmentation map, serving as a Quality Assurance tool. We propose a graph neural network-based transformer based on the Nodeformer architecture to measure and classify the segmentation errors at any point. We have evaluated our network on a high-resolution micro-CT dataset of the human inner-ear bony labyrinth structure by simulating erroneous 3D segmentation maps. Our network incorporates a convolutional encoder to compute node-centric features from the input micro-CT data, the Nodeformer to learn the latent graph embeddings, and a Multi-Layer Perceptron (MLP) to compute and classify the node-wise errors. Our network achieves a mean absolute error of ~0.042 over other Graph Neural Networks (GNN) and an accuracy of 79.53% over other GNNs in estimating and classifying the node-wise errors, respectively. We also put forth vertex-normal prediction as a custom pretext task for pre-training the CNN encoder to improve the network's overall performance. Qualitative analysis shows the efficiency of our network in correctly classifying errors and reducing misclassifications.

Deep cascaded architectures for magnetic resonance imaging (MRI) acceleration have shown remarkable success in providing high-quality reconstruction. However, as the number of cascades increases, the improvements in reconstruction tend to become marginal, indicating possible excess model capacity. Knowledge distillation (KD) is an emerging technique to compress these models, in which a trained deep teacher network is used to distill knowledge to a smaller student network such that the student learns to mimic the behavior of the teacher. Most KD methods focus on effectively training the student with a pre-trained teacher unaware of the student model. We propose SFT-KD-Recon, a student-friendly teacher training approach along with the student as a prior step to KD to make the teacher aware of the structure and capacity of the student and enable aligning the representations of the teacher with the student. In SFT, the teacher is jointly trained with the unfolded branch configurations of the student blocks using three loss terms - teacher-reconstruction loss, student-reconstruction loss, and teacher-student imitation loss, followed by KD of the student. We perform extensive experiments for MRI acceleration in 4x and 5x under-sampling on the brain and cardiac datasets on five KD methods using the proposed approach as a prior step. We consider the DC-CNN architecture and setup teacher as D5C5 (141765 parameters), and student as D3C5 (49285 parameters), denoting a compression of 2.87:1. Results show that (i) our approach consistently improves the KD methods with improved reconstruction performance and image quality, and (ii) the student distilled using our approach is competitive with the teacher, with the performance gap reduced from 0.53 dB to 0.03 dB.

Convolutional Neural network-based MR reconstruction methods have shown to provide fast and high quality reconstructions. A primary drawback with a CNN-based model is that it lacks flexibility and can effectively operate only for a specific acquisition context limiting practical applicability. By acquisition context, we mean a specific combination of three input settings considered namely, the anatomy under study, undersampling mask pattern and acceleration factor for undersampling. The model could be trained jointly on images combining multiple contexts. However the model does not meet the performance of context specific models nor extensible to contexts unseen at train time. This necessitates a modification to the existing architecture in generating context specific weights so as to incorporate flexibility to multiple contexts. We propose a multiple acquisition context based network, called MAC-ReconNet for MRI reconstruction, flexible to multiple acquisition contexts and generalizable to unseen contexts for applicability in real scenarios. The proposed network has an MRI reconstruction module and a dynamic weight prediction (DWP) module. The DWP module takes the corresponding acquisition context information as input and learns the context-specific weights of the reconstruction module which changes dynamically with context at run time. We show that the proposed approach can handle multiple contexts based on cardiac and brain datasets, Gaussian and Cartesian undersampling patterns and five acceleration factors. The proposed network outperforms the naive jointly trained model and gives competitive results with the context-specific models both quantitatively and qualitatively. We also demonstrate the generalizability of our model by testing on contexts unseen at train time.