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The implementation of our MICCAI22 paper "Asymmetry Disentanglement Network for Interpretable Acute Ischemic Stroke Infarct Segmentation in Non-Contrast CT Scans".

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ADN

The Pytorch implementation of our MICCAI22 paper Asymmetry Disentanglement Network for Interpretable Acute Ischemic Stroke Infarct Segmentation in Non-Contrast CT Scans.

Example Results

ADN can separate different kinds of asymmetries in NCCT images ( $A$: total asymmetry map, $P$: pathologigcal asymmetry map, $Q$: intrinsic anatomical asymmetry map) and generate pathology-salient ( $X+Q$ ) or pathology-compensated ( $X+P$ ) images for better clinical examination.

Dependencies

Python 3.7.10, Pytorch 1.10.2, etc.

Quick Start

ADN includes three parts: transformation network $T$, assymmetry extraction network $D$, and segmentation network $F$. In our experiments, we first train $T$, and then fix $T$ and jointly train $D$ and $F$. The following codes show a simple example that how to train the network $T$.

# A toy example to show how to train transform network
import os
import torch
from model.transform_net import PlaneFinder
import torch.optim as optim

# set GPU
os.environ["CUDA_VISIBLE_DEVICES"] = "0"

# transformation network T
align_model = PlaneFinder(is_train=True)
align_model.train()
align_model.cuda()

optimizer = optim.AdamW(align_model.parameters(),
                        lr=1e-5, betas=(0.9, 0.999), weight_decay=5e-4)

# load CT data
# size: (batch_size, num_channel, num_slices, height, width)
x = torch.rand((4, 1, 40, 256, 256)).cuda()

optimizer.zero_grad()

# x_t: transformer symmetric x
# view: x, y, z rotation and translation
# M: transformation matrix
# please refer to the comments of forward function for the definition of each return variable
x_t, _, _, view, M, _ = align_model(x)

align_model.loss_total.backward()

optimizer.step()

After training $T$, we jointly train $D$ and $F$. The following codes show a simple example about how to implement this. We first set warm_start=1 in the begining stages and then set warm_start=0.

# A toy example to show how to train the whole network without using tissue segmentation maps
# unet3d is borrowed from https://github.com/wolny/pytorch-3dunet/tree/master/pytorch3dunet/unet3d
import os
os.environ["CUDA_VISIBLE_DEVICES"] = "0"
import torch
from model.transform_net import PlaneFinder
import torch.optim as optim
import torch.nn as nn
from model.unet3d.unet_model import ResidualUNet3D
from model.unet3d.losses import GeneralizedDiceLoss

# affine transform
def stn(x, theta):
    # theta must be (Bs, 3, 4) = [R|t]
    grid = nn.functional.affine_grid(theta, x.size(), align_corners=False)
    out = nn.functional.grid_sample(x, grid, padding_mode='zeros', align_corners=False)
    return out

def loss_calc(pred, label):
    """
    This function returns cross entropy loss for semantic segmentation
    """
    label = label.cuda()
    BCELoss = nn.BCELoss()
    DiceLoss = GeneralizedDiceLoss(normalization="none")
    return BCELoss(pred, label), DiceLoss(pred.unsqueeze(dim=1), label.unsqueeze(dim=1))

# transformation network T
align_model = PlaneFinder(is_train=False)
align_model.cuda()
# load pretrained transformation network T
# Note that we train T first and then fixed it and train D and F
align_model.eval()

# asymmetry extraction network D
asym_model = ResidualUNet3D(in_channels=1, out_channels=1, f_maps=32, use_transconv=False, use_dp=True, p=0.2)
asym_model.cuda()
asym_model.train()

# segmentation network F
seg_model = ResidualUNet3D(in_channels=1, out_channels=1, f_maps=32, use_transconv=False, use_dp=True, p=0.2)
seg_model.cuda()
seg_model.train()

optimizer = optim.AdamW([{'params': asym_model.parameters(), 'lr': 1e-4},
                         {'params': seg_model.parameters(), 'lr': 1e-4}],
                        weight_decay=5e-4,
                        betas=(0.9, 0.999))

# load CT data
# size: (batch_size, num_channel, num_slices, height, width)
images = torch.rand((1, 1, 40, 256, 256)).cuda()
labels = torch.randint(size=(1, 40, 256, 256), low=0, high=2).float().cuda()

# Perform transformation
with torch.no_grad():
    images_t, images_r, images_t_f, _, M, M_inv = align_model(images)
    diff_t = images_t - images_t_f
    sym_comp_t = torch.zeros_like(images_t)
    sym_comp_t[diff_t > 0] = images_t[diff_t > 0]
    sym_comp_t[diff_t == 0] = images_t[diff_t == 0]
    sym_comp_t[diff_t < 0] = images_t_f[diff_t < 0]
    asym_map_t = nn.ReLU()(images_t_f - images_t)  # total asym map A

labels_t = stn(labels.unsqueeze(dim=1), M[:, :3, :]).squeeze(dim=1)

optimizer.zero_grad()
# separate asym to be anatomical asym Q and pathological asym P
subject_asym_conf_t = asym_model(images_t)  # pathological asym P
anatomy_asym_conf_t = asym_map_t - subject_asym_conf_t
anatomy_asym_conf_t = nn.ReLU()(anatomy_asym_conf_t)  # anatomical asym P
subject_asym_images_t = images_t + anatomy_asym_conf_t  # X_hat = X + Q

anatomy_asym_images_t = images_t + subject_asym_conf_t
anatomy_asym_images_t = torch.clamp(anatomy_asym_images_t, max=sym_comp_t)  # X_bar = X + P

# perform segmentation on X_hat
pred_t = seg_model(subject_asym_images_t)
pred_t = pred_t.squeeze(dim=1)
bce_loss, dice_loss = loss_calc(pred_t, labels_t)
seg_loss = bce_loss + dice_loss

lambda_seg = 1
lambda_reg = 10
warm_start = 1  # 1 use warm start else use regularization loss
# for warm start stage
if warm_start:
    reg_bce_loss, reg_dice_loss = loss_calc(subject_asym_conf_t.squeeze(dim=1), labels_t)
    reg_loss = reg_bce_loss + reg_dice_loss
else:
    subject_asym_msk_t = labels_t.unsqueeze(dim=1) == 1
    subject_asym_gt_t = asym_map_t * subject_asym_msk_t
    # 1. the size of subject asym (i.e. pathological asym) should be similar to the size of stroke
    reg_loss1 = nn.L1Loss()(subject_asym_conf_t.mean(), subject_asym_gt_t.mean())
    # 2. subject asym should from subject + anatomy
    sym_map_mask_t = asym_map_t == 0
    reg_loss2 = nn.L1Loss()(subject_asym_conf_t*sym_map_mask_t, torch.zeros_like(subject_asym_conf_t))
    # 3. anatomical asym should as large as possible
    reg_loss3 = -anatomy_asym_conf_t.mean()
    reg_loss = reg_loss1 + reg_loss2 + reg_loss3

loss = lambda_seg * seg_loss + lambda_reg * reg_loss
loss.backward()
optimizer.step()

DONE

The network structure of ADN

The code of complete process of training and testing

TODO

The illustration of data preparation, training and testing

Citing ADN

If you find our approaches useful in your research, please consider citing:

@inproceedings{ni2022asymmetry,
  title={Asymmetry Disentanglement Network for Interpretable Acute Ischemic Stroke Infarct Segmentation in Non-Contrast CT Scans},
  author={Ni, Haomiao and Xue, Yuan and Wong, Kelvin and Volpi, John and Wong, Stephen TC and Wang, James Z and Huang, Xiaolei},
  booktitle={International Conference on Medical Image Computing and Computer-Assisted Intervention},
  pages={416--426},
  year={2022},
  organization={Springer}
}

For questions with the code, please feel free to open an issue or contact me: homerhm.ni@gmail.com

Acknowledgement

Part of our code was borrowed from unsup3d and unet3d. We thank the authors of these repositories for their valuable implementations.

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The implementation of our MICCAI22 paper "Asymmetry Disentanglement Network for Interpretable Acute Ischemic Stroke Infarct Segmentation in Non-Contrast CT Scans".

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