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Jan Kirschke

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Published work

3 published item(s)

preprint2026arXiv

Whole-body CT attenuation and volume charts from routine clinical scans via evidence-grounded LLM report filtering

Interpreting quantitative CT biomarkers, such as organ volume and tissue attenuation, requires large-scale healthy reference distributions. However, creating these is challenging because clinical datasets are often heavily enriched with pathology. Here, we develop an evidence-grounded, cross-verified large language model (LLM) ensemble to filter pathological findings from radiology reports, enabling the construction of pathology-reduced cohorts from over 350,000 CT examinations. Five LLMs, first, flag structure-level abnormality candidates grounded in verbatim report evidence and, second, resolve disagreements via cross-verification. Using distribution-aware generalized additive models for location, scale, and shape, we establish comprehensive whole-body reference charts for 106 anatomical structures (volumes and attenuation) across adulthood, accounting for age, sex, contrast enhancement, and acquisition parameters. Longitudinal analyses reveal structure- and contrast-dependent changes distinct from cross-sectional trends. These resources facilitate covariate-adjusted centile scoring from routine CT, supporting standardized quantitative phenotyping, multi-site imaging studies, and scalable opportunistic screening research.

preprint2022arXiv

CheXplaining in Style: Counterfactual Explanations for Chest X-rays using StyleGAN

Deep learning models used in medical image analysis are prone to raising reliability concerns due to their black-box nature. To shed light on these black-box models, previous works predominantly focus on identifying the contribution of input features to the diagnosis, i.e., feature attribution. In this work, we explore counterfactual explanations to identify what patterns the models rely on for diagnosis. Specifically, we investigate the effect of changing features within chest X-rays on the classifier's output to understand its decision mechanism. We leverage a StyleGAN-based approach (StyleEx) to create counterfactual explanations for chest X-rays by manipulating specific latent directions in their latent space. In addition, we propose EigenFind to significantly reduce the computation time of generated explanations. We clinically evaluate the relevancy of our counterfactual explanations with the help of radiologists. Our code is publicly available.

preprint2022arXiv

Deep Quality Estimation: Creating Surrogate Models for Human Quality Ratings

Human ratings are abstract representations of segmentation quality. To approximate human quality ratings on scarce expert data, we train surrogate quality estimation models. We evaluate on a complex multi-class segmentation problem, specifically glioma segmentation, following the BraTS annotation protocol. The training data features quality ratings from 15 expert neuroradiologists on a scale ranging from 1 to 6 stars for various computer-generated and manual 3D annotations. Even though the networks operate on 2D images and with scarce training data, we can approximate segmentation quality within a margin of error comparable to human intra-rater reliability. Segmentation quality prediction has broad applications. While an understanding of segmentation quality is imperative for successful clinical translation of automatic segmentation quality algorithms, it can play an essential role in training new segmentation models. Due to the split-second inference times, it can be directly applied within a loss function or as a fully-automatic dataset curation mechanism in a federated learning setting.