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EPIONE - 2025

2025​​Activity reportProject-TeamEPIONE​​​‌

RNSR: 201822641L

Creation​ of the Project-Team: 2018​‌ May 01

Each year,​​ Inria research teams publish​​​‌ an Activity Report presenting​ their work and results​‌ over the reporting period.​​ These reports follow a​​​‌ common structure, with some​ optional sections depending on​‌ the specific team. They​​ typically begin by outlining​​​‌ the overall objectives and​ research programme, including the​‌ main research themes, goals,​​ and methodological approaches. They​​​‌ also describe the application​ domains targeted by the​‌ team, highlighting the scientific​​ or societal contexts in​​​‌ which their work is​ situated.

The reports then​‌ present the highlights of​​ the year, covering major​​​‌ scientific achievements, software developments,​ or teaching contributions. When​‌ relevant, they include sections​​ on software, platforms, and​​​‌ open data, detailing the​ tools developed and how​‌ they are shared. A​​ substantial part is dedicated​​​‌ to new results, where​ scientific contributions are described​‌ in detail, often with​​ subsections specifying participants and​​ associated keywords.

Finally, the​​​‌ Activity Report addresses funding,‌ contracts, partnerships, and collaborations‌​‌ at various levels, from​​ industrial agreements to international​​​‌ cooperations. It also covers‌ dissemination and teaching activities,‌​‌ such as participation in​​ scientific events, outreach, and​​​‌ supervision. The document concludes‌ with a presentation of‌​‌ scientific production, including major​​ publications and those produced​​​‌ during the year.

Keywords‌

Computer Science and Digital‌​‌ Science

  • A3.3. Data and​​ knowledge analysis
  • A3.4. Machine​​​‌ learning and statistics
  • A4.3.‌ Cryptography
  • A4.4. Security of‌​‌ equipment and software
  • A4.8.​​ Privacy-enhancing technologies
  • A5.2. Data​​​‌ visualization
  • A5.3. Image processing‌ and analysis
  • A5.6. Virtual‌​‌ reality, augmented reality
  • A5.9.​​ Signal processing
  • A6.1. Methods​​​‌ in mathematical modeling
  • A6.2.‌ Scientific computing, Numerical Analysis‌​‌ & Optimization
  • A6.3. Computation-data​​ interaction
  • A8.3. Geometry, Topology​​​‌
  • A9. Artificial intelligence
  • A9.2.‌ Machine learning
  • A9.3. Signal‌​‌ processing
  • A9.6. Decision support​​
  • A9.7. AI algorithmics
  • A9.9.​​​‌ Distributed AI, Multi-agent
  • A9.10.‌ Hybrid approaches for AI‌​‌
  • A9.12. Computer vision

Other​​ Research Topics and Application​​​‌ Domains

  • B2.2. Physiology and‌ diseases
  • B2.3. Epidemiology
  • B2.4.‌​‌ Therapies
  • B2.6. Biological and​​ medical imaging
  • B2.6.1. Brain​​​‌ imaging
  • B2.6.2. Cardiac imaging‌
  • B2.6.3. Biological Imaging

1‌​‌ Team members, visitors, external​​ collaborators

Research Scientists

  • Nicholas​​​‌ Ayache [Team leader‌, Inria, Senior‌​‌ Researcher, HDR]​​
  • Irene Balelli [Inria​​​‌, ISFP]
  • Benjamin‌ Billot [Inria,‌​‌ Researcher]
  • Hervé Delingette​​ [Inria, Senior​​​‌ Researcher, HDR]‌
  • Marco Lorenzi [Inria‌​‌, Senior Researcher,​​ from Oct 2025,​​​‌ HDR]
  • Marco Lorenzi‌ [Inria, Researcher‌​‌, until Sep 2025​​, HDR]
  • Guillaume​​​‌ Olikier [Inria,‌ Starting Research Position,‌​‌ until Aug 2025]​​
  • Xavier Pennec [Inria​​​‌, Senior Researcher,‌ HDR]
  • Maxime Sermesant‌​‌ [Inria, Senior​​ Researcher, HDR]​​​‌

Post-Doctoral Fellows

  • Safaa Al‌ Ali [Inria,‌​‌ until Jun 2025]​​
  • Francesco Cremonesi [Inria​​​‌]
  • Bernhard Follmer [‌Inria, Post-Doctoral Fellow‌​‌, from May 2025​​]
  • Jia Guo [​​​‌CHU Nice]
  • John‌ Kalkhof [Inria,‌​‌ Post-Doctoral Fellow, from​​ Jul 2025]
  • Huiyu​​​‌ Li [IHU Respirera‌, from May 2025‌​‌]
  • Buntheng Ly [​​IHU Lyric]
  • Ghiles​​​‌ Reguig [Inria]‌
  • Jesus Jairo Rodriguez Padilla‌​‌ [Inria]
  • Alessandro​​ Viani [Inria,​​​‌ Post-Doctoral Fellow, until‌ Feb 2025]

PhD‌​‌ Students

  • Amel Bakhouche [​​Université Côte d'Azur,​​​‌ from Feb 2025]‌
  • Olivier Bisson [Inria‌​‌]
  • Florencia Boccarato [​​Inria, from Feb​​​‌ 2025]
  • Fahym Bounazou‌ [AP-HP, from‌​‌ Feb 2025]
  • Alix​​ De Langlais [Inria​​​‌]
  • Nicolas Drettakis [‌Inria]
  • Ezem Sura‌​‌ Ekmekci [Inria]​​
  • Federica Facente [Inria​​​‌]
  • Camilla Ferrario [‌Inria]
  • Giulia Foroni‌​‌ [Inria, from​​ Oct 2025]
  • Sebastien​​​‌ Goffart [CHU Nice‌]
  • Lisa Guzzi [‌​‌Université Côte d'Azur,​​ until Oct 2025]​​​‌
  • Manasi Kattel [Inria‌]
  • Wassila Khatir [‌​‌Université Côte d'Azur]​​
  • Arnaud Lang [Inria​​​‌, from Dec 2025‌]
  • Maelis Morier [‌​‌Inria]
  • Huyen Trang​​​‌ Nguyen [Inria]​
  • Evariste Njomgue Fotso [​‌Inria]
  • Giuseppe Orlando​​ [Inria, from​​​‌ Jun 2025]
  • Rafael​ Luis Soares Da Costa​‌ E Silva [Inria​​]
  • Tom Szwagier [​​​‌Inria]
  • Adrien Tchuem​ Tchuente [Inria,​‌ from Oct 2025]​​
  • Elie Thellier [Inria​​​‌, from Mar 2025​]
  • Tony Zaayter [​‌Inria, from Nov​​ 2025]

Technical Staff​​​‌

  • Nicolas Cedilnik [Inria​, Engineer, from​‌ Mar 2025]
  • Lucie​​ Chambon [Inria,​​​‌ Engineer]
  • Gaetan Desrues​ [Inria, Engineer​‌, from Mar 2025​​]
  • Hye Lim Lee​​​‌ [Inria, Engineer​]
  • Marco Milanesio [​‌Université Côte d'Azur]​​
  • Mihaela Pop [Inria​​​‌, Engineer, from​ Mar 2025 until Oct​‌ 2025]
  • Hari Sreedhar​​ [Université Côte d'Azur​​​‌, Engineer, from​ Mar 2025]

Interns​‌ and Apprentices

  • Prabal Ghosh​​ [Inria, Intern​​​‌, from Apr 2025​ until Sep 2025]​‌
  • Tuan Hoang [Inria​​, Intern, from​​​‌ Apr 2025 until Aug​ 2025]
  • Arnaud Lang​‌ [Inria, Intern​​, from Apr 2025​​​‌ until Sep 2025]​
  • Tuan Anh Nguyen [​‌Inria, Intern,​​ from Apr 2025 until​​​‌ Aug 2025]
  • Giuseppe​ Orlando [Eurecom,​‌ from Feb 2025 until​​ May 2025]

Administrative​​​‌ Assistant

  • Nathalie Nordmann [​Inria]

Visiting Scientists​‌

  • Alessandra Corda [Politecnico​​ de Milano, from​​​‌ Nov 2025]
  • Hervé​ Lombaert [Polytechnique Montréal​‌, from Dec 2025​​]

External Collaborators

  • Sébastien​​​‌ Frey [CHU Nice​]
  • Eleonore Haupaix-Birgy [​‌CHU Nice, from​​ Feb 2025]
  • Cécile​​​‌ Rouzier [CHU Nice​]

2 Overall objectives​‌

2.1 Description

Our long-term​​ goal is to contribute​​​‌ to the development of​ what we call the​‌ e-patient (digital patient) for​​ e-medicine (digital medicine) (Fig.​​​‌ 1).

Figure
Figure 1​: The e-patient for​‌ e-medicine

The image shows​​ a cycle of personalized​​​‌ medicine integrating in vivo​ and in silico processes.​‌ In vivo includes images,​​ signals, and measures from​​​‌ clinical, biological, and genomic​ sources. These data feed​‌ into multi-scale computational models​​ of the human body,​​​‌ incorporating anatomy, physiology, and​ multiple scientific disciplines. This​‌ enables personalized simulations, planning,​​ control, and evolution for​​​‌ diagnosis, prognosis, and therapy.​ The cycle emphasizes personalization​‌ and the transition between​​ real-world data (in vivo)​​​‌ and computational modeling (in​ silico).

  • the e-patient (or​‌ digital patient) is a​​ set of computational models​​​‌ of the human body​ able to describe and​‌ simulate the anatomy and​​ the physiology of the​​​‌ patient's organs and tissues,​ at various scales, for​‌ an individual or a​​ population. The e-patient can​​​‌ be seen as a​ framework to integrate and​‌ analyze in a coherent​​ manner the heterogeneous information​​​‌ measured on the patient​ from disparate sources: imaging,​‌ biological, clinical, sensors, ...​​
  • e-medicine (or digital medicine)​​​‌ is defined as the​ computational tools applied to​‌ the e-patient to assist​​ the physician and the​​​‌ surgeon in their medical​ practice, to assess the​‌ diagnosis/prognosis, and to plan,​​ control and evaluate the​​ therapy.

The models that​​​‌ govern the algorithms designed‌ for e-patients and e-medicine‌​‌ come from various disciplines:​​ computer science, mathematics, medicine,​​​‌ statistics, physics, biology, chemistry,‌ etc. The parameters of‌​‌ those models must be​​ adjusted to an individual​​​‌ or a population based‌ on the available images,‌​‌ signals and data. This​​ adjustment is called personalization​​​‌ and usually requires solving‌ difficult inverse problems. The‌​‌ overall picture of the​​ construction of the personalized​​​‌ e-patient for e-medicine was‌ presented at the College‌​‌ de France through an​​ inaugural lecture and a​​​‌ series of courses and‌ seminars, concluded by an‌​‌ international workshop.

2.2 Organization​​

The research organization in​​​‌ our field is often‌ built on a virtuous‌​‌ triangle (Fig. 2).​​ On one vertex, academic​​​‌ research requires multidisciplinary collaborations‌ associating informatics and mathematics‌​‌ to other disciplines: medicine,​​ biology, physics, chemistry ...​​​‌ On a second vertex,‌ a clinical partnership is‌​‌ required to help defining​​ pertinent questions, to get​​​‌ access to clinical data,‌ and to clinically evaluate‌​‌ any proposed solution. On​​ the third vertex, an​​​‌ industrial partnership can be‌ introduced for the research‌​‌ activity itself, and also​​ to transform any proposed​​​‌ solution into a validated‌ product that can ultimately‌​‌ be transferred to the​​ clinical sites for an​​​‌ effective use on the‌ patients.

Figure
Figure 2:‌​‌ A pluridisciplinary research triangle.​​

The image depicts a​​​‌ triangle with three vertices‌ labeled "Academic," "Clinical," and‌​‌ "Industrial." Inside the triangle,​​ the core focus is​​​‌ on "e-patient, e-medicine research."‌ The Academic vertex lists‌​‌ fields like Informatics, Mathematics,​​ Medicine, Biology, Physics, Chemistry,​​​‌ and others. This indicates‌ the integration of various‌​‌ academic disciplines with clinical​​ and industrial applications in​​​‌ e-medicine and e-patient research.‌

Keeping this triangle in‌​‌ mind, we choose our​​ research directions within a​​​‌ virtuous circle: we look‌ at difficult problems raised‌​‌ by our clinical or​​ industrial partners, and then​​​‌ try to identify some‌ classes of generic fundamental/theoretical‌​‌ problems associated to their​​ resolution. We also study​​​‌ some fundamental/theoretical problems per‌ se in order to‌​‌ produce fundamental scientific advances​​ that can help in​​​‌ turn to promote new‌ applications.

3 Research program‌​‌

3.1 Introduction

Our research​​ objectives are organized along​​​‌ 5 scientific axes (Fig.‌ 3):

  1. Biomedical Image‌​‌ Analysis & Machine Learning​​
  2. Imaging & Phenomics, Biostatistics​​​‌
  3. Computational Anatomy, Geometric Statistics‌
  4. Computational Physiology & Image-Guided‌​‌ Therapy
  5. Computational Cardiology &​​ Image-Based Cardiac Interventions

Figure
Figure​​​‌ 3: Epione's five‌ main research axes

The‌​‌ image is a Venn​​ diagram with multiple overlapping​​​‌ circles representing different research‌ areas. The outermost circle‌​‌ is labeled "Research Axes."​​ Inside, various specialized fields​​​‌ such as Imaging Genetics,‌ BioStat, Comp. Anat, Geom.‌​‌ Stat., Med. Image Analysis,​​ Learning, Comp. Cardio, Image​​​‌ Based Intervention, Comp. Physio,‌ and Image-guided Therapy are‌​‌ shown. At the bottom,​​ there's a larger overlapping​​​‌ area labeled "Software/Hardware Environment."‌ The diagram illustrates the‌​‌ interconnectedness and overlap between​​ these research fields.

For​​​‌ each scientific axis, we‌ introduce the context and‌​‌ the long term vision​​ of our research.

3.2​​​‌ Biomedical Image Analysis &‌ Machine Learning

The long-term‌​‌ objective of biomedical image​​​‌ analysis is to extract,​ from biomedical images, pertinent​‌ information for the construction​​ of the e-patient and​​​‌ for the development of​ e-medicine. This relates to​‌ the development of advanced​​ segmentation and registration of​​​‌ images, the extraction of​ image biomarkers of pathologies,​‌ the detection and classification​​ of image abnormalities, the​​​‌ construction of temporal models​ of motion or evolution​‌ from time-series of images,​​ etc.

In addition, the​​​‌ growing availability of very​ large databases of biomedical​‌ images, the growing power​​ of computers and the​​​‌ progress of machine learning​ (ML) approaches have opened​‌ up new opportunities for​​ biomedical image analysis.

This​​​‌ is the reason why​ we decided to revisit​‌ a number of biomedical​​ image analysis problems with​​​‌ ML approaches, including segmentation​ and registration problems, automatic​‌ detection of abnormalities, prediction​​ of a missing imaging​​​‌ modality, etc. Not only​ those ML approaches often​‌ outperform the previous state-of-the-art​​ solutions in terms of​​​‌ performances (accuracy of the​ results, computing times), but​‌ they also tend to​​ offer a higher flexibility​​​‌ like the possibility to​ be transferred from one​‌ problem to another one​​ with a similar framework.​​​‌ However, even when successful,​ ML approaches tend to​‌ suffer from a lack​​ of explanatory power, which​​​‌ is particularly annoying for​ medical applications. We also​‌ plan to work on​​ methods that can interpret​​​‌ the results of the​ ML algorithms that we​‌ develop.

3.3 Imaging and​​ Phenomics, Biostatistics

The human​​​‌ phenotype is associated with​ a multitude of heterogeneous​‌ biomarkers quantified by imaging,​​ clinical and biological measurements,​​​‌ reflecting the biological and​ patho-physiological processes governing the​‌ human body, and essentially​​ linked to the underlying​​​‌ individual genotype. In order​ to deepen our understanding​‌ of these complex relationships​​ and better identify pathological​​​‌ traits in individuals and​ clinical groups, a long-term​‌ objective of e-medicine is​​ therefore to develop the​​​‌ tools for the joint​ analysis of this heterogeneous​‌ information, termed Phenomics,​​ within the unified modeling​​​‌ setting of the e-patient.​

To date the most​‌ common approach to the​​ analysis of the joint​​​‌ variation between the structure​ and function of organs​‌ represented in medical images,​​ and the classical -omics​​​‌ modalities from biology, such​ as genomics or lipidomics,​‌ is essentially based on​​ the massive univariate statistical​​​‌ testing of single candidate​ features out of the​‌ many available. This is​​ for example the case​​​‌ of genome-wide association studies​ (GWAS) aimed at identifying​‌ statistically significant effects in​​ pools consisting of up​​​‌ to millions of genetics​ variants. Such approaches have​‌ known limitations such as​​ multiple comparison problems, leading​​​‌ to underpowered discoveries of​ significant associations, and usually​‌ explain a rather limited​​ amount of data variance.​​​‌ Although more sophisticated machine​ learning approaches have been​‌ proposed, the reliability and​​ generalization of multivariate methods​​​‌ is currently hampered by​ the low sample size​‌ relatively to the usually​​ large dimension of the​​​‌ parameters space.

To address​ these issues this research​‌ axis investigates novel methods​​ for the integration of​​​‌ this heterogeneous information within​ a parsimonious and unified​‌ multivariate modeling framework. The​​ cornerstone of the project​​ consists in achieving an​​​‌ optimal trade-off between modeling‌ flexibility and ability to‌​‌ generalize on unseen data​​ by developing statistical learning​​​‌ methods informed by prior‌ information, either inspired by‌​‌ "mechanistic" biological processes, or​​ accounting for specific signal​​​‌ properties (such as the‌ structured information from spatio-temporal‌​‌ image time series). Finally,​​ particular attention will be​​​‌ paid to the effective‌ exploitation of the methods‌​‌ in the growing Big​​ Data scenario, either in​​​‌ the meta-analysis context, or‌ for the application in‌​‌ large datasets and biobanks.​​

Federated learning in multi-centric​​​‌ studies. The current research‌ scenario is characterized by‌​‌ medium/small scale (typically from​​ 50 to 1000 patients)​​​‌ heterogeneous datasets distributed across‌ centers and countries. The‌​‌ straightforward extension of learning​​ algorithms successfully applied to​​​‌ big data problems is‌ therefore difficult, and specific‌​‌ strategies need to be​​ envisioned in order to​​​‌ optimally exploit the available‌ information. To address this‌​‌ problem, we focus on​​ learning approaches to jointly​​​‌ model clinical data localized‌ in different centers. This‌​‌ is an important issue​​ emerging from recent large-scale​​​‌ multi-centric imaging-genetics studies in‌ which partners can only‌​‌ share model parameters (e.g.​​ regression coefficients between specific​​​‌ genes and imaging features),‌ as represented for example‌​‌ by the ENIGMA imaging-genetics​​ study, led by the​​​‌ collaborators at University of‌ Southern California. This problem‌​‌ requires the development of​​ statistical methods for federated​​​‌ model estimation, in order‌ to access data hosted‌​‌ in different clinical institutions​​ by simply transmitting the​​​‌ model parameters, that will‌ be in turn updated‌​‌ by using the local​​ available data. This approach​​​‌ is extended to the‌ definition of stochastic optimization‌​‌ strategies in which model​​ parameters are optimized on​​​‌ local datasets, and then‌ summarized in a meta-analysis‌​‌ context. Finally, this project​​ studies strategies for aggregating​​​‌ the information from heterogeneous‌ datasets, accounting for missing‌​‌ modalities due to different​​ study design and protocols.​​​‌ The developed methodology finds‌ important applications within the‌​‌ context of Big Data,​​ for the development of​​​‌ effective learning strategies for‌ massive datasets in the‌​‌ context of medical imaging​​ (such as with the​​​‌ UK biobank), and beyond.‌

3.4 Computational Anatomy and‌​‌ Geometric Statistics

Computational anatomy​​ is an emerging discipline​​​‌ at the interface of‌ geometry, statistics and image‌​‌ analysis which aims at​​ developing algorithms to model​​​‌ and analyze the biological‌ shape of tissues and‌​‌ organs. The goal is​​ not only to establish​​​‌ generative models of organ‌ anatomies across diseases, populations,‌​‌ species or ages but​​ also to model the​​​‌ organ development across time‌ (growth or aging) and‌​‌ to estimate their variability​​ and link to other​​​‌ functional, genetic or structural‌ information. Computational anatomy is‌​‌ a key component to​​ support computational physiology and​​​‌ is evidently crucial for‌ building the e-patient and‌​‌ to support e-medicine.

Pivotal​​ applications include the spatial​​​‌ normalization of subjects in‌ neuroscience (mapping all the‌​‌ anatomies into a common​​ reference system) and atlas​​​‌ to patient registration to‌ map generic knowledge to‌​‌ patient-specific data. Our objectives​​ will be to develop​​​‌ new efficient algorithmic methods‌ to address the emerging‌​‌ challenges described below and​​​‌ to generate precise specific​ anatomical model in particular​‌ for the brain and​​ the heart.

The objects​​​‌ of computational anatomy are​ often shapes extracted from​‌ images or images of​​ labels (segmentation). The observed​​​‌ organ images can also​ be modeled using registration​‌ as the random diffeomorphic​​ deformation of an unknown​​​‌ template (i.e. an orbit).​ In these cases as​‌ in many other applications,​​ invariance properties lead us​​​‌ to consider that these​ objects belong to non-linear​‌ spaces that have a​​ geometric structure. Thus, the​​​‌ mathematical foundations of computational​ anatomy rely on statistics​‌ on non-linear spaces.

Geometric​​ Statistics aim at studying​​​‌ this abstracted problem at​ the theoretical level. Our​‌ goal is to advance​​ the fundamental knowledge in​​​‌ this area, with potential​ applications to new areas​‌ outside of medical imaging.​​ Beyond the now classical​​​‌ Riemannian spaces, we aim​ at developing the foundations​‌ of statistical estimation on​​ affine connection spaces (e.g.​​​‌ Lie groups), quotient and​ stratified metric spaces (e.g.​‌ orbifolds and tree spaces).​​ In addition to the​​​‌ curvature, one of the​ key problem is the​‌ introduction of singularities at​​ the boundary of the​​​‌ regular strata (non-smooth and​ non-convex analysis).

A second​‌ objective is to develop​​ parametric and non-parametric dimension​​​‌ reduction methods in non-linear​ space. An important​‌ issue is to estimate​​ efficiently not only the​​​‌ model parameters (mean point,​ subspace, flag) but also​‌ their uncertainty. We also​​ want to quantify the​​​‌ influence of curvature and​ singularities on non-asymptotic estimation​‌ theory since we always​​ have a finite (and​​​‌ often too limited) number​ of samples. A key​‌ challenge in developing such​​ a geometrization of statistics​​​‌ will not only be​ to unify the theory​‌ for the different geometric​​ structures, but also to​​​‌ provide efficient practical algorithms​ to implement them.

A​‌ third objective is to​​ learn the geometry from​​​‌ the data. In​ the high dimensional but​‌ low sample size (small​​ data) setting which is​​​‌ the common situation in​ medical data, we believe​‌ that invariance properties are​​ essential to reasonably interpolate​​​‌ and approximate. New apparently​ antagonistic notions like approximate​‌ invariance could be the​​ key to this interaction​​​‌ between geometry and learning.​

Beyond the traditional statistical​‌ survey of the anatomical​​ shapes that is developed​​​‌ in computational anatomy above,​ we intend to explore​‌ other application fields exhibiting​​ geometric but non-medical data.​​​‌ For instance, applications can​ be found in Brain-Computer​‌ Interfaces (BCI), tree-spaces in​​ phylogenetics, Quantum Physics, etc.​​​‌

3.5 Computational Physiology and​ Image-Guided Therapy

Computational Physiology​‌ aims at developing computational​​ models of human organ​​​‌ functions, an important component​ of the e-patient, with​‌ applications in e-medicine and​​ more specifically in computer-aided​​​‌ prevention, diagnosis, therapy planning​ and therapy guidance. The​‌ focus of our research​​ is on descriptive (allowing​​​‌ to reproduce available observations),​ discriminative (allowing to separate​‌ two populations), and above​​ all predictive models which​​​‌ can be personalized from​ patient data including medical​‌ images, biosignals, biological information​​ and other available metadata.​​​‌ A key aspect of​ this scientific axis is​‌ therefore the coupling of​​ biophysical models with patient​​ data which implies that​​​‌ we are mostly considering‌ models with relatively few‌​‌ and identifiable parameters. To​​ this end, data assimilation​​​‌ methods aiming at estimating‌ biophysical model parameters in‌​‌ order to reproduce available​​ patient data are preferably​​​‌ developed as they potentially‌ lead to predictive models‌​‌ suitable for therapy planning.​​

Previous research projects in​​​‌ computational physiology have led‌ us to develop biomechanical‌​‌ models representing quasi-static small​​ or large soft tissue​​​‌ deformations (e.g. liver or‌ breast deformation after surgery),‌​‌ mechanical growth or atrophy​​ models (e.g. simulating brain​​​‌ atrophy related to neurodegenerative‌ diseases), heat transfer models‌​‌ (e.g. simulating radiofrequency ablation​​ of tumors), and tumor​​​‌ growth models (e.g. brain‌ or lung tumor growth).‌​‌

To improve the data​​ assimilation of biophysical models​​​‌ from patient data, a‌ long term objective of‌​‌ our research will be​​ to develop joint imaging​​​‌ and biophysical generative models‌ in a probabilistic framework‌​‌ which simultaneously describe the​​ appearance and function of​​​‌ an organ (or its‌ pathologies) in medical images.‌​‌ Indeed, current approaches for​​ the personalization of biophysical​​​‌ models often proceed in‌ two separate steps. In‌​‌ a first stage, geometric,​​ kinematic or functional features​​​‌ are first extracted from‌ medical images. In a‌​‌ second stage, they are​​ used by personalization methods​​​‌ to optimize model parameters‌ in order to match‌​‌ the extracted features. In​​ this process, subtle information​​​‌ present in the image‌ which could be informative‌​‌ for biophysical models is​​ often lost which may​​​‌ lead to limited personalization‌ results. Instead, we propose‌​‌ to develop more integrative​​ approaches where the extraction​​​‌ of image features would‌ be performed jointly with‌​‌ the model parameter fitting.​​ Those imaging and biophysical​​​‌ generative models should lead‌ to a better understanding‌​‌ of the content of​​ images, to a better​​​‌ personalization of model parameters‌ and also better estimates‌​‌ of their uncertainty.

3.6​​ Computational Cardiology and Image-Based​​​‌ Cardiac Interventions

Computational Cardiology‌ has been an active‌​‌ research topic within the​​ Computational Anatomy and Computational​​​‌ Physiology axes of the‌ previous Asclepios project, leading‌​‌ to the development of​​ personalized computational models of​​​‌ the heart designed to‌ help characterizing the cardiac‌​‌ function and predict the​​ effect of some device​​​‌ therapies like cardiac resynchronization‌ or tissue ablation. This‌​‌ axis of research has​​ now gained a lot​​​‌ of maturity and a‌ critical mass of involved‌​‌ scientists to justify an​​ individualized research axis of​​​‌ the new project Epione,‌ while maintaining many constructive‌​‌ interactions with the 4​​ other research axes of​​​‌ the project. This will‌ develop all the cardiovascular‌​‌ aspects of the e-patient​​ for cardiac e-medicine.

The​​​‌ new challenges we want‌ to address in computational‌​‌ cardiology are related to​​ the introduction of new​​​‌ levels of modeling and‌ to new clinical and‌​‌ biological applications. They also​​ integrate the presence of​​​‌ new sources of measurements‌ and the potential access‌​‌ to very large multimodal​​ databases of images and​​​‌ measurements at various spatial‌ and temporal scales.

4‌​‌ Application domains

The main​​ applications of our research​​​‌ are in the field‌ of healthcare and more‌​‌ precisely the domain of​​​‌ digital medicine and biomedical​ data analysis. The axes​‌ of research presented above​​ are related to many​​​‌ branches of medicine including​ cardiology, oncology, urology, neurology,​‌ otology, pneumology, radiology, surgery,​​ dermatology, nuclear medicine. Within​​​‌ those branches, the applications​ cover the following different​‌ stages of medicine: prevention,​​ diagnosis, prognosis, treatment.

5​​​‌ Social and environmental responsibility​

5.1 Footprint of research​‌ activities

An important activity​​ of Epione is to​​​‌ introduce priors from clinical​ knowledge within data analysis,​‌ through geometric information, biophysical​​ models, causality, etc. This​​​‌ enables to develop AI​ method requiring less data​‌ and computations, therefore with​​ a positive impact on​​​‌ the environmental footprint of​ epione research activity.

6​‌ Highlights of the year​​

6.1 Awards

  • Xavier Pennec​​​‌ is the laureate of​ the GSI Achievement Award​‌ recognizing outstanding achievement in​​ geometric science of information,​​​‌ received at the 7th​ international conference on Geometric​‌ Science of Information in​​ Saint-Malo on October 31,​​​‌ 2025. This award recognizes​ his long-term scientific contributions​‌ in geometric statistics.
  • Benjamin​​ Billot received an Outstanding​​​‌ Reviewer Award at the​ MICCAI 2025 conference. This​‌ distinction highlights the quality​​ and dedication of his​​​‌ contributions to the scientific​ community through peer review.​‌
  • Riccardo Taiello , received​​ the award “Prix de​​​‌ la Victoire de la​ recherche de la Ville​‌ de Nice” from the​​ City of Nice for​​​‌ his thesis “Privacy-preserving machine​ learning for large-scale collaborative​‌ healthcare data analysis”, supervised​​ by Marco Lorenzi and​​​‌ Melek Onen .
  • Wassila​ Khatir , co-supervised by​‌ Irene Balelli and Marco​​ Lorenzi , received the​​​‌ Outstanding Poster Award at​ the MEI Center and​‌ University Côte d'Azur International​​ Symposium in Osaka,​​​‌ Japan, for her work​ on "A Multi-omic Integration​‌ Approach to Understand the​​ Pathophysiology of Fragile X​​​‌ Syndrome”. She has also​ been granted for a​‌ student fellowship to attend​​ CompSysBio 2025 at Aussois​​​‌ Ski Resort, France, as​ part of her PhD​‌ research.
  • Maëlis Morier received​​ a Best Poster Award​​​‌ at the SophI.A Summit​ 2025 Conference, at Sophia​‌ Antipolis, for the work​​ “Learning Cardiac Electrophysiology with​​​‌ Graph Neural Networks for​ Fast Data-driven Personalized Predictions”​‌ 51.
  • Rafael Silva​​ , PhD student under​​​‌ the supervision of Maxime​ Sermesant , ranked 2nd​‌ for the 9th Prix​​ Pierre Laffitte organized by​​​‌ Mines Paris - PSL​ - Fondation Mines Paris​‌. This prize rewards​​ excellence and innovation in​​​‌ research done in partnership​ with industry.
  • Best Paper​‌ Awards for both Rafael​​ Silva  43 and Buntheng​​​‌ Ly  41 at the​ Functional Imaging and Modeling​‌ of the Heart (FIMH​​ 2025) conference in Dallas,​​​‌ Texas.
  • Olivier Bisson and​ Tom Szwagier were nominated​‌ for the best papers​​ awards at 7th international​​​‌ conference on Geometric Science​ of Information for their​‌ papers respectively on Log-Euclidean​​ Frameworks for Smooth Brain​​​‌ Connectivity Trajectories 34 and​ Eigengap Sparsity for Covariance​‌ Parsimony 44.

6.2​​ Promotions

  • Marco Lorenzi was​​​‌ promoted Research Director (directeur​ de recherche de deuxième​‌ classe DR2).

6.3 Others​​

  • Nicholas Ayache was invited​​​‌ to give a plenary​ talk at the “AI,​‌ Science, and Society” conference​​ organized by the French​​ Government as part of​​​‌ the international AI Action‌ Summit program.
  • This‌​‌ year, the longstanding collaboration​​ between Nicholas Ayache and​​​‌ the Brain Institute at‌ Pitié Salpétrière (Dr. O.‌​‌ Colliot and Pr. B.​​ Stankoff) on neuroimaging and​​​‌ multiple sclerosis led to‌ the approval of a‌​‌ new patent (MyeliGAN) for​​ the generation of synthetic​​​‌ 3D representations of myelin‌ content 64.
  • Following‌​‌ his recruitement last year​​ as Chargé de recherche​​​‌ de classe normale (CRCN)‌ Benjamin Billot was the‌​‌ recipient of the Idex​​ attractivity package (R2D2 -​​​‌ Talents Welcome Package) by‌ the Université Côte d'Azur‌​‌ for his research on​​ domain randomization for medical​​​‌ image analysis.
  • Marco Lorenzi‌ published with Maria Zualuaga‌​‌ (Eurecom) the book “Trustworthy​​ AI in Medical Imaging”,​​​‌ Elsevier, January 2025 52‌. This book brings‌​‌ together researchers, medical experts,​​ and industry partners and​​​‌ aims at tackling trustworthiness‌ while bridging the gap‌​‌ between AI research and​​ concrete medical applications.
  • Maxime​​​‌ Sermesant is a founding‌ member of the newly‌​‌ created Society for Artificial​​ Intelligence in Biomedical Imaging​​​‌ (IABM).

7‌ Latest software developments, platforms,‌​‌ open data

7.1 Latest​​ software developments

7.1.1 MedINRIA​​​‌

  • Name:
    medInria Suite
  • Keywords:‌
    Visualization, DWI, Health, Segmentation,‌​‌ Medical imaging, Python, Web​​ Application, Image registration
  • Scientific​​​‌ Description:
    MedInria aims at‌ creating an easily extensible‌​‌ platform for the distribution​​ of research algorithms developed​​​‌ at Inria for medical‌ image processing. This project‌​‌ has been funded by​​ the D2T (ADT MedInria-NT)​​​‌ in 2010, renewed in‌ 2012. A fast-track ADT‌​‌ was awarded in 2017​​ to transition the software​​​‌ core to more recent‌ dependencies and study the‌​‌ possibility of a consortium​​ creation.The Empenn team leads​​​‌ this Inria national project‌ and participates in the‌​‌ development of the common​​ core architecture and features​​​‌ of the software as‌ well as in the‌​‌ development of specific plugins​​ for the team's algorithm.​​​‌
  • Functional Description:
    medInria is‌ a software platform for‌​‌ the visualisation and processing​​ of medical images. MedInria​​​‌ aims to disseminate Inria's‌ research results in medical‌​‌ imaging to clinical, industrial​​ and academic circles. It​​​‌ is now a suite‌ that also includes a‌​‌ Python command line version​​ and a web version.​​​‌
  • Release Contributions:
    Python integration,‌ updated dependencies
  • News of‌​‌ the Year:
    New release​​ this year with Python​​​‌ integration and updated dependencies.‌
  • URL:
  • Contact:
    Maxime‌​‌ Sermesant
  • Participants:
    Maxime Sermesant,​​ Olivier Commowick
  • Partners:
    HARVARD​​​‌ Medical School, IHU -‌ LIRYC, NIH

7.1.2 Music‌​‌

  • Name:
    Multi-modality Platform for​​ Specific Imaging in Cardiology​​​‌
  • Keywords:
    Medical imaging, Cardiac‌ Electrophysiology, Computer-assisted surgery, Cardiac,‌​‌ Health
  • Functional Description:
    MUSIC​​ is a software developed​​​‌ by the Asclepios research‌ project in close collaboration‌​‌ with the IHU LIRYC​​ in order to propose​​​‌ functionalities dedicated to cardiac‌ interventional planning and guidance.‌​‌ This includes specific tools​​ (algorithms of segmentation, registration,​​​‌ etc.) as well as‌ pipelines. The software is‌​‌ based on the MedInria​​ platform.
  • News of the​​​‌ Year:
    new version with‌ new visualisation tools and‌​‌ updated python integration
  • URL:​​
  • Contact:
    Maxime Sermesant​​​‌
  • Participants:
    Florent Collot, Mathilde‌ Merle, Maxime Sermesant
  • Partner:‌​‌
    IHU- Bordeau

7.1.3 geomstats​​​‌

  • Name:
    Computations and statistics​ on manifolds with geometric​‌ structures
  • Keywords:
    Geometry, Statistic​​ analysis
  • Scientific Description:

    Geomstats​​​‌ is an open-source Python​ package for computations and​‌ statistics on manifolds. The​​ package is organized into​​​‌ two main modules: “geometry“​ and “learning“.

    The module​‌ `geometry` implements concepts in​​ differential geometry, and the​​​‌ module `learning` implements statistics​ and learning algorithms for​‌ data on manifolds.

    The​​ goal is to provide​​​‌ an easily accessible library​ for learning algorithms on​‌ Riemannian manifolds.

  • Functional Description:​​
    GeomStats is a Python​​​‌ package that performs computations​ on manifolds such as​‌ hyperspheres, hyperbolic spaces, spaces​​ of symmetric positive definite​​​‌ matrices and Lie groups​ of transformations. It provides​‌ efficient and extensively unit-tested​​ implementations of these manifolds,​​​‌ together with useful Riemannian​ metrics and associated Exponential​‌ and Logarithm maps. The​​ corresponding geodesic distances provide​​​‌ a range of intuitive​ choices of Machine Learning​‌ loss functions. The operations​​ implemented in GeomStats are​​​‌ available with different computing​ backends such as numpy,​‌ autograd, pytorch, and tensorflow.​​
  • Release Contributions:
    - addition​​​‌ of several metrics on​ the space of full-rank​‌ correlation matrices taking advantage​​ of diffeomorphism class, existing​​​‌ Riemannian manifolds, and/or quotient​ space structure - refactoring​‌ of quotient structure in​​ order to treat landmarks,​​​‌ curves, and shapes in​ an homogenized way, improvement​‌ of alignment algorithms in​​ those spaces - addition​​​‌ of varifold metric (on​ surfaces) by leveraging pykeops​‌ - full refactoring of​​ geodesic metric spaces: graph​​​‌ space, wald and BHV​ spaces, and spider (NB:​‌ only BHV explicitly takes​​ advantage of quotient structure,​​​‌ so the renaming) -​ improvement of numerics: better​‌ objects to handle optimization,​​ initial/boundary value problems, finite​​​‌ differences, and interpolation
  • News​ of the Year:
    The​‌ python package geomstats has​​ been enhanced in 2025​​​‌ with several types of​ log-Euclidean metrics on full​‌ rank correlation matrices. This​​ involved an important restructuration​​​‌ to allow the efficient​ use of pull-back and​‌ push-forward metrics between different​​ spaces. Application results to​​​‌ the modeling of the​ functional brain connectomes were​‌ published at GSI 2025​​ (O. Bisson, Y. Aeschlimann,​​​‌ S. Deslauriers-Gauthier, and X.​ Pennec. Log-Euclidean Frameworks for​‌ Smooth Brain Connectivity Trajectories.​​ In GSI'25 - Int.​​​‌ Conf. on Geometric Science​ of Information, Saint-Malo (France),​‌ France, October 2025).
  • URL:​​
  • Publications:
  • Contact:​​
    Xavier Pennec
  • Participants:
    Olivier​​​‌ Bisson, Xavier Pennec, Yann​ Thanwerdas, Luis Pereira, Anna​‌ Calissano, Elodie Maignant, Nina​​ Miolane, Alice Le Brigant​​​‌
  • Partners:
    University of California​ Santa Barbara, Université Panthéon-Sorbonne​‌

7.1.4 Fed-BioMed

  • Name:
    A​​ general software framework for​​​‌ federated learning in healthcare​
  • Keywords:
    Federated learning, Medical​‌ applications, Machine learning, Distributed​​ Applications, Deep learning
  • Scientific​​​‌ Description:
    While data in​ healthcare is produced in​‌ quantities never imagined before,​​ the feasibility of clinical​​​‌ studies is often hindered​ by the problem of​‌ data access and transfer,​​ especially regarding privacy concerns.​​​‌ Federated learning allows privacy-preserving​ data analyses using decentralized​‌ optimization approaches keeping data​​ securely decentralized. There are​​​‌ currently initiatives providing federated​ learning frameworks, which are​‌ however tailored to specific​​ hardware and modeling approaches,​​ and do not provide​​​‌ natively a deployable production-ready‌ environment. To tackle this‌​‌ issue, Fed-BioMed proposes an​​ open-source federated learning frontend​​​‌ framework with application in‌ healthcare. Fed-BioMed framework is‌​‌ based on a general​​ architecture accommodating for different​​​‌ models and optimization methods‌
  • Functional Description:

    Fed-BioMed software‌​‌ offers a distributed architecture​​ enabling machine learning in​​​‌ healthcare multi-centric studies with‌ a specific focus on‌​‌ real world use cases​​ requirements :

    - usability​​​‌ : compatible with PyTorch,‌ scikit-learn, MONAI , easy‌​‌ control via Jupyter notebook​​ interactive console , experiment​​​‌ control - security :‌ secured communications, model verification,‌​‌ secure aggregation, differential privacy​​ - hospital control and​​​‌ governance

  • News of the‌ Year:
    - Deployment of‌​‌ Secured Aggregation Schemes -​​ Redesign of Federated Dataset​​​‌ - Improve packaging and‌ portability
  • URL:
  • Publication:‌​‌
  • Contact:
    Marco Lorenzi​​
  • Partner:
    Université Côte d'Azur​​​‌ (UCA)

8 New results‌

8.1 Medical Image Analysis‌​‌ & Machine Learning

8.1.1​​ Prostate Cancer Detection and​​​‌ Characterization from multiparametric MRI‌

This work was funded‌​‌ by the AICOO and​​ DAICAP project in the​​​‌ scope of the Inria‌ APHP joint Bernouilli laboratory‌​‌ .

Keywords: Prostate cancer​​ detection; prostate cancer characterization​​​‌.

Participants: Florencia Boccarato‌, Fahym Bounazou,‌​‌ Hye Lim Lee,​​ Raphaele Renard-Penna, Hervé​​​‌ Delingette [Correspondant].

  • Preprocessing‌ of multiparametric MRI is‌​‌ essential for automated prostate​​ cancer detection. We propose​​​‌ a method to synthesize‌ high b-value diffusion weighted‌​‌ images (DWI) from standard​​ multi-b DWI using an​​​‌ optimized fusion of the‌ apparent diffusion coefficient (ADC)‌​‌ maps (see Fig. 4​​). Evaluations show improved​​​‌ lesion contrast, anatomical detail,‌ and overall image quality‌​‌ compared with vendor-synthesized images,​​ while remaining simple, interpretable,​​​‌ and suitable for multicenter‌ datasets.
  • Accurate localization of‌​‌ prostate tumors on multiparametric​​ MRI (mpMRI) is important​​​‌ for diagnosis, treatment planning‌ and communication between urologists,‌​‌ radiologists and pathologists. We​​ propose a data-driven approach​​​‌ to automatically determine the‌ main prostate sector associated‌​‌ with a given lesion.​​ We evaluate the optimized​​​‌ sectorization against the PI-RADS‌ v1 and v2.1 standards.‌​‌
  • We have worked on​​ the collection and curation​​​‌ of the multi-centric database‌ DAICAP involving 8 different‌​‌ university hospitals in France.​​ We have developed quality​​​‌ control processes and started‌ processing the data from‌​‌ the Health Data Hub.​​

Figure
Figure 4: Pipeline​​​‌ of acquisition-aware high-b‌ DWI synthesis.

The image‌​‌ depicts a flowchart for​​ synthesizing high b-value DWI​​​‌ in prostate multiparametric MRI‌ (mpMRI). It involves combining‌​‌ acquired DWI and apparent​​ diffusion coefficient (ADC) maps​​​‌ from different sources. The‌ process includes optimization steps‌​‌ to generate a synthesized​​ high b-value DWI image,​​​‌ incorporating lesion masks when‌ available. The flowchart details‌​‌ the linear regression to​​ derive ADC maps, their​​​‌ combination, and the synthesis‌ of the final DWI‌​‌ b* image.

8.1.2 Analysis​​ of European National Health​​​‌ data to study the‌ outcomes of patients with‌​‌ vascular diseases

This work​​ was partially funded by​​​‌ 3IA Côte d'Azur.

Keywords:‌ Data extraction; SNDS; Causal‌​‌ inference.

Participants: Amel​​ Bakhouche [Correspondant], Hervé​​​‌ Delingette, Juliette Raffort-Lareyre‌, Irene Balelli.‌​‌

Clinical outcomes after varicose​​​‌ vein surgery remain heterogeneous​ and difficult to predict.​‌ We developed ML models​​ on the QUALIVEIN cohort,​​​‌ a French vascular database​ that prospectively collects detailed​‌ operative information on patients​​ treated for chronic venous​​​‌ insufficiency (CVI), to predict​ 90-day clinical improvement and​‌ identify key predictors (see​​ Fig. 5).

We​​​‌ are now analyzing data​ from the Système National​‌ des Données de Santé​​ (SNDS), extracting a 10-year​​​‌ cohort to predict short-​ and long-term outcomes, study​‌ the evolution of surgical​​ techniques, and assess their​​​‌ impact using causal inference​ methods.

Figure
Figure 5:​‌ Feature importance plot showing​​ the most influential variables​​​‌ for the Random Forest​ model. BMI= Body Mass​‌ index; CEAP= Clinical, Etiological,​​ Anatomical, and Pathophysiological (CEAP)​​​‌ classification; VCSS= Venous Clinical​ Severity score.

The image​‌ is a horizontal bar​​ chart showing the mean​​​‌ importance of different features​ in a dataset. The​‌ y-axis lists the features:​​ PatientSurgeryCEAP, PatientSurgeryVCSS, BMI, ageatsurgery,​​​‌ and PatientSurgeryphlebectomies. The x-axis​ represents mean importance, ranging​‌ from 0 to 0.25.​​ PatientSurgeryCEAP has the highest​​​‌ importance, followed by PatientSurgeryVCSS,​ BMI, ageatsurgery, and PatientSurgeryphlebectomies​‌ in descending order of​​ importance.

8.1.3 Spatial regularization​​​‌ for improved accuracy and​ interpretability in keypoint-based registration​‌

This work has been​​ funded by the French​​​‌ government, through the 3IA​ Cote d'Azur Investments in​‌ the project managed by​​ the National Research Agency​​​‌ (ANR) with the reference​ number ANR-23-IACL-0001. Further support​‌ has come from NIH​​ NIBIB 1R01EB036945, NIH NICHD​​​‌ 1R01HD114338, NIH NIBIB 1R01EB032708,​ MIT Jameel Clinic, MIT​‌ CSAIL-Wistron Program.

Keywords: Spatial​​ regularization; Interpretability; Unsupervised image​​​‌ registration.

Participants: Benjamin​ Billot [Correspondant], Ramya​‌ Muthukrishnan, Esra Abaci​​ Turk, Ellen Grant​​​‌, Nicholas Ayache,​ Hervé Delingette, Polina​‌ Golland.

  • Unsupervised keypoint-based​​ registration seeks to improve​​​‌ interpretability while alleviating supervision​ requirements. Yet, the extracted​‌ features often are hardly​​ interpretable, thus undermining the​​​‌ purpose of this very​ method.
  • We propose a​‌ three-fold loss to regularize​​ the features' spatial distributions:​​​‌ a Kullback-Leibler (KL) divergence​ to model features as​‌ interpretable point spread functions,​​ a Frobenius norm on​​​‌ the spatial covariance for​ sharpness, and a novel​‌ repulsive loss to encourage​​ spatial diversity in keypoints​​​‌ (Fig. 6).
  • This​ regularization greatly improves the​‌ interpretability of the keypoints,​​ as well as the​​​‌ overall accuracy of unsupervised​ keypoint-based registration by now​‌ bridging the gap with​​ state-of-the-art supervised methods 33​​​‌.
  • This work is​ a collaboration between Inria,​‌ MIT CSAIL, and the​​ Boston Children's Hospital.

Figure
Figure​​​‌ 6: (A) Registration​ by unsupervised keypoint detection.​‌ Beyond the classical similarity​​ loss between fixed and​​​‌ moved volumes (leading to​ features comparable to B,left),​‌ we propose a three-fold​​ spatial regularization, whose effects​​​‌ on the features/keypoints are​ depicted in (B-D): interpretability,​‌ precision, and diversity.

This​​ image illustrates a deep​​​‌ learning model used for​ brain image registration. First,​‌ fixed and moving brain​​ images are processed through​​​‌ shared-weight convolutional neural networks.​ These networks extract features​‌ from which centers of​​ mass are computed. These​​​‌ are then used to​ compute an affine transform,​‌ aligning the moving image​​ to the fixed image.​​ Several loss functions guide​​​‌ the alignment process. The‌ transformed image is compared‌​‌ to the fixed image​​ to compute the similarity​​​‌ loss. The lower illustrations‌ depict how each loss‌​‌ function impacts feature representation.​​

8.1.4 Resource-efficient Automatic Refinement​​​‌ of Segmentations via Weak‌ Supervision from Light Feedback‌​‌

This work was supported​​ by an Inserm-Inria funding.​​​‌

Keywords: Weak supervision; Efficient‌ segmentation correction; Reaching clinical‌​‌ accuracy.

Participants: Alix​​ de Langlais [Correspondant],​​​‌ Benjamin Billot, Marc-Olivier‌ Gauci, Hervé Delingette‌​‌.

Foundation models enable​​ automated segmentation but may​​​‌ sometimes fail to reach‌ clinical accuracy. Existing refinement‌​‌ methods, however, require either​​ strong supervision or extensive​​​‌ user interaction. To address‌ this, we present SCORE,‌​‌ a weakly supervised framework​​ that refines segmentations using​​​‌ only light feedback based‌ on region wise quality‌​‌ scores and segmentation error​​ labels (Fig. 7).​​​‌ On humerus CT scans,‌ SCORE improves TotalSegmentator performance‌​‌ while greatly reducing annotation​​ effort.

Figure
Figure 7:​​​‌ Overview of SCORE, our‌ weakly supervised framework to‌​‌ refine segmentation from an​​ external tool using only​​​‌ light feedback. The network‌ takes as input a‌​‌ 3D image, its initial​​ segmentation, and a probability​​​‌ map for additional edge‌ priors.

The image illustrates‌​‌ a medical image segmentation​​ process. It starts with​​​‌ an input image processed‌ by an external segmentation‌​‌ tool's foundation model to​​ produce an initial segmentation.​​​‌ This is refined using‌ the SCORE (Segmentation Correction‌​‌ and Refinement) method, which​​ involves a probability edge​​​‌ detector creating a probability‌ map, further refined by‌​‌ a 3D UNet into​​ a refined segmentation. Weak​​​‌ supervision then evaluates the‌ quality score and labels‌​‌ errors as under-segmentation, over-segmentation,​​ or both, contributing to​​​‌ a weak supervision loss‌ for further training.

8.1.5‌​‌ Segmentation of Fractured Bones​​ from CT

This work​​​‌ was funded by the‌ French National Research Agency‌​‌ (ANR), through the project​​ RHU ReBone ANR-23-RHUS-0011

Keywords:​​​‌ Bone fractures; CT imaging‌.

Participants: Hervé Delingette‌​‌ [Correspondant], Hari Sreedhar​​, Marc-Olivier Gauci.​​​‌

The project RHU ReBone‌ is a research initiative‌​‌ aiming to improve pre-operative​​ planning of surgical reduction​​​‌ in complex fracture cases‌ of traumatic bone fractures.‌​‌ The contributions of Work​​ Package 1 in 2025​​​‌ were to:

  • Help establish‌ the inclusion criteria and‌​‌ descriptions of the three​​ fracture types of interest​​​‌ (distal radius fractures, tibial‌ plateau fractures, and acetabular‌​‌ fractures)
  • Prepare the documentation​​ and data management plans​​​‌ for compliance with GDPR‌ regulations concerning the use‌​‌ of medical data
  • Initiate​​ the automatic segmentation algorithms​​​‌ of bone fragments and‌ for initial fracture reduction‌​‌ planning

8.1.6 TBDM: Temporal​​ Boundary Distillation Module for​​​‌ Surgical Gesture Segmentation

This‌ work was funded by‌​‌ 3IA Cote d'Azur.

Keywords:​​ Surgical gesture segmentation; Action​​​‌ boundary modeling; Knowledge distillation‌.

Participants: Ezem Sura‌​‌ Ekmekci [Correspondant], Sebastien​​ Frey, Snehashis Majhi​​​‌, Khodor Hamadi,‌ Hervé Delingette, Matthieu‌​‌ Durand, Pierre Berthet-Rayne​​, François Bremond,​​​‌ Nicholas Ayache.

  • Collaboration:‌ This work was conducted‌​‌ in collaboration between Inria,​​ CHU Nice, and Caranx​​​‌ Medical.
  • Challenge Addressed: Developed‌ a solution for precise‌​‌ temporal localization of surgical​​​‌ gesture boundaries and transitions​ in robot-assisted surgery videos​‌ 19.
  • Key Innovation:​​ Introduced the Temporal Boundary​​​‌ Distillation Module (TBDM), a​ framework that explicitly models​‌ action transitions using RGB-only​​ video without requiring kinematic​​​‌ data or additional annotations.​
  • Technical Approach: Implemented knowledge​‌ distillation with cross-attention mechanisms​​ to learn boundary-aware features​​​‌ during training, with zero​ computational overhead at inference​‌ (Fig. 8).
  • Validation​​ and Results: Our method​​​‌ achieved up to 8.5​ edit score improvement on​‌ CholecT50 dataset. It also​​ obtained state-of-the-art performance on​​​‌ RARP-45 (81.4 edit score,​ 77.9 F1-50), and demonstrated​‌ consistent improvements across multiple​​ baseline architectures.
  • Impact: Created​​​‌ a generalizable, plug-and-play framework​ applicable to various surgical​‌ video analysis tasks.

Figure
Figure​​ 8: Overview of​​​‌ TBDM framework for Surgical​ Gesture Segmentation. During training,​‌ the boundary blocks generate​​ boundary-aware features to guide​​​‌ the projection layer. During​ inference, only the trained​‌ projection layer is used,​​ adding no extra cost,​​​‌ while achieving significant boundary​ precision in segmentation.

The​‌ image depicts a machine​​ learning framework for gesture​​​‌ recognition. It starts with​ pre-trained VideoMAE-v2 processing input​‌ video frames. The extracted​​ features go through a​​​‌ projection layer and a​ temporal model to predict​‌ gestures. During training, a​​ Temporal Boundary Distillation Module​​​‌ enhances learning by using​ class presence maps and​‌ cross-attention mechanisms. This module,​​ with trainable parameters, aggregates​​​‌ gesture classes and refines​ predictions using class boundary​‌ distillation.

8.1.7 Multi-stage CNN​​ for fast registration of​​​‌ 3D preoperative CTs to​ 2D intraoperative X-rays

This​‌ work was funded by​​ 3IA Cote d'Azur.

Keywords:​​​‌ Pose estimation; Multi-stage CNN;​ Image guidance.

Participants:​‌ Federica Facente [Correspondant],​​ Benjamin Billot, Vivek​​​‌ Gopalakrishnan, Manasi Kattel​, Wen Wei,​‌ Polina Golland, Hervé​​ Delingette, Nicholas Ayache​​​‌, Pierre Berthet-Rayne.​

In this work, we​‌ present LXPose (Live X-Ray​​ Pose Estimation) 50,​​​‌ a real-time multi-stage convolutional​ neural network (CNN) for​‌ accurate registration of 3D​​ preoperative CTs with 2D​​​‌ intraoperative X-rays. The method​ estimates the X-ray source​‌ pose to generate a​​ synthetic X-ray from the​​​‌ CT that best aligns​ with the input image,​‌ as illustrated in Fig.​​ 9A. This is​​​‌ achieved using a multi-stage​ CNN that progressively estimates​‌ the pose of the​​ C-arm in the CT​​​‌ scanner's coordinate system (Fig.​ 9B).

Figure
Figure 9​‌: (A) Method overview.​​ LXPose performs CT/X-ray registration​​​‌ by progressively estimating the​ pose of the X-ray​‌ source from which 2D​​ projections of the CT​​​‌ best align with the​ input X-ray. (B) LXPose​‌ architecture. A first CNN​​ regresses the pose parameters​​​‌ from a 2D input​ image. This initial pose​‌ is then used to​​ simulate a corresponding synthetic​​​‌ X-ray. Finally, the latter​ is used by a​‌ second CNN along with​​ the input image to​​​‌ predict a corrective term​ for final pose estimation.​‌

The image consists of​​ two parts, A and​​​‌ B, illustrating a medical​ imaging process involving X-ray​‌ and CT scans. Part​​ A shows an initial​​​‌ pose of an X-ray​ source relative to a​‌ 3D CT scan volume.​​ The process involves generating​​ a synthetic X-ray image​​​‌ from the initial pose,‌ comparing it to a‌​‌ target X-ray image, and​​ refining the X-ray source​​​‌ position to match the‌ target image better. Part‌​‌ B details a neural​​ network-based refinement method. It​​​‌ starts with a 2D‌ input image and uses‌​‌ convolutional neural networks (CNNs)​​ to predict pose adjustments.​​​‌ These adjustments refine the‌ initial synthetic X-ray image,‌​‌ aiming to reduce discrepancies​​ with the target X-ray​​​‌ image. The refined synthetic‌ X-ray is then generated‌​‌ using an X-ray simulator​​ and compared to the​​​‌ target X-ray to finalize‌ the pose estimation.

8.1.8‌​‌ Exploring Variability in Medical​​ Image Segmentation: New Metrics​​​‌ and Frameworks

This work‌ was funded by the‌​‌ MediTwin project and supported​​ by the French government​​​‌ under the France 2030‌ initiative.

Keywords: Interobserver variability;‌​‌ Medical image segmentation; Deep​​ learning.

Participants: Bernhard​​​‌ Föllmer [Correspondant], Hervé‌ Delingette.

The aim‌​‌ of this project is​​ to develop a statistical​​​‌ framework and novel metrics‌ for assessing interobserver variability‌​‌ in medical image segmentation.​​ The project consists of​​​‌ three pillars (Fig. 10‌):

  • Develop novel segmentation‌​‌ metrics for multi-rater comparison​​
  • Develop MaskStat—an open-source toolkit​​​‌ for segmentation statistics
  • Evaluate‌ metrics in real-world use‌​‌ cases and provide practical​​ recommendations

The project will​​​‌ enable rigorous performance and‌ quality assessment for medical‌​‌ image segmentation in the​​ presence of multiple observers.​​​‌

Figure
Figure 10: Overview‌ of the three project‌​‌ pillars: (1) development of​​ novel segmentation metrics for​​​‌ interobserver comparison, (2) MaskStat,‌ an open-source toolkit for‌​‌ segmentation statistics, and (3)​​ evaluation in practical applications​​​‌ and formulation of recommendations.‌

The image outlines a‌​‌ process for developing novel​​ segmentation metrics for multi-rater​​​‌ comparisons. It includes three‌ key steps: 1) Developing‌​‌ metrics by comparing multi-rater​​ segmentations and model predictions,​​​‌ 2) Introducing MaskStat, an‌ open-source toolkit for segmentation‌​‌ statistics to facilitate this​​ analysis, and 3) Applying​​​‌ these metrics in practical‌ scenarios for real-world use,‌​‌ showcasing various segmented images.​​

8.1.9 AI-based precision oncology​​​‌ to monitor response of‌ metastatic cancer to immunotherapy‌​‌ using PET/CT imaging

This​​ work was funded by​​​‌ 3IA Côte d'Azur.

Keywords:‌ Immunotherapy; PET/CT imaging; Precision‌​‌ oncology; Artificial intelligence.​​

Participants: Giulia Foroni [Correspondant]​​​‌, Marco Lorenzi,‌ Olivier Humbert.

This‌​‌ is a collaborative project​​ between INRIA and CAL.​​​‌ The goal is to‌ predict survival outcomes of‌​‌ metastatic cancer patients treated​​ with immunotherapy (Fig. 11​​​‌). During the first‌ part of this project,‌​‌ we reviewed classical survival​​ models in both static​​​‌ and longitudinal settings using‌ data from CAL center,‌​‌ and we started examining​​ advanced approaches to survival​​​‌ analysis:

  • Development of end-to-end‌ clustering pipelines integrated with‌​‌ survival analysis.
  • Structuring the​​ data through graph-based representations.​​​‌

Figure
Figure 11: Pipeline‌ for cox proportional hazards‌​‌ model on static and​​ longitudinal tabular data.

The​​​‌ image depicts a workflow‌ for predicting survival functions‌​‌ using PET/CT scans and​​ clinical data. It shows​​​‌ feature extraction from longitudinal‌ PET/CT images, processing these‌​‌ features through a Latent​​ Space and an LSTM​​​‌ (Long Short-Term Memory) model,‌ combining with tabular clinical‌​‌ data, and finally applying​​​‌ a Cox model to​ predict survival functions.

8.1.10​‌ Development of predictive models​​ in patients with Peripheral​​​‌ Artery Disease

This work​ was partially funded by​‌ the Horizon-Europe project VASCUL-AID​​ (ID 101080947).

Keywords: Peripheral​​​‌ artery disease; Angiography; Competing​ survival modeling.

Participants:​‌ Sébastien Goffart [Correspondant],​​ Odette Hart, Fabien​​​‌ Lareyre, Lisa Guzzi​, Kak Khee Yeung​‌, Hervé Delingette,​​ Manar Khashram, Juliette​​​‌ Raffort.

We benchmarked​ six machine learning and​‌ deep learning survival models​​ to predict amputation-free survival​​​‌ in 2,366 patients with​ peripheral artery disease undergoing​‌ revascularization 20. Non-linear​​ models achieved similar discrimination​​​‌ to Cox regression, while​ the DeepSurv model (NLCH)​‌ showed improved calibration. Competing​​ risk approaches were evaluated,​​​‌ and key clinical predictors​ were identified using SHAP-based​‌ feature importance 21.​​ Model performance is summarized​​​‌ in Figure 12.​

Figure
Figure 12: Survival​‌ model performance across five-fold​​ cross-validation in 483 patients:​​​‌ (A) discrimination assessed by​ the concordance index; (B)​‌ calibration assessed by the​​ integrated Brier score. Model​​​‌ comparisons were performed using​ Student's t-test (p >​‌ 0.05).

The image consists​​ of two tables (A​​​‌ and B) comparing several​ statistical models. Table A​‌ shows C-index values for​​ different models (CSF, CPH,​​​‌ NLCH, RSF, FG, DH)​ across five iterations, with​‌ mean and confidence intervals.​​ Table B presents Integrated​​​‌ Brier scores for the​ same models across five​‌ iterations, with mean and​​ confidence intervals. Models are​​​‌ abbreviated as follows: CPH​ (Cox proportional hazards model),​‌ CSF (conditional survival forest),​​ DH (DeepHit model), FG​​​‌ (Fine and Gray subdistribution​ hazard model), NLCH (non-linear​‌ CPH), and RSF (random​​ survival forest).

8.1.11 Automatic​​​‌ Segmentation of Lower-Limb Arteries​ on CTA for Pre-surgical​‌ Planning of Peripheral Artery​​ Disease.

This work was​​​‌ funded by 3IA Côte​ d'Azur.

Keywords: Peripheral artery​‌ disease; Image segmentation; Computed​​ tomography angiography; Deep learning​​​‌.

Participants: Lisa Guzzi​ [Correspondant], Maria A.​‌ Zuluaga, Fabien Lareyre​​, Gilles Di Lorenzo​​​‌, Sébastien Goffart,​ Andrea Chierici, Riccardo​‌ Taiello, Juliette Raffort​​, Hervé Delingette.​​​‌

Our work aims to​ develop and evaluate deep​‌ learning methods to segment​​ lower-limb arteries in peripheral​​​‌ artery disease (PAD) using​ computed tomography angiography (CTA)​‌ to support pre-surgical planning​​ (see Fig. 13).​​​‌

  • In 38, we​ proposed regional Hausdorff distance​‌ loss functions for medical​​ image segmentation, achieving state-of-the-art​​​‌ performance without auxiliary losses.​
  • In 37, we​‌ applied state-of-the-art segmentation methods​​ to automatically segment lower-limb​​​‌ arteries in CTA images​ for PAD pre-surgical planning.​‌

Figure
Figure 13: Overview​​ of the automatic segmentation​​​‌ of PAD-relevant structures on​ CTA images.

The image​‌ displays a detailed 3D​​ visualization of the lower​​​‌ limb arteries, segmented by​ type. Arteries are colored​‌ red, calcifications in blue,​​ and stents in yellow.​​​‌ Different artery types such​ as the aorta, common​‌ iliac artery, femoral artery,​​ and tibial arteries are​​​‌ each shown in distinct​ colors. Two cross-sectional CT​‌ scan images highlight arterial​​ structures and calcifications. The​​​‌ image demonstrates automatic segmentation​ of main arteries, calcifications,​‌ bypass arteries, and stents​​ in the lower limbs.​​

8.1.12 Segmentation of Abdominal​​​‌ Aortic Aneurysm from CT‌ Angiography

This work was‌​‌ partially funded by the​​ ANR project PREDICTA ANR-22-CE45-0023​​​‌

Keywords: Peripheral artery disease;‌ Angiography; Competing survival modeling‌​‌.

Participants: Jia Guo​​ [Correspondant], Fabien Lareyre​​​‌, Hervé Delingette,‌ Juliette Raffort.

We‌​‌ are developing an algorithm​​ for the segmentation of​​​‌ abdominal aortic aneurysm from‌ CT angiography which is‌​‌ essential for diagnosis, risk​​ stratification and endovascular aortic​​​‌ repair planning. Compared to‌ prior work 23,‌​‌ our objective is to​​ handle both ruptured and​​​‌ non ruptured aneuryms and‌ to extract relevant radiomics‌​‌ and geometrical features that​​ can predict surgical outcome​​​‌ (Fig. 14).

Figure
Figure‌ 14: Ground truth‌​‌ annotations of anatomical structures​​ surrounding abdominal aortic aneurysms​​​‌ used for our segmentation‌ algorithm.

The image displays‌​‌ four 3D models of​​ vascular structures. From left​​​‌ to right, the models‌ are labeled as "Private‌​‌ dataset," "AVT Site K,"​​ "AVT Site R," "AVT​​​‌ Site D," and "VascularModel."‌ Each model shows different‌​‌ sections of the vascular​​ system with varying levels​​​‌ of detail and different‌ colors, focusing primarily on‌​‌ the arterial structures. The​​ "Private dataset" model includes​​​‌ the heart and multiple‌ branching vessels with various‌​‌ colors. The "AVT" models​​ depict the aorta and​​​‌ its branches in red,‌ with minor differences in‌​‌ structure. The "VascularModel" shows​​ a more extensive network​​​‌ of blood vessels with‌ fine details in red.‌​‌

8.1.13 A Scalable Spatio-Temporal​​ Atlas of Neurodegenerative Brain​​​‌ Changes

This work was‌ funded by PEPR Santé‌​‌ Numerique (project Rewind).

Keywords:​​ Longitudinal disease progression; Neural​​​‌ cellular automata.

Participants:‌ John Kalkhof [Correspondant],‌​‌ Marco Lorenzi.

In​​ this project we developed​​​‌ SMART (Fig. 15),‌ a flexible and interpretable‌​‌ spatio-temporal brain atlas framework​​ for modeling longitudinal disease​​​‌ progression in MRI. The‌ core contribution is part‌​‌ of a scientific work​​ that introduces a model​​​‌ which:

  • Disentangles population-level disease‌ dynamics from subject-specific anatomical‌​‌ changes.
  • Learns region-wise ODE​​ trajectories with subject-specific temporal​​​‌ alignment.
  • Generates anatomically coherent,‌ diffeomorphic deformations using a‌​‌ conditioned multi-scale Neural Cellular​​ Automata.

Figure
Figure 15:​​​‌ Framework for Alzheimer's progression‌ forecasting: (A) infer disease‌​‌ stage and predict change​​ over dt; (B) apply​​​‌ region-wise signals voxelwise to‌ condition MED-NCA and estimate‌​‌ a deformation field to​​ the next timepoint; (C)​​​‌ results show expected changes,‌ notably ventricular expansion and‌​‌ hippocampal atrophy.

The image​​ presents a schematic of​​​‌ a medical imaging analysis‌ process divided into three‌​‌ parts: Progression Modeling (A),​​ Flow Prediction (B), and​​​‌ Qualitative Results (C). Part‌ A illustrates extracting progression‌​‌ features from input images​​ at time t1, producing​​​‌ a progression function. Part‌ B shows predicting flow‌​‌ by warping images and​​ calculating per voxel progression.​​​‌ Part C displays qualitative‌ results showing the difference‌​‌ between input and predicted​​ images, highlighting areas like​​​‌ ventricles and hippocampus.

8.1.14‌ MRI-TRUS prostate registration

This‌​‌ work was funded by​​ the French government, through​​​‌ the 3IA Cote d'Azur‌ Investments in the project‌​‌ managed by the National​​ Research Agency (ANR) with​​​‌ the reference number ANR-23-IACL-0001.‌

Keywords: MRI-TRUS rigid registration;‌​‌ Learning-based regression; ICP.​​​‌

Participants: Manasi Kattel [Correspondant]​, Federica Facente,​‌ Benjamin Billot, Hervé​​ Delingette, Nicholas Ayache​​​‌.

  • MUReg is a​ fully automated pipeline for​‌ rigid MRI-TRUS registration in​​ prostate cancer biopsy 39​​​‌.
  • Translation is initialized​ by aligning prostate mask​‌ centers obtained with 3D​​ UNets. Rotation is estimated​​​‌ using an attention-based CNN​ trained on segmentations, overcoming​‌ MRI-TRUS domain gaps and​​ prostate spheroidal symmetry with​​​‌ a novel bounding box​ vertices registration erroe (BBVRE)​‌ displacement-based loss. Alignment is​​ refined using the iterative​​​‌ closest points (ICP) algorithm​ (Figure 16).
  • MUReg​‌ significantly outperforms state-of-the-art methods​​ on a large clinical​​​‌ dataset.
  • Work was done​ in collaboration with industrial​‌ partner Koelis.

Figure
Figure 16​​: Overview of the​​​‌ MUReg pipeline for 3D​ MRI-TRUS rigid registration, including​‌ segmentation-based translation initialization, attention-based​​ CNN rotation estimation from​​​‌ masks, and final refinement​ using ICP.

The image​‌ depicts a three-step process​​ for aligning medical imaging​​​‌ data. Step 1 involves​ initializing translation using 3D​‌ U-Nets to process TRUS​​ and MRI volumes. Step​​​‌ 2 estimates rotation using​ encoders and attention mechanisms.​‌ Step 3 refines alignment​​ using Iterative Closest Point​​​‌ (ICP) with mesh data​ from TRUS and MRI.​‌ The process aims to​​ improve the accuracy of​​​‌ medical image registration.

8.1.15​ Data Exfiltration and Data​‌ Anonymization

This project has​​ been supported by the​​​‌ French government, through the​ National Research Agency (ANR)​‌ 3IA Côte d'Azur and​​ IA Cluster project (ANR-19-3IA-0002​​​‌ and ANR23-IACL-0001).

Keywords: Data​ exfiltration by compression attack;​‌ Medical image anonymization; Privacy;​​ Security.

Participants: Huiyu​​​‌ Li [Correspondant], Nicholas​ Ayache, Hervé Delingette​‌.

  • We introduce a​​ novel data exfiltration attack​​​‌ (Fig. 17A), named​ Data Exfiltration by Compression​‌ 25 to reveal the​​ potential data leackage from​​​‌ a healthcare data lake.​
  • We address the medical​‌ image anonymization problem with​​ a two-stage solution (Fig.​​​‌ 17B): latent code​ projection and optimization 40​‌ to protect the data​​ privacy from the outset.​​​‌

Figure
Figure 17: A.​ Privacy Threats and Protection​‌ in Data Lake. For​​ the Data Exfiltration Attack,​​​‌ the attacker first encodes​ the target data into​‌ compression codes Z. Then,​​ the codes and the​​​‌ network are exported. Finally,​ a decoder decompresses the​‌ codes to reconstruct the​​ original data. B. Overview​​​‌ of the proposed method,​ comprising two main stages:​‌ (1) latent code projection,​​ and (2) Latent code​​​‌ optimization to balance the​ trade-off between utility preservation​‌ and privacy protection.

The​​ image illustrates two processes​​​‌ related to medical image​ data security. (A) depicts​‌ medical image that are​​ compressed within a secure​​​‌ data lake and sent​ to an attacker, who​‌ then decompresses it to​​ restore its original form.​​​‌ (B) demonstrates the anonymization​ process of a chest​‌ X-ray. This image is​​ projected into a latent​​​‌ space for optimization. The​ optimized result provides a​‌ balance between privacy and​​ utility, ensuring anonymized images​​​‌ retain sufficient useful information.​

8.1.16 Lung Cancer Risk​‌ Prediction From a Single​​ Low-Dose Chest Computed Tomography​​​‌

Keywords: Lung cancer risk;​ Low-dose computed tomography (LDCT);​‌ Deep learning.

Participants:​​ Huiyu Li [Correspondant],​​ Benjamin Billot, Rima​​​‌ Guettache, Maud Collomb‌, Adeline Champrigaud,‌​‌ Isabelle Calléa, Julien​​ Dinkel, Charles Marquette​​​‌, Hervé Delingette.‌

  • We employ a validated‌​‌ deep learning model (Sybil)​​ to estimate lung cancer​​​‌ risk over a 6-year‌ horizon using three real-world‌​‌ hospital datasets (Fig. 18​​).
  • We conduct a​​​‌ comprehensive analysis of the‌ prediction results to identify‌​‌ patients who may benefit​​ from increased clinical attention​​​‌ and follow-up.

Figure
Figure 18‌: Overview of the‌​‌ Lung Cancer Risk Prediction​​ Project.

The image is​​​‌ a flowchart illustrating a‌ medical risk prediction and‌​‌ analysis system for lung​​ disease using CT scans.​​​‌ It starts with input‌ images from various datasets,‌​‌ processed by a ResNet-18​​ Encoder to extract features.​​​‌ These features undergo max‌ pooling 3D for global‌​‌ features and guided attention​​ for attention features. The​​​‌ hazard layer then predicts‌ risk, resulting in a‌​‌ risk score and a​​ highlighted area on the​​​‌ scan. Analysis includes risk‌ stratification and progression analysis.‌​‌ Finally, clinicians validate the​​ results for clinical decisions.​​​‌

8.1.17 Thyrosonics

This project‌ has received funding through‌​‌ BoostUrCAreer from the European​​ Union's Horizon 2020 research​​​‌ and innovation program under‌ grant agreement 847581. It‌​‌ has been co-funded by​​ the Region Provence-Alpes-Côte d'Azur​​​‌ and IDEX UCA/JEDI.

Keywords:‌ Thyroid Cancer; Ultrasound.‌​‌

Participants: Hari Sreedhar [Correspondant]​​, Hervé Delingette,​​​‌ Guillaume Lajoinie, Charles‌ Raffaelli.

  • This project‌​‌ investigates diverse aspects of​​ thyroid ultrasound, including inter-expert​​​‌ variability
  • A multi-center study‌ of thyroid ultrasound was‌​‌ conducted, and submitted to​​ the European Thyroid Journal.​​​‌

Figure
Figure 19: Examples‌ of thyroid nodule images‌​‌ generating inter-expert variability, here​​ in the case of​​​‌ describing echogenicity.

The image‌ contains two ultrasound scans,‌​‌ each with a green​​ square highlighting a specific​​​‌ area. Text overlays indicate‌ expert opinions on the‌​‌ echogenicity of the highlighted​​ regions. On the left​​​‌ scan, experts describe the‌ area as hyper-/isoechoic, hypoechoic,‌​‌ hyper-/isoechoic, and hypoechoic. On​​ the right scan, the​​​‌ same area is described‌ as hypoechoic, hypoechoic, hyper-/isoechoic,‌​‌ and very hypoechoic.

8.1.18​​ Mitigating Data Exfiltration Attacks​​​‌ through Layer-Wise Learning Rate‌ Decay Fine-Tuning

This work‌​‌ was supported by Région​​ Sud and France 2030​​​‌ through the I-Démo project‌ PLICIA, and by the‌​‌ French National Research Agency​​ (ANR) under the IA​​​‌ Cluster project ANR-23-IACL-0001.

Keywords:‌ Data lake security; Data‌​‌ exfiltration mitigation.

Participants:​​ Elie Thellier [Correspondant],​​​‌ Huiyu Li, Nicholas‌ Ayache, Hervé Delingette‌​‌.

We study data​​ exfiltration attacks in medical​​​‌ data lake-trained models, where‌ adversaries embed latent patient‌​‌ information into model parameters​​ for later reconstruction. We​​​‌ propose a new method‌ to mitigate those attacks‌​‌ that can be applied​​ before any model export.​​​‌ It is based on‌ fine-tuning with a decaying‌​‌ layer-wise learning rate that​​ corrupts embedded data while​​​‌ preserving task performance 46‌ (Fig. 20). Experiments‌​‌ show strong robustness against​​ state-of-the-art attacks.

Figure
Figure 20​​​‌: Overview of the‌ export-time mitigation of data‌​‌ exfiltration. A data lake-trained​​ model may encode both​​​‌ utility and private data.‌ Layer-wise learning rate decay‌​‌ fine-tuning applied at export​​​‌ disrupts memorization while preserving​ task performance, yielding a​‌ usable model without reconstruction​​ ability.

The image depicts​​​‌ a data protection process.​ It shows a "Data​‌ Lake" with a malicious​​ model that can exfiltrate​​​‌ data, identified by checkmarks​ for utility and data​‌ exfiltration. The malicious model​​ undergoes "Export-Time Mitigation" through​​​‌ a technique called "Layer-Wise​ LR Decay FT," where​‌ learning rates (LR) in​​ different layers (from high​​​‌ to low) are adjusted.​ This process produces a​‌ "Sanitized Model" that retains​​ utility but prevents data​​​‌ exfiltration.

8.1.19 Disease Progression​ Modeling and Stratification for​‌ detecting sub-trajectories in the​​ natural history of pathologies​​​‌

The work has been​ supported by the Michael​‌ J. Fox Foundation for​​ Parkinson's Research (MJFF), and​​​‌ to the French government,​ through the 3IA Côte​‌ d'Azur Investments in the​​ Future project managed by​​​‌ the National Research Agency​ (ANR) with the reference​‌ number ANR-19-P3IA- 0002, by​​ the TRAIN project ANR-22-FAI1-0003-02,​​​‌ and by the ANR​ JCJC project Fed-BioMed 19-CE45-0006-01.​‌

Keywords: Disease progression modeling;​​ Expectation maximization; Disease subtyping​​​‌.

Participants: Alessandro Viani​, Emile d'Angremont,​‌ Boris Gutman, Marco​​ Lorenzi [Correspondant].

  • Development​​​‌ of the Disease Progression​ Modeling and Stratification (DPMoSt)​‌ method, designed to analyze​​ biomarker sensitivity in subpopulations.​​​‌
  • Application of DPMoSt to​ the Parkinson's disease on​‌ both ENIGMA and PPMI​​ datasets.
  • Application of DPMoSt​​​‌ to the Alzheimer's disease​ on ADNI dataset. Notably,​‌ this analysis revealed an​​ association between APOE4 and​​​‌ accelerated cognitive decline (Fig.​ 21).
  • Presentation of​‌ the results at the​​ Longitudinal Disease Tracking and​​​‌ Modeling with Medical Images​ and Data workshop, part​‌ of the MICCAI conference.​​

Figure
Figure 21: DPMoSt-estimated​​​‌ biomarker trajectories derived from​ the ADNI dataset. The​‌ y-axis represents biomarker severity,​​ while the x-axis denotes​​​‌ re-parameterized time. Dots indicate​ individual longitudinal measurements for​‌ each subject. Solid lines​​ show the estimated trajectories,​​​‌ with shaded bands representing​ standard deviations. Colors distinguish​‌ the two subtypes identified​​ by the model. Each​​​‌ plot title displays the​ probability of biomarker specificity​‌ for the corresponding subtype.​​

The image displays scatter​​​‌ plots showing the progression​ of biomarker severity over​‌ time to conversion (in​​ years) for slow and​​​‌ fast progressors in Alzheimer's​ disease. Each plot represents​‌ a different biomarker: Hippocampus,​​ Ventricles, Entorhinal, ADAS11, FAQ,​​​‌ AV45, FDG, MMSE, CDRSB,​ MOCA. The plots show​‌ trends and confidence intervals​​ for both groups, highlighting​​​‌ the difference in biomarker​ severity progression between them.​‌

8.2 Imaging & Phenomics,​​ Biostatistics

8.2.1 Cardiac Electromechanical​​​‌ Model Sensitivity Analysis using​ Causal Discovery

This work​‌ has received funding from​​ the European Union Horizon​​​‌ 2020 Research and Innovation​ Program SimCardioTest (101016496), from​‌ the French government through​​ the National Research Agency​​​‌ (ANR) projects PEPR Digital​ Health ChroniCardio (22-PESN-0015), from​‌ ANR under the France​​ 2030 project RHU Talent​​​‌ (ANR-23-RHUS-0015), and from 3IA​ Côte d'Azur and IA​‌ Cluster (ANR-19-3IA-0002 and ANR-23-IACL-0001).​​

Keywords: Sensitivity analysis; Causal​​​‌ discovery; Electromechanical properties; Heart​ modeling.

Participants: Safaa​‌ Al-Ali [Correspondant], Jairo​​ Rodriguéz Padilla, Maxime​​​‌ Sermesant, Irene Balelli​.

In 32,​‌ we propose a causal​​ discovery-based pipeline for global​​ sensitivity analysis of a​​​‌ cardiac electromechanical model. The‌ method identifies and quantifies‌​‌ the relationships between the​​ model parameters and the​​​‌ key output of interest:‌ ejection fraction and pressure‌​‌ change in the left​​ ventricular cavity. It provides​​​‌ a precise identification of‌ the key parameters to‌​‌ be focused on, and​​ ensures stable results compared​​​‌ to classical global sensitivity‌ analysis methods, and despite‌​‌ a limited number of​​ available simulations. Figure 22​​​‌ shows the proposed sensitivity‌ analysis pipeline.

Figure
Figure 22‌​‌: Overview of the​​ proposed pipeline. Model parameters​​​‌ are sampled using Latent‌ Hypercube Sampling method (LHS)‌​‌ and the electromechanical model​​ computes the biomarkers of​​​‌ interest (the Ejection Fraction‌ and maximum pressure in‌​‌ the left ventricular cavity).​​ Prior knowledge can be​​​‌ incorporated to estimate a‌ weighted causal graph using‌​‌ the causal discovery method.​​ Causal weights obtained within​​​‌ the graph quantify sensitivity‌ and sign effects. Clustering‌​‌ and classification are finally​​ used to validate the​​​‌ causal relationships and their‌ interpretation.

The image illustrates‌​‌ a workflow for analyzing​​ electromechanical heart models using​​​‌ machine learning. It begins‌ with parameter generation (LHS),‌​‌ followed by model simulation​​ showing heart views. The​​​‌ outputs include various heart‌ function metrics. Domain knowledge‌​‌ aids in causal discovery​​ for sensitivity analysis, depicted​​​‌ as a weighted causal‌ graph with a matrix.‌​‌ Machine learning methods (Kmeans,​​ SVM, RF) validate and​​​‌ assess model data, integrating‌ insights for comprehensive analysis.‌​‌

8.2.2 Association of mtDNA​​ variants and phenotype in​​​‌ mitochondrial diseases with multi-OMICS‌ approaches

This work was‌​‌ funded by ANR MITOMICS.​​

Keywords: Machine Learning; Multi-omics;​​​‌ Mitochondrial diseases.

Participants:‌ Eléonore Birgy [Correspondant],‌​‌ Marco Lorenzi, Cécile​​ Rouzier.

Mitomics is​​​‌ a collaborative project between‌ INRIA Epione, CHU de‌​‌ Nice, CHU d'Angers et​​ Université de Nice et​​​‌ de Nantes aiming to‌ better understand mitochondrial diseases‌​‌ through the creation of​​ a multiomics data collection​​​‌ network and the development‌ of a database Mitomatcher.‌​‌ Mitochondrial diseases are heterogeneous​​ because both the nuclear​​​‌ and mitochondrial genomes are‌ involved. The goal is‌​‌ to better understand the​​ molecular mechanisms responsible for​​​‌ the clinicogenetic heterogenesis of‌ mitochondrial diseases through the‌​‌ co-occurrence of variants, multi-omics​​ data, and the use​​​‌ of innovative in silico‌ tools.

  • Work on human‌​‌ phenotype ontology (HPO, Protégé,​​ Sparql) and creation of​​​‌ clinic groups from simplified‌ ontology (Figure 23).‌​‌
  • Modeling: spectral clustering approaches​​ helps us to classify​​​‌ patients in different groups‌ corresponding to clusters, related‌​‌ with severity forms. Analysis​​ in progress with more​​​‌ included patient in the‌ database to study the‌​‌ association with genetic variants.​​
  • Multi-OMICS: adaptation and validation​​​‌ of OUTRIDER package for‌ analyzing transcriptomics data.

Figure
Figure‌​‌ 23: WP2: Spectral​​ clustering gives 2 clusters​​​‌ related to age of‌ patients and clinical pattern,‌​‌ related to different severity​​ forms of the disease.​​​‌ WP4: validation of outrider‌ to detect aberrant expression‌​‌ in control group. 2.​​

The image details a​​​‌ study on mitochondrial DNA‌ (mtDNA) variants and their‌​‌ association with clinical phenotypes​​ using spectral clustering. It​​​‌ shows clusters related to‌ age and severity of‌​‌ clinical phenotypes, specifically neuro-central​​​‌ and muscle issues, as​ well as diabetes with​‌ hearing impairment and cardio​​ symptoms. The analysis used​​​‌ the Mitomatcher database. The​ image also mentions the​‌ implementation and validation of​​ the OUTRIDER package for​​​‌ analyzing RNAseq data and​ validating aberrant expressions in​‌ diagnosed control groups.

8.2.3​​ Deciphering Fragile X Syndrome​​​‌ via Multi-Omic Integration

This​ work was funded by​‌ the Neuromod Institute.

Keywords:​​ Fragile X syndrome; Multi-omics;​​​‌ Translation; Bioinformatics.

Participants:​ Wassila Khatir [Correspondant],​‌ Irene Balelli, Marco​​ Lorenzi, Carole Gwizdek​​​‌.

We applied a​ Multi-Channel Variational Autoencoder (MCVAE)​‌ to integrate transcriptomic (TP)​​ and translatomic (TL) datasets​​​‌ from wild-type mice, aiming​ to capture physiological communication​‌ between these omic layers.​​ The model was then​​​‌ tested on Fmr1-knockout​ mice, which lack the​‌ RNA-binding protein FMRP. FMRP​​ normally regulates translation, and​​​‌ its absence leads to​ disrupted TP-TL communication, causing​‌ Fragile X Syndrome (FXS),​​ a neurodevelopmental disorder. The​​​‌ MCVAE identified anomalies reflecting​ coordinated molecular dysregulation in​‌ the knockout samples.

Key​​ findings include:

  • FMRP target​​​‌ enrichment confirmed that detected​ molecular perturbations overlap significantly​‌ with published FMRP-bound transcripts.​​
  • Functional annotation highlights indirect​​​‌ effects of Fmr1 deficiency.​
  • Pathway analysis shows enrichment​‌ in neurodevelopmental and synaptic​​ pathways, including synaptic plasticity​​​‌ and axon guidance, consistent​ with Fragile X Syndrome​‌ mechanisms.
  • The full workflow​​ and results are summarized​​​‌ in Figure 24.​

Figure
Figure 24: Multi-omic​‌ analysis of Fragile X​​ Syndrome using MCVAE. Top:​​​‌ (A) transcriptomic (TP) and​ translatomic (TL) layers coordinated​‌ by FMRP and (B)​​ cascading effect of lack​​​‌ of FMRP in Fragile​ X syndrome; bottom: workflow​‌ including data collection, preprocessing,​​ MCVAE integration, and anomaly​​​‌ detection in knockout samples.​

The image compares genetic​‌ and molecular differences between​​ wild-type (healthy) and Fmr1​​​‌ knockout (Fragile X Syndrome)​ phenotypes. It illustrates the​‌ interactions between transcriptomic (TP),​​ translatomic (TL), and proteomic​​​‌ levels. Panel A shows​ the healthy phenotype with​‌ FMRP functioning, while Panel​​ B depicts the FXS​​​‌ phenotype with absent FMRP.​ The bottom section details​‌ data preparation, machine learning​​ model training (including encoders​​​‌ and decoders), and anomaly​ scoring to differentiate between​‌ healthy and FXS phenotypes,​​ using transcriptomic and translatomic​​​‌ anomaly scores for validation.​

8.2.4 Consensus Enhances Individual​‌ Causal Models: a Use​​ Case on Lung Cancer​​​‌

This work was carried​ out with the support​‌ of Inria's institutional funding.​​

Keywords: Causal discovery; Uncertainty;​​​‌ Cancer genomics.

Participants:​ Arnaud Lang [Correspondant],​‌ Rodrigo Ramos, Safaa​​ Al-Ali, Mohammad Mousavi​​​‌, Anna Calissano,​ Irene Balelli.

Discovering​‌ causal relationships in real-world​​ medical data remains challenging​​​‌ due to the strong​ assumptions required by classical​‌ causal discovery algorithms, which​​ aim to infer directed​​​‌ graphs whose edges represent​ cause-effect relationships between features.​‌ In this work, we​​ propose a consensus causal​​​‌ model that aggregates multiple​ causal discovery methods to​‌ improve robustness and reliability.​​ We apply this approach​​​‌ to a lung cancer​ dataset combining patient characteristics,​‌ tumor data, and genetic​​ mutations. The resulting consensus​​​‌ causal graph (see Fig.​ 25, right graph)​‌ captures biologically validated causal​​ relationships that individual algorithms​​ fail to identify, highlighting​​​‌ the relevance of consensus-based‌ causal discovery in complex‌​‌ biomedical settings. This work​​ has been submitted.

Figure
Figure​​​‌ 25: (Left) Output‌ of a single algorithm‌​‌ (PC) and (Right) our​​ consensus causal graph. Light​​​‌ orange nodes correspond to‌ patient and tumor level‌​‌ variables, while dark orange​​ nodes contain information about​​​‌ genetic mutations affecting cellular‌ pathways. Dashed edges are‌​‌ undirected edges; edge color​​ intensity in the consensus​​​‌ causal model corresponds to‌ the frequency of the‌​‌ edge occurrence and yields​​ a heuristic measure of​​​‌ uncertainty regarding the causal‌ association (darker (resp. lighter)‌​‌ edge = higher (resp.​​ lower) occurrence).

The image​​​‌ shows two directed acyclic‌ graphs (DAGs) with nodes‌​‌ and edges. Each node​​ represents a variable, and​​​‌ each edge represents a‌ causal relationship between the‌​‌ variables. The left DAG​​ is simpler, with fewer​​​‌ connections, while the right‌ DAG is more complex,‌​‌ featuring more nodes and​​ edges indicating additional relationships.​​​‌ Both graphs contain variables‌ labeled with terms such‌​‌ as Status, Stage, Age,​​ Sex, Smoking, SPY, and​​​‌ SP1 through SP12.

8.3‌ Computational Anatomy & Geometric‌​‌ Statistics

8.3.1 Log-Euclidean frameworks​​ for smooth brain connectivity​​​‌ trajectories

This work was‌ funded by ERC grant‌​‌ #786854 (G-Statistics, European Research​​ Council, Horizon 2020) and​​​‌ by the French government‌ through the 3IA Côte‌​‌ d'Azur Investments ANR-23-IACL-0001 (managed​​ by ANR).

Keywords: Functional​​​‌ connectomes; Correlation matrices; Log-Euclidean‌ geometry.

Participants: Olivier‌​‌ Bisson [Correspondant], Yanis​​ Aeschlimann, Samuel Deslauriers-Gauthier​​​‌, Xavier Pennec.‌

Intrinsic polynomial regression of‌​‌ longitudinal connectomes in Cor​​ +(n)​​​‌ via Log-Euclidean diffeomorphisms (Off-Log‌ / Log-Scaling) 34:‌​‌ perform the regression in​​ the Euclidean image and​​​‌ pull back to preserve‌ correlation constraints (Fig. 26‌​‌). Related work: we​​ develop a unified theory​​​‌ of log-Euclidean Lie groups‌ on S+(‌​‌n) and Cor​​ +(n)​​​‌, and show that‌ all log-Euclidean metrics in‌​‌ a fixed dimension are​​ Riemannian-isometric via explicit isometries.​​​‌ We further characterize quotients‌ of log-Euclidean Lie groups‌​‌ 57.

Figure
Figure 26​​: Dynamic functional connectome​​​‌ trajectory and its intrinsic‌ polynomial regression (Log-Euclidean pullback),‌​‌ visualized after 3D PCA.​​

The image is a​​​‌ 3D scatter plot titled‌ "3D PCA: OffLog Inverse‌​‌ (MSE = 0.001550)." It​​ displays three datasets in​​​‌ a 3D space with‌ axes labeled PC 1,‌​‌ PC 2, and PC​​ 3. The datasets are​​​‌ distinguished by different colors‌ and markers: blue dots‌​‌ for "Original," cyan dots​​ for "OffLog," and red​​​‌ dots for "Sampled." The‌ plot illustrates the comparison‌​‌ of these datasets in​​ a three-dimensional Principal Component​​​‌ Analysis (PCA) space. The‌ datasets appear to follow‌​‌ similar paths, representing how​​ well the "OffLog" and​​​‌ "Sampled" datasets align with‌ the "Original" data.

8.3.2‌​‌ Eigengap sparsity for covariance​​ parsimony

This work was​​​‌ supported by the ERC‌ grant #786854 G-Statistics from‌​‌ the European Research Council​​ under the European Union's​​​‌ Horizon 2020 research and‌ innovation program and by‌​‌ the French government through​​ the 3IA Côte d'Azur​​​‌ Investments ANR-23-IACL-0001 managed by‌ the National Research Agency.‌​‌

Keywords: Covariance estimation; Parsimony;​​​‌ Eigengaps; Flag manifolds; Monotone​ cone; Isotonic regression.​‌

Participants: Tom Szwagier [Correspondant]​​, Guillaume Olikier,​​​‌ Xavier Pennec.

We​ propose a parsimonious covariance​‌ estimator leveraging the stratification​​ of symmetric matrices by​​​‌ the multiplicities of the​ eigenvalues 44. It​‌ involves solving a penalized​​ log-likelihood optimization problem via​​​‌ a projected gradient descent​ on a monotone cone.​‌ The algorithm, illustrated in​​ Figure 27, turns​​​‌ out to draw an​ interesting link between covariance​‌ parsimony and shrinkage.

Figure
Figure​​ 27: Illustration of​​​‌ the projected gradient descent​ algorithm from the double​‌ point of view of​​ the constraint set (monotone​​​‌ cone, top) and the​ eigenvalue profile (scree plot,​‌ bottom). The gradient step​​ makes eigenvalues mutually-attracted, up​​​‌ to the point where​ some of them violate​‌ the ordering constraints, going​​ outside of the monotone​​​‌ cone (gray zone). The​ projection onto the constraint​‌ set–which is nothing but​​ an isotonic regression–then boils​​​‌ down to equalizing the​ unsorted eigenvalues. This automatically​‌ induces covariance parsimony.

The​​ image illustrates an iterative​​​‌ process involving optimization within​ a monotone cone and​‌ eigenvalue adjustments. Top row:​​ A point is adjusted​​​‌ via a gradient step,​ projected back into the​‌ monotone cone, and iterated​​ until convergence to a​​​‌ final position. Bottom row:​ Bar graphs display eigenvalue​‌ distributions, showing a progression​​ through isotonic regression steps,​​​‌ ultimately achieving a balanced​ eigenvalue distribution.

8.3.3 Parsimonious​‌ Gaussian mixture models with​​ piecewise-constant eigenvalue profiles

This​​​‌ work was supported by​ the ERC grant #786854​‌ G-Statistics from the European​​ Research Council under the​​​‌ European Union's Horizon 2020​ research and innovation program​‌ and by the French​​ government through the 3IA​​​‌ Côte d'Azur Investments ANR-23-IACL-0001​ managed by the National​‌ Research Agency.

Keywords: Gaussian​​ mixture models; Parsimonious models;​​​‌ Eigenvalues; EM algorithm; Model​ selection.

Participants: Tom​‌ Szwagier [Correspondant], Pierre-Alexandre​​ Mattei, Charles Bouveyron​​​‌, Xavier Pennec.​

We introduce a new​‌ family of parsimonious Gaussian​​ mixture models with piecewise-constant​​​‌ covariance eigenvalue profiles 28​. These extend several​‌ low-rank models like the​​ celebrated mixtures of probabilistic​​​‌ principal component analyzers. To​ address the notoriously-challenging issue​‌ of jointly learning the​​ mixture parameters and hyperparameters,​​​‌ we propose a provably-monotonous​ component-wise penalized expectation–maximization algorithm​‌ (see Figure 28).​​ Our models achieve superior​​​‌ likelihood–parsimony tradeoffs on a​ variety of unsupervised experiments.​‌

Figure
Figure 28: Parsimonious​​ density fitting with the​​​‌ mixtures of principal subspace​ analyzers. Left: evolution of​‌ the mixture parameters over​​ the iterations, with increasing​​​‌ opacity. Right: evolution of​ the penalized log-likelihood (top)​‌ and the number of​​ parameters (bottom) over the​​​‌ iterations.

The image is​ composed of three main​‌ plots. The left plot​​ displays three distinct clusters​​​‌ of data points in​ grey, blue, and red,​‌ with elliptical confidence regions.​​ The top right plot​​​‌ shows penalized log-likelihood values​ increasing over 16 iterations.​‌ The bottom right plot​​ demonstrates a decreasing number​​​‌ of parameters over the​ same iterations. The plots​‌ together visualize a clustering​​ algorithm's performance, showing iterative​​​‌ improvements in log-likelihood and​ parameter reduction.

8.3.4 Rethinking​‌ statistical methods with flags​​

This work was supported​​ by the ERC grant​​​‌ #786854 G-Statistics from the‌ European Research Council under‌​‌ the European Union's Horizon​​ 2020 research and innovation​​​‌ program and by the‌ French government through the‌​‌ 3IA Côte d'Azur Investments​​ ANR-23-IACL-0001 managed by the​​​‌ National Research Agency.

Keywords:‌ Subspace learning; Grassmann manifolds;‌​‌ Flag manifolds; Nested subspaces;​​ Dimensionality reduction; Parsimony; Principal​​​‌ component analysis; Riemannian geometry;‌ Statistics.

Participants: Tom‌​‌ Szwagier [Correspondant], Xavier​​ Pennec.

The PhD​​​‌ thesis of Tom Szwagier‌ from Univ. Côte d'Azur‌​‌ 55 (defended on November​​ 28, 2025) aimed at​​​‌ establishing the interest of‌ flag manifolds in statistics.‌​‌ It comprises contributions on:​​ an efficient algorithm for​​​‌ the Riemannian logarithm on‌ flag manifolds, the principal‌​‌ subspace analysis methodology for​​ covariance matrices with close​​​‌ eigenvalues 29 and its‌ l1-relaxation 44, a‌​‌ Bayesian inference framework (in​​ preparation), an extension to​​​‌ Gaussian mixture models 28‌ and an extension beyond‌​‌ Gaussian distributions 61.​​

This last contribution develops​​​‌ the idea of replacing‌ Grassmanians (subspaces) with flags‌​‌ in subspace learning methods​​ beyond PCA. We propose​​​‌ a simple and easily‌ implementable principle (the flag‌​‌ trick) to enforce​​ nestedness of subspaces. The​​​‌ flag trick consists in‌ lifting Grassmannian optimization criteria‌​‌ to flag manifolds—the space​​ of nested subspaces of​​​‌ increasing dimension—via nested projectors‌ (see Figure 29).‌​‌ We apply the flag​​ trick to several classical​​​‌ machine learning methods and‌ show that it successfully‌​‌ addresses the nestedness issue​​ in subspace learning.

Figure
Figure​​​‌ 29: Illustration of‌ the flag trick methodology.‌​‌ A q-dimensional subspace​​ learning problem is converted​​​‌ into a multilevel nested‌ subspace learning problem and‌​‌ addressed via a steepest​​ descent algorithm on flag​​​‌ manifolds. The estimators associated‌ with each subspace can‌​‌ then be aggregated via​​ ensembling methods and yield​​​‌ improved predictions.

The image‌ illustrates a three-step process‌​‌ of the flag trick​​ methodology. First, "Subspace Learning"​​​‌ involves optimizing data on‌ Grassmannians to project high-dimensional‌​‌ data into lower dimensions​​ while maintaining essential structure.​​​‌ In "Nested Subspace Learning,"‌ data is further optimized‌​‌ on a flag manifold​​ using a "Flag Trick"​​​‌ to derive an optimal‌ flag. Finally, "Ensembling" combines‌​‌ the projections by hard​​ and soft voting to​​​‌ improve classification performance across‌ different dimensional projections.

8.4‌​‌ Computational Cardiology & Image-Based​​ Cardiac Interventions

8.4.1 Cardiac​​​‌ Electrophysiology Model Personalization

This‌ work was funded by‌​‌ BPI i-démo MediTwin.

Keywords:​​ Cardiac electrophysiology modeling; Lattice-Boltzmann​​​‌ method; Model personalization.‌

Participants: Nicolas Cedilnik [Correspondant]‌​‌, Jairo Rodríguez,​​ Buntheng Ly, Mihaela​​​‌ Pop, Maxime Sermesant‌.

  • We improved "cardiaclbm"‌​‌ (see Fig. 30),​​ a python package for​​​‌ monodomain, organ-scale fast (GPU-powered)‌ simulations of cardiac electrophysiology‌​‌ (EP) using the lattice-Boltzmann​​ method (LBM).
  • We used​​​‌ it in ongoing works,‌ where image-based arythmia simulations‌​‌ in infarcted pigs were​​ compared to real EP​​​‌ recordings.
  • We showed that‌ the LBM is fast‌​‌ enough to allow iterative​​ parameter tuning against non-invasive​​​‌ EP data, in a‌ multimodal (imaging and electrocardiographic)‌​‌ model personalization framework.

Figure
Figure​​ 30: Screenshot of​​​‌ a dynamic visualization tool‌ developed on top of‌​‌ the cardiaclbm python package,​​​‌ showing re-entrant depolarization wave​ (top left), analysis of​‌ EP properties (top right,​​ middle), and a simulated​​​‌ ECG (bottom).

The image​ displays a 3D model​‌ of a heart with​​ various color-coded data visualizations​​​‌ and graphs. The top​ left shows the heart's​‌ electrical activity with red​​ and blue gradients. The​​​‌ top middle and right​ sections provide additional visual​‌ data on heart functions​​ with time and speed​​​‌ metrics. Below, there are​ box plots and histograms​‌ illustrating statistical distributions, and​​ waveforms representing electrical signals​​​‌ over time. The bottom​ section includes playback controls​‌ for animation.

8.4.2 Differentiable​​ Electromechanical Modeling for Patient-Specific​​​‌ Cardiac Biomechanics

This work​ was funded by the​‌ France 2030 program (MediTwin​​ project).

Keywords: Cardiac biomechanics;​​​‌ Electromechanics; Personalization; Numerical simulation;​ Machine learning.

Participants:​‌ Gaëtan Desrues [Correspondant],​​ Maxime Sermesant.

  • Development​​​‌ of a 3D cardiac​ electromechanical model using the​‌ SOFA simulation framework. Application​​ to patient-specific four-chamber cardiac​​​‌ biomechanics (Fig. 31).​
  • Design of a modular​‌ differentiable simulation framework for​​ physics-based modeling in JAX.​​​‌ FEM-based electromechanical formulations implemented​ with fully differentiable operators.​‌
  • Integration of energy-based Hamiltonian​​ formulations and AI-driven methods​​​‌ for physics-informed modeling of​ cardiac electromechanics.
  • Cardiac electromechanical​‌ simulation for the assessment​​ and optimization of mitral​​​‌ valve implant design, including​ annular downsizing strategies.

Figure
Figure​‌ 31: Finite element​​ representations of patient-specific four-chamber​​​‌ cardiac anatomy and associated​ biomechanical submodels used for​‌ electromechanical simulations.

Finite element​​ representations of patient-specific four-chamber​​​‌ cardiac anatomy and associated​ biomechanical submodels used for​‌ electromechanical simulations.

8.4.3 Prediction​​ of stroke based on​​​‌ shape and simulation of​ the left atrium

This​‌ work was funded by​​ the ANR under the​​​‌ France 2030 project RHU​ Talent (ANR-23-RHUS-0015) (ANR, IHU​‌ Lyric, CHU Bordeaux, Université​​ de Bordeaux, Inria, CHU​​​‌ Dijon Bourgogne, inHEART, Cardiologs​ et Incepto).

Keywords: Stroke;​‌ Shape analysis; Bloodflow simulation;​​ Atrial fibrillation.

Participants:​​​‌ Nicolas Drettakis [Correspondant],​ Maxime Sermesant, Hubert​‌ Cochet.

This year​​ was first focused on​​​‌ adapting and upgrading the​ automatic segmentation, labeling and​‌ feature extraction pipeline for​​ the left atrium that​​​‌ was developed first in​ J. Harrison's PhD to​‌ use it on a​​ larger database. The pipeline​​​‌ was also adapted to​ be used in the​‌ BeatAF project to automatically​​ measure the diameters of​​​‌ the pulmonary veins before​ and after left atrium​‌ appendage ablation. We also​​ worked on preparing the​​​‌ use of bloodflow simulation​ of the left atrium​‌ to extract corresponding features​​ (see Fig. 32).​​​‌

Figure
Figure 32: Finite​ element representations of patient-specific​‌ four-chamber cardiac anatomy and​​ associated biomechanical submodels used​​​‌ for electromechanical simulations.

The​ image displays a 3D​‌ anatomical model of a​​ four-chamber cardiac anatomy with​​​‌ colored sections representing different​ veins or vascular structures.​‌ The table below indicates​​ that 1236 vein diameters​​​‌ were calculated for patients​ without anomalies, while 21​‌ (1.7%) were calculated by​​ hand for patients without​​​‌ any anomaly. The colors​ help distinguish between different​‌ segments or parts of​​ the system.

8.4.4 Myocardial​​​‌ Stiffness Quantification using Ultrasound​ Shear Wave Elastography and​‌ Reduced Modeling

This work​​ was funded by the​​ ANR (PEPR Digital Health​​​‌ ChroniCardio, 3IA Côte d'Azur,‌ IA Cluster, IHU Liryc),‌​‌ France 2030, and the​​ European Union (MediTwin project).​​​‌

Keywords: Cardiac mechanics; Reduced-order‌ models; Ultrafast ultrasound imaging;‌​‌ Myocardial stiffness; Patient-specific analyses​​.

Participants: Camilla Ferrario​​​‌ [Correspondant], Jairo Rodríguez‌ Padilla, Maelys Venet‌​‌, Olivier Villemain,​​ Maxime Sermesant.

We​​​‌ developed a pipeline to‌ estimate active myocardial contractility‌​‌ from shear wave elastography​​ (SWE). A reduced spherical​​​‌ electromechanical model predicts stiffness‌ using a rheological circuit.‌​‌ Active parameters, comprising reference​​ stiffness and cross bridge​​​‌ cycling rates, are calibrated‌ via the CMA-ES algorithm‌​‌ to minimize the mismatch​​ between modeled and clinical​​​‌ stiffness trajectories (Fig. 33‌) 35.

Figure
Figure‌​‌ 33: Active parameter​​ estimation. (i) Clinical input:​​​‌ In vivo shear wave‌ elastography (SWE) yields target‌​‌ myocardial stiffness kc​​ SWE (t)​​​‌. The bottom panel‌ shows cohort trajectories (gray)‌​‌ and their ensemble average​​ (dashed). (ii) Reduced electromechanical​​​‌ model: The left ventricle‌ (LV) is modeled as‌​‌ a thick-walled sphere. A​​ rheological circuit with active​​​‌ (kc,‌τc) and‌​‌ passive (We​​,Wv,​​​‌μ) components predicts‌ stiffness kc model‌​‌ (t;θ​​) from kinematics. (iii)​​​‌ Active parameter optimization: Parameters‌ θ (max stiffness k‌​‌0, rates k​​ ATP ,k SR​​​‌ ) are identified by‌ minimizing cost J(‌​‌θ) via CMA-ES.​​ The blue curve shows​​​‌ the optimal fit against‌ clinical data (dashed).

The‌​‌ image illustrates a medical​​ modeling process. First, clinical​​​‌ input is gathered using‌ ultrasound to measure heart‌​‌ tissue motion (shear wave​​ velocity). Next, a reduced​​​‌ spherical electromechanical model of‌ the heart is created‌​‌ to simulate its function.​​ Finally, an optimization method​​​‌ (CMA-ES) adjusts model parameters‌ to fit clinical data,‌​‌ optimizing the model for​​ accurate representation. Graphs display​​​‌ the data fitting process‌ and parameter adjustments over‌​‌ time.

8.4.5 Multimodal Personalization​​ of Cardiac Electrophysiology Models​​​‌ combining 12-lead ECG and‌ Computed Tomography

This work‌​‌ has been supported by​​ the French government through​​​‌ the National Research Agency‌ (ANR) 3IA Côte d'Azur,‌​‌ IA Cluster project and​​ IHU LIRYC (ANR-19-3IA-0002, ANR-23-IACL-0001​​​‌ and ANR-10-IAHU-04) and through‌ the France 2030 and‌​‌ the European Union (Next​​ Generation EU) MediTwin project.​​​‌ The authors are grateful‌ to the OPAL infrastructure‌​‌ from Université Côte d'Azur​​ for providing resources and​​​‌ support.

Keywords: Computational modeling;‌ Myocardial infarction; ECG; Computed‌​‌ tomography; Model personalization.​​

Participants: Buntheng Ly,​​​‌ Nicolas Cedilnik, Mihaela‌ Pop, Josselin Duchateau‌​‌, Frédéric Sacher,​​ Pierre Jaïs, Hubert​​​‌ Cochet, Maxime Sermesant‌.

We propose an‌​‌ automated framework for the​​ parameterization of cardiac electrophysiological​​​‌ model by combining information‌ derived from CT scans‌​‌ and 12-lead ECGs, with​​ the aim of fine-tuning​​​‌ model parameters based on‌ electrical features extracted from‌​‌ recorded ECGs at sinus​​ rhythm 41 (Fig. 34​​​‌). The optimized parameters‌ induced virtual VT with‌​‌ cycle length and pattern​​ closer to those recorded,​​​‌ as compared to the‌ baseline parameters.

Figure
Figure 34‌​‌: VT simulation pipeline​​​‌ with multi-modal personalization strategy.​

The image depicts a​‌ process of multimodal personalization​​ combining 12-lead ECG and​​​‌ computed tomography to optimize​ ventricular tachycardia (VT) simulations.​‌ It starts with a​​ cardiac CT scan, followed​​​‌ by an electrophysiological (EP)​ simulation domain. Virtual inductions​‌ and VT patterns are​​ generated through electrical stimulation.​​​‌ ECG leads are automatically​ placed for sinus rhythm​‌ analysis. The EP and​​ ECG simulations are optimized​​​‌ using multimodal optimization and​ CMA-ES, focusing on onsets​‌ and conduction velocity. The​​ optimized parameters are used​​​‌ to simulate VT patterns​ closely matching the ventricular​‌ tachycardia circuit location (VTCL).​​ The results table shows​​​‌ the VT induction results​ using both baseline and​‌ optimized parameters.

8.4.6 Learning​​ Cardiac Electrophysiology with Graph​​​‌ Neural Networks for Fast​ Data-driven Personalized Predictions

This​‌ work has received funding​​ from the French government​​​‌ through the National Research​ Agency DeepNum project (ANR-21-CE23-0017).​‌

Keywords: Graph neural network;​​ Data-driven modeling; Personalized cardiac​​​‌ electrophysiology.

Participants: Maëlis​ Morier [Correspondant], Patrick​‌ Gallinari, Maxime Sermesant​​.

We present AGATA​​​‌51, an Autoregressive​ Graph Attention network for​‌ fast and accurate cardiac​​ action potential simulation. Trained​​​‌ on FEM data (A)​ (see Fig. 35),​‌ AGATA predicts seconds of​​ propagation from only 25​​​‌ ms of input. Its​ architecture (B) (shown in​‌ Fig. 35) generalizes​​ from simple to realistic​​​‌ cardiac geometries, captures healthy​ and pathological dynamics, achieves​‌ a 3×10​​-5 mean absolute​​​‌ error, and is up​ to 19 times faster​‌ than FEM, enabling fast,​​ accurate, patient-specific digital twin​​​‌ modeling.

Figure
Figure 35:​ A. Framework for Action​‌ Potential simulation, starting from​​ an ellipsoid mesh, with​​​‌ Firedrake FEM computations and​ Pytorch Geometric graph conversion.​‌ t is a step​​ of the simulation. B.​​​‌ The architecture of AGATA,​ combining an autoregressive approach​‌ with an attention mechanism.​​ k1, k2 are the​​​‌ number of nodes in​ the layers.

The image​‌ illustrates a process for​​ simulating and analyzing heart​​​‌ tissue using computational models.​ (A) begins with generating​‌ a mesh of the​​ heart tissue categorized into​​​‌ healthy, gray zone, and​ scar areas. It then​‌ simulates the action potential​​ propagation using the Mitchell-Schaeffer​​​‌ model over time. The​ results are converted into​‌ a graph representation where​​ nodes contain action potential​​​‌ values and edges contain​ edge length and tissue​‌ type. (B) shows a​​ neural network model using​​​‌ attention mechanisms to process​ time-series data from the​‌ simulation. Multiple GATv2Conv layers​​ process the data in​​​‌ an autoregressive loop, combining​ output windows to produce​‌ the final output.

8.4.7​​ Uncertainty-Informed Multimodal Infarct Age​​​‌ Prediction from Imaging and​ Clinical Data

This work​‌ has been supported by​​ the French government through​​​‌ France 2030 (MediTwin) and​ the European Union (Next​‌ Generation EU), the National​​ Research Agency (ANR) Investments​​​‌ in the Future with​ 3IA Côte d'Azur and​‌ IA Cluster (ANR-19-3IA-0002 and​​ ANR-23-IACL-0001), LIRYC (ANR-10-IAHU-04) and​​​‌ ChroniCardio - ANR-22-PESN-0015. The​ authors are grateful to​‌ the OPAL infrastructure from​​ Université Côte d'Azur for​​​‌ providing resources and support.​

Keywords: Multimodal deep learning;​‌ Infarct age regression; Medical​​ imaging; Intramyocardial fat and​​ calcification; Myocardial thickness.​​​‌

Participants: Evariste Njomgue Fotso‌ [Correspondant], Marta Nuñez-Garcia‌​‌, Buntheng Ly,​​ Hubert Cochet, Maxime​​​‌ Sermesant.

Accurately estimating‌ the age of a‌​‌ myocardial infarction (MI) is​​ critical for prognostic assessment​​​‌ and for guiding post-MI‌ clinical management, particularly in‌​‌ applications such as arrhythmia​​ risk stratification. In this​​​‌ study, we address this‌ challenge by proposing a‌​‌ novel multimodal regression framework​​ for infarct age prediction​​​‌ 36.

The proposed‌ framework integrates quantitative descriptors‌​‌ of intramyocardial fat, calcification,​​ and myocardial thickness extracted​​​‌ from mid-wall mesh nodes,‌ followed by a quantile-range‌​‌ decision fusion strategy to​​ combine modality-specific predictions (Fig.​​​‌ 36). Accurate infarct‌ age estimation is especially‌​‌ important in clinical scenarios​​ such as silent MI—a​​​‌ well-established risk factor for‌ sudden cardiac death—where delayed‌​‌ diagnosis complicates timely therapeutic​​ intervention.

Moreover, in situations​​​‌ where infarct age information‌ is incomplete or uncertain,‌​‌ robust regression models can​​ provide reliable age estimates,​​​‌ thereby supporting more informed‌ clinical decision-making and personalized‌​‌ treatment planning.

Figure
Figure 36​​: (Top): Data​​​‌ processing pipeline. (Down):‌ Quantiles Range Decision Fusion:‌​‌ general setting. For each​​ modality, a predictor regressor​​​‌ and a conditional quantile‌ regressor are trained separately.‌​‌ Late fusion at the​​ decision level is then​​​‌ applied, selecting the best‌ infarct age prediction based‌​‌ on the smallest quantile​​ range.

(Top): Data​​​‌ processing pipeline. (Down):‌ Quantiles Range Decision Fusion:‌​‌ general setting. For each​​ modality, a predictor regressor​​​‌ and a conditional quantile‌ regressor are trained separately.‌​‌ Late fusion at the​​ decision level is then​​​‌ applied, selecting the best‌ infarct age prediction based‌​‌ on the smallest quantile​​ range.

8.4.8 In silico​​​‌ Assessment of Arrhythmia Inducibility‌ Dependence on Stimulus Location‌​‌ using Calibrated MR-based Infarcted​​ Heart Models

This work​​​‌ has received funding from‌ the European Union Horizon‌​‌ 2020 Research and Innovation​​ Program SimCardioTest (101016496), from​​​‌ the French government through‌ the National Research Agency‌​‌ (ANR) projects PEPR Digital​​ Health ChroniCardio (22-PESN-0015), 3IA​​​‌ Côte d'Azur and IA‌ Cluster (ANR-19-3IA-0002 and ANR-23-IACL-0001).‌​‌ The authors are also​​ grateful to the OPAL​​​‌ infrastructure from Université Côte‌ d'Azur for providing computational‌​‌ resources and associated support.​​

Keywords: Electrophysiology; Modeling; Simulations;​​​‌ Finite element; Personalization.‌

Participants: Jairo Rodríguez Padilla‌​‌ [Correspondant], Rafael Silva​​, Buntheng Ly,​​​‌ Graham Wright, Mihaela‌ Pop, Maxime Sermesant‌​‌.

The aim of​​ this work (42​​​‌) was to implement‌ a robust computational pipeline‌​‌ (Figure 37) to​​ build and calibrate digital​​​‌ twins able to accurately‌ predict VT inducibility using‌​‌ high-resolution preclinical MRI-EP datasets.​​ Novel aspects of the​​​‌ work include:

  • A data-driven‌ macroscopic model personalization method‌​‌ using intracardiac electrograms (iECGs)​​ from very dense contact​​​‌ catheter-based electro-anatomical maps.
  • Integration‌ of an atlas of‌​‌ fiber directions (instead of​​ rule-based fibers) into the​​​‌ 3D heart models.
  • A‌ fully Phyton-coded FEM implementation‌​‌ for the numerical solver​​ in FEniCSx.

Figure
Figure 37​​​‌: Workflow of 3D‌ MR-based biventricular model construction‌​‌ and the in silico​​ testing of stimulation protocols​​​‌ from different pacing sites‌ to study VT inducibility.‌​‌ GZ: Grey zone.

The​​​‌ image illustrates a workflow​ for simulating and analyzing​‌ ventricular tachycardia (VT) using​​ MRI scans. The process​​​‌ starts with MRI segmentation​ to identify healthy, scar,​‌ and gray zone (GZ)​​ tissues. A 3D model​​​‌ of the heart is​ built and parameterized, indicating​‌ stimulus locations. The model​​ undergoes VT inducibility simulations​​​‌ by applying stimulation protocols.​ If arrhythmia occurs, the​‌ VT is saved; otherwise,​​ the process continues to​​​‌ the next site. The​ simulations classify VTs into​‌ categories such as no​​ VT, reentry not sustained,​​​‌ and sustained VT.

8.4.9​ Miniaturizing Automated External Defibrillation​‌ with Frugal AI

This​​ work has been supported​​​‌ by the French government,​ through the National Research​‌ Agency (ANR) 3IA Côte​​ d'Azur and IA Cluster​​​‌ project (ANR-19-3IA-0002 and ANR-23-IACL-0001).​

Keywords: Frugal AI; Shockable​‌ rhythm detection; Embedded systems;​​ Deep learning; ECG analysis​​​‌.

Participants: Rafael Silva​ [Correspondant], Caroline Stehlé​‌, Maxime Sermesant.​​

In collaboration with Inn'Pulse​​​‌ and 3IA Côte d'Azur,​ we designed a frugal​‌ deep learning shock advisory​​ algorithm for ultra-portable defibrillators,​​​‌ combining neural architecture search,​ 8-bit quantization, external dataset​‌ validation, and STM32 deployment​​ tests to meet international​​​‌ standards while minimizing computation​ and energy consumption 43​‌, 62. The​​ methodology is summarized in​​​‌ Figure 38.

Figure
Figure​ 38: Overview of​‌ the proposed methodology: from​​ ECG data processing to​​​‌ model optimization and its​ deployment on a microcontroller.​‌

The image outlines a​​ workflow for developing and​​​‌ deploying neural network models​ for ECG data analysis.​‌ It consists of four​​ main steps: 1) Data​​​‌ preprocessing, where ECG recordings​ undergo segmentation, standardization, and​‌ augmentation; 2) Neural Architecture​​ Search, involving a Bayesian​​​‌ optimizer to generate and​ evaluate candidate architectures; 3)​‌ Model Quantization, converting the​​ original 32-bit model into​​​‌ an 8-bit quantized model​ using calibration data; 4)​‌ Embedded Deployment and Evaluation,​​ deploying the quantized model​​​‌ and evaluating its performance​ using the STM32 Cube.AI​‌ Framework, focusing on metrics​​ like inference time and​​​‌ energy consumption.

8.5 Multi-centric​ data and Federated Learning​‌

8.5.1 Development of a​​ 18FDG-PET normative uptake atlas​​​‌ and its clinical application​ for abnormal metabolic activity​‌ detection

This work was​​ funded by the project​​​‌ FEDERATED-PET.

Keywords: PET/CT scans;​ Machine learning; Lung cancer​‌.

Participants: Lucie Chambon​​ [Correspondant], Francesco Cremonesi​​​‌, Marco Lorenzi,​ Olivier Humbert.

This​‌ work proposes a normative​​ modeling framework for whole-body​​​‌ 18F-FDG PET scans (Fig.​ 39):

  • We constructed​‌ a multi-center PET normative​​ uptake atlas from healthy​​​‌ control cohorts.
  • We introduced​ an interpretable measure to​‌ quantify organ-level metabolic deviations.​​
  • We validated the method​​​‌ on an external lung​ cancer cohort, showing robust​‌ detection of pathological hyper-metabolism​​ across organs, and improved​​​‌ generalization compared with classical​ metrics based on standardized​‌ uptake value (SUV).

Figure
Figure​​ 39: Illustration of​​​‌ the normative atlas development​ and usage workflow.

The​‌ image depicts a medical​​ imaging process involving PET/CT​​​‌ scans. First, normal database​ images are segmented by​‌ organ. Next, standardized uptake​​ value (SUV) distributions are​​​‌ extracted for organs like​ the brain and stomach.​‌ These distributions are used​​ to create SUV distribution​​ atlases using Wasserstein barycenters.​​​‌ Finally, these atlases are‌ used to compare individual‌​‌ scans by calculating their​​ distances to the reference​​​‌ atlases.

8.5.2 Real-world Deployment‌ of Federated Learning in‌​‌ Biomedical Research Consortia with​​ Fed-BioMed

This work was​​​‌ funded by the European‌ Union EUCAIM project under‌​‌ Grant Agreement 101100633.

Keywords:​​ Biomedical data; Federated learning;​​​‌ Machine learning.

Participants:‌ Francesco Cremonesi [Correspondant],‌​‌ Sergen Cansiz, Lucie​​ Chambon, Ali Tolga​​​‌ Dincer, Yannick Bouillard‌, Jhonatan Leonardo Torres‌​‌ Sanchez, Marc Vesin​​, Marco Lorenzi.​​​‌

  • Fed-BioMed is an open-source‌ initiative aimed at enabling‌​‌ real-world deployment of federated​​ learning in biomedical research.​​​‌
  • In 2025, Fed-BioMed has‌ been actively developed and‌​‌ improved, in particular in​​ terms of its deployment​​​‌ process, integration with hospital‌ and research infrastructures, and‌​‌ interoperability with medical data​​ standards. The software is​​​‌ now in release v6.2.‌
  • Fed-BioMed supports state-of-the-art low-overhead‌​‌ secure aggregation protocols which​​ have been demonstrated on​​​‌ a real-world deployment of‌ three French hospitals from‌​‌ the UniCancer consortium (Centre​​ Antoine Lacassagne, Centre Henri​​​‌ Becquerel, Institut Curie), see‌ Fig. 40. The‌​‌ technical architecture has been​​ developed following a co-design​​​‌ approach involving all stakeholders‌ including data holders, data‌​‌ scientists, and software developers​​ 53. A preliminary​​​‌ integration of Fed-BioMed with‌ the public platform for‌​‌ the European Cancer Imaging​​ Infrastructure (EUCAIM) has also​​​‌ been achieved in 2025‌ 49.

Figure
Figure 40‌​‌: a) Pixel intensity​​ distribution grouped by clinical​​​‌ site. b) Breakdown of‌ FL experiment wallclock runtime.‌​‌ c) Distribution of Dice​​ scores for centralized (CL)​​​‌ and federated (FL) models,‌ combining all cross-validation folds.‌​‌ d) Clockwise from top​​ left: an example raw​​​‌ image, the ground truth‌ segmentation, the FL model‌​‌ prediction and the CL​​ model prediction.

The image​​​‌ contains four sub-figures. (a)‌ is a line plot‌​‌ showing the distribution of​​ pixel intensities for three​​​‌ datasets: CURIE, CHB, and‌ CAL. (b) is a‌​‌ bar chart comparing the​​ average wall clock time​​​‌ per round for these‌ datasets, divided into forward+backprop‌​‌ time and FL overhead.​​ (c) is a violin​​​‌ plot comparing DSC scores‌ for CL and FL,‌​‌ indicating performance distributions. (d)​​ shows sample medical images​​​‌ with raw, ground truth,‌ CL prediction, and FL‌​‌ prediction images.

8.5.3 Federated​​ domain adaptation for brain​​​‌ vessel segmentation

Keywords: Federated‌ learning; Domain adaptation; Vessel‌​‌ segmentation; Angiography.

Participants:​​ Tuan Anh Nguyen [Correspondant]​​​‌, Francesco Cremonesi,‌ Lucie Chambon, Marco‌​‌ Lorenzi.

  • The application​​ of Domain Adaptation techniques​​​‌ in the context of‌ federated learning allows to‌​‌ mitigate issues due to​​ heterogeneous data and missing​​​‌ lagels in a privacy-preserving‌ manner.
  • In the context‌​‌ of this project, the​​ scenario of Angiography-to-Angiography Translation​​​‌ was adressed in a‌ real-world deployment involving three‌​‌ institutions: INRIA, EURECOM, and​​ GIN (Grenoble Institute of​​​‌ Neuroscience), see Fig. 41‌.
  • Domain Adaptation techniques‌​‌ were used to transfer​​ annotations from publicly-available datasets​​​‌ to real-world clinical datasets‌ where only a handful‌​‌ of samples were annotated​​ by experts.
  • The deployment,​​​‌ supported by the Fed-BioMed‌ software, showed that the‌​‌ federated approach produced results​​​‌ that were closely aligned​ with those of the​‌ centralized domain adaptation, with​​ performance differences not exceeding​​​‌ 4% for most metrics.​

Figure
Figure 41: Using​‌ federated learning, 3 clients​​ collaboratively train a multimodal​​​‌ data factory F (in​ blue). Afterwards, source clients​‌ can contribute by training​​ locally segmentation branches (in​​​‌ orange), while target clients​ can asynchronously acquire the​‌ information required to segment​​ their data via domain​​​‌ adaptation (in pink) (figure​ taken from Galati et​‌ al, Federated Multi-centric Image​​ Segmentation with Uneven Label​​​‌ Distribution). On the right,​ an example of domain​‌ adaptation results.

The image​​ depicts a workflow involving​​​‌ federated learning, supervised learning,​ self-learning, and adaptation, all​‌ contributing to the generation​​ of brain MRI images.​​​‌ The diagram shows how​ ground truth images are​‌ used to train models​​ and generate predictions, with​​​‌ different components and loss​ functions contributing to the​‌ overall process. Additionally, there​​ are four MRI scans,​​​‌ two labeled as ground​ truth and two as​‌ prediction images, demonstrating the​​ outcomes of the process.​​​‌ The image highlights the​ interaction between different learning​‌ strategies to improve medical​​ image analysis.

8.5.4 Knowledge​​​‌ Guided Medical Report Generation​ for Pathology Specific Findings​‌

This work was funded​​ by PEPR Santé Numerique.​​​‌

Keywords: Radiology report generation;​ Vision language models.​‌

Participants: Giuseppe Orlando [Correspondant]​​, Olivier Humbert,​​​‌ Marco Lorenzi.

Our​ research is focused on​‌ optimizing Vision Language Models​​ for medical reporting. In​​​‌ collaboration with the Centre​ Antoine Lacassagne, we demonstrated​‌ that prompting generalist models​​ with targeted anatomical questions​​​‌ and merging the responses​ significantly improves report quality​‌ (Fig. 42). Building​​ on this, we introduce​​​‌ a segmentation guided 3D​ chest CT framework using​‌ quantitative features to ground​​ text in explicit evidence.​​​‌

Figure
Figure 42: The​ left panels illustrate our​‌ framework: prompting generalist models​​ (e.g., CT-CHAT) with targeted​​​‌ questions to extract specific​ clinical entities from CT​‌ scans for final report​​ assembly. The right panel​​​‌ shows F1 score comparisons,​ demonstrating the improvement of​‌ this knowledge guided approach.​​

The image illustrates a​​​‌ pipeline for extracting medical​ entities from chest CT​‌ scans using AI models.​​ On the left, it​​​‌ shows how questions about​ CT scans are processed​‌ through a vision language​​ model (CT-CHAT) to extract​​​‌ entities, which are then​ analyzed by a language​‌ model (Llama3.1 70B) to​​ generate a final report.​​​‌ The right side compares​ the F1 scores of​‌ different models (Generalist vs.​​ Knowledge Guided) across various​​​‌ medical findings using a​ radar chart. Different colored​‌ areas indicate the performance​​ of each model, with​​​‌ green and orange representing​ Knowledge Guided and Generalist​‌ models, respectively.

8.5.5 Fed-ComBat:​​ A Generalized Federated Framework​​​‌ for Batch Effect Harmonization​ in Collaborative Studies

This​‌ project received financial support​​ by the PEPR Santé​​​‌ Numerique.

Keywords: Federated learning;​ HarmonizationComBat; Medical imaging;​‌ Batch effects.

Participants:​​ Ghiles Reguig [Correspondant],​​​‌ Santiago Silva, Neil​ Oxtoby, Andre Altmann​‌, Marco Lorenzi.​​

The aim of this​​​‌ project is to develop​ robust analysis tools for​‌ neuroimaging data, that can​​ find application in multi-centric​​ studies such as the​​​‌ French CATI. We developed‌ a federated flexible framework‌​‌ for multi-centric data harmonization​​ based on ComBat. The​​​‌ described implementation relies on‌ a stochastic gradient descent‌​‌ optimization model which allows​​ to leverage a large​​​‌ family of linear and‌ nonlinear models. The method‌​‌ was tested on the​​ harmonization of a set​​​‌ of public datasets and‌ was compared to various‌​‌ methods from the literature​​ (using linear or nonlinear​​​‌ modelization of the biological‌ effects to keep). The‌​‌ results depicted in Figure​​ 43 show that our​​​‌ method yields similar results‌ to the state-of-the-art while‌​‌ allowing both a federated​​ learning scheme and nonlinear​​​‌ modelization of the biological‌ effects. The paper describing‌​‌ our contribution is currently​​ in submission and an​​​‌ implementation in the Fed-BioMed‌ library is in development‌​‌ for real-world usage.

Figure
Figure​​ 43: Comparison of​​​‌ age trajectories of the‌ right hippocampus. The columns‌​‌ represent conditions under which​​ the data is shown.​​​‌ We observe that harmonization‌ using linear models (SGD‌​‌ Linear, NeuroComBat and Fed-ComBat​​ Linear) show atrophy patterns​​​‌ that are not consistent‌ with the literature while‌​‌ the nonlinear ones (SGD​​ MLP, ComBatGAM and Fed-ComBat​​​‌ MLP) better match the‌ different rates of atrophy‌​‌ across lifespan regarding controls​​ (CN).

The image shows​​​‌ multiple scatter plots comparing‌ right hippocampus thickness against‌​‌ age across different diagnostic​​ groups and harmonization methods.​​​‌ From left to right,‌ the plots are labeled‌​‌ as Non-harmonized, SGD Linear,​​ SGD MLP, NeuroComBat, ComBat-GAM,​​​‌ d-ComBat, FedComBat Linear, and‌ FedComBat MLP.

9 Bilateral‌​‌ contracts and grants with​​ industry

9.1 Bilateral contracts​​​‌ with industry

9.1.1 Spin-off‌ company inHEART

Participants: Maxime‌​‌ Sermesant.

inHEART is​​ a spin-off of the​​​‌ Epione team and IHU‌ Liryc funded in 2017.‌​‌ inHEART provides a service​​ to generate detailed anatomical​​​‌ and structural meshes from‌ medical images, that can‌​‌ be used during ablation​​ interventions. inHEART received 2​​​‌ awards, one from Aquitaine‌ region and one i-LAB‌​‌ from the BPI. It​​ raised 3.2 million euros​​​‌ in 2020. It currently‌ employs 27 people. It‌​‌ is FDA and CE​​ certified.

9.1.2 Start-up Inn'Pulse​​​‌

Participants: Rafael Silva,‌ Caroline Stehle, Maxime‌​‌ Sermesant.

Inn'Pulse is​​ a start-up developing an​​​‌ ultra-portable automatic cardiac defibrillator.‌ We are designing AI‌​‌ algorithms for better signal​​ processing in collaboration with​​​‌ the 3IA TechPool.

9.1.3‌ Koelis

Participants: Nicholas Ayache‌​‌, Hervé Delingette,​​ Benjamin Billot.

The​​​‌ company Koelis participates in‌ the thesis work of‌​‌ Manasi Kattel on the​​ multimodal registration of MR​​​‌ and ultrasound images. The‌ objective is to improve‌​‌ the accuracy of the​​ targeted biopsies inside the​​​‌ prostate.

10 Partnerships and‌ cooperations

10.1 International initiatives‌​‌

10.1.1 International collaborations

  • Computer​​ Science and Artificial Intelligence​​​‌ Laboratory, Massachusetts Institute of‌ Technology. Benjamin Billot is‌​‌ currently collaborating with Prof.​​ Polina Golland, through the​​​‌ common supervision of Ramya‌ Muthukrishnan, on developing equivariant‌​‌ networks for motion tracking​​ in fetal MRI time​​​‌ series.
  • Harvard Medical School‌ and Massachusetts General Hospital.‌​‌ Benjamin Billot is a​​ collaborator of Dr. Juan​​​‌ Eugenio Iglesias to develop‌ new tools for neuro-imaging‌​‌ based on domain randomization​​​‌ strategies.
  • Hawkes Institute, University​ College London (UCL), London,​‌ UK. Benjamin Billot collaborates​​ with Prof. Daniel Alexander​​​‌ and Dr. Henry Tregidgo​ on developing new domain​‌ randomization and simulation strategies​​ for domain-agnostic segmentation of​​​‌ brain MRI scans across​ a wide range of​‌ populations.
  • University College London​​ (UCL), London, UK. Irene​​​‌ Balelli collaborates with the​ Department of Statistical Science​‌ and the UCL Causality​​ group (Dr. Anna Calissano​​​‌ and Dr. Karla Diaz​ Ordaz). The collaboration consists​‌ in exploring new methdologies​​ for causal learning based​​​‌ on graph theories for​ high dimensional data.
  • King's​‌ College London (KCL) and​​ Guy's Hospital, London, UK.​​​‌ Irene Balelli is currently​ collaborating with Pr. Mohammad​‌ Mousavi (King's Quantum group)​​ and Dr. Rocio Martinez-Nuñez​​​‌ on causal learning for​ respiratory epidemiology and quantum​‌ causal discovery.
  • McGill University,​​ Canada. Marco Lorenzi collaborates​​​‌ with Prof. J.-B. Poline​ for the development of​‌ federated learning architectures and​​ standards for reproducible collaborative​​​‌ analysis in multicentric neuroimaging​ studies.
  • University College London​‌ (UCL), London, UK. Marco​​ Lorenzi is a collaborator​​​‌ of the COMputational Biology​ in Imaging and geNEtics​‌ (COMBINE) group within the​​ Centre for Medical Image​​​‌ Computing (CMIC) of UCL.​ His collaboration is on​‌ the topic of spatio-temporal​​ analysis of medical images​​​‌ and imaging-genetics, with special​ focus on brain imaging​‌ analysis and biomarker development.​​
  • Laboratory of Neuroimaging of​​​‌ Aging (LANVIE), Faculty of​ Medicine, Geneva University Hospitals.​‌ Marco Lorenzi collaborates with​​ the LANVIE laboratory led​​​‌ by Prof. Giovanni B.​ Frisoni. The collaboration consists​‌ in developing and translating​​ novel approaches for disease​​​‌ progression modeling in neurodegenerative​ disorders, such as Alzheimer's​‌ disease.
  • Illinois Institute of​​ Technology (IIT, IL, USA).​​​‌ Marco Lorenzi is currently​ a collaborator of IIT​‌ for the investigation of​​ the progression of Parkison's​​​‌ disease using disease progression​ modeling.
  • Laboratory of Physics​‌ of Fluids, University of​​ Twente, Netherlands. Hervé Delingette​​​‌ is collaborating with Assistant​ Professor Guillaume Lajoinie, on​‌ the topics of Deep​​ Learning for ultrasound imaging​​​‌ in the framework of​ the BoostUrCareer Cofund program​‌ and the thesis of​​ Hari Sreedhar.

10.1.2 Participation​​​‌ in other International Programs​

CausalGene
  • Funding:
    EPSRC-funded project​‌ via the CHAI (Causality​​ in Healthcare AI) Hub.​​​‌
  • Title:
    Glucocorticoid effects on​ human airway cells through​‌ population of causal graphs.​​
  • Duration:
    From November 1,​​​‌ 2025 to June 30,​ 2026
  • Partners:
    • University College​‌ London (UCL), UK
    • Inria,​​ France
    • King's College London​​​‌ (KCL), UK
    • Guy's Hospital,​ UK
    • Asthma+Lung UK,​‌ UK
  • Inria contact:
    Irene​​ Balelli
  • Coordinator:
    UCL
  • Summary:​​​‌
    1% of the population​ worldwide receives long-term oral​‌ type of steroids called​​ glucocorticoids. 40% of those​​​‌ treatments are taken by​ patients with respiratory diseases​‌ including asthma, which affects​​ around 300 million people​​​‌ worldwide. However, how glucocorticoids​ work at the molecular​‌ level is not fully​​ understood, causing many undesired​​​‌ effects. CausalGene aims to​ unveil how the gene​‌ expression of lungs cells​​ changes upon administration of​​​‌ glucocorticoids. To understand the​ causal effects of glucocorticoids​‌ on cells reprogramming, CausalGene​​ combines methods from causal​​​‌ discovery and graph theory​ to reveal novel molecular​‌ mechanisms governing glucocorticoid cellular​​ activity and to start​​ designing better anti-inflammatory drugs.​​​‌

10.2 International research visitors‌

10.2.1 Visits of international‌​‌ scientists

Jean-Baptiste Poline
  • Status:​​
    Professor
  • Institution of origin:​​​‌
    McGill University
  • Dates:
    06/10/2025‌ - 17/10/02026
  • Context of‌​‌ the visit:
    Prof. J.-B.​​ Poline visited Epione with​​​‌ a grant IVADO-Inria for‌ building a collaboration with‌​‌ Marco Lorenzi on reproducible​​ collaborative learning methods and​​​‌ software in neuroimaging studies.‌
  • Mobility program/type of mobility:‌​‌
    Research stay
Hervé Lombaert​​
  • Status:
    Professor
  • Institution of​​​‌ origin:
    Polytechnique Montréal
  • Dates:‌
    December 2025
  • Context of‌​‌ the visit:
    Hervé Lombaert​​ visited Epione during 3​​​‌ weeks in December to‌ discuss potential collaborations, especially‌​‌ about X-Ray image processing.​​
  • Mobility program/type of mobility:​​​‌
    Research stay
Alessandra Corda‌
  • Status:
    PhD student
  • Institution‌​‌ of origin:
    Politecnico di​​ Milano
  • Dates:
    01/11/2025 -​​​‌ 01/02/02026
  • Context of the‌ visit:
    adaptation of electrophysiological‌​‌ models to experimental data​​
  • Mobility program/type of mobility:​​​‌
    Research stay

10.2.2 Visits‌ to international teams

  • Benjamin‌​‌ Billot received fundings from​​ Inria-London to visit Prof.​​​‌ Daniel Alexander and Dr.‌ Henry Tregidgo for a‌​‌ 1-week visit at the​​ Hawkes institute (UCL) in​​​‌ order to discuss a‌ future project for contrast-agnostic‌​‌ brain MRI segmentation.
  • Marco​​ Lorenzi was invited to​​​‌ join the French delegation‌ to attend the “France-Japan‌​‌ Bilateral Seminar on Health​​ Data,” co-hosted by the​​​‌ Science and Technology Department‌ of the French Embassy‌​‌ in Japan, PEPR Digital​​ Health (France 2030 Investment​​​‌ Plan), and the Keio‌ University School of Medicine.‌​‌
  • Marco Lorenzi was invited​​ to the Computer Science​​​‌ Department of Ruhr Universität‌ Bochum (RUB) within the‌​‌ framework of the Franco-German​​ project TRAIN.
  • Arnaud Lang​​​‌ received funding from the‌ Inria-London program for a‌​‌ 1 week visit to​​ Pr. Calissano at University​​​‌ College London in the‌ framework of his M2‌​‌ internship under the supervision​​ of Irene Balelli .​​​‌

10.3 European initiatives

10.3.1‌ Horizon Europe

EUCAIM

EUCAIM‌​‌ project on cordis.europa.eu

  • Title:​​
    EUropean Federation for CAncer​​​‌ Images
  • Duration:
    From January‌ 1, 2023 to December‌​‌ 31, 2026
  • Partners:
    • BBMRI-ERIC,​​ Austria
    • European Institute for​​​‌ Biomedical Imaging Research, Austria‌
    • Medical University of Innsbruck,‌​‌ Austria
    • Charité, Germany
    • ELIXIR,​​ Germany
    • German Cancer Research​​​‌ Center, Germany
    • Inria, France‌
    • Technical University of Munich,‌​‌ Germany
    • Aristotle University of​​ Thessaloniki, Greece
    • Hellenic Cancer​​​‌ Society, Greece
    • National and‌ Kapodistrian University of Athens,‌​‌ Greece
    • Gemelli University Hospital,​​ Italy
    • Italian National Research​​​‌ Council, Italy
    • University of‌ Pisa, Italy
    • Andalusian Health‌​‌ Service, Spain
    • Instituto de​​ Salud Carlos III, Spain​​​‌
    • University of Barcelona, Spain‌
    • Karolinska Institute, Sweden
    • Linköping‌​‌ University, Sweden
    • Umeå University,​​ Sweden
    • Pohjois-Savon Hyvinvointialue, Finland​​​‌
    • Oslo University Hospital, Norway‌
  • Inria contact:
    Marco Lorenzi‌​‌
  • Coordinator:
    Marco Lorenzi
  • Summary:​​
    The EUCAIM project is​​​‌ a cornerstone of the‌ European Cancer Imaging Initiative‌​‌ under Europe’s Beating Cancer​​ Plan. This initiative is​​​‌ a significant contributor to‌ the European Health Data‌​‌ Space and aims to​​ establish a pan-European digital​​​‌ and federated infrastructure of‌ FAIR (Findable, Accessible, Interoperable,‌​‌ and Reusable) cancer images.​​
DTRIP4H

DTRIP4H project on​​​‌ cordis.europa.eu

  • Title:
    Enabling Decentralized‌ Digital Twin Era in‌​‌ existing Research Infrastructures for​​ Predictive, Preventive, Personalized, and​​​‌ Participatory Health
  • Duration:
    From‌ January 1, 2025 to‌​‌ December 31, 2028
  • Partners:​​​‌
    • UAB Teraglobus, Lithuania
    • Inria,​ France
    • Instituto Pedro Nunes​‌ associacao para a inovacao​​ e desenvolvimento em ciencia​​​‌ e technologia, Portugal
    • Metropolia​ Ammattikorkeakoulu Oy, Finland
    • Ludwig-Maximilians-Universitaet​‌ Muenchen, Germany
    • Helsingin Yliopisto,​​ Finland
    • Digitaltwin Technology GMBH,​​​‌ Germany
    • Masarykova Univerzita, Czechia​
    • Centre for research and​‌ technology Hellas Certh, Greece​​
    • Oulun Yliopisto, Finland
    • Artificial​​​‌ intelligence expert SRL, Romania​
    • Klinikum der Ludwig-Maximilians-Universitaet Muenchen,​‌ Germany
    • Nec Italia SPA,​​ Italy
    • Chino SRL (Chino.io),​​​‌ Italy
    • Demcon Data Driven​ Solutions B.V., Netherlands
    • Europrean​‌ Health Management Association, Belgium​​
    • Linac-PET Scan Opco ltd,​​​‌ Cyprus
    • Nec Labortories Europe​ GMBH, Germany
    • Lapland University​‌ of Applied Sciences, Finland​​
    • Alma Mater Studiorum -​​​‌ Universita di Bologna, Italy​
    • Near Real Oy, Finland​‌
    • Demcon Sync Biosystems, Netherlands​​
    • Protobios, Estonia
    • Universidad del​​​‌ pais Vasco/ Euskal Herriko​ Unibertsitatae, Spain
    • Tallinn University​‌ of Technology, Estonia
    • Oulu​​ University of Applied Sciecnces,​​​‌ Finland
  • Inria contact:
    Marco​ Lorenzi
  • Coordinator:
    Marco Lorenzi​‌
  • Summary:
    In the face​​ of a rapidly advancing​​​‌ digital healthcare terrain, the​ DTRIP4H project emerges as​‌ a momentous effort to​​ revolutionize predictive, preventive, personalized,​​​‌ and participatory health paradigms​ within the EU. Amid​‌ significant incidence of chronic​​ conditions and cancer, there​​​‌ is a pressing need​ for a proactive shift​‌ in health strategies. Yet,​​ the full potential of​​​‌ European research infrastructures (RIs)​ is curtailed by investment​‌ deficits, fragmentation, and the​​ intricacies of data management.​​​‌ Digital Twin (DT) technology​ introduces a new age​‌ of precision by enabling​​ sophisticated simulations and analyses​​​‌ of intricate biological processes.​ In DTRIP4H, we start​‌ a new initiative in​​ Europe “decentralized health digital​​​‌ twin ecosystem consisting of​ RIs”. Using DTs, we​‌ aim to resolve critical​​ challenges around data harmonization,​​​‌ equitable access, and stringent​ privacy safeguards. Incorporating technologies​‌ such as federated learning,​​ Generative AI, and Virtual​​​‌ Reality (VR), the project​ aspires to create a​‌ decentralized digital twin environment​​ (DDTE). This will empower​​​‌ both internal and external​ RI users, such as​‌ researchers, innovators, and SMEs,​​ to craft DT applications​​​‌ that address specific scientific​ challenges, utilizing a blend​‌ of real-world and synthetic​​ data in compliance with​​​‌ regulatory frameworks, i.e. GDPR.​ We will develop 7​‌ innovative proof of concept​​ thematic health-related Use cases​​​‌ fulfilling the needs of​ scientists, SMEs, and industrial​‌ end users, particularly in​​ health topics related to​​​‌ cancer treatment, drug development,​ human environmental exposome, precision​‌ treatment for schizophrenia and​​ personalized medicine through Artificial​​​‌ Intelligence (AI), AR/VR empowered​ DTs utilizing DDTE, while​‌ adhering to FAIR data​​ principles. DTRIP4H adopts a​​​‌ human-centric methodology to elevate​ research efficacy, narrow the​‌ skills gap, and align​​ with the objectives of​​​‌ the European Research Area​ (ERA) and the Sustainable​‌ Development Goals (SDGs) by​​ 2030.

10.3.2 H2020 projects​​​‌

SimCardioTest

SimCardioTest project on​ cordis.europa.eu

  • Title:
    Simulation of​‌ Cardiac Devices and Drugs​​ for in-silico Testing and​​​‌ Certification
  • Duration:
    From January​ 1, 2021 to June​‌ 30, 2025
  • Partners:
    • Universidad​​ Pompeu Fabra, Spain
    • Inria,​​​‌ France
    • Virtual Physiological human​ Institute for integrative biomedical​‌ research, Belgium
    • Sorin CRM​​ SAS, France
    • ExactCure, France​​​‌
    • Simula research laboratory, Norway​
    • IniSilicoTrials Technologies, Netherlands
    • Université​‌ De Bordeaux, France
    • Boston​​ Scientific, United States
    • Universitat​​ Politecnica de Valencia, Spain​​​‌
    • IniSilicoTrials Technologies, Italy
  • Inria‌ contact:
    Maxime Sermesant
  • Coordinator:‌​‌
    Maxime Sermesant
  • Summary:

    Despite​​ massive investment in healthcare,​​​‌ huge research and development‌ cost increase and regulatory‌​‌ pathway complexity hamper tremendously​​ commercialization of new devices​​​‌ and medicines, putting patient‌ populations at risk of‌​‌ not receiving adequate therapy.​​ At the same time,​​​‌ outside healthcare, computer modeling‌ and simulation (CM&S) is‌​‌ precisely recognized to increase​​ speed and agility while​​​‌ reducing costs of development.‌ CM&S can create scientific‌​‌ evidence based on controlled​​ investigations including variability, uncertainty​​​‌ quantification, and satisfying demands‌ for safety, efficacy and‌​‌ improved access.

    Cardiac modeling​​ has dramatically gained maturity​​​‌ over the last decades,‌ with personalization to clinical‌​‌ data enabling validation. We​​ selected a number of​​​‌ cardiac devices and medicines‌ where CM&S is mature‌​‌ enough and that represent​​ the most common cardiac​​​‌ pathologies, to demonstrate a‌ standardized and rigorous approach‌​‌ for in-silico clinical trials.​​

    SimCardioTest will bring a​​​‌ disruptive innovation by creating‌ an integrated and secure‌​‌ platform standardizing and bridging​​ model simulations, in-silico trials,​​​‌ and certification support. This‌ environment will go beyond‌​‌ the state-of-the-art in computational​​ multi-physics and multi-scale personalized​​​‌ cardiac models. Diseased conditions‌ and gender/age differences will‌​‌ be considered to overcome​​ clinical trials limitations such​​​‌ as under-representation of groups‌ (e.g. women, children, low‌​‌ socio-economic status). Advanced big​​ data, visual analytics and​​​‌ artificial intelligence tools will‌ extract the most relevant‌​‌ information.

    It is critical​​ that Europe demonstrates its​​​‌ capacity to leverage in-silico‌ technology in order to‌​‌ be competitive in healthcare​​ innovation. SimCardioTest exploitation aims​​​‌ at delivering a major‌ economic impact on the‌​‌ European pharmaceutical and cardiac​​ devices industry. It will​​​‌ accelerate development, certification and‌ commercialization, and will produce‌​‌ a strong societal impact​​ contributing to personalized healthcare.​​​‌

inEurHeart

inEurHeart website

  • Title:‌
    inEurHeart: AI, Digital Twin‌​‌ & Clinical Trial for​​ a Disruption in Catheter​​​‌ Ablation
  • Duration:
    2022-2025
  • Partners:‌
    • Inria, France
    • Rotterdam University,‌​‌ Netherlands
    • Inserm, France
    • CHU​​ Bordeaux, France
    • inHEART, France​​​‌
    • Université de Bordeaux, France‌
  • Inria contact:
    Maxime Sermesant‌​‌
  • Coordinator:
    Inria
  • Summary:
    inEurHeart​​ is an innovation project​​​‌ in Artificial Intelligence, Digital‌ Twin & a Clinical‌​‌ Trial for a Disruption​​ in Catheter Ablation for​​​‌ Ventricular Tachycardia, making ablation‌ therapy accessible to most‌​‌ patients. This project is​​ a collaborative project between​​​‌ 5 organizations in France‌ and Netherlands funded by‌​‌ EIT Health - the​​ European Institute of Innovation​​​‌ and Technology, co-funded by‌ the European Union. This‌​‌ project will exemplify how​​ the academic-industrial relationships can​​​‌ be fostered and can‌ lead to drastic changes‌​‌ in clinical practice. EIT​​ Health provides a unique​​​‌ opportunity to transfer Artificial‌ Intelligence tools to enable‌​‌ the scale-up phase, and​​ to validate the technology​​​‌ through a randomized clinical‌ trial.

10.4 National initiatives‌​‌

10.4.1 PEPR Digital Health​​ ChroniCardio

Participants: Jairo Rodriguez​​​‌, Mihaela Pop,‌ Maxime Sermesant.

  • Duration:‌​‌
    2023 - 2027
  • Partners:​​
    • Inria
    • Hospices Civils de​​​‌ Lyon
    • Assistance Publique -‌ Hôpitaux de Marseille
    • Creatis,‌​‌ Lyon
  • Inria contact:
    Maxime​​ Sermesant
  • Coordinator:
    Inria
  • Summary:​​​‌
    ChroniCardio is a new‌ 4-year multi-institution project funded‌​‌ by the French Research​​​‌ Priority Programme on Digital​ Health to accelerate the​‌ integration of multi-scale data​​ (clinical, imaging, genetic, ECG,​​​‌ etc.) and the development​ of advanced modeling tools​‌ to predict the long-term​​ evolution of non-ischemic dilated​​​‌ and hypertrophic cardiomyopathies. This​ includes the risk of​‌ arrhythmia, heart failure and​​ sudden cardiac death. Our​​​‌ consortium brings together research​ scientists and engineers from​‌ Inria (Sophia Antipolis, Lyon,​​ Rennes, Bordeaux) and INSA​​​‌ / Lyon /University /​ CNRS (Lyon), and clinicians​‌ from Lyon and Marseille​​ University Hospitals. The project​​​‌ is coordinated by Maxime​ Sermesant , from Inria​‌ Epione team.

10.4.2 PEPR​​ Digital Health Rewind

Participants:​​​‌ Marco Lorenzi.

  • Duration:​
    2023 - 2027
  • Partners:​‌
    • Inria
    • CNRS
    • INSERM
    • Université​​ Grenoble Alpes
  • Inria contact:​​​‌
    Stephanie Allassonniére
  • Coordinator:
    Inria​
  • Summary:
    The project Rewind​‌ will focus on the​​ development of new mathematical​​​‌ and statistical approaches for​ the analysis of multimodal​‌ multiscale longitudinal data. These​​ models will be designed,​​​‌ implemented as prototypes and​ then transferred to an​‌ easy-used-well-documented platform where researchers​​ from diverse communities, in​​​‌ particular physicians, will be​ able to analyze their​‌ own data set.

10.4.3​​ PEPR Digital Health Secure,​​​‌ safe and fair machine​ learning for healthcare

Participants:​‌ Marco Lorenzi.

  • Duration:​​
    2023 - 2027
  • Partners:​​​‌
    • Inria
    • Lamsade (CNRS, Dauphine-PSL)​
    • CEA
  • Inria contact:
    Aurelien​‌ Bellet
  • Coordinator:
    Inria, Dauphine-PSL​​
  • Summary:
    The goal of​​​‌ this project is to​ overcome the challenges that​‌ prevent the effective use​​ of personalized health data.​​​‌ To achieve this, we​ will develop new machine​‌ learning algorithms that are​​ designed to handle the​​​‌ unique characteristics of multi-scale​ and heterogeneous individual health​‌ data, while providing formal​​ privacy guarantees robustness against​​​‌ adversarial attacks and changes​ in data dynamics, and​‌ fairness for under-represented populations.​​ By addressing these barriers,​​​‌ we hope to unlock​ the full potential of​‌ personalized health data for​​ a wide range of​​​‌ applications.

10.4.4 PEPR Digital​ Health Stratify Aging

Participants:​‌ Marco Lorenzi.

  • Duration:​​
    2023 - 2027
  • Partners:​​​‌
    • CEA
    • Inria
    • CNRS
    • INSERM​
  • Inria contact:
    Marco Lorenzi​‌ , Ghiles Reguig
  • Coordinator:​​
    CEA
  • Summary:
    The goal​​​‌ of StratifyAging is to​ focus on using high-quality,​‌ curated data from clinical​​ research to advance the​​​‌ field of patient stratification​ through the use of​‌ hypothesis-driven approaches or AI​​ algorithms. By harmonizing and​​​‌ aggregating data from various​ studies, it will be​‌ possible to reach a​​ large enough sample size​​​‌ to effectively stratify patients.​ This process will also​‌ lead to the development​​ of standard protocols that​​​‌ can be applied in​ routine care. As a​‌ result, a virtuous cycle​​ may be created, in​​​‌ which standardized data from​ routine care is collected​‌ and analyzed through the​​ Health Data Hub and​​​‌ used to perform population​ monitoring and develop normative​‌ charts and decision support​​ tools.

10.4.5 PEPR Digital​​​‌ Health Rewind

Participants: Marco​ Lorenzi.

  • Duration:
    2023​‌ - 2027
  • Partners:
    • Inria​​
    • CNRS
    • INSERM
  • Inria contact:​​​‌
    Marco Lorenzi , John​ Kalkhof , Giuseppe Orlando​‌
  • Coordinator:
    Inria
  • Summary:
    Rewind​​ focuses on the development​​​‌ of new mathematical and​ statistical approaches for the​‌ analysis of multimodal multiscale​​ longitudinal data. These models​​ will be designed, implemented​​​‌ as prototypes and then‌ transferred to an easy-used-well-documented‌​‌ platform where researchers from​​ diverse communities, in particular​​​‌ physicians, will be able‌ to analyze their own‌​‌ data set.

10.4.6 MediTwin​​

Participants: Maxime Sermesant,​​​‌ Hervé Delingette, Xavier‌ Pennec.

  • Duration:
    2024‌​‌ - 2028
  • Partners:
    • Dassault​​ Systemes
    • Inria
    • IHUs
    • Start-ups​​​‌
  • Inria contact:
    Maxime Sermesant‌
  • Coordinator:
    Dassault Systemes
  • Summary:‌​‌
    The MEDITWIN project will​​ offer personalized virtual twins​​​‌ of organs, metabolism and‌ cancer, for better diagnosis‌​‌ and treatment. In particular,​​ MEDITWIN will enable doctors​​​‌ to simulate future scenarios‌ for a patient. MEDITWIN‌​‌ will enable the industrialization,​​ clinical validation and standardization​​​‌ of these innovations, so‌ that these technologies can‌​‌ be deployed in a​​ standardized way and benefit​​​‌ as many people as‌ possible. The best standards‌​‌ of care will be​​ incorporated into virtualized experiences​​​‌ made accessible worldwide, setting‌ a new benchmark for‌​‌ quality in healthcare and​​ providing a decisive learning​​​‌ ground for progress in‌ medical science. The benefits‌​‌ of virtual twins will​​ be assessed for medical​​​‌ teams, patients, and the‌ healthcare system, notably in‌​‌ terms of improving the​​ efficiency of care, quality​​​‌ of multidisciplinary decision-making, and‌ effectiveness and safety of‌​‌ medical practices and interventions.​​

10.4.7 DAICAP

Participants: Hervé​​​‌ Delingette.

  • Duration:
    2020‌ - 2025
  • Partners:
    • AP-HP‌​‌
    • Inria
    • Incepto
    • CHU Bordeaux,​​ CHU Lille, CHU Strasbourg,​​​‌ Hopitaux Civils de Lyon‌
  • Inria contact:
    Hervé Delingette‌​‌
  • Coordinator:
    AP-HP
  • Summary:
    The​​ DAICAP project aims at​​​‌ creating a large multi-centric‌ study (8 clinical centers‌​‌ on 5 partner university​​ hospitals) combining multiparametric MR​​​‌ images of the prostate‌ and histology for the‌​‌ detection and characterization of​​ prostate cancer. Inria participates​​​‌ to the data collection,‌ quality control of restrospective‌​‌ and prospective data from​​ 1250 patients. It also​​​‌ performs the training and‌ evaluation of AI algorithms‌​‌ for prostate lesion detection.​​ The infrastructure of the​​​‌ Health Data Hub is‌ used to centralize the‌​‌ data and to fine-tune​​ the AI models. The​​​‌ DAICAP project was selected‌ by the Health Data‌​‌ Hub, the Grand Défi​​ « Amélioration des diagnostics​​​‌ médicaux par l'Intelligence Artificielle‌ », and Bpifrance in‌​‌ July 2020.

10.4.8 AICOO​​

Participants: Hervé Delingette.​​​‌

  • Duration:
    2024 - 2028‌
  • Partners:
    • Incepto
    • Inria
    • AP-HP‌​‌
    • France Imagerie Territoires
    • EDL​​
    • Easydoct
  • Inria contact:
    Hervé​​​‌ Delingette
  • Coordinator:
    Incepto
  • Summary:‌
    The AICOO project has‌​‌ been selected among the​​ winners of the French​​​‌ national « Innovation in‌ medical imaging » call‌​‌ for projects. It aims​​ to transform patient care​​​‌ at the early stage‌ of cancer detection by‌​‌ developing an oncology coordination​​ platform. The platform includes​​​‌ AI solutions for the‌ early detection of Prostate‌​‌ Cancer and the extraction​​ of advanced biomarkers. In​​​‌ this project, Inria develops‌ advanced machine learning solutions‌​‌ for the automatic characterization​​ of prostate lesion malignancy​​​‌ using multiparametric Magnetic Resonance‌ Imaging.

10.4.9 RHU ReBONE‌​‌

Participants: Hervé Delingette,​​ Alix de Langlais,​​​‌ Benjamin Billot.

  • Duration:‌
    2024 - 2029
  • Partners:‌​‌
    • Partenaires académiques : Université​​ Côte d'Azur, Inserm, Inria,​​​‌ CNRS, Institut Pasteur,Université de‌ Bretagne Occidentale, Université Paris‌​‌ Cité, Université Aix-Marseille, Mines​​​‌ de Paris
    • Partenaires industriels​ : Abys Medical, Newclip​‌ Technics, Addidream, Aguila Expertise,​​ Digital Medical Hub
    • Partenaires​​​‌ Cliniques : CHU Nice,​ AP-HP
  • Inria contact:
    Hervé​‌ Delingette
  • Coordinator:
    CHU Nice​​
  • Summary:
    The ReBone project​​​‌ has been selected among​ the winners of the​‌ French national « Recherche​​ Hospitalo-Universitaire en santé »​​​‌ (RHU) call for projects.​ It aims to develop​‌ novel personalized, automated, collaborative​​ and validated preoperative planning​​​‌ tools to simulate, prepare​ and then perform a​‌ secure and patient-specific surgical​​ intervention in osteoarticular surgery.​​​‌ In this project, Inria​ works on the collection​‌ and quality control of​​ medical image datasets associated​​​‌ with 3 use cases.​ We also develop new​‌ automated methods to delineate​​ fractured bony structures in​​​‌ CT images and participate​ to their validations in​‌ terms of clinical and​​ industrial use.

10.4.10 RHU​​​‌ TALENT

Participants: Maxime Sermesant​, Irene Balelli,​‌ Marco Lorenzi.

  • Duration:​​
    2024 - 2029
  • Partners:​​​‌
    • Partenaires académiques : U​ Bordeaux, IHU Liryc, Inria​‌
    • Partenaires industriels : Cardiologs,​​ inHEART, Incepto, AMPS
    • Partenaires​​​‌ cliniques : CHU Bordeaux,​ CHU Dijon
  • Inria contact:​‌
    Maxime Sermesant
  • Coordinator:
    Université​​ de Bordeaux
  • Summary:
    The​​​‌ consortium of academic centers​ and private companies brought​‌ together in the TALENT​​ project aims to revolutionize​​​‌ the prediction of stroke​ risk by developing digital​‌ tools capable of detecting​​ this increased risk. The​​​‌ work will focus on​ the analysis of widely​‌ available data, including chest​​ CT scans and/or electrocardiograms,​​​‌ and simpler clinical data​ such as age or​‌ the presence of diabetes.​​ Inria is in charge​​​‌ of image and shape​ analysis, causal discovery and​‌ multimodal learning.

10.4.11 IHU​​ RespirERA

Participants: Hervé Delingette​​​‌, Nicholas Ayache,​ Benjamin Billot.

  • Duration:​‌
    2024 - 2034
  • Partners:​​
    • Founders of the institute:​​​‌ Inria, Inserm, CHU Nice,​ Université Côte d'Azur
  • Inria​‌ contact:
    Hervé Delingette
  • Coordinator:​​
    CHU Nice
  • Summary:
    The​​​‌ RespirERA institute has been​ funded following the third​‌ wave of the French​​ national « Institut Hospitalo-Universitaire​​​‌ » (IHU) call for​ proposals. The institute aims​‌ to improve the care​​ in the field of​​​‌ respiratory diseases. The objectives​ are to reduce the​‌ incidence of lung diseases​​ linked to pollution and​​​‌ age and the impact​ of the exposome (all​‌ exposures to environmental factors),​​ extend the life expectancy​​​‌ of patients, delay dependency​ and progression to respiratory​‌ failure and avoid hospitalizations.​​ Inria is coordinating a​​​‌ workpackage in this new​ institute focusing on AI​‌ solutions for lung cancer​​ screening, and biomarker extraction​​​‌ from heterogenous data for​ the diagnosis of respiratory​‌ diseases. Hervé Delingette and​​ Nicholas Ayache are the​​​‌ members of the executive​ team.

10.4.12 Other national​‌ initiatives

Consulting for Industry​​
  • Nicholas Ayache has joined​​​‌ the Scientific Advisory Board​ of Caranx Medical in​‌ Oct 2021.
  • Maxime Sermesant​​ is a scientific advisor​​​‌ for the company inHEART​ (Bordeaux).
Institute 3IA Côte​‌ d'Azur
  • The 3IA Côte​​ d'Azur is one of​​​‌ the four "Interdisciplinary Institutes​ of Artificial Intelligence" that​‌ were created in France​​ in 2019. Its ambition​​​‌ is to create an​ innovative ecosystem that is​‌ influential at the local,​​ national and international levels,​​ and a focal point​​​‌ of excellence for research,‌ education and the world‌​‌ of AI.
  • Epione is​​ heavily involved in this​​​‌ institute since 5 permanent‌ researchers (Nicholas Ayache‌​‌ , Hervé Delingette ,​​ Marco Lorenzi , Maxime​​​‌ Sermesant and Xavier Pennec‌ ) are chair holders‌​‌ in this institute, and​​ Nicholas Ayache serves as​​​‌ scientific director. The 5‌ Epione chairs were renewed‌​‌ in 2023 by an​​ international jury. Hervé Delingette​​​‌ and Nicholas Ayache are‌ members of its scientific‌​‌ committee.
Funded projects
  • Marco​​ Lorenzi is PI of​​​‌ the project Fed-Ops (2025-2029),‌ with IBV, CAL and‌​‌ EURECOM. The project is​​ funded by the ANR,​​​‌ and aims at operationalizing‌ federated learning methods and‌​‌ software for real-world applications​​ of medical image analysis​​​‌ in multicentric studies.
  • Marco‌ Lorenzi is co-PI of‌​‌ the project FEDERATED-PET (2022-2026),​​ with Prof. Olivier Humbert​​​‌ (CAL, Nice). The project‌ is funded by the‌​‌ Institut National du Cancer​​ (INCa), and aims at​​​‌ developing the first French‌ federated learning infrastructure in‌​‌ a network of hospitals​​ from the Unicancer consortium.​​​‌
  • Marco Lorenzi is principal‌ investigator of the project‌​‌ TRAIN, funded by the​​ ANR, and co-PI of​​​‌ the project StratifyAging of‌ the PEPR Santé Numerique.‌​‌ He also participates to​​ the Horizon Europe Project​​​‌ EUCAIM.
Collaboration with national‌ hospitals
  • Epione has a‌​‌ longstanding collaboration with the​​ IHU-Bordeaux (Pr M. Haïssaguere​​​‌ and Pr P. Jaïs)‌ on cardiac imaging and‌​‌ modeling.
  • Epione also maintains​​ a close partnership with​​​‌ the Brain Institute at‌ Pitié Salpétrière (Dr. O.‌​‌ Colliot and Pr. B.​​ Stankoff) on neuroimaging and​​​‌ multiple sclerosis. This year,‌ this collaboration led to‌​‌ a common publication 27​​ and a patent 64​​​‌.
  • The IHU RespirERA‌ was selected in May‌​‌ 2023 among the 12​​ new institutes in France.​​​‌ This IHU is based‌ in Nice, and focuses‌​‌ on respiratory diseases. Inria​​ is one of its​​​‌ 4 founding institutions together‌ with the University Hospital‌​‌ of Nice, the Université​​ Côte d'Azur and INSERM.​​​‌ Hervé Delingette and Nicholas‌ Ayache are the members‌​‌ of the executive team​​ and are leading a​​​‌ workpackage focusing on AI‌ algorithms for data analysis.‌​‌
  • Several research projects of​​ Epione are part of​​​‌ the joint laboratory Bernouilli‌ between Inria and Assistance‌​‌ Publique des Hôpitaux de​​ Paris (AP-HP), in particular,​​​‌ the DAICAP, and PAIMRI‌ projects with Pr Raphaele‌​‌ Renard-Penna (Hospital La Pitié​​ Salpêtrière), on prostate cancer​​​‌ detection and characterization.
  • We‌ also have long term‌​‌ collaborations with the CHU​​ Nice, the Centre Antoine​​​‌ Lacassagne of Nice, and‌ the Hospital Lenval of‌​‌ Nice.

11 Dissemination

11.1​​ Promoting scientific activities

11.1.1​​​‌ Scientific events: organization

General‌ chair, scientific chair
  • Maxime‌​‌ Sermesant was the general​​ chair of the IABM​​​‌ (Intelligence Artificielle en Imagerie‌ BioMedicale) conference (300 people)‌​‌ organized in Nice (​​IABM 2025).
Member​​​‌ of the organizing committees‌
  • Irene Balelli was member‌​‌ of the organizing committee​​ of the Complex days​​​‌ (Nice, February), and of‌ the spring school GeMSS/Statlearn‌​‌ (Sophia Antipolis, April).
  • Maxime​​ Sermesant was a co-organizer​​​‌ of the STACOM MICCAI‌ (Medical Image Computing and‌​‌ Computer Assisted Intervention, Daejeon,​​​‌ Korea, SE) workshop with​ 100 participants. He also​‌ co-organized the InnovaHeart workshop​​ in Paris (50 people)​​​‌ and the "Imaging and​ Arrhythmia" workshop in Monaco​‌ (50 people). He is​​ co-president of the "One​​​‌ Health" conference series organized​ by ANRT.

11.1.2​‌ Scientific events: selection

Chair​​ of conference program committees​​​‌
  • Irene Balelli was Program​ Chair for ECAI 2025​‌ (European Conference on Artificial​​ Intelligence, Bologna, Italy). She​​​‌ is also part of​ the scientific committee of​‌ IABM 2026 (Colloque Français​​ en Intelligence Artificielle en​​​‌ Imagerie Biomédicale, Lyon).
  • Benjamin​ Billot was Area Chair​‌ for MIDL 2025 (Medical​​ Imaging with Deep Learning,​​​‌ Salt Lake City, USA).​
  • Xavier Pennec was a​‌ member of the scientific​​ committee of GSI 2025​​​‌ (Geometric Science of Information,​ Saint-Malo).
  • Marco Lorenzi was​‌ Area Chair for NeurIPS​​ 2025 (Neural Information Processing​​​‌ Systems, San Diego, USA).​
  • Maxime Sermesant was part​‌ of the scientific committee​​ of the 2025 SophIA​​​‌ Summit, the 2025 FIMH​ conference (Functional Imaging and​‌ Modeling of the Heart)​​ and the STACOM 2025​​​‌ (Statistical Atlases and Computational​ Modeling of the Heart)​‌ workshop.
Reviewer
  • Benjamin Billot​​ was a reviewer for​​​‌ MICCAI 2025 (Medical Image​ Computing and Computer Assisted​‌ Intervention, Daejeon, Korea) for​​ which he received the​​​‌ Outstanding reviewer award. He​ also reviewed workshop proposals​‌ for EurIPS 2025 (European​​ Information Processing Systems, Copenhagen,​​​‌ Denmark).
  • Marco Lorenzi was​ a reviewer for the​‌ conferences MICCAI 2025, ICML​​ 2025 (International Conference on​​​‌ Machine Learning, Vancouver, Canada),​ CVPR 2025 (Conference on​‌ Computer Vision and Pattern​​ Recognition, Nashville, USA), AISTATS​​​‌ 2025 (Artificial Intelligence and​ Statistics, Thailand).
  • Hervé Delingette​‌ was reviewer for MICCAI​​ 2025, for the MICCAI​​​‌ workshops MLMAI 2025, UNSURE​ 2025, and DECAF 2025.​‌
  • Francesco Cremonesi was a​​ reviewer for MICCAI 2025.​​​‌
  • Bernhard Föllmer was a​ reviewer for MICCAI 2025.​‌
  • Huiyu Li was a​​ reviewer for MIDL 2025.​​​‌
  • Jairo Rodríguez Padilla was​ a reviewer for the​‌ STACOM workshop of MICCAI​​ 2025 (Statistical Atlases and​​​‌ Computational Modeling of the​ Heart), as well as​‌ for FIMH 2025 (Functional​​ Imaging and Modeling of​​​‌ the Heart, Dallas, USA).​
  • Rafael Silva was a​‌ reviewer for ICLR 2025​​ (International Conference on Learning​​​‌ Representations, Singapore).
  • Tom Szwagier​ was a reviewer for​‌ GSI 2025.
  • Maxime Sermesant​​ was a reviewer for​​​‌ the FIMH conference and​ the STACOM workshop.

11.1.3​‌ Journal

Member of editorial​​ boards
  • Nicholas Ayache is​​​‌ the co-founder and the​ Co-Editor in Chief with​‌ J. Duncan of Medical​​ Image Analysis journal (Elsevier).​​​‌
  • Nicholas Ayache is a​ member of the advisory​‌ board of the Computer​​ Assisted Surgery journal (Taylor​​​‌ & Francis).
  • Hervé Delingette​ is a member of​‌ the editorial board of​​ Medical Image Analysis (Elsevier).​​​‌
  • Marco Lorenzi is member​ of the editorial board​‌ of Medical Image Analysis​​ (Elsevier).
  • Xavier Pennec is​​​‌ a member of the​ editorial boards of Medical​‌ Image Analysis (Elsevier), the​​ International Journal of Computer​​​‌ Vision (Springer), and of​ the Journal of Mathematical​‌ Imaging and Vision (Springer).​​
  • Bernhard Föllmer is associate​​​‌ editor for the Journal​ of Cardiovascular Computed Tomography​‌ (Elsevier).
Reviewer - reviewing​​ activities
  • Benjamin Billot was​​ reviewer for the following​​​‌ journals: Science, Nature Communications,‌ Medical Image Analysis, IEEE‌​‌ transactions on Medical Imaging,​​ NeuroImgae, and Imaging Neuroscience.​​​‌
  • Irene Balelli was a‌ reviewer for the following‌​‌ journals: Vaccine, Medical Image​​ Analysis, Computers in Biology​​​‌ and Medicine, Neuroimage, SMAI‌ J. of Computational Mathematics.‌​‌
  • Francesco Cremonesi was a​​ reviewer for the following​​​‌ journals: Medical Image Analysis,‌ Intelligence-Based Medicine, Computerized Medical‌​‌ Imaging and Graphics, and​​ Computers in Biology and​​​‌ Medicine.
  • Bernhard Föllmer was‌ a reviewer for the‌​‌ following Journals: Medical Image​​ Analysis, IEEE Transactions on​​​‌ Medical Imaging, International Journal‌ of Imaging Systems and‌​‌ Technology, International Journal of​​ Cardiovascular Imaging, Nature Reports,​​​‌ Quantitative Imaging in Medicine‌ and Surgery.
  • Maëlis Morier‌​‌ was a reviewer for​​ the following journals: SoftwareX​​​‌ and Medical Image Analysis.‌
  • Rafael Silva was a‌​‌ reviewer for Nature Scientific​​ Reports.
  • Tom Szwagier was​​​‌ a reviewer for the‌ International Journal of Computer‌​‌ Vision.
  • Maxime Sermesant was​​ a reviewer for Medical​​​‌ Image Analysis.

11.1.4 Invited‌ talks

  • Nicholas Ayache gave‌​‌ a series of invited​​ plenary talks at the​​​‌ following events and locations:‌
  • Benjamin Billot participated‌​‌ to the following events:​​
    • invited speaker at the​​​‌ Statlearn'25 Spring School (Sophia-Antipolis,‌ March) and at the‌​‌ 3IA Côte d'Azur (Sophia-Antipolis,​​ May).
    • pannelist in the​​​‌ webinar "Best practices for‌ MICCAI reviews and rebuttals"‌​‌ (online, February).
  • Xavier Pennec​​ participated to the following​​​‌ events:
    • keynote speaker at‌ the 2025 Workshop on‌​‌ Geometry, Topology, and Machine​​ Learning (Leipsiz, Germany, November).​​​‌
    • keynote courses at the‌ Schrödinger institute (ESI) for‌​‌ the Program on Infinite-dimensional​​ Geometry: Theory and Applications​​​‌ (Vienna, Austria, February).
    • was‌ invited speaker at: the‌​‌ French Académie des Sciences​​ (May, Paris); AfterShape 2025​​​‌ workshop (Saclay, June); Mathematical‌ Imaging and Surface Processing‌​‌ workshop (Oberwolfach, Germany, February);​​ Geometry for statistics and​​​‌ AI workshop (Lesbos, Greece,‌ Oberwolfach, May); Séminaire Données‌​‌ et Aléatoire Théorie &​​ Applications, (Grenoble, June).
  • Marco​​​‌ Lorenzi participated to the‌ following events:
    • keynote talk‌​‌ at the Annual Meeting​​ of the PEPR Santé​​​‌ Numerique (Rennes, October).
    • invitation‌ by the French Embassy‌​‌ in Japan to present​​ to the France-Japan bilateral​​​‌ seminar on health data‌ hosted by the Keio‌​‌ University School of Medicine​​ (Tokyo, Japan, June).
    • invited​​​‌ lecturer at: RUB University‌ (Germany, June), University of‌​‌ Queensland (Australia, October), and​​ to Geneva University Hospitals​​​‌ (Switzerland, June).
    • panelist in‌ the round table “AI‌​‌ in healthcare” of the​​ AI4People Summit 2025 held​​​‌ by AI4People Institute and‌ the European Parliament.
  • Herve‌​‌ Delingette gave invited presentations​​ during the following events:​​​‌
    • Sophia Summit 2025 (Sophia‌ Antipolis, Novermber)
    • The 5th‌​‌ Joint meeting on Lung​​​‌ Cancer (Nice, October)
    • IABM​ 2025 meeting (Nice, March).​‌
  • Maxime Sermesant gave invited​​ talks at:
    • the King's​​​‌ College London Doctoral School​
    • the Health Data Hub​‌ - Citadel meeting in​​ Montreal
    • the Imaging Workshop,​​​‌ IHU Liryc.

11.1.5 Research​ administration

  • Nicholas Ayache has​‌ been the scientific director​​ of the 3IA Cote-d'Azur​​​‌ for 6 years since​ its creation (Sept 2019-​‌ Oct 2025) and Chair​​ of its Scientific Council.​​​‌ He has been a​ member of the scientific​‌ council of the Mécénat​​ Santé program of the​​​‌ AXA group (2024-2025). He​ is a member of​‌ the scientific advisory board​​ of the start-up companies​​​‌ inHeart (digital heart) and​ Caranx Medical (Medical Robotics).​‌
  • Nicholas Ayache is a​​ member of the French​​​‌ Academy of Sciences, and​ participates to the scientific​‌ activities of two of​​ its sections (Computer Science​​​‌ and Applications of Sciences).​ He is also a​‌ member of the French​​ Academy of Surgery.
  • Irene​​​‌ Balelli is a member​ of the scientific advisory​‌ board of the GIS​​ (scientific interest group) FC3R​​​‌ since July 2023, and​ of the Scientific committee​‌ of the Academy 2​​ (Complex Systems) since November​​​‌ 2023.
  • Irene Balelli is​ in charge of the​‌ pedagogical orgization of the​​ AI for Health track​​​‌ of the Data Science​ & AI Master, Université​‌ Côte d'Azur, France.
  • Irene​​ Balelli is member of​​​‌ the NICE committee since​ October 2025.
  • Xavier Pennec​‌ is co-director of the​​ Ecole doctorale STIC of​​​‌ Université Côte d'Azur. He​ is a member of​‌ the committee of EDSTIC,​​ of the Doctoral follow-up​​​‌ Committee (CSD) at Inria​ Sophia Antipolis. He was​‌ also a member of​​ the executive committee of​​​‌ the Academy 4 (Living​ systems Complexity and diversity)​‌ of the IDEX JEDI​​ at University Côte d'Azur​​​‌ up to October 2025.​
  • Xavier Pennec was a​‌ member of the grant​​ panel for the Collaborative​​​‌ Research in Computational Neuroscience​ (CRCNS) call 2025.
  • Marco​‌ Lorenzi became member of​​ the European Laboratory for​​​‌ Learning and Intelligent Systems​ (ELLIS).
  • Marco Lorenzi is​‌ member of the Member​​ of the Comité de​​​‌ Centre of the Centre​ Inria d'Université Côte d'Azur.​‌ He is External Advisory​​ Board of the HealthData@EU​​​‌ Pilot project.
  • Marco Lorenzi​ was a member of​‌ the grant panel of​​ the call for DataIA​​​‌ Fellowships 2025.
  • Hervé Delingette​ is one of the​‌ 2 scientific directors of​​ the IdEx program UCA​​​‌ JEDI under the direction​ of the IdEX vice-president​‌ of the Université Côte​​ d'Azur. He is an​​​‌ administrator and a member​ of the scientific committee​‌ of the Groupement de​​ Coopération Sanitaires (GCS) CARES​​​‌ involving the Université Côte​ d'Azur and the 3​‌ local hospitals (CHU Nice,​​ Centre Antoine Lacassagne, Fondation​​​‌ Lenval). He is also​ a member of the​‌ research and innovation committee​​ organized by the employer​​​‌ union UPE06.
  • Hervé Delingette​ is the contact person​‌ at the Inria center​​ of Université Côte d'Azur​​​‌ for research data management.​ Hervé Delingette is the​‌ Inria representative at the​​ executive committee of the​​​‌ DATAZUR structure, helping Université​ Côte d'Azur researchers handle​‌ their research data.

11.2​​ Teaching - Supervision -​​ Juries - Educational and​​​‌ pedagogical outreach

11.2.1 Teaching‌

  • Master: Irene Balelli ,‌​‌ Research awareness, 6h EURECOM,​​ Sophia Antipolis.
  • Licence: Irene​​​‌ Balelli , Advanced statistical‌ modeling, 22.5h ETD, Univ.‌​‌ Côte d'Azur, France.
  • Licence:​​ Irene Balelli , Statistical​​​‌ modeling for complex data‌ and Big Data, 37.5h‌​‌ ETD, Univ. Côte d'Azur,​​ France.
  • Master: Hervé Delingette​​​‌ and Xavier Pennec ,‌ Medical Image Analysis based‌​‌ on generative, geometric and​​ biophysical models, 21h course​​​‌ (28.5 ETD), Master 2‌ MVA, ENS Saclay, France.‌​‌
  • Master: Hervé Delingette and​​ Xavier Pennec , Medical​​​‌ Image Processing, 24h course,‌ Master Data-Science and Artificial‌​‌ Intelligence, Université Côte d'Azur,​​ France.
  • Master: Hervé Delingette​​​‌ , AI in Digital‌ Pathology, 3h course, Master‌​‌ of Science Biobanks and​​ Complex Data Management, Univ.​​​‌ Côte d'Azur, France.
  • Hervé‌ Delingette , 2h course,‌​‌ Diplôme d'Etudes Supérieures Inter​​ Universitaires - Réutilisation de​​​‌ données pour la recherche‌ en santé (DESIU REDS)‌​‌
  • Master: Hervé Delingette ,​​ AI in Oncology 2h​​​‌ course, Master Cancérologie et‌ Recherche Translationnelle, Univ. Côte‌​‌ d'Azur, France.
  • Master: Marco​​ Lorenzi and V. Alessandro,​​​‌ Bayesian Learning, 30h course,‌ Master Data Science, Univ.‌​‌ Côte d'Azur, France.
  • Master:​​ Marco Lorenzi , Model​​​‌ Selection and Resampling Methods,‌ 30h course, Master Data‌​‌ Science, Univ. Côte d'Azur,​​ France.
  • Marco Lorenzi and​​​‌ Francesco Cremonesi presented a‌ 6 hour workshop with‌​‌ title "Analyse des données​​ de santé sensibles par​​​‌ l'apprentissage fédéré” for Inria‌ Academy, Valbonne, France
  • Marco‌​‌ Lorenzi , Francesco Cremonesi​​ , and Lucie Chambon​​​‌ , Federated Learning and‌ the Fed-BioMed software AI4Health‌​‌ Summer School, 1h ETD,​​ Paris.
  • Master: Francesco Cremonesi​​​‌ , Federated Learning, 8h‌ ETD, École d'ingénieur ISIS,‌​‌ Castres, France
  • Master: Francesco​​ Cremonesi , Federated Learning,​​​‌ 6h ETD, École Centrale‌ Marseille, Marseille, France
  • Lucie‌​‌ Chambon , Francesco Cremonesi​​ and John Kalkhof ,​​​‌ Federated Learning and the‌ Fed-BioMed software, AI for‌​‌ maternal health: machine learning,​​ federated learning, and ethical​​​‌ innovation for obstetric ultrasound,‌ 6h ETD, University of‌​‌ Embu, Embu, Kenya.
  • Master:​​ Lucie Chambon and Francesco​​​‌ Cremonesi , Federated Learning,‌ 16h ETD, École d'ingénieur‌​‌ ISIS, Castres, France
  • Master:​​ Lucie Chambon and Ali​​​‌ Tolga Dincer , 6h‌ ETD, Master DSAI, Université‌​‌ Cote d'Azur
  • License: Olivier​​ Bisson , L2 Math​​​‌ (Calculus II), 16h ETD,‌ and L1 Math (Introduction‌​‌ à l'analyse), 36h ETD,​​ Univ. Côte d'Azur, France.​​​‌
  • Project Management: Gaëtan Desrues‌ , Mathématiques Appliquées et‌​‌ Modélisation (Ingénierie Numérique), 20h,​​ École d'ingénieur Polytech Nice​​​‌ Sophia, France
  • License: Nicolas‌ Drettakis , Introduction à‌​‌ l'informatique, 18h ETD, Université​​ Nice Cote d'Azur, Nice,​​​‌ France.
  • Bachelor: Giulia Foroni‌ and Olivier Humbert ,‌​‌ Séminaire IA et santé​​ SANURN, 6h ETD, School​​​‌ of Medicine, Université Cote‌ d'Azur, Nice, France.
  • Master:‌​‌ Jairo Rodríguez Padilla ,​​ Cardiac Digital Twin, 15h​​​‌ ETD, École d'ingénieur ISEN‌ Yncréa Ouest, Caen, France.‌​‌
  • Master: Rafael Silva ,​​ Électronique Analogique, 54h TP,​​​‌ Polytech Nice Sophia, Sophia‌ Antipolis, France
  • University Diploma:‌​‌ Rafael Silva , DU​​ Intelligence Artificielle et Santé,​​​‌ 8h TD, Faculté de‌ Médecine, Nice, France

11.2.2‌​‌ Supervision: defended PhDs

  • Lisa​​ Guzzi , Automatic segmentation​​​‌ of the vascular system‌ to enhance AI-based decision‌​‌ support system for peripheral​​​‌ artery disease 54,​ Université Côte d'Azur, 3IA​‌ fellowship. Started in 2022.​​ Directed by Hervé Delingette​​​‌ , Juliette Raffort-Lareyre
  • Tom​ Szwagier , Rethinking statistical​‌ methods with Flags spaces​​ 55, Université Côte​​​‌ d'Azur. Started in 2022.​ Directed by Xavier Pennec​‌ .

11.2.3 Supervision: ongoing​​ PhDs

  • Amel Bakhouche :​​​‌ Analysis of European National​ Health data and vascular​‌ registries to better understand​​ the outcomes of patients​​​‌ with vascular diseases. CHU-Inria​ PhD started in February​‌ 2025. Co-directed by Hervé​​ Delingette , Irene Balelli​​​‌ and Juliette Raffort-Lareyre (CHU​ Nice).
  • Olivier Bisson :​‌ Géométrie, Stratification et application​​ des matrices de corrélation​​​‌ structurées. Directed by Xavier​ Pennec . 3IA PhD​‌ started in October 2023.​​
  • Florencia Boccarato : Effective​​​‌ AI based Characterization of​ Prostate Cancer from Multiparametric​‌ MRI. Directed by Hervé​​ Delingette and Raphaele Renard-Penna​​​‌ (PUPH Sorbonne Université, AP-HP),​ funded by the AICOO​‌ project.
  • Fahym Bounazou :​​ Early AI-based detection of​​​‌ prostate cancer from multiparametric​ MRI. Directed by Hervé​‌ Delingette and Raphaele Renard-Penna​​ (PUPH Sorbonne Université, AP-HP),​​​‌ funded by the AICOO​ project.
  • Alix de Langlais​‌ : Automatic generation of​​ three-dimensional models of extremity​​​‌ fractures of proximal humerus​ for preoperative planning and​‌ intraoperative assistance in mixed​​ reality, Inria-INSERM funded PhD​​​‌ started in June 2024.​ Co-directed by Hervé Delingette​‌ , and Marc-Olivier Gauci​​ (Orthopedics Surgeon, CHU Nice,​​​‌ IBV).
  • Nicolas Drettakis :​ CT scan-based prediction of​‌ stroke risk from the​​ shape of the left​​​‌ atrium. Directed by Maxime​ Sermesant .
  • Ezem Sura​‌ Ekmekci : Temporal Boundary​​ Distillation Module for Surgical​​​‌ Gesture Segmentation. Directed by​ Nicholas Ayache and François​‌ Brémond , and co-supervised​​ by Hervé Delingette and​​​‌ Pierre Berthet-Rayne .
  • Federica​ Facente : Learning Statistical​‌ and Biomedical Models for​​ multimodal image analysis -​​​‌ application to Image Guided​ Surgical Robotics, 3IA PhD​‌ started in September 2023.​​ Co-directed by Nicholas Ayache​​​‌ , Pierre Berthet-Rayne (CTO​ and co-founder of Caranx-Medical,​‌ 3IA affiliate chair holder)​​ and Hervé Delingette .​​​‌
  • Camilla Ferrario : Electromechanical​ modeling of non-ischemic cardomyopathies,​‌ funded by PEPR Digital​​ Health ChroniCardio, started in​​​‌ September 2024.
  • Giulia Foroni​ : Development of survival​‌ analysis methods to model​​ spatio-temporal changes in PET/CT​​​‌ images of lung cancer​ patients treated with immunotherapy.​‌ 3IA funding. Co-directed by​​ Marco Lorenzi and Olivier​​​‌ Humbert (IBV, CAL).
  • Sébastien​ Goffart : Development of​‌ predictive models in patients​​ with peripheral artery disease,​​​‌ Université Côte d'Azur. ANR​ grant handled by CHU​‌ Nice. Started in 2023.​​ Co-directed by Hervé Delingette​​​‌ , and Juliette Raffort-Lareyre.​
  • Manasi Kattel : Deep​‌ learning methods for the​​ analysis and registration of​​​‌ US images, Université Côte​ d'Azur. 3IA Côte d'Azur​‌ fellowship. Started in December​​ 2023. Co-directed by Nicholas​​​‌ Ayache and Hervé Delingette​ .
  • Wassila Khatir :​‌ Integromics analysis: a new​​ approach to study the​​​‌ pathophysiology of X-Fragile Syndrome​ (FXS), Université Côte d'Azur.​‌ Neuromod fellowship. Started in​​ March 2024. Co-directed by​​​‌ Irene Balelli , Marco​ Lorenzi and Carole Gwizdek​‌ (IPMC).
  • Arnaud Lang :​​ Multimodal prediction for Cardioembolic​​​‌ stroke: etiology and risk.​ RHU TALENT funded PhD​‌ started in December 2025.​​ Co-directed by Irene Balelli​​ , Marco Lorenzi and​​​‌ Maxime Sermesant .
  • Maëlis‌ Morier : Deep Learning‌​‌ Meets Numerical Modeling, AI​​ and Biophysics for Computational​​​‌ Cardiology, started in 2023.‌ Co-supervised by Maxime Sermesant‌​‌ and Patrick Gallinari (Sorbonne​​ Universités).
  • Huyen Trang Nguyen​​​‌ : Robust Biomarker Extraction‌ in PET-CT Imaging Data‌​‌ for Immunotherapy in Lung​​ Cancer. Franco-German ANR Train,​​​‌ co-directed with Olivier Humbert‌ (Centre Antoine Lacassagne).
  • Evariste‌​‌ Njomgue Fotso : Multimodal​​ learning for sudden cardiac​​​‌ death risk prediction. Funded‌ by MediTwin, started in‌​‌ 2023.
  • Giuseppe Orlando :​​ Vision-Language analysis for multimodal​​​‌ analysis of health records‌ and PET/CT imaging data‌​‌ in lung cancer. Project​​ funced by PEPR Santé​​​‌ Numerique. Co-supervision of Marco‌ Lorenzi and Olivier Humbert‌​‌ (IBV, CAL).
  • Rafael Silva​​ : Artificial Intelligence for​​​‌ Cardiac Monitoring: Portable Multimodal‌ Cardiac Function Analysis. Started‌​‌ in 2023. Co-directed by​​ Maxime Sermesant and Pamela​​​‌ Moceri (CHU Nice).
  • Adrien‌ Tchuem Tchuente : Generative‌​‌ AI applied to multi-modal​​ and multi-scale cardiac imaging.​​​‌ Directed by Maxime Sermesant‌ .
  • Elie Thellier :‌​‌ Generative AI for the​​ anonymization of medical images.​​​‌ Directed by Hervé Delingette‌ and Nicholas Ayache ,‌​‌ funded by project PLICIA.​​
  • Tony Zaayter : Geometric​​​‌ statistics on stratified quotient‌ spaces: topologically constrained multi-atlases‌​‌ for brain diffeomorphometry. Directed​​ by Xavier Pennec and​​​‌ co-supervised by Mathieu Carrière‌ . Funded by Meditwin,‌​‌ started in Nov 2025.​​

11.2.4 Juries

  • Irene Balelli​​​‌ was Member of the‌ admissibility jury for the‌​‌ 2025 recruitment campaign for​​ CRCN/ISFP at Inria Center​​​‌ at Université Côte d'Azur.‌
  • Xavier Pennec was a‌​‌ member of the jury​​ and reviewer of the​​​‌ HDR of Benjamin Charlier‌ (Univ. Montpellier), a member‌​‌ of the jury and​​ reviewer of the PhD​​​‌ of Alexey Lazarev (Univ.‌ Toulouse) and a member‌​‌ of the PhD jury​​ of of Gaël Le​​​‌ Ruz (Univ. Paris Sorbonne).‌ He was also a‌​‌ jury member of the​​ PhD of Tom Szwagier​​​‌ as PhD advisor.
  • Marco‌ Lorenzi was reviewer and‌​‌ member of the HDR​​ of Kassem Kallas (University​​​‌ of Western Brittany), a‌ member of the jury‌​‌ and reviewer of the​​ PhD of Matthis Manthe​​​‌ (Université de Lyon), of‌ Jon Middleton (University of‌​‌ Copenhagen), and reviewer of​​ the PhD of Martin​​​‌ Saint-Jalmes (University of Melbourne).‌
  • Hervé Delingette was reviewer‌​‌ of the thesis of​​ Emma Sarfati (Institut polytechnique​​​‌ de Paris, Telecom Paris),‌ of Robin Cremese (Université‌​‌ Paris sciences et lettres,​​ Institut Pasteur), of Ali​​​‌ Keshavarzi (Institut Polytechnique de‌ Paris, Telecom Paris). He‌​‌ chaired the PhD defense​​ of Faisal Jayousi (Université​​​‌ Côte d'Azur, Inria Morpheme),‌ and of Yanis Aeschlimann‌​‌ (Université Côte d'Azur, Inria​​ Cronos). He was a​​​‌ member of the PhD‌ defense of Lisa Guzzi‌​‌ (Université Côte d'Azur) as​​ its PhD co-director, and​​​‌ co-supervisor. He was a‌ member of the recruitment‌​‌ committee for the 2025​​ Inria "Chaire de Professeur​​​‌ Junior" on Trustworthy AI‌ for Personalized Medicine.‌​‌

11.3 Popularization

11.3.1 Specific​​ official responsibilities in science​​​‌ outreach structures

  • Irene Balelli‌ is part of the‌​‌ EssentiElles Santé network, for​​ women in healthcare science.​​​‌

11.3.2 Participation in Live‌ events

  • Hervé Delingette gave‌​‌ an invited presentation at​​​‌ the Terra Numerica institute​ on the topics of​‌ "AI for Medicine" on​​ February 26th in Sophia​​​‌ Antipolis.

12 Scientific production​

12.1 Major publications

  • 1​‌ articleN.Nicolas Cedilnik​​, M.Mihaela Pop​​​‌, J.Josselin Duchateau​, F.Frédéric Sacher​‌, P.Pierre Jaïs​​, H.Hubert Cochet​​​‌ and M.Maxime Sermesant​. Efficient Patient-Specific Simulations​‌ of Ventricular Tachycardia Based​​ on Computed Tomography-Defined Wall​​​‌ Thickness Heterogeneity.JACC:​ Clinical ElectrophysiologySeptember 2023​‌HALDOI
  • 2 article​​H.Hind Dadoun,​​​‌ H.Hervé Delingette,​ A.-L.Anne-Laure Rousseau,​‌ E.Eric de Kerviler​​ and N.Nicholas Ayache​​​‌. Deep Clustering for​ Abdominal Organ Classification in​‌ US imaging.Journal​​ of Medical Imaging10​​​‌32023, 034502​HALDOI
  • 3 article​‌Y.Yann Fraboni,​​ R.Richard Vidal,​​​‌ L.Laetitia Kameni and​ M.Marco Lorenzi.​‌ A General Theory for​​ Federated Optimization with Asynchronous​​​‌ and Heterogeneous Clients Updates​.Journal of Machine​‌ Learning Research24March​​ 2023, 1-43HAL​​​‌
  • 4 miscY.Yann​ Fraboni, R.Richard​‌ Vidal, L.Laetitia​​ Kameni and M.Marco​​​‌ Lorenzi. Clustered Sampling:​ Low-Variance and Improved Representativity​‌ for Clients Selection in​​ Federated Learning.May​​​‌ 2021HAL
  • 5 article​N.Nicolas Guigui,​‌ N.Nina Miolane and​​ X.Xavier Pennec.​​​‌ Introduction to Riemannian Geometry​ and Geometric Statistics: from​‌ basic theory to implementation​​ with Geomstats.Foundations​​​‌ and Trends in Machine​ Learning163February​‌ 2023, 329-493HAL​​DOI
  • 6 articleD.​​​‌Dimitri Hamzaoui, S.​Sarah Montagne, R.​‌Raphaële Renard-Penna, N.​​Nicholas Ayache and H.​​​‌Hervé Delingette. Morphologically-Aware​ Consensus Computation via Heuristics-based​‌ IterATive Optimization (MACCHIatO).​​Journal of Machine Learning​​​‌ for Biomedical Imaging2​UNSURE 2022 Special Issue​‌September 2023, 361-389​​HALDOI
  • 7 inproceedings​​​‌J.Josquin Harrison,​ J.James Benn and​‌ M.Maxime Sermesant.​​ Improving Neural Network Surface​​​‌ Processing with Principal Curvatures​.NeurIPS ProceedingsNeurips​‌ 2024 - 38th Annual​​ Conference on Neural Information​​​‌ Processing Systems2024Vancouver,​ CanadaDecember 2024HAL​‌
  • 8 articleV.Victoriya​​ Kashtanova, M.Mihaela​​​‌ Pop, I.Ibrahim​ Ayed, P.Patrick​‌ Gallinari and M.Maxime​​ Sermesant. Simultaneous data​​​‌ assimilation and cardiac electrophysiology​ model correction using differentiable​‌ physics and deep learning​​.Interface Focus13​​​‌6December 2023HAL​DOI
  • 9 articleJ.​‌Julian Krebs, H.​​Hervé Delingette, N.​​​‌Nicholas Ayache and T.​Tommaso Mansi. Learning​‌ a Generative Motion Model​​ from Image Sequences based​​​‌ on a Latent Motion​ Matrix.IEEE Transactions​‌ on Medical ImagingFebruary​​ 2021HALDOI
  • 10​​​‌ articleM.Maxime Sermesant​, H.Hervé Delingette​‌, H.Hubert Cochet​​, P.Pierre Jaïs​​​‌ and N.Nicholas Ayache​. Applications of artificial​‌ intelligence in cardiovascular imaging​​.Nature Reviews Cardiology​​​‌March 2021HALDOI​
  • 11 articleP.Paul​‌ Tourniaire, M.Marius​​ Ilie, P.Paul​​​‌ Hofman, N.Nicholas​ Ayache and H.Hervé​‌ Delingette. MS-CLAM: Mixed​​ Supervision for the classification​​ and localization of tumors​​​‌ in Whole Slide Images‌.Medical Image Analysis‌​‌852023, 102763​​HALDOI
  • 12 article​​​‌Z.Zihao Wang,‌ T.Thomas Demarcy,‌​‌ C.Clair Vandersteen,​​ D.Dan Gnansia,​​​‌ C.Charles Raffaelli,‌ N.Nicolas Guevara and‌​‌ H.Hervé Delingette.​​ Bayesian Logistic Shape Model​​​‌ Inference: application to cochlear‌ image segmentation.Medical‌​‌ Image AnalysisOctober 2021​​HAL
  • 13 articleY.​​​‌Yingyu Yang, M.‌Marie Rocher, P.‌​‌Pamela Moceri and M.​​Maxime Sermesant. Echocardiography​​​‌ Analysis with Deep Learning‌ using Priors: Multi-centric Evaluation‌​‌ of Generalisation.Journal​​ of Machine Learning for​​​‌ Biomedical Imaging2November‌ 2024November 2024,‌​‌ 2293-2325HALDOI

12.2​​ Publications of the year​​​‌

International journals

International peer-reviewed‌ conferences

Conferences without proceedings

  • 49‌​‌ inproceedingsF.Francesco Cremonesi​​, L.Lucie Chambon​​​‌, N.Nelson Mokkadem‌, H. T.Huyen‌​‌ Thi Trang Nguyen,​​ O.Oliver Humbert and​​​‌ M.Marco Lorenzi.‌ Knowledge-based semantic enrichment of‌​‌ medical imaging data for​​ automatic phenotyping and pattern​​​‌ discovery in metastatic lung‌ cancer.2025 SNMMI‌​‌ Annual Meeting - Society​​ for Nuclear Medicine and​​​‌ Molecular ImagingNew orleans,‌ LA, United StatesJune‌​‌ 2025HALback to​​ text
  • 50 inproceedingsF.​​​‌Federica Facente, B.‌Benjamin Billot, V.‌​‌Vivek Gopalakrishnan, M.​​Manasi Kattel, W.​​​‌Wen Wei, P.‌Polina Golland, H.‌​‌Hervé Delingette, N.​​Nicholas Ayache and P.​​​‌Pierre Berthet-Rayne. Multi-stage‌ CNN for fast registration‌​‌ of 3D preoperative CTs​​ to 2D intraoperative X-rays​​​‌.MICCAI 2025 -‌ COLlaborative Intelligence and Autonomy‌​‌ in Image-guided Surgery (COLAS)​​Daejon, South KoreaSeptember​​​‌ 2025HALback to‌ text
  • 51 inproceedingsM.‌​‌Maëlis Morier and J.​​​‌Jairo Rodríguez-Padilla. Learning​ Cardiac Electrophysiology with Graph​‌ Neural Networks for Fast​​ Data-driven Personalised Predictions.​​​‌Functional Imaging and Modeling​ of the Heart: 13th​‌ International Conference, FIMH 2025,​​ Dallas, TX, USA, June​​​‌ 1–5, 2025, Proceedings, Part​ II (Lecture Notes in​‌ Computer Science, 15673)FIMH​​ 2025 - 13th Functional​​​‌ Imaging and Modeling of​ the Heart International Conference​‌15672 (Part I) and​​ 15673 (Part II)Dallas​​​‌ (TX), United StatesJuly​ 2025, LNCS 15672​‌ and LNCS 15673HAL​​back to textback​​​‌ to text

Scientific books​

Scientific book chapters​​​‌

  • 53 inbookF.Francesco​ Cremonesi, M.Marc​‌ Vesin, S.Sergen​​ Cansiz, Y.Yannick​​​‌ Bouillard, I.Irene​ Balelli, L.Lucia​‌ Innocenti, R.Riccardo​​ Taiello, S.Santiago​​​‌ Silva, S.-S.Samy-Safwan​ Ayed, M.Melek​‌ Önen, F.Fanny​​ Orlhac, C.Christophe​​​‌ Nioche, B.Bastien​ Houis, R.Romain​‌ Modzelewski, N.Nathan​​ Lapel, R.Renaud​​​‌ Schiappa, O.Olivier​ Humbert and M.Marco​‌ Lorenzi. Fed-BioMed: Open,​​ Transparent and Trusted Federated​​​‌ Learning for Real-world Healthcare​ Applications.832Federated​‌ Learning SystemsStudies in​​ Computational IntelligenceSpringer Nature​​​‌ SwitzerlandApril 2025,​ 19-41HALDOIback​‌ to text

Doctoral dissertations​​ and habilitation theses

Reports​‌ & preprints

Other scientific publications

  • 62​​​‌ inproceedingsR.Rafael Silva​, C.Caroline Stehlé​‌, M.Maxime Sermesant​​, G.Guillaume Pétriat​​, P.-H.Pierre-Henri Cadet​​​‌ and T.Thierry Tibi‌. Frugal AI for‌​‌ Automated Cardiac Defibrillation: Balancing​​ Performance & Hardware Constraints​​​‌.FIMH 2025 -‌ 13th International Conference on‌​‌ Functional Imaging and Modeling​​ of the HeartFunctional​​​‌ Imaging and Modeling of‌ the HeartLNCS-15672Dallas‌​‌ (TX), United StatesJune​​ 2025HALback to​​​‌ text

Scientific popularization

  • 63‌ inproceedingsC.Camilla Ferrario‌​‌. Myocardial Stiffness Quantification​​ Using Ultrasound Shear Wave​​​‌ Elastography and Reduced Modeling‌ for Subject-Specific Simulations.‌​‌Journées annuelles du PEPR​​ Santé NumériqueLille (France),​​​‌ FranceOctober 2025HAL‌

Patents