Chuang Niu

Zhihao Chen, Chuang Niu, Qi Gao et al.

This paper studies 3D low-dose computed tomography (CT) imaging. Although various deep learning methods were developed in this context, typically they focus on 2D images and perform denoising due to low-dose and deblurring for super-resolution separately. Up to date, little work was done for simultaneous in-plane denoising and through-plane deblurring, which is important to obtain high-quality 3D CT images with lower radiation and faster imaging speed. For this task, a straightforward method is to directly train an end-to-end 3D network. However, it demands much more training data and expensive computational costs. Here, we propose to link in-plane and through-plane transformers for simultaneous in-plane denoising and through-plane deblurring, termed as LIT-Former, which can efficiently synergize in-plane and through-plane sub-tasks for 3D CT imaging and enjoy the advantages of both convolution and transformer networks. LIT-Former has two novel designs: efficient multi-head self-attention modules (eMSM) and efficient convolutional feedforward networks (eCFN). First, eMSM integrates in-plane 2D self-attention and through-plane 1D self-attention to efficiently capture global interactions of 3D self-attention, the core unit of transformer networks. Second, eCFN integrates 2D convolution and 1D convolution to extract local information of 3D convolution in the same fashion. As a result, the proposed LIT-Former synergize these two subtasks, significantly reducing the computational complexity as compared to 3D counterparts and enabling rapid convergence. Extensive experimental results on simulated and clinical datasets demonstrate superior performance over state-of-the-art models. The source code is made available at https://github.com/hao1635/LIT-Former.

Zilong Li, Qi Gao, Yaping Wu et al.

Metal implants and other high-density objects in patients introduce severe streaking artifacts in CT images, compromising image quality and diagnostic performance. Although various methods were developed for CT metal artifact reduction over the past decades, including the latest dual-domain deep networks, remaining metal artifacts are still clinically challenging in many cases. Here we extend the state-of-the-art dual-domain deep network approach into a quad-domain counterpart so that all the features in the sinogram, image, and their corresponding Fourier domains are synergized to eliminate metal artifacts optimally without compromising structural subtleties. Our proposed quad-domain network for MAR, referred to as Quad-Net, takes little additional computational cost since the Fourier transform is highly efficient, and works across the four receptive fields to learn both global and local features as well as their relations. Specifically, we first design a Sinogram-Fourier Restoration Network (SFR-Net) in the sinogram domain and its Fourier space to faithfully inpaint metal-corrupted traces. Then, we couple SFR-Net with an Image-Fourier Refinement Network (IFR-Net) which takes both an image and its Fourier spectrum to improve a CT image reconstructed from the SFR-Net output using cross-domain contextual information. Quad-Net is trained on clinical datasets to minimize a composite loss function. Quad-Net does not require precise metal masks, which is of great importance in clinical practice. Our experimental results demonstrate the superiority of Quad-Net over the state-of-the-art MAR methods quantitatively, visually, and statistically. The Quad-Net code is publicly available at https://github.com/longzilicart/Quad-Net.

Chuang Niu, Md Sayed Tanveer, Md Zabirul Islam et al.

Current LLMs for creating fully-structured reports face the challenges of formatting errors, content hallucinations, and privacy leakage issues when uploading data to external servers.We aim to develop an open-source, accurate LLM for creating fully-structured and standardized LCS reports from varying free-text reports across institutions and demonstrate its utility in automatic statistical analysis and individual lung nodule retrieval. With IRB approvals, our retrospective study included 5,442 de-identified LDCT LCS radiology reports from two institutions. We constructed two evaluation datasets by labeling 500 pairs of free-text and fully-structured radiology reports and one large-scale consecutive dataset from January 2021 to December 2023. Two radiologists created a standardized template for recording 27 lung nodule features on LCS. We designed a dynamic-template-constrained decoding method to enhance existing LLMs for creating fully-structured reports from free-text radiology reports. Using consecutive structured reports, we automated descriptive statistical analyses and a nodule retrieval prototype. Our best LLM for creating fully-structured reports achieved high performance on cross-institutional datasets with an F1 score of about 97%, with neither formatting errors nor content hallucinations. Our method consistently improved the best open-source LLMs by up to 10.42%, and outperformed GPT-4o by 17.19%. The automatically derived statistical distributions were consistent with prior findings regarding attenuation, location, size, stability, and Lung-RADS. The retrieval system with structured reports allowed flexible nodule-level search and complex statistical analysis. Our developed software is publicly available for local deployment and further research.

Yuhui Ruan, Qiao Yuan, Chuang Niu et al.

Deep learning has been successfully applied to low-dose CT (LDCT) image denoising for reducing potential radiation risk. However, the widely reported supervised LDCT denoising networks require a training set of paired images, which is expensive to obtain and cannot be perfectly simulated. Unsupervised learning utilizes unpaired data and is highly desirable for LDCT denoising. As an example, an artifact disentanglement network (ADN) relies on unparied images and obviates the need for supervision but the results of artifact reduction are not as good as those through supervised learning.An important observation is that there is often hidden similarity among unpaired data that can be utilized. This paper introduces a new learning mode, called quasi-supervised learning, to empower the ADN for LDCT image denoising.For every LDCT image, the best matched image is first found from an unpaired normal-dose CT (NDCT) dataset. Then, the matched pairs and the corresponding matching degree as prior information are used to construct and train our ADN-type network for LDCT denoising.The proposed method is different from (but compatible with) supervised and semi-supervised learning modes and can be easily implemented by modifying existing networks. The experimental results show that the method is competitive with state-of-the-art methods in terms of noise suppression and contextual fidelity. The code and working dataset are publicly available at https://github.com/ruanyuhui/ADN-QSDL.git.

Qing Lyu, Josh Tan, Michael E. Zapadka et al.

The large language model called ChatGPT has drawn extensively attention because of its human-like expression and reasoning abilities. In this study, we investigate the feasibility of using ChatGPT in experiments on using ChatGPT to translate radiology reports into plain language for patients and healthcare providers so that they are educated for improved healthcare. Radiology reports from 62 low-dose chest CT lung cancer screening scans and 76 brain MRI metastases screening scans were collected in the first half of February for this study. According to the evaluation by radiologists, ChatGPT can successfully translate radiology reports into plain language with an average score of 4.27 in the five-point system with 0.08 places of information missing and 0.07 places of misinformation. In terms of the suggestions provided by ChatGPT, they are general relevant such as keeping following-up with doctors and closely monitoring any symptoms, and for about 37% of 138 cases in total ChatGPT offers specific suggestions based on findings in the report. ChatGPT also presents some randomness in its responses with occasionally over-simplified or neglected information, which can be mitigated using a more detailed prompt. Furthermore, ChatGPT results are compared with a newly released large model GPT-4, showing that GPT-4 can significantly improve the quality of translated reports. Our results show that it is feasible to utilize large language models in clinical education, and further efforts are needed to address limitations and maximize their potential.

Chuang Niu, Qing Lyu, Christopher D. Carothers et al.

Modern medical records include a vast amount of multimodal free text clinical data and imaging data from radiology, cardiology, and digital pathology. Fully mining such big data requires multitasking; otherwise, occult but important aspects may be overlooked, adversely affecting clinical management and population healthcare. Despite remarkable successes of AI in individual tasks with single-modal data, the progress in developing generalist medical AI remains relatively slow to combine multimodal data for multitasks because of the dual challenges of data curation and model architecture. The data challenge involves querying and curating multimodal structured and unstructured text, alphanumeric, and especially 3D tomographic scans on an individual patient level for real-time decisions and on a scale to estimate population health statistics. The model challenge demands a scalable and adaptable network architecture to integrate multimodal datasets for diverse clinical tasks. Here we propose the first-of-its-kind medical multimodal-multitask foundation model (M3FM) with application in lung cancer screening and related tasks. After we curated a comprehensive multimodal multitask dataset consisting of 49 clinical data types including 163,725 chest CT series and 17 medical tasks involved in LCS, we develop a multimodal question-answering framework as a unified training and inference strategy to synergize multimodal information and perform multiple tasks via free-text prompting. M3FM consistently outperforms the state-of-the-art single-modal task-specific models, identifies multimodal data elements informative for clinical tasks and flexibly adapts to new tasks with a small out-of-distribution dataset. As a specialty-oriented generalist medical AI model, M3FM paves the way for similar breakthroughs in other areas of medicine, closing the gap between specialists and the generalist.

Wenjun Xia, Yongyi Shi, Chuang Niu et al.

Computed tomography (CT) involves a patient's exposure to ionizing radiation. To reduce the radiation dose, we can either lower the X-ray photon count or down-sample projection views. However, either of the ways often compromises image quality. To address this challenge, here we introduce an iterative reconstruction algorithm regularized by a diffusion prior. Drawing on the exceptional imaging prowess of the denoising diffusion probabilistic model (DDPM), we merge it with a reconstruction procedure that prioritizes data fidelity. This fusion capitalizes on the merits of both techniques, delivering exceptional reconstruction results in an unsupervised framework. To further enhance the efficiency of the reconstruction process, we incorporate the Nesterov momentum acceleration technique. This enhancement facilitates superior diffusion sampling in fewer steps. As demonstrated in our experiments, our method offers a potential pathway to high-definition CT image reconstruction with minimized radiation.

Chuang Niu, Ge Wang

Early detection of lung nodules with computed tomography (CT) is critical for the longer survival of lung cancer patients and better quality of life. Computer-aided detection/diagnosis (CAD) is proven valuable as a second or concurrent reader in this context. However, accurate detection of lung nodules remains a challenge for such CAD systems and even radiologists due to not only the variability in size, location, and appearance of lung nodules but also the complexity of lung structures. This leads to a high false-positive rate with CAD, compromising its clinical efficacy. Motivated by recent computer vision techniques, here we present a self-supervised region-based 3D transformer model to identify lung nodules among a set of candidate regions. Specifically, a 3D vision transformer (ViT) is developed that divides a CT image volume into a sequence of non-overlap cubes, extracts embedding features from each cube with an embedding layer, and analyzes all embedding features with a self-attention mechanism for the prediction. To effectively train the transformer model on a relatively small dataset, the region-based contrastive learning method is used to boost the performance by pre-training the 3D transformer with public CT images. Our experiments show that the proposed method can significantly improve the performance of lung nodule screening in comparison with the commonly used 3D convolutional neural networks.

Chuang Niu, Giridhar Dasegowda, Pingkun Yan et al.

Although radiographs are the most frequently used worldwide due to their cost-effectiveness and widespread accessibility, the structural superposition along the x-ray paths often renders suspicious or concerning lung nodules difficult to detect. In this study, we apply "X-ray dissectography" to dissect lungs digitally from a few radiographic projections, suppress the interference of irrelevant structures, and improve lung nodule detectability. For this purpose, a collaborative detection network is designed to localize lung nodules in 2D dissected projections and 3D physical space. Our experimental results show that our approach can significantly improve the average precision by 20+% in comparison with the common baseline that detects lung nodules from original projections using a popular detection network. Potentially, this approach could help re-design the current X-ray imaging protocols and workflows and improve the diagnostic performance of chest radiographs in lung diseases.

Wenjun Xia, Hsin Wu Tseng, Chuang Niu et al.

Breast cancer is the most prevalent cancer among women worldwide, and early detection is crucial for reducing its mortality rate and improving quality of life. Dedicated breast computed tomography (CT) scanners offer better image quality than mammography and tomosynthesis in general but at higher radiation dose. To enable breast CT for cancer screening, the challenge is to minimize the radiation dose without compromising image quality, according to the ALARA principle (as low as reasonably achievable). Over the past years, deep learning has shown remarkable successes in various tasks, including low-dose CT especially few-view CT. Currently, the diffusion model presents the state of the art for CT reconstruction. To develop the first diffusion model-based breast CT reconstruction method, here we report innovations to address the large memory requirement for breast cone-beam CT reconstruction and high computational cost of the diffusion model. Specifically, in this study we transform the cutting-edge Denoising Diffusion Probabilistic Model (DDPM) into a parallel framework for sub-volume-based sparse-view breast CT image reconstruction in projection and image domains. This novel approach involves the concurrent training of two distinct DDPM models dedicated to processing projection and image data synergistically in the dual domains. Our experimental findings reveal that this method delivers competitive reconstruction performance at half to one-third of the standard radiation doses. This advancement demonstrates an exciting potential of diffusion-type models for volumetric breast reconstruction at high-resolution with much-reduced radiation dose and as such hopefully redefines breast cancer screening and diagnosis.

Rodrigo de Barros Vimieiro, Chuang Niu, Hongming Shan et al.

Digital breast tomosynthesis (DBT) exams should utilize the lowest possible radiation dose while maintaining sufficiently good image quality for accurate medical diagnosis. In this work, we propose a convolution neural network (CNN) to restore low-dose (LD) DBT projections to achieve an image quality equivalent to a standard full-dose (FD) acquisition. The proposed network architecture benefits from priors in terms of layers that were inspired by traditional model-based (MB) restoration methods, considering a model-based deep learning approach, where the network is trained to operate in the variance stabilization transformation (VST) domain. To accurately control the network operation point, in terms of noise and blur of the restored image, we propose a loss function that minimizes the bias and matches residual noise between the input and the output. The training dataset was composed of clinical data acquired at the standard FD and low-dose pairs obtained by the injection of quantum noise. The network was tested using real DBT projections acquired with a physical anthropomorphic breast phantom. The proposed network achieved superior results in terms of the mean normalized squared error (MNSE), training time and noise spatial correlation compared with networks trained with traditional data-driven methods. The proposed approach can be extended for other medical imaging application that requires LD acquisitions.

Chuang Niu, Ge Wang

Self-supervised representation learning maps high-dimensional data into a meaningful embedding space, where samples of similar semantic contents are close to each other. Most of the recent representation learning methods maximize cosine similarity or minimize the distance between the embedding features of different views from the same sample usually on the $l2$ normalized unit hypersphere. To prevent the trivial solutions that all samples have the same embedding feature, various techniques have been developed, such as contrastive learning, stop gradient, variance and covariance regularization, etc. In this study, we propose MUlti-Segmental Informational Coding (MUSIC) for self-supervised representation learning. MUSIC divides the embedding feature into multiple segments that discriminatively partition samples into different semantic clusters and different segments focus on different partition principles. Information theory measurements are directly used to optimize MUSIC and theoretically guarantee trivial solutions are avoided. MUSIC does not depend on commonly used techniques, such as memory bank or large batches, asymmetry networks, gradient stopping, momentum weight updating, etc, making the training framework flexible. Our experiments demonstrate that MUSIC achieves better results than most related Barlow Twins and VICReg methods on ImageNet classification with linear probing, and requires neither deep projectors nor large feature dimensions. Code will be made available.

Chuang Niu, Ge Wang

Minimum redundancy among different elements of an embedding in a latent space is a fundamental requirement or major preference in representation learning to capture intrinsic informational structures. Current self-supervised learning methods minimize a pair-wise covariance matrix to reduce the feature redundancy and produce promising results. However, such representation features of multiple variables may contain the redundancy among more than two feature variables that cannot be minimized via the pairwise regularization. Here we propose the High-Order Mixed-Moment-based Embedding (HOME) strategy to reduce the redundancy between any sets of feature variables, which is to our best knowledge the first attempt to utilize high-order statistics/information in this context. Multivariate mutual information is minimum if and only if multiple variables are mutually independent, which suggests the necessary conditions of factorized mixed moments among multiple variables. Based on these statistical and information theoretic principles, our general HOME framework is presented for self-supervised representation learning. Our initial experiments show that a simple version in the form of a three-order HOME scheme already significantly outperforms the current two-order baseline method (i.e., Barlow Twins) in terms of the linear evaluation on representation features.

Chuang Niu, Christopher Wiedeman, Mengzhou Li et al.

This study aims to improve photon counting CT (PCCT) image resolution using denoising diffusion probabilistic models (DDPM). Although DDPMs have shown superior performance when applied to various computer vision tasks, their effectiveness has yet to be translated to high dimensional CT super-resolution. To train DDPMs in a conditional sampling manner, we first leverage CatSim to simulate realistic lower resolution PCCT images from high-resolution CT scans. Since maximizing DDPM performance is time-consuming for both inference and training, especially on high-dimensional PCCT data, we explore both 2D and 3D networks for conditional DDPM and apply methods to accelerate training. In particular, we decompose the 3D task into efficient 2D DDPMs and design a joint 2D inference in the reverse diffusion process that synergizes 2D results of all three dimensions to make the final 3D prediction. Experimental results show that our DDPM achieves improved results versus baseline reference models in recovering high-frequency structures, suggesting that a framework based on realistic simulation and DDPM shows promise for improving PCCT resolution.

Zhihao Chen, Tao Chen, Chenhui Wang et al.

While various deep learning methods were proposed for low-dose computed tomography (CT) denoising, they often suffer from over-smoothing, blurring, and lack of explainability. To alleviate these issues, we propose a plug-and-play Language-Engaged Dual-space Alignment loss (LEDA) to optimize low-dose CT denoising models. Our idea is to leverage large language models (LLMs) to align denoised CT and normal dose CT images in both the continuous perceptual space and discrete semantic space, which is the first LLM-based scheme for low-dose CT denoising. LEDA involves two steps: the first is to pretrain an LLM-guided CT autoencoder, which can encode a CT image into continuous high-level features and quantize them into a token space to produce semantic tokens derived from the LLM's vocabulary; and the second is to minimize the discrepancy between the denoised CT images and normal dose CT in terms of both encoded high-level features and quantized token embeddings derived by the LLM-guided CT autoencoder. Extensive experimental results on two public LDCT denoising datasets demonstrate that our LEDA can enhance existing denoising models in terms of quantitative metrics and qualitative evaluation, and also provide explainability through language-level image understanding. Source code is available at https://github.com/hao1635/LEDA.

Zhihao Chen, Tao Chen, Chenhui Wang et al.

Low-dose computed tomography (LDCT) reduces radiation exposure but often degrades image quality, potentially compromising diagnostic accuracy. Existing deep learning-based denoising methods focus primarily on pixel-level mappings, overlooking the potential benefits of high-level semantic guidance. Recent advances in vision-language models (VLMs) suggest that language can serve as a powerful tool for capturing structured semantic information, offering new opportunities to improve LDCT reconstruction. In this paper, we introduce LangMamba, a Language-driven Mamba framework for LDCT denoising that leverages VLM-derived representations to enhance supervision from normal-dose CT (NDCT). LangMamba follows a two-stage learning strategy. First, we pre-train a Language-guided AutoEncoder (LangAE) that leverages frozen VLMs to map NDCT images into a semantic space enriched with anatomical information. Second, we synergize LangAE with two key components to guide LDCT denoising: Semantic-Enhanced Efficient Denoiser (SEED), which enhances NDCT-relevant local semantic while capturing global features with efficient Mamba mechanism, and Language-engaged Dual-space Alignment (LangDA) Loss, which ensures that denoised images align with NDCT in both perceptual and semantic spaces. Extensive experiments on two public datasets demonstrate that LangMamba outperforms conventional state-of-the-art methods, significantly improving detail preservation and visual fidelity. Remarkably, LangAE exhibits strong generalizability to unseen datasets, thereby reducing training costs. Furthermore, LangDA loss improves explainability by integrating language-guided insights into image reconstruction and offers a plug-and-play fashion. Our findings shed new light on the potential of language as a supervisory signal to advance LDCT denoising. The code is publicly available on https://github.com/hao1635/LangMamba.

Chuang Niu, Wenjun Xia, Hongming Shan et al.

Self-supervised learning (SSL) has emerged as a crucial technique in image processing, encoding, and understanding, especially for developing today's vision foundation models that utilize large-scale datasets without annotations to enhance various downstream tasks. This study introduces a novel SSL approach, Information-Maximized Soft Variable Discretization (IMSVD), for image representation learning. Specifically, IMSVD softly discretizes each variable in the latent space, enabling the estimation of their probability distributions over training batches and allowing the learning process to be directly guided by information measures. Motivated by the MultiView assumption, we propose an information-theoretic objective function to learn transform-invariant, non-travail, and redundancy-minimized representation features. We then derive a joint-cross entropy loss function for self-supervised image representation learning, which theoretically enjoys superiority over the existing methods in reducing feature redundancy. Notably, our non-contrastive IMSVD method statistically performs contrastive learning. Extensive experimental results demonstrate the effectiveness of IMSVD on various downstream tasks in terms of both accuracy and efficiency. Thanks to our variable discretization, the embedding features optimized by IMSVD offer unique explainability at the variable level. IMSVD has the potential to be adapted to other learning paradigms. Our code is publicly available at https://github.com/niuchuangnn/IMSVD.

Chuang Niu, Hongming Shan, Ge Wang

The similarity among samples and the discrepancy between clusters are two crucial aspects of image clustering. However, current deep clustering methods suffer from the inaccurate estimation of either feature similarity or semantic discrepancy. In this paper, we present a Semantic Pseudo-labeling-based Image ClustEring (SPICE) framework, which divides the clustering network into a feature model for measuring the instance-level similarity and a clustering head for identifying the cluster-level discrepancy. We design two semantics-aware pseudo-labeling algorithms, prototype pseudo-labeling, and reliable pseudo-labeling, which enable accurate and reliable self-supervision over clustering. Without using any ground-truth label, we optimize the clustering network in three stages: 1) train the feature model through contrastive learning to measure the instance similarity, 2) train the clustering head with the prototype pseudo-labeling algorithm to identify cluster semantics, and 3) jointly train the feature model and clustering head with the reliable pseudo-labeling algorithm to improve the clustering performance. Extensive experimental results demonstrate that SPICE achieves significant improvements (~10%) over existing methods and establishes the new state-of-the-art clustering results on six image benchmark datasets in terms of three popular metrics. Importantly, SPICE significantly reduces the gap between unsupervised and fully-supervised classification; e.g., there is only a 2% (91.8% vs 93.8%) accuracy difference on CIFAR-10. Our code has been made publically available at https://github.com/niuchuangnn/SPICE.

Chuang Niu, Jun Zhang, Ge Wang et al.

We propose a self-supervised Gaussian ATtention network for image Clustering (GATCluster). Rather than extracting intermediate features first and then performing the traditional clustering algorithm, GATCluster directly outputs semantic cluster labels without further post-processing. Theoretically, we give a Label Feature Theorem to guarantee the learned features are one-hot encoded vectors, and the trivial solutions are avoided. To train the GATCluster in a completely unsupervised manner, we design four self-learning tasks with the constraints of transformation invariance, separability maximization, entropy analysis, and attention mapping. Specifically, the transformation invariance and separability maximization tasks learn the relationships between sample pairs. The entropy analysis task aims to avoid trivial solutions. To capture the object-oriented semantics, we design a self-supervised attention mechanism that includes a parameterized attention module and a soft-attention loss. All the guiding signals for clustering are self-generated during the training process. Moreover, we develop a two-step learning algorithm that is memory-efficient for clustering large-size images. Extensive experiments demonstrate the superiority of our proposed method in comparison with the state-of-the-art image clustering benchmarks. Our code has been made publicly available at https://github.com/niuchuangnn/GATCluster.

Zhihao Chen, Bin Hu, Chuang Niu et al.

Large language models (LLMs), such as ChatGPT, have demonstrated impressive capabilities in various tasks and attracted an increasing interest as a natural language interface across many domains. Recently, large vision-language models (VLMs) like BLIP-2 and GPT-4 have been intensively investigated, which learn rich vision-language correlation from image-text pairs. However, despite these developments, the application of LLMs and VLMs in image quality assessment (IQA), particularly in medical imaging, remains to be explored, which is valuable for objective performance evaluation and potential supplement or even replacement of radiologists' opinions. To this end, this paper introduces IQAGPT, an innovative image quality assessment system integrating an image quality captioning VLM with ChatGPT for generating quality scores and textual reports. First, we build a CT-IQA dataset for training and evaluation, comprising 1,000 CT slices with diverse quality levels professionally annotated. To better leverage the capabilities of LLMs, we convert annotated quality scores into semantically rich text descriptions using a prompt template. Second, we fine-tune the image quality captioning VLM on the CT-IQA dataset to generate quality descriptions. The captioning model fuses the image and text features through cross-modal attention. Third, based on the quality descriptions, users can talk with ChatGPT to rate image quality scores or produce a radiological quality report. Our preliminary results demonstrate the feasibility of assessing image quality with large models. Remarkably, our IQAGPT outperforms GPT-4 and CLIP-IQA, as well as the multi-task classification and regression models that solely rely on images.

Chuang Niu, Pengwei Wu, Bruno De Man et al.

Foundation models (FMs) are rapidly reshaping medical imaging, shifting the field from narrowly trained, task-specific networks toward large, general-purpose models that can be adapted across modalities, anatomies, and clinical tasks. In this review, we synthesize the emerging landscape of medical imaging FMs along three major axes: principles of FM design, applications of FMs, and forward-looking challenges and opportunities. Taken together, this review provides a technically grounded, clinically aware, and future-facing roadmap for developing FMs that are not only powerful and versatile but also trustworthy and ready for responsible translation into clinical practice.

Chuang Niu, Ge Wang

Accurate risk assessment in lung cancer screening is critical for enabling early cancer detection and minimizing unnecessary invasive procedures. The Lung CT Screening Reporting and Data System (Lung-RADS) has been widely used as the standard framework for patient management and follow-up. Nevertheless, Lung-RADS faces trade-offs between sensitivity and specificity, as it stratifies risk solely based on lung nodule characteristics without incorporating various risk factors. Here we propose a reasoning language model (RLM) to integrate radiology findings with longitudinal medical records for individualized lung cancer risk assessment. Through a systematic study including dataset construction and distillation, supervised fine-tuning, reinforcement learning, and comprehensive evaluation, our model makes significant improvements in risk prediction performance on datasets in the national lung screening trial. Notably, RLM can decompose the risk evaluation task into sub-components, analyze the contributions of diverse risk factors, and synthesize them into a final risk score computed using our data-driven system equation. Our approach improves both predictive accuracy and monitorability through the chain of thought reasoning process, thereby facilitating clinical translation into lung cancer screening.

Wenjun Xia, Chuang Niu, Ge Wang

Computed tomography (CT) is a major medical imaging modality. Clinical CT scenarios, such as low-dose screening, sparse-view scanning, and metal implants, often lead to severe noise and artifacts in reconstructed images, requiring improved reconstruction techniques. The introduction of deep learning has significantly advanced CT image reconstruction. However, obtaining paired training data remains rather challenging due to patient motion and other constraints. Although deep learning methods can still perform well with approximately paired data, they inherently carry the risk of hallucination due to data inconsistencies and model instability. In this paper, we integrate the data fidelity with the state-of-the-art generative AI model, referred to as the Poisson flow generative model (PFGM) with a generalized version PFGM++, and propose a novel CT framework: Flow-Oriented Reconstruction Conditioning Engine (FORCE). In our experiments, the proposed method shows superior performance in various CT imaging tasks, outperforming existing unsupervised reconstruction approaches.

Mengzhou Li, Chuang Niu, Ge Wang et al.

X-ray photon-counting computed tomography (PCCT) for extremity allows multi-energy high-resolution (HR) imaging but its radiation dose can be further improved. Despite the great potential of deep learning techniques, their application in HR volumetric PCCT reconstruction has been challenged by the large memory burden, training data scarcity, and domain gap issues. In this paper, we propose a deep learning-based approach for PCCT image reconstruction at halved dose and doubled speed validated in a New Zealand clinical trial. Specifically, we design a patch-based volumetric refinement network to alleviate the GPU memory limitation, train network with synthetic data, and use model-based iterative refinement to bridge the gap between synthetic and clinical data. Our results in a reader study of 8 patients from the clinical trial demonstrate a great potential to cut the radiation dose to half that of the clinical PCCT standard without compromising image quality and diagnostic value.

Chuang Niu, Ge Wang

X-ray imaging is the most popular medical imaging technology. While x-ray radiography is rather cost-effective, tissue structures are superimposed along the x-ray paths. On the other hand, computed tomography (CT) reconstructs internal structures but CT increases radiation dose, is complicated and expensive. Here we propose "x-ray dissectography" to extract a target organ/tissue digitally from few radiographic projections for stereographic and tomographic analysis in the deep learning framework. As an exemplary embodiment, we propose a general X-ray dissectography network, a dedicated X-ray stereotography network, and the X-ray imaging systems to implement these functionalities. Our experiments show that x-ray stereography can be achieved of an isolated organ such as the lungs in this case, suggesting the feasibility of transforming conventional radiographic reading to the stereographic examination of the isolated organ, which potentially allows higher sensitivity and specificity, and even tomographic visualization of the target. With further improvements, x-ray dissectography promises to be a new x-ray imaging modality for CT-grade diagnosis at radiation dose and system cost comparable to that of radiographic or tomosynthetic imaging.

Yuxuan Liang, Chuang Niu, Chen Wei et al.

The phase function is a key element of a light propagation model for Monte Carlo (MC) simulation, which is usually fitted with an analytic function with associated parameters. In recent years, machine learning methods were reported to estimate the parameters of the phase function of a particular form such as the Henyey-Greenstein phase function but, to our knowledge, no studies have been performed to determine the form of the phase function. Here we design a convolutional neural network to estimate the phase function from a diffuse optical image without any explicit assumption on the form of the phase function. Specifically, we use a Gaussian mixture model as an example to represent the phase function generally and learn the model parameters accurately. The Gaussian mixture model is selected because it provides the analytic expression of phase function to facilitate deflection angle sampling in MC simulation, and does not significantly increase the number of free parameters. Our proposed method is validated on MC-simulated reflectance images of typical biological tissues using the Henyey-Greenstein phase function with different anisotropy factors. The effects of field of view (FOV) and spatial resolution on the errors are analyzed to optimize the estimation method. The mean squared error of the phase function is 0.01 and the relative error of the anisotropy factor is 3.28%.

Weiwen Wu, Chuang Niu, Shadi Ebrahimian et al.

By the ALARA (As Low As Reasonably Achievable) principle, ultra-low-dose CT reconstruction is a holy grail to minimize cancer risks and genetic damages, especially for children. With the development of medical CT technologies, the iterative algorithms are widely used to reconstruct decent CT images from a low-dose scan. Recently, artificial intelligence (AI) techniques have shown a great promise in further reducing CT radiation dose to the next level. In this paper, we demonstrate that AI-powered CT reconstruction offers diagnostic image quality at an ultra-low-dose level comparable to that of radiography. Specifically, here we develop a Split Unrolled Grid-like Alternative Reconstruction (SUGAR) network, in which deep learning, physical modeling and image prior are integrated. The reconstruction results from clinical datasets show that excellent images can be reconstructed using SUGAR from 36 projections. This approach has a potential to change future healthcare.

Jiajin Zhang, Hanqing Chao, Xuanang Xu et al.

The extensive use of medical CT has raised a public concern over the radiation dose to the patient. Reducing the radiation dose leads to increased CT image noise and artifacts, which can adversely affect not only the radiologists judgement but also the performance of downstream medical image analysis tasks. Various low-dose CT denoising methods, especially the recent deep learning based approaches, have produced impressive results. However, the existing denoising methods are all downstream-task-agnostic and neglect the diverse needs of the downstream applications. In this paper, we introduce a novel Task-Oriented Denoising Network (TOD-Net) with a task-oriented loss leveraging knowledge from the downstream tasks. Comprehensive empirical analysis shows that the task-oriented loss complements other task agnostic losses by steering the denoiser to enhance the image quality in the task related regions of interest. Such enhancement in turn brings general boosts on the performance of various methods for the downstream task. The presented work may shed light on the future development of context-aware image denoising methods.

Arjun Krishna, Kedar Bartake, Chuang Niu et al.

Deep learning has shown great promise for CT image reconstruction, in particular to enable low dose imaging and integrated diagnostics. These merits, however, stand at great odds with the low availability of diverse image data which are needed to train these neural networks. We propose to overcome this bottleneck via a deep reinforcement learning (DRL) approach that is integrated with a style-transfer (ST) methodology, where the DRL generates the anatomical shapes and the ST synthesizes the texture detail. We show that our method bears high promise for generating novel and anatomically accurate high resolution CT images at large and diverse quantities. Our approach is specifically designed to work with even small image datasets which is desirable given the often low amount of image data many researchers have available to them.

Chuang Niu, Ge Wang, Pingkun Yan et al.

We propose a Noise Entangled GAN (NE-GAN) for simulating low-dose computed tomography (CT) images from a higher dose CT image. First, we present two schemes to generate a clean CT image and a noise image from the high-dose CT image. Then, given these generated images, an NE-GAN is proposed to simulate different levels of low-dose CT images, where the level of generated noise can be continuously controlled by a noise factor. NE-GAN consists of a generator and a set of discriminators, and the number of discriminators is determined by the number of noise levels during training. Compared with the traditional methods based on the projection data that are usually unavailable in real applications, NE-GAN can directly learn from the real and/or simulated CT images and may create low-dose CT images quickly without the need of raw data or other proprietary CT scanner information. The experimental results show that the proposed method has the potential to simulate realistic low-dose CT images.

Chuang Niu, Mengzhou Li, Fenglei Fan et al.

Image denoising is a prerequisite for downstream tasks in many fields. Low-dose and photon-counting computed tomography (CT) denoising can optimize diagnostic performance at minimized radiation dose. Supervised deep denoising methods are popular but require paired clean or noisy samples that are often unavailable in practice. Limited by the independent noise assumption, current unsupervised denoising methods cannot process correlated noises as in CT images. Here we propose the first-of-its-kind similarity-based unsupervised deep denoising approach, referred to as Noise2Sim, that works in a nonlocal and nonlinear fashion to suppress not only independent but also correlated noises. Theoretically, Noise2Sim is asymptotically equivalent to supervised learning methods under mild conditions. Experimentally, Nosie2Sim recovers intrinsic features from noisy low-dose CT and photon-counting CT images as effectively as or even better than supervised learning methods on practical datasets visually, quantitatively and statistically. Noise2Sim is a general unsupervised denoising approach and has great potential in diverse applications.

Chen Wei, Yiping Tang, Chuang Niu et al.

Recently proposed neural architecture search (NAS) algorithms adopt neural predictors to accelerate the architecture search. The capability of neural predictors to accurately predict the performance metrics of neural architecture is critical to NAS, and the acquisition of training datasets for neural predictors is time-consuming. How to obtain a neural predictor with high prediction accuracy using a small amount of training data is a central problem to neural predictor-based NAS. Here, we firstly design a new architecture encoding scheme that overcomes the drawbacks of existing vector-based architecture encoding schemes to calculate the graph edit distance of neural architectures. To enhance the predictive performance of neural predictors, we devise two self-supervised learning methods from different perspectives to pre-train the architecture embedding part of neural predictors to generate a meaningful representation of neural architectures. The first one is to train a carefully designed two branch graph neural network model to predict the graph edit distance of two input neural architectures. The second method is inspired by the prevalently contrastive learning, and we present a new contrastive learning algorithm that utilizes a central feature vector as a proxy to contrast positive pairs against negative pairs. Experimental results illustrate that the pre-trained neural predictors can achieve comparable or superior performance compared with their supervised counterparts with several times less training samples. We achieve state-of-the-art performance on the NASBench-101 and NASBench201 benchmarks when integrating the pre-trained neural predictors with an evolutionary NAS algorithm.

Weiwen Wu, Dianlin Hu, Wenxiang Cong et al.

Tomographic image reconstruction with deep learning is an emerging field, but a recent landmark study reveals that several deep reconstruction networks are unstable for computed tomography (CT) and magnetic resonance imaging (MRI). Specifically, three kinds of instabilities were reported: (1) strong image artefacts from tiny perturbations, (2) small features missing in a deeply reconstructed image, and (3) decreased imaging performance with increased input data. On the other hand, compressed sensing (CS) inspired reconstruction methods do not suffer from these instabilities because of their built-in kernel awareness. For deep reconstruction to realize its full potential and become a mainstream approach for tomographic imaging, it is thus critically important to meet this challenge by stabilizing deep reconstruction networks. Here we propose an Analytic Compressed Iterative Deep (ACID) framework to address this challenge. ACID synergizes a deep reconstruction network trained on big data, kernel awareness from CS-inspired processing, and iterative refinement to minimize the data residual relative to real measurement. Our study demonstrates that the deep reconstruction using ACID is accurate and stable, and sheds light on the converging mechanism of the ACID iteration under a Bounded Relative Error Norm (BREN) condition. In particular, the study shows that ACID-based reconstruction is resilient against adversarial attacks, superior to classic sparsity-regularized reconstruction alone, and eliminates the three kinds of instabilities. We anticipate that this integrative data-driven approach will help promote development and translation of deep tomographic image reconstruction networks into clinical applications.

Chuang Niu, Wenxiang Cong, Fenglei Fan et al.

Deep neural network based methods have achieved promising results for CT metal artifact reduction (MAR), most of which use many synthesized paired images for training. As synthesized metal artifacts in CT images may not accurately reflect the clinical counterparts, an artifact disentanglement network (ADN) was proposed with unpaired clinical images directly, producing promising results on clinical datasets. However, without sufficient supervision, it is difficult for ADN to recover structural details of artifact-affected CT images based on adversarial losses only. To overcome these problems, here we propose a low-dimensional manifold (LDM) constrained disentanglement network (DN), leveraging the image characteristics that the patch manifold is generally low-dimensional. Specifically, we design an LDM-DN learning algorithm to empower the disentanglement network through optimizing the synergistic network loss functions while constraining the recovered images to be on a low-dimensional patch manifold. Moreover, learning from both paired and unpaired data, an efficient hybrid optimization scheme is proposed to further improve the MAR performance on clinical datasets. Extensive experiments demonstrate that the proposed LDM-DN approach can consistently improve the MAR performance in paired and/or unpaired learning settings, outperforming competing methods on synthesized and clinical datasets.

Chen Wei, Chuang Niu, Yiping Tang et al.

Neural architecture search (NAS) is a promising method for automatically design neural architectures. NAS adopts a search strategy to explore the predefined search space to find outstanding performance architecture with the minimum searching costs. Bayesian optimization and evolutionary algorithms are two commonly used search strategies, but they suffer from computationally expensive, challenge to implement or inefficient exploration ability. In this paper, we propose a neural predictor guided evolutionary algorithm to enhance the exploration ability of EA for NAS (NPENAS) and design two kinds of neural predictors. The first predictor is defined from Bayesian optimization and we propose a graph-based uncertainty estimation network as a surrogate model that is easy to implement and computationally efficient. The second predictor is a graph-based neural network that directly outputs the performance prediction of the input neural architecture. The NPENAS using the two neural predictors are denoted as NPENAS-BO and NPENAS-NP respectively. In addition, we introduce a new random architecture sampling method to overcome the drawbacks of the existing sampling method. Extensive experiments demonstrate the superiority of NPENAS. Quantitative results on three NAS search spaces indicate that both NPENAS-BO and NPENAS-NP outperform most existing NAS algorithms, with NPENAS-BO achieving state-of-the-art performance on NASBench-201 and NPENAS-NP on NASBench-101 and DARTS, respectively.

Yiping Tang, Chuang Niu, Minghao Dong et al.

Temporal action detection is a fundamental yet challenging task in video understanding. Many of the state-of-the-art methods predict the boundaries of action instances based on predetermined anchors akin to the two-dimensional object detection detectors. However, it is hard to detect all the action instances with predetermined temporal scales because the durations of instances in untrimmed videos can vary from few seconds to several minutes. In this paper, we propose a novel action detection architecture named anchor-free one-stage temporal action detector (AFO-TAD). AFO-TAD achieves better performance for detecting action instances with arbitrary lengths and high temporal resolution, which can be attributed to two aspects. First, we design a receptive field adaption module which dynamically adjusts the receptive field for precise action detection. Second, AFO-TAD directly predicts the categories and boundaries at every temporal locations without predetermined anchors. Extensive experiments show that AFO-TAD improves the state-of-the-art performance on THUMOS'14.

Chuang Niu, Shenghan Ren, Jimin Liang

Pixel-level annotation demands expensive human efforts and limits the performance of deep networks that usually benefits from more such training data. In this work we aim to achieve high quality instance and semantic segmentation results over a small set of pixel-level mask annotations and a large set of box annotations. The basic idea is exploring detection models to simplify the pixel-level supervised learning task and thus reduce the required amount of mask annotations. Our architecture, named DASNet, consists of three modules: detection, attention, and segmentation. The detection module detects all classes of objects, the attention module generates multi-scale class-specific features, and the segmentation module recovers the binary masks. Our method demonstrates substantially improved performance compared to existing semi-supervised approaches on PASCAL VOC 2012 dataset.