Fangyijie Wang

Fangyijie Wang, Guénolé Silvestre, Kathleen M. Curran

Fetal head segmentation is a crucial step in measuring the fetal head circumference (HC) during gestation, an important biometric in obstetrics for monitoring fetal growth. However, manual biometry generation is time-consuming and results in inconsistent accuracy. To address this issue, convolutional neural network (CNN) models have been utilized to improve the efficiency of medical biometry. But training a CNN network from scratch is a challenging task, we proposed a Transfer Learning (TL) method. Our approach involves fine-tuning (FT) a U-Net network with a lightweight MobileNet as the encoder to perform segmentation on a set of fetal head ultrasound (US) images with limited effort. This method addresses the challenges associated with training a CNN network from scratch. It suggests that our proposed FT strategy yields segmentation performance that is comparable when trained with a reduced number of parameters by 85.8%. And our proposed FT strategy outperforms other strategies with smaller trainable parameter sizes below 4.4 million. Thus, we contend that it can serve as a dependable FT approach for reducing the size of models in medical image analysis. Our key findings highlight the importance of the balance between model performance and size in developing Artificial Intelligence (AI) applications by TL methods. Code is available at https://github.com/13204942/FT_Methods_for_Fetal_Head_Segmentation.

Jieyun Bai, Zihao Zhou, Zhanhong Ou et al.

Segmentation of the fetal and maternal structures, particularly intrapartum ultrasound imaging as advocated by the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) for monitoring labor progression, is a crucial first step for quantitative diagnosis and clinical decision-making. This requires specialized analysis by obstetrics professionals, in a task that i) is highly time- and cost-consuming and ii) often yields inconsistent results. The utility of automatic segmentation algorithms for biometry has been proven, though existing results remain suboptimal. To push forward advancements in this area, the Grand Challenge on Pubic Symphysis-Fetal Head Segmentation (PSFHS) was held alongside the 26th International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI 2023). This challenge aimed to enhance the development of automatic segmentation algorithms at an international scale, providing the largest dataset to date with 5,101 intrapartum ultrasound images collected from two ultrasound machines across three hospitals from two institutions. The scientific community's enthusiastic participation led to the selection of the top 8 out of 179 entries from 193 registrants in the initial phase to proceed to the competition's second stage. These algorithms have elevated the state-of-the-art in automatic PSFHS from intrapartum ultrasound images. A thorough analysis of the results pinpointed ongoing challenges in the field and outlined recommendations for future work. The top solutions and the complete dataset remain publicly available, fostering further advancements in automatic segmentation and biometry for intrapartum ultrasound imaging.

Sidra Aleem, Fangyijie Wang, Mayug Maniparambil et al.

The Segment Anything Model (SAM) and CLIP are remarkable vision foundation models (VFMs). SAM, a prompt driven segmentation model, excels in segmentation tasks across diverse domains, while CLIP is renowned for its zero shot recognition capabilities. However, their unified potential has not yet been explored in medical image segmentation. To adapt SAM to medical imaging, existing methods primarily rely on tuning strategies that require extensive data or prior prompts tailored to the specific task, making it particularly challenging when only a limited number of data samples are available. This work presents an in depth exploration of integrating SAM and CLIP into a unified framework for medical image segmentation. Specifically, we propose a simple unified framework, SaLIP, for organ segmentation. Initially, SAM is used for part based segmentation within the image, followed by CLIP to retrieve the mask corresponding to the region of interest (ROI) from the pool of SAM generated masks. Finally, SAM is prompted by the retrieved ROI to segment a specific organ. Thus, SaLIP is training and fine tuning free and does not rely on domain expertise or labeled data for prompt engineering. Our method shows substantial enhancements in zero shot segmentation, showcasing notable improvements in DICE scores across diverse segmentation tasks like brain (63.46%), lung (50.11%), and fetal head (30.82%), when compared to un prompted SAM. Code and text prompts are available at: https://github.com/aleemsidra/SaLIP.

Xingyue Huang, Rishabh, Gregor Franke et al.

Recent advances in Large Language Models (LLMs) have shown that their reasoning capabilities can be significantly improved through Reinforcement Learning with Verifiable Reward (RLVR), particularly in domains like mathematics and programming, where ground-truth correctness can be automatically evaluated. However, extending this success to other reasoning-intensive domains remains challenging due to the scarcity of high-quality, verifiable datasets and the high cost of human supervision. In this work, we introduce the Loong Project: an open-source framework for scalable synthetic data generation and verification across a diverse range of reasoning-intensive domains. The framework consists of two key components: (1) LoongBench, a curated seed dataset containing 8,729 human-vetted examples across 12 domains (e.g., Advanced Mathematics, Chemistry, Logic), each paired with executable code and rich metadata; and (2) LoongEnv, a modular synthetic data generation environment that supports multiple prompting strategies to produce new question-answer-code triples. Together, these components form an agent-environment loop that enables reinforcement learning, where an LLM-based agent is rewarded for generating Chain-of-Thought (CoT) solutions that align with code-executed answers. Empirically, we benchmark LoongBench on a broad suite of both open-source and proprietary LLMs to evaluate domain coverage and reveal performance bottlenecks. In addition, we conduct a comprehensive analysis of synthetic data generated by LoongEnv, examining correctness, difficulty, and diversity. Code and documentation are available at https://github.com/camel-ai/loong.

Fangyijie Wang, Guenole Silvestre, Kathleen Curran

Ultrasound measurements have been examined as potential tools for predicting the likelihood of successful vaginal delivery. The angle of progression (AoP) is a measurable parameter that can be obtained during the initial stage of labor. The AoP is defined as the angle between a straight line along the longitudinal axis of the pubic symphysis (PS) and a line from the inferior edge of the PS to the leading edge of the fetal head (FH). However, the process of measuring AoP on ultrasound images is time consuming and prone to errors. To address this challenge, we propose the Mix Transformer U-Net (MiTU-Net) network, for automatic fetal head-pubic symphysis segmentation and AoP measurement. The MiTU-Net model is based on an encoder-decoder framework, utilizing a pre-trained efficient transformer to enhance feature representation. Within the efficient transformer encoder, the model significantly reduces the trainable parameters of the encoder-decoder model. The effectiveness of the proposed method is demonstrated through experiments conducted on a recent transperineal ultrasound dataset. Our model achieves competitive performance, ranking 5th compared to existing approaches. The MiTU-Net presents an efficient method for automatic segmentation and AoP measurement, reducing errors and assisting sonographers in clinical practice. Reproducibility: Framework implementation and models available on https://github.com/13204942/MiTU-Net.

Fangyijie Wang, Guénolé Silvestre, Kathleen M. Curran

Accurate measurement of fetal head circumference is crucial for estimating fetal growth during routine prenatal screening. Prior to measurement, it is necessary to accurately identify and segment the region of interest, specifically the fetal head, in ultrasound images. Recent advancements in deep learning techniques have shown significant progress in segmenting the fetal head using encoder-decoder models. Among these models, U-Net has become a standard approach for accurate segmentation. However, training an encoder-decoder model can be a time-consuming process that demands substantial computational resources. Moreover, fine-tuning these models is particularly challenging when there is a limited amount of data available. There are still no "best-practice" guidelines for optimal fine-tuning of U-net for fetal ultrasound image segmentation. This work summarizes existing fine-tuning strategies with various backbone architectures, model components, and fine-tuning strategies across ultrasound data from Netherlands, Spain, Malawi, Egypt and Algeria. Our study shows that (1) fine-tuning U-Net leads to better performance than training from scratch, (2) fine-tuning strategies in decoder are superior to other strategies, (3) network architecture with less number of parameters can achieve similar or better performance. We also demonstrate the effectiveness of fine-tuning strategies in low-resource settings and further expand our experiments into few-shot learning. Lastly, we publicly released our code and specific fine-tuned weights.

Fangyijie Wang, Kevin Whelan, Félix Balado et al.

Medical image data is less accessible than in other domains due to privacy and regulatory constraints. In addition, labeling requires costly, time-intensive manual image annotation by clinical experts. To overcome these challenges, synthetic medical data generation offers a promising solution. Generative AI (GenAI), employing generative deep learning models, has proven effective at producing realistic synthetic images. This study proposes a novel mask-guided GenAI approach using diffusion models to generate synthetic fetal head ultrasound images paired with segmentation masks. These synthetic pairs augment real datasets for supervised fine-tuning of the Segment Anything Model (SAM). Our results show that the synthetic data captures real image features effectively, and this approach reaches state-of-the-art fetal head segmentation, especially when trained with a limited number of real image-mask pairs. In particular, the segmentation reaches Dice Scores of 94.66\% and 94.38\% using a handful of ultrasound images from the Spanish and African cohorts, respectively. Our code, models, and data are available on GitHub.

Fangyijie Wang, Yuan Liang, Sourav Bhattacharjee et al.

Accurate gestational age (GA) estimation, ideally through fetal ultrasound measurement, is a crucial aspect of providing excellent antenatal care. However, deriving GA from manual fetal biometric measurements depends on the operator and is time-consuming. Hence, automatic computer-assisted methods are demanded in clinical practice. In this paper, we present a novel feature fusion framework to estimate GA using fetal ultrasound images without any measurement information. We adopt a deep learning model to extract deep representations from ultrasound images. We extract radiomic features to reveal patterns and characteristics of fetal brain growth. To harness the interpretability of radiomics in medical imaging analysis, we estimate GA by fusing radiomic features and deep representations. Our framework estimates GA with a mean absolute error of 8.0 days across three trimesters, outperforming current machine learning-based methods at these gestational ages. Experimental results demonstrate the robustness of our framework across different populations in diverse geographical regions. Our code is publicly available on \href{https://github.com/13204942/RadiomicsImageFusion_FetalUS}.

Fangyijie Wang, Kathleen M. Curran, Guénolé Silvestre

Accurate segmentation of ultrasound (US) images of the cervical muscles is crucial for precision healthcare. The demand for automatic computer-assisted methods is high. However, the scarcity of labeled data hinders the development of these methods. Advanced semi-supervised learning approaches have displayed promise in overcoming this challenge by utilizing labeled and unlabeled data. This study introduces a novel semi-supervised learning (SSL) framework that integrates dual neural networks. This SSL framework utilizes both networks to generate pseudo-labels and cross-supervise each other at the pixel level. Additionally, a self-supervised contrastive learning strategy is introduced, which employs a pair of deep representations to enhance feature learning capabilities, particularly on unlabeled data. Our framework demonstrates competitive performance in cervical segmentation tasks. Our codes are publicly available on https://github.com/13204942/SSL\_Cervical\_Segmentation.

Fangyijie Wang, Tanya Akumu, Vien Ngoc Dang et al.

Foundation models promise to unify multiple clinical tasks within a single framework, but recent ultrasound studies report that unified models can underperform task-specific baselines. We hypothesize that this degradation arises not from model capacity limitations, but from task aggregation strategies that ignore interactions between task heterogeneity and available training data scale. In this work, we systematically analyze when heterogeneous ultrasound tasks can be jointly learned without performance loss, establishing practical criteria for task aggregation in unified clinical imaging models. We introduce M2DINO, a multi-organ, multi-task framework built on DINOv3 with task-conditioned Mixture-of-Experts blocks for adaptive capacity allocation. We systematically evaluate 27 ultrasound tasks spanning segmentation, classification, detection, and regression under three paradigms: task-specific, clinically-grouped, and all-task unified training. Our results show that aggregation effectiveness depends strongly on training data scale. While clinically-grouped training can improve performance in data-rich settings, it may induce substantial negative transfer in low-data settings. In contrast, all-task unified training exhibits more consistent performance across clinical groups. We further observe that task sensitivity varies by task type in our experiments: segmentation shows the largest performance drops compared with regression and classification. These findings provide practical guidance for ultrasound foundation models, emphasizing that aggregation strategies should jointly consider training data availability and task characteristics rather than relying on clinical taxonomy alone.

Zi Ye, Tianxiang Chen, Fangyijie Wang et al.

In pediatric cardiology, the accurate and immediate assessment of cardiac function through echocardiography is crucial since it can determine whether urgent intervention is required in many emergencies. However, echocardiography is characterized by ambiguity and heavy background noise interference, causing more difficulty in accurate segmentation. Present methods lack efficiency and are prone to mistakenly segmenting some background noise areas, such as the left ventricular area, due to noise disturbance. To address these issues, we introduce P-Mamba, which integrates the Mixture of Experts (MoE) concept for efficient pediatric echocardiographic left ventricular segmentation. Specifically, we utilize the recently proposed ViM layers from the vision mamba to enhance our model's computational and memory efficiency while modeling global dependencies.In the DWT-based Perona-Malik Diffusion (PMD) Block, we devise a PMD Block for noise suppression while preserving the left ventricle's local shape cues. Consequently, our proposed P-Mamba innovatively combines the PMD's noise suppression and local feature extraction capabilities with Mamba's efficient design for global dependency modeling. We conducted segmentation experiments on two pediatric ultrasound datasets and a general ultrasound dataset, namely Echonet-dynamic, and achieved state-of-the-art (SOTA) results. Leveraging the strengths of the P-Mamba block, our model demonstrates superior accuracy and efficiency compared to established models, including vision transformers with quadratic and linear computational complexity.