Hong-Yu Zhou

Yangji He, Weihan Liang, Dongyang Zhao et al.

This paper presents new hierarchically cascaded transformers that can improve data efficiency through attribute surrogates learning and spectral tokens pooling. Vision transformers have recently been thought of as a promising alternative to convolutional neural networks for visual recognition. But when there is no sufficient data, it gets stuck in overfitting and shows inferior performance. To improve data efficiency, we propose hierarchically cascaded transformers that exploit intrinsic image structures through spectral tokens pooling and optimize the learnable parameters through latent attribute surrogates. The intrinsic image structure is utilized to reduce the ambiguity between foreground content and background noise by spectral tokens pooling. And the attribute surrogate learning scheme is designed to benefit from the rich visual information in image-label pairs instead of simple visual concepts assigned by their labels. Our Hierarchically Cascaded Transformers, called HCTransformers, is built upon a self-supervised learning framework DINO and is tested on several popular few-shot learning benchmarks. In the inductive setting, HCTransformers surpass the DINO baseline by a large margin of 9.7% 5-way 1-shot accuracy and 9.17% 5-way 5-shot accuracy on miniImageNet, which demonstrates HCTransformers are efficient to extract discriminative features. Also, HCTransformers show clear advantages over SOTA few-shot classification methods in both 5-way 1-shot and 5-way 5-shot settings on four popular benchmark datasets, including miniImageNet, tieredImageNet, FC100, and CIFAR-FS. The trained weights and codes are available at https://github.com/StomachCold/HCTransformers.

Meng Lou, Shu Zhang, Hong-Yu Zhou et al.

Recent studies have integrated convolutions into transformers to introduce inductive bias and improve generalization performance. However, the static nature of conventional convolution prevents it from dynamically adapting to input variations, resulting in a representation discrepancy between convolution and self-attention as the latter computes attention maps dynamically. Furthermore, when stacking token mixers that consist of convolution and self-attention to form a deep network, the static nature of convolution hinders the fusion of features previously generated by self-attention into convolution kernels. These two limitations result in a sub-optimal representation capacity of the entire network. To find a solution, we propose a lightweight Dual Dynamic Token Mixer (D-Mixer) to simultaneously learn global and local dynamics via computing input-dependent global and local aggregation weights. D-Mixer works by applying an efficient global attention module and an input-dependent depthwise convolution separately on evenly split feature segments, endowing the network with strong inductive bias and an enlarged receptive field. We use D-Mixer as the basic building block to design TransXNet, a novel hybrid CNN-Transformer vision backbone network that delivers compelling performance. In the ImageNet-1K classification, TransXNet-T surpasses Swin-T by 0.3% in top-1 accuracy while requiring less than half of the computational cost. Furthermore, TransXNet-S and TransXNet-B exhibit excellent model scalability, achieving top-1 accuracy of 83.8% and 84.6% respectively, with reasonable computational costs. Additionally, our proposed network architecture demonstrates strong generalization capabilities in various dense prediction tasks, outperforming other state-of-the-art networks while having lower computational costs. Code is publicly available at https://github.com/LMMMEng/TransXNet.

Weijian Huang, Cheng Li, Hong-Yu Zhou et al.

Recently, multi-modal vision-language foundation models have gained significant attention in the medical field. While these models offer great opportunities, they still face crucial challenges, such as the requirement for fine-grained knowledge understanding in computer-aided diagnosis and the capability of utilizing very limited or even no task-specific labeled data in real-world clinical applications. In this study, we present MaCo, a masked contrastive chest X-ray foundation model that tackles these challenges. MaCo explores masked contrastive learning to simultaneously achieve fine-grained image understanding and zero-shot learning for a variety of medical imaging tasks. It designs a correlation weighting mechanism to adjust the correlation between masked chest X-ray image patches and their corresponding reports, thereby enhancing the model's representation learning capabilities. To evaluate the performance of MaCo, we conducted extensive experiments using 6 well-known open-source X-ray datasets. The experimental results demonstrate the superiority of MaCo over 10 state-of-the-art approaches across tasks such as classification, segmentation, detection, and phrase grounding. These findings highlight the significant potential of MaCo in advancing a wide range of medical image analysis tasks.

Chaoqi Chen, Yushuang Wu, Qiyuan Dai et al.

Graph Neural Networks (GNNs) have gained momentum in graph representation learning and boosted the state of the art in a variety of areas, such as data mining (\emph{e.g.,} social network analysis and recommender systems), computer vision (\emph{e.g.,} object detection and point cloud learning), and natural language processing (\emph{e.g.,} relation extraction and sequence learning), to name a few. With the emergence of Transformers in natural language processing and computer vision, graph Transformers embed a graph structure into the Transformer architecture to overcome the limitations of local neighborhood aggregation while avoiding strict structural inductive biases. In this paper, we present a comprehensive review of GNNs and graph Transformers in computer vision from a task-oriented perspective. Specifically, we divide their applications in computer vision into five categories according to the modality of input data, \emph{i.e.,} 2D natural images, videos, 3D data, vision + language, and medical images. In each category, we further divide the applications according to a set of vision tasks. Such a task-oriented taxonomy allows us to examine how each task is tackled by different GNN-based approaches and how well these approaches perform. Based on the necessary preliminaries, we provide the definitions and challenges of the tasks, in-depth coverage of the representative approaches, as well as discussions regarding insights, limitations, and future directions.

Hong-Yu Zhou, Chixiang Lu, Chaoqi Chen et al.

Recent advances in self-supervised learning (SSL) in computer vision are primarily comparative, whose goal is to preserve invariant and discriminative semantics in latent representations by comparing siamese image views. However, the preserved high-level semantics do not contain enough local information, which is vital in medical image analysis (e.g., image-based diagnosis and tumor segmentation). To mitigate the locality problem of comparative SSL, we propose to incorporate the task of pixel restoration for explicitly encoding more pixel-level information into high-level semantics. We also address the preservation of scale information, a powerful tool in aiding image understanding but has not drawn much attention in SSL. The resulting framework can be formulated as a multi-task optimization problem on the feature pyramid. Specifically, we conduct multi-scale pixel restoration and siamese feature comparison in the pyramid. In addition, we propose non-skip U-Net to build the feature pyramid and develop sub-crop to replace multi-crop in 3D medical imaging. The proposed unified SSL framework (PCRLv2) surpasses its self-supervised counterparts on various tasks, including brain tumor segmentation (BraTS 2018), chest pathology identification (ChestX-ray, CheXpert), pulmonary nodule detection (LUNA), and abdominal organ segmentation (LiTS), sometimes outperforming them by large margins with limited annotations.

Chaoqi Chen, Jiongcheng Li, Hong-Yu Zhou et al.

Domain Adaptive Object Detection (DAOD) focuses on improving the generalization ability of object detectors via knowledge transfer. Recent advances in DAOD strive to change the emphasis of the adaptation process from global to local in virtue of fine-grained feature alignment methods. However, both the global and local alignment approaches fail to capture the topological relations among different foreground objects as the explicit dependencies and interactions between and within domains are neglected. In this case, only seeking one-vs-one alignment does not necessarily ensure the precise knowledge transfer. Moreover, conventional alignment-based approaches may be vulnerable to catastrophic overfitting regarding those less transferable regions (e.g. backgrounds) due to the accumulation of inaccurate localization results in the target domain. To remedy these issues, we first formulate DAOD as an open-set domain adaptation problem, in which the foregrounds and backgrounds are seen as the ``known classes'' and ``unknown class'' respectively. Accordingly, we propose a new and general framework for DAOD, named Foreground-aware Graph-based Relational Reasoning (FGRR), which incorporates graph structures into the detection pipeline to explicitly model the intra- and inter-domain foreground object relations on both pixel and semantic spaces, thereby endowing the DAOD model with the capability of relational reasoning beyond the popular alignment-based paradigm. The inter-domain visual and semantic correlations are hierarchically modeled via bipartite graph structures, and the intra-domain relations are encoded via graph attention mechanisms. Empirical results demonstrate that the proposed FGRR exceeds the state-of-the-art performance on four DAOD benchmarks.

Hong-Yu Zhou, Yizhou Yu, Chengdi Wang et al.

During the diagnostic process, clinicians leverage multimodal information, such as chief complaints, medical images, and laboratory-test results. Deep-learning models for aiding diagnosis have yet to meet this requirement. Here we report a Transformer-based representation-learning model as a clinical diagnostic aid that processes multimodal input in a unified manner. Rather than learning modality-specific features, the model uses embedding layers to convert images and unstructured and structured text into visual tokens and text tokens, and bidirectional blocks with intramodal and intermodal attention to learn a holistic representation of radiographs, the unstructured chief complaint and clinical history, structured clinical information such as laboratory-test results and patient demographic information. The unified model outperformed an image-only model and non-unified multimodal diagnosis models in the identification of pulmonary diseases (by 12% and 9%, respectively) and in the prediction of adverse clinical outcomes in patients with COVID-19 (by 29% and 7%, respectively). Leveraging unified multimodal Transformer-based models may help streamline triage of patients and facilitate the clinical decision process.

Yunfei Xie, Ce Zhou, Lang Gao et al.

This paper introduces MedTrinity-25M, a comprehensive, large-scale multimodal dataset for medicine, covering over 25 million images across 10 modalities with multigranular annotations for more than 65 diseases. These multigranular annotations encompass both global information, such as modality and organ detection, and local information like ROI analysis, lesion texture, and region-wise correlations. Unlike the existing multimodal datasets, which are limited by the availability of image-text pairs, we have developed the first automated pipeline that scales up multimodal data by generating multigranular visual and textual annotations in the form of image-ROI-description triplets without the need for any paired text descriptions. Specifically, data from over 30 different sources have been collected, preprocessed, and grounded using domain-specific expert models to identify ROIs related to abnormal regions. We then build a comprehensive knowledge base and prompt multimodal large language models to perform retrieval-augmented generation with the identified ROIs as guidance, resulting in multigranular textual descriptions. Compared to existing datasets, MedTrinity-25M provides the most enriched annotations, supporting a comprehensive range of multimodal tasks such as captioning and report generation, as well as vision-centric tasks like classification and segmentation. We propose LLaVA-Tri by pretraining LLaVA on MedTrinity-25M, achieving state-of-the-art performance on VQA-RAD, SLAKE, and PathVQA, surpassing representative SOTA multimodal large language models. Furthermore, MedTrinity-25M can also be utilized to support large-scale pre-training of multimodal medical AI models, contributing to the development of future foundation models in the medical domain. We will make our dataset available.

Hong-Yu Zhou, Yunxiang Fu, Zhicheng Zhang et al.

Protein representation learning has primarily benefited from the remarkable development of language models (LMs). Accordingly, pre-trained protein models also suffer from a problem in LMs: a lack of factual knowledge. The recent solution models the relationships between protein and associated knowledge terms as the knowledge encoding objective. However, it fails to explore the relationships at a more granular level, i.e., the token level. To mitigate this, we propose Knowledge-exploited Auto-encoder for Protein (KeAP), which performs token-level knowledge graph exploration for protein representation learning. In practice, non-masked amino acids iteratively query the associated knowledge tokens to extract and integrate helpful information for restoring masked amino acids via attention. We show that KeAP can consistently outperform the previous counterpart on 9 representative downstream applications, sometimes surpassing it by large margins. These results suggest that KeAP provides an alternative yet effective way to perform knowledge enhanced protein representation learning.

Hong-Yu Zhou, Chenyu Lian, Liansheng Wang et al.

Modern studies in radiograph representation learning rely on either self-supervision to encode invariant semantics or associated radiology reports to incorporate medical expertise, while the complementarity between them is barely noticed. To explore this, we formulate the self- and report-completion as two complementary objectives and present a unified framework based on masked record modeling (MRM). In practice, MRM reconstructs masked image patches and masked report tokens following a multi-task scheme to learn knowledge-enhanced semantic representations. With MRM pre-training, we obtain pre-trained models that can be well transferred to various radiography tasks. Specifically, we find that MRM offers superior performance in label-efficient fine-tuning. For instance, MRM achieves 88.5% mean AUC on CheXpert using 1% labeled data, outperforming previous R$^2$L methods with 100% labels. On NIH ChestX-ray, MRM outperforms the best performing counterpart by about 3% under small labeling ratios. Besides, MRM surpasses self- and report-supervised pre-training in identifying the pneumonia type and the pneumothorax area, sometimes by large margins.

Zhixiong Yang, Junwen Pan, Yanzhan Yang et al.

Medical image classification has been widely adopted in medical image analysis. However, due to the difficulty of collecting and labeling data in the medical area, medical image datasets are usually highly-imbalanced. To address this problem, previous works utilized class samples as prior for re-weighting or re-sampling but the feature representation is usually still not discriminative enough. In this paper, we adopt the contrastive learning to tackle the long-tailed medical imbalance problem. Specifically, we first propose the category prototype and adversarial proto-instance to generate representative contrastive pairs. Then, the prototype recalibration strategy is proposed to address the highly imbalanced data distribution. Finally, a unified proto-loss is designed to train our framework. The overall framework, namely as Prototype-aware Contrastive learning (ProCo), is unified as a single-stage pipeline in an end-to-end manner to alleviate the imbalanced problem in medical image classification, which is also a distinct progress than existing works as they follow the traditional two-stage pipeline. Extensive experiments on two highly-imbalanced medical image classification datasets demonstrate that our method outperforms the existing state-of-the-art methods by a large margin.

Jiansen Guo, Hong-Yu Zhou, Liansheng Wang et al.

Recent medical image segmentation models are mostly hybrid, which integrate self-attention and convolution layers into the non-isomorphic architecture. However, one potential drawback of these approaches is that they failed to provide an intuitive explanation of why this hybrid combination manner is beneficial, making it difficult for subsequent work to make improvements on top of them. To address this issue, we first analyze the differences between the weight allocation mechanisms of the self-attention and convolution. Based on this analysis, we propose to construct a parallel non-isomorphic block that takes the advantages of self-attention and convolution with simple parallelization. We name the resulting U-shape segmentation model as UNet-2022. In experiments, UNet-2022 obviously outperforms its counterparts in a range segmentation tasks, including abdominal multi-organ segmentation, automatic cardiac diagnosis, neural structures segmentation, and skin lesion segmentation, sometimes surpassing the best performing baseline by 4%. Specifically, UNet-2022 surpasses nnUNet, the most recognized segmentation model at present, by large margins. These phenomena indicate the potential of UNet-2022 to become the model of choice for medical image segmentation.

Chenyu Lian, Hong-Yu Zhou, Chun-Ka Wong et al.

Vision-language alignment using chest X-rays and radiology reports has emerged as an advanced paradigm for zero-shot classification and grounding of chest X-ray findings. However, standard contrastive learning typically treats radiographs and reports from different patients simply as negative pairs. This assumption introduces noisy negatives, as different patients frequently exhibit similar findings. Such noisy negatives cause semantic ambiguity and degrade performance in zero-shot understanding tasks. To address this challenge, we propose CoNNS, a concept-guided noisy-negative suppression framework. To support the negative suppression mechanism, unlike previous methods that use raw reports or templatized texts, we construct a hierarchical concept ontology using large language models. The ontology structures 41 key clinical concepts by explicitly modeling presence, attributes (location and characteristics), and texts (evidential segment and presence statement). Leveraging this ontology, we implement a cross-patient pair relabeling strategy comprising three steps: (1) Fine-Grained Breakdown to categorize pairs based on finding presence; (2) Noisy Negative Filtering to resolve semantic conflicts by removing false negatives; and (3) Hard Negative Mining to identify subtle attribute discrepancies using a lightweight language model. Finally, we propose a Concept-Aware NCE loss to align visual features with text while suppressing the identified noisy negatives. Extensive experiments across multi-granularity zero-shot grounding tasks and five zero-shot classification datasets validate that CoNNS outperforms existing state-of-the-art models. The code is available at https://github.com/DopamineLcy/conns.

Xiaoman Zhang, Julián N. Acosta, Hong-Yu Zhou et al.

Recent advancements in artificial intelligence have significantly improved the automatic generation of radiology reports. However, existing evaluation methods fail to reveal the models' understanding of radiological images and their capacity to achieve human-level granularity in descriptions. To bridge this gap, we introduce a system, named ReXKG, which extracts structured information from processed reports to construct a comprehensive radiology knowledge graph. We then propose three metrics to evaluate the similarity of nodes (ReXKG-NSC), distribution of edges (ReXKG-AMS), and coverage of subgraphs (ReXKG-SCS) across various knowledge graphs. We conduct an in-depth comparative analysis of AI-generated and human-written radiology reports, assessing the performance of both specialist and generalist models. Our study provides a deeper understanding of the capabilities and limitations of current AI models in radiology report generation, offering valuable insights for improving model performance and clinical applicability.

Chaoqi Chen, Luyao Tang, Leitian Tao et al.

Albeit the notable performance on in-domain test points, it is non-trivial for deep neural networks to attain satisfactory accuracy when deploying in the open world, where novel domains and object classes often occur. In this paper, we study a practical problem of Domain Generalization under Category Shift (DGCS), which aims to simultaneously detect unknown-class samples and classify known-class samples in the target domains. Compared to prior DG works, we face two new challenges: 1) how to learn the concept of ``unknown'' during training with only source known-class samples, and 2) how to adapt the source-trained model to unseen environments for safe model deployment. To this end, we propose a novel Activate and Reject (ART) framework to reshape the model's decision boundary to accommodate unknown classes and conduct post hoc modification to further discriminate known and unknown classes using unlabeled test data. Specifically, during training, we promote the response to the unknown by optimizing the unknown probability and then smoothing the overall output to mitigate the overconfidence issue. At test time, we introduce a step-wise online adaptation method that predicts the label by virtue of the cross-domain nearest neighbor and class prototype information without updating the network's parameters or using threshold-based mechanisms. Experiments reveal that ART consistently improves the generalization capability of deep networks on different vision tasks. For image classification, ART improves the H-score by 6.1% on average compared to the previous best method. For object detection and semantic segmentation, we establish new benchmarks and achieve competitive performance.

Ge Zheng, Bin Yang, Jiajin Tang et al.

A long-standing goal of AI systems is to perform complex multimodal reasoning like humans. Recently, large language models (LLMs) have made remarkable strides in such multi-step reasoning on the language modality solely by leveraging the chain of thought (CoT) to mimic human thinking. However, the transfer of these advancements to multimodal contexts introduces heightened challenges, including but not limited to the impractical need for labor-intensive annotation and the limitations in terms of flexibility, generalizability, and explainability. To evoke CoT reasoning in multimodality, this work first conducts an in-depth analysis of these challenges posed by multimodality and presents two key insights: "keeping critical thinking" and "letting everyone do their jobs" in multimodal CoT reasoning. Furthermore, this study proposes a novel DDCoT prompting that maintains a critical attitude through negative-space prompting and incorporates multimodality into reasoning by first dividing the reasoning responsibility of LLMs into reasoning and recognition and then integrating the visual recognition capability of visual models into the joint reasoning process. The rationales generated by DDCoT not only improve the reasoning abilities of both large and small language models in zero-shot prompting and fine-tuning learning, significantly outperforming state-of-the-art methods but also exhibit impressive generalizability and explainability.

Jiaxin Wu, Yizhou Yu, Hong-Yu Zhou

Large Language Models (LLMs) show promise for natural language generation in healthcare, but risk hallucinating factually incorrect information. Deploying LLMs for medical question answering necessitates reliable uncertainty estimation (UE) methods to detect hallucinations. In this work, we benchmark popular UE methods with different model sizes on medical question-answering datasets. Our results show that current approaches generally perform poorly in this domain, highlighting the challenge of UE for medical applications. We also observe that larger models tend to yield better results, suggesting a correlation between model size and the reliability of UE. To address these challenges, we propose Two-phase Verification, a probability-free Uncertainty Estimation approach. First, an LLM generates a step-by-step explanation alongside its initial answer, followed by formulating verification questions to check the factual claims in the explanation. The model then answers these questions twice: first independently, and then referencing the explanation. Inconsistencies between the two sets of answers measure the uncertainty in the original response. We evaluate our approach on three biomedical question-answering datasets using Llama 2 Chat models and compare it against the benchmarked baseline methods. The results show that our Two-phase Verification method achieves the best overall accuracy and stability across various datasets and model sizes, and its performance scales as the model size increases.

Hong-Yu Zhou, Chixiang Lu, Liansheng Wang et al.

Self-supervised representation learning has been extremely successful in medical image analysis, as it requires no human annotations to provide transferable representations for downstream tasks. Recent self-supervised learning methods are dominated by noise-contrastive estimation (NCE, also known as contrastive learning), which aims to learn invariant visual representations by contrasting one homogeneous image pair with a large number of heterogeneous image pairs in each training step. Nonetheless, NCE-based approaches still suffer from one major problem that is one homogeneous pair is not enough to extract robust and invariant semantic information. Inspired by the archetypical triplet loss, we propose GraVIS, which is specifically optimized for learning self-supervised features from dermatology images, to group homogeneous dermatology images while separating heterogeneous ones. In addition, a hardness-aware attention is introduced and incorporated to address the importance of homogeneous image views with similar appearance instead of those dissimilar homogeneous ones. GraVIS significantly outperforms its transfer learning and self-supervised learning counterparts in both lesion segmentation and disease classification tasks, sometimes by 5 percents under extremely limited supervision. More importantly, when equipped with the pre-trained weights provided by GraVIS, a single model could achieve better results than winners that heavily rely on ensemble strategies in the well-known ISIC 2017 challenge.

Chenyu Lian, Hong-Yu Zhou, Jing Qin

Disease screening is critical for early detection and timely intervention in clinical practice. However, most current screening models for medical images suffer from limited interpretability and suboptimal performance. They often lack effective mechanisms to reference historical cases or provide transparent reasoning pathways. To address these challenges, we introduce EviScreen, an evidential reasoning framework for disease screening that leverages region-level evidence from historical cases. The proposed EviScreen offers retrospection interpretability through regional evidence retrieved from dual knowledge banks. Using this evidential mechanism, the subsequent evidence-aware reasoning module makes predictions using both the current case and evidence from historical cases, thereby enhancing disease screening performance. Furthermore, rather than relying on post-hoc saliency maps, EviScreen enhances localization interpretability by leveraging abnormality maps derived from contrastive retrieval. Our method achieves superior performance on our carefully established benchmarks for real-world disease screening, yielding notably higher specificity at clinical-level recall. Code is publicly available at https://github.com/DopamineLcy/EviScreen.

Julián N. Acosta, Xiaoman Zhang, Siddhant Dogra et al.

We present Head CT Ontology Normalized Evaluation (HeadCT-ONE), a metric for evaluating head CT report generation through ontology-normalized entity and relation extraction. HeadCT-ONE enhances current information extraction derived metrics (such as RadGraph F1) by implementing entity normalization through domain-specific ontologies, addressing radiological language variability. HeadCT-ONE compares normalized entities and relations, allowing for controllable weighting of different entity types or specific entities. Through experiments on head CT reports from three health systems, we show that HeadCT-ONE's normalization and weighting approach improves the capture of semantically equivalent reports, better distinguishes between normal and abnormal reports, and aligns with radiologists' assessment of clinically significant errors, while offering flexibility to prioritize specific aspects of report content. Our results demonstrate how HeadCT-ONE enables more flexible, controllable, and granular automated evaluation of head CT reports.

Chenyu Lian, Hong-Yu Zhou, Yizhou Yu et al.

Parameter-efficient fine-tuning (PEFT) that was initially developed for exploiting pre-trained large language models has recently emerged as an effective approach to perform transfer learning on computer vision tasks. However, the effectiveness of PEFT on medical vision foundation models is still unclear and remains to be explored. As a proof of concept, we conducted a detailed empirical study on applying PEFT to chest radiography foundation models. Specifically, we delved into LoRA, a representative PEFT method, and compared it against full-parameter fine-tuning (FFT) on two self-supervised radiography foundation models across three well-established chest radiograph datasets. Our results showed that LoRA outperformed FFT in 13 out of 18 transfer learning tasks by at most 2.9% using fewer than 1% tunable parameters. Combining LoRA with foundation models, we set up new state-of-the-art on a range of data-efficient learning tasks, such as an AUROC score of 80.6% using 1% labeled data on NIH ChestX-ray14. We hope this study can evoke more attention from the community in the use of PEFT for transfer learning on medical imaging tasks. Code and models are available at https://github.com/RL4M/MED-PEFT.

Chenyu Lian, Hong-Yu Zhou, Dongyun Liang et al.

Medical vision-language alignment through cross-modal contrastive learning shows promising performance in image-text matching tasks, such as retrieval and zero-shot classification. However, conventional cross-modal contrastive learning (CLIP-based) methods suffer from suboptimal visual representation capabilities, which also limits their effectiveness in vision-language alignment. In contrast, although the models pretrained via multimodal masked modeling struggle with direct cross-modal matching, they excel in visual representation. To address this contradiction, we propose ALTA (ALign Through Adapting), an efficient medical vision-language alignment method that utilizes only about 8% of the trainable parameters and less than 1/5 of the computational consumption required for masked record modeling. ALTA achieves superior performance in vision-language matching tasks like retrieval and zero-shot classification by adapting the pretrained vision model from masked record modeling. Additionally, we integrate temporal-multiview radiograph inputs to enhance the information consistency between radiographs and their corresponding descriptions in reports, further improving the vision-language alignment. Experimental evaluations show that ALTA outperforms the best-performing counterpart by over 4% absolute points in text-to-image accuracy and approximately 6% absolute points in image-to-text retrieval accuracy. The adaptation of vision-language models during efficient alignment also promotes better vision and language understanding. Code is publicly available at https://github.com/DopamineLcy/ALTA.

Weijian Huang, Cheng Li, Hong-Yu Zhou et al.

The development of medical vision-language foundation models has attracted significant attention in the field of medicine and healthcare due to their promising prospect in various clinical applications. While previous studies have commonly focused on feature learning at a single learning scale, investigation on integrating multi-scale information is lacking, which may hinder the potential for mutual reinforcement among these features. This paper aims to bridge this gap by proposing a method that effectively exploits multi-scale information to enhance the performance of medical foundation models. The proposed method simultaneously exploits features at the local, instance, modality and global aspects, facilitating comprehensive representation learning within the models. We evaluate the effectiveness of the proposed method on six open-source datasets across different clinical tasks, demonstrating its ability to enhance the performance of medical foundation models.

Mohammed Baharoon, Luyang Luo, Michael Moritz et al.

We introduce ReXGroundingCT, the first publicly available dataset linking free-text findings to pixel-level 3D segmentations in chest CT scans. The dataset includes 3,142 non-contrast chest CT scans paired with standardized radiology reports from CT-RATE. Construction followed a structured three-stage pipeline. First, GPT-4 was used to extract and standardize findings, descriptors, and metadata from reports originally written in Turkish and machine-translated into English. Second, GPT-4o-mini categorized each finding into a hierarchical ontology of lung and pleural abnormalities. Third, 3D annotations were produced for all CT volumes: the training set was quality-assured by board-certified radiologists, and the validation and test sets were fully annotated by board-certified radiologists. Additionally, a complementary chain-of-thought dataset was created to provide step-by-step hierarchical anatomical reasoning for localizing findings within the CT volume, using GPT-4o and localization coordinates derived from organ segmentation models. ReXGroundingCT contains 16,301 annotated entities across 8,028 text-to-3D-segmentation pairs, covering diverse radiological patterns from 3,142 non-contrast CT scans. About 79% of findings are focal abnormalities and 21% are non-focal. The dataset includes a public validation set of 50 cases and a private test set of 100 cases, both annotated by board-certified radiologists. The dataset establishes a foundation for enabling free-text finding segmentation and grounded radiology report generation in CT imaging. Model performance on the private test set is hosted on a public leaderboard at https://rexrank.ai/ReXGroundingCT. The dataset is available at https://huggingface.co/datasets/rajpurkarlab/ReXGroundingCT.

Jiarun Liu, Hao Yang, Hong-Yu Zhou et al.

Accurate medical image segmentation demands the integration of multi-scale information, spanning from local features to global dependencies. However, it is challenging for existing methods to model long-range global information, where convolutional neural networks (CNNs) are constrained by their local receptive fields, and vision transformers (ViTs) suffer from high quadratic complexity of their attention mechanism. Recently, Mamba-based models have gained great attention for their impressive ability in long sequence modeling. Several studies have demonstrated that these models can outperform popular vision models in various tasks, offering higher accuracy, lower memory consumption, and less computational burden. However, existing Mamba-based models are mostly trained from scratch and do not explore the power of pretraining, which has been proven to be quite effective for data-efficient medical image analysis. This paper introduces a novel Mamba-based model, Swin-UMamba, designed specifically for medical image segmentation tasks, leveraging the advantages of ImageNet-based pretraining. Our experimental results reveal the vital role of ImageNet-based training in enhancing the performance of Mamba-based models. Swin-UMamba demonstrates superior performance with a large margin compared to CNNs, ViTs, and latest Mamba-based models. Notably, on AbdomenMRI, Encoscopy, and Microscopy datasets, Swin-UMamba outperforms its closest counterpart U-Mamba_Enc by an average score of 2.72%.

Junyou Su, He Zhu, Xiao Luo et al.

Supervised fine-tuning (SFT) is fundamental to adapting large language models, yet training on complete datasets incurs prohibitive costs with diminishing returns. Existing data selection methods suffer from severe domain specificity: techniques optimized for general instruction-following fail on reasoning tasks, and vice versa. We observe that measuring entropy differences between base models and minimally instruction-tuned calibrated models reveals a pattern -- samples with the lowest differential entropy consistently yield optimal performance across domains, yet this principle manifests domain-adaptively: reasoning tasks favor entropy increase (cognitive expansion), while general tasks favor entropy decrease (cognitive compression). We introduce InstructDiff, a unified framework that operationalizes differential entropy as a domain-adaptive selection criterion through warmup calibration, bi-directional NLL filtering, and entropy-based ranking. Extensive experiments show that InstructDiff achieves 17\% relative improvement over full data training on mathematical reasoning and 52\% for general instruction-following, outperforming prior baselines while using only 10\% of the data.

Chenyu Lian, Hong-Yu Zhou, Zhanli Hu et al.

Retinal anomaly detection plays a pivotal role in screening ocular and systemic diseases. Despite its significance, progress in the field has been hindered by the absence of a comprehensive and publicly available benchmark, which is essential for the fair evaluation and advancement of methodologies. Due to this limitation, previous anomaly detection work related to retinal images has been constrained by (1) a limited and overly simplistic set of anomaly types, (2) test sets that are nearly saturated, and (3) a lack of generalization evaluation, resulting in less convincing experimental setups. Furthermore, existing benchmarks in medical anomaly detection predominantly focus on one-class supervised approaches (training only with negative samples), overlooking the vast amounts of labeled abnormal data and unlabeled data that are commonly available in clinical practice. To bridge these gaps, we introduce a benchmark for retinal anomaly detection, which is comprehensive and systematic in terms of data and algorithm. Through categorizing and benchmarking previous methods, we find that a fully supervised approach leveraging disentangled representations of abnormalities (DRA) achieves the best performance but suffers from significant drops in performance when encountering certain unseen anomalies. Inspired by the memory bank mechanisms in one-class supervised learning, we propose NFM-DRA, which integrates DRA with a Normal Feature Memory to mitigate the performance degradation, establishing a new SOTA. The benchmark is publicly available at https://github.com/DopamineLcy/BenchReAD.

Shu Zhang, Zihao Li, Hong-Yu Zhou et al.

The difficulties in both data acquisition and annotation substantially restrict the sample sizes of training datasets for 3D medical imaging applications. As a result, constructing high-performance 3D convolutional neural networks from scratch remains a difficult task in the absence of a sufficient pre-training parameter. Previous efforts on 3D pre-training have frequently relied on self-supervised approaches, which use either predictive or contrastive learning on unlabeled data to build invariant 3D representations. However, because of the unavailability of large-scale supervision information, obtaining semantically invariant and discriminative representations from these learning frameworks remains problematic. In this paper, we revisit an innovative yet simple fully-supervised 3D network pre-training framework to take advantage of semantic supervisions from large-scale 2D natural image datasets. With a redesigned 3D network architecture, reformulated natural images are used to address the problem of data scarcity and develop powerful 3D representations. Comprehensive experiments on four benchmark datasets demonstrate that the proposed pre-trained models can effectively accelerate convergence while also improving accuracy for a variety of 3D medical imaging tasks such as classification, segmentation and detection. In addition, as compared to training from scratch, it can save up to 60% of annotation efforts. On the NIH DeepLesion dataset, it likewise achieves state-of-the-art detection performance, outperforming earlier self-supervised and fully-supervised pre-training approaches, as well as methods that do training from scratch. To facilitate further development of 3D medical models, our code and pre-trained model weights are publicly available at https://github.com/urmagicsmine/CSPR.

Bin-Bin Gao, Hong-Yu Zhou

Multi-label image recognition is a practical and challenging task compared to single-label image classification. However, previous works may be suboptimal because of a great number of object proposals or complex attentional region generation modules. In this paper, we propose a simple but efficient two-stream framework to recognize multi-category objects from global image to local regions, similar to how human beings perceive objects. To bridge the gap between global and local streams, we propose a multi-class attentional region module which aims to make the number of attentional regions as small as possible and keep the diversity of these regions as high as possible. Our method can efficiently and effectively recognize multi-class objects with an affordable computation cost and a parameter-free region localization module. Over three benchmarks on multi-label image classification, we create new state-of-the-art results with a single model only using image semantics without label dependency. In addition, the effectiveness of the proposed method is extensively demonstrated under different factors such as global pooling strategy, input size and network architecture. Code has been made available at~\url{https://github.com/gaobb/MCAR}.

Hong-Yu Zhou, Julián Nicolás Acosta, Subathra Adithan et al.

Current medical AI systems are often limited to narrow applications, hindering widespread adoption. We present MedVersa, a generalist foundation model trained on tens of millions of compiled medical instances. MedVersa unlocks generalist learning from multimodal inputs and outputs, representing the first example of a generalist model reaching competitive performance with leading specialized solutions across a variety of medical imaging scenarios. MedVersa achieves state-of-the-art performance in nine tasks, sometimes outperforming counterparts by over 10%. Radiologist evaluation shows MedVersa-generated reports get superior performance in 95% of normal studies, while matching or exceeding human reports in 71% of cases overall. User studies showed notable reductions in report writing time and discrepancies with the use of MedVersa. Our findings underscore the value of flexible, multimodal AI systems in advancing medical image interpretation and supporting clinical expertise.

Meng Lou, Hanning Ying, Xiaoqing Liu et al.

Automated classification of liver lesions in multi-phase CT and MR scans is of clinical significance but challenging. This study proposes a novel Siamese Dual-Resolution Transformer (SDR-Former) framework, specifically designed for liver lesion classification in 3D multi-phase CT and MR imaging with varying phase counts. The proposed SDR-Former utilizes a streamlined Siamese Neural Network (SNN) to process multi-phase imaging inputs, possessing robust feature representations while maintaining computational efficiency. The weight-sharing feature of the SNN is further enriched by a hybrid Dual-Resolution Transformer (DR-Former), comprising a 3D Convolutional Neural Network (CNN) and a tailored 3D Transformer for processing high- and low-resolution images, respectively. This hybrid sub-architecture excels in capturing detailed local features and understanding global contextual information, thereby, boosting the SNN's feature extraction capabilities. Additionally, a novel Adaptive Phase Selection Module (APSM) is introduced, promoting phase-specific intercommunication and dynamically adjusting each phase's influence on the diagnostic outcome. The proposed SDR-Former framework has been validated through comprehensive experiments on two clinical datasets: a three-phase CT dataset and an eight-phase MR dataset. The experimental results affirm the efficacy of the proposed framework. To support the scientific community, we are releasing our extensive multi-phase MR dataset for liver lesion analysis to the public. This pioneering dataset, being the first publicly available multi-phase MR dataset in this field, also underpins the MICCAI LLD-MMRI Challenge. The dataset is accessible at:https://bit.ly/3IyYlgN.

Lijun Liu, Linwei Chen, Zhishou Zhang et al.

General-purpose Large Vision-Language Models (LVLMs), despite their massive scale, often falter in dermatology due to "diffuse attention" - the inability to disentangle subtle pathological lesions from background noise. In this paper, we challenge the assumption that parameter scaling is the only path to medical precision. We introduce SkinFlow, a framework that treats diagnosis as an optimization of visual information transmission efficiency. Our approach utilizes a Virtual-Width Dynamic Vision Encoder (DVE) to "unfold" complex pathological manifolds without physical parameter expansion, coupled with a two-stage Reinforcement Learning strategy. This strategy sequentially aligns explicit medical descriptions (Stage I) and reconstructs implicit diagnostic textures (Stage II) within a constrained semantic space. Furthermore, we propose a clinically grounded evaluation protocol that prioritizes diagnostic safety and hierarchical relevance over rigid label matching. Empirical results are compelling: our 7B model establishes a new state-of-the-art on the Fitzpatrick17k benchmark, achieving a +12.06% gain in Top-1 accuracy and a +28.57% boost in Top-6 accuracy over the massive general-purpose models (e.g., Qwen3VL-235B and GPT-5.2). These findings demonstrate that optimizing geometric capacity and information flow yields superior diagnostic reasoning compared to raw parameter scaling.

Xiaoman Zhang, Hong-Yu Zhou, Xiaoli Yang et al.

AI-driven models have demonstrated significant potential in automating radiology report generation for chest X-rays. However, there is no standardized benchmark for objectively evaluating their performance. To address this, we present ReXrank, https://rexrank.ai, a public leaderboard and challenge for assessing AI-powered radiology report generation. Our framework incorporates ReXGradient, the largest test dataset consisting of 10,000 studies, and three public datasets (MIMIC-CXR, IU-Xray, CheXpert Plus) for report generation assessment. ReXrank employs 8 evaluation metrics and separately assesses models capable of generating only findings sections and those providing both findings and impressions sections. By providing this standardized evaluation framework, ReXrank enables meaningful comparisons of model performance and offers crucial insights into their robustness across diverse clinical settings. Beyond its current focus on chest X-rays, ReXrank's framework sets the stage for comprehensive evaluation of automated reporting across the full spectrum of medical imaging.

Jiarun Liu, Hong-Yu Zhou, Cheng Li et al.

Existing contrastive language-image pre-training aims to learn a joint representation by matching abundant image-text pairs. However, the number of image-text pairs in medical datasets is usually orders of magnitude smaller than that in natural datasets. Besides, medical image-text pairs often involve numerous complex fine-grained correspondences. This paper aims to enhance the data efficiency by introducing multiple-to-multiple local relationship modeling to capture denser supervisions. More specifically, we propose a Medical Language-Image Pre-training (MLIP) framework, which exploits the limited image-text medical data more efficiently through patch-sentence matching. Furthermore, we introduce a masked contrastive learning strategy with semantic integrity estimation to reduce redundancy in images while preserving the underlying semantics. Our evaluation results show that MLIP outperforms previous work in zero/few-shot classification and few-shot segmentation tasks by a large margin.

Hao Yang, Hong-Yu Zhou, Cheng Li et al.

Multimodal deep learning utilizing imaging and diagnostic reports has made impressive progress in the field of medical imaging diagnostics, demonstrating a particularly strong capability for auxiliary diagnosis in cases where sufficient annotation information is lacking. Nonetheless, localizing diseases accurately without detailed positional annotations remains a challenge. Although existing methods have attempted to utilize local information to achieve fine-grained semantic alignment, their capability in extracting the fine-grained semantics of the comprehensive context within reports is limited. To address this problem, a new method is introduced that takes full sentences from textual reports as the basic units for local semantic alignment. This approach combines chest X-ray images with their corresponding textual reports, performing contrastive learning at both global and local levels. The leading results obtained by this method on multiple datasets confirm its efficacy in the task of lesion localization.

Hao Yang, Hong-Yu Zhou, Jiarun Liu et al.

Existing deep learning models for defining pathology from clinical imaging data rely on expert annotations and lack generalization capabilities in open clinical environments. Here, we present a generalizable vision-language model for Annotation-Free pathology Localization (AFLoc). The core strength of AFLoc is extensive multi-level semantic structure-based contrastive learning, which comprehensively aligns multi-granularity medical concepts with abundant image features to adapt to the diverse expressions of pathologies without the reliance on expert image annotations. We conduct primary experiments on a dataset of 220K pairs of image-report chest X-ray images and perform validation across eight external datasets encompassing 34 types of chest pathologies. The results demonstrate that AFLoc outperforms state-of-the-art methods in both annotation-free localization and classification tasks. Additionally, we assess the generalizability of AFLoc on other modalities, including histopathology and retinal fundus images. We show that AFLoc exhibits robust generalization capabilities, even surpassing human benchmarks in localizing five different types of pathological images. These results highlight the potential of AFLoc in reducing annotation requirements and its applicability in complex clinical environments.

Bin Yang, Yulin Zhang, Hong-Yu Zhou et al.

Detection transformers have been applied to human-object interaction (HOI) detection, enhancing the localization and recognition of human-action-object triplets in images. Despite remarkable progress, this study identifies a critical issue-"Toxic Siblings" bias-which hinders the interaction decoder's learning, as numerous similar yet distinct HOI triplets interfere with and even compete against each other both input side and output side to the interaction decoder. This bias arises from high confusion among sibling triplets/categories, where increased similarity paradoxically reduces precision, as one's gain comes at the expense of its toxic sibling's decline. To address this, we propose two novel debiasing learning objectives-"contrastive-then-calibration" and "merge-then-split"-targeting the input and output perspectives, respectively. The former samples sibling-like incorrect HOI triplets and reconstructs them into correct ones, guided by strong positional priors. The latter first learns shared features among sibling categories to distinguish them from other groups, then explicitly refines intra-group differentiation to preserve uniqueness. Experiments show that we significantly outperform both the baseline (+9.18% mAP on HICO-Det) and the state-of-the-art (+3.59% mAP) across various settings.

Jiarun Liu, Hong-Yu Zhou, Weijian Huang et al.

Scaling up model and data size have demonstrated impressive performance improvement over a wide range of tasks. Despite extensive studies on scaling behaviors for general-purpose tasks, medical images exhibit substantial differences from natural data. It remains unclear the key factors in developing medical vision foundation models at scale due to the absence of an extensive understanding of scaling behavior in the medical domain. In this paper, we explored the scaling behavior across model sizes, training algorithms, data sizes, and imaging modalities in developing scalable medical vision foundation models by self-supervised learning. To support scalable pretraining, we introduce BioVFM-21M, a large-scale biomedical image dataset encompassing a wide range of biomedical image modalities and anatomies. We observed that scaling up does provide benefits but varies across tasks. Additional analysis reveals several factors correlated with scaling benefits. Finally, we propose BioVFM, a large-scale medical vision foundation model pretrained on 21 million biomedical images, which outperforms the previous state-of-the-art foundation models across 12 medical benchmarks. Our results highlight that while scaling up is beneficial for pursuing better performance, task characteristics, data diversity, pretraining methods, and computational efficiency remain critical considerations for developing scalable medical foundation models.

Oishi Banerjee, Hong-Yu Zhou, Subathra Adithan et al.

Recent advances in generative vision-language models (VLMs) have exciting potential implications for AI in radiology, yet VLMs are also known to produce hallucinations, nonsensical text, and other unwanted behaviors that can waste clinicians' time and cause patient harm. Drawing on recent work on direct preference optimization (DPO), we propose a simple method for modifying the behavior of pretrained VLMs performing radiology report generation by suppressing unwanted types of generations. We apply our method to the prevention of hallucinations of prior exams, addressing a long-established problem behavior in models performing chest X-ray report generation. Across our experiments, we find that DPO fine-tuning achieves a 3.2-4.8x reduction in lines hallucinating prior exams while maintaining model performance on clinical accuracy metrics. Our work is, to the best of our knowledge, the first work to apply DPO to medical VLMs, providing a data- and compute- efficient way to suppress problem behaviors while maintaining overall clinical accuracy.

Fei Gao, Siwen Wang, Fandong Zhang et al.

Medical image analysis suffers from a shortage of data, whether annotated or not. This becomes even more pronounced when it comes to 3D medical images. Self-Supervised Learning (SSL) can partially ease this situation by using unlabeled data. However, most existing SSL methods can only make use of data in a single dimensionality (e.g. 2D or 3D), and are incapable of enlarging the training dataset by using data with differing dimensionalities jointly. In this paper, we propose a new cross-dimensional SSL framework based on a pseudo-3D transformation (CDSSL-P3D), that can leverage both 2D and 3D data for joint pre-training. Specifically, we introduce an image transformation based on the im2col algorithm, which converts 2D images into a format consistent with 3D data. This transformation enables seamless integration of 2D and 3D data, and facilitates cross-dimensional self-supervised learning for 3D medical image analysis. We run extensive experiments on 13 downstream tasks, including 2D and 3D classification and segmentation. The results indicate that our CDSSL-P3D achieves superior performance, outperforming other advanced SSL methods.

Hong-Yu Zhou, Xiaoyu Chen, Yinghao Zhang et al.

Pre-training lays the foundation for recent successes in radiograph analysis supported by deep learning. It learns transferable image representations by conducting large-scale fully-supervised or self-supervised learning on a source domain. However, supervised pre-training requires a complex and labor intensive two-stage human-assisted annotation process while self-supervised learning cannot compete with the supervised paradigm. To tackle these issues, we propose a cross-supervised methodology named REviewing FreE-text Reports for Supervision (REFERS), which acquires free supervision signals from original radiology reports accompanying the radiographs. The proposed approach employs a vision transformer and is designed to learn joint representations from multiple views within every patient study. REFERS outperforms its transfer learning and self-supervised learning counterparts on 4 well-known X-ray datasets under extremely limited supervision. Moreover, REFERS even surpasses methods based on a source domain of radiographs with human-assisted structured labels. Thus REFERS has the potential to replace canonical pre-training methodologies.

Hong-Yu Zhou, Chixiang Lu, Sibei Yang et al.

Preserving maximal information is one of principles of designing self-supervised learning methodologies. To reach this goal, contrastive learning adopts an implicit way which is contrasting image pairs. However, we believe it is not fully optimal to simply use the contrastive estimation for preservation. Moreover, it is necessary and complemental to introduce an explicit solution to preserve more information. From this perspective, we introduce Preservational Learning to reconstruct diverse image contexts in order to preserve more information in learned representations. Together with the contrastive loss, we present Preservational Contrastive Representation Learning (PCRL) for learning self-supervised medical representations. PCRL provides very competitive results under the pretraining-finetuning protocol, outperforming both self-supervised and supervised counterparts in 5 classification/segmentation tasks substantially.

Hong-Yu Zhou, Jiansen Guo, Yinghao Zhang et al.

Transformer, the model of choice for natural language processing, has drawn scant attention from the medical imaging community. Given the ability to exploit long-term dependencies, transformers are promising to help atypical convolutional neural networks to overcome their inherent shortcomings of spatial inductive bias. However, most of recently proposed transformer-based segmentation approaches simply treated transformers as assisted modules to help encode global context into convolutional representations. To address this issue, we introduce nnFormer, a 3D transformer for volumetric medical image segmentation. nnFormer not only exploits the combination of interleaved convolution and self-attention operations, but also introduces local and global volume-based self-attention mechanism to learn volume representations. Moreover, nnFormer proposes to use skip attention to replace the traditional concatenation/summation operations in skip connections in U-Net like architecture. Experiments show that nnFormer significantly outperforms previous transformer-based counterparts by large margins on three public datasets. Compared to nnUNet, nnFormer produces significantly lower HD95 and comparable DSC results. Furthermore, we show that nnFormer and nnUNet are highly complementary to each other in model ensembling.

Hong-Yu Zhou, Chixiang Lu, Sibei Yang et al.

Vision transformers have attracted much attention from computer vision researchers as they are not restricted to the spatial inductive bias of ConvNets. However, although Transformer-based backbones have achieved much progress on ImageNet classification, it is still unclear whether the learned representations are as transferable as or even more transferable than ConvNets' features. To address this point, we systematically investigate the transfer learning ability of ConvNets and vision transformers in 15 single-task and multi-task performance evaluations. Given the strong correlation between the performance of pre-trained models and transfer learning, we include 2 residual ConvNets (i.e., R-101x3 and R-152x4) and 3 Transformer-based visual backbones (i.e., ViT-B, ViT-L and Swin-B), which have close error rates on ImageNet, that indicate similar transfer learning performance on downstream datasets. We observe consistent advantages of Transformer-based backbones on 13 downstream tasks (out of 15), including but not limited to fine-grained classification, scene recognition (classification, segmentation and depth estimation), open-domain classification, face recognition, etc. More specifically, we find that two ViT models heavily rely on whole network fine-tuning to achieve performance gains while Swin Transformer does not have such a requirement. Moreover, vision transformers behave more robustly in multi-task learning, i.e., bringing more improvements when managing mutually beneficial tasks and reducing performance losses when tackling irrelevant tasks. We hope our discoveries can facilitate the exploration and exploitation of vision transformers in the future.

Hong-Yu Zhou, Chengdi Wang, Haofeng Li et al.

Semi-Supervised classification and segmentation methods have been widely investigated in medical image analysis. Both approaches can improve the performance of fully-supervised methods with additional unlabeled data. However, as a fundamental task, semi-supervised object detection has not gained enough attention in the field of medical image analysis. In this paper, we propose a novel Semi-Supervised Medical image Detector (SSMD). The motivation behind SSMD is to provide free yet effective supervision for unlabeled data, by regularizing the predictions at each position to be consistent. To achieve the above idea, we develop a novel adaptive consistency cost function to regularize different components in the predictions. Moreover, we introduce heterogeneous perturbation strategies that work in both feature space and image space, so that the proposed detector is promising to produce powerful image representations and robust predictions. Extensive experimental results show that the proposed SSMD achieves the state-of-the-art performance at a wide range of settings. We also demonstrate the strength of each proposed module with comprehensive ablation studies.

Hong-Yu Zhou, Hualuo Liu, Shilei Cao et al.

Learning by imitation is one of the most significant abilities of human beings and plays a vital role in human's computational neural system. In medical image analysis, given several exemplars (anchors), experienced radiologist has the ability to delineate unfamiliar organs by imitating the reasoning process learned from existing types of organs. Inspired by this observation, we propose OrganNet which learns a generalized organ concept from a set of annotated organ classes and then transfer this concept to unseen classes. In this paper, we show that such process can be integrated into the one-shot segmentation task which is a very challenging but meaningful topic. We propose pyramid reasoning modules (PRMs) to model the anatomical correlation between anchor and target volumes. In practice, the proposed module first computes a correlation matrix between target and anchor computerized tomography (CT) volumes. Then, this matrix is used to transform the feature representations of both anchor volume and its segmentation mask. Finally, OrganNet learns to fuse the representations from various inputs and predicts segmentation results for target volume. Extensive experiments show that OrganNet can effectively resist the wide variations in organ morphology and produce state-of-the-art results in one-shot segmentation task. Moreover, even when compared with fully-supervised segmentation models, OrganNet is still able to produce satisfying segmentation results.

Luyan Liu, Zhiwei Wen, Songwei Liu et al.

Considering the scarcity of medical data, most datasets in medical image analysis are an order of magnitude smaller than those of natural images. However, most Network Architecture Search (NAS) approaches in medical images focused on specific datasets and did not take into account the generalization ability of the learned architectures on unseen datasets as well as different domains. In this paper, we address this point by proposing to search for generalizable U-shape architectures on a composited dataset that mixes medical images from multiple segmentation tasks and domains creatively, which is named MixSearch. Specifically, we propose a novel approach to mix multiple small-scale datasets from multiple domains and segmentation tasks to produce a large-scale dataset. Then, a novel weaved encoder-decoder structure is designed to search for a generalized segmentation network in both cell-level and network-level. The network produced by the proposed MixSearch framework achieves state-of-the-art results compared with advanced encoder-decoder networks across various datasets.

Shuang Yu, Hong-Yu Zhou, Kai Ma et al.

Medical images are generally labeled by multiple experts before the final ground-truth labels are determined. Consensus or disagreement among experts regarding individual images reflects the gradeability and difficulty levels of the image. However, when being used for model training, only the final ground-truth label is utilized, while the critical information contained in the raw multi-rater gradings regarding the image being an easy/hard case is discarded. In this paper, we aim to take advantage of the raw multi-rater gradings to improve the deep learning model performance for the glaucoma classification task. Specifically, a multi-branch model structure is proposed to predict the most sensitive, most specifical and a balanced fused result for the input images. In order to encourage the sensitivity branch and specificity branch to generate consistent results for consensus labels and opposite results for disagreement labels, a consensus loss is proposed to constrain the output of the two branches. Meanwhile, the consistency/inconsistency between the prediction results of the two branches implies the image being an easy/hard case, which is further utilized to encourage the balanced fusion branch to concentrate more on the hard cases. Compared with models trained only with the final ground-truth labels, the proposed method using multi-rater consensus information has achieved superior performance, and it is also able to estimate the difficulty levels of individual input images when making the prediction.

Munan Ning, Cheng Bian, Donghuan Lu et al.

Primary angle closure glaucoma (PACG) is the leading cause of irreversible blindness among Asian people. Early detection of PACG is essential, so as to provide timely treatment and minimize the vision loss. In the clinical practice, PACG is diagnosed by analyzing the angle between the cornea and iris with anterior segment optical coherence tomography (AS-OCT). The rapid development of deep learning technologies provides the feasibility of building a computer-aided system for the fast and accurate segmentation of cornea and iris tissues. However, the application of deep learning methods in the medical imaging field is still restricted by the lack of enough fully-annotated samples. In this paper, we propose a novel framework to segment the target tissues accurately for the AS-OCT images, by using the combination of weakly-annotated images (majority) and fully-annotated images (minority). The proposed framework consists of two models which provide reliable guidance for each other. In addition, uncertainty guided strategies are adopted to increase the accuracy and stability of the guidance. Detailed experiments on the publicly available AGE dataset demonstrate that the proposed framework outperforms the state-of-the-art semi-/weakly-supervised methods and has a comparable performance as the fully-supervised method. Therefore, the proposed method is demonstrated to be effective in exploiting information contained in the weakly-annotated images and has the capability to substantively relieve the annotation workload.

Hong-Yu Zhou, Shuang Yu, Cheng Bian et al.

In deep learning era, pretrained models play an important role in medical image analysis, in which ImageNet pretraining has been widely adopted as the best way. However, it is undeniable that there exists an obvious domain gap between natural images and medical images. To bridge this gap, we propose a new pretraining method which learns from 700k radiographs given no manual annotations. We call our method as Comparing to Learn (C2L) because it learns robust features by comparing different image representations. To verify the effectiveness of C2L, we conduct comprehensive ablation studies and evaluate it on different tasks and datasets. The experimental results on radiographs show that C2L can outperform ImageNet pretraining and previous state-of-the-art approaches significantly. Code and models are available.