Chenyu Gao

Chenyu Gao, Michael E. Kim, Ho Hin Lee et al.

Imaging findings inconsistent with those expected at specific chronological age ranges may serve as early indicators of neurological disorders and increased mortality risk. Estimation of chronological age, and deviations from expected results, from structural MRI data has become an important task for developing biomarkers that are sensitive to such deviations. Complementary to structural analysis, diffusion tensor imaging (DTI) has proven effective in identifying age-related microstructural changes within the brain white matter, thereby presenting itself as a promising additional modality for brain age prediction. Although early studies have sought to harness DTI's advantages for age estimation, there is no evidence that the success of this prediction is owed to the unique microstructural and diffusivity features that DTI provides, rather than the macrostructural features that are also available in DTI data. Therefore, we seek to develop white-matter-specific age estimation to capture deviations from normal white matter aging. Specifically, we deliberately disregard the macrostructural information when predicting age from DTI scalar images, using two distinct methods. The first method relies on extracting only microstructural features from regions of interest. The second applies 3D residual neural networks (ResNets) to learn features directly from the images, which are non-linearly registered and warped to a template to minimize macrostructural variations. When tested on unseen data, the first method yields mean absolute error (MAE) of 6.11 years for cognitively normal participants and MAE of 6.62 years for cognitively impaired participants, while the second method achieves MAE of 4.69 years for cognitively normal participants and MAE of 4.96 years for cognitively impaired participants. We find that the ResNet model captures subtler, non-macrostructural features for brain age prediction.

Aravind R. Krishnan, Kaiwen Xu, Thomas Li et al.

The reconstruction kernel in computed tomography (CT) generation determines the texture of the image. Consistency in reconstruction kernels is important as the underlying CT texture can impact measurements during quantitative image analysis. Harmonization (i.e., kernel conversion) minimizes differences in measurements due to inconsistent reconstruction kernels. Existing methods investigate harmonization of CT scans in single or multiple manufacturers. However, these methods require paired scans of hard and soft reconstruction kernels that are spatially and anatomically aligned. Additionally, a large number of models need to be trained across different kernel pairs within manufacturers. In this study, we adopt an unpaired image translation approach to investigate harmonization between and across reconstruction kernels from different manufacturers by constructing a multipath cycle generative adversarial network (GAN). We use hard and soft reconstruction kernels from the Siemens and GE vendors from the National Lung Screening Trial dataset. We use 50 scans from each reconstruction kernel and train a multipath cycle GAN. To evaluate the effect of harmonization on the reconstruction kernels, we harmonize 50 scans each from Siemens hard kernel, GE soft kernel and GE hard kernel to a reference Siemens soft kernel (B30f) and evaluate percent emphysema. We fit a linear model by considering the age, smoking status, sex and vendor and perform an analysis of variance (ANOVA) on the emphysema scores. Our approach minimizes differences in emphysema measurement and highlights the impact of age, sex, smoking status and vendor on emphysema quantification.

Zhiyuan Li, Chenyu Gao, Praitayini Kanakaraj et al.

An incomplete field-of-view (FOV) in diffusion magnetic resonance imaging (dMRI) can severely hinder the volumetric and bundle analyses of whole-brain white matter connectivity. Although existing works have investigated imputing the missing regions using deep generative models, it remains unclear how to specifically utilize additional information from paired multi-modality data and whether this can enhance the imputation quality and be useful for downstream tractography. To fill this gap, we propose a novel framework for imputing dMRI scans in the incomplete part of the FOV by integrating the learned diffusion features in the acquired part of the FOV to the complete brain anatomical structure. We hypothesize that by this design the proposed framework can enhance the imputation performance of the dMRI scans and therefore be useful for repairing whole-brain tractography in corrupted dMRI scans with incomplete FOV. We tested our framework on two cohorts from different sites with a total of 96 subjects and compared it with a baseline imputation method that treats the information from T1w and dMRI scans equally. The proposed framework achieved significant improvements in imputation performance, as demonstrated by angular correlation coefficient (p < 1E-5), and in downstream tractography accuracy, as demonstrated by Dice score (p < 0.01). Results suggest that the proposed framework improved imputation performance in dMRI scans by specifically utilizing additional information from paired multi-modality data, compared with the baseline method. The imputation achieved by the proposed framework enhances whole brain tractography, and therefore reduces the uncertainty when analyzing bundles associated with neurodegenerative.

Yihao Liu, Chenyu Gao, Lianrui Zuo et al.

Modern deep learning methods have achieved impressive results across tasks from disease classification, estimating continuous biomarkers, to generating realistic medical images. Most of these approaches are trained to model conditional distributions defined by a specific predictive direction with a specific set of input variables. We introduce MetaVoxel, a generative joint diffusion modeling framework that models the joint distribution over imaging data and clinical metadata by learning a single diffusion process spanning all variables. By capturing the joint distribution, MetaVoxel unifies tasks that traditionally require separate conditional models and supports flexible zero-shot inference using arbitrary subsets of inputs without task-specific retraining. Using more than 10,000 T1-weighted MRI scans paired with clinical metadata from nine datasets, we show that a single MetaVoxel model can perform image generation, age estimation, and sex prediction, achieving performance comparable to established task-specific baselines. Additional experiments highlight its capabilities for flexible inference.Together, these findings demonstrate that joint multimodal diffusion offers a promising direction for unifying medical AI models and enabling broader clinical applicability.

Gaurav Rudravaram, Lianrui Zuo, Karthik Ramadass et al.

Acquisition differences across sites, scanners, and protocols in dMRI introduce variability that complicates structural connectome analysis. This motivates deep learning models that can represent high-dimensional connectomes in a low-dimensional space while explicitly separating acquisition-related effects from biological variation. Conventional dimensionality reduction methods model all variance as continuous, so acquisition effects often get absorbed into a continuous latent space. Recent hybrid latent-space models combine discrete and continuous components to address this, but typically require manual capacity tuning to ensure the discrete component captures the intended variability. We introduce an unsupervised framework that removes this manual tuning by architecturally annealing encoder outputs before decoding, allowing the model to adaptively balance discrete and continuous latent variables during training. To evaluate it, we curated a dataset of N=7,416 structural connectomes derived from dMRI, spanning ages 2 to 102 and 13 studies with 25 unique acquisition-parameter combinations. Of these, 5,900 are cognitively unimpaired, 877 have mild cognitive impairment (MCI), and 639 have Alzheimer's disease (AD). We compare against a standard VAE, PCA with k-means clustering, and hybrid models that anneal only through the loss function. Our architectural annealing produces stronger site learning (ARI=0.53, p<0.05) than these baselines. Results show that a hybrid continuous-discrete latent space, with architectural rather than loss-based annealing, provides a useful unsupervised mechanism for capturing acquisition variability in dMRI: by jointly modeling smooth and categorical structure, the Joint-VAE recovers clusters aligned with scanner and protocol differences.

Qi Zhu, Chenyu Gao, Peng Wang et al.

Texts appearing in daily scenes that can be recognized by OCR (Optical Character Recognition) tools contain significant information, such as street name, product brand and prices. Two tasks -- text-based visual question answering and text-based image captioning, with a text extension from existing vision-language applications, are catching on rapidly. To address these problems, many sophisticated multi-modality encoding frameworks (such as heterogeneous graph structure) are being used. In this paper, we argue that a simple attention mechanism can do the same or even better job without any bells and whistles. Under this mechanism, we simply split OCR token features into separate visual- and linguistic-attention branches, and send them to a popular Transformer decoder to generate answers or captions. Surprisingly, we find this simple baseline model is rather strong -- it consistently outperforms state-of-the-art (SOTA) models on two popular benchmarks, TextVQA and all three tasks of ST-VQA, although these SOTA models use far more complex encoding mechanisms. Transferring it to text-based image captioning, we also surpass the TextCaps Challenge 2020 winner. We wish this work to set the new baseline for this two OCR text related applications and to inspire new thinking of multi-modality encoder design. Code is available at https://github.com/ZephyrZhuQi/ssbaseline

Chenyu Gao, Qi Zhu, Peng Wang et al.

In this paper, we propose an end-to-end structured multimodal attention (SMA) neural network to mainly solve the first two issues above. SMA first uses a structural graph representation to encode the object-object, object-text and text-text relationships appearing in the image, and then designs a multimodal graph attention network to reason over it. Finally, the outputs from the above modules are processed by a global-local attentional answering module to produce an answer splicing together tokens from both OCR and general vocabulary iteratively by following M4C. Our proposed model outperforms the SoTA models on TextVQA dataset and two tasks of ST-VQA dataset among all models except pre-training based TAP. Demonstrating strong reasoning ability, it also won first place in TextVQA Challenge 2020. We extensively test different OCR methods on several reasoning models and investigate the impact of gradually increased OCR performance on TextVQA benchmark. With better OCR results, different models share dramatic improvement over the VQA accuracy, but our model benefits most blessed by strong textual-visual reasoning ability. To grant our method an upper bound and make a fair testing base available for further works, we also provide human-annotated ground-truth OCR annotations for the TextVQA dataset, which were not given in the original release. The code and ground-truth OCR annotations for the TextVQA dataset are available at https://github.com/ChenyuGAO-CS/SMA

Junyu Gao, Wei Lin, Bin Zhao et al.

This technical report attempts to provide efficient and solid kits addressed on the field of crowd counting, which is denoted as Crowd Counting Code Framework (C$^3$F). The contributions of C$^3$F are in three folds: 1) Some solid baseline networks are presented, which have achieved the state-of-the-arts. 2) Some flexible parameter setting strategies are provided to further promote the performance. 3) A powerful log system is developed to record the experiment process, which can enhance the reproducibility of each experiment. Our code is made publicly available at \url{https://github.com/gjy3035/C-3-Framework}. Furthermore, we also post a Chinese blog\footnote{\url{https://zhuanlan.zhihu.com/p/65650998}} to describe the details and insights of crowd counting.

Chenyu Gao, Michael E. Kim, Karthik Ramadass et al.

Estimated brain age from magnetic resonance image (MRI) and its deviation from chronological age can provide early insights into potential neurodegenerative diseases, supporting early detection and implementation of prevention strategies. Diffusion MRI (dMRI) presents an opportunity to build an earlier biomarker for neurodegenerative disease prediction because it captures subtle microstructural changes that precede more perceptible macrostructural changes. However, the coexistence of macro- and micro-structural information in dMRI raises the question of whether current dMRI-based brain age estimation models are leveraging the intended microstructural information or if they inadvertently rely on the macrostructural information. To develop a microstructure-specific brain age, we propose a method for brain age identification from dMRI that mitigates the model's use of macrostructural information by non-rigidly registering all images to a standard template. Imaging data from 13,398 participants across 12 datasets were used for the training and evaluation. We compare our brain age models, trained with and without macrostructural information mitigated, with an architecturally similar T1-weighted (T1w) MRI-based brain age model and two recent, popular, openly available T1w MRI-based brain age models that primarily use macrostructural information. We observe difference between our dMRI-based brain age and T1w MRI-based brain age across stages of neurodegeneration, with dMRI-based brain age being older than T1w MRI-based brain age in participants transitioning from cognitively normal (CN) to mild cognitive impairment (MCI), but younger in participants already diagnosed with Alzheimer's disease (AD). Furthermore, dMRI-based brain age may offer advantages over T1w MRI-based brain age in predicting the transition from CN to MCI up to five years before diagnosis.

Lucas W. Remedios, Chloe Cho, Trent M. Schwartz et al.

Purpose: Understanding how the pancreas changes is critical for detecting deviations in type 2 diabetes and other pancreatic disease. We measure pancreas size and shape using morphological measurements from ages 0 to 90. Our goals are to 1) identify reliable clinical imaging modalities for AI-based pancreas measurement, 2) establish normative morphological aging trends, and 3) detect potential deviations in type 2 diabetes. Approach: We analyzed a clinically acquired dataset of 2533 patients imaged with abdominal CT or MRI. We resampled the scans to 3mm isotropic resolution, segmented the pancreas using automated methods, and extracted 13 morphological pancreas features across the lifespan. First, we assessed CT and MRI measurements to determine which modalities provide consistent lifespan trends. Second, we characterized distributions of normative morphological patterns stratified by age group and sex. Third, we used GAMLSS regression to model pancreas morphology trends in 1350 patients matched for age, sex, and type 2 diabetes status to identify any deviations from normative aging associated with type 2 diabetes. Results: When adjusting for confounders, the aging trends for 10 of 13 morphological features were significantly different between patients with type 2 diabetes and non-diabetic controls (p < 0.05 after multiple comparisons corrections). Additionally, MRI appeared to yield different pancreas measurements than CT using our AI-based method. Conclusions: We provide lifespan trends demonstrating that the size and shape of the pancreas is altered in type 2 diabetes using 675 control patients and 675 diabetes patients. Moreover, our findings reinforce that the pancreas is smaller in type 2 diabetes. Additionally, we contribute a reference of lifespan pancreas morphology from a large cohort of non-diabetic control patients in a clinical setting.

Lucas W. Remedios, Chloe Cho, Trent M. Schwartz et al.

Purpose: Although elevated BMI is a well-known risk factor for type 2 diabetes, the disease's presence in some lean adults and absence in others with obesity suggests that detailed body composition may uncover abdominal phenotypes of type 2 diabetes. With AI, we can now extract detailed measurements of size, shape, and fat content from abdominal structures in 3D clinical imaging at scale. This creates an opportunity to empirically define body composition signatures linked to type 2 diabetes risk and protection using large-scale clinical data. Approach: To uncover BMI-specific diabetic abdominal patterns from clinical CT, we applied our design four times: once on the full cohort (n = 1,728) and once on lean (n = 497), overweight (n = 611), and obese (n = 620) subgroups separately. Briefly, our experimental design transforms abdominal scans into collections of explainable measurements through segmentation, classifies type 2 diabetes through a cross-validated random forest, measures how features contribute to model-estimated risk or protection through SHAP analysis, groups scans by shared model decision patterns (clustering from SHAP) and links back to anatomical differences (classification). Results: The random-forests achieved mean AUCs of 0.72-0.74. There were shared type 2 diabetes signatures in each group; fatty skeletal muscle, older age, greater visceral and subcutaneous fat, and a smaller or fat-laden pancreas. Univariate logistic regression confirmed the direction of 14-18 of the top 20 predictors within each subgroup (p < 0.05). Conclusions: Our findings suggest that abdominal drivers of type 2 diabetes may be consistent across weight classes.

Aravind R. Krishnan, Thomas Z. Li, Lucas W. Remedios et al.

Reconstruction kernels in computed tomography (CT) affect spatial resolution and noise characteristics, introducing systematic variability in quantitative imaging measurements such as emphysema quantification. Choosing an appropriate kernel is therefore essential for consistent quantitative analysis. We propose a multipath cycleGAN model for CT kernel harmonization, trained on a mixture of paired and unpaired data from a low-dose lung cancer screening cohort. The model features domain-specific encoders and decoders with a shared latent space and uses discriminators tailored for each domain.We train the model on 42 kernel combinations using 100 scans each from seven representative kernels in the National Lung Screening Trial (NLST) dataset. To evaluate performance, 240 scans from each kernel are harmonized to a reference soft kernel, and emphysema is quantified before and after harmonization. A general linear model assesses the impact of age, sex, smoking status, and kernel on emphysema. We also evaluate harmonization from soft kernels to a reference hard kernel. To assess anatomical consistency, we compare segmentations of lung vessels, muscle, and subcutaneous adipose tissue generated by TotalSegmentator between harmonized and original images. Our model is benchmarked against traditional and switchable cycleGANs. For paired kernels, our approach reduces bias in emphysema scores, as seen in Bland-Altman plots (p<0.05). For unpaired kernels, harmonization eliminates confounding differences in emphysema (p>0.05). High Dice scores confirm preservation of muscle and fat anatomy, while lung vessel overlap remains reasonable. Overall, our shared latent space multipath cycleGAN enables robust harmonization across paired and unpaired CT kernels, improving emphysema quantification and preserving anatomical fidelity.

Chenyu Gao, Kaiwen Xu, Michael E. Kim et al.

Defacing is often applied to head magnetic resonance image (MRI) datasets prior to public release to address privacy concerns. The alteration of facial and nearby voxels has provoked discussions about the true capability of these techniques to ensure privacy as well as their impact on downstream tasks. With advancements in deep generative models, the extent to which defacing can protect privacy is uncertain. Additionally, while the altered voxels are known to contain valuable anatomical information, their potential to support research beyond the anatomical regions directly affected by defacing remains uncertain. To evaluate these considerations, we develop a refacing pipeline that recovers faces in defaced head MRIs using cascaded diffusion probabilistic models (DPMs). The DPMs are trained on images from 180 subjects and tested on images from 484 unseen subjects, 469 of whom are from a different dataset. To assess whether the altered voxels in defacing contain universally useful information, we also predict computed tomography (CT)-derived skeletal muscle radiodensity from facial voxels in both defaced and original MRIs. The results show that DPMs can generate high-fidelity faces that resemble the original faces from defaced images, with surface distances to the original faces significantly smaller than those of a population average face (p < 0.05). This performance also generalizes well to previously unseen datasets. For skeletal muscle radiodensity predictions, using defaced images results in significantly weaker Spearman's rank correlation coefficients compared to using original images (p < 10-4). For shin muscle, the correlation is statistically significant (p < 0.05) when using original images but not statistically significant (p > 0.05) when any defacing method is applied, suggesting that defacing might not only fail to protect privacy but also eliminate valuable information.

Chenyu Gao, Shunxing Bao, Michael Kim et al.

Purpose: In diffusion MRI (dMRI), the volumetric and bundle analyses of whole-brain tissue microstructure and connectivity can be severely impeded by an incomplete field-of-view (FOV). This work aims to develop a method for imputing the missing slices directly from existing dMRI scans with an incomplete FOV. We hypothesize that the imputed image with complete FOV can improve the whole-brain tractography for corrupted data with incomplete FOV. Therefore, our approach provides a desirable alternative to discarding the valuable dMRI data, enabling subsequent tractography analyses that would otherwise be challenging or unattainable with corrupted data. Approach: We propose a framework based on a deep generative model that estimates the absent brain regions in dMRI scans with incomplete FOV. The model is capable of learning both the diffusion characteristics in diffusion-weighted images (DWI) and the anatomical features evident in the corresponding structural images for efficiently imputing missing slices of DWI outside of incomplete FOV. Results: For evaluating the imputed slices, on the WRAP dataset the proposed framework achieved PSNRb0=22.397, SSIMb0=0.905, PSNRb1300=22.479, SSIMb1300=0.893; on the NACC dataset it achieved PSNRb0=21.304, SSIMb0=0.892, PSNRb1300=21.599, SSIMb1300= 0.877. The proposed framework improved the tractography accuracy, as demonstrated by an increased average Dice score for 72 tracts (p < 0.001) on both the WRAP and NACC datasets. Conclusions: Results suggest that the proposed framework achieved sufficient imputation performance in dMRI data with incomplete FOV for improving whole-brain tractography, thereby repairing the corrupted data. Our approach achieved more accurate whole-brain tractography results with extended and complete FOV and reduced the uncertainty when analyzing bundles associated with Alzheimer's Disease.

Chenyu Gao, Qi Zhu, Peng Wang et al.

Vision-and-Language (VL) pre-training has shown great potential on many related downstream tasks, such as Visual Question Answering (VQA), one of the most popular problems in the VL field. All of these pre-trained models (such as VisualBERT, ViLBERT, LXMERT and UNITER) are built with Transformer, which extends the classical attention mechanism to multiple layers and heads. To investigate why and how these models work on VQA so well, in this paper we explore the roles of individual heads and layers in Transformer models when handling $12$ different types of questions. Specifically, we manually remove (chop) heads (or layers) from a pre-trained VisualBERT model at a time, and test it on different levels of questions to record its performance. As shown in the interesting echelon shape of the result matrices, experiments reveal different heads and layers are responsible for different question types, with higher-level layers activated by higher-level visual reasoning questions. Based on this observation, we design a dynamic chopping module that can automatically remove heads and layers of the VisualBERT at an instance level when dealing with different questions. Our dynamic chopping module can effectively reduce the parameters of the original model by 50%, while only damaging the accuracy by less than 1% on the VQA task.

Jayanta Dey, Joshua T. Vogelstein, Hayden S. Helm et al.

In lifelong learning, data are used to improve performance not only on the present task, but also on past and future (unencountered) tasks. While typical transfer learning algorithms can improve performance on future tasks, their performance on prior tasks degrades upon learning new tasks (called forgetting). Many recent approaches for continual or lifelong learning have attempted to maintain performance on old tasks given new tasks. But striving to avoid forgetting sets the goal unnecessarily low. The goal of lifelong learning should be to use data to improve performance on both future tasks (forward transfer) and past tasks (backward transfer). In this paper, we show that a simple approach -- representation ensembling -- demonstrates both forward and backward transfer in a variety of simulated and benchmark data scenarios, including tabular, vision (CIFAR-100, 5-dataset, Split Mini-Imagenet, and Food1k), and speech (spoken digit), in contrast to various reference algorithms, which typically failed to transfer either forward or backward, or both. Moreover, our proposed approach can flexibly operate with or without a computational budget.