Alexander Shieh

McKell Woodland, Austin Castelo, Mais Al Taie et al.

Fréchet Inception Distance (FID) is a widely used metric for assessing synthetic image quality. It relies on an ImageNet-based feature extractor, making its applicability to medical imaging unclear. A recent trend is to adapt FID to medical imaging through feature extractors trained on medical images. Our study challenges this practice by demonstrating that ImageNet-based extractors are more consistent and aligned with human judgment than their RadImageNet counterparts. We evaluated sixteen StyleGAN2 networks across four medical imaging modalities and four data augmentation techniques with Fréchet distances (FDs) computed using eleven ImageNet or RadImageNet-trained feature extractors. Comparison with human judgment via visual Turing tests revealed that ImageNet-based extractors produced rankings consistent with human judgment, with the FD derived from the ImageNet-trained SwAV extractor significantly correlating with expert evaluations. In contrast, RadImageNet-based rankings were volatile and inconsistent with human judgment. Our findings challenge prevailing assumptions, providing novel evidence that medical image-trained feature extractors do not inherently improve FDs and can even compromise their reliability. Our code is available at https://github.com/mckellwoodland/fid-med-eval.

Alexander Shieh, Tejas Sudharshan Mathai, Jianfei Liu et al.

Universal lesion detection and tagging (ULDT) in CT studies is critical for tumor burden assessment and tracking the progression of lesion status (growth/shrinkage) over time. However, a lack of fully annotated data hinders the development of effective ULDT approaches. Prior work used the DeepLesion dataset (4,427 patients, 10,594 studies, 32,120 CT slices, 32,735 lesions, 8 body part labels) for algorithmic development, but this dataset is not completely annotated and contains class imbalances. To address these issues, in this work, we developed a self-training pipeline for ULDT. A VFNet model was trained on a limited 11.5\% subset of DeepLesion (bounding boxes + tags) to detect and classify lesions in CT studies. Then, it identified and incorporated novel lesion candidates from a larger unseen data subset into its training set, and self-trained itself over multiple rounds. Multiple self-training experiments were conducted with different threshold policies to select predicted lesions with higher quality and cover the class imbalances. We discovered that direct self-training improved the sensitivities of over-represented lesion classes at the expense of under-represented classes. However, upsampling the lesions mined during self-training along with a variable threshold policy yielded a 6.5\% increase in sensitivity at 4 FP in contrast to self-training without class balancing (72\% vs 78.5\%) and a 11.7\% increase compared to the same self-training policy without upsampling (66.8\% vs 78.5\%). Furthermore, we show that our results either improved or maintained the sensitivity at 4FP for all 8 lesion classes.

Tao Sheng, Tejas Sudharshan Mathai, Alexander Shieh et al.

The skeletal region is one of the common sites of metastatic spread of cancer in the breast and prostate. CT is routinely used to measure the size of lesions in the bones. However, they can be difficult to spot due to the wide variations in their sizes, shapes, and appearances. Precise localization of such lesions would enable reliable tracking of interval changes (growth, shrinkage, or unchanged status). To that end, an automated technique to detect bone lesions is highly desirable. In this pilot work, we developed a pipeline to detect bone lesions (lytic, blastic, and mixed) in CT volumes via a proxy segmentation task. First, we used the bone lesions that were prospectively marked by radiologists in a few 2D slices of CT volumes and converted them into weak 3D segmentation masks. Then, we trained a 3D full-resolution nnUNet model using these weak 3D annotations to segment the lesions and thereby detected them. Our automated method detected bone lesions in CT with a precision of 96.7% and recall of 47.3% despite the use of incomplete and partial training data. To the best of our knowledge, we are the first to attempt the direct detection of bone lesions in CT via a proxy segmentation task.

Jia-Yan Wu, Alexander Te-Wei Shieh, Shih-Ju Hsu et al.

Machine-generated citation sentences can aid automated scientific literature review and assist article writing. Current methods in generating citation text were limited to single citation generation using the citing document and a cited document as input. However, in real-world situations, writers often summarize several studies in one sentence or discuss relevant information across the entire paragraph. In addition, multiple citation intents have been previously identified, implying that writers may need control over the intents of generated sentences to cover different scenarios. Therefore, this work focuses on generating multiple citations and releasing a newly collected dataset named CiteMI to drive the future research. We first build a novel generation model with the Fusion-in-Decoder approach to cope with multiple long inputs. Second, we incorporate the predicted citation intents into training for intent control. The experiments demonstrate that the proposed approaches provide much more comprehensive features for generating citation sentences.

Alexander Te-Wei Shieh, Yung-Sung Chuang, Shang-Yu Su et al.

Randomized controlled trials (RCTs) represent the paramount evidence of clinical medicine. Using machines to interpret the massive amount of RCTs has the potential of aiding clinical decision-making. We propose a RCT conclusion generation task from the PubMed 200k RCT sentence classification dataset to examine the effectiveness of sequence-to-sequence models on understanding RCTs. We first build a pointer-generator baseline model for conclusion generation. Then we fine-tune the state-of-the-art GPT-2 language model, which is pre-trained with general domain data, for this new medical domain task. Both automatic and human evaluation show that our GPT-2 fine-tuned models achieve improved quality and correctness in the generated conclusions compared to the baseline pointer-generator model. Further inspection points out the limitations of this current approach and future directions to explore.