Yunhe Gao

Yunhe Gao, Xingjian Shi, Yi Zhu et al. · amazon-science

Models should be able to adapt to unseen data during test-time to avoid performance drops caused by inevitable distribution shifts in real-world deployment scenarios. In this work, we tackle the practical yet challenging test-time adaptation (TTA) problem, where a model adapts to the target domain without accessing the source data. We propose a simple recipe called \textit{Data-efficient Prompt Tuning} (DePT) with two key ingredients. First, DePT plugs visual prompts into the vision Transformer and only tunes these source-initialized prompts during adaptation. We find such parameter-efficient finetuning can efficiently adapt the model representation to the target domain without overfitting to the noise in the learning objective. Second, DePT bootstraps the source representation to the target domain by memory bank-based online pseudo-labeling. A hierarchical self-supervised regularization specially designed for prompts is jointly optimized to alleviate error accumulation during self-training. With much fewer tunable parameters, DePT demonstrates not only state-of-the-art performance on major adaptation benchmarks VisDA-C, ImageNet-C, and DomainNet-126, but also superior data efficiency, i.e., adaptation with only 1\% or 10\% data without much performance degradation compared to 100\% data. In addition, DePT is also versatile to be extended to online or multi-source TTA settings.

Yunhe Gao, Yabin Zhang, Chong Wang et al. · stanford

Foundation models have transformed vision and language by learning general-purpose representations from large-scale unlabeled data, yet 3D medical imaging lacks analogous approaches. Existing self-supervised methods rely on low-level reconstruction or contrastive objectives that fail to capture the anatomical semantics critical for medical image analysis, limiting transfer to downstream tasks. We present MASS (MAsk-guided Self-Supervised learning), which treats in-context segmentation as the pretext task for learning general-purpose medical imaging representations. MASS's key insight is that automatically generated class-agnostic masks provide sufficient structural supervision for learning semantically rich representations. By training on thousands of diverse mask proposals spanning anatomical structures and pathological findings, MASS learns what semantically defines medical structures: the holistic combination of appearance, shape, spatial context, and anatomical relationships. We demonstrate effectiveness across data regimes: from small-scale pretraining on individual datasets (20-200 scans) to large-scale multi-modal pretraining on 5K CT, MRI, and PET volumes, all without annotations. MASS demonstrates: (i) few-shot segmentation on novel structures, (ii) matching full supervision with only 20-40\% labeled data while outperforming self-supervised baselines by over 20 in Dice score in low-data regimes, and (iii) frozen-encoder classification on unseen pathologies that matches full supervised training with thousands of samples. Mask-guided self-supervised pretraining captures broadly generalizable knowledge, opening a path toward 3D medical imaging foundation models without expert annotations. Code is available: https://github.com/Stanford-AIMI/MASS.

Ashwin Kumar, Robbie Holland, Corey Barrett et al.

Recent medical multimodal foundation models are built as multimodal LLMs (MLLMs) by connecting a CLIP-pretrained vision encoder to an LLM using LLaVA-style finetuning. This two-stage, decoupled approach introduces a projection layer that can distort visual features. This is especially concerning in medical imaging where subtle cues are essential for accurate diagnoses. In contrast, early-fusion generative approaches such as Chameleon eliminate the projection bottleneck by processing image and text tokens within a single unified sequence, enabling joint representation learning that leverages the inductive priors of language models. We present CheXmix, a unified early-fusion generative model trained on a large corpus of chest X-rays paired with radiology reports. We expand on Chameleon's autoregressive framework by introducing a two-stage multimodal generative pretraining strategy that combines the representational strengths of masked autoencoders with MLLMs. The resulting models are highly flexible, supporting both discriminative and generative tasks at both coarse and fine-grained scales. Our approach outperforms well-established generative models across all masking ratios by 6.0% and surpasses CheXagent by 8.6% on AUROC at high image masking ratios on the CheXpert classification task. We further inpaint images over 51.0% better than text-only generative models and outperform CheXagent by 45% on the GREEN metric for radiology report generation. These results demonstrate that CheXmix captures fine-grained information across a broad spectrum of chest X-ray tasks. Our code is at: https://github.com/StanfordMIMI/CheXmix.

Yunhe Gao, Zhuowei Li, Di Liu et al.

A major focus of clinical imaging workflow is disease diagnosis and management, leading to medical imaging datasets strongly tied to specific clinical objectives. This scenario has led to the prevailing practice of developing task-specific segmentation models, without gaining insights from widespread imaging cohorts. Inspired by the training program of medical radiology residents, we propose a shift towards universal medical image segmentation, a paradigm aiming to build medical image understanding foundation models by leveraging the diversity and commonality across clinical targets, body regions, and imaging modalities. Towards this goal, we develop Hermes, a novel context-prior learning approach to address the challenges of data heterogeneity and annotation differences in medical image segmentation. In a large collection of eleven diverse datasets (2,438 3D images) across five modalities (CT, PET, T1, T2 and cine MRI) and multiple body regions, we demonstrate the merit of the universal paradigm over the traditional paradigm on addressing multiple tasks within a single model. By exploiting the synergy across tasks, Hermes achieves state-of-the-art performance on all testing datasets and shows superior model scalability. Results on two additional datasets reveals Hermes' strong performance for transfer learning, incremental learning, and generalization to downstream tasks. Hermes's learned priors demonstrate an appealing trait to reflect the intricate relations among tasks and modalities, which aligns with the established anatomical and imaging principles in radiology. The code is available: https://github.com/yhygao/universal-medical-image-segmentation.

Di Liu, Yunhe Gao, Qilong Zhangli et al.

Combining information from multi-view images is crucial to improve the performance and robustness of automated methods for disease diagnosis. However, due to the non-alignment characteristics of multi-view images, building correlation and data fusion across views largely remain an open problem. In this study, we present TransFusion, a Transformer-based architecture to merge divergent multi-view imaging information using convolutional layers and powerful attention mechanisms. In particular, the Divergent Fusion Attention (DiFA) module is proposed for rich cross-view context modeling and semantic dependency mining, addressing the critical issue of capturing long-range correlations between unaligned data from different image views. We further propose the Multi-Scale Attention (MSA) to collect global correspondence of multi-scale feature representations. We evaluate TransFusion on the Multi-Disease, Multi-View \& Multi-Center Right Ventricular Segmentation in Cardiac MRI (M\&Ms-2) challenge cohort. TransFusion demonstrates leading performance against the state-of-the-art methods and opens up new perspectives for multi-view imaging integration towards robust medical image segmentation.

Qilong Zhangli, Jingru Yi, Di Liu et al.

Top-down instance segmentation framework has shown its superiority in object detection compared to the bottom-up framework. While it is efficient in addressing over-segmentation, top-down instance segmentation suffers from over-crop problem. However, a complete segmentation mask is crucial for biological image analysis as it delivers important morphological properties such as shapes and volumes. In this paper, we propose a region proposal rectification (RPR) module to address this challenging incomplete segmentation problem. In particular, we offer a progressive ROIAlign module to introduce neighbor information into a series of ROIs gradually. The ROI features are fed into an attentive feed-forward network (FFN) for proposal box regression. With additional neighbor information, the proposed RPR module shows significant improvement in correction of region proposal locations and thereby exhibits favorable instance segmentation performances on three biological image datasets compared to state-of-the-art baseline methods. Experimental results demonstrate that the proposed RPR module is effective in both anchor-based and anchor-free top-down instance segmentation approaches, suggesting the proposed method can be applied to general top-down instance segmentation of biological images.

Yabin Zhang, Maya Varma, Yunhe Gao et al.

Out-of-distribution (OOD) detection aims to identify samples that deviate from in-distribution (ID). One popular pipeline addresses this by introducing negative labels distant from ID classes and detecting OOD based on their distance to these labels. However, such labels may present poor activation on OOD samples, failing to capture the OOD characteristics. To address this, we propose \underline{T}est-time \underline{A}ctivated \underline{N}egative \underline{L}abels (TANL) by dynamically evaluating activation levels across the corpus dataset and mining candidate labels with high activation responses during the testing process. Specifically, TANL identifies high-confidence test images online and accumulates their assignment probabilities over the corpus to construct a label activation metric. Such a metric leverages historical test samples to adaptively align with the test distribution, enabling the selection of distribution-adaptive activated negative labels. By further exploring the activation information within the current testing batch, we introduce a more fine-grained, batch-adaptive variant. To fully utilize label activation knowledge, we propose an activation-aware score function that emphasizes negative labels with stronger activations, boosting performance and enhancing its robustness to the label number. Our TANL is training-free, test-efficient, and grounded in theoretical justification. Experiments on diverse backbones and wide task settings validate its effectiveness. Notably, on the large-scale ImageNet benchmark, TANL significantly reduces the FPR95 from 17.5\% to 9.8\%. Codes are available at \href{https://github.com/YBZh/OpenOOD-VLM}{YBZh/OpenOOD-VLM}.

Yabin Zhang, Chong Wang, Yunhe Gao et al.

Chest X-rays (CXRs) are among the most frequently performed imaging examinations worldwide, yet rising imaging volumes increase radiologist workload and the risk of diagnostic errors. Although artificial intelligence (AI) systems have shown promise for CXR interpretation, most generate only final predictions, without making explicit how visual evidence is translated into radiographic findings and diagnostic predictions. We present CheXOne, a reasoning-enabled vision-language model for CXR interpretation. CheXOne jointly generates diagnostic predictions and explicit, clinically grounded reasoning traces that connect visual evidence, radiographic findings, and these predictions. The model is trained on 14.7 million instruction and reasoning samples curated from 30 public datasets spanning 36 CXR interpretation tasks, using a two-stage framework that combines instruction tuning with reinforcement learning to improve reasoning quality. We evaluate CheXOne in zero-shot settings across visual question answering, report generation, visual grounding and reasoning assessment, covering 17 evaluation settings. CheXOne outperforms existing medical and general-domain foundation models and achieves strong performance on independent public benchmarks. A clinical reader study demonstrates that CheXOne-drafted reports are comparable to or better than resident-written reports in 55% of cases, while effectively addressing clinical indications and enhancing both report writing and CXR interpretation efficiency. Further analyses involving radiologists reveal that the generated reasoning traces show high clinical factuality and provide causal support for the final predictions, offering a plausible explanation for the performance gains. These results suggest that explicit reasoning can improve model performance, interpretability and clinical utility in AI-assisted CXR interpretation.

Chong Wang, Yabin Zhang, Yunhe Gao et al.

Foundation models for medical imaging are typically pretrained on increasingly large datasets, following a "scale-at-all-costs" paradigm. However, this strategy faces two critical challenges: large-scale medical datasets often contain substantial redundancy and severe class imbalance that bias representation learning toward over-represented patterns, and indiscriminate training regardless of heterogeneity in data quality incurs considerable computational inefficiency. Here we demonstrate that active, principled data curation during pretraining can serve as a viable, cost-effective alternative to brute-force dataset enlargement. We introduce CheXficient, a chest X-ray (CXR) foundation model that selectively prioritizes informative training samples. CheXficient is pretrained on only 22.7% of 1,235,004 paired CXR images and reports while consuming under 27.3% of the total compute budget, yet achieving comparable or superior performance to its full-data counterpart and other large-scale pretrained models. We assess CheXficient across 20 individual benchmarks spanning 5 task types, including non-adapted off-the-shelf evaluations (zero-shot findings classification and crossmodal retrieval) and adapted downstream tasks (disease prediction, semantic segmentation, and radiology report generation). Further analyses show that CheXficient systematically prioritizes under-represented training samples, improving generalizability on long-tailed or rare conditions. Overall, our work offers practical insights into the data and computation demands for efficient pretraining and downstream adaptation of medical vision-language foundation models.

Difei Gu, Yunhe Gao, Mu Zhou et al.

Accurate disease interpretation from radiology remains challenging due to imaging heterogeneity. Achieving expert-level diagnostic decisions requires integration of subtle image features with clinical knowledge. Yet major vision-language models (VLMs) treat images as holistic entities and overlook fine-grained image details that are vital for disease diagnosis. Clinicians analyze images by utilizing their prior medical knowledge and identify anatomical structures as important region of interests (ROIs). Inspired from this human-centric workflow, we introduce Anatomy-VLM, a fine-grained, vision-language model that incorporates multi-scale information. First, we design a model encoder to localize key anatomical features from entire medical images. Second, these regions are enriched with structured knowledge for contextually-aware interpretation. Finally, the model encoder aligns multi-scale medical information to generate clinically-interpretable disease prediction. Anatomy-VLM achieves outstanding performance on both in- and out-of-distribution datasets. We also validate the performance of Anatomy-VLM on downstream image segmentation tasks, suggesting that its fine-grained alignment captures anatomical and pathology-related knowledge. Furthermore, the Anatomy-VLM's encoder facilitates zero-shot anatomy-wise interpretation, providing its strong expert-level clinical interpretation capabilities.

Zhuowei Li, Haizhou Shi, Yunhe Gao et al.

Large Vision-Language Models (LVLMs) can reason effectively over both textual and visual inputs, but they tend to hallucinate syntactically coherent yet visually ungrounded contents. In this paper, we investigate the internal dynamics of hallucination by examining the tokens logits ranking throughout the generation process, revealing three key patterns in how LVLMs process information: (1) gradual visual information loss - visually grounded tokens gradually become less favored throughout generation, and (2) early excitation - semantically meaningful tokens achieve peak activation in the layers earlier than the final layer. (3) hidden genuine information - visually grounded tokens though not being eventually decoded still retain relatively high rankings at inference. Based on these insights, we propose VISTA (Visual Information Steering with Token-logit Augmentation), a training-free inference-time intervention framework that reduces hallucination while promoting genuine information. VISTA works by combining two complementary approaches: reinforcing visual information in activation space and leveraging early layer activations to promote semantically meaningful decoding. Compared to existing methods, VISTA requires no external supervision and is applicable to various decoding strategies. Extensive experiments show that VISTA on average reduces hallucination by about 40% on evaluated open-ended generation task, and it consistently outperforms existing methods on four benchmarks across four architectures under three decoding strategies. Code is available at https://github.com/LzVv123456/VISTA.

Zhuowei Li, Zihao Xu, Ligong Han et al.

In-context Learning (ICL) empowers large language models (LLMs) to swiftly adapt to unseen tasks at inference-time by prefixing a few demonstration examples before queries. Despite its versatility, ICL incurs substantial computational and memory overheads compared to zero-shot learning and is sensitive to the selection and order of demonstration examples. In this work, we introduce Implicit In-context Learning (I2CL), an innovative paradigm that reduces the inference cost of ICL to that of zero-shot learning with minimal information loss. I2CL operates by first generating a condensed vector representation, namely a context vector, extracted from the demonstration examples. It then conducts an inference-time intervention through injecting a linear combination of the context vector and query activations back into the model's residual streams. Empirical evaluation on nine real-world tasks across three model architectures demonstrates that I2CL achieves few-shot level performance at zero-shot inference cost, and it exhibits robustness against variations in demonstration examples. Furthermore, I2CL facilitates a novel representation of task-ids, enhancing task similarity detection and fostering effective transfer learning. We also perform a comprehensive analysis and ablation study on I2CL, offering deeper insights into its internal mechanisms. Code is available at https://github.com/LzVv123456/I2CL.

Jiaming Liu, Felix Petersen, Yunhe Gao et al.

Adversarial diffusion and diffusion-inversion methods have advanced unpaired image-to-image translation, but each faces key limitations. Adversarial approaches require target-domain adversarial loss during training, which can limit generalization to unseen data, while diffusion-inversion methods often produce low-fidelity translations due to imperfect inversion into noise-latent representations. In this work, we propose the Self-Supervised Semantic Bridge (SSB), a versatile framework that integrates external semantic priors into diffusion bridge models to enable spatially faithful translation without cross-domain supervision. Our key idea is to leverage self-supervised visual encoders to learn representations that are invariant to appearance changes but capture geometric structure, forming a shared latent space that conditions the diffusion bridges. Extensive experiments show that SSB outperforms strong prior methods for challenging medical image synthesis in both in-domain and out-of-domain settings, and extends easily to high-quality text-guided editing.

Difei Gu, Yunhe Gao, Yang Zhou et al.

Automated chest radiographs interpretation requires both accurate disease classification and detailed radiology report generation, presenting a significant challenge in the clinical workflow. Current approaches either focus on classification accuracy at the expense of interpretability or generate detailed but potentially unreliable reports through image captioning techniques. In this study, we present RadAlign, a novel framework that combines the predictive accuracy of vision-language models (VLMs) with the reasoning capabilities of large language models (LLMs). Inspired by the radiologist's workflow, RadAlign first employs a specialized VLM to align visual features with key medical concepts, achieving superior disease classification with an average AUC of 0.885 across multiple diseases. These recognized medical conditions, represented as text-based concepts in the aligned visual-language space, are then used to prompt LLM-based report generation. Enhanced by a retrieval-augmented generation mechanism that grounds outputs in similar historical cases, RadAlign delivers superior report quality with a GREEN score of 0.678, outperforming state-of-the-art methods' 0.634. Our framework maintains strong clinical interpretability while reducing hallucinations, advancing automated medical imaging and report analysis through integrated predictive and generative AI. Code is available at https://github.com/difeigu/RadAlign.

Bangwei Guo, Meng Ye, Yunhe Gao et al.

Despite the advances in learning-based image segmentation approach, the accurate segmentation of cardiac structures from magnetic resonance imaging (MRI) remains a critical challenge. While existing automatic segmentation methods have shown promise, they still require extensive manual corrections of the segmentation results by human experts, particularly in complex regions such as the basal and apical parts of the heart. Recent efforts have been made on developing interactive image segmentation methods that enable human-in-the-loop learning. However, they are semi-automatic and inefficient, due to their reliance on click-based prompts, especially for 3D cardiac MRI volumes. To address these limitations, we propose VerSe, a Versatile Segmentation framework to unify automatic and interactive segmentation through mutiple queries. Our key innovation lies in the joint learning of object and click queries as prompts for a shared segmentation backbone. VerSe supports both fully automatic segmentation, through object queries, and interactive mask refinement, by providing click queries when needed. With the proposed integrated prompting scheme, VerSe demonstrates significant improvement in performance and efficiency over existing methods, on both cardiac MRI and out-of-distribution medical imaging datasets. The code is available at https://github.com/bangwayne/Verse.

Eva Prakash, Yunhe Gao, Chong Wang et al.

Chest radiograph interpretation requires temporal reasoning over prior and current studies, yet most vision-language models are trained on static image-report pairs and lack explicit supervision for modeling longitudinal change. We introduce CheXTemporal, a dataset for temporally grounded reasoning in chest radiography consisting of paired prior-current chest X-rays (CXR) with finding-level temporal and spatial annotations. The dataset includes a five-class progression taxonomy (new, worse, stable, improved, resolved), localized spatial supervision of pathology, explicit spatial-temporal alignment across paired studies, and multi-source coverage for cross-domain evaluation. We additionally construct a 280K-pair silver dataset with automatically derived temporal and anatomical supervision for large-scale evaluation under weaker supervision. Using these resources, we evaluate multiple state-of-the-art vision-language CXR models on grounding and progression-classification tasks in a zero-shot setting. Across both gold and silver evaluations, current models exhibit consistent limitations in spatial grounding, fine-grained temporal reasoning, and robustness under distribution shift. In particular, models perform substantially better on salient progression categories such as worse than on temporally subtle states such as stable and resolved, suggesting limited modeling of longitudinal disease evolution in chest radiography.

Yunhe Gao, Difei Gu, Mu Zhou et al.

Although explainability is essential in the clinical diagnosis, most deep learning models still function as black boxes without elucidating their decision-making process. In this study, we investigate the explainable model development that can mimic the decision-making process of human experts by fusing the domain knowledge of explicit diagnostic criteria. We introduce a simple yet effective framework, Explicd, towards Explainable language-informed criteria-based diagnosis. Explicd initiates its process by querying domain knowledge from either large language models (LLMs) or human experts to establish diagnostic criteria across various concept axes (e.g., color, shape, texture, or specific patterns of diseases). By leveraging a pretrained vision-language model, Explicd injects these criteria into the embedding space as knowledge anchors, thereby facilitating the learning of corresponding visual concepts within medical images. The final diagnostic outcome is determined based on the similarity scores between the encoded visual concepts and the textual criteria embeddings. Through extensive evaluation of five medical image classification benchmarks, Explicd has demonstrated its inherent explainability and extends to improve classification performance compared to traditional black-box models. Code is available at \url{https://github.com/yhygao/Explicd}.

Zhiqiang Tang, Yunhe Gao, Yi Zhu et al.

Traditional normalization techniques (e.g., Batch Normalization and Instance Normalization) generally and simplistically assume that training and test data follow the same distribution. As distribution shifts are inevitable in real-world applications, well-trained models with previous normalization methods can perform badly in new environments. Can we develop new normalization methods to improve generalization robustness under distribution shifts? In this paper, we answer the question by proposing CrossNorm and SelfNorm. CrossNorm exchanges channel-wise mean and variance between feature maps to enlarge training distribution, while SelfNorm uses attention to recalibrate the statistics to bridge gaps between training and test distributions. CrossNorm and SelfNorm can complement each other, though exploring different directions in statistics usage. Extensive experiments on different fields (vision and language), tasks (classification and segmentation), settings (supervised and semi-supervised), and distribution shift types (synthetic and natural) show the effectiveness. Code is available at https://github.com/amazon-research/crossnorm-selfnorm

Zhiqiang Tang, Yunhe Gao, Leonid Karlinsky et al.

Data augmentation is one of the most important tools in training modern deep neural networks. Recently, great advances have been made in searching for optimal augmentation policies in the image classification domain. However, two key points related to data augmentation remain uncovered by the current methods. First is that most if not all modern augmentation search methods are offline and learning policies are isolated from their usage. The learned policies are mostly constant throughout the training process and are not adapted to the current training model state. Second, the policies rely on class-preserving image processing functions. Hence applying current offline methods to new tasks may require domain knowledge to specify such kind of operations. In this work, we offer an orthogonal online data augmentation scheme together with three new augmentation networks, co-trained with the target learning task. It is both more efficient, in the sense that it does not require expensive offline training when entering a new domain, and more adaptive as it adapts to the learner state. Our augmentation networks require less domain knowledge and are easily applicable to new tasks. Extensive experiments demonstrate that the proposed scheme alone performs on par with the state-of-the-art offline data augmentation methods, as well as improving upon the state-of-the-art in combination with those methods. Code is available at https://github.com/zhiqiangdon/online-augment .

Yunhe Gao, Di Liu, Zhuowei Li et al.

Medical image segmentation remains challenging due to the vast diversity of anatomical structures, imaging modalities, and segmentation tasks. While deep learning has made significant advances, current approaches struggle to generalize as they require task-specific training or fine-tuning on unseen classes. We present Iris, a novel In-context Reference Image guided Segmentation framework that enables flexible adaptation to novel tasks through the use of reference examples without fine-tuning. At its core, Iris features a lightweight context task encoding module that distills task-specific information from reference context image-label pairs. This rich context embedding information is used to guide the segmentation of target objects. By decoupling task encoding from inference, Iris supports diverse strategies from one-shot inference and context example ensemble to object-level context example retrieval and in-context tuning. Through comprehensive evaluation across twelve datasets, we demonstrate that Iris performs strongly compared to task-specific models on in-distribution tasks. On seven held-out datasets, Iris shows superior generalization to out-of-distribution data and unseen classes. Further, Iris's task encoding module can automatically discover anatomical relationships across datasets and modalities, offering insights into medical objects without explicit anatomical supervision.

Bangwei Guo, Yunhe Gao, Meng Ye et al.

Medical image segmentation is fundamental to clinical decision-making, yet existing models remain fragmented. They are usually trained on single knowledge sources and specific to individual tasks, modalities, or organs. This fragmentation contrasts sharply with clinical practice, where experts seamlessly integrate diverse knowledge: anatomical priors from training, exemplar-based reasoning from reference cases, and iterative refinement through real-time interaction. We present $\textbf{K-Prism}$, a unified segmentation framework that mirrors this clinical flexibility by systematically integrating three knowledge paradigms: (i) $\textit{semantic priors}$ learned from annotated datasets, (ii) $\textit{in-context knowledge}$ from few-shot reference examples, and (iii) $\textit{interactive feedback}$ from user inputs like clicks or scribbles. Our key insight is that these heterogeneous knowledge sources can be encoded into a dual-prompt representation: 1-D sparse prompts defining $\textit{what}$ to segment and 2-D dense prompts indicating $\textit{where}$ to attend, which are then dynamically routed through a Mixture-of-Experts (MoE) decoder. This design enables flexible switching between paradigms and joint training across diverse tasks without architectural modifications. Comprehensive experiments on 18 public datasets spanning diverse modalities (CT, MRI, X-ray, pathology, ultrasound, etc.) demonstrate that K-Prism achieves state-of-the-art performance across semantic, in-context, and interactive segmentation settings. Code will be released upon publication.

Di Liu, Long Zhao, Qilong Zhangli et al.

The task of shape abstraction with semantic part consistency is challenging due to the complex geometries of natural objects. Recent methods learn to represent an object shape using a set of simple primitives to fit the target. \textcolor{black}{However, in these methods, the primitives used do not always correspond to real parts or lack geometric flexibility for semantic interpretation.} In this paper, we investigate salient and efficient primitive descriptors for accurate shape abstractions, and propose \textit{Deep Deformable Models (DDMs)}. DDM employs global deformations and diffeomorphic local deformations. These properties enable DDM to abstract complex object shapes with significantly fewer primitives that offer broader geometry coverage and finer details. DDM is also capable of learning part-level semantic correspondences due to the differentiable and invertible properties of our primitive deformation. Moreover, DDM learning formulation is based on dynamic and kinematic modeling, which enables joint regularization of each sub-transformation during primitive fitting. Extensive experiments on \textit{ShapeNet} demonstrate that DDM outperforms the state-of-the-art in terms of reconstruction and part consistency by a notable margin.

Yunhe Gao, Mu Zhou, Di Liu et al.

Transformers have demonstrated remarkable performance in natural language processing and computer vision. However, existing vision Transformers struggle to learn from limited medical data and are unable to generalize on diverse medical image tasks. To tackle these challenges, we present MedFormer, a data-scalable Transformer designed for generalizable 3D medical image segmentation. Our approach incorporates three key elements: a desirable inductive bias, hierarchical modeling with linear-complexity attention, and multi-scale feature fusion that integrates spatial and semantic information globally. MedFormer can learn across tiny- to large-scale data without pre-training. Comprehensive experiments demonstrate MedFormer's potential as a versatile segmentation backbone, outperforming CNNs and vision Transformers on seven public datasets covering multiple modalities (e.g., CT and MRI) and various medical targets (e.g., healthy organs, diseased tissues, and tumors). We provide public access to our models and evaluation pipeline, offering solid baselines and unbiased comparisons to advance a wide range of downstream clinical applications.

Qi Chang, Hui Qu, Zhennan Yan et al.

Multi-modality images have been widely used and provide comprehensive information for medical image analysis. However, acquiring all modalities among all institutes is costly and often impossible in clinical settings. To leverage more comprehensive multi-modality information, we propose a privacy secured decentralized multi-modality adaptive learning architecture named ModalityBank. Our method could learn a set of effective domain-specific modulation parameters plugged into a common domain-agnostic network. We demonstrate by switching different sets of configurations, the generator could output high-quality images for a specific modality. Our method could also complete the missing modalities across all data centers, thus could be used for modality completion purposes. The downstream task trained from the synthesized multi-modality samples could achieve higher performance than learning from one real data center and achieve close-to-real performance compare with all real images.

Yunhe Gao, Mu Zhou, Dimitris Metaxas

Transformer architecture has emerged to be successful in a number of natural language processing tasks. However, its applications to medical vision remain largely unexplored. In this study, we present UTNet, a simple yet powerful hybrid Transformer architecture that integrates self-attention into a convolutional neural network for enhancing medical image segmentation. UTNet applies self-attention modules in both encoder and decoder for capturing long-range dependency at different scales with minimal overhead. To this end, we propose an efficient self-attention mechanism along with relative position encoding that reduces the complexity of self-attention operation significantly from $O(n^2)$ to approximate $O(n)$. A new self-attention decoder is also proposed to recover fine-grained details from the skipped connections in the encoder. Our approach addresses the dilemma that Transformer requires huge amounts of data to learn vision inductive bias. Our hybrid layer design allows the initialization of Transformer into convolutional networks without a need of pre-training. We have evaluated UTNet on the multi-label, multi-vendor cardiac magnetic resonance imaging cohort. UTNet demonstrates superior segmentation performance and robustness against the state-of-the-art approaches, holding the promise to generalize well on other medical image segmentations.

Yunhe Gao, Rui Huang, Yiwei Yang et al.

Radiotherapy is a treatment where radiation is used to eliminate cancer cells. The delineation of organs-at-risk (OARs) is a vital step in radiotherapy treatment planning to avoid damage to healthy organs. For nasopharyngeal cancer, more than 20 OARs are needed to be precisely segmented in advance. The challenge of this task lies in complex anatomical structure, low-contrast organ contours, and the extremely imbalanced size between large and small organs. Common segmentation methods that treat them equally would generally lead to inaccurate small-organ labeling. We propose a novel two-stage deep neural network, FocusNetv2, to solve this challenging problem by automatically locating, ROI-pooling, and segmenting small organs with specifically designed small-organ localization and segmentation sub-networks while maintaining the accuracy of large organ segmentation. In addition to our original FocusNet, we employ a novel adversarial shape constraint on small organs to ensure the consistency between estimated small-organ shapes and organ shape prior knowledge. Our proposed framework is extensively tested on both self-collected dataset of 1,164 CT scans and the MICCAI Head and Neck Auto Segmentation Challenge 2015 dataset, which shows superior performance compared with state-of-the-art head and neck OAR segmentation methods.

Yunhe Gao, Zhiqiang Tang, Mu Zhou et al.

Data augmentation has proved extremely useful by increasing training data variance to alleviate overfitting and improve deep neural networks' generalization performance. In medical image analysis, a well-designed augmentation policy usually requires much expert knowledge and is difficult to generalize to multiple tasks due to the vast discrepancies among pixel intensities, image appearances, and object shapes in different medical tasks. To automate medical data augmentation, we propose a regularized adversarial training framework via two min-max objectives and three differentiable augmentation models covering affine transformation, deformation, and appearance changes. Our method is more automatic and efficient than previous automatic augmentation methods, which still rely on pre-defined operations with human-specified ranges and costly bi-level optimization. Extensive experiments demonstrated that our approach, with less training overhead, achieves superior performance over state-of-the-art auto-augmentation methods on both tasks of 2D skin cancer classification and 3D organs-at-risk segmentation.

Yunhe Gao, Rui Huang, Ming Chen et al.

In this paper, we propose an end-to-end deep neural network for solving the problem of imbalanced large and small organ segmentation in head and neck (HaN) CT images. To conduct radiotherapy planning for nasopharyngeal cancer, more than 10 organs-at-risk (normal organs) need to be precisely segmented in advance. However, the size ratio between large and small organs in the head could reach hundreds. Directly using such imbalanced organ annotations to train deep neural networks generally leads to inaccurate small-organ label maps. We propose a novel end-to-end deep neural network to solve this challenging problem by automatically locating, ROI-pooling, and segmenting small organs with specifically designed small-organ sub-networks while maintaining the accuracy of large organ segmentation. A strong main network with densely connected atrous spatial pyramid pooling and squeeze-and-excitation modules is used for segmenting large organs, where large organs' label maps are directly output. For small organs, their probabilistic locations instead of label maps are estimated by the main network. High-resolution and multi-scale feature volumes for each small organ are ROI-pooled according to their locations and are fed into small-organ networks for accurate segmenting small organs. Our proposed network is extensively tested on both collected real data and the \emph{MICCAI Head and Neck Auto Segmentation Challenge 2015} dataset, and shows superior performance compared with state-of-the-art segmentation methods.