Qingqiao Hu

Qingqiao Hu, Hao Wang, Jing Luo et al.

Automated medical image segmentation inherently involves a certain degree of uncertainty. One key factor contributing to this uncertainty is the ambiguity that can arise in determining the boundaries of a target region of interest, primarily due to variations in image appearance. On top of this, even among experts in the field, different opinions can emerge regarding the precise definition of specific anatomical structures. This work specifically addresses the modeling of segmentation uncertainty, known as inter-rater uncertainty. Its primary objective is to explore and analyze the variability in segmentation outcomes that can occur when multiple experts in medical imaging interpret and annotate the same images. We introduce a novel Bayesian neural network-based architecture to estimate inter-rater uncertainty in medical image segmentation. Our approach has three key advancements. Firstly, we introduce a one-encoder-multi-decoder architecture specifically tailored for uncertainty estimation, enabling us to capture the rater-specific representation of each expert involved. Secondly, we propose Bayesian modeling for the new architecture, allowing efficient capture of the inter-rater distribution, particularly in scenarios with limited annotations. Lastly, we enhance the rater-specific representation by integrating an attention module into each decoder. This module facilitates focused and refined segmentation results for each rater. We conduct extensive evaluations using synthetic and real-world datasets to validate our technical innovations rigorously. Our method surpasses existing baseline methods in five out of seven diverse tasks on the publicly available \emph{QUBIQ} dataset, considering two evaluation metrics encompassing different uncertainty aspects. Our codes, models, and the new dataset are available through our GitHub repository: https://github.com/HaoWang420/bOEMD-net .

Qingqiao Hu, Hongwei Li, Jianguo Zhang

Medical image synthesis has attracted increasing attention because it could generate missing image data, improving diagnosis and benefits many downstream tasks. However, so far the developed synthesis model is not adaptive to unseen data distribution that presents domain shift, limiting its applicability in clinical routine. This work focuses on exploring domain adaptation (DA) of 3D image-to-image synthesis models. First, we highlight the technical difference in DA between classification, segmentation and synthesis models. Second, we present a novel efficient adaptation approach based on 2D variational autoencoder which approximates 3D distributions. Third, we present empirical studies on the effect of the amount of adaptation data and the key hyper-parameters. Our results show that the proposed approach can significantly improve the synthesis accuracy on unseen domains in a 3D setting. The code is publicly available at https://github.com/WinstonHuTiger/2D_VAE_UDA_for_3D_sythesis

Qingqiao Hu, Daoan Zhang, Jiebo Luo et al.

Learning meaningful and interpretable representations from high-dimensional volumetric magnetic resonance (MR) images is essential for advancing personalized medicine. While Vision Transformers (ViTs) have shown promise in handling image data, their application to 3D multi-contrast MR images faces challenges due to computational complexity and interpretability. To address this, we propose a novel state-space-model (SSM)-based masked autoencoder which scales ViT-like models to handle high-resolution data effectively while also enhancing the interpretability of learned representations. We propose a latent-to-spatial mapping technique that enables direct visualization of how latent features correspond to specific regions in the input volumes in the context of SSM. We validate our method on two key neuro-oncology tasks: identification of isocitrate dehydrogenase mutation status and 1p/19q co-deletion classification, achieving state-of-the-art accuracy. Our results highlight the potential of SSM-based self-supervised learning to transform radiomics analysis by combining efficiency and interpretability.

Meilong Xu, Qingqiao Hu, Xiaoling Hu et al.

Topological correctness is crucial for tubular structures such as blood vessels, nerve fibers, and road networks. Existing topology-preserving methods rely on domain-specific ground truth, which is costly and rarely transfers across domains. When deployed to a new domain without annotations, a key question arises: how can we detect topological anomalies without ground-truth supervision? We reframe this as topological anomaly detection, a structured visual reasoning task requiring a model to locate and classify topological errors in predicted segmentation masks. Vision-Language Models (VLMs) are natural candidates; however, we find that state-of-the-art VLMs perform nearly at random, lacking the fine-grained, topology-aware perception needed to identify sparse connectivity errors in dense structures. To bridge this gap, we develop an automated data-curation pipeline that synthesizes diverse topological anomalies with verifiable annotations across progressively difficult levels, thereby constructing the first large-scale, multi-domain benchmark for this task. We then introduce Topo-R1, a framework that endows VLMs with topology-aware perception via two-stage training: supervised fine-tuning followed by reinforcement learning with Group Relative Policy Optimization (GRPO). Central to our approach is a topology-aware composite reward that integrates type-aware Hungarian matching for structured error classification, spatial localization scoring, and a centerline Dice (clDice) reward that directly penalizes connectivity disruptions, thereby jointly incentivizing semantic precision and structural fidelity. Extensive experiments demonstrate that Topo-R1 establishes a new paradigm for annotation-free topological quality assessment, consistently outperforming general-purpose VLMs and supervised baselines across all evaluation protocols.

Kehan Qi, Saumya Gupta, Qingqiao Hu et al.

Magnetic Resonance Imaging (MRI) offers excellent soft-tissue contrast without ionizing radiation, but its long acquisition time limits clinical utility. Recent methods accelerate MRI by under-sampling $k$-space and reconstructing the resulting images using deep learning. Unrolled networks have been widely used for the reconstruction task due to their efficiency, but suffer from unstable evolving caused by freely-learnable parameters in intermediate steps. In contrast, diffusion models based on stochastic differential equations offer theoretical stability in both medical and natural image tasks but are computationally expensive. In this work, we introduce flow ODEs to MRI reconstruction by theoretically proving that unrolled networks are discrete implementations of conditional probability flow ODEs. This connection provides explicit formulations for parameters and clarifies how intermediate states should evolve. Building on this insight, we propose Flow-Aligned Training (FLAT), which derives unrolled parameters from the ODE discretization and aligns intermediate reconstructions with the ideal ODE trajectory to improve stability and convergence. Experiments on three MRI datasets show that FLAT achieves high-quality reconstructions with up to $3\times$ fewer iterations than diffusion-based generative models and significantly greater stability than unrolled networks.

Weimin Lyu, Qingqiao Hu, Kehan Qi et al.

Whole-slide images (WSIs) in pathology can reach up to 10,000 x 10,000 pixels, posing significant challenges for multimodal large language model (MLLM) due to long context length and high computational demands. Previous methods typically focus on patch-level analysis or slide-level classification using CLIP-based models with multi-instance learning, but they lack the generative capabilities needed for visual question answering (VQA). More recent MLLM-based approaches address VQA by feeding thousands of patch tokens directly into the language model, which leads to excessive resource consumption. To address these limitations, we propose Token Compression Pathology LLaVA (TCP-LLaVA), the first MLLM architecture to perform WSI VQA via token compression. TCP-LLaVA introduces a set of trainable compression tokens that aggregate visual and textual information through a modality compression module, inspired by the [CLS] token mechanism in BERT. Only the compressed tokens are forwarded to the LLM for answer generation, significantly reducing input length and computational cost. Experiments on ten TCGA tumor subtypes show that TCP-LLaVA outperforms existing MLLM baselines in VQA accuracy while reducing training resource consumption by a substantial margin.

Qingqiao Hu, Weimin Lyu, Meilong Xu et al.

Whole Slide Image (WSI) understanding is fundamentally challenging due to its gigapixel scale and the extreme sparsity of diagnostically relevant regions. Unlike human experts who primarily rely on key areas to arrive at a diagnosis, existing slide-level multimodal large language models (MLLMs) for pathology rely on heavy slide-level encoders that process thousands of patch features in a brute-force manner, resulting in excessive computational cost. In this work, we revisit the WSI-language modeling paradigm and show that tile-level features exhibit strong global and local redundancy, whereas only a small subset of tiles are truly task-relevant. Motivated by this observation, we introduce an efficient MLLM framework, called LoC-Path, that replaces the expensive slide-level encoder with redundancy-reducing modules. We first design a Sparse Token Merger (STM) and an MAE-pretrained resampler to remove local redundancy and compress globally redundant tile tokens into a compact slide-level representation set. We then propose a Cross-Attention Routing Adapter (CARA) and a Token Importance Scorer (TIS) to integrate the compressed visual representation with the language model in a computation-efficient manner. Extensive experiments demonstrate that our approach achieves performance comparable to existing state-of-the-art whole-slide MLLMs, while requiring significantly lower computation and memory.

Hongwei Bran Li, Gian Marco Conte, Qingqiao Hu et al.

Automated brain tumor segmentation methods have become well-established and reached performance levels offering clear clinical utility. These methods typically rely on four input magnetic resonance imaging (MRI) modalities: T1-weighted images with and without contrast enhancement, T2-weighted images, and FLAIR images. However, some sequences are often missing in clinical practice due to time constraints or image artifacts, such as patient motion. Consequently, the ability to substitute missing modalities and gain segmentation performance is highly desirable and necessary for the broader adoption of these algorithms in the clinical routine. In this work, we present the establishment of the Brain MR Image Synthesis Benchmark (BraSyn) in conjunction with the Medical Image Computing and Computer-Assisted Intervention (MICCAI) 2023. The primary objective of this challenge is to evaluate image synthesis methods that can realistically generate missing MRI modalities when multiple available images are provided. The ultimate aim is to facilitate automated brain tumor segmentation pipelines. The image dataset used in the benchmark is diverse and multi-modal, created through collaboration with various hospitals and research institutions.