Yan Cao

Yuhao Huang, Xin Yang, Xiaoqiong Huang et al.

Deep segmentation models often face the failure risks when the testing image presents unseen distributions. Improving model robustness against these risks is crucial for the large-scale clinical application of deep models. In this study, inspired by human learning cycle, we propose a novel online reflective learning framework (RefSeg) to improve segmentation robustness. Based on the reflection-on-action conception, our RefSeg firstly drives the deep model to take action to obtain semantic segmentation. Then, RefSeg triggers the model to reflect itself. Because making deep models realize their segmentation failures during testing is challenging, RefSeg synthesizes a realistic proxy image from the semantic mask to help deep models build intuitive and effective reflections. This proxy translates and emphasizes the segmentation flaws. By maximizing the structural similarity between the raw input and the proxy, the reflection-on-action loop is closed with segmentation robustness improved. RefSeg runs in the testing phase and is general for segmentation models. Extensive validation on three medical image segmentation tasks with a public cardiac MR dataset and two in-house large ultrasound datasets show that our RefSeg remarkably improves model robustness and reports state-of-the-art performance over strong competitors.

Chaoyu Chen, Xin Yang, Rusi Chen et al.

Ultrasound (US) image segmentation is an active research area that requires real-time and highly accurate analysis in many scenarios. The detect-to-segment (DTS) frameworks have been recently proposed to balance accuracy and efficiency. However, existing approaches may suffer from inadequate contour encoding or fail to effectively leverage the encoded results. In this paper, we introduce a novel Fourier-anchor-based DTS framework called Fourier Feature Pyramid Network (FFPN) to address the aforementioned issues. The contributions of this paper are two fold. First, the FFPN utilizes Fourier Descriptors to adequately encode contours. Specifically, it maps Fourier series with similar amplitudes and frequencies into the same layer of the feature map, thereby effectively utilizing the encoded Fourier information. Second, we propose a Contour Sampling Refinement (CSR) module based on the contour proposals and refined features produced by the FFPN. This module extracts rich features around the predicted contours to further capture detailed information and refine the contours. Extensive experimental results on three large and challenging datasets demonstrate that our method outperforms other DTS methods in terms of accuracy and efficiency. Furthermore, our framework can generalize well to other detection or segmentation tasks.

Yuhao Huang, Xin Yang, Han Zhou et al.

The Segment Anything Model (SAM) can achieve satisfactory segmentation performance under high-quality box prompts. However, SAM's robustness is compromised by the decline in box quality, limiting its practicality in clinical reality. In this study, we propose a novel Robust Box prompt based SAM (\textbf{RoBox-SAM}) to ensure SAM's segmentation performance under prompts with different qualities. Our contribution is three-fold. First, we propose a prompt refinement module to implicitly perceive the potential targets, and output the offsets to directly transform the low-quality box prompt into a high-quality one. We then provide an online iterative strategy for further prompt refinement. Second, we introduce a prompt enhancement module to automatically generate point prompts to assist the box-promptable segmentation effectively. Last, we build a self-information extractor to encode the prior information from the input image. These features can optimize the image embeddings and attention calculation, thus, the robustness of SAM can be further enhanced. Extensive experiments on the large medical segmentation dataset including 99,299 images, 5 modalities, and 25 organs/targets validated the efficacy of our proposed RoBox-SAM.

Zhongnuo Yan, Tong Han, Yuhao Huang et al.

Medical image segmentation aims to delineate the anatomical or pathological structures of interest, playing a crucial role in clinical diagnosis. A substantial amount of high-quality annotated data is crucial for constructing high-precision deep segmentation models. However, medical annotation is highly cumbersome and time-consuming, especially for medical videos or 3D volumes, due to the huge labeling space and poor inter-frame consistency. Recently, a fundamental task named Moving Object Segmentation (MOS) has made significant advancements in natural images. Its objective is to delineate moving objects from the background within image sequences, requiring only minimal annotations. In this paper, we propose the first foundation model, named iMOS, for MOS in medical images. Extensive experiments on a large multi-modal medical dataset validate the effectiveness of the proposed iMOS. Specifically, with the annotation of only a small number of images in the sequence, iMOS can achieve satisfactory tracking and segmentation performance of moving objects throughout the entire sequence in bi-directions. We hope that the proposed iMOS can help accelerate the annotation speed of experts, and boost the development of medical foundation models.

Jian Wang, Xin Yang, Xiaohong Jia et al.

Thyroid nodule classification and segmentation in ultrasound images are crucial for computer-aided diagnosis; however, they face limitations owing to insufficient labeled data. In this study, we proposed a multi-view contrastive self-supervised method to improve thyroid nodule classification and segmentation performance with limited manual labels. Our method aligns the transverse and longitudinal views of the same nodule, thereby enabling the model to focus more on the nodule area. We designed an adaptive loss function that eliminates the limitations of the paired data. Additionally, we adopted a two-stage pre-training to exploit the pre-training on ImageNet and thyroid ultrasound images. Extensive experiments were conducted on a large-scale dataset collected from multiple centers. The results showed that the proposed method significantly improves nodule classification and segmentation performance with limited manual labels and outperforms state-of-the-art self-supervised methods. The two-stage pre-training also significantly exceeded ImageNet pre-training.

Yuhao Huang, Ao Chang, Haoran Dou et al.

Accurate segmentation of nodules in both 2D breast ultrasound (BUS) and 3D automated breast ultrasound (ABUS) is crucial for clinical diagnosis and treatment planning. Therefore, developing an automated system for nodule segmentation can enhance user independence and expedite clinical analysis. Unlike fully-supervised learning, weakly-supervised segmentation (WSS) can streamline the laborious and intricate annotation process. However, current WSS methods face challenges in achieving precise nodule segmentation, as many of them depend on inaccurate activation maps or inefficient pseudo-mask generation algorithms. In this study, we introduce a novel multi-agent reinforcement learning-based WSS framework called Flip Learning, which relies solely on 2D/3D boxes for accurate segmentation. Specifically, multiple agents are employed to erase the target from the box to facilitate classification tag flipping, with the erased region serving as the predicted segmentation mask. The key contributions of this research are as follows: (1) Adoption of a superpixel/supervoxel-based approach to encode the standardized environment, capturing boundary priors and expediting the learning process. (2) Introduction of three meticulously designed rewards, comprising a classification score reward and two intensity distribution rewards, to steer the agents' erasing process precisely, thereby avoiding both under- and over-segmentation. (3) Implementation of a progressive curriculum learning strategy to enable agents to interact with the environment in a progressively challenging manner, thereby enhancing learning efficiency. Extensively validated on the large in-house BUS and ABUS datasets, our Flip Learning method outperforms state-of-the-art WSS methods and foundation models, and achieves comparable performance as fully-supervised learning algorithms.

Mingyuan Luo, Xin Yang, Zhongnuo Yan et al.

Three-dimensional (3D) ultrasound (US) aims to provide sonographers with the spatial relationships of anatomical structures, playing a crucial role in clinical diagnosis. Recently, deep-learning-based freehand 3D US has made significant advancements. It reconstructs volumes by estimating transformations between images without external tracking. However, image-only reconstruction poses difficulties in reducing cumulative drift and further improving reconstruction accuracy, particularly in scenarios involving complex motion trajectories. In this context, we propose an enhanced motion network (MoNetV2) to enhance the accuracy and generalizability of reconstruction under diverse scanning velocities and tactics. First, we propose a sensor-based temporal and multi-branch structure that fuses image and motion information from a velocity perspective to improve image-only reconstruction accuracy. Second, we devise an online multi-level consistency constraint that exploits the inherent consistency of scans to handle various scanning velocities and tactics. This constraint exploits both scan-level velocity consistency, path-level appearance consistency, and patch-level motion consistency to supervise inter-frame transformation estimation. Third, we distill an online multi-modal self-supervised strategy that leverages the correlation between network estimation and motion information to further reduce cumulative errors. Extensive experiments clearly demonstrate that MoNetV2 surpasses existing methods in both reconstruction quality and generalizability performance across three large datasets.

Yuanji Zhang, Yuhao Huang, Haoran Dou et al.

Orofacial clefts are among the most common congenital craniofacial abnormalities, yet accurate prenatal detection remains challenging due to the scarcity of experienced specialists and the relative rarity of the condition. Early and reliable diagnosis is essential to enable timely clinical intervention and reduce associated morbidity. Here we show that an artificial intelligence system, trained on over 45,139 ultrasound images from 9,215 fetuses across 22 hospitals, can diagnose fetal orofacial clefts with sensitivity and specificity exceeding 93% and 95% respectively, matching the performance of senior radiologists and substantially outperforming junior radiologists. When used as a medical copilot, the system raises junior radiologists' sensitivity by more than 6%. Beyond direct diagnostic assistance, the system also accelerates the development of clinical expertise. A pilot study involving 24 radiologists and trainees demonstrated that the model can improve the expertise development for rare conditions. This dual-purpose approach offers a scalable solution for improving both diagnostic accuracy and specialist training in settings where experienced radiologists are scarce.

Chaoyu Chen, Xin Yang, Yuhao Huang et al.

Fetal pose estimation in 3D ultrasound (US) involves identifying a set of associated fetal anatomical landmarks. Its primary objective is to provide comprehensive information about the fetus through landmark connections, thus benefiting various critical applications, such as biometric measurements, plane localization, and fetal movement monitoring. However, accurately estimating the 3D fetal pose in US volume has several challenges, including poor image quality, limited GPU memory for tackling high dimensional data, symmetrical or ambiguous anatomical structures, and considerable variations in fetal poses. In this study, we propose a novel 3D fetal pose estimation framework (called FetusMapV2) to overcome the above challenges. Our contribution is three-fold. First, we propose a heuristic scheme that explores the complementary network structure-unconstrained and activation-unreserved GPU memory management approaches, which can enlarge the input image resolution for better results under limited GPU memory. Second, we design a novel Pair Loss to mitigate confusion caused by symmetrical and similar anatomical structures. It separates the hidden classification task from the landmark localization task and thus progressively eases model learning. Last, we propose a shape priors-based self-supervised learning by selecting the relatively stable landmarks to refine the pose online. Extensive experiments and diverse applications on a large-scale fetal US dataset including 1000 volumes with 22 landmarks per volume demonstrate that our method outperforms other strong competitors.

Shuangchi He, Zehui Lin, Xin Yang et al.

Standard plane recognition plays an important role in prenatal ultrasound (US) screening. Automatically recognizing the standard plane along with the corresponding anatomical structures in US image can not only facilitate US image interpretation but also improve diagnostic efficiency. In this study, we build a novel multi-label learning (MLL) scheme to identify multiple standard planes and corresponding anatomical structures of fetus simultaneously. Our contribution is three-fold. First, we represent the class correlation by word embeddings to capture the fine-grained semantic and latent statistical concurrency. Second, we equip the MLL with a graph convolutional network to explore the inner and outer relationship among categories. Third, we propose a novel cluster relabel-based contrastive learning algorithm to encourage the divergence among ambiguous classes. Extensive validation was performed on our large in-house dataset. Our approach reports the highest accuracy as 90.25% for standard planes labeling, 85.59% for planes and structures labeling and mAP as 94.63%. The proposed MLL scheme provides a novel perspective for standard plane recognition and can be easily extended to other medical image classification tasks.

Xindi Hu, Limin Wang, Xin Yang et al.

The ultrasound (US) screening of the infant hip is vital for the early diagnosis of developmental dysplasia of the hip (DDH). The US diagnosis of DDH refers to measuring alpha and beta angles that quantify hip joint development. These two angles are calculated from key anatomical landmarks and structures of the hip. However, this measurement process is not trivial for sonographers and usually requires a thorough understanding of complex anatomical structures. In this study, we propose a multi-task framework to learn the relationships among landmarks and structures jointly and automatically evaluate DDH. Our multi-task networks are equipped with three novel modules. Firstly, we adopt Mask R-CNN as the basic framework to detect and segment key anatomical structures and add one landmark detection branch to form a new multi-task framework. Secondly, we propose a novel shape similarity loss to refine the incomplete anatomical structure prediction robustly and accurately. Thirdly, we further incorporate the landmark-structure consistent prior to ensure the consistency of the bony rim estimated from the segmented structure and the detected landmark. In our experiments, 1,231 US images of the infant hip from 632 patients are collected, of which 247 images from 126 patients are tested. The average errors in alpha and beta angles are 2.221 degrees and 2.899 degrees. About 93% and 85% estimates of alpha and beta angles have errors less than 5 degrees, respectively. Experimental results demonstrate that the proposed method can accurately and robustly realize the automatic evaluation of DDH, showing great potential for clinical application.

Yan Cao, Keting Lu, Xiaoping Chen et al.

Reinforcement learning methods have been used to compute dialog policies from language-based interaction experiences. Efficiency is of particular importance in dialog policy learning, because of the considerable cost of interacting with people, and the very poor user experience from low-quality conversations. Aiming at improving the efficiency of dialog policy learning, we develop algorithm LHUA (Learning with Hindsight, User modeling, and Adaptation) that, for the first time, enables dialog agents to adaptively learn with hindsight from both simulated and real users. Simulation and hindsight provide the dialog agent with more experience and more (positive) reinforcements respectively. Experimental results suggest that, in success rate and policy quality, LHUA outperforms competitive baselines from the literature, including its no-simulation, no-adaptation, and no-hindsight counterparts.

Dawei Li, Yan Cao, Guoliang Shi et al.

Automatic leaf segmentation, as well as identification and classification methods that built upon it, are able to provide immediate monitoring for plant growth status to guarantee the output. Although 3D plant point clouds contain abundant phenotypic features, plant leaves are usually distributed in clusters and are sometimes seriously overlapped in the canopy. Therefore, it is still a big challenge to automatically segment each individual leaf from a highly crowded plant canopy in 3D for plant phenotyping purposes. In this work, we propose an overlapping-free individual leaf segmentation method for plant point clouds using the 3D filtering and facet region growing. In order to separate leaves with different overlapping situations, we develop a new 3D joint filtering operator, which integrates a Radius-based Outlier Filter (RBOF) and a Surface Boundary Filter (SBF) to help to separate occluded leaves. By introducing the facet over-segmentation and facet-based region growing, the noise in segmentation is suppressed and labeled leaf centers can expand to their whole leaves, respectively. Our method can work on point clouds generated from three types of 3D imaging platforms, and also suitable for different kinds of plant species. In experiments, it obtains a point-level cover rate of 97% for Epipremnum aureum, 99% for Monstera deliciosa, 99% for Calathea makoyana, and 87% for Hedera nepalensis sample plants. At the leaf level, our method reaches an average Recall at 100.00%, a Precision at 99.33%, and an average F-measure at 99.66%, respectively. The proposed method can also facilitate the automatic traits estimation of each single leaf (such as the leaf area, length, and width), which has potential to become a highly effective tool for plant research and agricultural engineering.

Dawei Li, Siyuan Yan, Xin Cai et al.

Change detection is a fundamental task in computer vision. Despite significant advances have been made, most of the change detection methods fail to work well in challenging scenes due to ubiquitous noise and interferences. Nowadays, post-processing methods (e.g. MRF, and CRF) aiming to enhance the binary change detection results still fall short of the requirements on universality for distinctive scenes, applicability for different types of detection methods, accuracy, and real-time performance. Inspired by the nature of image filtering, which separates noise from pixel observations and recovers the real structure of patches, we consider utilizing image filters to enhance the detection masks. In this paper, we present an integrated filter which comprises a weighted local guided image filter and a weighted spatiotemporal tree filter. The spatiotemporal tree filter leverages the global spatiotemporal information of adjacent video frames and meanwhile the guided filter carries out local window filtering of pixels, for enhancing the coarse change detection masks. The main contributions are three: (i) the proposed filter can make full use of the information of the same object in consecutive frames to improve its current detection mask by computations on a spatiotemporal minimum spanning tree; (ii) the integrated filter possesses both advantages of local filtering and global filtering; it not only has good edge-preserving property but also can handle heavily textured and colorful foreground regions; and (iii) Unlike some popular enhancement methods (MRF, and CRF) that require either a priori background probabilities or a posteriori foreground probabilities for every pixel to improve the coarse detection masks, our method is a versatile enhancement filter that can be applied after many different types of change detection methods, and is particularly suitable for video sequences.