Kai Ding

Yong Xien Chng, Xuchong Qiu, Yizeng Han et al.

Despite extensive research, open-vocabulary segmentation methods still struggle to generalize across diverse domains. To reduce the computational cost of adapting Vision-Language Models (VLMs) while preserving their pre-trained knowledge, most methods freeze the VLMs for mask classification and train only the mask generator. However, our comprehensive analysis reveals a surprising insight: open-vocabulary segmentation is primarily bottlenecked by mask classification, not mask generation. This discovery prompts us to rethink the existing paradigm and explore an alternative approach. Instead of freezing the VLM, we propose to freeze the pre-trained mask generator and focus on optimizing the mask classifier. Building on the observation that VLMs pre-trained on global-pooled image-text features often fail to capture fine-grained semantics necessary for effective mask classification, we propose a novel Fine-grained Semantic Adaptation (FISA) method to address this limitation. FISA enhances the extracted visual features with fine-grained semantic awareness by explicitly integrating this crucial semantic information early in the visual encoding process. As our method strategically optimizes only a small portion of the VLM's parameters, it enjoys the efficiency of adapting to new data distributions while largely preserving the valuable VLM pre-trained knowledge. Extensive ablation studies confirm the superiority of our approach. Notably, FISA achieves new state-of-the-art results across multiple representative benchmarks, improving performance by up to +1.0 PQ and +3.0 mIoU and reduces training costs by nearly 5x compared to previous best methods. Our code and data will be made public.

Yi Luo, Yike Guo, Hamed Hooshangnejad et al.

Lung nodule detection in chest CT is crucial for early lung cancer diagnosis, yet existing deep learning approaches face challenges when deployed in clinical settings with limited annotated data. While curriculum learning has shown promise in improving model training, traditional static curriculum strategies fail in data-scarce scenarios. We propose Scale Adaptive Curriculum Learning (SACL), a novel training strategy that dynamically adjusts curriculum design based on available data scale. SACL introduces three key mechanisms:(1) adaptive epoch scheduling, (2) hard sample injection, and (3) scale-aware optimization. We evaluate SACL on the LUNA25 dataset using YOLOv11 as the base detector. Experimental results demonstrate that while SACL achieves comparable performance to static curriculum learning on the full dataset in mAP50, it shows significant advantages under data-limited conditions with 4.6%, 3.5%, and 2.0% improvements over baseline at 10%, 20%, and 50% of training data respectively. By enabling robust training across varying data scales without architectural modifications, SACL provides a practical solution for healthcare institutions to develop effective lung nodule detection systems despite limited annotation resources.

Hamed Hooshangnejad, Xue Feng, Gaofeng Huang et al.

Lung cancer is a devastating disease with the highest mortality rate among cancer types. Over 60% of non-small cell lung cancer (NSCLC) patients, which accounts for 87% of diagnoses, require radiation therapy. Rapid treatment initiation significantly increases the patient's survival rate and reduces the mortality rate. Accurate tumor segmentation is a critical step in the diagnosis and treatment of NSCLC. Manual segmentation is time and labor-consuming and causes delays in treatment initiation. Although many lung nodule detection methods, including deep learning-based models, have been proposed, there is still a long-standing problem of high false positives (FPs) with most of these methods. Here, we developed an electronic health record (EHR) guided lung tumor auto-segmentation called EXACT-Net (EHR-enhanced eXACtitude in Tumor segmentation), where the extracted information from EHRs using a pre-trained large language model (LLM), was used to remove the FPs and keep the TP nodules only. The auto-segmentation model was trained on NSCLC patients' computed tomography (CT), and the pre-trained LLM was used with the zero-shot learning approach. Our approach resulted in a 250% boost in successful nodule detection using the data from ten NSCLC patients treated in our institution.

Wenxuan Li, Xinze Zhou, Qi Chen et al.

PanTS is a large-scale, multi-institutional dataset curated to advance research in pancreatic CT analysis. It contains 36,390 CT scans from 145 medical centers, with expert-validated, voxel-wise annotations of over 993,000 anatomical structures, covering pancreatic tumors, pancreas head, body, and tail, and 24 surrounding anatomical structures such as vascular/skeletal structures and abdominal/thoracic organs. Each scan includes metadata such as patient age, sex, diagnosis, contrast phase, in-plane spacing, slice thickness, etc. AI models trained on PanTS achieve significantly better performance in pancreatic tumor detection, localization, and segmentation compared to those trained on existing public datasets. Our analysis indicates that these gains are directly attributable to the 16x larger-scale tumor annotations and indirectly supported by the 24 additional surrounding anatomical structures. As the largest and most comprehensive resource of its kind, PanTS offers a new benchmark for developing and evaluating AI models in pancreatic CT analysis.

Yi Luo, Hamed Hooshangnejad, Xue Feng et al.

Background: Lung cancer ranks as the leading cause of cancer-related mortality worldwide. The complexity of tumor delineation, crucial for radiation therapy, requires expertise often unavailable in resource-limited settings. Artificial Intelligence(AI), particularly with advancements in deep learning (DL) and natural language processing (NLP), offers potential solutions yet is challenged by high false positive rates. Purpose: The Oncology Contouring Copilot (OCC) system is developed to leverage oncologist expertise for precise tumor contouring using textual descriptions, aiming to increase the efficiency of oncological workflows by combining the strengths of AI with human oversight. Methods: Our OCC system initially identifies nodule candidates from CT scans. Employing Language Vision Models (LVMs) like GPT-4V, OCC then effectively reduces false positives with clinical descriptive texts, merging textual and visual data to automate tumor delineation, designed to elevate the quality of oncology care by incorporating knowledge from experienced domain experts. Results: Deployments of the OCC system resulted in a significant reduction in the false discovery rate by 35.0%, a 72.4% decrease in false positives per scan, and an F1-score of 0.652 across our dataset for unbiased evaluation. Conclusions: OCC represents a significant advance in oncology care, particularly through the use of the latest LVMs to improve contouring results by (1) streamlining oncology treatment workflows by optimizing tumor delineation, reducing manual processes; (2) offering a scalable and intuitive framework to reduce false positives in radiotherapy planning using LVMs; (3) introducing novel medical language vision prompt techniques to minimize LVMs hallucinations with ablation study, and (4) conducting a comparative analysis of LVMs, highlighting their potential in addressing medical language vision challenges.