Juexiao Zhou

Juexiao Zhou, Longxi Zhou, Di Wang et al. · tsinghua

Heterogeneous data is endemic due to the use of diverse models and settings of devices by hospitals in the field of medical imaging. However, there are few open-source frameworks for federated heterogeneous medical image analysis with personalization and privacy protection simultaneously without the demand to modify the existing model structures or to share any private data. In this paper, we proposed PPPML-HMI, an open-source learning paradigm for personalized and privacy-preserving federated heterogeneous medical image analysis. To our best knowledge, personalization and privacy protection were achieved simultaneously for the first time under the federated scenario by integrating the PerFedAvg algorithm and designing our novel cyclic secure aggregation with the homomorphic encryption algorithm. To show the utility of PPPML-HMI, we applied it to a simulated classification task namely the classification of healthy people and patients from the RAD-ChestCT Dataset, and one real-world segmentation task namely the segmentation of lung infections from COVID-19 CT scans. For the real-world task, PPPML-HMI achieved $\sim$5\% higher Dice score on average compared to conventional FL under the heterogeneous scenario. Meanwhile, we applied the improved deep leakage from gradients to simulate adversarial attacks and showed the solid privacy-preserving capability of PPPML-HMI. By applying PPPML-HMI to both tasks with different neural networks, a varied number of users, and sample sizes, we further demonstrated the strong robustness of PPPML-HMI.

Juexiao Zhou, Haoyang Li, Xingyu Liao et al. · tsinghua

Revoking personal private data is one of the basic human rights, which has already been sheltered by several privacy-preserving laws in many countries. However, with the development of data science, machine learning and deep learning techniques, this right is usually neglected or violated as more and more patients' data are being collected and used for model training, especially in intelligent healthcare, thus making intelligent healthcare a sector where technology must meet the law, regulations, and privacy principles to ensure that the innovation is for the common good. In order to secure patients' right to be forgotten, we proposed a novel solution by using auditing to guide the forgetting process, where auditing means determining whether a dataset has been used to train the model and forgetting requires the information of a query dataset to be forgotten from the target model. We unified these two tasks by introducing a new approach called knowledge purification. To implement our solution, we developed AFS, a unified open-source software, which is able to evaluate and revoke patients' private data from pre-trained deep learning models. We demonstrated the generality of AFS by applying it to four tasks on different datasets with various data sizes and architectures of deep learning networks. The software is publicly available at \url{https://github.com/JoshuaChou2018/AFS}.

Juexiao Zhou, Xiuying Chen, Xin Gao

Medical artificial general intelligence (AGI) is an emerging field that aims to develop systems specifically designed for medical applications that possess the ability to understand, learn, and apply knowledge across a wide range of tasks and domains. Large language models (LLMs) represent a significant step towards AGI. However, training cross-domain LLMs in the medical field poses significant challenges primarily attributed to the requirement of collecting data from diverse domains. This task becomes particularly difficult due to privacy restrictions and the scarcity of publicly available medical datasets. Here, we propose Medical AGI (MedAGI), a paradigm to unify domain-specific medical LLMs with the lowest cost, and suggest a possible path to achieve medical AGI. With an increasing number of domain-specific professional multimodal LLMs in the medical field being developed, MedAGI is designed to automatically select appropriate medical models by analyzing users' questions with our novel adaptive expert selection algorithm. It offers a unified approach to existing LLMs in the medical field, eliminating the need for retraining regardless of the introduction of new models. This characteristic renders it a future-proof solution in the dynamically advancing medical domain. To showcase the resilience of MedAGI, we conducted an evaluation across three distinct medical domains: dermatology diagnosis, X-ray diagnosis, and analysis of pathology pictures. The results demonstrated that MedAGI exhibited remarkable versatility and scalability, delivering exceptional performance across diverse domains. Our code is publicly available to facilitate further research at https://github.com/JoshuaChou2018/MedAGI.

Juexiao Zhou, Xiaonan He, Liyuan Sun et al.

Skin and subcutaneous diseases rank high among the leading contributors to the global burden of nonfatal diseases, impacting a considerable portion of the population. Nonetheless, the field of dermatology diagnosis faces three significant hurdles. Firstly, there is a shortage of dermatologists accessible to diagnose patients, particularly in rural regions. Secondly, accurately interpreting skin disease images poses a considerable challenge. Lastly, generating patient-friendly diagnostic reports is usually a time-consuming and labor-intensive task for dermatologists. To tackle these challenges, we present SkinGPT-4, which is the world's first interactive dermatology diagnostic system powered by an advanced visual large language model. SkinGPT-4 leverages a fine-tuned version of MiniGPT-4, trained on an extensive collection of skin disease images (comprising 52,929 publicly available and proprietary images) along with clinical concepts and doctors' notes. We designed a two-step training process to allow SkinGPT to express medical features in skin disease images with natural language and make accurate diagnoses of the types of skin diseases. With SkinGPT-4, users could upload their own skin photos for diagnosis, and the system could autonomously evaluate the images, identifies the characteristics and categories of the skin conditions, performs in-depth analysis, and provides interactive treatment recommendations. Meanwhile, SkinGPT-4's local deployment capability and commitment to user privacy also render it an appealing choice for patients in search of a dependable and precise diagnosis of their skin ailments. To demonstrate the robustness of SkinGPT-4, we conducted quantitative evaluations on 150 real-life cases, which were independently reviewed by certified dermatologists, and showed that SkinGPT-4 could provide accurate diagnoses of skin diseases.

Juexiao Zhou, Bin Zhang, Xiuying Chen et al.

With the fast-growing and evolving omics data, the demand for streamlined and adaptable tools to handle the analysis continues to grow. In response to this need, we introduce Auto Bioinformatics Analysis (AutoBA), an autonomous AI agent based on a large language model designed explicitly for conventional omics data analysis. AutoBA simplifies the analytical process by requiring minimal user input while delivering detailed step-by-step plans for various bioinformatics tasks. Through rigorous validation by expert bioinformaticians, AutoBA's robustness and adaptability are affirmed across a diverse range of omics analysis cases, including whole genome sequencing (WGS), RNA sequencing (RNA-seq), single-cell RNA-seq, ChIP-seq, and spatial transcriptomics. AutoBA's unique capacity to self-design analysis processes based on input data variations further underscores its versatility. Compared with online bioinformatic services, AutoBA deploys the analysis locally, preserving data privacy. Moreover, different from the predefined pipeline, AutoBA has adaptability in sync with emerging bioinformatics tools. Overall, AutoBA represents a convenient tool, offering robustness and adaptability for complex omics data analysis.

Xiuying Chen, Tairan Wang, Juexiao Zhou et al.

Artificial intelligence (AI) systems, particularly those based on deep learning models, have increasingly achieved expert-level performance in medical applications. However, there is growing concern that such AI systems may reflect and amplify human bias, and reduce the quality of their performance in historically under-served populations. The fairness issue has attracted considerable research interest in the medical imaging classification field, yet it remains understudied in the text generation domain. In this study, we investigate the fairness problem in text generation within the medical field and observe significant performance discrepancies across different races, sexes, and age groups, including intersectional groups, various model scales, and different evaluation metrics. To mitigate this fairness issue, we propose an algorithm that selectively optimizes those underperformed groups to reduce bias. The selection rules take into account not only word-level accuracy but also the pathology accuracy to the target reference, while ensuring that the entire process remains fully differentiable for effective model training. Our evaluations across multiple backbones, datasets, and modalities demonstrate that our proposed algorithm enhances fairness in text generation without compromising overall performance. Specifically, the disparities among various groups across different metrics were diminished by more than 30% with our algorithm, while the relative change in text generation accuracy was typically within 2%. By reducing the bias generated by deep learning models, our proposed approach can potentially alleviate concerns about the fairness and reliability of text generation diagnosis in medical domain. Our code is publicly available to facilitate further research at https://github.com/iriscxy/GenFair.

Yuetan Chu, Gongning Luo, Longxi Zhou et al.

Pulmonary artery-vein segmentation is crucial for disease diagnosis and surgical planning and is traditionally achieved by Computed Tomography Pulmonary Angiography (CTPA). However, concerns regarding adverse health effects from contrast agents used in CTPA have constrained its clinical utility. In contrast, identifying arteries and veins using non-contrast CT, a conventional and low-cost clinical examination routine, has long been considered impossible. Here we propose a High-abundant Pulmonary Artery-vein Segmentation (HiPaS) framework achieving accurate artery-vein segmentation on both non-contrast CT and CTPA across various spatial resolutions. HiPaS first performs spatial normalization on raw CT volumes via a super-resolution module, and then iteratively achieves segmentation results at different branch levels by utilizing the lower-level vessel segmentation as a prior for higher-level vessel segmentation. We trained and validated HiPaS on our established multi-centric dataset comprising 1,073 CT volumes with meticulous manual annotations. Both quantitative experiments and clinical evaluation demonstrated the superior performance of HiPaS, achieving an average dice score of 91.8% and a sensitivity of 98.0%. Further experiments showed the non-inferiority of HiPaS segmentation on non-contrast CT compared to segmentation on CTPA. Employing HiPaS, we have conducted an anatomical study of pulmonary vasculature on 11,784 participants in China (six sites), discovering a new association of pulmonary vessel anatomy with sex, age, and disease states: vessel abundance suggests a significantly higher association with females than males with slightly decreasing with age, and is also influenced by certain diseases, under the controlling of lung volumes.