Puyang Wang

Zihan Li, Yunxiang Li, Qingde Li et al. · uw

Deep learning has been widely used in medical image segmentation and other aspects. However, the performance of existing medical image segmentation models has been limited by the challenge of obtaining sufficient high-quality labeled data due to the prohibitive data annotation cost. To alleviate this limitation, we propose a new text-augmented medical image segmentation model LViT (Language meets Vision Transformer). In our LViT model, medical text annotation is incorporated to compensate for the quality deficiency in image data. In addition, the text information can guide to generate pseudo labels of improved quality in the semi-supervised learning. We also propose an Exponential Pseudo label Iteration mechanism (EPI) to help the Pixel-Level Attention Module (PLAM) preserve local image features in semi-supervised LViT setting. In our model, LV (Language-Vision) loss is designed to supervise the training of unlabeled images using text information directly. For evaluation, we construct three multimodal medical segmentation datasets (image + text) containing X-rays and CT images. Experimental results show that our proposed LViT has superior segmentation performance in both fully-supervised and semi-supervised setting. The code and datasets are available at https://github.com/HUANGLIZI/LViT.

Zi Li, Lin Tian, Tony C. W. Mok et al. · harvard

Estimating displacement vector field via a cost volume computed in the feature space has shown great success in image registration, but it suffers excessive computation burdens. Moreover, existing feature descriptors only extract local features incapable of representing the global semantic information, which is especially important for solving large transformations. To address the discussed issues, we propose SAMConvex, a fast coarse-to-fine discrete optimization method for CT registration that includes a decoupled convex optimization procedure to obtain deformation fields based on a self-supervised anatomical embedding (SAM) feature extractor that captures both local and global information. To be specific, SAMConvex extracts per-voxel features and builds 6D correlation volumes based on SAM features, and iteratively updates a flow field by performing lookups on the correlation volumes with a coarse-to-fine scheme. SAMConvex outperforms the state-of-the-art learning-based methods and optimization-based methods over two inter-patient registration datasets (Abdomen CT and HeadNeck CT) and one intra-patient registration dataset (Lung CT). Moreover, as an optimization-based method, SAMConvex only takes $\sim2$s ($\sim5s$ with instance optimization) for one paired images.

Minghui Zhang, Yangqian Wu, Hanxiao Zhang et al. · harvard

Open international challenges are becoming the de facto standard for assessing computer vision and image analysis algorithms. In recent years, new methods have extended the reach of pulmonary airway segmentation that is closer to the limit of image resolution. Since EXACT'09 pulmonary airway segmentation, limited effort has been directed to quantitative comparison of newly emerged algorithms driven by the maturity of deep learning based approaches and clinical drive for resolving finer details of distal airways for early intervention of pulmonary diseases. Thus far, public annotated datasets are extremely limited, hindering the development of data-driven methods and detailed performance evaluation of new algorithms. To provide a benchmark for the medical imaging community, we organized the Multi-site, Multi-domain Airway Tree Modeling (ATM'22), which was held as an official challenge event during the MICCAI 2022 conference. ATM'22 provides large-scale CT scans with detailed pulmonary airway annotation, including 500 CT scans (300 for training, 50 for validation, and 150 for testing). The dataset was collected from different sites and it further included a portion of noisy COVID-19 CTs with ground-glass opacity and consolidation. Twenty-three teams participated in the entire phase of the challenge and the algorithms for the top ten teams are reviewed in this paper. Quantitative and qualitative results revealed that deep learning models embedded with the topological continuity enhancement achieved superior performance in general. ATM'22 challenge holds as an open-call design, the training data and the gold standard evaluation are available upon successful registration via its homepage.

Xirui Hou, Pengfei Guo, Puyang Wang et al.

Cerebrovascular disease is a leading cause of death globally. Prevention and early intervention are known to be the most effective forms of its management. Non-invasive imaging methods hold great promises for early stratification, but at present lack the sensitivity for personalized prognosis. Resting-state functional magnetic resonance imaging (rs-fMRI), a powerful tool previously used for mapping neural activity, is available in most hospitals. Here we show that rs-fMRI can be used to map cerebral hemodynamic function and delineate impairment. By exploiting time variations in breathing pattern during rs-fMRI, deep learning enables reproducible mapping of cerebrovascular reactivity (CVR) and bolus arrive time (BAT) of the human brain using resting-state CO2 fluctuations as a natural 'contrast media'. The deep-learning network was trained with CVR and BAT maps obtained with a reference method of CO2-inhalation MRI, which included data from young and older healthy subjects and patients with Moyamoya disease and brain tumors. We demonstrate the performance of deep-learning cerebrovascular mapping in the detection of vascular abnormalities, evaluation of revascularization effects, and vascular alterations in normal aging. In addition, cerebrovascular maps obtained with the proposed method exhibited excellent reproducibility in both healthy volunteers and stroke patients. Deep-learning resting-state vascular imaging has the potential to become a useful tool in clinical cerebrovascular imaging.

Zhanghexuan Ji, Dazhou Guo, Puyang Wang et al.

Deep learning empowers the mainstream medical image segmentation methods. Nevertheless current deep segmentation approaches are not capable of efficiently and effectively adapting and updating the trained models when new incremental segmentation classes (along with new training datasets or not) are required to be added. In real clinical environment, it can be preferred that segmentation models could be dynamically extended to segment new organs/tumors without the (re-)access to previous training datasets due to obstacles of patient privacy and data storage. This process can be viewed as a continual semantic segmentation (CSS) problem, being understudied for multi-organ segmentation. In this work, we propose a new architectural CSS learning framework to learn a single deep segmentation model for segmenting a total of 143 whole-body organs. Using the encoder/decoder network structure, we demonstrate that a continually-trained then frozen encoder coupled with incrementally-added decoders can extract and preserve sufficiently representative image features for new classes to be subsequently and validly segmented. To maintain a single network model complexity, we trim each decoder progressively using neural architecture search and teacher-student based knowledge distillation. To incorporate with both healthy and pathological organs appearing in different datasets, a novel anomaly-aware and confidence learning module is proposed to merge the overlapped organ predictions, originated from different decoders. Trained and validated on 3D CT scans of 2500+ patients from four datasets, our single network can segment total 143 whole-body organs with very high accuracy, closely reaching the upper bound performance level by training four separate segmentation models (i.e., one model per dataset/task).

Puyang Wang, Dazhou Guo, Dandan Zheng et al.

Intrathoracic airway segmentation in computed tomography (CT) is a prerequisite for various respiratory disease analyses such as chronic obstructive pulmonary disease (COPD), asthma and lung cancer. Unlike other organs with simpler shapes or topology, the airway's complex tree structure imposes an unbearable burden to generate the "ground truth" label (up to 7 or 3 hours of manual or semi-automatic annotation on each case). Most of the existing airway datasets are incompletely labeled/annotated, thus limiting the completeness of computer-segmented airway. In this paper, we propose a new anatomy-aware multi-class airway segmentation method enhanced by topology-guided iterative self-learning. Based on the natural airway anatomy, we formulate a simple yet highly effective anatomy-aware multi-class segmentation task to intuitively handle the severe intra-class imbalance of the airway. To solve the incomplete labeling issue, we propose a tailored self-iterative learning scheme to segment toward the complete airway tree. For generating pseudo-labels to achieve higher sensitivity , we introduce a novel breakage attention map and design a topology-guided pseudo-label refinement method by iteratively connecting breaking branches commonly existed from initial pseudo-labels. Extensive experiments have been conducted on four datasets including two public challenges. The proposed method ranked 1st in both EXACT'09 challenge using average score and ATM'22 challenge on weighted average score. In a public BAS dataset and a private lung cancer dataset, our method significantly improves previous leading approaches by extracting at least (absolute) 7.5% more detected tree length and 4.0% more tree branches, while maintaining similar precision.

Puyang Wang, Pengfei Guo, Keyi Chai et al.

Clinical MRI encompasses diverse imaging protocols--spanning anatomical targets (cardiac, brain, knee), contrasts (T1, T2, mapping), sampling patterns (Cartesian, radial, spiral, kt-space), and acceleration factors--yet current deep learning reconstructions are typically protocol-specific, hindering generalization and deployment. We introduce Scalable Deep Unrolled Model (SDUM), a universal framework combining a Restormer-based reconstructor, a learned coil sensitivity map estimator (CSME), sampling-aware weighted data consistency (SWDC), universal conditioning (UC) on cascade index and protocol metadata, and progressive cascade expansion training. SDUM exhibits foundation-model-like scaling behavior: reconstruction quality follows PSNR ${\sim}$ log(parameters) with correlation $r{=}0.986$ ($R^2{=}0.973$) up to 18 cascades, demonstrating predictable performance gains with model depth. A single SDUM trained on heterogeneous data achieves state-of-the-art results across all four CMRxRecon2025 challenge tracks--multi-center, multi-disease, 5T, and pediatric--without task-specific fine-tuning, surpassing specialized baselines by up to ${+}1.0$~dB. On CMRxRecon2024, SDUM outperforms the winning method PromptMR+ by ${+}0.55$~dB; on fastMRI brain, it exceeds PC-RNN by ${+}1.8$~dB. Ablations validate each component: SWDC ${+}0.43$~dB over standard DC, per-cascade CSME ${+}0.51$~dB, UC ${+}0.38$~dB. These results establish SDUM as a practical path toward universal, scalable MRI reconstruction.

Pengfei Guo, Puyang Wang, Jinyuan Zhou et al.

Fast and accurate reconstruction of magnetic resonance (MR) images from under-sampled data is important in many clinical applications. In recent years, deep learning-based methods have been shown to produce superior performance on MR image reconstruction. However, these methods require large amounts of data which is difficult to collect and share due to the high cost of acquisition and medical data privacy regulations. In order to overcome this challenge, we propose a federated learning (FL) based solution in which we take advantage of the MR data available at different institutions while preserving patients' privacy. However, the generalizability of models trained with the FL setting can still be suboptimal due to domain shift, which results from the data collected at multiple institutions with different sensors, disease types, and acquisition protocols, etc. With the motivation of circumventing this challenge, we propose a cross-site modeling for MR image reconstruction in which the learned intermediate latent features among different source sites are aligned with the distribution of the latent features at the target site. Extensive experiments are conducted to provide various insights about FL for MR image reconstruction. Experimental results demonstrate that the proposed framework is a promising direction to utilize multi-institutional data without compromising patients' privacy for achieving improved MR image reconstruction. Our code will be available at https://github.com/guopengf/FLMRCM.

Dazhou Guo, Zhanghexuan Ji, Yanzhou Su et al.

Precision medicine in the quantitative management of chronic diseases and oncology would be greatly improved if the Computed Tomography (CT) scan of any patient could be segmented, parsed and analyzed in a precise and detailed way. However, there is no such fully annotated CT dataset with all anatomies delineated for training because of the exceptionally high manual cost, the need for specialized clinical expertise, and the time required to finish the task. To this end, we proposed a novel continual learning-driven CT model that can segment complete anatomies presented using dozens of previously partially labeled datasets, dynamically expanding its capacity to segment new ones without compromising previously learned organ knowledge. Existing multi-dataset approaches are not able to dynamically segment new anatomies without catastrophic forgetting and would encounter optimization difficulty or infeasibility when segmenting hundreds of anatomies across the whole range of body regions. Our single unified CT segmentation model, CL-Net, can highly accurately segment a clinically comprehensive set of 235 fine-grained whole-body anatomies. Composed of a universal encoder, multiple optimized and pruned decoders, CL-Net is developed using 13,952 CT scans from 20 public and 16 private high-quality partially labeled CT datasets of various vendors, different contrast phases, and pathologies. Extensive evaluation demonstrates that CL-Net consistently outperforms the upper limit of an ensemble of 36 specialist nnUNets trained per dataset with the complexity of 5% model size and significantly surpasses the segmentation accuracy of recent leading Segment Anything-style medical image foundation models by large margins. Our continual learning-driven CL-Net model would lay a solid foundation to facilitate many downstream tasks of oncology and chronic diseases using the most widely adopted CT imaging.

Pengfei Guo, Jeya Maria Jose Valanarasu, Puyang Wang et al.

Reconstructing magnetic resonance (MR) images from undersampled data is a challenging problem due to various artifacts introduced by the under-sampling operation. Recent deep learning-based methods for MR image reconstruction usually leverage a generic auto-encoder architecture which captures low-level features at the initial layers and high-level features at the deeper layers. Such networks focus much on global features which may not be optimal to reconstruct the fully-sampled image. In this paper, we propose an Over-and-Under Complete Convolutional Recurrent Neural Network (OUCR), which consists of an overcomplete and an undercomplete Convolutional Recurrent Neural Network(CRNN). The overcomplete branch gives special attention in learning local structures by restraining the receptive field of the network. Combining it with the undercomplete branch leads to a network which focuses more on low-level features without losing out on the global structures. Extensive experiments on two datasets demonstrate that the proposed method achieves significant improvements over the compressed sensing and popular deep learning-based methods with less number of trainable parameters.

Pengfei Guo, Puyang Wang, Rajeev Yasarla et al.

Data-driven automatic approaches have demonstrated their great potential in resolving various clinical diagnostic dilemmas in neuro-oncology, especially with the help of standard anatomic and advanced molecular MR images. However, data quantity and quality remain a key determinant of, and a significant limit on, the potential of such applications. In our previous work, we explored synthesis of anatomic and molecular MR image network (SAMR) in patients with post-treatment malignant glioms. Now, we extend it and propose Confidence Guided SAMR (CG-SAMR) that synthesizes data from lesion information to multi-modal anatomic sequences, including T1-weighted (T1w), gadolinium enhanced T1w (Gd-T1w), T2-weighted (T2w), and fluid-attenuated inversion recovery (FLAIR), and the molecular amide proton transfer-weighted (APTw) sequence. We introduce a module which guides the synthesis based on confidence measure about the intermediate results. Furthermore, we extend the proposed architecture for unsupervised synthesis so that unpaired data can be used for training the network. Extensive experiments on real clinical data demonstrate that the proposed model can perform better than the state-of-theart synthesis methods.

Pengfei Guo, Puyang Wang, Jinyuan Zhou et al.

Data-driven automatic approaches have demonstrated their great potential in resolving various clinical diagnostic dilemmas for patients with malignant gliomas in neuro-oncology with the help of conventional and advanced molecular MR images. However, the lack of sufficient annotated MRI data has vastly impeded the development of such automatic methods. Conventional data augmentation approaches, including flipping, scaling, rotation, and distortion are not capable of generating data with diverse image content. In this paper, we propose a method, called synthesis of anatomic and molecular MR images network (SAMR), which can simultaneously synthesize data from arbitrary manipulated lesion information on multiple anatomic and molecular MRI sequences, including T1-weighted (T1w), gadolinium enhanced T1w (Gd-T1w), T2-weighted (T2w), fluid-attenuated inversion recovery (FLAIR), and amide proton transfer-weighted (APTw). The proposed framework consists of a stretch-out up-sampling module, a brain atlas encoder, a segmentation consistency module, and multi-scale label-wise discriminators. Extensive experiments on real clinical data demonstrate that the proposed model can perform significantly better than the state-of-the-art synthesis methods.

Jeya Maria Jose V., Rajeev Yasarla, Puyang Wang et al.

Automatic segmentation of anatomical landmarks from ultrasound (US) plays an important role in the management of preterm neonates with a very low birth weight due to the increased risk of developing intraventricular hemorrhage (IVH) or other complications. One major problem in developing an automatic segmentation method for this task is the limited availability of annotated data. To tackle this issue, we propose a novel image synthesis method using multi-scale self attention generator to synthesize US images from various segmentation masks. We show that our method can synthesize high-quality US images for every manipulated segmentation label with qualitative and quantitative improvements over the recent state-of-the-art synthesis methods. Furthermore, for the segmentation task, we propose a novel method, called Confidence-guided Brain Anatomy Segmentation (CBAS) network, where segmentation and corresponding confidence maps are estimated at different scales. In addition, we introduce a technique which guides CBAS to learn the weights based on the confidence measure about the estimate. Extensive experiments demonstrate that the proposed method for both synthesis and segmentation tasks achieve significant improvements over the recent state-of-the-art methods. In particular, we show that the new synthesis framework can be used to generate realistic US images which can be used to improve the performance of a segmentation algorithm.

Eric Z. Chen, Puyang Wang, Xiao Chen et al.

Fast and accurate MRI image reconstruction from undersampled data is crucial in clinical practice. Deep learning based reconstruction methods have shown promising advances in recent years. However, recovering fine details from undersampled data is still challenging. In this paper, we introduce a novel deep learning based method, Pyramid Convolutional RNN (PC-RNN), to reconstruct images from multiple scales. Based on the formulation of MRI reconstruction as an inverse problem, we design the PC-RNN model with three convolutional RNN (ConvRNN) modules to iteratively learn the features in multiple scales. Each ConvRNN module reconstructs images at different scales and the reconstructed images are combined by a final CNN module in a pyramid fashion. The multi-scale ConvRNN modules learn a coarse-to-fine image reconstruction. Unlike other common reconstruction methods for parallel imaging, PC-RNN does not employ coil sensitive maps for multi-coil data and directly model the multiple coils as multi-channel inputs. The coil compression technique is applied to standardize data with various coil numbers, leading to more efficient training. We evaluate our model on the fastMRI knee and brain datasets and the results show that the proposed model outperforms other methods and can recover more details. The proposed method is one of the winner solutions in the 2019 fastMRI competition.

Puyang Wang, Vishal M. Patel, Ilker Hacihaliloglu

Various imaging artifacts, low signal-to-noise ratio, and bone surfaces appearing several millimeters in thickness have hindered the success of ultrasound (US) guided computer assisted orthopedic surgery procedures. In this work, a multi-feature guided convolutional neural network (CNN) architecture is proposed for simultaneous enhancement, segmentation, and classification of bone surfaces from US data. The proposed CNN consists of two main parts: a pre-enhancing net, that takes the concatenation of B-mode US scan and three filtered image features for the enhancement of bone surfaces, and a modified U-net with a classification layer. The proposed method was validated on 650 in vivo US scans collected using two US machines, by scanning knee, femur, distal radius and tibia bones. Validation, against expert annotation, achieved statistically significant improvements in segmentation of bone surfaces compared to state-of-the-art.

Puyang Wang, Vishal M. Patel

We propose a novel approach for generating high quality visible-like images from Synthetic Aperture Radar (SAR) images using Deep Convolutional Generative Adversarial Network (GAN) architectures. The proposed approach is based on a cascaded network of convolutional neural nets (CNNs) for despeckling and image colorization. The cascaded structure results in faster convergence during training and produces high quality visible images from the corresponding SAR images. Experimental results on both simulated and real SAR images show that the proposed method can produce visible-like images better compared to the recent state-of-the-art deep learning-based methods.

Puyang Wang, He Zhang, Vishal M. Patel

Synthetic Aperture Radar (SAR) images are often contaminated by a multiplicative noise known as speckle. Speckle makes the processing and interpretation of SAR images difficult. We propose a deep learning-based approach called, Image Despeckling Convolutional Neural Network (ID-CNN), for automatically removing speckle from the input noisy images. In particular, ID-CNN uses a set of convolutional layers along with batch normalization and rectified linear unit (ReLU) activation function and a component-wise division residual layer to estimate speckle and it is trained in an end-to-end fashion using a combination of Euclidean loss and Total Variation (TV) loss. Extensive experiments on synthetic and real SAR images show that the proposed method achieves significant improvements over the state-of-the-art speckle reduction methods.