Zifan Chen

Hexin Dong, Zifan Chen, Mingze Yuan et al.

As one of the most challenging and practical segmentation tasks, open-world semantic segmentation requires the model to segment the anomaly regions in the images and incrementally learn to segment out-of-distribution (OOD) objects, especially under a few-shot condition. The current state-of-the-art (SOTA) method, Deep Metric Learning Network (DMLNet), relies on pixel-level metric learning, with which the identification of similar regions having different semantics is difficult. Therefore, we propose a method called region-aware metric learning (RAML), which first separates the regions of the images and generates region-aware features for further metric learning. RAML improves the integrity of the segmented anomaly regions. Moreover, we propose a novel meta-channel aggregation (MCA) module to further separate anomaly regions, forming high-quality sub-region candidates and thereby improving the model performance for OOD objects. To evaluate the proposed RAML, we have conducted extensive experiments and ablation studies on Lost And Found and Road Anomaly datasets for anomaly segmentation and the CityScapes dataset for incremental few-shot learning. The results show that the proposed RAML achieves SOTA performance in both stages of open world segmentation. Our code and appendix are available at https://github.com/czifan/RAML.

Mingze Yuan, Peng Bao, Jiajia Yuan et al.

With the rapid development of artificial intelligence, large language models (LLMs) have shown promising capabilities in mimicking human-level language comprehension and reasoning. This has sparked significant interest in applying LLMs to enhance various aspects of healthcare, ranging from medical education to clinical decision support. However, medicine involves multifaceted data modalities and nuanced reasoning skills, presenting challenges for integrating LLMs. This paper provides a comprehensive review on the applications and implications of LLMs in medicine. It begins by examining the fundamental applications of general-purpose and specialized LLMs, demonstrating their utilities in knowledge retrieval, research support, clinical workflow automation, and diagnostic assistance. Recognizing the inherent multimodality of medicine, the review then focuses on multimodal LLMs, investigating their ability to process diverse data types like medical imaging and EHRs to augment diagnostic accuracy. To address LLMs' limitations regarding personalization and complex clinical reasoning, the paper explores the emerging development of LLM-powered autonomous agents for healthcare. Furthermore, it summarizes the evaluation methodologies for assessing LLMs' reliability and safety in medical contexts. Overall, this review offers an extensive analysis on the transformative potential of LLMs in modern medicine. It also highlights the pivotal need for continuous optimizations and ethical oversight before these models can be effectively integrated into clinical practice. Visit https://github.com/mingze-yuan/Awesome-LLM-Healthcare for an accompanying GitHub repository containing latest papers.

Mingze Yuan, Yingda Xia, Hexin Dong et al.

Real-world medical image segmentation has tremendous long-tailed complexity of objects, among which tail conditions correlate with relatively rare diseases and are clinically significant. A trustworthy medical AI algorithm should demonstrate its effectiveness on tail conditions to avoid clinically dangerous damage in these out-of-distribution (OOD) cases. In this paper, we adopt the concept of object queries in Mask Transformers to formulate semantic segmentation as a soft cluster assignment. The queries fit the feature-level cluster centers of inliers during training. Therefore, when performing inference on a medical image in real-world scenarios, the similarity between pixels and the queries detects and localizes OOD regions. We term this OOD localization as MaxQuery. Furthermore, the foregrounds of real-world medical images, whether OOD objects or inliers, are lesions. The difference between them is less than that between the foreground and background, possibly misleading the object queries to focus redundantly on the background. Thus, we propose a query-distribution (QD) loss to enforce clear boundaries between segmentation targets and other regions at the query level, improving the inlier segmentation and OOD indication. Our proposed framework is tested on two real-world segmentation tasks, i.e., segmentation of pancreatic and liver tumors, outperforming previous state-of-the-art algorithms by an average of 7.39% on AUROC, 14.69% on AUPR, and 13.79% on FPR95 for OOD localization. On the other hand, our framework improves the performance of inlier segmentation by an average of 5.27% DSC when compared with the leading baseline nnUNet.

Zifan Chen, Jie Zhao, Hao Yu et al.

Accurate and efficient lumbar spine disease identification is crucial for clinical diagnosis. However, existing deep learning models with millions of parameters often fail to learn with only hundreds or dozens of medical images. These models also ignore the contextual relationship between adjacent objects, such as between vertebras and intervertebral discs. This work introduces a multi-scale context-guided network with coarse-to-fine localization and classification, named CCF-Net, for lumbar spine disease identification. Specifically, in learning, we divide the localization objective into two parallel tasks, coarse and fine, which are more straightforward and effectively reduce the number of parameters and computational cost. The experimental results show that the coarse-to-fine design presents the potential to achieve high performance with fewer parameters and data requirements. Moreover, the multi-scale context-guided module can significantly improve the performance by 6.45% and 5.51% with ResNet18 and ResNet50, respectively. Our code is available at https://github.com/czifan/CCFNet.pytorch.

Zifan Chen, Xinyu Nan, Jiazheng Li et al.

Volumetric segmentation is important in medical imaging, but current methods face challenges like requiring lots of manual annotations and being tailored to specific tasks, which limits their versatility. General segmentation models used for natural images don't perform well with the unique features of medical images. There's a strong need for an adaptable approach that can effectively handle different 3D medical structures and imaging modalities. In this study, we present PAM (Propagating Anything Model), a segmentation approach that uses a 2D prompt, like a bounding box or sketch, to create a complete 3D segmentation of medical image volumes. PAM works by modeling relationships between slices, maintaining information flow across the 3D structure. It combines a CNN-based UNet for processing within slices and a Transformer-based attention module for propagating information between slices, leading to better generalizability across various imaging modalities. PAM significantly outperformed existing models like MedSAM and SegVol, with an average improvement of over 18.1% in dice similarity coefficient (DSC) across 44 medical datasets and various object types. It also showed stable performance despite prompt deviations and different propagation setups, and faster inference speeds compared to other models. PAM's one-view prompt design made it more efficient, reducing interaction time by about 63.6% compared to two-view prompts. Thanks to its focus on structural relationships, PAM handled unseen and complex objects well, showing a unique ability to generalize to new situations. PAM represents an advancement in medical image segmentation, effectively reducing the need for extensive manual work and specialized training. Its adaptability makes it a promising tool for more automated and reliable analysis in clinical settings.

Xinyu Nan, Meng He, Zifan Chen et al.

The incidence of gastrointestinal cancers remains significantly high, particularly in China, emphasizing the importance of accurate prognostic assessments and effective treatment strategies. Research shows a strong correlation between abdominal muscle and fat tissue composition and patient outcomes. However, existing manual methods for analyzing abdominal tissue composition are time-consuming and costly, limiting clinical research scalability. To address these challenges, we developed an AI-driven tool for automated analysis of abdominal CT scans to effectively identify and segment muscle, subcutaneous fat, and visceral fat. Our tool integrates a multi-view localization model and a high-precision 2D nnUNet-based segmentation model, demonstrating a localization accuracy of 90% and a Dice Score Coefficient of 0.967 for segmentation. Furthermore, it features an interactive interface that allows clinicians to refine the segmentation results, ensuring high-quality outcomes effectively. Our tool offers a standardized method for effectively extracting critical abdominal tissues, potentially enhancing the management and treatment for gastrointestinal cancers. The code is available at https://github.com/NanXinyu/AI-Tool4Abdominal-Seg.git}{https://github.com/NanXinyu/AI-Tool4Abdominal-Seg.git.

Zifan Chen, Jiazheng Li, Jie Zhao et al.

**Background:** Accurate 3D CT scan segmentation of gastric tumors is pivotal for diagnosis and treatment. The challenges lie in the irregular shapes, blurred boundaries of tumors, and the inefficiency of existing methods. **Purpose:** We conducted a study to introduce a model, utilizing human-guided knowledge and unique modules, to address the challenges of 3D tumor segmentation. **Methods:** We developed the PropNet framework, propagating radiologists' knowledge from 2D annotations to the entire 3D space. This model consists of a proposing stage for coarse segmentation and a refining stage for improved segmentation, using two-way branches for enhanced performance and an up-down strategy for efficiency. **Results:** With 98 patient scans for training and 30 for validation, our method achieves a significant agreement with manual annotation (Dice of 0.803) and improves efficiency. The performance is comparable in different scenarios and with various radiologists' annotations (Dice between 0.785 and 0.803). Moreover, the model shows improved prognostic prediction performance (C-index of 0.620 vs. 0.576) on an independent validation set of 42 patients with advanced gastric cancer. **Conclusions:** Our model generates accurate tumor segmentation efficiently and stably, improving prognostic performance and reducing high-throughput image reading workload. This model can accelerate the quantitative analysis of gastric tumors and enhance downstream task performance.

ZiFan Chen, Xin Qin, Chao Yang et al.

The existing human pose estimation methods are confronted with inaccurate long-distance regression or high computational cost due to the complex learning objectives. This work proposes a novel deep learning framework for human pose estimation called composite localization to divide the complex learning objective into two simpler ones: a sparse heatmap to find the keypoint's approximate location and two short-distance offsetmaps to obtain its final precise coordinates. To realize the framework, we construct two types of composite localization networks: CLNet-ResNet and CLNet-Hourglass. We evaluate the networks on three benchmark datasets, including the Leeds Sports Pose dataset, the MPII Human Pose dataset, and the COCO keypoints detection dataset. The experimental results show that our CLNet-ResNet50 outperforms SimpleBaseline by 1.14% with about 1/2 GFLOPs. Our CLNet-Hourglass outperforms the original stacked-hourglass by 4.45% on COCO.