Qingsong Yao

Fenghe Tang, Ronghao Xu, Qingsong Yao et al.

The generative self-supervised learning strategy exhibits remarkable learning representational capabilities. However, there is limited attention to end-to-end pre-training methods based on a hybrid architecture of CNN and Transformer, which can learn strong local and global representations simultaneously. To address this issue, we propose a generative pre-training strategy called Hybrid Sparse masKing (HySparK) based on masked image modeling and apply it to large-scale pre-training on medical images. First, we perform a bottom-up 3D hybrid masking strategy on the encoder to keep consistency masking. Then we utilize sparse convolution for the top CNNs and encode unmasked patches for the bottom vision Transformers. Second, we employ a simple hierarchical decoder with skip-connections to achieve dense multi-scale feature reconstruction. Third, we implement our pre-training method on a collection of multiple large-scale 3D medical imaging datasets. Extensive experiments indicate that our proposed pre-training strategy demonstrates robust transfer-ability in supervised downstream tasks and sheds light on HySparK's promising prospects. The code is available at https://github.com/FengheTan9/HySparK

Heqin Zhu, Qingsong Yao, S. Kevin Zhou

Accurate anatomical landmark detection plays an increasingly vital role in medical image analysis. Although existing methods achieve satisfying performance, they are mostly based on CNN and specialized for a single domain say associated with a particular anatomical region. In this work, we propose a universal model for multi-domain landmark detection by taking advantage of transformer for modeling long dependencies and develop a domain-adaptive transformer model, named as DATR, which is trained on multiple mixed datasets from different anatomies and capable of detecting landmarks of any image from those anatomies. The proposed DATR exhibits three primary features: (i) It is the first universal model which introduces transformer as an encoder for multi-anatomy landmark detection; (ii) We design a domain-adaptive transformer for anatomy-aware landmark detection, which can be effectively extended to any other transformer network; (iii) Following previous studies, we employ a light-weighted guidance network, which encourages the transformer network to detect more accurate landmarks. We carry out experiments on three widely used X-ray datasets for landmark detection, which have 1,588 images and 62 landmarks in total, including three different anatomies (head, hand, and chest). Experimental results demonstrate that our proposed DATR achieves state-of-the-art performances by most metrics and behaves much better than any previous convolution-based models. The code will be released publicly.

Haoran Lai, Qingsong Yao, Zihang Jiang et al.

The advancement of Zero-Shot Learning in the medical domain has been driven forward by using pre-trained models on large-scale image-text pairs, focusing on image-text alignment. However, existing methods primarily rely on cosine similarity for alignment, which may not fully capture the complex relationship between medical images and reports. To address this gap, we introduce a novel approach called Cross-Attention Alignment for Radiology Zero-Shot Classification (CARZero). Our approach innovatively leverages cross-attention mechanisms to process image and report features, creating a Similarity Representation that more accurately reflects the intricate relationships in medical semantics. This representation is then linearly projected to form an image-text similarity matrix for cross-modality alignment. Additionally, recognizing the pivotal role of prompt selection in zero-shot learning, CARZero incorporates a Large Language Model-based prompt alignment strategy. This strategy standardizes diverse diagnostic expressions into a unified format for both training and inference phases, overcoming the challenges of manual prompt design. Our approach is simple yet effective, demonstrating state-of-the-art performance in zero-shot classification on five official chest radiograph diagnostic test sets, including remarkable results on datasets with long-tail distributions of rare diseases. This achievement is attributed to our new image-text alignment strategy, which effectively addresses the complex relationship between medical images and reports. Code and models are available at https://github.com/laihaoran/CARZero.

Wenxin Ma, Qingsong Yao, Xiang Zhang et al.

Unsupervised anomaly detection (UAD) from images strives to model normal data distributions, creating discriminative representations to distinguish and precisely localize anomalies. Despite recent advancements in the efficient and unified one-for-all scheme, challenges persist in accurately segmenting anomalies for further monitoring. Moreover, this problem is obscured by the widely-used AUROC metric under imbalanced UAD settings. This motivates us to emphasize the significance of precise segmentation of anomaly pixels using pAP and DSC as metrics. To address the unsolved segmentation task, we introduce the Unified Anomaly Segmentation (UniAS). UniAS presents a multi-level hybrid pipeline that progressively enhances normal information from coarse to fine, incorporating a novel multi-granularity gated CNN (MGG-CNN) into Transformer layers to explicitly aggregate local details from different granularities. UniAS achieves state-of-the-art anomaly segmentation performance, attaining 65.12/59.33 and 40.06/32.50 in pAP/DSC on the MVTec-AD and VisA datasets, respectively, surpassing previous methods significantly. The codes are shared at https://github.com/Mwxinnn/UniAS.

Fenghe Tang, Qingsong Yao, Wenxin Ma et al.

Medical image segmentation remains a formidable challenge due to the label scarcity. Pre-training Vision Transformer (ViT) through masked image modeling (MIM) on large-scale unlabeled medical datasets presents a promising solution, providing both computational efficiency and model generalization for various downstream tasks. However, current ViT-based MIM pre-training frameworks predominantly emphasize local aggregation representations in output layers and fail to exploit the rich representations across different ViT layers that better capture fine-grained semantic information needed for more precise medical downstream tasks. To fill the above gap, we hereby present Hierarchical Encoder-driven MAE (Hi-End-MAE), a simple yet effective ViT-based pre-training solution, which centers on two key innovations: (1) Encoder-driven reconstruction, which encourages the encoder to learn more informative features to guide the reconstruction of masked patches; and (2) Hierarchical dense decoding, which implements a hierarchical decoding structure to capture rich representations across different layers. We pre-train Hi-End-MAE on a large-scale dataset of 10K CT scans and evaluated its performance across seven public medical image segmentation benchmarks. Extensive experiments demonstrate that Hi-End-MAE achieves superior transfer learning capabilities across various downstream tasks, revealing the potential of ViT in medical imaging applications. The code is available at: https://github.com/FengheTan9/Hi-End-MAE

Haoran Lai, Zihang Jiang, Qingsong Yao et al.

The development of 3D medical vision-language models holds significant potential for disease diagnosis and patient treatment. However, compared to 2D medical images, 3D medical images, such as CT scans, face challenges related to limited training data and high dimension, which severely restrict the progress of 3D medical vision-language models. To address these issues, we collect a large amount of unlabeled 3D CT data and utilize self-supervised learning to construct a 3D visual foundation model for extracting 3D visual features. Then, we apply 3D spatial convolutions to aggregate and project high-level image features, reducing computational complexity while preserving spatial information. We also construct two instruction-tuning datasets based on BIMCV-R and CT-RATE to fine-tune the 3D vision-language model. Our model demonstrates superior performance compared to existing methods in report generation, visual question answering, and disease diagnosis. Code and data will be made publicly available soon.

Haoran Lai, Zihang Jiang, Qingsong Yao et al.

3D medical images such as computed tomography are widely used in clinical practice, offering a great potential for automatic diagnosis. Supervised learning-based approaches have achieved significant progress but rely heavily on extensive manual annotations, limited by the availability of training data and the diversity of abnormality types. Vision-language alignment (VLA) offers a promising alternative by enabling zero-shot learning without additional annotations. However, we empirically discover that the visual and textural embeddings after alignment endeavors from existing VLA methods form two well-separated clusters, presenting a wide gap to be bridged. To bridge this gap, we propose a Bridged Semantic Alignment (BrgSA) framework. First, we utilize a large language model to perform semantic summarization of reports, extracting high-level semantic information. Second, we design a Cross-Modal Knowledge Interaction module that leverages a cross-modal knowledge bank as a semantic bridge, facilitating interaction between the two modalities, narrowing the gap, and improving their alignment. To comprehensively evaluate our method, we construct a benchmark dataset that includes 15 underrepresented abnormalities as well as utilize two existing benchmark datasets. Experimental results demonstrate that BrgSA achieves state-of-the-art performances on both public benchmark datasets and our custom-labeled dataset, with significant improvements in zero-shot diagnosis of underrepresented abnormalities.

Rongsheng Wang, Qingsong Yao, Zihang Jiang et al.

Despite significant advancements in medical vision-language pre-training, existing methods have largely overlooked the inherent linguistic complexity and imbalanced isssue within medical reports, as well as the complex cross-modality contextual relationships between texts and images. To close this gap, we propose a novel Entity-centered Context-aware Medical Vision-language Pre-training (ECAMP) framework, which establishes a more entity-centered, context-sensitive, and balanced understanding of medical reports to effectively pre-train the vision encoder. We first distill entity-centered context from medical reports utilizing large language models, enabling ECAMP to draw more precise supervision from the text modality. By further incorporating entity-aware re-balanced factor and descriptor masking strategies into masked languange modeling, ECAMP significantly enhances the knowledge of entities within the reports. A context-guided super-resolution task is proposed alongside a multi-scale context fusion design to improve the semantic integration of both coarse and fine-level image representations, which prompts better performance for multi-scale downstream applications. ECAMP integrates these innovations together, leading to significant performance leaps over current state-of-the-art methods and establish a new standard for cross-modality pre-training in medical imaging. The effectiveness of ECAMP is demonstrated by extensive experiments on various domains and organs, which achieves cutting-edge results on multiple tasks including classification, segmentation, and detection across 5 public chest X-ray and 4 fundoscopy datasets respectively.

Quan Quan, Qingsong Yao, Jun Li et al.

The success of deep learning methods relies on the availability of well-labeled large-scale datasets. However, for medical images, annotating such abundant training data often requires experienced radiologists and consumes their limited time. Few-shot learning is developed to alleviate this burden, which achieves competitive performances with only several labeled data. However, a crucial yet previously overlooked problem in few-shot learning is about the selection of template images for annotation before learning, which affects the final performance. We herein propose a novel Sample Choosing Policy (SCP) to select "the most worthy" images for annotation, in the context of few-shot medical landmark detection. SCP consists of three parts: 1) Self-supervised training for building a pre-trained deep model to extract features from radiological images, 2) Key Point Proposal for localizing informative patches, and 3) Representative Score Estimation for searching the most representative samples or templates. The advantage of SCP is demonstrated by various experiments on three widely-used public datasets. For one-shot medical landmark detection, its use reduces the mean radial errors on Cephalometric and HandXray datasets by 14.2% (from 3.595mm to 3.083mm) and 35.5% (4.114mm to 2.653mm), respectively.