Chuang Han

Fubao Zhu, Yanhui Tian, Chuang Han et al.

The privacy protection mechanism of federated learning (FL) offers an effective solution for cross-center medical collaboration and data sharing. In multi-site medical image segmentation, each medical site serves as a client of FL, and its data naturally forms a domain. FL supplies the possibility to improve the performance of seen domains model. However, there is a problem of domain generalization (DG) in the actual de-ployment, that is, the performance of the model trained by FL in unseen domains will decrease. Hence, MLA-BIN is proposed to solve the DG of FL in this study. Specifically, the model-level attention module (MLA) and batch-instance style normalization (BIN) block were designed. The MLA represents the unseen domain as a linear combination of seen domain models. The atten-tion mechanism is introduced for the weighting coefficient to obtain the optimal coefficient ac-cording to the similarity of inter-domain data features. MLA enables the global model to gen-eralize to unseen domain. In the BIN block, batch normalization (BN) and instance normalization (IN) are combined to perform the shallow layers of the segmentation network for style normali-zation, solving the influence of inter-domain image style differences on DG. The extensive experimental results of two medical image seg-mentation tasks demonstrate that the proposed MLA-BIN outperforms state-of-the-art methods.

Zhanyuan Jia, Ni Yao, Danyang Sun et al.

Background: Brain tumor segmentation has a significant impact on the diagnosis and treatment of brain tumors. Accurate brain tumor segmentation remains challenging due to their irregular shapes, vague boundaries, and high variability. Objective: We propose a brain tumor segmentation method that combines deep learning with prior knowledge derived from a region-growing algorithm. Methods: The proposed method utilizes a multi-scale feature fusion (MSFF) module and adaptive attention mechanisms (AAM) to extract multi-scale features and capture global contextual information. To enhance the model's robustness in low-confidence regions, the Monte Carlo Dropout (MC Dropout) strategy is employed for uncertainty estimation. Results: Extensive experiments demonstrate that the proposed method achieves superior performance on Brain Tumor Segmentation (BraTS) datasets, significantly outperforming various state-of-the-art methods. On the BraTS2021 dataset, the test Dice scores are 89.18% for Enhancing Tumor (ET) segmentation, 93.67% for Whole Tumor (WT) segmentation, and 91.23% for Tumor Core (TC) segmentation. On the BraTS2019 validation set, the validation Dice scores are 87.43%, 90.92%, and 90.40% for ET, WT, and TC segmentation, respectively. Ablation studies further confirmed the contribution of each module to segmentation accuracy, indicating that each component played a vital role in overall performance improvement. Conclusion: This study proposed a novel 3D brain tumor segmentation network based on the U-Net architecture. By incorporating the prior knowledge and employing the uncertainty estimation method, the robustness and performance were improved. The code for the proposed method is available at https://github.com/chenzhao2023/UPMAD_Net_BrainSeg.

Ni Yao, Hang Hu, Kaicong Chen et al.

Objectives To develop and validate a deep learning-based diagnostic model incorporating uncertainty estimation so as to facilitate radiologists in the preoperative differentiation of the pathological subtypes of renal cell carcinoma (RCC) based on CT images. Methods Data from 668 consecutive patients, pathologically proven RCC, were retrospectively collected from Center 1. By using five-fold cross-validation, a deep learning model incorporating uncertainty estimation was developed to classify RCC subtypes into clear cell RCC (ccRCC), papillary RCC (pRCC), and chromophobe RCC (chRCC). An external validation set of 78 patients from Center 2 further evaluated the model's performance. Results In the five-fold cross-validation, the model's area under the receiver operating characteristic curve (AUC) for the classification of ccRCC, pRCC, and chRCC was 0.868 (95% CI: 0.826-0.923), 0.846 (95% CI: 0.812-0.886), and 0.839 (95% CI: 0.802-0.88), respectively. In the external validation set, the AUCs were 0.856 (95% CI: 0.838-0.882), 0.787 (95% CI: 0.757-0.818), and 0.793 (95% CI: 0.758-0.831) for ccRCC, pRCC, and chRCC, respectively. Conclusions The developed deep learning model demonstrated robust performance in predicting the pathological subtypes of RCC, while the incorporated uncertainty emphasized the importance of understanding model confidence, which is crucial for assisting clinical decision-making for patients with renal tumors. Clinical relevance statement Our deep learning approach, integrated with uncertainty estimation, offers clinicians a dual advantage: accurate RCC subtype predictions complemented by diagnostic confidence references, promoting informed decision-making for patients with RCC.

Huan Huang, Liheng Qiu, Shenmiao Yang et al.

Background: Accurate segmentation of diffuse large B-cell lymphoma (DLBCL) lesions is challenging due to their complex patterns in medical imaging. Objective: This study aims to develop a precise segmentation method for DLBCL using 18F-Fluorodeoxyglucose (FDG) positron emission tomography (PET) and computed tomography (CT) images. Methods: We propose a 3D dual-branch encoder segmentation method using shifted window transformers and a Multi-Scale Information Fusion (MSIF) module. To enhance feature integration, the MSIF module performs multi-scale feature fusion using cross-attention mechanisms with a shifted window framework. A gated neural network within the MSIF module dynamically balances the contributions from each modality. The model was optimized using the Dice Similarity Coefficient (DSC) loss function. Additionally, we computed the total metabolic tumor volume (TMTV) and performed statistical analyses. Results: The model was trained and validated on a dataset of 165 DLBCL patients using 5-fold cross-validation, achieving a DSC of 0.7512. Statistical analysis showed a significant improvement over comparative methods (p < 0.05). Additionally, a Pearson correlation coefficient of 0.91 and an R^2 of 0.89 were observed when comparing manual annotations to segmentation results for TMTV measurement. Conclusion: This study presents an effective automatic segmentation method for DLBCL that leverages the complementary strengths of PET and CT imaging. Our method has the potential to improve diagnostic interpretations and assist in treatment planning for DLBCL patients.

Fubao Zhu, Zhanyuan Jia, Zhiguo Wang et al.

Alzheimer's disease (AD) is an irreversible neurodegenerative disorder, and early diagnosis is critical for timely intervention. However, most existing classification frameworks face challenges in multicenter studies, as they often neglect inter-site heterogeneity and lack mechanisms to quantify uncertainty, which limits their robustness and clinical applicability. To address these issues, we proposed Uncertainty-Guided Federated Domain Adaptation (UG-FedDA), a novel multicenter AD classification framework that integrates uncertainty quantification (UQ) with federated domain adaptation to handle cross-site structure magnetic resonance imaging (MRI) heterogeneity under privacy constraints. Our approach extracts multi-template region-of-interest (RoI) features using a self-attention transformer, capturing both regional representations and their interactions. UQ is integrated to guide feature alignment, mitigating source-target distribution shifts by down-weighting uncertain samples. Experiments are conducted on three public datasets: the Alzheimer's Disease Neuroimaging Initiative (ADNI), the Australian Imaging, Biomarkers and Lifestyle study (AIBL), and the Open Access Series of Imaging Studies (OASIS). UG-FedDA achieved consistent cross-domain improvements in accuracy, sensitivity, and area under the ROC curve across three classification tasks: AD vs. normal controls (NC), mild cognitive impairment (MCI) vs. AD, and NC vs. MCI. For NC vs. AD, UG-FedDA achieves accuracies of 90.54%, 89.04%, and 77.78% on ADNI, AIBL and OASIS datasets, respectively. For MCI vs. AD, accuracies are 80.20% (ADNI), 71.91% (AIBL), and 79.73% (OASIS). For NC vs. MCI, results are 76.87% (ADNI), 73.91% (AIBL), and 83.73% (OASIS). These results demonstrate that the proposed framework not only adapts efficiently across multiple sites but also preserves strict privacy.